Metabolic syndrome and related disorders最新文献

Background: Coronary artery calcium (CAC) score is a predictor of ischemic heart disease and closely linked to metabolic syndrome (MS). This study investigates the relationship between CAC and benign hepato-pancreaticobiliary disorders.

Methods: A retrospective, cross-sectional, observational study was conducted on individuals who underwent cardiac computed tomography scans between 2015 and 2022 at a tertiary medical center. Multivariate logistic regression explored the association between CAC and potential confounders. Additionally, a logistic regression model was applied to determine whether CAC independently predicts benign hepato-pancreaticobiliary disorders [steatotic liver disease (SLD), fatty pancreas, gallstones, choledocholithiasis, pancreatic calcifications, and pancreatic duct stones].

Results: Among 2422 individuals, 725 met inclusion. Univariate regression analysis indicated CAC was significantly linked to SLD, older age, male sex, and MS. Both SLD and fatty pancreas showed an association with CAC in individuals with and without MS (P < 0.001). Multivariate analysis demonstrated that CAC was independently associated with increasing age [OR: 1.18 (95% CI: 1.15-1.62), P < 0.001], male sex [OR: 3.12 (95% CI: 2.52-4.26), P < 0.001], MS [OR: 1.29 (95% CI: 1.25-2.45), P < 0.001], SLD [OR: 1.26 (95% CI: 1.12-2.42), P < 0.001], fatty pancreas [OR: 1.79 (95% CI: 1.19-1.98), P < 0.001], gallstones [OR: 1.82 (95% CI: 1.64-2.05), P < 0.001], choledocholithiasis [OR: 1.21 (95% CI: 1.19-2.62), P < 0.001], and pancreatic calcifications [OR: 1.74 (95% CI: 1.12-2.32), P < 0.001], regardless of MS.

Conclusions: The CAC score is correlated with an increased prevalence of SLD, fatty pancreas, and other benign pancreaticobiliary conditions, independent of MS.

Purpose: Steatotic liver disease (SLD) is a prevalent condition that can progress to fibrosis if untreated. The most commonly used screening tool for liver disease is the FIB-4 score, which can help rule out advanced liver fibrosis. This study aims to assess whether a simple tool such as waist circumference (WC) can screen for both hepatic steatosis and fibrosis.

Methods: This study was based on analysis of patient data from the NHANES 2017-2018 database, including WC, laboratory values, and Fibroscan data. Of 9254 participants, 6846 were excluded due to incomplete or missing lab and Fibroscan data (2408 included). Receiver operator characteristics (ROC) curve analyses assessed the performance of WC, fatty liver index (FLI), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in predicting steatosis at two cut-off points: controlled attenuation parameter (CAP) ≥248 dB/m and ≥294 dB/m. ROC analyses also compared WC and FIB-4 performance in predicting significant fibrosis based on liver stiffness measurement (LSM) cutoff: <8.2 kPa (F0-F1) or ≥8.2 kPa (F2-F4). Analyses were performed using JMP Pro version 17.

Results: WC was shown to be a strong predictor of steatosis and fibrosis among men and women. WC and FLI were comparable predictors for steatosis among men; however, FLI outperformed WC as a predictor of steatosis among women. WC and FLI were shown to be more effective predictors of steatosis in men and women at both CAP cutoff values when compared with HOMA-IR. All three measures were more predictive of steatosis in men than in women. In a subgroup analysis of 1053 participants ages 35-65 years, WC outperformed FIB-4 in predicting significant fibrosis.

Conclusion: WC is an independent predictor of hepatic steatosis and fibrosis among US adults. WC should be measured routinely in primary care settings, facilitating earlier intervention for those at risk for liver steatosis and fibrosis.

Background: Sarcopenic obesity (SO), defined as the coexistence of low muscle mass and function and excessive fat mass, is increasingly recognized as a health concern in older individuals with diabetes. Despite its clinical importance, SO often remains undiagnosed in outpatient settings due to complex diagnostic requirements.

