Metabolic syndrome and related disorders最新文献

Objective: Diabetic foot ulcer is a condition associated with type 2 diabetes mellitus (T2DM). This study aims to examine the influence of mean platelet volume (MPV) on predicting amputation decisions in patients with diabetic foot ulcers. Methods: Patients with diabetic foot ulcers who presented to the tertiary healthcare facility from June 2023 to June 2024 were included. The first group comprises individuals who opted for amputation, whereas the second group includes patients without indications for amputation. Results: The mean age of patients with diabetic foot ulcers is 62.68 years, and the mean glycated hemoglobin A1c level is 9.62%. The initial group comprises 61 patients who opted for amputation, whereas the subsequent group includes 56 individuals who lacked an indication for amputation. The initial group exhibits markedly elevated values for MPV, total cholesterol, and low-density lipoprotein (LDL) (P = 0.001, P = 0.004, P = 0.020). Logistic regression research indicates that elevated levels of LDL and MPV substantially heighten the chance of amputation. The receiver operating characteristic curve study established the MPV cutoff value for amputation prediction at 11.2. The sensitivity and specificity of this value in predicting amputation were [β = 0.01, OR (odds ratio) = 1.01, 95% confidence interval (CI): 1.00-1.03, P = 0.006] for LDL and (β = 0.52, OR = 1.68, 95% CI: 1.18-2.39, P = 0.003) for MPV. Every unit increment in the MPV value corresponds to an approximate 68.8% elevation in the probability of amputation. Conclusion: In individuals with diabetic foot ulcers, MPV and LDL levels are independent variables affecting amputation and may function as predictors for amputation.

Background: Poor sleep has been identified as a strong risk factor for metabolic syndrome. Shift workers, who often experience reduced and misaligned sleep due to nighttime work schedules, are particularly susceptible to both sleep disturbances and metabolic syndrome. However, the interplay among shift work, sleep disturbances, and metabolic syndrome remains insufficiently explored. This systematic review aimed to critically appraise, compare, and synthesize the current evidence on the pathways linking these factors. Methods: A comprehensive literature search was conducted across major electronic databases and peer-reviewed journals specializing in metabolic disorders and sleep disorders. Two independent reviewers screened titles, abstracts, and full texts for relevance. Methodological quality was assessed using the Newcastle-Ottawa Scale. Results: Out of 4,982 studies identified, 15 met the predefined inclusion criteria, encompassing diverse occupational groups with fixed and rotating shift patterns and totaling 37,147 participants. Most studies demonstrated a positive association between shift work and sleep disturbances, particularly among fixed night shift workers. Longer durations of night shift exposure were linked to increased risk of metabolic syndrome. Notably, reduced sleep quantity was more strongly associated with metabolic syndrome than impaired sleep quality. The methodological quality of the included studies was moderate to high. Conclusion: This review highlights a consistent association between shift work, sleep disturbances, and metabolic syndrome. Shift work appears to impact both sleep health and metabolic outcomes independently. These findings underscore the need for targeted interventions and longitudinal studies to further elucidate causal pathways and inform occupational health strategies.

Purpose: This study aimed to investigate health-related quality of life (HRQOL) and related factors in Hangzhou, China, in patients with non-alcoholic fatty liver disease (NAFLD). Methods: The Chinese version of the EQ-5D-5L questionnaire was employed to assess HRQOL in 594 patients. A standardized questionnaire was employed to gather data regarding demographics, clinical characteristics, and lifestyle. This study employed Tobit regression models alongside multiple linear regression to examine the components influencing HRQOL, encompassing utility values and the EQ visual analogue scale (EQ-VAS). Results: This study included 594 participants with a mean age of 42.03 ± 13.83 years. The median utility index was 0.951 (P25-P75: 0.934-1.000), and the median EQ-VAS score was 76 (P25-P75: 66-82). Anxiety and depression were the predominant entry (31.9%) among the five health dimensions. Tobit regression models indicated that retirement (P = 0.011), monthly income >6000 (P = 0.002), alcohol consumption (P = 0.012), low-intensity activity (P = 0.002), obesity (P = 0.004), and cirrhosis (P = 0.038) were correlated with diminished HRQOL. The outcomes of multiple linear regression analyses indicated that regular exercise (β = 3.200; P = 0.003) and alcohol consumption (β = 2.466; P = 0.049) exhibited significant positive correlations with EQ-VAS scores, whereas obesity (β = -4.259; P = 0.005) and severe hepatic steatosis (β = -3.912; P = 0.036) demonstrated significant negative correlations. Conclusions: The anxiety/depression dimension was the most prevalent problem. The current investigation identified a notable correlation between HRQOL and low-intensity activity, obesity, and cirrhosis. Obesity and severe hepatic steatosis exhibited a substantial negative correlation with the EQ-VAS score. Future efforts should focus on enhancing the mental health and lifestyle of NAFLD patients.

