Metabolic syndrome predicts worse perioperative outcomes in patients treated with radical prostatectomy for non-metastatic prostate cancer
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01.06.2021 |
Luzzago S.
Palumbo C.
Rosiello G.
Pecoraro A.
Deuker M.
Stolzenbach F.
Mistretta F.A.
Tian Z.
Musi G.
Montanari E.
Shariat S.F.
Saad F.
Briganti A.
de Cobelli O.
Karakiewicz P.I.
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Surgical Oncology |
10.1016/j.suronc.2020.12.013 |
0 |
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© 2021 Elsevier Ltd Objectives: Metabolic syndrome (MetS) and its components (high blood pressure, BMI≥30, altered fasting glucose, low HDL cholesterol and high triglycerides) may undermine early perioperative outcomes after radical prostatectomy (RP). We tested this hypothesis. Materials & methods: Within the National Inpatient Sample database (2008–2015) we identified RP patients. The effect of MetS was tested in four separate univariable analyses, as well as in multivariable regression models predicting: 1) overall complications, 2) length of stay, 3) total hospital charges and 4) non-home based discharge. All models were weighted and adjusted for clustering, as well as all available patient and hospital characteristics. Results: Of 91,618 patients: 1) 50.2% had high blood pressure, 2) 8.0% had BMI≥30, 3) 13.0% had altered fasting glucose, 4) 22.8% had high triglycerides and 5) 0.03% had low HDL cholesterol. Respectively, one vs. two vs. three vs. four MetS components were recorded in 36.2% vs. 19.0% vs. 5.5% vs. 0.8% patients. Of all patients, 6.3% exhibited ≥3 components and qualified for MetS diagnosis. The rates of MetS increased over time (EAPC:+9.8%; p < 0.001). All four tested MetS components (high blood pressure, BMI≥30, altered fasting glucose and high triglycerides) achieved independent predictor status in all four examined endpoints. Moreover, a highly statistically significant dose-response was also confirmed for all four tested endpoints. Conclusion: MetS and its components consistently and strongly predict early adverse outcomes after RP. Moreover, the strength of the effect was directly proportional to the number of MetS components exhibited by each individual patient, even if formal MetS diagnosis of ≥3 components has not been met.
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Associations between metabolic syndrome and four heavy metals: A systematic review and meta-analysis
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15.03.2021 |
Xu P.
Liu A.
Li F.
Tinkov A.A.
Liu L.
Zhou J.C.
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Environmental Pollution |
10.1016/j.envpol.2021.116480 |
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© 2021 Elsevier Ltd Four most concerned heavy metal pollutants, arsenic, cadmium, lead, and mercury may share common mechanisms to induce metabolic syndrome (MetS). However, recent studies exploring the relationships between MetS and metal exposure presented inconsistent findings. We aimed to clarify the relationship between heavy metal exposure biomarkers and MetS using a meta-analysis and systematic review approach. Literature search was conducted in international and the Chinese national databases up to June 2020. Of selected studies, we extracted the relevant data and evaluated the quality of each study's methodology. We then calculated the pooled effect sizes (ESs), standardized mean differences (SMDs), and their 95% confidence intervals (CIs) using a random-effect meta-analysis approach followed by stratification analyses for control of potential confounders. Involving 55,536 participants, the included 22 articles covered 52 observational studies reporting ESs and/or metal concentrations on specific metal and gender. Our results show that participants with MetS had significantly higher levels of heavy metal exposure [pooled ES = 1.16, 95% CI: 1.09, 1.23; n = 42, heterogeneity I2 = 75.6%; and SMD = 0.22, 95% CI: 0.15, 0.29; n = 32, I2 = 94.2%] than those without MetS. Pooled ESs in the subgroups stratified by arsenic, cadmium, lead, and mercury were 1.04 (95% CI: 0.97, 1.10; n = 8, I2 = 61.0%), 1.10 (0.95, 1.27; 11, 45.0%), 1.21 (1.00, 1.48; 12, 82.9%), and 1.26 (1.06, 1.48; 11, 67.7%), respectively. Pooled ESs in the subgroups stratified by blood, urine, and the other specimen were 1.22 (95% CI: 1.08, 1.38; n = 26, I2 = 75.8%), 1.06 (1.00, 1.13; 14, 58.1%), and 2.41 (1.30, 4.43; 2, 0.0%), respectively. In conclusion, heavy metal exposure was positively associated with MetS. Further studies are warranted to examine the effects of individual metals and their interaction on the relationship between MetS and heavy metals. The exposure to heavy metals was positively associated with the prevalence of metabolic syndrome. Exposures to lead and mercury had a stronger association with the risk of metabolic syndrome.
