Correlation of oxidative stress and metabolic risk factors in apparently healthy adults

Background: Diabetes, hypertension, obesity, and dyslipidemia, all are the risk factors of metabolic syndrome (MS). Various studies have shown that each risk factor is associated with increased inflammation. hsCRP is a non-specific, sensitive inflammatory marker that is raised in various inflammatory conditions. Similarly, glutathione is an antioxidant which binds with ROS produced during inflammation and reduces damage caused by ROS. Aims and Objectives: This study has been planned to find the correlation between oxidative stress and metabolic risk factors in apparently healthy adults. Materials and Methods: We recruited apparently healthy adults (n = 120) and measured waist circumference, blood pressure, lipid profile, Fasting blood sugar, serum GSH, and hsCRP in all the subjects. Seventy-seven subjects were found to have at least one or more metabolic risk factors (Group A) according to NCEP ATP III criteria with waist circumference >90 cm for male and >80 cm for female and 43 were without any metabolic risk factors (Group B). Thereafter, we compared the serum levels of hsCRP and serum GSH with persons having one or more risk factors for MS. Results: In this study, we observed that subjects with metabolic risk factors were having more oxidative stress indicated by increased hsCRP (4783.1 ± 2060.21) and low serum GSH (3.17 ± 0.81) in comparison to controls (1640.5 ± 547.47 and 4.79 ± 0.77, respectively). This increase in hsCRP and decrease in GSH in case group was statistically significant. We also found the higher basal hsCRP levels in control group as per AHA/CDC study. Conclusion: We observed in this study that Indians without any risk factors for MS have relatively higher CRP levels and are at intermediate risk for cardiovascular disease. It was also observed that as the number of metabolic risk factors increases, the levels of hsCRP increases, and serum GSH decreases. This indicates that more risk factors are associated with higher oxidative stress.

DIETARY AND CARDIO-METABOLIC RISK FACTORS AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS ATTENDING MEDICAL OUT-PATIENT CLINIC OF A FEDERAL TEACHING HOSPITAL IN NIGERIA

The increasing prevalence of cardio-metabolic risks contributes to an increase in the prevalence of diabetes mellitus. Although the cardiovascular risk factors among type 2 diabetic patients is well known, the dietary and cardio-metabolic risk factors has not been fully investigated. This study was carried out to determine the cardio- metabolic risk factors in 45 purposively-selected adult diabetic patients attending the Medical Out-Patient Clinic, University College Hospital (UCH), Ibadan. A 24-hour dietary recall was used to determine the dietary intake of the patients. Weight and height were measured to determine body mass index (BMI) which was categorized as underweight (<18.5kg/m2), normal weight (18.5-24.9kg/m2), overweight (25-29.9kg/m2) and obese (?30.0kg/m2) and also waist-hip ratio. Biochemical parameters (triglyceride, blood pressure, total cholesterol, fasting blood glucose, high and low density lipoprotein cholesterol) were obtained from their hospital records. Data were analyzed using descriptive statistics, Chi-square test and correlation at p<0.05. The mean age of the patients was 61.3±8.15 years. Their mean BMI was 30.2±6.94kg/m². About (37.8%) of the patients had systolic stage one hypertension, 88.9% had normal triglyceride, 55.6% had normal fasting blood glucose and 80.0% had normal total cholesterol. Less than half (44.4%) of the patients were obese, 33.3% had high waist-hip ratio. A positive and signi?cant correlation was only observed between regular exercise and fasting blood glucose of the patients. The cardio- metabolic risk factors were slightly high among type 2 diabetic patients in UCH, Ibadan. Diabetic individuals should be educated to maintain healthy lifestyles, comply with the right diets in order to reduce complications.

