Pub Date : 2024-10-01Epub Date: 2024-06-07DOI: 10.1089/met.2024.0065
Carolina Costa-Santos, Gabriella Guarilha Costa Dias Mattar, Ronan Antonio Fuziwara, Jorge Alexandre de Araújo Peres, Márcia Silva Queiroz
Objective: Screen time (ST) has shown negative effects on physical and mental health, with an increase in the prevalence of overweight, metabolic syndrome (MetS), and obesity. The time spent in front of the screens was also associated with higher odds of selecting indicators of cardiometabolic disease in adulthood. In view of this, the aim of this study was to identify the risk of MetS and type 2 diabetes mellitus (T2DM) in healthy young males and relate it to ST and sleep time. Methods: We evaluated physical and laboratory characteristics, dichotomous diagnosis criteria, and continuous scores to assess MetS and Finnish Diabetes Risk Score questionnaire to measure the T2DM risk. Results: The means of MetS dichotomous and continuous severity criteria, among individuals with <7 hr of sleep, were higher than those with adequate sleep. We did not observe a direct impact of ST on the risk of MetS; nevertheless, >8 hr of ST increased 1.22 points in the T2DM risk. Conclusion: Excessive ST increased the risk of T2DM, but not of MetS. Moreover, sleeping <7 hr was associated with a higher mean of dichotomous and continuous severity criteria for MetS.
{"title":"Screen Time and Hours of Sleep Influence the Estimate Risk of Diabetes Mellitus and Metabolic Syndrome in Healthy Young Males.","authors":"Carolina Costa-Santos, Gabriella Guarilha Costa Dias Mattar, Ronan Antonio Fuziwara, Jorge Alexandre de Araújo Peres, Márcia Silva Queiroz","doi":"10.1089/met.2024.0065","DOIUrl":"10.1089/met.2024.0065","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Screen time (ST) has shown negative effects on physical and mental health, with an increase in the prevalence of overweight, metabolic syndrome (MetS), and obesity. The time spent in front of the screens was also associated with higher odds of selecting indicators of cardiometabolic disease in adulthood. In view of this, the aim of this study was to identify the risk of MetS and type 2 diabetes mellitus (T2DM) in healthy young males and relate it to ST and sleep time. <b><i>Methods:</i></b> We evaluated physical and laboratory characteristics, dichotomous diagnosis criteria, and continuous scores to assess MetS and Finnish Diabetes Risk Score questionnaire to measure the T2DM risk. <b><i>Results:</i></b> The means of MetS dichotomous and continuous severity criteria, among individuals with <7 hr of sleep, were higher than those with adequate sleep. We did not observe a direct impact of ST on the risk of MetS; nevertheless, >8 hr of ST increased 1.22 points in the T2DM risk. <b><i>Conclusion:</i></b> Excessive ST increased the risk of T2DM, but not of MetS. Moreover, sleeping <7 hr was associated with a higher mean of dichotomous and continuous severity criteria for MetS.</p>","PeriodicalId":18405,"journal":{"name":"Metabolic syndrome and related disorders","volume":" ","pages":"626-635"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aims to elucidate the comprehensive effects of metabolic syndrome (MetS) on the structural integrity of subcortical brain regions and associated structures through high-resolution magnetic resonance imaging (MRI) volumetric analysis, thereby contributing to a deeper understanding of the neuroanatomical dimensions of MetS and its potential implications for cognitive functions and overall brain health. Methods: A cross-sectional design was implemented, involving 25 individuals diagnosed with MetS for at least one year and a healthy control group of 15 individuals at a tertiary hospital's family medicine clinic in Eastern Turkey. Participants underwent a high-resolution MRI scan using a 1.5T Siemens Aera scanner. The MRICloud platform was employed for comprehensive segmentation and quantitative analysis of various brain structures. Results: The study revealed significant volumetric reductions in all measured subcortical brain regions among individuals with MetS compared to the control group (all P < 0.05). Notable differences were observed in key structures such as the substantia nigra, corpus callosum, and thalamus. In subcortical structures, the largest volumetric differences were noted in the basal ganglia L (1322.4 mm³), while the most significant percentage differences were seen in the substantia nigra R (25.24%) and caudate nucleus L (21.02%). Conclusion: The findings from this study underscore the significant neuroanatomical changes associated with MetS, manifesting as volumetric reductions in critical subcortical brain areas. These alterations underscore the necessity for further research into the comprehensive influence of MetS on cognitive processes and the potential for early therapeutic interventions.
