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第一届亚太地区关于
糖尿病、肥胖和高血压争议到共识会议 (CODHy)
中国上海,2011 年 6 月2 日~ 6 月5 日
 
  Metabolic Syndrome (MS) Print

METABOLIC SYNDROME, THE DIFFERENCE BETWEEN CRITERION IN MALE SUBJECTS

F.M.S. Adam (1), J.M.F. Adam (1)

1 Diabetes and Lipid Centre Wahidin Sudirohusodo Hospital, Division of Endocrinology, Department of Internal Medicine, Hasanuddin University,Makasar, Indonesia

 

Background. There is no universal criterion for the diagnosis of metabolic syndrome. In 2001 the NCEP ATP III introduced the clinical diagnosis of this syndrome. In 2005, the IDF introduced a new criterion that modifies NCEPATP III. Another criterion was introduce by AHA/NHLBI in 2010, basically the same as NCEP ATP III, except for lower   fasting blood sugar. Aim of this study is to compare the prevalence of metabolic syndrome among males using two different criterion, IDF and AHA/NHLBI.

Subjects and methods. Subjects were from the East Indonesia Diabetes Epidemiology Group. In this study we focused only to male subjects. We excluded those who were known as diabetes mellitus, on treatment for hypertension, and dyslipidemia. After 12-h fasting, blood were collected for fasting blood sugar, triglycerides, and HDL-cholesterol. In this study we used the Asia-Pacific criterion for waist circumference.

Results. During two years period 1439 males fulfill the criterion for screening. Compared to IDF criterion, more subjects with metabolic syndrome were diagnosed by AHA/NHLBI i,e  23.0% by  IDF and  33.2% with AHA/NHLBI. The overlap between these two criterion was 9.6%, whereas 13.4% have metabolic syndrome by IDF but not AHA/NHLBI and 23.6% by the AHA/NHBI but not the IDF criterion.

Conclusion. In this study, using the AHA/NHLBI detected more male metabolic syndrome compared to IDF criterion.

 

METABOLIC SYNDROME AND HYPOTHYROIDISM - ADDITIONAL RISK FACTORS IN CARDIOVASCULAR DISEASES

E.G. Circo (1), M.N. Beciu (1), R.E. Circo (1)

1 Ovidius University, Constanta, Romania

 

Introduction: Hypothyroidism correlate with metabolic syndrome is one of the major causes of risk in the development of degenerative cardiovascular pathology.

Methods: Patients were evaluate the characteristics of metabolic syndrome and dosage of the serum metabolic constant; assessment of the thyroid (serum hormone dosage level, thyroid antibodies, thyroid and cardiac ultrasonography). The data obtained were assessed in two differentiated study groups: group 1 - patients with cardio-vascular disease, metabolic syndrome and thyroid disease; group 2 - patients with cardio-vascular diseases and thyroid disease without metabolic syndrome.

Results: The incidence of metabolic syndrome in the study group was 45%. A percentage of 86% of patients with metabolic syndrome and endocrine diseases were associated with primary hypothyroidism. Females had a net prevail in group 1 (85%) and in group 2 (90%). The incidence of cardiovascular complications was maximum in group age 51-60 (54%). Cardiovascular complications were significantly as increased incidence (p <0.001) among cardiac patients associating metabolic syndrome and hypothyroidism.  Index calculation non-HDL - cholesterol revealed a higher risk among patients in group 2 (64%) associated with hypothyroidism, compared with those of batch 1 (47%). Hyperuricaemia was encountered more frequently among patients in group 2 (58%) compared to those in group 1 (42%). 86% of cases had primary hypothyroidism, sex ratio F:M=8:1. Cardiovascular complications were significantly higher among patients with metabolic syndrome and hypothyroidism (p<0.001); atherogenic index was 4.8 – group 1 and 5.6 – group 2.

Conclusions: Among patients with cardio-vascular diseases associated metabolic syndrome is frequent. Hypothyroidism represents an additional risk factor. It is necessary to determine serum thyroid hormones levels for the patients with coronary heart disease.

 

 

METABOLIC SYNDROME – POSSIBLE MARKER FOR ADRENAL INCIDENTALOMA FUNCTIONALITY

E.G. Circo (1), M.N. Beciu (1), R.E. Circo (1)

1 Ovidius University, Constanta, Romania

 

Introduction. The adrenal incidentaloma is defined as a mass lesion found unexpectedly in an adrenal gland by an imaging procedure performed for another reason than suspected adrenal pathology.

