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Challenges and Opportunities in Metabolic Syndrome

Challenges and Opportunities in Metabolic Syndrome

Marina Lancaster D. de Moraes Salles
Department of Biochemistry and Nutrition, School of Nutrition, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil

Nataly Garcia
Department of Biochemistry and Nutrition, School of Nutrition, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil

Lucas Fornari Laurindo
Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil

Angiseli Damaceno Scanavacca
Department of Biochemistry and Nutrition, School of Nutrition, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil

Karla Regina Ezídio
Department of Biochemistry and Nutrition, School of Nutrition, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil

Ricardo José Tofano
Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil

Cláudia Rucco Penteado Detregiachi
Department of Biochemistry and Nutrition, School of Nutrition, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil; Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil

Jesselina F. dos Santos Haber
Department of Biochemistry and Nutrition, School of Nutrition, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil

Mara Silva Foratto Marconatto
Department of Biochemistry and Nutrition, School of Nutrition, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil

Sandra Maria Barbalho
Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil; Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil; Department of Biochemistry, School of Food and Technology of Marilia (FATEC), Avenida Castro Alves, 62, Marília, São Paulo 17500-000, Brazil

Karina Quesada
Department of Biochemistry and Nutrition, School of Nutrition, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil; Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília, São Paulo 17525-902, Brazil

Abstract

Poor sleep quality can affect cardiovascular health and is considered a significant risk factor for the development of risk factors for Metabolic syndrome (MetS). This study aimed to investigate possible associations between sleep quality measured by the Pittsburgh Sleep Quality Index and the MetS. This was a cross-sectional that comprised data from 208 patients. Biochemical and anthropometric parameters were assessed. The identification of MetS was performed according to the International Diabetes Federation guidelines. The quantitative variables were described with the support of the BioEstat 5.3 software. To assess the association of the studied variables with the diagnosis of MetS, the Mann-Whitney and Chi-square (n x n) statistical tests were used. The level of significance considered was 5%. According to the International Diabetes Federation criteria, 111 (53,36%) men and women presented MetS. There were no statically significant differences between the groups with or without sleep disorders and the values of waist circumference (p=0.6996), high-density lipoprotein cholesterol levels (p=0.7940), triglycerides levels (p=0.8703), blood pressure values (p= 0.9851, and p=0.9795 for systolic and diastolic blood pressure, respectively), and glycemia (p=0.5351). Eighty-eight volunteers (42%) presented sleep quality dysfunction, with the highest proportion observed among individuals affected by MetS (p=0.0019). Our results indicate an association between sleep quality and the prevalence of MetS . Therefore, sleep quality could be evaluated in patients with MetS so that the therapeutic strategy would not be limited to the intervention in biochemical and anthropometric factors.

L.A. Ruyatkina
Novosibirsk State Medical University, Novosibirsk, Russia

D.S. Ruyatkin
Novosibirsk State Medical University, Novosibirsk, Russia

L.V. Shcherbakova
Institute of Internal and Preventive Medicine – a branch of the Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia

Abstract

Introduction. The gradual clustering of cardio-metabolic factors in women depending on age and decline of ovarian function justifies attention to the phenotype of the formation of the metabolic syndrome during the menopausal transition depending on the presence of hypertension without dysglycemia.

Aim. To evaluate the association of indicators of the functional state of the pituitary-ovarian axis with markers of metabolic syndrome (MetS) and parameters of insulin resistance (IR) in a cohort of normoglycemic women aged 35-59 years with different levels of blood pressure.

Patients and methods. In a cohort of women 35–59 years old without dysglycemia (n = 88), 58 women had hypertension, 30 were normotensive. It was determined: body mass index (BMI), waist circumference (WC), levels of blood pressure, triglycerides (TG), HDL-C, insulin, follicle-stimulating hormone (FSH) and estradiol, fasting glucose (FG); TyG and HOMA2-IR indices. Using SPSS (version 17) assessed the median (25; 75%); intergroup differences using the Mann-Whitney test; correlation analyzes: Spearman (R) and partial correlation (Rрс) to level out the influence of age.

