Epidemiological characteristics of hyperuricemia in metabolic syndrome and its different components in the physical examination population

Objective:To explore the epidemiological characteristics of hyperuricemia(HUA)in the metabolic syndrome(MS)and its different components in the physical examination population.Methods:Subjects who underwent medical check-ups at a hospital health management center from June 2021 to March 2023 were included in the study.To analyze the prevalence of HUA in MS and its different components,further,stratify the study population by gender and assess the serum uric acid(SUA)levels and prevalence of HUA in people with different numbers of MS components and the combination of MS components with the highest prevalence of HUA in both sexes.Logistic regression was used to analyze the risk of HUA in people with different numbers of MS components.Result:A total of 66,520 individuals were enrolled in the study.SUA levels(t=-82.947,P<0.001)and HUA prevalence(χ^(2)=3421.632,P<0.001)were significantly higher in the MS group than in the Non-MS group.SUA levels and prevalence of HUA were significantly higher in abdominal obesity,hypertension,decreased HDL-C and evaluated TG than in normal subjects(P<0.001),while there were gender differences in SUA levels and HUA prevalence in diabetic patients,with significantly lower SUA levels and HUA prevalence in men with diabetes than in those with normal blood glucose,an opposite result in women.SUA levels and HUA prevalence gradually increased with the increasing number of MS components in women,whereas in men,such a trend was only observed in MS1-MS4.The combination of MS components with the highest prevalence of HUA was abdominal obesity+hypertension+decreased HDL-C+evaluated TG(54.35%)in men and abdominal obesity+hypertension+diabetes+decreased HDL-C+evaluated TG(41.46%)in women.Logistic regression analysis showed that after adjusting for gender,age and ethnicity,the risk of HUA increased with the number of MS components in women,while in men,the risk of HUA increased continuously from MS1-MS4.Further adjustment for BMI,elevated TC,elevated LDL-C,and coronary artery disease,the results remained consistent.Conclusion:MS and its components are risk factors for HUA in the physical examination population,with different combinations of MS components having different correlations with HUA,and the risk of developing HUA correlates with the number of abnormal MS components.

Metabolic Syndrome: Epidemiological, Clinical and Biological Profiles in the Cardiology and Internal Medicine Departments of the Mother-Child CHU “Luxembourg”

Introduction: The metabolic syndrome is a clinical entity defined by the association in the same subject of four of the following five factors: abdominal obesity (or android), type 2 diabetes, hypertension, hypo HDL cholesterolemia, hypertriglyceridemia. The aim of the work was to study the epidemiological, clinical-biological profiles and complications of patients in the cardiology and internal medicine department of the Mother-Child CHU “Luxembourg”. Materials and Methods: We carried out a cross-sectional study, from September 2019 to June 2020 in the cardiology and internal department of the mother-child CHU “Luxembourg”. All patients with metabolic syndrome admitted to the two departments who agreed to participate during the study period were included in the study. These patients meet the 2009 harmonization attempt criteria (IDF 2009). The variables studied were: socio-demographic characteristics (sex, age, profession), pathological history, clinical signs (functional signs, BMI, waist size), paraclinical signs (ECG, cardiac ultrasound, laboratory assessment) and complications. Results: A total of 104 patients were included. The female sex represented 58.65% of cases. The 60 to 69 age group was the majority with 40.78%, housewives occupied 41.34% of cases. Diabetes, arterial hypertension and dyslipidemia were the most represented cardiovascular risk factors with respectively: 80.77%, 79.81% and 53.85%. Visual blurring was the most common functional sign with 23.08% of cases. Moderate obesity was observed in 34% of patients. Waist circumference was high in 39.53% of male patients and 37.70% of female patients. Cardiac ultrasound found a severely collapsed ejection fraction in 25% of patients. HDL-c levels were low in 64.52% of male patients and 75% of female patients. The most observed complications were: dyslipidemia (53.85%), stroke and renal failure with 23% respectively. Conclusion: The metabolic syndrome remains a real public health problem, constantly increasing in our populations and constitutes a danger by its constituent elements.