{"title":"Structural Brain Alterations in Metabolic Syndrome: A Comprehensive MRI Volumetric Analysis of Subcortical and Associated Structures.","authors":"Hatice Cakir, Mukadder Sunar, Sonay Aydın, Osman Kagan Cakir, Ersan Gursoy","doi":"10.1089/met.2024.0048","DOIUrl":"10.1089/met.2024.0048","url":null,"abstract":"<p><p><b><i>Objective:</i></b> This study aims to elucidate the comprehensive effects of metabolic syndrome (MetS) on the structural integrity of subcortical brain regions and associated structures through high-resolution magnetic resonance imaging (MRI) volumetric analysis, thereby contributing to a deeper understanding of the neuroanatomical dimensions of MetS and its potential implications for cognitive functions and overall brain health. <b><i>Methods:</i></b> A cross-sectional design was implemented, involving 25 individuals diagnosed with MetS for at least one year and a healthy control group of 15 individuals at a tertiary hospital's family medicine clinic in Eastern Turkey. Participants underwent a high-resolution MRI scan using a 1.5T Siemens Aera scanner. The MRICloud platform was employed for comprehensive segmentation and quantitative analysis of various brain structures. <b><i>Results:</i></b> The study revealed significant volumetric reductions in all measured subcortical brain regions among individuals with MetS compared to the control group (all <i>P</i> < 0.05). Notable differences were observed in key structures such as the substantia nigra, corpus callosum, and thalamus. In subcortical structures, the largest volumetric differences were noted in the basal ganglia L (1322.4 mm³), while the most significant percentage differences were seen in the substantia nigra R (25.24%) and caudate nucleus L (21.02%). <b><i>Conclusion:</i></b> The findings from this study underscore the significant neuroanatomical changes associated with MetS, manifesting as volumetric reductions in critical subcortical brain areas. These alterations underscore the necessity for further research into the comprehensive influence of MetS on cognitive processes and the potential for early therapeutic interventions.</p>","PeriodicalId":18405,"journal":{"name":"Metabolic syndrome and related disorders","volume":" ","pages":"583-590"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-06-13DOI: 10.1089/met.2024.0115
Nazar Akhverdyan, Amanda Wieland, Shelby Sullivan, Mark Lindsay, Sheila Swartwood, Gretchen Arndt, Laura Katherine Kaizer, Thomas Jensen
Introduction: Current guidelines recommend the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD), especially in patients with comorbid diabetes and obesity. This study investigated the effects of GLP-1RAs on hepatic steatosis and fibrosis in patients with MASLD, as measured by changes in vibration-controlled transient elastography (VCTE) and other clinical parameters in a real-world clinical setting. Methods: We conducted a single-center, retrospective analysis of 96 patients with MASLD from a multidisciplinary care clinic who completed VCTE at baseline and follow-up within 6-24 months to compare changes in controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), as well as other metabolic markers, between GLP-1RA users and nonusers using two-sample t-tests and Wilcoxon rank-sum tests. We also assessed whether improvements in hepatic steatosis, defined as a change in CAP >38 dB/m as previously described in the literature, were associated with improvement in fibrosis. Results: GLP-1RA use resulted in significant improvements in weight (-8.1 kg vs. -3.5 kg, P = 0.009), body mass index (BMI) (-2.9 kg/m2 vs. -1.3 kg/m2, P = 0.012), alanine aminotransferase (-15.0 IU/L vs. -4.0 IU/L, P = 0.017), aspartate aminotransferase (-5.0 IU/L vs. -1.0 IU/L, P = 0.021), glycated hemoglobin (HbA1c) (-0.7% vs. 0.1%, P = 0.019), and CAP (-59.9 dB/m vs. -29.1 dB/m, P = 0.016). Responders also had significant improvements in weight (-9.2 kg vs. -1.9 kg, P < 0.001), BMI (-3.3 kg/m2 vs. -0.7 kg/m2, P < 0.001), diastolic blood pressure (-6.1 mmHg vs. -0.7 mmHg, P = 0.028), HbA1c (-0.8% vs. 0.3%, P < 0.001), and LSM (-1.5 kPa vs. 0.1 kPa, P < 0.001). Conclusions: Patients with MASLD treated with GLP-1RAs showed significant improvements in hepatic steatosis and multiple other metabolic parameters, with weight loss as the proposed mechanism for this liver improvement. In addition, change in CAP >38 dB/m was associated with improvements in LSM and other metabolic parameters, suggesting the clinical utility of VCTE in the surveillance of MASLD.