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Selenium, Zinc, Chromium, and Vanadium Levels in Serum, Hair, and Urine Samples of Obese Adults Assessed by Inductively Coupled Plasma Mass Spectrometry
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01.02.2021 |
Tinkov A.A.
Skalnaya M.G.
Ajsuvakova O.P.
Serebryansky E.P.
Chao J.C.J.
Aschner M.
Skalny A.V.
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Biological Trace Element Research |
10.1007/s12011-020-02177-w |
4 |
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© 2020, Springer Science+Business Media, LLC, part of Springer Nature. The objective of this study was to investigate of selenium (Se), zinc (Zn), chromium (Cr), and vanadium (V) levels in blood serum, hair, and urine of adult obese patients. A total of 199 lean and 196 obese subjects were enrolled in the study. Serum, hair, and urinary metal and metalloid analysis were performed by inductively coupled plasma mass spectrometry at NexION 300D (PerkinElmer Inc., USA). The results established that obese subjects were characterized by 47% and 30% lower serum Cr and V levels compared with controls, respectively, whereas serum Se levels exceeded control values by 9%. In contrast, hair Cr, Se, and V content in obese subjects exceeded the control values by 51%, 21%, and 50%, respectively. In turn, hair Zn levels were found to be significantly lower by 11% compared with the lean control values. In urine, the levels of V and Zn were found to be 30% and 18% higher in obese patients. Prevalence of hypertension in obese subjects was associated with a trend for impaired Se and Zn levels. In a regression model adjusted for age, gender, hypertension, atherosclerosis, and glucose intolerance, serum Cr, V, and hair Zn were inversely associated with body mass index (BMI), whereas hair Se was considered as the positive predictor. Our data allow proposing that the observed alterations may at least partially contribute to metabolic disturbances in obesity. In turn, monitoring of Se exposure in a well-nourished adult population is required to reduce its potential contribution to obesity.
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Selenium, Zinc, Chromium, and Vanadium Levels in Serum, Hair, and Urine Samples of Obese Adults Assessed by Inductively Coupled Plasma Mass Spectrometry
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01.02.2021 |
Tinkov A.A.
Skalnaya M.G.
Ajsuvakova O.P.
Serebryansky E.P.
Chao J.C.J.
Aschner M.
Skalny A.V.
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Biological Trace Element Research |
10.1007/s12011-020-02177-w |
4 |
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© 2020, Springer Science+Business Media, LLC, part of Springer Nature. The objective of this study was to investigate of selenium (Se), zinc (Zn), chromium (Cr), and vanadium (V) levels in blood serum, hair, and urine of adult obese patients. A total of 199 lean and 196 obese subjects were enrolled in the study. Serum, hair, and urinary metal and metalloid analysis were performed by inductively coupled plasma mass spectrometry at NexION 300D (PerkinElmer Inc., USA). The results established that obese subjects were characterized by 47% and 30% lower serum Cr and V levels compared with controls, respectively, whereas serum Se levels exceeded control values by 9%. In contrast, hair Cr, Se, and V content in obese subjects exceeded the control values by 51%, 21%, and 50%, respectively. In turn, hair Zn levels were found to be significantly lower by 11% compared with the lean control values. In urine, the levels of V and Zn were found to be 30% and 18% higher in obese patients. Prevalence of hypertension in obese subjects was associated with a trend for impaired Se and Zn levels. In a regression model adjusted for age, gender, hypertension, atherosclerosis, and glucose intolerance, serum Cr, V, and hair Zn were inversely associated with body mass index (BMI), whereas hair Se was considered as the positive predictor. Our data allow proposing that the observed alterations may at least partially contribute to metabolic disturbances in obesity. In turn, monitoring of Se exposure in a well-nourished adult population is required to reduce its potential contribution to obesity.
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Dietary nitrate attenuates high-fat diet-induced obesity via mechanisms involving higher adipocyte respiration and alterations in inflammatory status
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01.01.2020 |
Peleli M.