Results. In the general cohort of women, the influence of postmenopausal duration, FSH and estradiol levels on MetS and TyG parameters depended on age, except for the correlation of postmenopausal duration with FG (Rpc = 0.313; p = 0.004). The range of associations of MetS markers with each other and TyG in the group of patients with hypertension is similar to those in the general cohort of women. In both cohorts, the interrelations between FG, WC, insulin and TyG remained relevant with partial correlation. The Index TyG, associated with HOMA2-IR (R=0.600; p<0.001; Rpc=0.426; p<0.001), had a greater range of connections with MetS components, as well as with FSH (R=0.312; p=0.017; Rpc =0.286; p=0.030) and estradiol (R= -0.393; p=0.002; Rpc = -0.376; p=0.004) in the presence of hypertension.

Conclusion. The influence of indicators of the functional state of the pituitary-ovarian axis on MetS and TyG markers was revealed, along with a spectrum of associations of parameters and factors in the formation of menopausal MetS with IR indices, especially TyG. Correlation relations between FG with postmenopausal duration and MetS components, as well as estradiol in case of hypertension, reflect a high risk of progression to dysglycemia.

J. Varga
National Public Health Center. Budapest, Hungary

K. Kardos
National Public Health Center. Budapest, Hungary

I. Nagy
National Public Health Center. Budapest, Hungary

L. Szirtes
Metal Carbon Ltd., Budapest, Hungary

Abstract

The rhythmic functioning of the human body is influenced by many factors. The development of innovation in recent decades has made it possible to study heart rate variability.

Objectives: (1) obtaining more accurate information than previously available to understand the complex effects on the human body, (2) logical exploration of the directions and magnitudes of variations in the metabolic factors and HRV parameters, (3) drawing attention to the importance of understanding these complex effects and to use them for prevention in occupational health.

Methods: Using non-invasive methods of the HRV analysis, physiological measurements were taken at workplaces with the participation of people at work, both at rest in lying position and during work. In the present study, we focused on analysing the measurement data from groups where, due to the workplace conditions (e.g. chemical safety regulations), clinical laboratory test results were also available. Measurement results were evaluated using the SPSS software system and other advanced mathematical methods.

Results: Of the more than 5,000 physiological measurements carried out at the workplace over nearly 20 years, 571 had measurement results that could be used to analyze changes in the individuals’ metabolism and heart rate. These analyses enabled us to assess the reported relationships, by taking into account (1) the combined changes in heart rate, blood pressure, blood glucose, cholesterol, triglyceride, body weight and HRV parameters, (2) the effects of age, years of service and life characteristics, and (3) the mathematical reliability criteria. On the basis of the available sample size and individual characteristics, groups with favorable and unfavorable conditions were formed. Differences in the data of these groups compared to each other and to the mean demonstrate the striking nature of the results. The reliability of the results was ensured by the mathematical methods used in the analysis.

Conclusion: The simultaneous variations of metabolic syndrome factors and HRV parameters highlight the potential and the importance of using new methods developed through innovation.

Shoemaker R 
Heyman A 
Lark David
 

Abstract

Problems with executive cognitive function, including recent memory, concentration, word finding, confusion, decreased assimilation, and disorientation, can have a variety of sources of disease, including inflammation, metabolic disturbances, and degenerative processes that are typically found in diseases where chronic fatigue is present. The problems presented by multiple coexisting cognitive symptoms are finding: 1) a single diagnostic test that has a history of use by clinicians working with brain-injured patients, such as NeuroQuant (NQ); 2) that is affordable, accurate, and reliable to use as a measure of benefits, or lack of same; and 3) screening, causation, and sequential features of therapy. Furthermore, the complexity of brain injury shows us the limitations of human versus machine-based testing, with advances in transcriptomics leading the way in a new world of diagnostics and therapies that follow gene activation studies.

The objective of this report was to retrospectively look at results of the transcriptomic testing of white blood cells, combined with a brain volumetric imaging study, in an observational study to provide a basis to identify the specific causation of brain injury caused by exposure to the interior environment of water-damaged buildings (WDB). By comparing transcriptomic abnormalities with known volumetric patterns of injury to cortical grey matter, enlargement of superior lateral ventricles and atrophy of grey matter nuclei, we demonstrate the feasibility of treatment of brain injury employing noninvasive methods in preparation for novel treatments previously shown to be effective. We intend to use these tests sequentially in a before-and-after fashion to show correction of metabolic and inflammatory conditions found in chronic inflammatory response syndrome (CIRS) in a subsequent study.