简介:现行指南建议使用胰高血糖素样肽-1受体激动剂(GLP-1RA)治疗代谢功能障碍相关性脂肪性肝病(MASLD),尤其是合并糖尿病和肥胖症的患者。本研究调查了 GLP-1RA 对 MASLD 患者肝脏脂肪变性和纤维化的影响,这些影响是通过实际临床环境中振动控制瞬时弹性成像(VCTE)和其他临床参数的变化来测量的。研究方法我们对96名来自多学科护理诊所的MASLD患者进行了单中心回顾性分析,这些患者在基线时完成了VCTE,并在6-24个月内进行了随访,我们使用双样本t检验和Wilcoxon秩和检验比较了GLP-1RA使用者和非使用者之间受控衰减参数(CAP)和肝脏硬度测量(LSM)以及其他代谢指标的变化。我们还评估了肝脏脂肪变性的改善(定义为 CAP >38 dB/m 的变化,如之前文献中所述)是否与肝纤维化的改善相关。结果:使用 GLP-1RA 后,体重(-8.1 千克 vs. -3.5 千克,P = 0.009)、体重指数 (BMI)(-2.9 千克/平方米 vs. -1.3 千克/平方米,P = 0.012)、丙氨酸氨基转移酶(-15.0 IU/L vs. -4.0 IU/L,P = 0.012)均有显著改善。-4.0 IU/L,P = 0.017)、天冬氨酸氨基转移酶(-5.0 IU/L vs. -1.0 IU/L,P = 0.021)、糖化血红蛋白(HbA1c)(-0.7% vs. 0.1%,P = 0.019)和 CAP(-59.9 dB/m vs. -29.1 dB/m,P = 0.016)。应答者的体重(-9.2 千克 vs. -1.9 千克,P < 0.001)、体重指数(-3.3 千克/平方米 vs. -0.7 千克/平方米,P < 0.001)、舒张压(-6.1 毫米汞柱 vs. -0.7 毫米汞柱,P = 0.028)、HbA1c(-0.8% vs. 0.3%,P < 0.001)和 LSM(-1.5 千帕 vs. 0.1 千帕,P < 0.001)也有明显改善。结论接受 GLP-1RAs 治疗的 MASLD 患者的肝脏脂肪变性和其他多个代谢指标均有显著改善,体重减轻是肝脏改善的机制之一。此外,CAP >38 dB/m 的变化与 LSM 和其他代谢参数的改善有关,这表明 VCTE 在监测 MASLD 方面具有临床实用性。
{"title":"Changes in Transient Elastography with Glucagon-Like Peptide-1 Receptor Agonist Use in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Real-World Retrospective Analysis.","authors":"Nazar Akhverdyan, Amanda Wieland, Shelby Sullivan, Mark Lindsay, Sheila Swartwood, Gretchen Arndt, Laura Katherine Kaizer, Thomas Jensen","doi":"10.1089/met.2024.0115","DOIUrl":"10.1089/met.2024.0115","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Current guidelines recommend the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD), especially in patients with comorbid diabetes and obesity. This study investigated the effects of GLP-1RAs on hepatic steatosis and fibrosis in patients with MASLD, as measured by changes in vibration-controlled transient elastography (VCTE) and other clinical parameters in a real-world clinical setting. <b><i>Methods:</i></b> We conducted a single-center, retrospective analysis of 96 patients with MASLD from a multidisciplinary care clinic who completed VCTE at baseline and follow-up within 6-24 months to compare changes in controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), as well as other metabolic markers, between GLP-1RA users and nonusers using two-sample <i>t</i>-tests and Wilcoxon rank-sum tests. We also assessed whether improvements in hepatic steatosis, defined as a change in CAP >38 dB/m as previously described in the literature, were associated with improvement in fibrosis. <b><i>Results:</i></b> GLP-1RA use resulted in significant improvements in weight (-8.1 kg vs. -3.5 kg, <i>P</i> = 0.009), body mass index (BMI) (-2.9 kg/m<sup>2</sup> vs. -1.3 kg/m<sup>2</sup>, <i>P</i> = 0.012), alanine aminotransferase (-15.0 IU/L vs. -4.0 IU/L, <i>P</i> = 0.017), aspartate aminotransferase (-5.0 IU/L vs. -1.0 IU/L, <i>P</i> = 0.021), glycated hemoglobin (HbA1c) (-0.7% vs. 0.1%, <i>P</i> = 0.019), and CAP (-59.9 dB/m vs. -29.1 dB/m, <i>P</i> = 0.016). Responders also had significant improvements in weight (-9.2 kg vs. -1.9 kg, <i>P</i> < 0.001), BMI (-3.3 kg/m<sup>2</sup> vs. -0.7 kg/m<sup>2</sup>, <i>P</i> < 0.001), diastolic blood pressure (-6.1 mmHg vs. -0.7 mmHg, <i>P</i> = 0.028), HbA1c (-0.8% vs. 0.3%, <i>P</i> < 0.001), and LSM (-1.5 kPa vs. 0.1 kPa, <i>P</i> < 0.001). <b><i>Conclusions:</i></b> Patients with MASLD treated with GLP-1RAs showed significant improvements in hepatic steatosis and multiple other metabolic parameters, with weight loss as the proposed mechanism for this liver improvement. In addition, change in CAP >38 dB/m was associated with improvements in LSM and other metabolic parameters, suggesting the clinical utility of VCTE in the surveillance of MASLD.</p>","PeriodicalId":18405,"journal":{"name":"Metabolic syndrome and related disorders","volume":" ","pages":"608-618"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: There are some studies without consensus on the association between metabolic syndrome (MetS) and health-related quality of life (HRQoL) and few studies among elderly participants; therefore, the aim of this study is evaluating the association between MetS and HRQoL between elderly participants after adjusting for possible confounding factors. Methods: A cross-sectional analysis was conducted with the data from baseline phase of the IRanian Longitudinal Study on Ageing. The MetS diagnosis was conducted based on the National Cholesterol Education Program Adult Treatment Panel III guidelines. The participants were 3452 subjects aged ≥60 years with and without MetS. The Prospective Epidemiological Research Studies in Iran version of the SF-12 questionnaire was used to examine subjects' perspectives on their well-being and general health level. The association between MetS and HRQoL was evaluated through multivariable linear regression model after adjusting for possible covariates. Results: MetS independently had an inverse association with subscales of HRQoL including physical functioning, physical problems, general health, social functioning, and emotional problems, even after fully adjusting for studied confounding factors. An inverse association was also observed between MetS and both mental component summary and physical component summary in the fully adjusted model. Conclusion: Older adults with MetS had a relatively worse physical and mental HRQoL in comparison with individuals without MetS. Independent of any underlying factors, the inverse association of MetS with HRQoL emphasizes the necessity of routine screening and treatment of MetS in older populations.