Metabolic risk factors in first acute coronary syndrome (MERIFACS) Study

Objectives: In acute coronary syndrome (ACS) patients the focus is on major conventional risk factors - CRF [diabetes, hypertension, elevated low-density cholesterol (LDL-C) and smoking] whereas others - specific metabolic risk factors - MRF [high-density lipoprotein cholesterol (HDL-C), body-mass index (BMI), waist-hip ratio (WHR), and triglycerides, and HbA1c get less attention. Methods: This is a prospective caseecontrol observational study from 15 tertiary care hospitals in India. CRF and MRF in patients presenting with first incidence of ACS (n ¼ 2153) were compared with matched controls (n ¼ 1210). Results: Propensity score matching (PSM) yielded 1193 cases and matched 1210 controls. Risk factor prevalence in cases vs. controls were CRF: hypertension - 39.4% vs 16.4% (p < 0.0001), diabetes - 42.6% vs 12.7% (p < 0.0001), smoking - 28.3% vs 9.3% (p < 0.0001) and elevated LDL-C - 70.2% vs 57.9% (p < 0.0001). MRF: High BMI - 54.7% vs 55.1% (p ¼ 0.84), increased waist: hip ratio 79.5% vs 63.6% (p < 0.0001), high HbA1c - 37.8% vs 14.9% (p < 0.0001), low HDL-C - 56.2% vs 42.8% (p < 0.0001) and elevated triglycerides - 49.7% vs 44.2% (p ¼ 0.007). Adjusted Odds ratios by multivariate analysis were CRF: hypertension - 2.3 (p < 0.001), diabetes - 4.7 (p < 0.001), high LDL-C - 3.3 (p < 0.001) and smoking6.3 (p < 0.001). MRF: High waist: hip ratio - 2.4 (p < 0.001) high HbA1c - 3.2 (p < 0.001), low HDL-C 2.2 (p < 0.001) and elevated triglycerides - 0.878 p ¼ 0.17. Conclusion: In India, the risk of ACS conferred by specific metabolic risk factors (High waist: hip ratio, Low HDL-C and High HbA1c) is comparable to that caused by CRF

Mitos y realidades sobre la obesidad en el síndrome de ovario poliquístico / Myths and realities about obesity in polycystic ovary syndrome

Introducción: La asociación entre la obesidad y el síndrome de ovario poliquístico es importante porque amplifica los trastornos metabólicos, reproductivos, psicológicos o de la calidad de vida. Sin embargo, es común que se sobrevalore o se emplee como criterio diagnóstico, lo que denota una definición no clara de esta relación. Objetivo: Analizar lo que, en opinión de los autores, pudieran ser "mitos" sobre la obesidad en el síndrome de ovario poliquístico y su coherencia con la evidencia disponible. Métodos: Se realizó una revisión del estado del arte en este tema. Se localizaron 230 artículos en las bases PubMed, Medline, Scielo y Google Académico, y se contrastó con los criterios propios. Conclusiones: Algunas creencias generalizadas sobre la obesidad en el síndrome de ovario poliquístico, aunque tienen cierto grado de certidumbre, se malinterpretan o magnifican, por lo que pueden considerarse "mitos". Entender que las mujeres con síndrome de ovario poliquístico pueden no tener obesidad y, aún así, tener adiposidad abdominal y los efectos que de ella derivan, no niega la evidencia indiscutible de que la obesidad, si está presente, agrava el síndrome. Polemizar sobre el tema pretende contribuir a que se diagnostique el síndrome no solo en mujeres con obesidad y que se considere factor de riesgo para la obesidad. Debe entenderse que la obesidad asociada al síndrome puede revertirse y que se pueden incorporar estilos de vida saludable y un control del peso corporal como pilares del tratamiento en todas las mujeres que padezcan este(AU)

Introduction: The association between obesity and polycystic ovary syndrome is important because it amplifies metabolic, reproductive, psychological, or quality of life disorders. However, it is commonly overestimated or used as a diagnostic criterion, which denotes an unclear definition of this relationship. Objective: To analyze what, in the authors' opinion, could be "myths" about obesity in polycystic ovary syndrome and their consistency with the available evidence. Methods: A state-of-the-art review on this subject was performed and contrasted with own criteria. Conclusions: Some widespread beliefs about obesity in polycystic ovary syndrome, although they have some degree of certainty, are misinterpreted or magnified, so they can be considered "myths". Understanding that the patients may not suffer from obesity and still have abdominal adiposity and the effects that derive from it, does not deny the indisputable evidence that, if present, it aggravates the syndrome. Discussing the subject intends to contribute to diagnose the syndrome not only in women with obesity. The aim is to consider it as a risk factor for obesity and to prevent it, to understand that obesity can be reversed, and to incorporate counseling on healthy lifestyles and body weight control as pillars of treatment in all women with the syndrome, with or without obesity(AU)

A cohort study of nutritional metabolic risk factors associated with recurrence in patients with initially diagnosed ulcerative colitis / 中华临床营养杂志

