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Query: UMLS:C0948265 (metabolic syndrome)
 24,271 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The metabolic syndrome and imaging of subclinical coronary artery disease are novel approaches to identify cardiovascular risk at an early disease stage before the onset of complications. The metabolic syndrome is defined as a combination of major and emerging cardiovascular risk factors that are related to underlying insulin resistance. These risk factors accelerate atherosclerotic disease progression and increase the risk for future cardiovascular events. Atherosclerosis imaging visualizes the presence of subclinical disease burden many years before the onset of symptoms. The early identification of asymptomatic persons with increased cardiovascular risk provides the opportunity to prevent of future disease complications. The relationship between the metabolic syndrome and sublinical disease burden is incompletely understood. Although further evaluation of the potential role for the emerging biomarkers and imaging techniques in the setting of the metabolic syndrome is needed, it is obvious that cardiovascular nurses need to develop a heightened awareness of patients at risk for future events.
J Cardiovasc Nurs
PMID:Identification of the metabolic syndrome and imaging of subclinical coronary artery disease: early markers of cardiovascular risk. 1682 83

This article reviews the criteria for the metabolic syndrome with a focus on the 5 components of the National Cholesterol Education Program definition (increased waist circumference, increased triglycerides, low high-density lipoprotein cholesterol, high blood pressure, and increased fasting glucose). Epidemiologic trends for the disorder and its prevalence are presented. The relation to cardiovascular disease and diabetes is discussed, as are findings from current studies explaining the risk factors. The article reviews the current recommendations for managing the metabolic syndrome including behavioral (weight reduction and increased physical activity) and pharmacological modalities. Relevant population-based studies and clinical trials are discussed with attention drawn to those clinical implications that are important for nurses to understand as they provide care to the growing population of clients expected to develop the metabolic syndrome.
J Cardiovasc Nurs
PMID:The metabolic syndrome: risk factors and management. 1682 85

Metabolic syndrome is a clustering of cardiovascular risk factors. Its definition is the presence of any 3 of the following: obesity, hypertriglyceridemia, low high-density lipoprotein, hypertension, and impaired fasting glucose. The development of coronary artery disease is the most dreaded complication of this disease. In the United States, Mexican Americans and African American women are the most affected. Management of this syndrome includes physical exercise, weight loss, and effective drug treatment of dyslipidemia, high blood pressure, and impaired fasting blood glucose. Because of the increasing prevalence of obesity and diabetes, there is a rise in fatal and nonfatal cardiovascular events. With the development of effective antiplatelet medication and newer drug-eluting stents, percutaneous coronary intervention has become an effective revascularization strategy for those with coronary artery disease. Rates of stent restenosis and target-lesion revascularization have been reduced. Oral hypoglycemic drugs like thiazolidinediones improve insulin resistance and may have a favorable effect in those with metabolic syndrome. Diagnosis and appropriate management of metabolic syndrome are challenges as the presence of risk factors predates the coronary event.
J Cardiovasc Nurs
PMID:Clinical outcomes in metabolic syndrome. 1682 84

One in four adults living in the United States has metabolic syndrome, a constellation of risk factors associated with increased risk for developing type 2 diabetes and cardiovascular disease. A common characteristic in patients with metabolic syndrome is abdominal obesity along with an increased body mass index. Traditional dietary recommendations for treating the metabolic syndrome and associated obesity include high-carbohydrate, low-fat regimens. Despite the widespread use of these dietary guidelines, the rates of metabolic syndrome and obesity continue to rise in the United States. As a result, public interest in alternative dietary approaches to weight loss has escalated, sparking renewed interest in low-carbohydrate diet regimens, most notably Dr. Atkins' New Diet Revolution, a New York Times bestseller. Despite this renewed interest, there is little scientific evidence to determine the safety and efficacy of low-carbohydrate diets on cardiovascular health. Because most energy in a low-carbohydrate diet are derived from protein and fat, there is considerable concern that such diets will raise lipid levels and overall risk for coronary disease. In this article, we review the sparse literature on the impact of low-carbohydrate diets on weight loss and lipid parameters.
J Cardiovasc Nurs
PMID:The skinny on low-carbohydrate diets: should they be recommended to patients with the metabolic syndrome? 1682 86