{"title":"Association Between Metabolic Syndrome and Health-Related Quality of Life in Older Adults: Findings from the IRanian Longitudinal Study on Ageing.","authors":"Ali Gholami, Azam Doustmohammadian, Seyed Morteza Shamshirgaran, Nayyereh Aminisani, Mohsen Azimi-Nezhad, Hamid Abasi, Mitra Hariri","doi":"10.1089/met.2023.0049","DOIUrl":"10.1089/met.2023.0049","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> There are some studies without consensus on the association between metabolic syndrome (MetS) and health-related quality of life (HRQoL) and few studies among elderly participants; therefore, the aim of this study is evaluating the association between MetS and HRQoL between elderly participants after adjusting for possible confounding factors. <b><i>Methods:</i></b> A cross-sectional analysis was conducted with the data from baseline phase of the IRanian Longitudinal Study on Ageing. The MetS diagnosis was conducted based on the National Cholesterol Education Program Adult Treatment Panel III guidelines. The participants were 3452 subjects aged ≥60 years with and without MetS. The Prospective Epidemiological Research Studies in Iran version of the SF-12 questionnaire was used to examine subjects' perspectives on their well-being and general health level. The association between MetS and HRQoL was evaluated through multivariable linear regression model after adjusting for possible covariates. <b><i>Results:</i></b> MetS independently had an inverse association with subscales of HRQoL including physical functioning, physical problems, general health, social functioning, and emotional problems, even after fully adjusting for studied confounding factors. An inverse association was also observed between MetS and both mental component summary and physical component summary in the fully adjusted model. <b><i>Conclusion:</i></b> Older adults with MetS had a relatively worse physical and mental HRQoL in comparison with individuals without MetS. Independent of any underlying factors, the inverse association of MetS with HRQoL emphasizes the necessity of routine screening and treatment of MetS in older populations.</p>","PeriodicalId":18405,"journal":{"name":"Metabolic syndrome and related disorders","volume":" ","pages":"575-582"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This meta-analysis aimed to compare the effect of the real-time continuous glucose monitoring (rt-CGM) and flash glucose monitoring (FGM) on glycemic control in adults with type 1 diabetes mellitus (T1DM). Methods: A systematic literature search of all relevant studies comparing the clinical effectiveness of rt-CGM and FGM in adults with T1DM on Cochrane Library, PubMed, Embase, Web of Science, and Scopus from January 2015 to June 2023 was performed. The primary endpoints were glycated hemoglobin (HbA1c) and TIR (time in range). Secondary endpoints included time below range [TBR (<3.9 mmol/L) and (<3.0 mmol/L)], time above range [TAR (>10.0 mmol/L) and (>13.9 mmol/L)], mean glucose, and glycemic variability (GV) [standard deviations (SD) and coefficient of variation (CV)]. Results: Six studies with 1516 TIDM patients, including three randomized controlled trials and three observational studies, were enrolled in this meta-analysis. Compared to FGM, rt-CGM led to greater glycemic control, represented by higher TIR (%, 3.9 ∼ 10 mmol/L) (SMD = 0.59, 95%CI: 0.37 ∼ 0.81, p < 0.001), decreased TBR (%, <3.9 mmol/L) (SMD = -1.45, 95%CI: -2.33 ∼ -0.57, p = 0.001), decreased TAR [(%, >10.0 mmol/L) (SMD = -0.38, 95%CI: -0.71 ∼ -0.04, p = 0.03) and (%, >13.9 mmol/L) (SMD = -0.42, 95%CI: -0.79 ∼ -0.04, p = 0.03), respectively], lower mean glucose (SMD = -0.18, 95%CI: -0.31 ∼ -0.06, p = 0.003), decreased SD (SMD = -0.70, 95%CI: -1.09 ∼ -0.31, p < 0.001), and decreased CV (SMD = -0.76, 95%CI: -1.05 ∼ -0.47, p < 0.001). However, there was no difference in lowering HbA1c and TBR (%, <3.0 mmol/L) between groups. Conclusion: The rt-CGM outperformed FGM in improving several key CGM metrics among adults with T1DM, but there is no significant difference in HbA1c and TBR (<3.0 mmol/L).