Ferreira D.
Tarnawski L.
McCann Haworth S.
Xuechen L.
Zhuge Z.
Newton P.
Massart J.
Chagin A.
Olofsson P.
Ruas J.
Weitzberg E.
Lundberg J.
Carlström M.
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Redox Biology |
10.1016/j.redox.2019.101387 |
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© 2019 The Authors Emerging evidence indicates that dietary nitrate can reverse several features of the metabolic syndrome, but the underlying molecular mechanisms still remain elusive. The aim of the present study was to explore mechanisms involved in the effects of dietary nitrate on the metabolic dysfunctions induced by high-fat diet (HFD) in mice. Four weeks old C57BL/6 male mice, exposed to HFD for ten weeks, were characterised by increased body weight, fat content, increased fasting glucose and impaired glucose clearance. All these metabolic abnormalities were significantly attenuated by dietary nitrate. Mechanistically, subcutaneous primary mouse adipocytes exposed to palmitate (PA) and treated with nitrite exhibited higher mitochondrial respiration, increased protein expression of total mitochondrial complexes and elevated gene expression of the thermogenesis gene UCP-1, as well as of the creatine transporter SLC6A8. Finally, dietary nitrate increased the expression of anti-inflammatory markers in visceral fat, plasma and bone marrow-derived macrophages (Arginase-1, Egr-2, IL-10), which was associated with reduction of NADPH oxidase-derived superoxide production in macrophages. In conclusion, dietary nitrate may have therapeutic utility against obesity and associated metabolic complications possibly by increasing adipocyte mitochondrial respiration and by dampening inflammation and oxidative stress.
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Aluminium levels in hair and urine are associated with overweight and obesity in a non-occupationally exposed population
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01.12.2019 |
Tinkov A.
Skalnaya M.
Aaseth J.
Ajsuvakova O.
Aschner M.
Skalny A.
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Journal of Trace Elements in Medicine and Biology |
10.1016/j.jtemb.2019.08.005 |
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© 2019 Elsevier GmbH Background: Data on the association between aluminium (Al) exposure and obesity and/or metabolic syndrome are insufficient. The objective of the present study was to investigate the association between hair and urine Al levels and obesity. Methods: A total of 206 lean and 205 obese non-occupationally exposed subjects (30–50 y.o.) were enrolled in the study. Hair and urine Al levels were assessed with ICP-MS. Laboratory quality control was performed using the certified reference materials of human hair, plasma, and urine. Results: Hair and urinary Al levels in obese subjects were significantly higher by 31% and 46% compared to the control levels, respectively. The presence of hypertension (41% cases), atherosclerosis (8%), type 2 diabetes mellitus (10%), and non-alcoholic fatty liver disease (NAFLD) (53%) in obese patients were not associated with Al levels in the studied subjects. An overall multiple regression model established urinary Al levels (β = 0.395; p < 0.001), hypertension (β = 0.331; p < 0.001) and NAFLD (β = 0.257; p = 0.003) were significantly and directly associated with BMI. Hair Al levels were found to be border-line significantly related to BMI after adjustment for several confounders (β = −0.205; p = 0.054). Conclusions: Aluminium body burden is associated with increased body weight, although the causal relationship between Al exposure and obesity is not clear. Both clinical and experimental studies are required to further investigate the impact of Al exposure on metabolic parameters in obesity and especially direct effects of Al in adipose tissue.
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Effects of different dietary regimes alone or in combination with standardized Aronia melanocarpa extract supplementation on lipid and fatty acids profiles in rats
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01.11.2019 |
Milic P.
Jeremic J.
Zivkovic V.
Srejovic I.
Jeremic N.
Bradic J.
Nikolic Turnic T.
Milosavljevic I.
Bolevich S.
Bolevich S.
Labudovic Borovic M.
Arsic A.
Mitrovic M.
Jakovljevic V.
Vucic V.