Robbert Bipat
Department of Physiology, Faculty of Medical Science, Anton de Kom University of Suriname, Kernkampweg 5 Paramaribo, Suriname

Indira Magali
Department of Physiology, Faculty of Medical Science, Anton de Kom University of Suriname, Kernkampweg 5 Paramaribo, Suriname

Rubaina Soekhoe
Department of Physiology, Faculty of Medical Science, Anton de Kom University of Suriname, Kernkampweg 5 Paramaribo, Suriname

Jerry Toelsie
Department of Physiology, Faculty of Medical Science, Anton de Kom University of Suriname, Kernkampweg 5 Paramaribo, Suriname

Abstract

Emerging evidence suggests that a high postprandial glucose level in plasma or blood is an important factor for the etiology of non-communicable disorders like the metabolic syndrome, diabetes, obesity and cardiovascular disease. A high sugar content of the food naturally increases the postprandial glucose level. However, quite a few studies provided proof in the past that the physical properties like viscosity, temperature, and water content of the food we consume also may influence the level of this parameter. The aim of this study is to give a narrative review of present findings that showed the physical properties of consumed food influenced the postprandial glucose level.

The online databases Medline, Pubmed, Google Scholar and Hinari have been searched for publications on “plasma glucose” and “temperature” or “viscosity” or “solubility” or “water content”. All articles dealing with the influence on the postprandial glucose level in the blood have been included. Articles written in a language we could not understand or without a proper translation into English have been excluded.

In general, most available studies showed that the physical properties temperature, viscosity, and water content of consumed food influenced the postprandial glucose. An increased temperature, increased viscosity and decreased water content of the food is generally associated with a higher postprandial glucose level in blood or plasma after consumption. Further detailed studies in both preclinical as well as clinical trials should be considered to obtain more detailed results regarding this.

Amir Hadanny
Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel

Joseph Maroon
Neurosurgery department, UPMC, Pittsburgh, PA, United States

Shai Efrati
Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel- Aviv University, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.

Abstract

Introduction: The application of hyperbaric oxygen therapy for patients with both acute and chronic traumatic brain injury has been suggested for over five decades. In the past decade, the design and quality of studies were more detailed and thorough leading to an improved unerstanding of the uses of HBOT and the profiles of the patients who can benefit the most.

Objectives: Perform a comprehensive literature review of hyperbaric oxygen therapy application for the treatment of patients with both acute, subacute and chronic traumatic brain injury.

Methods: Extensive literature search from 1969 to April 2023 was performed on April 1st 2023 within the following databases: Cochrane Library, PubMed, Google Scholar, and Web of Science, including humans clinical data, in articles providing information on the type of treatment and clinical outcomes. Articles were first categorized into acute-subacute traumatic brain inury and chronic traumatic brain injury and further classified into low, medium or high level quality.

Results: There was high level evidence including nine randomized controlled trials, one meta-analysis and two prospective study evaluating the clinical effects of hyperbaric oxygen therapy in patients suffering from traumatic brain injuries in the acute and subacute settings. Mortality was significantly reduced in all studies that used it as an endpoint, while favorable functional outcomes in survivors showed mixed results.

In chronic severe traumatic brain injury, there is low to moderate evidence including two uncontrolled prospective studies, two cohort studies and eight case reports suggesting improved outcomes.

In chronic mild traumatic brain injury, there is high level evidence including seven randomized controlled trials, and six prospective studies suggesting significant improvement in cognitive function, symptoms and quality of life.

Conclusions: Hyperbaric oxygen therapy may be recommended in acute moderate-severe traumatic brain injury patients (Type 2a recommendation, level A evidence). However, further studies are needed to both evaluate outcomes and to determine the optimal treatment protocols for the different types of injuries (Type 1 recommendation, level A evidence).

