Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0948265 (metabolic syndrome)
 24,271 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sympathetic activation is associated with metabolic syndrome (MS) and increased risk of cardiovascular disease. The aim of this study was to investigate whether cardiac autonomic activity or sympathovagal balance, as estimated by a 24-hour power spectral analysis of heart rate variation, is associated with serum concentrations of high-sensitivity C-reactive protein (hs-CRP), a sensitive predictor for cardiovascular events, in type 2 diabetic patients with and without MS. We studied 104 type 2 diabetic patients (50 female and 54 male). The diagnosis of MS was based on the National Cholesterol Education Program Adult Treatment Panel III criteria. Based on the serum hs-CRP, diabetic patients were also divided into 3 groups: low risk (CRP < 1.0 mg/L), moderate risk (1.0 < or = CRP < or = 3.0), and high risk (CRP > 3.0). Heart rate variation was determined automatically every 5 minutes over 24 hours using an ambulatory Holter electrocardiographic recording. Power spectral analysis of the R-R intervals was performed by fast Fourier transformation. Low frequency (LF, both sympathetic and parasympathetic activities), high frequency (HF, pure parasympathetic activity), and the ratio of LF to HF, an index of sympathovagal balance, were used as indices of cardiac autonomic activity. Blood concentrations of hs-CRP, interleukin 6, and plasminogen activator inhibitor 1 were higher in diabetic patients with than in those without MS (P < .0001, P = .0056, and P < .0001, respectively). Both the 24-hour mean LF and the LF-to-HF ratio were also significantly higher in diabetic patients with than in those without MS (P = .0397 and P = .0483, respectively). The LF-to-HF ratio at 6:00 am was significantly higher in diabetic patients with a high CRP concentration than in those with a low or moderate CRP concentration (P < .001 and P < .01, respectively). Only urinary albumin and hs-CRP were independent factors predicting the LF-to-HF ratio at 6:00 am in diabetic patients. In conclusion, type 2 diabetic patients with MS have elevated markers of inflammation and evidence of cardiac sympathetic predominance. High serum concentrations of hs-CRP are associated with relative cardiac sympathetic overactivity during the early morning in type 2 diabetic patients.
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PMID:High serum high-sensitivity C-reactive protein concentrations are associated with relative cardiac sympathetic overactivity during the early morning period in type 2 diabetic patients with metabolic syndrome. 1683 35

The link between plasminogen activator inhibitor (PAI)-1 and the metabolic syndrome with obesity was established many years ago. Increased PAI-1 level can be now considered a true component of the syndrome. The metabolic syndrome is associated with an increased risk of developing cardiovascular disease, and PAI-1 overexpression may participate in this process. The mechanisms of PAI-1 overexpression during obesity are complex, and it is conceivable that several inducers are involved at the same time at several sites of synthesis. Interestingly, recent in vitro and in vivo studies showed that besides its role in atherothrombosis, PAI-1 is also implicated in adipose tissue development and in the control of insulin signaling in adipocytes. These findings suggest PAI-1 inhibitors serve in the control of atherothrombosis and insulin resistance.
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PMID:PAI-1 and the metabolic syndrome: links, causes, and consequences. 1693 89

Metabolic syndrome (MS) is characterized by the presence of at least three of the following alterations: enlargement of the waist diameter, higher levels of arterial pressure, low density lipoprotein cholesterol and glycemia, and reduction of high density lipoprotein cholesterol. The prevalence of MS reaches 23% in young adults, a percentage that increases with age. People with MS have a greater risk of suffering from cardiovascular disease (CVD). The physiopathologic alterations now found to exist in MS are diverse; among them is endothelial dysfunction, which triggers atherogenic lesions and hypercoagulability characterized by alterations of the coagulation factors and the regulatory proteins of fibrinolysis such as the plasminogen activator inhibitor (PAI-1). The increase in oxidative stress and/or the reactive oxygen species in patients with MS is partially related to the oxidation state of the lipoproteins, especially of the low density lipoproteins. This fact favors atherogenesis. Moreover, the oxidative stress produces alterations in the production of adipokines, cytokines secreted by the adipose tissues. The abnormality in the transport of lipoprotein diminishes the catabolism of the very low density lipoprotein (VLDL) and increases the catabolism of the high density lipoprotein (HDL), which creates insulin resistance. This process is associated with a lower concentration of adiponectin that in turn regulates the catabolism of VLDL and HDL; consequently increasing the flow of fatty acids from the adipose tissue to the liver and muscles. The proinflammatory cytokines, among them tumor necrosis factor alpha (TNF-alpha), are of great importance in MS regulating different processes and molecules such as PAI-1. PAI-1 is controlled by the group of transcription factors peroxisome proliferator-activated receptor (PPAR), especially by PPAR gamma and alpha ligands. In summary, MS includes multiple alterations related to insulin resistance at several levels: hepatic, muscular, adipose and vascular tissue (endothelium). The exact mechanism that underlies the relationship between MS and CVD are not sufficiently known yet; pathogenic explanations are lacking for the mechanisms relating metabolic factors to insulin resistance and the association with the development of atherosclerosis and thrombosis. MS alterations and the main aspects related to homeostasis alterations are examined in this report.
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PMID:Hemostasis alterations in metabolic syndrome (review). 1701 29

