Metabolic syndrome and related disorders最新文献

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.

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.

Metabolic dysfunction-associated steatotic liver disease (MASLD) has replaced the term nonalcoholic fatty liver disease to better reflect its relationship with metabolic dysfunction without creating stigma. MASLD is defined by the presence of hepatic steatosis associated with risk factors, such as type 2 diabetes and overweight/obesity, without the need to exclude other causes of chronic liver disease. The global prevalence of MASLD is high, having an impact in more than one-third of the world's population, particularly in adults with overweight or obesity. When we talk about gender, it is more common in men than in women. MASLD is a complex disorder resulting from the interaction of environmental, genetic, and epigenetic factors, which leads to the dysregulation of lipid metabolism and liver accumulation of fatty acids. MASLD could be diagnosed through imaging methods and serological biomarkers. Elastography and magnetic resonance imaging are the most precise techniques for evaluating liver fibrosis. The treatment focuses on lifestyle modification, which involves weight loss, regular exercise, and a balanced diet. The Mediterranean diet and coffee consumption also have beneficial effects. Several pharmacological therapies are currently being studied, with promising results reported to date. This review aims to provide a comprehensive clinical overview of MASLD, laying the groundwork for understanding the change in nomenclature and becoming familiar with the new term, diagnosis, and treatment.

Background: Acute pancreatitis (AP) is frequently linked to metabolic syndrome (MetS) and its individual components. Coronary artery calcium (CAC) score is also associated with MetS. This study aims to investigate the relationship between CAC and the occurrence of AP. Methods: This retrospective, single-center, case-control study included 352 patients admitted to a tertiary medical referral center between January 2017 and December 2023. Patients were divided into AP (case) and non-AP (control) groups, with controls matched to cases based on sex and age. Results: The prevalence of MetS was significantly higher among AP patients (38.2%) compared to controls (13.3%) (OR: 2.66, 95% CI: 1.72-4.32; P < 0.001). Similarly, CAC was more common in the AP group (35.5%) than in controls (10.8%) and was significantly associated with AP (OR: 3.47; 95% CI: 1.99-4.93, P < 0.001). Multivariate logistic regression, adjusted for smoking, alcohol use, gallstone history, CAC, and MetS components, confirmed associations between AP and smoking (OR: 2.23; 95% CI: 1.78-4.98, P < 0.001), alcohol consumption (OR: 1.78; 95% CI: 1.07-2.76, P = 0.027), gallstones (OR: 22.93; 95% CI: 18.22-49.82, P < 0.001), and positive CAC score (OR: 3.47; 95% CI: 1.99-4.93, P < 0.001). Conclusions: MetS and CAC score are significantly associated with admission for AP. Further studies are needed to explore potential causative mechanisms.

Background: The global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing, particularly among young adults, posing significant long-term health risks. Early identification of at-risk individuals is crucial for timely intervention and prevention of liver fibrosis. This study aimed to evaluate the prevalence of MASLD in young adults aged 18-30 years and assess the utility of noninvasive fibrosis scores (fibrosis 4 index, AST-to-platelet ratio index [APRI], Hepamet fibrosis score) in risk stratification. Methods: A retrospective study was conducted on 327 young adults who attended internal medicine outpatient clinics. The diagnosis of MASLD was established based on imaging findings and the presence of metabolic risk factors. Noninvasive fibrosis assessment was performed using the FIB-4, APRI, and hepamet scores, which were subsequently compared between the MASLD and non-MASLD groups. Statistical analyses included parametric and nonparametric tests, with a significance threshold set at p < 0.05. Results: Among the 327 participants, 36.8% (n = 120) were diagnosed with MASLD. Patients in the MASLD group exhibited significantly higher FIB-4, APRI, and Hepamet scores compared to those in the non-MASLD group (p < 0.05). Additionally, the MASLD group had significantly elevated body mass index, blood pressure, fasting glucose, triglyceride levels, and insulin resistance compared to the non-MASLD group (p < 0.05 for all comparisons). Conclusions: MASLD is highly prevalent among young adults and associated with metabolic risk factors. Noninvasive fibrosis scores provide an effective, accessible tool for early risk assessment and should be integrated into routine clinical practice for young adults to prevent future liver-related complications.