{"title":"Effect of Real-Time Continuous Glucose Monitoring Versus Flash Glucose Monitoring on Glycemic Control in Adults with Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis.","authors":"Danrui Chen,Beisi Lin,Zhigu Liu,Mengyun Lei,Yanling Yang,Bin Yao,Jinhua Yan,Daizhi Yang,Wen Xu","doi":"10.1089/met.2024.0025","DOIUrl":"https://doi.org/10.1089/met.2024.0025","url":null,"abstract":"Objective: This meta-analysis aimed to compare the effect of the real-time continuous glucose monitoring (rt-CGM) and flash glucose monitoring (FGM) on glycemic control in adults with type 1 diabetes mellitus (T1DM). Methods: A systematic literature search of all relevant studies comparing the clinical effectiveness of rt-CGM and FGM in adults with T1DM on Cochrane Library, PubMed, Embase, Web of Science, and Scopus from January 2015 to June 2023 was performed. The primary endpoints were glycated hemoglobin (HbA1c) and TIR (time in range). Secondary endpoints included time below range [TBR (<3.9 mmol/L) and (<3.0 mmol/L)], time above range [TAR (>10.0 mmol/L) and (>13.9 mmol/L)], mean glucose, and glycemic variability (GV) [standard deviations (SD) and coefficient of variation (CV)]. Results: Six studies with 1516 TIDM patients, including three randomized controlled trials and three observational studies, were enrolled in this meta-analysis. Compared to FGM, rt-CGM led to greater glycemic control, represented by higher TIR (%, 3.9 ∼ 10 mmol/L) (SMD = 0.59, 95%CI: 0.37 ∼ 0.81, p < 0.001), decreased TBR (%, <3.9 mmol/L) (SMD = -1.45, 95%CI: -2.33 ∼ -0.57, p = 0.001), decreased TAR [(%, >10.0 mmol/L) (SMD = -0.38, 95%CI: -0.71 ∼ -0.04, p = 0.03) and (%, >13.9 mmol/L) (SMD = -0.42, 95%CI: -0.79 ∼ -0.04, p = 0.03), respectively], lower mean glucose (SMD = -0.18, 95%CI: -0.31 ∼ -0.06, p = 0.003), decreased SD (SMD = -0.70, 95%CI: -1.09 ∼ -0.31, p < 0.001), and decreased CV (SMD = -0.76, 95%CI: -1.05 ∼ -0.47, p < 0.001). However, there was no difference in lowering HbA1c and TBR (%, <3.0 mmol/L) between groups. Conclusion: The rt-CGM outperformed FGM in improving several key CGM metrics among adults with T1DM, but there is no significant difference in HbA1c and TBR (<3.0 mmol/L).","PeriodicalId":18405,"journal":{"name":"Metabolic syndrome and related disorders","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142175739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Metabolic syndrome (MetS) comprises a cluster of cardiovascular risk factors. Physical inactivity and reduced physical fitness are associated with one or more components of MetS. However, MetS has many components, and the unclear relationship between the components and physical fitness parameters can provide a plain and straightforward understanding of the clustering method. Aim: To identify the relationship between physical fitness parameters, physical activity levels, and components of MetS using hierarchical cluster analysis. Methods: One hundred twenty-one patients (mean age = 51.4 ± 7.1/years, F:90, M:31) who were diagnosed as having MetS according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria were included in the study. Fasting plasma glucose (FPG), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were analyzed. Systolic and diastolic blood pressures, (SBP and DBP), were evaluated. Body composition (waist and hip circumference, (WC and HC), waist-to-hip ratio (WHR), body mass index (BMI), percent body fat, and visceral fat), upper and lower extremity muscle strength (dynamometer), and functional exercise capacity [6-minute walk test (6MWT)] were assessed as physical fitness parameters. Physical activity levels were assessed using a pedometer and number of steps (NS) was determined. Results: Of the patients, 45.5% were diagnosed as having MetS based on four components. The dendrogram consisted of two main clusters and four subclusters. The main cluster I composed of BMI, HC, WC, visceral fat, HDL-C, percent fat, SBP, DBP, and percent quadriceps. The main cluster II comprised FPG, TG, WHR, handgrip strength, 6MWT, and NS. Conclusion: MetS components clustered with different physical fitness parameters. The clusters in the dendrogram can provide substantial implications for heterogeneous MetS components and physical fitness parameters. Future studies are needed to elucidate the effectiveness of dendrogram-derived exercise programs in MetS.