Obesity, or overweight, in childhood is a major risk factor for the metabolic syndrome in adolescence, as the prevalence in US children tripled between 1970 and 2000. An increase in the metabolic syndrome in youth has followed this increase. In population-based studies, the prevalence of the syndrome ranged from 3.6% to 4.2%. In smaller studies with many overweight youth, the prevalence was 28.7% to 39.7% in those who were overweight and 49.7% in those who were severely obese. Overweight children are likely to have hyperinsulinemia, high-density lipoprotein cholesterol, high triglycerides, and hypertension, which are components of the metabolic syndrome. Nurses have an important role in screening for these metabolic syndrome components. Screening is especially important in boys and girls who are overweight and in girls with early menarche. A problem when screening children and adolescents is determining normative values, but guidelines are available. Prevention and management of the metabolic syndrome are not specific to the syndrome, but rather should be focused on the underlying problem of overweight and related problems that comprise the syndrome. We must use all avenues available to us, including influencing public and school policies, and pay close attention to overweight and metabolic syndrome components in our clinical practice, whether with children or adults. Preventing and managing the metabolic syndrome should be a family matter, and the necessary lifestyle changes will benefit the entire family.
J Cardiovasc Nurs
PMID:Changing our future: obesity and the metabolic syndrome in children and adolescents. 1682 87

Insulin resistance has been described in several diseases that increase cardiovascular risk and mortality, such as diabetes, obesity, hypertension, metabolic syndrome, and heart failure. Abnormalities of insulin signaling account for insulin resistance. Insulin mediates its action on target organs through phosphorylation of a transmembrane-spanning tyrosine kinase receptor, the insulin receptor (IR). Several mechanisms have been described as responsible for the inhibition of insulin-stimulated tyrosine phosphorylation of IR and the IR substrate (IRS) proteins, including proteasome-mediated degradation, phosphatase-mediated dephosphorylation, and kinase-mediated serine/threonine phosphorylation. In particular, phosphorylation of IRS-1 on serine Ser612 causes dissociation of the p85 subunit of phosphatidylinositol 3-kinase, inhibiting further signaling. On the other hand, phosphorylation of IRS-1 on Ser307 results in its dissociation from the IR and triggers proteasome-dependent degradation. Dysregulation of sympathetic nervous and renin-angiotensin systems resulting in enhanced stimulation of both adrenergic and angiotensin II receptors is a typical feature of several cardiovascular diseases and, at the same time, is involved in the pathogenesis of insulin resistance. The characterization of molecular mechanisms involved in the pathogenesis of insulin resistance may help to design efficacious pharmacologic molecules to treat endothelial and metabolic dysfunction associated with insulin resistance states to reduce the cardiovascular risk and to ameliorate the prognosis of patients with cardiovascular diseases.
Trends Cardiovasc Med 2006 Aug
PMID:Insulin resistance and cardiovascular risk: New insights from molecular and cellular biology. 1683 60

The antidiabetic compound pioglitazone, an activator of the intracellular peroxisome proliferator-activated receptor-gamma, and decreases metabolic and vascular insulin resistance. The drug is well tolerated, and its metabolic effects include improvements in blood glucose and lipid control. Vascular effects consist of improvements in endothelial function and hypertension, and a reduction in surrogate markers of artherosclerosis. In a large, placebo-controlled, outcome study in secondary prevention, PROactive study, the use of pioglitazone in addition to an existing optimized macrovascular risk management resulted in a significant reduction of macrovascular endpoints within a short observation period that was comparable to the effect of statins and angiotensin converting enzyme inhibitors in other trials. These results underline the value of pioglitazone for managing the increased cardiovascular risk of patients with a metabolic syndrome or Type 2 diabetes mellitus.
Expert Rev Cardiovasc Ther 2006 Jul
PMID:Pioglitazone: an antidiabetic drug with cardiovascular therapeutic effects. 1691 64