Background: Frailty and metabolic syndrome (MetS) are common conditions in older adults and may share overlapping pathophysiological pathways that impact mortality. Objectives: We aimed to investigate the effect of frailty and MetS on mortality the older adults. Methods: This study included 1100 outpatients aged ≥60 years. We followed the participants for five years, during which 13.2% of them died. The status of MetS was assessed using the criteria established by the National Cholesterol Education Program Third Adult Treatment Panel. We evaluated frailty using the FRAIL scale. Results: Mean age was 71.57 ± 7.09 years. The frail group had a significantly higher mean age (73.13 ± 7.75) compared to the nonfrail (70.20 ± 6.23) and prefrail (70.86 ± 6.73) groups (P < 0.001). In all three groups, women made up the majority, but in the frail group (76.9%), there were significantly more women than other groups (P < 0.001). MetS was more prevalent in prefrail and frail groups compared to those who were nonfrail (nonfrail: %59.1, prefrail: %71, frail: %70.2) (P = 0.010). The frail group showed a higher frequency of cognitive impairment, depressive mood, malnutrition, and dependency. The overall mortality rate for the sample was 13.2%, as anticipated, the frail group has a significantly higher mortality rate (23.4%) compared to the other two groups (nonfrail: 5.3%, prefrail: 10.2%) (P < 0.001). The Cox proportional hazards model indicated that the frail group demonstrated an increased mortality risk over five years, even after adjusting for age, sex, and metabolic disorders (hazard ratio: 4.44, 95% confidence interval = 2.19-9.02, P < 0.001). Conclusions: Frailty was a more accurate predictor of mortality than MetS, regardless of age.

To investigate the association between neck to waist circumference (N/W) ratio and insulin resistance in the adult general population under 50 years. We analyzed data from the 2020 Korea Health National Analysis Nutrition Examination Survey (KNHANES) to examine the relationship between N/W ratio and insulin resistance in the general population under 50. After adjusting for age, sex, and various cardiometabolic variables, the N/W ratio was significantly associated with fasting blood glucose, insulin, HbA1c, and homeostatic model assessment of insulin resistance (HOMA-IR) index, as well as BMI (p < 0.01). In the lowest N/W ratio quartile (Q1), metabolic risk indicators including BMI, waist circumference, blood pressure, fasting plasma glucose, HDL cholesterol, and HOMA-IR index were notably higher than those in the highest quartile (Q4) (p < 0.0001). This suggests that a higher N/W ratio may be associated with a lower metabolic risk profile. The N/W ratio is a significant predictor of insulin resistance, independent of other risk factors, in the general Korean population under 50. These findings underscore the utility of the N/W ratio as an accessible screening tool for assessing cardiometabolic risks.

Background: Knee osteoarthritis (KOA) is a multifactorial degenerative joint disease and a leading cause of disability in older adults. Obesity is the most modifiable risk factor for KOA. Previous studies have suggested an association between polymorphisms in the FTO (fat mass and obesity associated) genes and KOA, potentially mediated by obesity. This study aimed to evaluate the association between the rs1558902 FTO genetic variant, obesity, and KOA in a northern Mexican Mestizo population. Materials and Methods: A total of 462 individuals were included in the study. Participants were classified into three groups: (i) a reference population (n = 189), (ii) individuals with primary KOA (n = 130), and (iii) non-KOA individuals (n = 143). The rs1558902 variant was genotyped using DNA microarray technology in the reference population and by real-time PCR in the KOA and non-KOA groups. Binary and multinomial regression analyses were performed. Results: The rs1558902 variant showed a significant association with obesity in the reference population under codominant (p = 0.012) and recessive (p = 0.008) genetic models. These associations remained statistically significant after adjustment for sex and age using multinomial logistic regression. In the codominant model, the association with an odds ratio (OR) of 6.884 (95% confidence interval [CI]: 1.470-32.225; p = 0.014), while in the recessive model, the OR was 7.429 (95% CI: 1.619-34.091; p = 0.010). However, no significant association was observed between rs1558902 and KOA. Conclusions: These findings confirm the association between the rs1558902 FTO variant and overweight/obesity in a northern Mexican Mestizo population, but not with KOA. Further research is needed to explore this association in the context of other genetic and clinical factors.