Objective: To estimate the incidence of the adrenal mass and to define the algorithm for managing patients with incidental adrenal mass and metabolic syndrome

Methods: Were studied 41 patients (7 men and 34 women) with typical computed tomography features of adrenal mass. The structure of the adrenal incidentaloma group (n=34) was: batch A-nonsecretory tumors (n=21) (61.8%-TN) and batch B-secretor tumors (n=13) (38,2%-TS) whereby 4 patients with one-sided pheochromocytoma, 5 with Cushing syndrome, 2 with subclinical Cushing syndrome and 2 with adrenal hypertrophy.

Results :Overweight or obesity were found in 33,3% by batch A and 30,8% by batch B ; hypertension in 61,9% by batch A  and 69,2% by batch B; diabetes mellitus in 19% by batch A and 30,8% by batch B ; dislipidemia in 42,9% by batch A and 30,8% by batch B; osteoporosis in14,3% by batch A and 23,1% by batch B.

Conclusions: The tumor assess, the imagistic features and the quality of secretory/ nonsecretory tumor is essential. Some features of the metabolic syndrome described to the patients with adrenal incidentalomas are enlarged the medically problem and sometime may be considered the evidence for functional involvement of incidentaloma.

 

 

THE INCIDENCE OF METABOLIC SYNDROME IN A GROUP OF PATIENTS WITH IMPAIRED GLUCOSE TOLERANCE

E.G. Circo (1), M. Seceleanu (1), M. N. Beciu (1)

1 Ovidius University, Constanta, Romania

 

Introduction: Altered carbohydrate metabolism is a component of metabolic syndrome symptoms.

Aim of the study: Determination of incidence and the cardiovascular risk of metabolic syndrome in patients with impaired glucose tolerance.

Material and method: Descriptive study, epidemiological and transverse including 362 adult patients with impaired glucose tolerance. Diagnostic criteria of metabolic syndrome were defined by the "International Diabetes Federation (IDF)," The 3rd Report of the National Cholesterol Education Program (NCEP-ATP III) and the World Health Organization (WHO).

Results: The incidence of metabolic syndrome was: 80.2% (IDF) and 72.6% (NCEP-ATP III) and 68.5% (WHO); among smokers was significantly higher (p <0.005) 93% (IDF), 84% (NCEP-ATP III) and 81% (WHO) than non-smokers: 64% (IDF), 61% (NCEP -ATP III) and 57.4% (WHO). Percentage metabolic syndrome was more common in sedentary patients: 91.5% (IDF), 81.2% (NCEP-ATP III) and 80% (WHO) versus those with constant physical activity 73.2% (IDF), 69.8% (NCEP-ATP III) and 71% (WHO) (p <0.001); was more common (p <0.001) in males compared with females: 61% / 39% (IDF) 63% 37% (NCEP-ATP III) and 58% 42% (WHO); low significant (p<0.05) for alcohol consumption.

Coronary heart disease and stroke were more frequent (p <0.001) in patients with metabolic syndrome than those without symptomatic criteria of  syndrome: 27% / 2% (IDF), 38% / 5% (NCEP-ATP III) and 25% / 7% (WHO); moderate significance (p <0.05%) in men compared to women: 18% / 12% (IDF), 21% / 15% (NCEP-ATP III) and 17% / 11 % (WHO).

Conclusions: Association of metabolic syndrome / impaired glucose tolerance is common. Prevention of cardiovascular complications for these patients involves early diagnosis of metabolic syndrome.

 

DIAGNOSTIC VALUE OF CHEMICAL BIOMARKERS IN THE PREDICTION OF NON ALCOLIC STEATO HEPATITIS (NASH) IN DIABETICS’ MELLITUS PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE

F. Gharibi (1), S. Hasani (2), A. Sharifian (3)

1 Kurdistan University of Medical Science, Sanandaj, Iran

2 Medical University of Kurdistan

3 Kurdistan Digestive Research Center

 

Background: Liver biopsy is considered as the gold standard for assessing non-alcoholic fatty liver disease (NAFLD) histological lesions. The aim of this study was to determine the diagnostic utility of non-invasive biochemical markers for prediction non alcoholic steatohepatitis among diabetic mellitus type 2 patients with NAFLD.