The current epidemic of obesity warrants aggressive screening for associated comorbid conditions; namely, the metabolic syndrome and diabetes mellitus. Approximately 25-30% of patients with acute coronary syndrome have diabetes. Of the remaining patients, most have a spectrum of abnormal glucose metabolism, including previously undiagnosed impaired fasting glucose and diabetes mellitus. This article reviews the current literature and the author's own experience of this subject, as well as highlighting effective new agents in treating diabetes.
Expert Rev Cardiovasc Ther 2006 Jul
PMID:Frequency of undiagnosed and untreated diabetes mellitus in patients with acute coronary syndromes. 1691 68

The metabolic syndrome is a commonly encountered clinical phenotype presenting as concurrent metabolic abnormalities, including central obesity, dysglycemia, dyslipidemia, and hypertension. Several definitions exist, and it is debated whether or not the clustered risk factors impart a higher cardiovascular risk than the simple sum of the individual components. Nevertheless, the concept of a metabolic syndrome has proven helpful in emphasizing the importance of obesity, insulin resistance and related traits in relation to cardiovascular disease risk. Furthermore, the metabolic syndrome as defined by the National Cholesterol Education Program appears to have a component of heritability, which suggests a genetic basis. Indeed, patients with certain rare single-gene disorders express clusters of abnormalities commonly seen in the metabolic syndrome. Moreover, studies indicate that common genetic variants are associated with the development of this syndrome, although the associations are quite weak and replication of findings has been poor. As with most complex traits, it is premature to propose molecular genetic testing for diagnosis, treatment or both. Unresolved issues include the roles of gene-environment interactions, ethnicity, and sex. In this review, we look at the currently available evidence for common genes that predispose to the development of the metabolic syndrome.
Nat Clin Pract Cardiovasc Med 2006 Sep
PMID:Genetic determinants of the metabolic syndrome. 1693 65

Metabolic syndrome is a constellation of interrelated risk factors of metabolic origin that often accompany obesity and consist of atherogenic dyslipidemia, elevated blood pressure, impaired glucose tolerance, a prothrombotic state, and a proinflammatory state. Using a modification of the criteria by the National Cholesterol Education Program Adult Treatment Panel III, metabolic syndrome in children and adolescents can be clinically diagnosed when three or more of the following are present: body mass index > or = 2 z score, systolic or diastolic blood pressure greater than 95th percentile, triglyceride level greater than 95th percentile, and/or high-density lipoprotein cholesterol less than 5th percentile and impaired glucose tolerance (fasting glucose > 110 mg/dL ). The prevalence of the metabolic syndrome in adolescents has been shown to be 4% overall, but it is 30% to 50% in overweight adolescents. In the United States, 18% to 22% of children and adolescents are overweight; the prevalence of a metabolic syndrome phenotype among US adolescents has also been increasing significantly over the past decade. All of the features of metabolic syndrome are risk factors for atherosclerosis, and metabolic syndrome has been shown to constitute risk for atherosclerotic cardiovascular disease in adults. In children and adolescents with metabolic syndrome, biomarkers of an increased risk of adverse cardiovascular outcomes are already present. Therefore, there is need for prevention and treatment of metabolic syndrome in this population. The mainstay of the treatment is dietary intervention and promotion of active lifestyle to achieve and maintain optimum weight, normal blood pressure, and normal lipid profile for the height and age. The pharmaceutical intervention is usually not required and its long-term outcome has not been studied. There is need for large studies for the management and long-term outcomes of metabolic syndrome in children and adolescents if the future tides of cardiovascular and other associated complications of metabolic syndrome are to be turned around.
Curr Treat Options Cardiovasc Med 2006 Sep
PMID:Metabolic syndrome in children and adolescents. 1693 79


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