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Molecular and Cellular Biochemistry |
10.1007/s11010-019-03597-6 |
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© 2019, Springer Science+Business Media, LLC, part of Springer Nature. This study investigated different dietary strategies, high-fat (HFd), or standard diet (Sd) alone or in combination with standardized Aronia melanocarpa extract (SAE), as a polyphenol-rich diet, and their effects on lipids and fatty acids (FA) in rats with metabolic syndrome (MetS). Wistar albino rats were randomly divided into two groups: healthy and rats with MetS, and then depending on dietary patterns on six groups: healthy rats fed with Sd, healthy rats fed with Sd and SAE, rats with MetS fed with HFd, rats with MetS fed with HFd and SAE, rats with MetS fed with Sd, and rats with MetS fed with Sd and SAE. 4 weeks later, after an overnight fast (12–14 h), blood for determination of total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), index of lipid peroxidation (measured as TBARS), and FA was collected. Increased FA and lipid concentration found in MetS rats were reduced when changing dietary habits from HFd to Sd with or without SAE consumption. Consumption of SAE slightly affects the FA profiles, mostly palmitoleic acid in healthy rats and PUFA in MetS + HFd rats. Nevertheless, in a high-fat diet, SAE supplementation significantly decreases n-6/n-3 ratio, thereby decreasing systemic inflammation. Further researches are warranted to confirm these effects in humans.
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Dysregulated iron metabolism-associated dietary pattern predicts an altered body composition and metabolic syndrome
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01.11.2019 |
Cempaka A.
Tseng S.
Yuan K.
Bai C.
Tinkov A.
Skalny A.
Chang J.
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Nutrients |
10.3390/nu11112733 |
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© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Diet plays an important role in the development of obesity and may contribute to dysregulated iron metabolism (DIM). A cross-sectional survey of 208 adults was conducted in Taipei Medical University Hospital (Taipei, Taiwan). A reduced-rank regression from 31 food groups was used for a dietary pattern analysis. DIM was defined as at least four of the following criteria: serum hepcidin (men >200 ng/mL and women >140 ng/mL), hyperferritinemia (serum ferritin of >300 ng/mL in men and >200 ng/mL in women), central obesity, non-alcoholic fatty liver disease, and two or more abnormal metabolic profiles. Compared to non-DIM patients, DIM patients were associated with an altered body composition and had a 4.52-fold (95% confidence interval (CI): (1.95–10.49); p < 0.001) greater risk of metabolic syndrome (MetS) after adjusting for covariates. A DIM-associated dietary pattern (high intake of deep-fried food, processed meats, chicken, pork, eating out, coffee, and animal fat/skin but low intake of steamed/boiled/raw foods and dairy products) independently predicted central obesity (odds ratio (OR): 1.57; 95% CI: 1.05–2.34; p < 0.05) and MetS (OR: 1.89; 95% CI: 1.07–3.35; p < 0.05). Individuals with the highest DIM pattern scores (tertile 3) had a higher visceral fat mass (%) (β = 0.232; 95% CI: 0.011–0.453; p < 0.05) but lower skeletal muscle mass (%) (β = −1.208; 95% CI: −2.177–−0.239; p < 0.05) compared to those with the lowest DIM pattern scores (tertile 1). In conclusion, a high score for the identified DIM-associated dietary pattern was associated with an unhealthier body composition and a higher risk of MetS.
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The organizational aspects of early diagnostic of metabolic syndrome on the basis of implementation of new genetic, cellular and bio-informational technologies
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01.09.2019 |
Khabriev R.
Kakorina E.
Kuzmina L.
Fishman B.
Prozorova I.
Raff S.
Abdulin A.
Iukhno M.
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Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsiny |
10.32687/0869-866X-2019-27-5-796-802 |
0 |
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The characteristic feature of molecular medicine as medicine based on molecular structure of human genome data, is its individual character. It is focused on correcting pathological process in specific individual considering unique characteristics of its genome. The other most important feature is its expressed preventive direction. The complete genome information can be obtained well before the onset of disease. The appropriate preventive measures can completely eliminate or significantly prevent development of severe disease. The establishment of gene network of every multi-factorial disease, identification of central genes and genes-modifiers in it, analysis of association of their alleles with disease, development on this basis of set of preventive measures for specific patient constitute conceptual and methodological basis of predictive medicine. As a result of the examination, information can be obtained concerning particular risk of disease development. The physician, considering the results of molecular genetic analysis, elaborates tactics of pathogenetically justified preventive therapy, i.e. corrects congenital metabolic defect.
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Treatment of hypertension in obese patients: Focus on telmisartan
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01.01.2018 |
Deneka I.
Rodionov A.
Fomin V.