Objective: This study aimed to investigate the risk of SO using simple screening tools, namely the SARC-F questionnaire and handgrip strength (HGS), and to identify associated clinical, functional, and metabolic factors in diabetic patients aged 50 and older.

Methods: A cross-sectional analysis was conducted with 276 diabetic outpatients. Risk of SO was defined based on a body mass index of 30 kg/m² or more, combined with either a SARC-F score of 4 or above or low HGS values (below 35 kg for men and 20 kg for women). Data on comorbidities, functionality, falls, depression, and metabolic control were collected.

Results: The prevalence of SO risk was 16.2% with HGS and 8.7% with SARC-F. Falls, depressive symptoms, and reduced quality of life were associated with SARC-F-based SO, while hypertension, elevated HbA1c, and lower quality of life were linked to HGS-based SO.

Conclusion: Simple screening methods can help identify SO risk in diabetic outpatients and support timely clinical decision-making.

Objective: To evaluate the long-term effects of sleeve gastrectomy (SG) on glucose excursion and hypoglycemia in persons without diabetes during the oral glucose tolerance test (OGTT).

Methods: This quasi-experimental study included persons undergoing body contouring surgeries, some of whom had a history of SG, while the remaining did not have a history of SG. An OGTT (75 grams) was undertaken at four time points (before body contouring surgery, immediate postoperative, short-term, and long-term postoperative). Glucose levels were measured at six time points (fasting, 15, 30, 45, 60, and 120 min). Glucose excursion was analyzed using Tai's trapezoidal rule and Doi's weighted average glucose (dwAG). Statistical models included linear and logistic regression.

Results: The study evaluated 125 OGTTs. The SG group exhibited significantly higher rates of level 1 hypoglycemia (12.5%) compared to the non-SG group (3.2%). SG increased the odds of hypoglycemia 8-fold [OR: 8.11, (95% UI: 1.43-45.95)] compared to the non-SG group. Hypoglycemia occurred predominantly at 120 min. Logistic regression indicated no relationship of age, body fat, and gender on hypoglycemia odds. The unified measures (dwAG and Tai's area) demonstrated that glucose excursion was less after SG then with participants without bariatric surgery.

Conclusions: SG alters the OGTT responses, leading to increased risk of late post-load hypoglycemia in participants without diabetes. Data from this study will assist with OGTT management in post-SG patients, and it is suggested that use of unified measures like dwAG may be useful.

Objective: This study examines the impact of body mass index (BMI) on homeostatic model assessment for insulin sensitivity (HOMA-S) and homeostatic model assessment for pancreatic β-cell function (HOMA-B) in adults with obesity but without diabetes. Additionally, the association of key hormones, leptin and gastric inhibitory peptide (GIP), with HOMA indices and BMI has been investigated.

Methods: This cross-sectional study involved 289 adults without diabetes from Hamad General Hospital in Qatar. BMI was analyzed as a predictor of HOMA-S and HOMA-B using adjusted multivariable linear regression. A logistic regression model was used to investigate hormonal predictors of insulin sensitive phenotype (ISP), and results were presented using margins plots, stratified by obesity classes.

Results: We found a strong, linear dose-response relationship between BMI and HOMA indices, with each unit increase in BMI linked to approximately a 2% decline in HOMA-S and a 1% rise in HOMA-B. Subgroup analysis revealed that the effects on ISP were more strongly driven by hormonal variations, particularly leptin and GIP levels, than by BMI alone.

Conclusions: Our findings demonstrate that BMI is a proxy for hormonal variations, particularly in leptin and GIP, which more strongly predict insulin sensitivity. These results support the need for incorporating hormonal markers into obesity-related risk assessment and management strategies.