Background: Metabolic syndrome (MetS) is increasingly prevalent globally and is linked to inflammation in cardiac tissues. Cardiac allograft vasculopathy (CAV) is a significant inflammatory condition and a leading cause of graft failure after orthotopic heart transplantation (OHT). The relationship between MetS and CAV remains poorly understood. Methods: A literature search was conducted from inception to September 2024, including studies that reported associations between MetS or its components (obesity, hypertension, dyslipidemia, and diabetes mellitus) and CAV. The primary endpoint was the development of CAV after OHT. Results were presented as odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI), employing both random and fixed-effect models based on heterogeneity. Results: A total of 16 studies involving 3,366 patients were included. The prevalence of MetS was high before OHT (32%, 95% CI: 24-41%, I² = 75%) and increased after OHT (37%, 95% CI: 18-61%, I² = 83%). MetS was significantly associated with CAV (OR = 1.99, 95% CI: 1.28-3.09, I² = 36%). Key components of MetS linked to CAV included obesity (OR = 1.54, 95% CI: 1.11-2.13, I² = 0%) and dyslipidemia (OR = 1.87, 95% CI: 1.49-2.36, I² = 0%). New-onset diabetes mellitus after transplantation increases the risk of CAV with an HR of 1.71 (95% CI: 1.56-1.88, I² = 0%). Conclusion: The high prevalence of MetS both before and after OHT is associated with an increased risk of CAV, highlighting the need for targeted interventions to manage MetS in heart transplant recipients.

Purpose: Obesity is the most important factor in obstructive sleep apnea (OSA). Even if metabolic surgery (MS) weight loss is achieved, the therapeutic effect has not been proven for OSA. This study compared the apnea-hypopnea index (AHI) before surgery (T0), 1 year after surgery (T1), and 2 years after surgery (T2), assuming that the effect of MS on the AHI is influenced by the ANB angle (formed by point A, nasion, and point B), which reflects the anteroposterior relationship between the maxilla and mandible. Methods: The study included 47 patients with a body mass index ≥35 kg/m² who underwent MS. To compare the AHI before and after surgery, we classified participants into three groups based on the ANB angle at the initial examination: skeletal Class I (>1° and <4°), II (≥4°), and III (≤1°). Results: The mean AHI of all participants was 56.8 events/hr at T0, 26.5 at T1, and 23.7 at T2. Both postsurgical values were significantly lower than the presurgical value at T0. The mean AHI in skeletal Class I was 19.1 at T1 and 15.1 at T2, which was a significant decrease compared with T0 (50.4). Although the mean AHI was 38.8 at T1 and 38.8 at T2 in the skeletal Class II, which were lower than that at T0 (65.9), no significant difference was observed. The mean AHI was 20.0 at T1 and 15.3 at T2 in the skeletal Class III, which were significantly decreased as compared with that at T0 (53.5). Conclusion: Measuring the ANB angle prior to surgery is useful for predicting the postoperative effect.