Application of the back-error propagation artificial neural network(BPANN) on genetic variants in the PPAR-γ and RXR-α gene and risk of metabolic syndrome in a Chinese Han population

This study was aimed to explore the associations between the combined effects of several polymorphisms in the PPAR-γ and RXR-α gene and environmental factors with the risk of metabolic syndrome by back-error propaga- tion artificial neural network （BPANN）. We established the model based on data gathered from metabolic syndrome patients （n = 1012） and normal controls （n = 1069） by BPANN. Mean impact value （MIV） for each input variable was calculated and the sequence of factors was sorted according to their absolute MIVs. Generalized multifactor dimensionality reduction （GMDR） confirmed a joint effect of PPAR-9＂ and RXR-a based on the results from BPANN. By BPANN analysis, the sequences according to the importance of metabolic syndrome risk fac- tors were in the order of body mass index （BMI）, serum adiponectin, rs4240711, gender, rs4842194, family history of type 2 diabetes, rs2920502, physical activity, alcohol drinking, rs3856806, family history of hypertension, rs1045570, rs6537944, age, rs17817276, family history of hyperlipidemia, smoking, rs1801282 and rs3132291. However, no polymorphism was statistically significant in multiple logistic regression analysis. After controlling for environmental factors, A1, A2, B1 and B2 （rs4240711, rs4842194, rs2920502 and rs3856806） models were the best models （cross-validation consistency 10/10, P = 0.0107） with the GMDR method. In conclusion, the interaction of the PPAR-γ and RXR-α gene could play a role in susceptibility to metabolic syndrome. A more realistic model is obtained by using BPANN to screen out determinants of diseases of multiple etiologies like metabolic syndrome.

Exploratory metabolomics of metabolic syndrome: A status report

Metabolic syndrome(MetS) is as a cluster of cardio-metabolic factors that greatly increase the risk of chronic diseases such as type II diabetes mellitus and atherosclerotic cardiovascular disease. In the United States, obesity, physical inactivity, aging, and genetics(to a minor extent) have arisen as risk factors for developing MetS. Although 35% of American adults suffer from MetS, its pathogenesis largely remains unknown. Worse, there is a lack of screening and optimum therapy for this disease. Researchers have consequently turned towards metabolomics to identify biomarkers to better understand MetS. The purpose of this review is to characterize various metabolites and their potential connections to MetS. Numerous studies have also characterized MetS as a disease of increased inflammation, and therefore this review also explores how metabolites play a role in various inflammatory pathways. Our review explores a broad range of metabolites including biogenic amines, branched chain amino acids, aromatic amines, phosphatidylcholines, as well as a variety of other molecules. We will explore their biochemical pathways and their potential role in serving as biomarkers.

Alcohol consumption and metabolic syndrome among Shanghai adults: A randomized multistage stratified cluster sampling investigation

AIM: To examine the relations of alcohol consumption to the prevalence of metabolic syndrome in Shanghai adults. METHODS: We performed a cross-sectional analysis of data from the randomized multistage stratified cluster sampling of Shanghai adults, who were evaluated for alcohol consumption and each component of metabolic syndrome, using the adapted U.S. National Cholesterol Education Program criteria. Current alcohol consumption was defined as more than once of alcohol drinking per month. RESULTS: The study population consisted of 3953 participants (1524 men) with a mean age of 54.3 ± 12.1 years. Among them, 448 subjects (11.3%) were current alcohol drinkers, including 405 males and 43 females. After adjustment for age and sex, the prevalence of current alcohol drinking and metabolic syndrome in the general population of Shanghai was 13.0% and 15.3%, respectively. Compared with nondrinkers, the prevalence of hypertriglyceridemia and hypertension was higher while the prevalence of abdominal obesity, low serum high-density-lipoprotein cholesterol (HDL-C) and diabetes mellitus was lower in subjects who consumed alcohol twice or more per month, with a trend toward reducing the prevalence of metabolic syndrome. Among the current alcohol drinkers, systolic blood pressure, HDL-C, fastingplasma glucose, and prevalence of hypertriglyceridemia tended to increase with increased alcohol consumption. However, low-density-lipoprotein cholesterol concentration, prevalence of abdominal obesity, low serum HDL-C and metabolic syndrome showed the tendency to decrease. Moreover, these statistically significant differences were independent of gender and age.CONCLUSION: Current alcohol consumption is associated with a lower prevalence of metabolic syndrome irrespe- ctive of alcohol intake (g/d), and has a favorable influence on HDL-C, waist circumference, and possible diabetes mellitus. However, alcohol intake increases the likelihood of hypertension, hypertriglyceridemia and hyperglycemia. The clinical significance of these findings needs further investigation.