Objective:To investigate the nutritional and metabolic risk factors associated with recurrence in patients with newly diagnosed ulcerative colitis (UC), so as to allow better clinical prediction of recurrence.Methods:A retrospective cohort study was conducted. Patients newly diagnosed with UC (mild and moderate) from the People's Hospital of Xinjiang Uygur Autonomous Region were screened based on prespecified inclusion and exclusion criteria from January 2016 to January 2019. Patients were followed up regularly for three years. Subgroups were determined according to the presence or absence of recurrence. The patients in the UC recurrence group were further stratified according to the time to recurrence into short-term (0-6 months), mid-term (6-12 months) and long-term (12-36 months) recurrence groups. The nutritional and metabolic risk factors related to recurrence were evaluated by univariate analysis and multifactorial logistic regression analysis, and the predictive value was evaluated via receiver operating characteristic curve. The risk factors were then compared across the 3 subgroups with recurrence.Results:A total of 210 patients newly diagnosed with UC (mild and moderate) were included, including 38 experiencing recurrence within 0-6 months, 27 within 6-12 months, 24 within 12-36 months, and 121 without recurrence. There were no statistically significant differences in gender, age, smoking history, and family history in the recurrence group compared with the non-recurrence group. Univariate analysis suggested significant differences in homocysteine, folate, total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), apolipoprotein A/B (ApoA/B), 25-hydroxy vitamin D 3, and body mass index (BMI) between recurrence and non-recurrence groups ( P < 0.05). Multifactorial binary logistic regression analysis suggested that homocysteine ( OR = 0.869, 95% CI: 0.782 to 0.965, P = 0.009), triglycerides ( OR = 0.176, 95% CI: 0.060 to 0.519, P = 0.002), LDL ( OR = 0.256, 95% CI: 0.089 to 0.733, P = 0.011), 25-hydroxy vitamin D 3 ( OR = 0.937, 95% CI: 0.895 to 0.0.982, P = 0.006), and BMI ( OR = 1.319, 95% CI: 1.162 to 1.498, P < 0.01) were independent risk factors for UC recurrence. The predictive efficiency of individual risk factors in descending order was as following: LDL (AUC = 0.762, Youden's index [YI] = 0.42, cut-off value = 2.345), triglycerides (AUC = 0.718, YI = 0.361, cut-off value = 1), homocysteine (AUC = 0.666, YI = 0.283, cut-off value = 13.265). There were no statistically significant differences in gender, age, smoking history, and family history across the short-term, mid-term and long-term recurrence groups. There were significant differences in HDL and ApoA/B levels between the short-term and the long-term recurrence groups ( P < 0.05). Conclusions:Recurrence of the disease in UC patients results from the combined effects of multiple factors. The changes in homocysteine, triglycerides, LDL, 25-hydroxy vitamin D 3, and BMI in UC patients should be proactively monitored to prevent recurrence.

Efectos de la frecuencia de consumo de alimentos ultraprocesados y su asociación con los indicadores del estado nutricional de una población económicamente activa en México

RESUMEN El objetivo de este estudio fue determinar la relación entre consumo de alimentos ultraprocesados y los indicadores del estado de nutricional de una muestra de población económicamente activa en México. Se realizó un estudio transversal en individuos de ambos sexos (18 a 60 años, n=150). Para la obtención de datos antropométricos de la población y de composición corporal, se utilizó un equipo de bioimpedancia. Además, se aplicó un cuestionario de frecuencia de consumo de alimentos ultraprocesados (previamente validada) para la evaluación dietética. Los resultados de los indicadores de estado nutricional demostraron que el 80% de la población estudiada presentó obesidad y sobrepeso; el 88,7% tuvo un % de grasa alto; y el 75,3% presentó riesgo metabólico alto. Con respecto a la evaluación dietética, el grupo de alimentos de ultraprocesados con alto contenido de azúcares simples fue el de mayor consumo (47%, 10,4 veces por semana). Los resultados del análisis de correlación de Pearson, indicaron que existe una correlación negativa significativa entre la edad y el consumo en cuatro de cinco grupos de alimentos ultraprocesados. Finalmente, se encontró que la muestra presenta riesgos de salud importantes que pueden afectar su calidad de vida y productividad. Se deben implementar estrategias a corto plazo de mejora de hábitos de alimentación y estilo de vida saludables en este sector de la población tan importante.

ABSTRACT This work aimed to correlate ultra-processed product consumption and nutritional status in a sample of the Mexican labor force population. A cross-sectional study assessed subjects from both genders (18 to 60 years, n=150). Bioimpedance equipment was used to obtain anthropometric measurements and body composition parameters. Moreover, a previously validated frequency questionnaire of ultra-processed foods was used to obtain dietetic data. Results from the nutritional status evaluation indicated that 80% of the sample was obese or overweight; 88.7% had high total fat mass percentage, and 75.3% had high metabolic risk. Regarding the dietetic evaluation, ultra-processed products with high sugar content were the most consumed (47%, up to10.4 times per week). Furthermore, the Pearson correlation analysis results showed a significant negative correlation between age and consumption in four of the five ultra-processed product groups evaluated. Therefore, there is a need to implement internal strategies to diminish the consumption of ultra-processed products and improve healthy food choices and physical activity of the sample to avoid quality of life deterioration and reduce economic losses in this sector.