Background: Recent studies have identified a U-shaped association between sleep duration and both poor cardiovascular health (CVH) and metabolic syndrome (MetS). However, the extent to which sleep quality affects cardiometabolic health remains understudied. Here, we examined associations of sleep quality with CVH and MetS. Methods: In a nationally representative cross-sectional study of US adults (n = 3,293), we assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI), operationalized as a continuous score (range 0-23 points) and binary (good vs. poor sleep quality) variable. We derived CVH score (range 0-100 points) using the Life's Essential 8 construct, and defined MetS using the National Cholesterol Education Program Adult Treatment Panel III criteria. We examined associations via regression models, adjusting for sociodemographic and lifestyle factors. Results: In fully adjusted models, a 1-point higher PSQI score was associated with lower CVH scores (β -0.61; 95% CI -0.72, -0.51) and higher odds of MetS (OR 1.02; 95% CI 1.00, 1.03). Similarly, poor (vs. good) quality sleep was associated with lower CVH scores (β -4.1; 95% CI -5.4, -2.8) and higher odds of MetS (OR 1.27; 95% CI 1.04, 1.56). The associations with CVH score and MetS appeared to be driven primarily by health behaviors metrics and hypertriglyceridemia, respectively. No significant interactions were seen with age or gender. Conclusions: In this cross-sectional study, individuals with poor sleep quality were found to have worse CVH scores and higher odds of MetS. Future studies could explore whether strategies promoting better quality sleep would help improve CVH and prevent MetS.

Purpose: We conducted an observational study on how profound hypothyroidism affects circulating citrate, a potential biomarker of mitochondrial dysfunction linked to mortality. Methods: Sixteen differentiated thyroid carcinoma patients were first studied during hypothyroidism, i.e., 4-6 weeks after total thyroidectomy, and subsequently after 20 weeks of thyroid hormone supplementation. 5 patients were also studied during euthyroidism, i.e., before total thyroidectomy. Circulating citrate and total ketone bodies were measured by nuclear magnetic resonance spectroscopy. Results: During profound hypothyroidism (mean thyroid stimulating hormone [TSH] 106 ± 77 mU/L), circulating citrate was 72% higher (95% CI: 48%-96%), reaching 157 ± 48 µmol/L, compared to 93 ± 25 µmol/L during thyroid hormone administration (mean TSH 0.20 ± 0.53 mU/L). This increase remained significant after adjusting for estimated glomerular filtration rate (eGFR) (P < 0.001) and body mass index (BMI) (P < 0.001). Citrate during hypothyroidism was also higher compared to five euthyroid patients studied before total thyroidectomy (P = 0.014). Total ketone bodies did not significantly change during hypothyroidism (P = 0.62). Conclusion: Short-term profound hypothyroidism gives rise to a major increase in circulating citrate, also when adjusted for changes in eGFR and BMI, conceivably attributable to hypothyroidism-related mitochondrial dysfunction. It is suggested that thyroid function status should be taken into consideration when evaluating the association of circulating citrate with adverse health outcomes.

Background: Based on the high prevalence of kidney stone disease (KSD) and its possible relationship with metabolic components, the aim of this study was to examine the associations of metabolic syndrome (MetS) and its components with KSD. Methods: This is a cross-sectional assessment of the Prospective Epidemiological Research Studies of Iranian Adults (PERSIAN) Guilan cohort study (PGCS), which includes 10,520 participants aged between 35 and 70 in northern Iran from 2014 to 2017. Demographic data and clinical characteristics were filled out. MetS was determined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) with the following criteria: hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), hypertension, abdominal obesity, and hyperglycemia. The association of self-reported KSD with MetS was examined using logistic regression analysis. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Results: The prevalence of MetS and KSD was 41.8% and 15.6%, respectively. In the unadjusted model, MetS was associated with 18% increased odds of KSD (OR = 1.18, 95% CI: 1.06-1.31). This association remained significant after adjustment for some demographic characteristics (aOR = 1.30, 95% CI: 1.16-1.46). All MetS components except for low HDL-C were also associated with increased odds of KSD, after adjusting for some demographic variables. In addition, the odds of KSD increased with the number of MetS components, up to an almost 2.2-fold odds among subjects with all five MetS components. Conclusion: This study found that the risk of KSD increases with MetS as a whole, all MetS components except for low HDL-C, and the number of MetS components. Our study might provide evidence for individualized management of MetS for preventing KSD.