Obesity is linked to a variety of metabolic disorders, such as insulin resistance and atherosclerosis. Dysregulated production of fat-derived secretory factors, adipocytokines, is partly responsible for obesity-linked metabolic disorders. However, the mechanistic role of obesity per se to adipocytokine dysregulation has not been fully elucidated. Here, we show that adipose tissue of obese mice is hypoxic and that local adipose tissue hypoxia dysregulates the production of adipocytokines. Tissue hypoxia was confirmed by an exogenous marker, pimonidazole, and by an elevated concentration of lactate, an endogenous marker. Moreover, local tissue hypoperfusion (measured by colored microspheres) was confirmed in adipose tissue of obese mice. Adiponectin mRNA expression was decreased, and mRNA of C/EBP homologous protein (CHOP), an endoplasmic reticulum (ER) stress-mediated protein, was significantly increased in adipose tissue of obese mice. In 3T3-L1 adipocytes, hypoxia dysregulated the expression of adipocytokines, such as adiponectin and plasminogen activator inhibitor type-1, and increased the mRNAs of ER stress marker genes, CHOP and GRP78 (glucose-regulated protein, 78 kD). Expression of CHOP attenuated adiponectin promoter activity, and RNA interference of CHOP partly reversed hypoxia-induced suppression of adiponectin mRNA expression in adipocytes. Hypoxia also increased instability of adiponectin mRNA. Our results suggest that hypoperfusion and hypoxia in adipose tissues underlie the dysregulated production of adipocytokines and metabolic syndrome in obesity.
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PMID:Adipose tissue hypoxia in obesity and its impact on adipocytokine dysregulation. 1897 32

Coronary artery disease (CAD) is less common in African than Indian or White subjects and elevated plasminogen activator inhibitor (PAI)-1 levels may be a risk factor for CAD. Therefore, PAI-1 levels were measured in the three populations and related to the -675 PAI-1 4G/5G promoter genotype. PAI-1 levels and anthropometric variables were measured in 310 Indian, 269 White and 107 African subjects. The PAI-1 4G allele frequency was lower in the African (0.13) than Indian (0.54) or White (0.58) populations and explained the lower PAI-1 levels in African (41.5+/-25.1 versus 68.0+/-33.3 and 70.5+/-35.7 ng/ml, respectively; p<0.0001) subjects. Except for White subjects, PAI-1 levels were higher in those with metabolic syndrome or type 2 diabetes. PAI-1 genotype did not associate with either disorder. Metabolic syndrome-related factors had little influence on PAI-1 levels in White subjects but in African and Indians subjects these variables had a major influence on PAI-1 levels in those with the 5G/5G genotype but not in subjects with the 4G/4G genotype. Ethnic differences in PAI-1 levels are largely due to differences in the frequency of the 4G and 5G alleles at the -675 locus. In Indian and African, but not White populations, the ability of metabolic syndrome-related factors to influence PAI-1 levels is modulated by the -675 genotype.
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PMID:The influence of metabolic syndrome components on plasma PAI-1 concentrations is modified by the PAI-1 4G/5G genotype and ethnicity. 1746 13

Impaired fibrinolysis may be associated with development of atherothrombotic cardiovascular disease (CVD) in metabolic syndrome or type 2 diabetes. Plasma plasminogen activator inhibitor (PAI)-1, a potent inhibitor of fibrinolysis, is elevated in a number of clinical situations that are associated with high incidence of CVD. Impaired fibrinolysis resulting from high plasma PAI-1 can lead to excessive fibrin accumulation within vessels, resulting in atherothrombosis. Increased expression of PAI-1 is found in atherosclerotic lesions in humans, especially atherosclerotic plaques in patients with type 2 diabetes. This increased vascular expression of PAI-1 promotes neointima formation via accumulation of fibrin or fibrinogen as a result of inhibited clearance of platelet-fibrin thrombi. PAI-1, an acute phase protein, also could be involved in vascular inflammation. PAI-1 may be associated not only systemically but also locally with development of CVD.
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PMID:Plasminogen activator inhibitor (PAI)-1 in vascular inflammation and thrombosis. 1748 72