Protective effect of alcohol consumption for fatty liver but not metabolic syndrome

AIM:To investigate the effect of alcohol on the metabolic syndrome (MS) and fatty liver in Japanese men and women.METHODS:A cross-sectional study was conducted in a medical health checkup program at a general hospital.This study involved 18 571 Japanese men and women,18-88 years of age,with a mean body mass index of 22.6 kg/m 2.A standardized questionnaire was administered.The total amount of alcohol consumed per week was calculated,and categorized into four grades.Fatty liver was examined by ultrasound modified criteria of the revised National Cholesterol Educa-tion Program Adult Treatment Panel Ⅲ and the new International Diabetes Federation.RESULTS:The prevalence of fatty liver decreased in men and women with light to moderate alcohol consumption,whereas the prevalence of MS was not so changed.The prevalence of fatty liver of any grade in men was lower than that in those with no or minimal alcohol consumption.In women with light to moderate alcohol consumption,prevalence of fatty liver was lower than that in women with no or minimal alcohol consumption.By logistic regression analysis,the odds ratio (OR) for MS in women with light alcohol consumption was decreased to < 1.0,but this change was not clear in men.The OR for fatty liver was clearly < 1.0 in men with any level of alcohol consumption and in women with light to moderate consumption.CONCLUSION:Light to moderate alcohol consumption has a favorable effect for fatty liver,but not for MS in Japanese men and women.

Effects of Chinese herbal medicine Yiqi Huaju Qingli Formula in metabolic syndrome patients with microalbuminuria:a randomized placebo-controlled trial

BACKGROUND： Microalbuminuria （MAU） is a key component of metabolic syndrome （MetS） and is an early sign of diabetic nephropathy as well. Although routine Western medicine treatments are given to MetS patients to control high blood pressure, hyperglycemia and dyslipidemia, some patients still experience progressive renal lesions and it is necessary to modify and improve the treatment strategy for MetS patients. OBJECTIVE： To investigate the efficacy of Yiqi Huaju Qingli Herb Formula, a compound traditional Chinese herbal medicine, in MetS patients with MAU when it is combined with routine Western medicine treatment. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： Sixty patients with MetS were randomized into the Chinese herbal formula group （CHF, Yiqi Huaju Qingli formula treatment in combination with Western medicine） and control group （placebo in combination with Western medicine）. All treatments were administered for 12 weeks. MAIN OUTCOME MEASURES： Urinary microalbumin （MA）, urinary albumin-to-creatinine ratio （UACR）, 24-hour total urine protein （24-hTP）, body mass index （BMI）, waist circumference （WC）, waist-to-hip ratio （WHR）, fasting plasma glucose （FPG）, 2-hour postprandial plasma glucose （2-hPPG）, glycosylated hemoglobin （HbAlc）, homeostasis model assessment for insulin resistance （HOMA-IR）, blood lipid profile and blood pressure were observed. RESULTS： Compared with the control group, CHF treatment significantly decreased BMI （P〈0.05）, WC （P〈0.01） and WHR （P〈0.01）. Both groups had significant decreases in FPG, 2-hPPG, HbAlc, HOMA-IR, MA, and UACR, with CHF treatment showing better effects on these parameters compared with the control treatment （P〈0.05）. Both treatments significantly reduced the levels of total cholesterol, low-density lipoprotein cholesterol and triacylglycerol （TAG）, and a greater reduction in TAG was observed with CHF treatment （P〈0.05）. The level of high-density lipoprotein cholesterol did not change in the control group after treatment （P〉0.05）, whereas it significantly increased with CHF treatment （P〈0.01）. Compared with before the treatment, significant decreases in systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were observed in both groups （P〈0.01）. However, there was no significant difference between the two groups （P〉0.05）. CONCLUSION： Combined treatment ofYiqi Huaju Qingli Formula and Western medicine significantly alleviated MAU, which may correlate with the improvement of insulin sensitivity and glucose and lipid metabolism. TRIAL REGISTRATION IDENTIFIER： This trial was registered in the Chinese Clinical Trial Registry with the identifier ChiCTR-TRC-11001633.