Sucralose (a.k.a. Splenda when combined with dextrose and maltodextrin) is a popular nonnutritive sweetener (NNS) found in several beverages marketed for health benefits and fitness. This article examines the mechanistic aspects of sucralose's metabolic effects on satiety, obesity, glycemic control, and adipogenesis, along with gut dysbiosis, inflammation, and disruption of intestinal permeability. Some evidence suggests that sucralose may also alter appetite regulation, taste perception, and energy intake. Additionally, there are safety concerns regarding its carcinogenic potential and its epigenetic effect on the fetus due to consistent maternal consumption. Based on current findings of NNS, it was concluded that sucralose may be of use in weight reduction in the short term as an NNS. However, this needs to be weighed against the possible long-term metabolic side effects and safety precautions.

Background: Variants in ADIPOQ may affect gene expression and serum adiponectin levels (SAL), contributing to the development of metabolic syndrome (MetS) components and cardiometabolic disorders in Mexican adolescents.

Aim: To evaluate the association of the genetic variants rs266729, rs822396, rs2241766, and rs1501299 in ADIPOQ, their haplotypes, and SAL with MetS components and cardiometabolic parameters in adolescents from western Mexico.

Materials and methods: A total of 494 adolescents from Jalisco, Mexico, aged 10-17 years, were studied. The biochemical and clinical characteristics of cardiometabolic disorders were diagnosed based on age-, sex-, and population-specific percentiles. Peripheral blood samples were obtained. Serum was separated and SAL were measured by ELISA. DNA was extracted and genotyped using real-time polymerase chain reaction for allelic discrimination. Hardy-Weinberg equilibrium was assessed, and associations were analyzed using logistic regression and Spearman correlations, with a 95% statistical confidence level.

Results: SAL were lower in adolescents with MetS (P = 0.03) and low high-density lipoprotein (P = 0.01). The rs266729G allele was associated with very low-density lipoprotein >30 mg/dL in the additive inheritance model [AIM; odds ratio (OR) = 1.59, 95% confidence interval (CI) = 1.01-2.53, P = 0.04], dominant inheritance model (DIM; OR = 2.26, 95% CI = 1.07-4.73, P = 0.03), and codominant inheritance model (OR = 2.23, 95% CI = 1.03-4.81, P = 0.04). The rs822396G allele was associated with decreased SAL in AIM (OR = 5.00, 95% CI = 1.69-14.7, P = 0.004) and DIM (OR = 5.23, 95% CI = 1.41-21.6, P = 0.01). The rs2241766G allele (recessive model) was associated with increased alanine aminotransferase levels (OR = 3.73, 95% CI = 1.10-12.6, P = 0.03) and correlated with higher SAL (R = 0.202, P = 0.045). In controls, the haplotype rs822396-rs2241766-rs1501299 is in linkage disequilibrium (D' = 1), but the correlation is low (R² < 0.1), while in MetS adolescents, D' was incomplete. Several haplotypes were associated with cardiometabolic parameters.

Conclusion: The variants in ADIPOQ, are associated with MetS and low SAL. The rs822396G allele appears to be a key factor for low SAL and its association with cardiometabolic parameters. The rs2241766T allele was linked to low SAL and clinical characteristics of MetS.