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Cardiovascular Therapy and Prevention (Russian Federation) |
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1 |
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© 2018 Cardiovascular Therapy and Prevention. The article discusses the role of telmisartan in the treatment of arterial hypertension in patients with metabolic syndrome. Telmisartan is second-generation type 1 angiotensin II receptor blocker, which has unique pleiotropic effects due to partial affinity for receptors that activate the proliferation of subtype γ peroxisomes (PPARγ) located in adipose tissue. The interrelation of metaflamation, a specific chronic inflammatory process with pathogenetic mechanisms of development of cardiovascular diseases, including arterial hypertension, is also described in study. The role of the adiponectin peptide is considered, which synthesis is stimulated by partial PPARγ receptor agonists (as mentioned above - telmisartan). It has a positive effect on fat and carbohydrate metabolism, as well as cardioprotective properties. The conclusion contains the results of numerous randomized studies and meta-analyzes confirming the high efficacy of telmisartan in the treatment of arterial hypertension in patients with morbid obesity.
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Abnormal microcirculation and red blood cell function as a cardiovascular risk factor in metabolic syndrome
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01.01.2018 |
Podzolkov V.
Koroleva T.
Pisarev M.
Kudryavtseva M.
Zateyshchikova D.
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Rational Pharmacotherapy in Cardiology |
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1 |
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© 2018 Stolichnaya Izdatelskaya Kompaniya. The metabolic syndrome is a highly prevalent condition associated with increased cardiovascular risk in the population. Microvasculature is the terminal part of the cardiovascular system which primarily reacts to the increased secretion of the pro inflammatory adipokines typical for the metabolic syndrome. Microcirculation and blood cell abnormalities are the leading mechanisms of cardiovascular events development in this condition. Prevalence of microcirculation abnormalities and red blood cell dysfunction in metabolic syndrome and their role in the increased blood viscosity and cardiovascular events development are covered by the paper. The microcirculation abnormalities with a special focus on red blood cell dysfunction (impaired aggregation, stiffness) seen in metabolic syndrome and associated conditions are discussed in detail. The impact of abnormal red blood cell deformability (secondary to cholesterol accumulation in the cellular membranes) on the hemorheological abnormalities is revealed. Abnormal red blood cell surface charge due to proinflammatory changes associated with insulin resistance in diabetes mellitus is highlighted. These abnormalities lead to increased red blood cell aggregation and plasma viscosity that are the essential components of cardiovascular events pathogenesis. Their timely diagnosis is crucial for effective cardiovascular prevention.
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Relation of disturbances in the erythrocytes electrical activity with dyslipidemia in the metabolic syndrome
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01.01.2018 |
Podzolkov V.
Koroleva T.
Bragina A.
Kudryavtseva M.
Bragina G.
Pisarev M.
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Rational Pharmacotherapy in Cardiology |
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1 |
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© 2018 Stolichnaya Izdatelskaya Kompaniya. Aim. To study the erythrocyte electric charge (EEC) in patients with metabolic syndrome (MS). Material and methods. 112 patients (mean age 61.4±7.2 years) with MS (average duration of MS 8.7±5.2 years) were examined. Control group consisted of healthy volunteers (n=25) of similar age. The level of EEC was detected by the method of adsorption of a positive cationic dye (cationic blue O) on the surface of the erythrocyte plasma membrane up to the complete neutralization of their negative charge, followed by photometry of the solution and calculation of the number of charges on the erythrocyte cell surface. The results of the study were processed by Statistica 10.0 software. Results. Hypertension was found in 73% of patients with MS, hyperglycemia - in 39%, diabetes - in 36%, dyslipidemia - in 80% of patients. The EEC in MS patients (1.59±0.05×107) was lower than this in the control group (1.65±0.03×107; p < 0.05). With MS duration more than 5 years, the EEC was significantly lower in comparison with control group (p < 0.05). In patients with obesity II-III degrees as well as dyslipidemia the EEC values were significantly lower vs control group (p < 0.05). In patients with MS, a significant negative correlation of EEC with total cholesterol (r=-0.51, p < 0.05) and triglycerides (r=-0.51, p < 0.05) levels were revealed. Conclusion. In patients with MS with increase in the MS duration, degree of obesity and lipid metabolism disorders, significantly lower values of EEC were observed..