Metabolic syndrome is directly associated with gamma glutamyl transpeptidase elevation in Japanese women

AIM:This study aimed to determine whether metabolic syndrome is directly or indirectly,through fatty liver,associated with elevated gamma-glutamyl transpeptidase (GGT) levels in Japanese women. METHODS:From 4 366 women who received their annual health check-up,4 211 women were selected for analysis. All 4 211 women were negative for both hepatitis B surface antigen and antibody to hepatitis C virus.Clinical and biochemical variables were examined by using univariate and multivariate analysis. RESULTS:A raised GGT level (>68 IU/L) was seen in 258 (6.1%) of the 4 211 women.In univariate analysis,all variables examined (age,body mass index,blood pressure, hemoglobin concentration,fasting blood glucose, glycosylated hemoglobin Alc,cholesterol,triglyceride,and uric acid) were associated with the elevated GGT level, whereas in multivariate analysis,four variables (age≧50 yr, hemoglobin≧14 g/dL,triglyceride≧150 mg/dL,and presence of diabetes) were significantly and independently associated with raised GGT level.Clinical variables predicting the presence of ultrasonographic evidence of fatty liver were also examined by multivariate analysis;four variables were associated with the presence of fatty liver:BMI≧25 kg/m^2, hemoglobin≧14 g/dL,triglyceride≧150 mg/dL,and uric acid ≧ 7 mg/dL.There was no significant association between the raised GGT level and the presence of fatty liver. Hypertriglyceridemia was significantly and independently associated with both the raised GGT level and the presence of fatty liver. CONCLUSION:Metabolic syndrome seemed to be directly, not indirectly through fatty liver,associated with the raised GGT level in Japanese women.

Enhancing the treatment of metabolic syndrome with integrative medicine

Metabolic syndrome, with the main clinical manifestations of obesity, dyslipidemia, elevated blood pressure, and elevated blood glucose levels, has become an increasingly prevalant global public health concern. Metabolic syndrome is a convergence of multiple risk factors related to cardiovascular disease. When the concept of metabolic syndrome was initially proposed, some researchers thought the concept was unnecessary, since there were already measures in place to describe the separate cardiovascular risk factors such as dyslipidemia, hypertension and diabetes. However, a large number of epidemiological investigations confirmed that even if blood glucose or blood pressure did not reach the cutoff point of the diseases,

Metabolic Syndrome and Perioperative Complications during Scheduled Surgeries with Spinal Anesthesia

Background: Metabolic syndrome (MS) is a constellation of factors associated with increased risk of developing cardiovascular diseases and Diabetes Mellitus. Despite of the many studies related to MS, little is known about its impact on scenarios such as surgical anesthesia. Objective: To examine the correlation between demographic and metabolic variables with the occurrence of perioperative complications in patients with MS undergoing scheduled surgeries using a spinal anesthesia technique in the surgery department at the University Clinic San Juan de Dios in Cartagena de Indias, Colombia. Methods: Observational, analytical, cross-sectional, single-center study of 150 subjects with MS and 150 control subjects. Perioperative complications, socio-demographic, hemodynamic and respiratory variables were registered. Groups were compared using t test, Fisher’s exact test or Chi-square, as appropriate. We applied a logistic multiple regression model, adjusted by backward stepwise at 0.25 and forward at 0.05, to find possible incompatible associations. p value < 0.05 was considered significant. Results: There were significant differences between groups in age, American Society of Anesthesiologists physical status classification, frequency of diseases associated to MS and perioperative complications. There were no cases of mortality among patients. There was statistically significant difference between the two groups for intraoperative hypotension and hypertension with p values of <0.0001 and 0.034. Among postoperative complications there was statistically significant difference in pain (13.3% vs 5.3% in patients without MS) and nausea and/or postoperative vomiting (8% vs 2% in patients without MS) with a p value of 0.027 and 0.015 (by Fisher) respectively. Conclusions: Metabolic abnormalities in MS are a risk factor for developing complications in the perioperative period of patients scheduled for surgeries using the subarachnoid anesthesia technique. Accordingly, it is appropriate to implement health intervention strategies by the surgical team, aiming at their prevention and management.

Metabolic syndrome after liver transplantation: Preventable illness or common consequence?