Metabolic diseases, including obesity, diabetes, and cardiovascular disorders, are increasingly prevalent due to genetic, environmental, and lifestyle factors. Sterol regulatory element-binding proteins (SREBPs) are key transcription factors that regulate genes involved in lipid synthesis and cholesterol homeostasis. Dysregulation of SREBPs contributes to metabolic disorders, with overactivation of SREBP-1c driving excessive lipid synthesis, leading to hyperlipidemia. In diabetes, altered SREBP activity impairs insulin secretion and promotes lipid accumulation, exacerbating disease progression. SREBP-2 is critical for cholesterol metabolism and is linked to atherosclerosis. This review explores the therapeutic potential of targeting SREBPs. Compounds such as betulin, fatostatin, xanthohumol, vitamin D derivatives, and BF175 can modulate SREBP activity, reduce lipid accumulation, and improve metabolic outcomes in experimental models. Clarifying SREBP regulatory mechanisms across tissues, advancing small-molecule modulators, and applying gene-editing technologies such as CRISPR-Cas9 may enable more personalized therapeutic strategies. Integrating lifestyle interventions with pharmacological treatments may offer a comprehensive approach to improving therapeutic outcomes in metabolic diseases.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) and chronic kidney disease (CKD) are linked through the cardiovascular-kidney-metabolic (CKM) health spectrum. This study examines the association between albuminuria and advanced liver fibrosis, both prognostic risk factors for severe kidney and liver outcomes, in patients with MASLD. Methods: This was a retrospective cross-sectional study of primary care patients with MASLD between 2012 and 2023. Urinary microalbumin-to-creatinine ratio (uACR) was the primary predictor variable and categorized as elevated (≥30 mg/g) or normal (<30 mg/g). The primary outcome was a fibrosis-4 index (FIB-4) at high risk for advanced fibrosis (≥2.67). Bivariate analyses described the cohort overall and by uACR status. Logistic regression models estimated the association of an elevated uACR with a FIB-4 at high risk for advanced fibrosis. Results: The sample included 463 patients of whom 45% had a uACR ≥30 mg/g and 9% had an FIB-4 ≥2.67. In the unadjusted logistic Firth regression model, uACR ≥30 mg/g was associated with an increased odds of having a high-risk FIB-4 (odds ratio [OR] 2.04; 95% confidence interval [CI] 1.06-3.90). After adjusting for estimated glomerular filtration rate (eGFR), there was no significant association between uACR ≥30 mg/g and a high-risk FIB-4 (OR: 1.73; 95% CI: 0.88-3.39). Using a predictor variable combining uACR and eGFR measures, the unadjusted (OR: 3.83; 95% CI: 1.77-8.25) and adjusted (OR: 2.87; 95% CI: 1.29-6.37) logistic Firth regression models demonstrated an association between ACR ≥30 mg/g and eGFR <59 mL/min with the outcome of a high-risk FIB-4. Conclusion: Albuminuria and reduced eGFR were associated with measures of advanced fibrosis in primary care patients with MASLD, highlighting the link between CKD and MASLD along the CKM health spectrum.

Objective: This study aimed to evaluate the predictive value of complete blood count-derived inflammatory indices for metabolic syndrome (MetS) in children and adolescents with obesity. Methods: A cross-sectional study was conducted from January to March 2025. Participants aged 5-17.9 years with obesity were classified into MetS and non-MetS groups according to the International Diabetes Federation pediatric criteria. Participants were further stratified by pubertal stage into prepubertal, pubertal, and postpubertal groups. Results: A total of 343 subjects with obesity (median age: 13.3 years; interquartile range: 4.74) were studied. MetS was diagnosed in 97 individuals (28.2%). Those with MetS had significantly higher body mass index (BMI), waist circumference, hip circumference, waist-to-height ratio, blood pressure, triglycerides, fasting plasma glucose, insulin levels, and Homeostasis Model Assessment of Insulin Resistance, and lower high-density lipoprotein cholesterol (HDL-C) compared with participants without MetS. Notably, inflammatory markers, including the neutrophil-to-HDL-C ratio, lymphocyte-to-HDL-C ratio, monocyte-to-HDL-C ratio, and platelet-to-HDL-C ratio (PHR), were also elevated in the MetS group. Correlation analyses revealed significant associations between these indices and various cardiometabolic parameters, including insulin resistance markers. Logistic regression analysis identified BMI and PHR as the most robust independent predictors of MetS. Additionally, stage-specific cutoff values for these markers were established according to pubertal development. Conclusions: The study shows that certain novel inflammatory indices are elevated in children with MetS and are significantly correlated with key cardiometabolic risk factors. These results suggest that such markers could serve as practical tools for early detection of cardiometabolic risk in youth with obesity.