Background: Increasing maternal body mass index (BMI) represents a risk factor for Gestational Diabetes Mellitus (GDM) and adverse obstetrical and perinatal outcomes. Objective: To stratify clinical outcomes for pregnancies affected by GDM according to maternal BMI. Methods: Retrospective cohort study including individuals ≥18 years of age who were diagnosed with GDM from 2018 to 2022. Universal GDM screening was employed with a 50 g oral glucose challenge test ± a 100 g oral glucose tolerance test. Maternal demographics, preexisting medical conditions, and selected obstetric and neonatal morbidities were evaluated. Results: A total of 2193 pregnancies in 2110 women affected by GDM were identified. This included 506 (23.0%) with normal baseline maternal BMI, 596 (27.2%) with overweight, and 1091 (49.7%) with obese BMI. Adverse maternal outcomes were more frequent in the obese compared to overweight or normal BMI categories (cesarean delivery: normal 26.9% vs. overweight 28.5% vs. obese 40.9%; p < 0.001; hypertensive disorders of pregnancy: normal 8.7% vs. overweight 12.1% vs. obese 16.8%; p < 0.001). Postpartum glucose intolerance was higher in women with obesity (normal 7.3% vs. overweight 5.9% vs. obese 14.9%; p < 0.001). Infants born to mothers with obesity had higher birthweights (normal 3.3 kg vs. overweight 3.4 kg vs. obese 3.5 kg; p < 0.001), were more likely to have neonatal hypoglycemia (normal 29.4% vs. overweight 24.3% vs. obese 41.9%; p < 0.001) and require intensive care unit admission (normal 8.1% vs. overweight 5.9% vs. obese 11.9%; p < 0.001). Conclusions: Patients with GDM and baseline BMI in the obese range experienced the highest rate of adverse outcomes, while those with overweight BMI had similar outcomes to individuals who had normal BMI at baseline.

Background: The triglyceride-glucose (TyG) index and related parameters have recently been advocated as efficient diagnostic markers for metabolic dysfunction-associated steatotic liver disease (MASLD) in the general population. Yet, there is a paucity of data addressing their significance in MASLD diagnosis and severity assessment in the vulnerable population of type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate the predictive capacity of TyG-related indices for MASLD diagnosis in patients with T2DM, and to investigate the relationship of these parameters with hepatic steatosis severity. Methods: This cross-sectional study encompassed a cohort of 600 adults diagnosed with T2DM, who were enrolled from the diabetes and metabolism outpatient clinic at Alexandria Main University Hospital. After excluding secondary causes, hepatic steatosis was diagnosed using the FibroScan 430 mini+ machine (EchoSense, Paris, France), with results expressed as the controlled attenuation parameter. Anthropometric and biochemical measurements were utilized to derive TyG-related indices, including TyG index, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), and TyG-waist to height ratio (TyG-WHtR). Results: MASLD was diagnosed in 83% of the recruited subjects. The studied TyG-related parameters were markedly higher in patients with severe steatosis. Moreover, multivariate analysis identified TyG-BMI as an independent risk factor for severe steatosis. Furthermore, the receiver operating characteristic curve was used to assess the diagnostic performance of the studied TyG indices for detecting MASLD in individuals with T2DM. The area under the curve for each of the four indicators was as follows: 0.775 for TyG-BMI, followed by 0.755 for TyG-WC, 0.741 for TyG-WHtR, and 0.637 for TyG index. These findings revealed good predictive capacity for all four parameters, especially TyG-BMI, which exhibited the highest level of predictive accuracy. Conclusion: The TyG index and related parameters, particularly TyG-BMI, are reliable and cost-effective biomarkers for detecting and assessing the severity of MASLD.