The metabolic syndrome is common after liver transplant being present in approximately half of recipients. It has been associated with adverse outcomes such as progression of hepatitis C and major vascular events. As the United States population ages and the rate of obesity increases, prevention of the metabolic syndrome in the post-transplant population deserves special consideration. Currently, the metabolic syndrome after transplant appears at least two times more common than observed rates in the general population. Specific guidelines for patients after transplant does not exist, therefore prevention rests upon knowledge of risk factors and the presence of modifiable elements. The current article will focus on risk factors for the development of the metabolic syndrome after transplant, will highlight potentially modifiable factors and propose potential areas for intervention. As in the non-transplant population, behavioral choices might have a major role. Opportunities exist in this regard for health prevention studies incorporating lifestyle changes. Other factors such as the need for immunosuppression, and the changing characteristics of wait listed patients are not modifiable, but are important to know in order to identify persons at higher risk. Although immunosuppression after transplant is unavoidable, the contribution of different agents to the development of components of the metabolic syndrome is also discussed. Ultimately, an increased risk of the metabolic syndrome after transplant is likely unavoidable, however, there are many opportunities to reduce the prevalence.

Prevalence of metabolic syndrome in adults in Khanh Hoa,Viet Nam

Background The metabolic syndrome (MS) is characterized by a specific clustering of risk factors, including dyslipidemia, central adiposity, systemic hypertension, insulin resistance, and dysglycemia. It is associated with an increased risk of developing cardiovascular disease (CVD). Accurate data on prevalence and characteristics of MS will facilitate the development of preventive strategies for CVD. Objective To estimate accurately the prevalence of MS among Vietnamese adults with the usual criteria or with the criteria modified for Asian populations. Design and methods We studied a representative, cross-sectional, population-based sample of 856 subjects (mean age 52.82 ± 16.36) classified in three age groups from 15-34 years, 35-54 years and ＞ 54 years of age, living in Khanh Hoa Province, Viet Nam. MS was diagnosed according to the criteria defined by the Third Report of the National Cholesterol Education Program Expect Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel Ⅲ) (NCEP-ATP Ⅲ) and by the modified criteria for some Asian populations in which the waist circumference (WC) is considered abnormal if it is ＞ 90 cm for males and ＞ 80 cm for females.Results Using the NCEP-ATP Ⅲ criteria, the prevalence of MS in the studied population was 10.0％ (CI 95 ％:8.1-12.3). It was 2.4 ％ in the 15-34 age group (men 4.5％ and women 1.2％),5.2％ (men 6.3％,women 4.5％ ) in 35-54 age group and 15.8％ (men 9.7％, women 21.7％) in over 54 age group, respectively. And it was more common in women than in men (11.7％ vs 8.0％, P ＜0.001). Using 2001 population census data of the whole province over 15 years (695 218 habitants) we estimated that about 35 193 people suffered from the MS.The WC was the least common feature of MS (2.1％ for men and in 6.1％ for women).Overall,45.2 ％ of the studied population had one feature of MS, 23.1％ had two features, 8.2％ had three features, 1.6％ had four features, and 0.2％ had all five features. No feature of MS was identified in 21.7％.Using the modified criteria,the prevalence of MS in the studied population was 15.7％. It was 4.0％ in the 15-34 age group, 12.5％ in the 35-54 age group and 21.5％ in the＞54 age group. Prevalence of modified WC feature was 10.9％ for men and 23.6％ for women.Conclusions MS is more accurately identified among Vietnamese adults using the modified criterion of the WC for some Asian populations. Its prevalence is similar to that in the developed countries. ( J Geriatr Cardiol 2004;1(2) :95-100.)

Physical activity levels in American and Japanese men from the ERA-JUMP Study and associations with metabolic syndrome