Patrones morfológicos asociados a factores de riesgo metabólico en población de adolescentes escolarizados / Morphological patterns associated with metabolic risk factors in the adolescent school population

RESUMEN: El aumento sostenido en la prevalencia de sobrepeso y obesidad en niños, niñas y adolescentes, causa alarma en la comunidad científica, que observa incrementos importantes en las enfermerdades asociadas a Síndrome Metabólico (SM), en la vida adulta. Chile presenta un 75 % con sobrepeso y obesidad en la población adulta y un 50,9 % en la población estudiantil, con un 66,2 % de sedentarismo. Los objetivos de este trabajo fueron determinar los perfiles antropométricos y su asociación a riesgo metabólico en adolescentes de colegio particular subvencionado de Arica-Chile. El total de los alumnos de enseñanza media, n= 810 (mujeres n= 437 y hombres n= 373), fueron evaluados según: peso, talla, perímetro de cintura, índice cintura-talla (ICT), índice de masa corporal (IMC). A todos ellos se les calculó el riesgo metabólico según protocolos de Ashwell & Gibson (2016) y el IMC según fórmula de Quetelet. Los datos fueron analizados en estadístico para tendencia central, dispersión y porcentajes. Para correlación se utilizó test de Pearson (r>0,5). Los resultados muestran que un 44,1 % de las mujeres y un 37,2 % de los hombres presentan sobrepeso y obesidad. El riesgo metabólico general de la población en estudio fue de 24,6 % (24,7 % y 24,4 % en mujeres y hombres respectivamente). Se observó una alta correlación entre PC / ICT (r= 0,92), IMC / ICT (r= 0,86) y Peso / PC (r= 0,87). Se concluye que las y los adolescentes presentan valores antropométricos alterados que indican altos índices de riesgos metabólicos. Los parámetros más alterados se observan en el segundo año de enseñanza media con porcentajes de sobrepeso y obesidad de 49,1 % en las mujeres versus 33,8 % en los hombres. Independientemente, los hombres presentaron mejores índices morfométricos que las mujeres. Se observaron altas correlaciones (r> 0,5) en todos los parámetros en estudio, asociados a riesgo metabólico. Se sugiere enfocar las intervenciones educativas según sello de vida saludable, incentivando la actividad física y mejorar los hábitos alimenticios en las y los adolescentes escolarizados.

SUMMARY: The sustained increase in the prevalence of overweight and obesity in children and adolescents causes alarm in the scientific community, who observe significant increases in diseases associated with Metabolic Syndrome (MS), in adult life. Chile presents 75 % with overweight and obesity in the adult population and 50.9 % in the student population and with 66.2 % of sedentary lifestyle. The objectives of this work were to determine the anthropometric profiles and their association with metabolic risk in adolescents from a subsidized private school in Arica-Chile. The total of high school students, n = 810 (women n = 437 and men n = 373), were evaluated according to: weight, height, waist circumference, waist-height index (WHI), body mass index (BMI). Metabolic risk was calculated for all of them according to Ashwell & Gibson protocols and BMI according to Quetelet's formula. The data were analyzed in statistics for central tendency, dispersion, and percentages. Pearson test (r> 0.5) was used for correlation. The results show that 44.1 % of women and 37.2 % of men are overweight and obese. The general metabolic risk of the study population was 24.6 % (24.7 % and 24.4 % in women and men, respectively). A high correlation was observed between WC / WHI (r = 0.92), BMI / WHI (r = 0.86) and Weight / WC (r = 0.87). It is concluded that adolescents present altered anthropometric values that indicate high rates of metabolic risks. The most altered parameters were observed in the second year of secondary education with percentages of overweight and obesity of 49.1 % in women versus 33.8 % in men. Regardless, males presented better morphometric indices than females. High correlations (r> 0.5) were observed in all the parameters under study, associated with metabolic risk. It is suggested to focus educational interventions according to the seal of healthy living, encouraging physical activity and improving eating habits in school adolescents.