Methods: 198 Diabetic mellitus type 2 patients were screened with abdominal sonography to evaluate prevalence of NAFLD among them .100 patients (51%) had NAFLD .finally، Thirty three patients diagnosed with liver statuses by ultrsonographic examination participated in the study. accordig there liver biopsies، they had two groups; simple statuses and NASH(Borderline and overt non alcoholic steatohepatitis). chemical biomarkers results of them compare with X2 and Fisher test.

Results: Twenty one patients (63.6%) had Non alcoholic steatohepatitis (NASH) consist of 9 patients with overt and 12 patients with Borderline NASH and Twelve OF them (36.4%) had simple steatosis.Average of AST in steatosis group was 23.6 and in NASH group was 26.85 that not significant Average of ALT in steatosis group was34.4 and in NASH group was35.1 that not significant، Average of GGT and ALP in steatosis group and NASH was not significant. age ،BMI،Serum Cholestrol ،Serum triglyceride، total and direct Billirubin had not significant differences amog them.

Conclusion: In Diabetic mellitus type 2 patients with NAFLD، biochemical markers could not predicted non alcoholic steatohepatitis from simple steatosis.

 

COLLAGEN-IV CONTRIBUTES TO NITRIC OXIDE-INDUCED ANGIOGENESIS OF AORTIC AND LUNG ENDOTHELIAL CELLS

W. Han (1), H. Wang (1), Y. Su (1)

1 Department of Pharmacology & Toxicology, Georgia Health Sciences University, Augusta, GA 30912, USA

 

Nitric oxide (NO) mediates endothelial angiogenesis via inducing the expression of integrin ?v?3. During angiogenesis, endothelial cells adhere to and migrate into the extracellular matrix through integrins. Collagen-IV binds to integrin ?v?3 leading to integrin activation which affects a number of signaling processes in endothelial cells. In the present study, we evaluated the role of collagen-IV in NO-induced angiogenesis. Aortic and lung endothelial cells were incubated with NO donor 2,2'-(hydroxynitrosohydrazino) bis-ethanamine (NOC-18) and then collagen-IV mRNA and protein as well as monolayer wound repair, cell proliferation, and tube formation were determined. Our results showed that NO donor 2,2'-(hydroxynitrosohydrazino) bis-ethanamine (NOC-18) causes increases in collagen-IV mRNA and protein in aortic and lung endothelial cells. Addition of collagen-IV into the coating of endothelial culture increases endothelial monolayer wound repair, proliferation and tube formation. Inhibition of collagen-IV synthesis using gene silencing attenuates NOC-18-induced increases in monolayer wound repair, cell proliferation and tube formation as well as in the phosphorylation of focal adhesion kinase (FAK). Integrin blocking antibody LM609 prevents NOC-18-induced increase in endothelial monolayer wound repair. Inhibition of protein kinase G (PKG) using the specific PKG inhibitor KT5823 or PKG siRNA prevents NOC-18-induced increases in collagen-IV protein and mRNA and endothelial angiogenesis. Together, these results indicate that NO promotes collagen-IV synthesis via PKG signaling pathway and that the increase in collagen-IV synthesis contributes to NO-induced endothelial angiogenesis through integrin-FAK signaling.

 

EFFECTS OF MEASURES AND POLICIES BASED ON PREVENTIVE GUIDANCE AND INTERVENTION FOR THE METABOLIC SYNDROME

H. Imai (1), H. Nakao (1), F. Sata (1)

1 National Institute of Public Health, Japan

 

Objective: In Japan, measures were instituted via preventive guidance and intervention for people with the metabolic syndrome (METS) based on national lifestyle disease countermeasures from 2008. The objective of this research was to collect data from people receiving health checks and investigate public guidance and intervention to clarify results of this large-scale social experiment on public health.

Method: Model prefectures were selected in regions throughout Japan to avoid regional bias and data were collected from METS patients and a reserve group in these prefectures. People who did or did not receive health guidance and intervention were analyzed to determine the effects such activities.