Background:Metabolic syndrome(MetS) is a global health problem.Physical activity(PA) is a known modifiable risk factor for MetS and individual MetS components.However,the role of PA could differ between sub-populations due to differences in the variability of PA and other MetS risk factors.To examine these differences,multi-country studies with standardized outcome measurement methods across cohorts are needed.Methods:Cross-sectional PA levels(total and domain specific) in healthy middle-aged(44-56 years) men in the Risk Factor Assessment among Japanese and U.S.Men in the Post-World War Ⅱ Birth Cohort(ERA-JUMP) Study(n=730;American:n=417;Japanese:n=313;from population-representative samples in Pittsburgh,Pennsylvania,USA,and Kusatsu,Shiga,Japan) were compared.The relationships between PA levels and MetS(overall and specific components) in/across the American and Japanese sub-cohorts(adjusting for age,smoking,and alcohol consumption)were also assessed using the same instruments(pedometer and validated questionnaire) to measure PA in both cohorts.Results:A total of 510 individuals provided complete data on PA(American:n=265;Japanese:n=245).The American cohort had significantly lower mean±SD steps/day(7878±3399 steps/day) vs.the Japanese cohort(9055±3797 steps/day)(p <0.001) but had significantly higher self-reported moderate-vigorous leisure PA(American:15.9(7.4-30.3) metabolic task equivalent hours per week(MET-b/week) vs.Japanese:4.0(0-11.3) METh/week,p <0.0001).In both sub-cohorts,each 1000 steps/day increase was associated with lower odds of having MetS(American:OR=0.90,95%CI:0.83-0.98;Japanese:OR=0.87,95%CI:0.79-0.95) and the individual MetS component of high waist circumference(American:OR=0.86,95%CI:0.79-0.94;Japanese:OR=0.87,95%CI:0.80-0.95).In the American cohort only,higher self-reported leisure PA(Met-b/week) was associated with lower odds of MetS and high waist circumference(OR=0.98,95%CI:0.97-0.99 for MetS and waist circumference,respectively).Conclusion:Higher total step counts/day had an important protective effect on MetS prevalence in both the Japanese and American cohorts,despite differences in PA levels and other MetS risk factors.The effect of steps/day(across all intensity levels) was much greater than domainspecific moderate-vigorous PA captured by questionnaire,suggesting the need for measurement tools that can best capture total movement when examining the effects of PA on MetS development.

Negative Association of Domestic Activity and Active Commuting with Metabolic Syndrome in a Chinese Population Aged 35-64 Years

Objective To understand the associations of physical activity domains with metabolic syndrome among a middle-aged Chinese population. Methods In all, 3326 professional adults aged 35-64 years from Beijing and Zhejiang province were recruited with a cluster random sampling method. The Global Physical Activity Questionnaire was modified, and the recommended Asia-Pacific cut-offs of waist circumstance were introduced into the criteria for metabolic syndrome from the Adult Treatment Panel III. A binary logistic regression model was applied to examine the association of all physical activity domains with the risk of the syndrome. Results Participants who engaged in domestic activity for 〉1176 MET-min/week had a 41.6% less chance of having metabolic syndrome [odds ratio （OR）, 0.584; 95% confidence interval （CI）, 0.480-0.710] than those without this activity. In adjusted models, adults who actively commuted for 〉33 MET-rain/week but 〈52g MET-min/week had a 25% less chance of having the syndrome （OR, 0.750; 95% CI, 0.582-0.966） than those who did not. No interaction was detected between the two domains of activity and the syndrome. Conclusion This study highlighted the independently negative association of traffic and house activity with the prevalence of the syndrome in this sample with a generally low level of moderate activity.

Metabolic syndrome in the development and progression of prostate cancer

Prostate cancer(PCa)is the most common noncutaneous malignancy and second leading cause of cancerspecific mortality for men in the United States.There is a wide spectrum of aggressiveness ranging from biologically significant to indolent disease,which has led to an interest in the identification of risk factors for its development and progression.Emerging evidence has suggested an association between metabolic syndrome(MetS)and PCa.MetS represents a cluster of metabolic derangements that confer an increased risk of cardiovascular disease and type 2 diabetes mellitus.Its individual components include obesity,dyslipidemias,high blood pressure,and high fasting glucose levels.Met S has become pervasive and is currently associated with a high socioeconomic cost in both industrialized and developing countries throughout the world.The relationship between MetS and PCa is complex and yet to be fully defined.A better understanding of this relationship will facilitate the development of novel therapeutic targets for the prevention of PCa and improvement of outcomes among diagnosed men in the future.In this review,we evaluate the current evidence on the role of MetS in the development and progression of PCa.We also discuss the clinical implications on the manage-ment of PCa and consider the future direction of this subject.

Metabolic Syndrome: Consensus and Controversy: State of the Art

Metabolic syndrome is an epidemic that affects more and more people, increasing the probability of suffering metabolic and cardiovascular diseases in the short, medium or long term depending on the severity. The purpose of this article is to review the metabolic syndrome, assessing consensus, controversy and prevalence. The methodology was the preparation of a literature review on various health care databases, which were from 43 articles published from 2010 to 2015, in the general population. SM rate ranges from 0% to 90% depending on genders, ages and regions. There is still lack of consensus on cutoffs of diagnostic criteria. Thus, it is concluded that the prevalence of metabolic syndrome is being increased, urging the need for early diagnosis and treatment to promote the health of the global population.