Composición corporal y factores de riesgo metabólico en profesores de enseñanza básica de colegios de Chile / Body composition and metabolic risk factors in primary in primary school teachers in Chile

En el mundo la obesidad es considerada una pandemia que provoca grandes cambios metabólicos, responsables de las llamadas enfermedades crónicas no transmisibles (ECNT), las cuales presentan un 60 % de mortalidad, según la Organización Mundial de la Salud (2016). En Chile el 75 % de la población adulta y el 50,9 % de la población estudiantil, muestran índices de masa corporal de sobrepeso y obesidad, con un nivel de sedentarismo general de 66,2 %. Los objetivos de este trabajo fueron determinar los perfiles antropométricos, riesgo metabólico y niveles de actividad física en profesores de enseñanza básica en un colegio particular subvencionado de Arica-Chile. El total de los profesores, 12 varones y 29 mujeres, fueron evaluados según: peso, talla, perímetro de cintura, índice cintura-talla (ICT), índice de masa corporal (IMC), masa grasa (MG), masa grasa visceral (MGV) y masa muscular (MM). A todos ellos se les calculó el riesgo metabólico según protocolos de Ashwell & Gibson (2016) y el IMC según fórmula de Quetelet. Para determinar los porcentajes de MG, MM y MGV, se utilizó instrumento de bioimpedancia eléctrica, Omron HBF-514C. Posteriormente se les aplicó una encuesta sobre nivel de actividad física (IPAQ). Los datos fueron analizados en estadístico IBM SPSS para tendencia central, dispersión, conteos y porcentajes. Para correlación se usó test de Pearson (r>0,5). Los resultados muestran que un 68,3 % de los profesores presenta sobrepeso y obesidad. El IMC y porcentaje de MGV son significativamente más alto en varones que en mujeres (30,6 ±7,0 / 26,9±4,6 y 11,2±5,6 / 7,6±2,5 respectivamente). El riesgo metabólico general de la población en estudio fue de 58,5 % (75 % y 51,7 % varones y mujeres respectivamente). Se observa una alta correlación entre IMC-MGV (0,84), IMC-ICT (0,84) y MM-MG (0,85). Respecto al nivel de actividad física, solo el 19,5 % de los profesores muestra un nivel de actividad física alto. Se concluye que los profesores presentan valores antropométricos alterados que indican altos índices de riesgos metabólicos y con bajos niveles de actividad física. Independientemente, las mujeres presentan mejores índices morfométricos en todos los parámetros en estudio respecto a los profesores varones. Existe una alta correlación (r) entre el índice de masa corporal y los porcentajes de masa de grasa visceral y el índice de de cintura talla. Se sugiere enfocar las intervenciones educativas según sello de vida saludable, incentivando la actividad física y mejorar los hábitos alimenticios en los profesores.

Obesity is considered a global pandemic that causes major metabolic changes. It is responsible for the so-called noncommunicable chronic diseases (NCDs), which report a 60 % mortality rate (WHO, 2017). In Chile, 63 % of the population shows body mass indexes (BMI) of overweight and obesity, with a sedentary level of 86.7 %. The objectives of this work were to determine the anthropometric profiles, metabolic risk, and physical activity levels in primary school teachers, in a subsidized school in Arica, Chile. The teachers (n=41), 12 men, and 29 women were evaluated according to weight, height, waist circumference (WC), waist-to-height index (WHI), BMI, Fat Mass (FM), Visceral Fat Mass (VFM) and Muscle Mass (MM). All of them were calculated for metabolic risk, according to Ashwell & Gibson protocols and BMI according to Quetelet's formula. To determine the percentages of FM, MM, and VFM, an electric bioimpedance instrument, Omron HBF-514C, was used. Subsequently, a survey of physical activity level (IPAQ) was applied. The data were analyzed in the IBM SPSS statistic for central tendency, dispersion, counts, and percentages. For correlation, Pearson's test (r> 0.5) was used. The results show that 68.3 % of teachers are overweight and obese. BMI and percentage of VFM are significantly higher in men than in women (30.6 ± 7.0 / 26.9 ± 4.6 and 11.2 ± 5.6 / 7.6 ± 2.5 respectively). The overall metabolic risk of the study population was 58.5 % (75 % and 51.7 % men and women, respectively). There is a high correlation between BMIVFM (0.84), BMI-WHI (0.84), MM-FM (0.85). Regarding the level of physical activity, only 19.5 % of teachers show a high level of physical activity. It is concluded that teachers have altered anthropometric values that indicate high rates of metabolic risks and low levels of physical activity. Regardless, women have better morphometric indexes in all parameters under study, compared to male teachers. There is a high correlation (r) between body mass index and percentages of visceral fat mass and waist height index. It is suggested to focus on educational interventions according to the healthy life seal, promoting physical activity, and improving eating habits in teachers.