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Change in the functional state of erythrocytes as a component of microcirculatory disorders in metabolic syndrome
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01.01.2018 |
Podzolkov V.
Koroleva T.
Bragina A.
Kudryavtseva M.
Druzhinina N.
Pisarev M.
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Rational Pharmacotherapy in Cardiology |
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2 |
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© 2018, Stolichnaya Izdatelskaya Kompaniya. Aim. To study the erythrocyte electric charge (EEC) in patients with metabolic syndrome (MS) depending on glycemia levels. Material and methods. 112 patients (45 men and 67 women, age 61.4±7.2 years) with MS (MS duration 8.7±5.2 years) were studied. EEC level was detected by the method of adsorption of a positive cationic dye (cationic blue O) on the surface of the erythrocyte plasma membrane up to the complete neutralization of their negative charge, followed by photometry of the solution and calculation of the number of charges on the erythrocyte cell surface. All statistical analyses were done using Statistics 10.0 software. Results: Abdominal obesity was registered in 100% of patients, hypertension - in 73%, fasting hyperglycemia - in 75%, dyslipidemia - in 80% of patients. Mean glycated hemoglobin (HbA1c) level in patients with MS was 7.3±1.9%. The mean EEC level in group of MS patients (1.59±0.05×107) was significantly lower than in the control group (1.67±0.03×107), p < 0.05. In patients with MS and fasting hyperglycemia the EEC levels were significantly lower than in those without fasting hyperglycemia (1.58±0.05×107 vs 1.64±0.03×107, respectively; p < 0.001). Significant negative correlations between EEC and age (r=-0.43, p < 0.05), average duration of MS (r=-0.87, p < 0.05), average plasma glucose concentration (r=-0.6, p < 0.05), average duration of fasting hyperglycemia (r=-0.83, p < 0.05), and blood HbA1c level (r=-0.56, p < 0.05) were found in patients with MS. Conclusion: Significantly lower values of EEC are observed in MS patients with increasing age, duration of MS, and duration of hyperglycemia. Negative correlation between HbA1c and EEC was also shown.
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Changes in proinflammatory cytokines in patients with chronic periodontitis and metabolic syndrome, depending on gender and age
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01.01.2018 |
Petrukhina N.
Zorina O.
Shikh E.
Kartysheva E.
Kudryavtsev A.
Berkutova I.
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Stomatologiia |
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In a study of 537 patients with chronic generalized periodontitis and metabolic syndrome (MS) depending on age and gender, it was found that the increase of TNF-α and IL-6 in the content of periodontal pockets correlated with the severity of chronic generalized periodontitis and MS. For these cytokines, there was a clear gender relationship: women had higher levels in periodontal pocket content than men. For IL-1β and IL-4 cytokines, there is no coupling between the severity of the damage and the level of cytokines in the periodontal pocket. The developed model for calculating the risk of chronic generalized periodontitis depending on the level of TNF-α in the patient's periodontal pockets allows predicting and monitoring the dynamics of the disease.
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Gallstone disease as a clinical marker of metabolic syndrome
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01.01.2018 |
Svistunov A.
Osadchuk M.
Kireeva N.
Osadchuk A.
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Obesity and Metabolism |
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© 2018 Russian Association of Endocrinologists. The prevalence of cholelithiasis, its close pathogenetic connection with metabolic syndrome, high frequency of surgical intervention, significant economic losses put forward this comorbid pathology in a number of leading problems of modern clinical medicine. The factors associated with the metabolic syndrome not only increase the risk of developing cholelithiasis, but also form the basis of non-drug and drug therapy. Metabolic syndrome often determines the occurrence of three common and potentially life-Threatening complications of cholelithiasis: Acute cholecystitis, acute cholangitis and biliary pancreatitis. Therefore, the solution of this problem is associated with the need for early detection of additional risk factors for cholelithiasis, optimization of the early diagnostic and prognostic model of existing multi-organ pathology with the aim of reducing the progression of the disease and its complications. The data obtained in recent years on the human genome with metabolic syndrome and cholelithiasis make it possible to predict the development of comorbid pathology and to fully ensure the effectiveness of primary prevention.
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Metabolic syndrome: Development of the issue, main diagnostic criteria
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01.01.2018 |
Belenkov Y.
Privalova E.
Kaplunova V.
Zektser V.