Genetic and Metabolic Determinants of Plasminogen Activator Inhibitor 1 (PAI-1) in Tunisian Type 2 Diabetes Patients

Background: PAI-1 (plasminogen activator inhibitor-1) is a powerful regulator of fibrinolysis and plasma level is high in type 2 diabetes and cardio-vascular disease, which is determined by genetic polymorphisms in PAI-1 gene and environmental factors. The aim of the study was to examine the determinants of plasma PAI-1 Ag level among type 2 diabetes patients. Methods: 491 Tunisian type 2 diabetes patients had clinical evaluation (weight, high, BMI, Waist Circumference), laboratory investigations including FBG Hb1Ac, cholesterol, triglyceride;HDL-cholesterol was done;plasma PAI-1 antigen level was done with ELISA;&minus;675 4G/5G and &minus;844 G/A polymorphisms of PAI-1 gene was done by PCR-ASA and PCR-RFLP respectively. Results: The mean age for our patients was 58.3 ± 10.5 years;sex-ratio = 0.92;mean PAI-1 level was 34.6 ± 21.3 ng/ml. We didn’t find correlation between PAI-1 level and BMI, but we have found significant correlation between PAI-1 and waist circumference (p = 0.032), most enhanced in men (P = 0.002), T2D patients who have FBG > 11 mmol/l had PAI-1 Ag level higher than those who have FBG P = 0.034), but no difference found between T2D with high Hb1Ac > 8% and those with Hb1Ac < 8%, significant correlation was seen between PAI-1 level and LDL-cholesterol (P = 0.05), high correlation between PAI-1 Ag level and &minus;675 4G/5G polymorphism genotype was seen, 4G/4G carriers had the highest PAI-1 level, 4G/5G had intermediary level and 5G/5G had the lowest level (P &minus;844G/A polymorphism genotypes. Using multiple variable linear regression analysis, the independent factor associated with plasma PAI-1 level was &minus;675 4G/5G polymorphism (regression coefficient β = 4.6, P Conclusion: the present study identifies &minus;675 4G/5G not &minus;844 G/A polymorphism of PAI gene as the principal determinant of plasma PAI-1 level in Tunisian T2D patients, the android fat distribution, dyslipidemia and hyperglycemia play a modest role in this variation.

OCULO-CEREBRO-RENAL SYNDROME (LOWE'S SYNDROME)

Oculo-cerebro-renal syndrome (Lowe's syndrome) is characterized by mental and motor retardation, cataract, glaucoma and renal abnormalities. It is an X-linked recessive metabolic disease. Two brothers suffering from Lowe's syndrome are reported. Their mother with lenticular opacities and peculiar facial appearance is in concordance with the obligate carrier. The ocular changes and heridity are discussed.

Epidemiological status of metabolic syndrome and its correlation with renal damage in Shanghai Chongming rural areas

Objective To investigate the prevalence of metabolic syndrome in adults in Shanghai Chongming area and to analyze the relationship between metabolic syndrome and chronic kidney disease.Methods A total of 7679 residents aged 30 years or over in Chongming District of Shanghai were randomly sampled and investigated by questionnaires,physical examinations,and laboratory examinations.The metabolic syndrome was diagnosed by the diagnostic criteria of metabolic syndrome according to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes in 2017.

Effects of modified Lingguizhugan decoction combined with weekend fasting on metabolic syndrome

OBJECTIVE:To assess the therapeutic effect of weekend fasting and administration of a modified Lingguizhugan decoction on metabolic syndrome(MetS).METHODS:Twenty-one patients with MetS were recruited from the First Affiliated Hospital of Sun Yat-Sen University.Fasting plasma glucose(FPG),30-min and 2-h post-prandial blood glucose(PG),fasting serum insulin(FINS),blood pressure(BP),body mass index(BMI),waist circumference(WC),homeostasis model assessment for insulin resistance index(HOMA-IR),and levels of triglyceride(TG),total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were tested.Patients were allowed to drink only water and a Chinese herbal decoction during weekends.All samples were tested again after 12 weeks of treatment.RESULTS:FPG,30-min PG,2-h PG,FINS,LDL-C,systolic BP,diastolic BP,BMI,WC,and HOMA-IR de-creased significantly(P<0.05)compared with before treatment.Levels of TG,TC,and HDL-C did not change significantly.CONCLUSION:Weekend fasting improved glucose metabolism,lowered BP,reduced LDL-C levels,BMI,and WC.These data suggest that weekend fasting may be an effective therapy for MetS by protection against coronary atherosclerosis.