Results: This study was performed on 383,430 people from 40 to 74 years old examined for METS in 8 model prefectures. They included 60,964 who received health guidance. To clarify effects of preventive guidance and intervention, differences in changes in body weights, waist size, blood glucose (HbA1c), triglycerides and blood pressure for 2008 and 2009 were analyzed. Body weights dropped by 2.4% in men and 3.0% in women. Other values also showed decreases.

Discussion: Quantitative evaluation was performed on health guidance in the first year of a new system of measures against lifestyle diseases. Data were collected nationwide to avoid bias and the effects of health guidance and intervention were examined. Prompt clarification of these results is indispensable in validation of the new preventive measures. The results are highly useful for all persons related to this system.

 

SOCIOECONOMIC STATUS AND METABOLIC SYNDROME AMONG RURAL WOMEN OF BANGLADESH

A.M.S. Islam (1,2), S. Jesmin (1,2), M.R. Islam (1,2), M.S. Mia (1,2), S.N. Sultana (1,2), S. Zaedi (1,2), S. Kimura (1)

1 National Center for Global Health and Medicine (NCGM), Tokyo, Japan

2 Health and Diseases Research Center for Rural Peoples (HDRCRP), Dhaka, Bangladesh

 

Background: Metabolic syndrome (MS) is now considered as a global epidemic. Although, socioeconomic status (SES) has been identified as an important determinant of health across a broad range of health issues, however, no previous studies of MS so far have explicitly examined the effect of SES in the Bangladeshi context. The purpose of this study, thus, was to estimate the prevalence of MS and its association with the socioeconomic conditions in Bangladeshi rural women.

Methods: A total of 1485 apparently healthy rural women aged ≥15 years were studied using a population based cross-sectional survey following the World Health Organization's STEPS approach (modified). Education, family income, land ownership and living housing area were considered as indicators of SES.

Results: The prevalence of MS was 35.56. Higher prevalence was found among the respondents with higher SES (MS vs. non-MS: family income ≥140 USD 3.6% vs. 2.7%, family income 70-139 USD 21% vs. 15.5%, family income <70 USD 74.5% vs. 78%, p=0.071; family having land 71.8% vs. 52.3%, family having no land 26.6% vs. 43.2%, p=<0.001; family living area >1,000 sq. ft 84.4% vs. 70.5%, family living area ≤1,000 sq. ft 15.6% vs. 29.5%, p=<0.001; having formal education 43.3% vs. 50.4%, having no education 56.7% vs. 49.6%, p=0.017).

Conclusions: MS was significantly more prevalent among upper SES compared to lower SES which indicates SES as an emerging risk factor of MS in developing countries like Bangladesh which further calls for a need of promoting health awareness and increasing healthy rural amenities for prevention.

 

PREVALENCE OF METABOLIC SYNDROME IN PRE- AND POST- MENOPAUSAL RURAL WOMEN OF BANGLADESH: RESULT FROM A POPULATION- BASED STUDY

R. Islam (1,2), S. Jesmin (1,2), S. Mia (1,2), A.M.S. Islam (1,2), S.N. Sultana (1,2), S. Zaedi (1,2), A. Rahman (1), N. Yamaguchi (2), M. Hiroe (2), S. Kimura (2)

1 Health and Diseases Research Center for Rural Peoples (HDRCRP), Dhaka, Bangladesh

2 National Center for Global Health and Medicine (NCGM), Tokyo, Japan

 

Background: Gender differences in prevalence and consequences of the metabolic syndrome (MS) as a strong predictor of cardiovascular disease (CVD) are challenging problems. Post-menopausal status may explain in part the cause of acceleration of CVD with aging.

Aim: The present community-based, cross-sectional investigation was aimed at identifying the principal components of risk variables associated with the metabolic syndrome in pre-menopause and post-menopausal Bangladeshi rural women.

Methods: This is a descriptive cross-sectional study carried out at rural Bangladeshi women. Socio-demographic information, anthropometric measurements and blood pressure were obtained from the subjects in a standardized manner. Venous samples were collected for necessary investigations and analyzed at the hospital central laboratory.