{"title":"Using Cluster Analysis to Identify Metabolic Syndrome Components and Physical Fitness in Patients with Metabolic Syndrome.","authors":"Şafak Yiğit, Buket Akıncı, Büşra Ülker Ekşi, Damla Korkmaz Dayıcan, Fulya Çalıkoğlu, Yusuf Çelik, İpek Yeldan, İlhan Satman","doi":"10.1089/met.2024.0041","DOIUrl":"10.1089/met.2024.0041","url":null,"abstract":"<p><p><b><i>Background:</i></b> Metabolic syndrome (MetS) comprises a cluster of cardiovascular risk factors. Physical inactivity and reduced physical fitness are associated with one or more components of MetS. However, MetS has many components, and the unclear relationship between the components and physical fitness parameters can provide a plain and straightforward understanding of the clustering method. <b><i>Aim:</i></b> To identify the relationship between physical fitness parameters, physical activity levels, and components of MetS using hierarchical cluster analysis. <b><i>Methods:</i></b> One hundred twenty-one patients (mean age = 51.4 ± 7.1/years, F:90, M:31) who were diagnosed as having MetS according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria were included in the study. Fasting plasma glucose (FPG), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were analyzed. Systolic and diastolic blood pressures, (SBP and DBP), were evaluated. Body composition (waist and hip circumference, (WC and HC), waist-to-hip ratio (WHR), body mass index (BMI), percent body fat, and visceral fat), upper and lower extremity muscle strength (dynamometer), and functional exercise capacity [6-minute walk test (6MWT)] were assessed as physical fitness parameters. Physical activity levels were assessed using a pedometer and number of steps (NS) was determined. <b><i>Results:</i></b> Of the patients, 45.5% were diagnosed as having MetS based on four components. The dendrogram consisted of two main clusters and four subclusters. The main cluster I composed of BMI, HC, WC, visceral fat, HDL-C, percent fat, SBP, DBP, and percent quadriceps. The main cluster II comprised FPG, TG, WHR, handgrip strength, 6MWT, and NS. <b><i>Conclusion:</i></b> MetS components clustered with different physical fitness parameters. The clusters in the dendrogram can provide substantial implications for heterogeneous MetS components and physical fitness parameters. Future studies are needed to elucidate the effectiveness of dendrogram-derived exercise programs in MetS.</p>","PeriodicalId":18405,"journal":{"name":"Metabolic syndrome and related disorders","volume":" ","pages":"558-565"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-22DOI: 10.1089/met.2023.0311
Carla Cristina de Oliveira Bernardo, Guilherme Godoy, Wilson Eik Filho, Rui Curi, Roberto Barbosa Bazotte
Liver diseases have a global prevalence of 25%, accounting for 4% of all deaths worldwide, and are associated with a 36% increased risk of fatal and nonfatal cardiovascular events. Metabolic dysfunction-associated steatotic liver disease constitutes the liver expression of metabolic syndrome and represents the primary type of liver disease. Microscopical analysis of biopsies, which allows the evaluation of a small portion of tissue with inferences made to the entire organ, is considered the gold standard for determining the presence of liver diseases. However, potential sampling errors in liver biopsies are conceivable because the obtained tissue represents only a tiny fraction of the entire liver mass and may not accurately reflect the true pathological state. Studies have demonstrated the existence of sampling errors in liver biopsies, particularly concerning the severity of inflammation, degree of fibrosis, and the presence of cirrhosis. Also, clinical studies have shown that histopathological abnormalities are better detected in humans when liver samples are collected from both the right and the left lobes. However, a gap exists in clinical investigation to clarify the role of differences between these lobes in improving the diagnostic and prognostic for liver diseases. Building upon the heterogeneous nature of pathological alterations observed in liver lobes, this perspective review provided recommendations to enhance the precision of diagnosis and prognostic accuracy of liver diseases.
{"title":"Heterogeneous Pathological Changes in Liver Lobes During Liver Disease: A Perspective Review.","authors":"Carla Cristina de Oliveira Bernardo, Guilherme Godoy, Wilson Eik Filho, Rui Curi, Roberto Barbosa Bazotte","doi":"10.1089/met.2023.0311","DOIUrl":"10.1089/met.2023.0311","url":null,"abstract":"<p><p>Liver diseases have a global prevalence of 25%, accounting for 4% of all deaths worldwide, and are associated with a 36% increased risk of fatal and nonfatal cardiovascular events. Metabolic dysfunction-associated steatotic liver disease constitutes the liver expression of metabolic syndrome and represents the primary type of liver disease. Microscopical analysis of biopsies, which allows the evaluation of a small portion of tissue with inferences made to the entire organ, is considered the gold standard for determining the presence of liver diseases. However, potential sampling errors in liver biopsies are conceivable because the obtained tissue represents only a tiny fraction of the entire liver mass and may not accurately reflect the true pathological state. Studies have demonstrated the existence of sampling errors in liver biopsies, particularly concerning the severity of inflammation, degree of fibrosis, and the presence of cirrhosis. Also, clinical studies have shown that histopathological abnormalities are better detected in humans when liver samples are collected from both the right and the left lobes. However, a gap exists in clinical investigation to clarify the role of differences between these lobes in improving the diagnostic and prognostic for liver diseases. Building upon the heterogeneous nature of pathological alterations observed in liver lobes, this perspective review provided recommendations to enhance the precision of diagnosis and prognostic accuracy of liver diseases.</p>","PeriodicalId":18405,"journal":{"name":"Metabolic syndrome and related disorders","volume":" ","pages":"494-498"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-05-23DOI: 10.1089/met.2024.0038
Swarnima Pandey
With the change in lifestyle of people, there has been a considerable increase in diabetes, which brings with it certain follow-up pathological conditions, which lead to a substantial medical burden. Identifying biomarkers that aid in screening, diagnosis, and prognosis of diabetes and its associated pathologies would help better patient management and facilitate a personalized treatment approach for prevention and treatment. With the advancement in techniques and technologies, metabolomics has emerged as an omics approach capable of large-scale high throughput data analysis and identifying and quantifying metabolites that provide an insight into the underlying mechanism of the disease and its progression. Diabetes and metabolomics keywords were searched in correspondence with the assigned keywords, including kidney, cardiovascular diseases and critical illness from PubMed and Scopus, from its inception to Dec 2023. The relevant studies from this search were extracted and included in the study. This review is focused on the biomarkers identified in diabetes, diabetic kidney disease, diabetes-related development of CVD, and its role in critical illness.