Increased circulating levels of plasminogen activator inhibitor 1 (PAI-1) have been associated with atherothrombosis. Plasminogen activator inhibitor 1 levels are elevated in obstructive sleep apnea (OSA) and in the metabolic syndrome, both of which confer excess coronary risk. We investigated whether apnea-hypopnea index (AHI) and the metabolic syndrome would interact in determining plasma concentration of PAI-1. Full-night polysomnography was performed in 2 different groups consisting of a total of 180 unmedicated apneic and nonapneic subjects of whom 20% met the diagnostic criteria for the metabolic syndrome. Distinct AHI cutoffs were selected to define 3 OSA groups with different apnea severity: (a) AHI of at least 5 (n = 115), (b) AHI of at least 10 (n = 84), and (c) AHI of at least 15 (n = 72). Plasminogen activator inhibitor 1 concentration was determined in plasma and statistical analyses controlled for age, sex, ethnicity, and smoking status. In both study groups, PAI-1 was positively correlated with AHI (P's < .002) and was also higher in subjects with the metabolic syndrome than in those without (P' < .013). The interaction between AHI and the metabolic syndrome independently predicted PAI-1 across all subjects and in all 3 OSA groups (P < .05). The AHI was not a significant predictor of PAI-1 in the presence of the metabolic syndrome. If the metabolic syndrome was absent, AHI accounted for between 10% and 13% of the variance in PAI-1 across all subjects and in all 3 OSA severity groups (P < .05). In conclusion, more severe apnea was independently associated with higher PAI-1 concentration in subjects without the metabolic syndrome. Once the metabolic syndrome is clinically manifest, it may be more important than apnea in determining PAI-1 levels.
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PMID:Elevated plasminogen activator inhibitor 1 in sleep apnea and its relation to the metabolic syndrome: an investigation in 2 different study samples. 1757 Feb 60

The adipocyte metabolism has been shown to change during the fat enlargement process associated to obesity. Several procoagulant proteins such as plasminogen activator inhibitor type 1, tissue factor or factor VII and also inducible nitric oxide synthase show higher expression in adipose tissue of obese people in comparison to lean. This overexpression could explain at least a part of the atherogenic and cardiovascular risk associated with obesity. In addition to cytokine secretion, many other features have been observed to be common to adipocyte and monocyte/macrophage lines: for example, phagocytic and microbicidal activities, and possibly a cellular plasticity of adipose precursors. Overweight and obesity are associated with an increased risk of such metabolic abnormalities as dyslipidemia, hypertension or type 2 diabetes mellitus and cardiovascular diseases, common features of the metabolic syndrome. Initially, insulin resistance or hyperinsulinemia was suggested as the origin of these abnormalities. More recent studies indicate that adipokynes have an important role in obesity-associated metabolic complications, and suggest that chronically elevated local or systemic concentrations of adipokynes contribute to the development of complications associated with obesity and metabolic syndrome. Considering all the evidence relating to diet and inflammation, the best diet for protecting against the metabolic derangements associated with obesity and metabolic syndrome would be high in fibre-rich cereals, fruit, vegetables, fish, virgin olive oil and nuts; moderate in wine; and low in meat, processed meat foods and trans-fatty acids.
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PMID:Inflammation, obesity and comorbidities: the role of diet. 1790 26

The metabolic syndrome refers to the clustering of upper body obesity, atherogenic dyslipidemia, insulin resistance and elevated blood pressure. Both, obesity and metabolic syndrome, have the potential to influence on the incidence and severity of cardiovascular disease with serious implications for worldwide health care systems. Obesity plays a central role in the development of insulin resistance and dyslipidemia through the mediation of a pro-inflammatory and pro-thrombotic state. Adipose tissue has been shown to exert important endocrine and immune functions. Pathogenesis of obesity associated metabolic syndrome is mediated by disturbed production and release of biologically active molecules by fat cells and other cells infiltrating fat tissue. In obese subjects synthesis of several bioactive compounds--adipokines and cytokines/chemokines by adipose tissue cells is dysregulated. Those bioactive molecules participate in regulation of apetite and energy homeostasis, lipid metabolism (tumour necrosis factor alpha--TNF-alpha), insulin sensitivity (TNF-alpha, adiponectin, resistin, visfatin) immunity (monocyte chemoattractant protein-1--MCP-1, TNF-alpha, IL-6), angiogenesis, blood pressure and hemostasis (plasminogen activator inhibitor--PAI-1). The effects of major pro-/anti-inflammatory and pro-thrombotic adipokines on several physiological processes will be discussed in this review. Also, an evidence-based approach to the laboratory diagnosis and treatment of metabolic syndrome will be presented.
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PMID:Markers of pro-inflammatory and pro-thrombotic state in the diagnosis of metabolic syndrome. 1821 26

In this hospital-based cross-sectional study we investigated differences in the levels of serum atherosclerotic and fibrinolytic markers and the prevalence of metabolic syndrome (MS) among patients with four subtypes of cerebral infarctions. Blood samples were taken from 171 cerebral infarction inpatients to determine the levels of high-sensitivity C-reactive protein, serum total homocysteine, serum plasminogen activator inhibitor 1 and lipoprotein a. Subjects were also screened for MS. Atherothrombotic infarction was most prevalent, followed by lacunar and embolic infarction. The median length of hospital stay was longest for embolic infarcts. There were no statistically significant differences in serum marker concentrations. The proportion of MS varied significantly among the subtypes, and was highest among patients with embolic infarctions with the lowest high density cholesterol levels. MS was most prevalent among patients having undergone embolic events that are reported to have the worst prognoses. Further epidemiologic studies are needed to better understand the characteristics and differences in the etiology of cerebral infarction subtypes.
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PMID:Prevalence of metabolic syndrome and serum marker levels in patients with four subtypes of cerebral infarction in Japan. 1841 Oct 50


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