Findings: 1802 subjects (1094 pre-menopause and 708 post-menopause) with a mean age of 39.9 ± 13.9 (range 15-85) years were studied. Prevalence of the modifiable cardiovascular risk factors screened were as follows: generalized BMI>=30kg/m2 2.8% (pre-menopause 3.0%, post-menopause 2.5%, p=0.333), truncal obesity 8.4% (pre-menopause 8.4%, post-menopause 8.4%, p=0.51), hypertension 28.2% (pre-menopause 14.5%, post-menopause 49.4%, p<0.001), elevated fasting blood glucose (>=6.1 mmol/L) 35.4% (pre-menopause 26.2%, post-menopause 49.6%, p<0.001), hypercholesterolaemia 35.5% (pre-menopause 32.8%, post-menopause 39.7%, p=0.002), elevated LDL-cholesterol 42.7% (pre-menopause 41.5%, post-menopause 44.0%, p=0.208), low HDL-cholesterol 84.0% (pre-menopause 80.7%, post-menopause 87.3%, p<0.001), hypertriglyceridaemia 28.7% (pre-menopause 23.2%, post-menopause 37.1%, p<0.001), MS 25.8% (pre-menopause 17.4%, post-menopause 38.8%, p<0.001) and atherogenic index (HDLc/TC<0.18) 32.8% (pre-menopause 23.4%, post-menopause 42.2%, p<0.001).

Conclusions: The prevalence of metabolic syndrome and the associated modifiable cardiovascular risk factors were higher in post-menopausal women compared to those in pre-menopausal women in rural Bangladesh.

 

PREVALENCE OF METABOLIC SYNDROME AMONG RURAL BANGLADESHI WOMEN

R. Islam (1,2), S. Mia (1,2), A. Rahman (1), S.N. Sultana (1,2), R. Mahmood (1), A.M.S. Islam (1,2), S. Zaedi (1,2), N. Yamaguchi (2), M. Hiroe (2), S. Kimura (2), S. Jesmin (1,2)

1 Health & Diseases Research Center for Rural Peoples (HDRCRP), Dhaka, Bangladesh

2 National Center for Global Health and Medicine (NCGM), Tokyo, Japan

 

Objective: Metabolic syndrome (MS) is described as a cluster of abnormalities that confers an increased risk of developing atherosclerotic cardiovascular diseases and also type 2 diabetes mellitus. MS is now considered as a global epidemic; with current estimates revealing that about 20-30% of the adult population worldwide is affected by this syndrome. The purpose of the present study was to assess the prevalence of metabolic syndrome - related disorders in rural women of Bangladesh.

Methods: In the present study, a total of 1485 apparently healthy rural Bangladesh women aged >=15 years were studied using a population based cross-sectional survey according to the World Health Organization’s STEPS approach (modified). The prevalence of MS was estimated using NCEP ATP III, modified NCEP ATP III and IDF criteria.

Results: The prevalence rates of MS were 25.05% (NCEP ATP III), 35.56% (modified NCEP ATP III), and 17.51% (IDF), as revealed by the present study. Furthermore, 10.03% had excess waist circumference, 29.43% had elevated blood pressure, 30.57% had elevated fasting plasma glucose level, 85.05% had low HDL values and 26.87% had increased triglyceride values. Low plasma HDL level was found to be the most common abnormality in this population. Elevated waist circumference was the least frequent component.

Conclusions: The present study shows a high prevalence of MS and its associated risk factors in rural Bangladeshi women. These findings are important in that they provide insights that should be helpful in formulating public health policy and in the development of future health prevention strategies in Bangladesh.

 

ASSESSING PREVALENCE OF METABOLIC SYNDROME AND ASSOCIATION OF THIS SYNDROME WITH CORONARY HEART DISEASE (CHD) IN PATIENTS WERE REFERRED TO THE HEART CENTER OF HAMEDAN UNIVERSITY OF MEDICAL SCIENCE

L. Jamshidi (1), A. Seif (1)

1 Islamic Azad University, Hamedan Branch, Iran

 

Objective: The metabolic syndrome is a growing health problem in the world. The metabolic syndrome, which consists of multiple interrelated risk factors, increases the risk for atherosclerotic cardiovascular disease by 1.5-3 folds, and raises the risk for type 2diabetes by 3-5 folds. It affects over 26 percent   of adults, or over 50 million Americans. Patients with metabolic syndrome (M.S) are known to be at high risk for heart disease and diabetes. The aim of this study was, Assessing prevalence of metabolic syndrome and association of this   syndrome with coronary heart disease in patients were referred to the heart center of Hamedan University 1387.