{"title":"Metabolomics Characterization of Disease Markers in Diabetes and Its Associated Pathologies.","authors":"Swarnima Pandey","doi":"10.1089/met.2024.0038","DOIUrl":"10.1089/met.2024.0038","url":null,"abstract":"<p><p>With the change in lifestyle of people, there has been a considerable increase in diabetes, which brings with it certain follow-up pathological conditions, which lead to a substantial medical burden. Identifying biomarkers that aid in screening, diagnosis, and prognosis of diabetes and its associated pathologies would help better patient management and facilitate a personalized treatment approach for prevention and treatment. With the advancement in techniques and technologies, metabolomics has emerged as an omics approach capable of large-scale high throughput data analysis and identifying and quantifying metabolites that provide an insight into the underlying mechanism of the disease and its progression. Diabetes and metabolomics keywords were searched in correspondence with the assigned keywords, including kidney, cardiovascular diseases and critical illness from PubMed and Scopus, from its inception to Dec 2023. The relevant studies from this search were extracted and included in the study. This review is focused on the biomarkers identified in diabetes, diabetic kidney disease, diabetes-related development of CVD, and its role in critical illness.</p>","PeriodicalId":18405,"journal":{"name":"Metabolic syndrome and related disorders","volume":" ","pages":"499-509"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-05-14DOI: 10.1089/met.2024.0030
Zekai Zhang, Beibei Cao, Qiutong Wu
Introduction: Chronic kidney disease (CKD) is associated with metabolic disorders. However, the evidence for the causality of circulating metabolites to promote or prevent CKD is still lacking. Methods: The two-sample Mendelian randomization (MR) analysis was conducted to evaluate the latent causal relationship between the genetically proxied 486 blood metabolites and CKD. Genome-wide association study (GWAS) data for exposures were derived from 7824 European GWAS on metabolite levels, which have been extensively utilized in the medical field to elucidate the mechanisms underlying disease onset and progression. The random inverse variance weighted (IVW) is the primary analysis for causality analysis while MR-Egger and weighted median as complementary analyses. For the further identification of metabolites, reverse MR and linkage disequilibrium score regression were performed for further evaluation. The drug target for N-acetylornithine was subsequently supplemented into the analysis, with MR and colocalization analysis being utilized. Key metabolic pathways were identified via MetaboAnalyst 4.0 (https://www.metaboanalyst.ca/) online website. Results:N-acetylornithine was identified as a reliable metabolite that increases the susceptibility to estimated glomerular filtration rate (eGFR) decrease (β = 0.047; 95% confidence interval: -0.068 to -0.026; PIVW = 1.5E-5). The "glyoxylate and dicarboxylate metabolism" pathway showed significant relevance to CKD development (P = 6E-4), whereas the "glycine, serine, and threonine metabolism" pathway was also recognized as associated with CKD by general practitioners (P = 7E-4). Colocalization analysis revealed a robust genetic link between N-acetylornithine and both CKD and eGFR, with 85.1% and 99.4% colocalization rates, respectively. IVW-MR analysis substantiated these findings with a significant positive association for CKD (odds ratio = 1.43, P = 4.7E-5) and a negative correlation with eGFR (b = -0.04, P = 1.13E-31). Conclusions: MR was utilized to explore the potential causal links between 61 genetic serum metabolites and CKD. N-acetylornithine and NAT8 were further explored as a potential therapeutic target for CKD treatment.
{"title":"Causality of Genetically Determined Metabolites on Chronic Kidney Disease: A Two-Sample Mendelian Randomization Study <i>In Silico</i>.","authors":"Zekai Zhang, Beibei Cao, Qiutong Wu","doi":"10.1089/met.2024.0030","DOIUrl":"10.1089/met.2024.0030","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Chronic kidney disease (CKD) is associated with metabolic disorders. However, the evidence for the causality of circulating metabolites to promote or prevent CKD is still lacking. <b><i>Methods:</i></b> The two-sample Mendelian randomization (MR) analysis was conducted to evaluate the latent causal relationship between the genetically proxied 486 blood metabolites and CKD. Genome-wide association study (GWAS) data for exposures were derived from 7824 European GWAS on metabolite levels, which have been extensively utilized in the medical field to elucidate the mechanisms underlying disease onset and progression. The random inverse variance weighted (IVW) is the primary analysis for causality analysis while MR-Egger and weighted median as complementary analyses. For the further identification of metabolites, reverse MR and linkage disequilibrium score regression were performed for further evaluation. The drug target for <i>N</i>-acetylornithine was subsequently supplemented into the analysis, with MR and colocalization analysis being utilized. Key metabolic pathways were identified via MetaboAnalyst 4.0 (https://www.metaboanalyst.ca/) online website. <b><i>Results:</i></b> <i>N</i>-acetylornithine was identified as a reliable metabolite that increases the susceptibility to estimated glomerular filtration rate (eGFR) decrease (β = 0.047; 95% confidence interval: -0.068 to -0.026; <i>P</i><sub>IVW</sub> = 