Vinogradova N.
Ilgisonis I.
Shakaryants G.
Kozhevnikova M.
Lishuta A.
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Rational Pharmacotherapy in Cardiology |
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1 |
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© 2018 Stolichnaya Izdatelskaya Kompaniya. All rights reserved. Obesity is one of the leading and the most serious risk factors of cardiovascular diseases. Overweight provokes many metabolic and hemodynamic disorders. About 30% of inhabitants of the planet have overweight and prevalence of obesity increases by 10% every 10 years according to the WHO data. The probability of arterial hypertension in obese patients is 50% higher than in people with normal body mass. Framingham study showed that obesity is an independent, significant risk factor of ischemic heart disease, myocardial infarction, cerebral stroke and diabetes mellitus. The most dangerous is the central obesity with the preferential fat deposition in the abdomen. Combination of visceral obesity, violation of carbohydrate and lipid metabolism, arterial hypertension, and close pathogenic relationship between these factors underlie the isolated symptom complex known as metabolic syndrome. J. Vague was the first to describe relationship between abdominal obesity with cardiovascular disease and mortality in 1947. In our country G.F. Lang noticed common combination of arterial hypertension with obesity, lipid and carbohydrate metabolism disorders. Thus, metabolic syndrome significantly increases risk and severity of cardiovascular disease. Within last decades criteria of metabolic syndrome stays constant. The factors of insulin resistance and endothelial dysfunction as stages of the pathogenesis of the metabolic syndrome have been studied in detail. The mechanisms of insulin resistance and endothelial dysfunction are discussed in detail in this article as well as inflammatory markers and the significance of highly sensitive C-reactive protein.
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The thickness of the epicardial fat is the "visit card" of metabolic syndrome
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01.01.2018 |
Drapkina O.
Shepel R.
Deeva T.
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Obesity and Metabolism |
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0 |
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© 2018 Blackwell Publishing Ltd. All rights reserved. AIMS: On the basis of echocardiography to evaluate the thickness of epicardial fat (TEF) in patients with metabolic syndrome (MS) and to establish a connection with the main indicators of laboratory and instrumental methods of research. MATERIALS AND METHODS: The study included 76 patients, 43 patients with MS and 33 without MS.The average age of patients in the MS group at the time of inclusion in the study was 62.7±10.3 years in the control group (without MS) - 60±14.7 years. All patients underwent a comprehensive examination that included the collection of complaints, study of history, physical examination, anthropometric measurements, laboratory (including the study of the levels of caspase - 8, leptin in blood plasma enzyme-linked immunosorbent assay using kits «Platinum ELISA») and instrumental examination (echocardiography, ultrasound examination of organs of small pelvis). TEF was determined using transthoracic echocardiography on the machine Acuson Sequoia 512. RESULTS: According transthoracic echocardiography was significantly higher in the group of patients with MS and was 4.67±1.7 mm, as compared to 2.66+1.15 mm in the control group (p<0.001). Identified moderate and strong correlation between TEF and weight of the patients, waist circumference, ratio of waist circumference to hip circumference, body mass index, glucose levels in the blood plasma, the presence of diabetes mellitus type 2, ultrasonic signs of steatosis of the liver and pancreas, increased aminotransferases, the level of caspase-8 concentration in plasma leptin. Patients the MS group with increased TEF increases the risk of developing hypertension, ischemic heart disease, left ventricular hypertrophy, diastolic dysfunction of the left ventricle type 2, level of caspase-8 and concentration in plasma leptin. CONCLUSION: Based on the obtained data, the measurement of TEF is justified in patients with MS in everyday clinical practice. The correlations between theTEF and the clinical and metabolic parameters of the CVD and MS make it possible to consider the TEF as a new marker of the risk of developing MS and cardiovascular diseases.
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Evaluation of leptin serum levels in patients with metabolic syndrome and left ventricular myocardial hypertrophy
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01.01.2018 |
Drapkina O.
Shepel R.
Deeva T.