Methods: a cross sectional study has been made with 1064 patient. We examined all C.H.D patient (at total 514) attended in a heart center during 3 month and 550 without CHD disease. Patients with 3 or more of the following symptoms (NCEP & ATPIII criteria) are considered to have the Metabolic syndrome: abdominal obesity (waist >102 cm for men; >88 cm for women), increased triglycerides (>150 mg/dl); low HDL-C (<40 mg/dl in men; <50 mg/dl in women), elevated blood pressure ≥130/≥85 mmHg, and a raised fasting glucose (≥110 mg/dl).

Results: we have found significant differences between M.S and C.H.D. The prevalence of M.S was 32.5 in patient and 21.3 in other population. There were 46.3% women &53.7% men and 13.6% smoking. Hypertriglyceridemia equal to or over 150 mg/dl was 39.1%

Conclusion: The prevalence of M.S in the sample of C.H.D patient was very high, and their correlation with other risk factors very significant .Thus, the cardiovascular risk of this patient is very high.

 

CIRCULATING LEVELS OF VEGF AND ITS RECEPTORS, sVGEF-R1 AND sVEGF-R2 IN METABOLIC SYNDROME IN BANGLADESHI RURAL WOMEN

S. Jesmin (1,2), N. Yamaguchi (2), R. Islam (1,2), S. Mia (1,2), A.M.S. Islam (1,2), S.N. Sultana (1,2), S. Zaedi (1,2), M. Moroi (2), M. Hiroe (2)

1 Health and Diseases Research Center for Rural Peoples (HDRCRP), Dhaka, Bangladesh

2 National Center for Global Health and Medicine (NCGM), Tokyo, Japan

 

Objective: Metabolic syndrome (MS) is associated with impaired angiogenesis where vascular endothelial growth factor (VEGF) plays a key role in angiogenesis through binding to its specific receptor, sVEGF-R1 and sVEGF-R2. The purpose of the present study was to assess circulating levels of VEGF, sVEGF-R1, and sVEGF-R2 in subjects with Metabolic Syndrome (MS) or without metabolic syndrome (non-MS) and further examined their association with clinical and metabolic parameters.

Methods and results: A total of 1485 rural Bangladeshi women aged ≥15 years were studied using a population based cross-sectional survey. The prevalence rates of MS were 25.05% (NCEP ATP III). VEGF levels were significantly increased in MS subjects (MS vs. non-MS: 575 vs. 490, p<0.001). There were no significant relation of sVEGF-R1 and sVEGF-R2 with MS (sVEGF-R1, MS vs. non-MS: 446 vs. 667, p=0.093; sVEGF-R2, MS vs. non-MS: 8943 vs. 9400, p=0.0.344). In multivariable analyses, we found that VEGF had significant positive associations with fasting blood glucose (r=0.181, p<0.001), BMI (r=0.143, p<0.001), cholesterol (r=0.101, p<0.001), non-HDL cholesterol (r=0.091, p<0.001), LDL cholesterol (r=0.079, p=0.007), insulin(r=0.075, p=0.022), DBP (r=0.064, p=0.025) and SBP (r=0.057, p=0.048) even after adjusting for age. Multiple regression analysis revealed that fasting blood glucose (beta= 0.158, p = 0.001) and BMI (beta = 0.083, p = 0.017) were independent determinants of VEGF. We also found that mean VEGF levels increased in proportion to the accumulation of components of MS.

Conclusions: The correlation of VEGF needs further investigations to define the clinical utility and predictive value of serum VEGF levels in MS.

 

INSULIN RESISTANCE, INFLAMMATION, AND NONALCOHOLIC FATTY LIVER DISEASE IN THE METABOLICALLY HEALTHY AND NON-OBESE ADULTS OVER 50 YEARS

S. Kim (1), J. Choi (1). M. Kim (1)

1 Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea

 

Objective: The aim of this study is to examine the association of insulin resistance and inflammation with NAFLD in metabolically healthy and non-obese adults over 50 years.