Progresión del deterioro cognitivo y su relación con factores de riesgo modificables en una cohorte de adultos / Progression of cognitive impairment and its relation to modifiable risk factors in a cohort of adults

Resumen Un estudio de corte transversal realizado entre 2012-2014 en adultos autónomos de Bogotá, mostró una prevalencia de 23% de demencia, encontrándose asociada con baja escolaridad, edad avanzada e hipertensión arterial. La relación de estos factores de riesgo con la progresión del dete rioro cognitivo no ha sido estudiada en nuestra población. Objetivo: evaluar la asociación entre factores de riesgo cardiometabólicos o sociales con la progresión a deterioro cognitivo leve (DCL) o demencia, en adultos autónomos de Bogotá. Material y métodos: una cohorte de sujetos normales y con DCL, del estudio de 2012-2014, se revaluó aplicándose el protocolo neuropsiquiátrico y neuropsicológico del estudio anterior. Se realizaron análisis de correspondencia múltiple y de regresión logística. Resultados: se revaluaron 215 adultos autónomos, 118 sujetos habían sido diagnosticados con cognición normal y 97 con DCL en el primer estudio; 73% fueron mujeres con edad promedio de 71(DE:7.3) años y escolaridad de 8.2 (DE: 5.4) años. Progresaron a demencia 6% de los sujetos en un tiempo de 4(DE:1) años. Un 75% de sujetos normales permaneció sin cambio y 22% progresó a DCL; mientras que 65% de sujetos con DCL no tuvo cambios y un 25% se normalizó. Progresar de normal a DCL se asoció con baja escolaridad OR=2.43 (IC95% 1.004-5.91; p=0.049) y de DCL a demencia con IMC<25 OR=6.3 (IC95% 1.26-31; p=0.025). Conclusión: tener baja escolaridad (<5 años) se asoció en los sujetos normales con un mayor riesgo de progresión a DCL, mientras que tener un IMC <25 aumentó el riesgo de progresión a demencia en los sujetos con DCL. No identificamos factores protectores en los sujetos que se nor malizaron. (Acta Med Colomb 2019; 44: 66-74).

Abstract A cross-sectional study carried out between 2012-2014 in autonomous adults of Bogotá showed a 23% prevalence of dementia, being associated with low schooling, advanced age and arterial hy pertension. The relationship between these risk factors and the progression of cognitive deterioration has not been studied in our population. Objective: to evaluate the association between cardio-metabolic or social risk factors with the progression to mild cognitive impairment (MCI) or dementia, in autonomous adults of Bogotá. Material and methods: a cohort of normal subjects with MCI, from the 2012-2014 study was re-evaluated applying the neuropsychiatric and neuropsychological protocol of the previous study. Multiple correspondence and logistic regression analyzes were performed. Results: 215 autonomous adults were re-evaluated; 118 subjects had been diagnosed with normal cognition and 97 with MCI in the first study; 73% were women with an average age of 71 (SD: 7.3) years and schooling of 8.2 (SD: 5.4) years. 6% of the subjects progressed to dementia in a time of 4 (SD: 1) years. 75% of normal subjects remained unchanged and 22% progressed to MCI while 65% of subjects with MCI did not change and 25% normalized. Progressing from normal to MCI was associated with low schooling OR = 2.43 (95% CI 1.004-5.91; p = 0.049) and from MCI to dementia with BMI≤25 OR = 6.3 (IC95% 1.26-31; p = 0.025). Conclusion: having low schooling (≤5 years) was associated in normal subjects with a higher risk of progression to MCI, while having a BMI ≤25 increased the risk of progression to dementia in subjects with MCI. Protective factors in subjects who normalized were not identified. (Acta Med Colomb 2019; 44: 66-74).

A Tertiary Care Hospital Based Study on Prevalence of Metabolic Syndrome in Coronary Artery Disease Cases

Background: Coronary artery disease (CAD) is the major causes of death in the developed world. It has been reported that there is high prevalence of cardiac risk factors and associated morbidity in the adult population. These risk factors are known as the metabolic syndrome. Due to the alterations in lifestyle, low physical activity, the epidemic of obesity and insulin resistance, metabolic syndrome is a growing health problem in adults. Methods: In this study, 150 total numbers of cases were included. This study conducted in the Department of Medicine in K M Medical College & Hospital, Mathura. The duration of study was over period of one year. Results: In this study, 150 total numbers of cases were included. Out of  150 cases 65.4% were male and 34.6% were female.36% cases 51-60 age group predominantly found followed by >60 & <51.  This study showed risk factor of Diabetic mellitus which were in 67 cases in IHD with metabolic syndrome group. While in IHD without metabolic syndrome group IHD higher risk found followed by other group. Conclusions: This study suggested that, Metabolic syndrome significantly increases the risk of coronary artery disease also. To prevent the development of metabolic syndrome, it is necessary to modify lifestyle.