1.5E-5). The \"glyoxylate and dicarboxylate metabolism\" pathway showed significant relevance to CKD development (<i>P</i> = 6E-4), whereas the \"glycine, serine, and threonine metabolism\" pathway was also recognized as associated with CKD by general practitioners (<i>P</i> = 7E-4). Colocalization analysis revealed a robust genetic link between <i>N</i>-acetylornithine and both CKD and eGFR, with 85.1% and 99.4% colocalization rates, respectively. IVW-MR analysis substantiated these findings with a significant positive association for CKD (odds ratio = 1.43, <i>P</i> = 4.7E-5) and a negative correlation with eGFR (<i>b</i> = -0.04, <i>P</i> = 1.13E-31). <b><i>Conclusions:</i></b> MR was utilized to explore the potential causal links between 61 genetic serum metabolites and CKD. <i>N</i>-acetylornithine and <i>NAT8</i> were further explored as a potential therapeutic target for CKD treatment.</p>","PeriodicalId":18405,"journal":{"name":"Metabolic syndrome and related disorders","volume":" ","pages":"525-550"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-05-27DOI: 10.1089/met.2024.0031
Riley C C Brown, Jeff S Coombes, Marguerite M Conley, Lindsey Webb, Hannah L Mayr, Nicole M Isbel, Dev K Jegatheesan, Graeme A Macdonald, Nicola W Burton, Jaimon T Kelly, Ingrid J Hickman, Shelley E Keating
Aims: Exercise interventions positively affect numerous cardiometabolic risk factors. To better evaluate the health effects of exercise training, it may be more appropriate to evaluate risk factors together. The Metabolic Syndrome Severity Score (MetSSS) is a composite score representing cardiometabolic risk. Purpose: To evaluate the relationships between physical activity, neuromuscular fitness, exercise capacity, and the MetSSS in a heterogenous sample of people with complex chronic disease. Material and Methods: Fifty-three people with kidney or liver disease and at least one feature of the metabolic syndrome (MetS) were included. Pearson correlations were conducted between physical activity, neuromuscular fitness, exercise capacity, and the MetSSS. Linear regressions were performed for multi-level categorical variables. Independent variables with an association with MetSSS (P ≤ 0.2) were included in a multiple regression analysis. Results: The 6-minute walk test (6MWT) distance was inversely and independently associated with MetSSS [standardized beta coefficient (β) = -0.31, P = 0.04]. No relationship was found between MetSSS and physical activity or neuromuscular fitness. Mean 6MWT in the highest tertile was 550 m (range: 505-620 m) and 346 m (range: 233-408 m) in the lowest. The analysis showed a medium-large between-group effect for the difference in MetSSS for the lowest and highest tertile of 6MWT [Eta squared (η2) = 0.16, P = 0.01]. Conclusions: Exercise capacity was inversely and independently associated with MetSSS in people with complex chronic disease. Clinical trials with exercise interventions are needed to further investigate if improvements in exercise capacity result in clinically significant changes in the MetSSS.
{"title":"Evaluating the Potential of a Novel Metabolic Syndrome Severity Score to Inform Exercise Interventions for People with Complex Chronic Conditions.","authors":"Riley C C Brown, Jeff S Coombes, Marguerite M Conley, Lindsey Webb, Hannah L Mayr, Nicole M Isbel, Dev K Jegatheesan, Graeme A Macdonald, Nicola W Burton, Jaimon T Kelly, Ingrid J Hickman, Shelley E Keating","doi":"10.1089/met.2024.0031","DOIUrl":"10.1089/met.2024.0031","url":null,"abstract":"<p><p><b><i>Aims:</i></b> Exercise interventions positively affect numerous cardiometabolic risk factors. To better evaluate the health effects of exercise training, it may be more appropriate to evaluate risk factors together. The Metabolic Syndrome Severity Score (MetSSS) is a composite score representing cardiometabolic risk. <b><i>Purpose:</i></b> To evaluate the relationships between physical activity, neuromuscular fitness, exercise capacity, and the MetSSS in a heterogenous sample of people with complex chronic disease. <b><i>Material and Methods:</i></b> Fifty-three people with kidney or liver disease and at least one feature of the metabolic syndrome (MetS) were included. Pearson correlations were conducted between physical activity, neuromuscular fitness, exercise capacity, and the MetSSS. Linear regressions were performed for multi-level categorical variables. Independent variables with an association with MetSSS (<i>P</i> ≤ 0.2) were included in a multiple regression analysis. <b><i>Results:</i></b> The 6-minute walk test (6MWT) distance was inversely and independently associated with MetSSS [standardized beta coefficient (β) = -0.31, <i>P</i> = 0.04]. No relationship was found between MetSSS and physical activity or neuromuscular fitness. Mean 6MWT in the highest tertile was 550 m (range: 505-620 m) and 346 m (range: 233-408 m) in the lowest. The analysis showed a medium-large between-group effect for the difference in MetSSS for the lowest and highest tertile of 6MWT [Eta squared (η<sup>2</sup>) = 0.16, <i>P</i> = 0.01]. <b><i>Conclusions:</i></b> Exercise capacity was inversely and independently associated with MetSSS in people with complex chronic disease. Clinical trials with exercise interventions are needed to further investigate if improvements in exercise capacity result in clinically significant changes in the MetSSS.</p>","PeriodicalId":18405,"journal":{"name":"Metabolic syndrome and related disorders","volume":" ","pages":"516-524"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}