Materials/Methods: This was a cross sectional study of 759 subjects who were aged 50 years and older. Diagnosis of NAFLD was based on sonographic evidence of fatty liver without significant alcohol consumption and other cause of chronic liver disease. We defined metabolically healthy subjects as having nothing of metabolic components: high blood pressure (130/85 mmHg), elevated fasting glucose (100 mg/dL), hypertriglyceridaemia (150 mg/dL), low high density lipoprotein-cholesterol (men, <40 mg/dL; women, <50 mg/dL), and abdominal obesity measured by a waist circumference of 90 cm for men and 80cm for women. High sensitivity C-reactive protein (hs-CRP), homeostasis model assessment of insulin resistance (HOMA-IR), and uric acid were divided into quartile groups. We computed odds ratios (OR) for each quartile relative to the lowest quartile group.

Results: After adjusting for age, sex, smoking status, regular exercise, hs-CRP, HOMA-IR, and uric acid, significant association was found between NAFLD and higher levels of hs-CRP, HOMA-IR, and uric acid. After adjusting for age, sex, smoking status, regular exercise, hs-CRP, HOMA-IR, and uric acid, the ORs(95% confidence interval) of NAFLD with the highest quartile of hs-CRP, HOMA-IR, and uric acid comparing the lowest quartile of them were 2.58(1.03-6.50), 2.55(1.08-6.05), and 5.15(1.78-14.89), respectively.

Conclusions: Insulin resistance and inflammation are associated with NAFLD in metabolically healthy and non-obese adults over 50 years.

 

QUERCETIN/ ADENOSINE COMBINATION INDUCED INSULIN RESISTANCE IN HIGH FAT DIET-FED MICE

C.Y. Lee (1)

1 Monash University, Sunway Campus

 

Food-drug or food-food interactions refer to a situation whereby one or more substances alter(s) the bioavailability or the clinical effectiveness of the other substance when they are being taken concomitantly. Both quercetin and adenosine are plant constituents reported to be effective in improving dyslipidemia. This study looked at the summative effect of these two compounds in high fat diet-induced obesity. C57BL/6 mice were divided into five groups, and each group was fed with the following diet: low fat diet or control (C); high fat diet (HF); high fat diet + 0.8% quercetin incorporated into drinking water (Q); high fat diet + 0.01% adenosine in water (A); and high fat diet + 0.8% quercetin + 0.01% adenosine, both compounds dissolved in water (QA). Results showed that quercetin in the presence of adenosine (QA), was not effective in preventing body weight gain and adiposity. QA potently kept the plasma glucose and adiponectin at basal levels, but significantly elevated insulin level, implying the onset of insulin resistance (IR). Adenosine and quercetin, which separately up-regulated endothelial nitric oxide synthase (eNOS) expression, caused a distinctive reduction of eNOS expression when given as a mixture to mice. As reported, IR led to the impairment of insulin-induced eNOS activation. Quercetin per se did not have any effect on liver fatty acid-binding protein (LFABP) expression. However, quercetin together with adenosine, have down-regulated LFABP. In conclusion, there was no beneficial effect of consuming two compounds which individually claimed to improve metabolic syndrome parameters.

 

MODELING OF LIVER GLUCOSE METABOLISM OUTGOING FROM POSITRON EMISSION TOMOGRAPHY WITH PHYSIOLOGICALLY INTERPRETED MODEL PARAMETERS

Z. Rausova (1), J. Chrenova (1), P. Nuutila (2), P. Iozzo (3), L. Dedik (1)

1 Faculty of Mechanical Engineering, Slovak University of Technology, Bratislava, Slovakia

2 Turku PET Centre, University of Turku, Turku, Finland

3 Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy

 

Aims: Our aims were to develop mathematical models, capable of evaluating mechanisms within the liver and/or the whole-body blood metabolism; to obtain novel information to the role of liver blood flow and the other significant physiologically interpreted parameters; to experimentally validate the constructed circulatory model using the data from a pig trial and to simulate measured plasma tracer concentration-time profiles of the individuals enrolled; to find differences in physiologically interpreted parameters between the two groups of pigs in a fasting state and in euglycemic supraphysiological hyperinsulinemia.

Materials and Methods: The group of pigs in a fasting state and the group of pigs with euglycemic supraphysiological hyperinsulinemia were scanned by positron emission tomography after a single dose of [18F] FDG tracer and at the same time frequent sampling was obtained in carotid artery, portal vein and hepatic vein. Structural mathematical models with physiologically interpreted parameters were used. A system-approach was used to the liver and/or the whole-body system by the tools of the linear dynamic system theory.