Hyperbaric oxygen threrapy should be recommended in chronic traumatic brain injury for a selected group of patients suffering from prolonged post-concussion syndrome who have clear evidence of metabolic dysfunctional brain regions as determined by neuroimaging (Type 2a recommendation, level B-R evidence). Patients should be properly evaluated by standardized cognitive tests and functional brain imaging (Type 1 recommendation, level B-R evidence).

David G. Hoel & Allen Miller
 

Abstract

It is becoming well understood that low blood levels of 25-hydroxyvitamin D (25(OH)D) are a risk factor for many diseases and other adverse health effects including hypertension, cardiovascular disease, stroke, breast cancer, colorectal cancer, metabolic syndrome, type 2 diabetes, obesity, multiple sclerosis, type 1 diabetes, rheumatoid arthritis, Alzheimer’s disease, autism, schizophrenia, asthma, preterm birth, maternal mortality, myopia and COVID-19.  Levels of serum 25(OH)D are at the same time a measure of vitamin D status and, since 70-90% of this biomolecule is produced by sun exposure, a measure of sun exposure.  There is some disagreement among scientists as to whether vitamin D supplements are an effective substitute for sun exposure for attenuation of these diseases and adverse health effects.  In this paper we review the current state of the science on this subject and conclude that vitamin D supplements are not an adequate substitute for sun exposure for attenuation of most of these diseases and adverse health effects, particularly hypertension and cardiovascular disease, and should not be recommended in lieu of sun exposure to patients presenting with low levels of serum 25(OH)D. Vitamin D supplementation for such patients could even be harmful, because it will raise patients’ serum 25(OH)D levels, thereby giving patients a false sense of security and obscuring the best available metric for insufficient sun exposure. 

Sebahattin Celik
Department of General Surgery, Van Yüzüncü Yıl University Faculty of Medicine.

İskan Çallı
Department of General Surgery, Van Yüzüncü Yıl University Faculty of Medicine.

Serpil Sevimli Deniz
Department of Computer Technologies, Gevaş Vocational School, Van Yüzüncü Yıl University

M. Kadir Bartin
General Surgery Clinic, Van Training and Research Hospital

Öztekin Çıkman
Department of General Surgery, Van Yüzüncü Yıl University Faculty of Medicine.

Muharrem Duran
General practitionerr in Emergency Depertmant, Van Training and Research Hospital

Serhat Binici
Department of General Surgery, Van Yüzüncü Yıl University Faculty of Medicine.

Abstract

World Health Organization defines obesity as “excessive fat accumulation at a level that may impair health”. Obesity is also officially defined as a “disease” by many surgical and endocrine societies (1,2), and also accepted as a risk factor for some cancers, cardiovascular diseases, chronic kidney disease, diabetes, metabolic syndrome, non-alcoholic fatty liver disease, as well as many chronic diseases (2). Although the degree of accuracy is debated, obesity is still defined as a body mass index (BMI) above 30 (1).

Obesity, which was alarming in western countries in the past, is currently a public health problem that concerns the whole world, except for a few southern African and Asian countries (1). Preventive measures are important in tackling the public health problem. In this context, an active life and low-calorie nutrition are accepted as basic preventive practices.

Velin Stratev
Department of pulmonary rehabilitation and lifestyle medicine, Cathinka Guldbergs Hospital, Norway

Odd-Magne Fjeldstad
Department of pulmonary rehabilitation and lifestyle medicine, Cathinka Guldbergs Hospital, Norway

Abstract

Chronic obstructive pulmonary disease (COPD) is chronic disease that affects mostly the lungs but there is growing evidence that it is also a systemic condition associated with a number of accompanying diseases known as comorbidities. Chronic inflammation and oxidative stress are the highlight pathogenic processes that interrelate COPD and comorbidities with additional disease specific risk factors and mechanisms. Through complex interactions COPD increases the risk for certain comorbidities and they in turn have negative impact on health status and contribute to mortality in COPD patients. Treatment of comorbidities in terms of coexistence with COPD may require more specific personalized therapeutic approach. Here we review the pathogenic mechanisms which define COPD as a systemic disease; the most common comorbidities of COPD: cardiovascular disease, diabetes and metabolic syndrome, cachexia, osteoporosis, depression/anxiety and obstructive sleep apnea; the pathways which connect these diseases with COPD and the latest treatment approaches.