Perirenal fat thickness is associated with metabolic risk factors in patients with chronic kidney disease

BACKGROUND: Adipose tissue accumulation in specific body compartments has been associated with diabetes, hypertension and dyslipidemia. Perirenal fat (PRF) may lead to have direct lipotoxic effects on renal function and intrarenal hydrostatic pressure. This study was undertaken to explore the association of PRF with cardiovascular risk factors and different stages of chronic kidney disease (CKD). METHODS: We studied 103 patients with CKD of different stages (1 to 5). PRF was measured by B-mode renal ultrasonography in the distal third between the cortex and the hepatic border and/or spleen. RESULTS: The PRF thickness was greater in CKD patients with impaired fasting glucose than in those with normal glucose levels (1.10 ± 0.40 cm vs. 0.85 ± 0.39 cm, P < 0.01). Patients in CKD stages 4 and 5 (glomerular filtration rate [GFR] < 30 mL/min/1.73 m²) had the highest PRF thickness. Serum triglyceride levels correlated positively with the PRF thickness; the PRF thickness was greater in patients with triglyceride levels ≥ 150 mg/dL (1.09 ± 0.40 cm vs. 0.86 ± 0.36 cm, P < 0.01). In patients with a GFR < 60 mL/min/1.73 m², uric acid levels correlated positively with the PRF thickness (P < 0.05). CONCLUSION: In CKD patients, the PRF thickness correlated significantly with metabolic risk factors that could affect kidney function.

Trends in metabolic risk factors among patients with diabetes mellitus according to income levels: the Korea National Health and Nutrition Examination Surveys 1998 ~ 2014 / 한국영양학회지

PURPOSE: Management of the metabolic risk factors in diabetes patients is essential for preventing or delaying diabetic complications. This study compared the levels of the metabolic risk factors in diabetes patients according to the income levels, and examined the secular trends in recent decades. METHODS: The data from the Korea National Health and Nutrition Examination Survey 1998 ~ 2014 were used. The diabetes patients were divided into three groups based on their household income levels. General information was obtained through self-administered questionnaires, and the blood biomarkers and blood pressure data were obtained from a health examination. Multivariable linear regression models were used to compare the metabolic biomarker levels according to the household income levels, adjusting for potential confounding factors. RESULTS: The fasting blood glucose, hemoglobin A1c, and blood lipid (total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride) levels were similar in the three groups. During the survey period of 16 years, the blood pressure showed a significant decreasing trend with time in all groups (p < 0.001). In contrast, the fasting blood glucose (p = 0.004), total cholesterol (p < 0.001), and LDL-cholesterol levels (p = 0.007) decreased significantly, and the HDL-cholesterol level (p < 0.001) increased significantly in the highest-income groups. In the lowest-income group, the fasting blood glucose (p = 0.02), total cholesterol (p < 0.001), and triglyceride (p = 0.003) levels showed a significant decreasing trend over time. On the other hand, the middle-income group showed no significant change in any of the metabolic risk factors except for blood pressure. CONCLUSION: The level of management of metabolic risk factors according to the income level of Korean diabetes patients was similar. On the other hand, the highest- and lowest-income groups showed positive trends of management of these factors during 16 years of observation, whereas the middle-income group did not show any improvement.

Intoxicación por parafenilendiamina: reporte de dos casos y revisión de la literatura / Paraphenylenediamine poisoning: A report of two cases and literature review / Intoxicação por parafenilendiamina: reporte de dois casos e revisão da literatura

Los tintes para el cabello son sustancias de uso frecuente por la población general. Su composición varía de acuerdo al fabricante, pero dentro de sus componentes universales con potencial tóxico se tienen: peróxido de hidrógeno, amoniaco y sustancias oxidantes como la parafenilendiamina. La exposición a estas sustancias puede ser accidental, ocupacional o autoinfligida y es frecuente que por falta de información por parte del personal de salud sobre estos productos no se tengan en consideración los riesgos asociados en el servicio de urgencias. A continuación se presentan dos casos de pacientes con diferentes desenlaces, expuestos con intensión auto-lítica o accidental a tintes que contenían parafenilendiamina, una de las sustancias que explica el compromiso metabólico, renal y cardiovascular asociado a su exposición.