Introduction: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive tumor often accompanied by various metabolic abnormalities both before and after clinical diagnosis. Diagnosis at advanced stages significantly increases mortality risk. This study aimed to investigate the potential relationship between metabolic and inflammatory parameters at the time of diagnosis and disease stage, and their impact on prognosis in patients with pancreatic cancer. Materials and Methods: A total of 89 patients (43.8% male, 56.2% female) diagnosed with PDAC were included in the retrospective, single-center study. Disease stages at diagnosis that were categorized as stages 1-2 (resectable) and stages 3-4 (locally advanced and metastatic), height, weight, accompanying diseases, body mass index (BMI), inflammatory parameters (C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), and metabolic parameters (glucose, HbA1c %, triglyceride, High-Density Lipoprotein [HDL]-cholesterol, Low-Density Lipoprotein [LDL]-cholesterol) were recorded. These parameters were compared between early and advanced stage patients, and their effect on one-year survival was evaluated. Results: The mean age of the patients was 62.7 years; 45.1% of the patients were in stages 1-2, while 48.3% were in stage 4. The one-year overall mortality rate was 32.6%, and the mortality rate was 52.1% in advanced stage (stages 3-4) patients and 9.8% in early stage (stages 1-2) patients. Mean CRP and NLR levels were significantly higher in patients who died compared to those who survived (7.4 vs. 4.4, p = 0.001; p = 0.000, respectively). Mean HDL-cholesterol level was lower in patients who died compared to survivors (34 mg/dL vs. 47.2 mg/dL, p = 0.001). Mean fasting blood glucose and HbA1c levels were higher in patients who died compared to survivors (167 mg/dL vs. 135 mg/dL, 7.5% vs. 6.6%; p = 0.008; p = 0.037, respectively). There were no significant differences in gender, BMI, presence of co-morbidities, triglyceride, or LDL-cholesterol levels between the groups. Conclusion: Recognizing clinical biomarkers predicting prognosis in PDAC could significantly contribute to disease management.

Background: Cardiovascular disease (CVD) will be the leading cause of mortality in Africa by 2030. Yet, little is known about the key drivers of CVD risk in the region. Objective: To examine the risk factors associated with CVD risk in a sample of rural midlife and elderly Kenyans. Methods: Cross-sectional study design. Data were collected following established protocols and included physical activity (PA), body mass index (BMI), waist circumference, blood pressure (BP), and self-reported medical history. Absolute CVD risk scores [Framingham risk scores (FRS)] were computed using non-lab-based Framingham algorithm. Descriptive and inferential statistics were used to evaluate factors associated with CVD risk scores and related sex-specific differences. Results: The sample (N = 102; mean age 59.8 ± 7.3 years; 57.8% female) was on average highly active (median 8891 steps/day) with 61.8% hypertension prevalence. Females versus males had higher BMI (29.2 vs. 24.8 kg/m²; P < 0.001) and central adiposity (84.8 vs. 18.6%; P < 0.001). However, they had lower systolic BP (129.3 vs. 138.3 mmHg; P = 0.032) and didn't smoke (0.0 vs. 11.6%; P = 0.012). Females also were 6.6 years younger (P < 0.001) and had fewer years of education (P < 0.001) and less PA (P = 0.046). Overall, 34.3% of the sample was at high risk of CVD (FRS ≥20%), but females had lower risk compared with males (median FRS 7.4 vs. 25.0%; P < 0.001). Higher CVD risk was associated with higher education (P < 0.001) and having adequate income (P = 0.048). When considering females separately, none of the sociodemographic characteristics or PA measures were associated with CVD risk, but for males, higher CVD risk was associated with higher education (P = 0.025) and lower PA (P = 0.009). Conclusion: Age, BMI, BP, and smoking partially explain sex differences in CVD risk burden. However, sex differences also exist with males being older with higher education-factors associated with higher CVD risk. More research is needed to examine factors associated with absolute CVD risk in females.