Results: Three kinds of structural models, single input and single output or multiple outputs and multiple inputs and single output, were verified. Differences between the group of fasting pigs and the group of pigs in euglycemic supraphysiological hyperinsulinemia were found from the view of the estimated parameters of the structural models.

Conclusion: Suitability of the structural mathematical models for the estimation of physiologically interpreted parameters from PET was validated.

 

EFFECTS OF 4 YEAR TESTOSTERONE TREATMENT ON COMPONENTS OF THE METABOLIC SYNDROME

F. Saad (1,2), A. Haider (3), L.J. Gooren (4)

1 Bayer Schering Pharma, Scientific Affairs Men’s Healthcare

2 Gulf Medical University School of Medicine, Ajman, UAE

3 Private Urology Praxis, Bremerhaven, Germany

4 Endocrinology, VUmc, Amsterdam, The Netherlands

 

Background: Elderly men often show a concurrence of a decline of testosterone with features of the metabolic syndrome. This study tested the effects of normalization of testosterone.

Materials and methods: 136 hypogonadal men (38 – 83 years, mean 60.6 ± 8.0 years), with testosterone levels between 0.14 –4.51 ng/mL (N>4.90 ng/ml) were treated with parenteral testosterone undecanoate for 4 years as the sole intervention.

Results: Plasma testosterone rose from 3.3 ± 1.9 ng/mL to 4.1 ± 1.5 ng/mL (P< 0.01) at 3 months, then stabilized at 6.8 ± 1.3 ng/mL after the first 6 months.  There was a remarkable progressive linear decline of body weight, waist circumference, serum cholesterol, triglycerides, LDL-cholesterol and C-reactive protein over the 4 year period.  Plasma glucose declined over the first 18 months. There was a significant decrease of levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) over the first 24 months, then values leveled off. Both systolic and diastolic blood pressure decreased over the first 30 months.  At baseline 52/136 met the criteria of the metabolic syndrome as defined by the National Cholesterol Education Program (2001); after two years of testosterone treatment this number had declined to 12/136.

Conclusion: With testosterone treatment over four years, the most significant  improvement of the metabolic syndrome, including blood pressure, was noted  over the first 24 months but over the following 24 months improvements were at least maintained or even further improvement was observed.  Decreases in AST and ALT are likely to indicate improvement of liver steatosis.

 

WAIST TO THIGH RATIO AS A PREDICTOR OF INSULIN RESISTANCE: A CROSS-SECTIONAL STUDY OF KOREAN WOMEN

K.Y. Son (2), S.J. Kim (1), J.H. Park (1), B. Cho (1)

1 Department of Family Medicine, Seoul National University Hospital, Seoul, Korea

2 Center for Health Promotion, Seoul National University Hospital, Seoul, Korea

 

Background: Insulin resistance is the strongest predictor of non-insulin-dependent diabetes mellitus and visceral obesity is regarded as a major cause. The purpose of this investigation is to ascertain if waist to thigh ratio can be used as a reliable marker for insulin resistance.

Methods: The subjects of this cross sectional study were 95 women above 20 years old who visited a university hospital obesity center between December 2009 and June 2010. History taking and anthropometric measurements were conducted by a single trained physician. Insulin resistance is defined as HOMA-IR above 3.04.

Results: Median age of total participants was 37.43+ 11.45 years. HOMA-IR showed a positive correlation with body weight, BMI, hypertension, waist circumference, waist to thigh ratio, triglyceride and LDL cholesterol while showing a negative correlation with HDL cholesterol by the Spearman’s rank correlation analysis. A simple linear regression analysis showed a positive correlation between waist to thigh ratio and log-transformed HOMA-IR (R2:0.07,P<0.01). Waist to thigh ratio proved to be the most useful marker for the detection of insulin resistance showing AUC 0.70±0.55 (P<0.005) by the ROC curve when compared with other traditional index such as BMI, waist circumference and waist to hip ratio. The ROC curve demonstrated that the optimal waist to thigh ratio for discriminating insulin resistance was 1.46 (sensitivity: 80.0%, specificity: 51.4%)(P<0.001).

Conclusion: There is a positive association between waist to thigh ratio and HOMA-IR. Waist to thigh ratio is a useful and reliable marker for the detection of insulin resistance.


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