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Rational Pharmacotherapy in Cardiology |
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© Rational Pharmacotherapy in Cardiology 2018. Aim. To study serum level of leptin in patients with the metabolic syndrome (MS), including in patients with MS in combination with left ventricular hypertrophy (LVH) to determine the diagnostic significance of this marker in MS. Material and methods. The study involved 43 patients with MS, 33 of them with signs of LVH, and 33 patients without MS comparable age, including 10 patients with LVH. The average age of patients in the MS group at the time of inclusion into the study was 62.7±10.3 years, in the control group (without MS) - 60±14.7 years. All patients underwent a comprehensive examination that included the collection of complaints, study of history, physical examination, anthropometric measurements, laboratory and instrumental examination, including study of the serum level of leptin. Results. Patients of both groups had statistically significant differences in the size of the heart chambers, the presence of LVH signs, left ventricle contractile function, the thickness of the epicardial fat layer. Thus, enlargement of the heart, thickness of the interventricular septum, posterior wall of the left ventricle, thickness of epicardial fat, reduction of ejection fraction of the left ventricle and characteristics of aortic atherosclerosis were observed significantly more often in patients with MS compared with the group without MS (p < 0.05).The average serum level of leptin in the MS group (41.89±33.28 ng/ml) was significantly higher compared to the group without MS (17.64±16.87 ng/ml), p < 0.001. At that women had significantly higher levels of serum leptin (38.65±29.23 ng/ml) compared to males (19.54±27.23 ng/ml), p=0.006. A positive correlation between leptin levels and symptoms of LVH (r=0.294, p < 0.001) was revealed: in the absence of LVH average level of leptin was 21.7±4.1 ng/ml, in the presence of signs of LVH - 39.2±4.95 ng/ml. Conclusions. Leptin levels in MS patients is higher than in patients without MS, and in patients with MS associated with LVH is higher than in MS patients without LVH. As the leptin level increases, the risk of LVH increases.
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Galectin-3 in patients with left ventricular hypertrophy and metabolic syndrome
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01.01.2018 |
Drapkina O.
Shepel R.
Deeva T.
Kaburova A.
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Arterial Hypertension (Russian Federation) |
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© 2018 All-Russian Public Organization Antihypertensive League. All Rights Reserved. objective. To investigate the serum levels of galectin-3 in patients with metabolic syndrome (MS) and in patients with combination of MS and left ventricular hypertrophy (LVH), as well as to define the role of this marker of fibrosis in MS. design and methods. The study included 43 patients with MS (33 patients had LVH), and 33 patients of comparable age without MS (LVH was diagnosed in 10). The level of serum galectin-3 was determined by enzyme immunoassay kits Platinum ELISA. Results. The average level of galectin-3 in the MS group was significantly higher (1,89 ± 1,71 ng/ml), compared to the group without MS (1,03 ± 0,22 ng/ml, p = 0,006). The study showed a positive correlation between the level of galectin-3 and LVH (r = 0,323, p = 0,004). The mean value of galectin-3 in patients with no evidence of LVH was 1,2 ± 0,76 ng/ml, in patients with LVH — 2,1 ± 2,02 ng/ml. conclusions. In patients with MS the level of galectin-3 was higher than in patients without MS, and in patients with MS and concomitant LVH it was higher than in patients without LVH. In patients with MS and LVH increased galectin-3 levels may indicate the severity of myocardial fibrosis and help for prognosis evaluation.
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The forensic medical characteristic of sudden death associated with metabolic syndrome
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01.01.2018 |
Pigolkin Y.
Dorosheva Z.
Oganesyan N.
Gornostaev D.
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Sudebno-Meditsinskaya Ekspertiza |
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© 2018 Media Sphera Publishing Group. All rights reserved. The detection of grade II-III central obesity on a corpse in conjunction with the identification of two additional criteria (such as arterial hypertension and impaired glucose tolerance) provides, if combined with the autopsy data (including the visual reduction of muscular mass, the increased total amount of the adipose tissue, gynecomastia in men together with hypertrophied abdominal adipose tissue accumulation, decreased face and body pilosis), a basis for diagnostics of metabolic syndrome (MS). The objective parameters for this purpose are waist circumference measurements, corpse weight and height, the degree of visceral obesity, narrowing of the renal arteries as a result of their compression by the surrounding adipose tissue, and accumulation of epicardial fat confirmed by the results of the biochemical analysis. The signs of plasmorrhagia combined with fibrinoid degeneration of the vascular walls in the microcirculatory bed make it possible to suspect, with a high degree of probability, the development of hypertensive crisis that may result in a sudden death of the patients presenting with metabolic syndrome.
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