Hair dyes are substances commonly used by the general population. Although their composition varies depending on the manufacturer, the following compounds have the greatest potential for toxicity: ammonium, hydrogen peroxide, and oxidizing substances such as paraphenylenediamine. Exposure to these substances could be accidental, occupational, or self-induced. Unfortunately, this information is often unknown to the clinical practitioners, making it difficult to diagnose and properly treat patients under this kind of intoxication in the emergency room. In this paper, we present two cases with different outcomes in which the patients were exposed (either accidentally or self-induced) to hair dye containing paraphenylenediamine, one of the substances that explains the metabolic, cardiovascular, and kidney compromise associated to this intoxication.

As tintas para o cabelo são substâncias de uso frequente pela população geral. Sua composição varia de acordo ao fabricante, mas dentro dos seus componentes universais com potencial tóxico se tem: peróxido de hidrogeno, amoníaco e substâncias oxidantes como a parafenilendiamina. A exposição a estas substâncias pode ser acidental, ocupacional ou auto-infligida e é frequente que por falta de informação por parte do pessoal de saúde sobre estes produtos não se tenham em consideração os riscos associados no serviço de emergências. A continuação se apresentam dois casos de pacientes com diferentes desfechos, expostos com intensão auto-lítica ou acidental a tintas que continham parafenilendiamina, uma das substâncias que explica o compromisso metabólico, renal e cardiovascular associado a sua exposição.

Evaluación de síndrome metabólico en varones hospitalizados en Unidad de Corta Estadía Psiquiátrica Marzo 2017 / Evaluation of metabolic syndrome in Hospitalized Men in the Short Stay Psychiatric Unit. March 2017

El síndrome metabólico (SM) corresponde a un conjunto de factores de riesgo derivados de la obesidad visceral e insulinoresistencia. 35.3% de la población adulta chilena presentó SM en el período 2009 - 2010, con diferencia significativa entre hombres y mujeres (41.6% vs 30.9%, respectivamente). En Estados Unidos se ha calculado que la media de años potencialmente perdidos en pacientes con enfermedades mentales va de 25 a 30, comparada con la población general. La principal causa de muerte es la enfermedad coronaria. La mayoría de los pacientes en tratamiento neuroléptico en hospitales psiquiátricos no reciben control de factores de riesgo metabólicos. La evidencia señala que los pacientes esquizofrénicos no son adecuadamente pesquisados ni tratados por Dislipidemia (hasta un 88% de estos pacientes siguen sin tratamiento) ni por hipertensión (hasta un 62%). El objetivo de este trabajo es evaluar factores de riesgo cardiovascular en varones hospitalizados en unidad de corta estadía psiquiátrica del Instituto Psiquiátrico Dr. José Horwitz Barak. Se evaluó a 35 pacientes varones, de los cuales un 37% presentó SM, un 45.3% presentó sobrepeso.

The metabolic syndrome (MS) corresponds to a set of risk factors derived from visceral obesity and insulin resistance. 35.3% of the Chilean adult population had MS in the 2009-2010 period, with a significant difference between men and women (41.6% vs 30.9%, respectively). In the United States, it has been estimated that the average number of years potentially lost in patients with mental illness ranges from 25 to 30, compared with the general population. The main cause of death is coronary heart disease. Most patients on neuroleptic treatment in psychiatric hospitals do not receive control of metabolic risk factors. The evidence indicates that schizophrenic patients are not adequately researched or treated for dyslipidemia (up to 88% of these patients remain untreated) or hypertension (up to 62%). OBJECTIVE: To evaluate cardiovascular risk factors in hospitalized men in a short stay psychiatric unit of the Psychiatric Institute Dr. José Horwitz Barak. Thirty-five male patients were evaluated, of which 37% had MS, and 45.3% were overweight.

Prevalence of cardio metabolic risk factors and related socio-demographic factors in adults aged 18-59 years in 15 provinces of China / 中华流行病学杂志

Objective To analyze the prevalence and co-prevalence of cardio metabolic (CM) risk factors in adults in China.Methods The project data of 2015 Nutritional Status and Health Transition of Chinese Residents were used,and 5 456 adults aged 18-59 years with complete sociodemographic,anthropometric,and blood biochemical data were selected as the study subjects.The definition released by the International Diabetes Federation in 2005 were used to define each CM risk factors,including central obesity,elevated TG,reduced HDL-C,elevated blood pressure and elevated FPG.The co-prevalence of the risk factors was defined as adults having ≥2 risk factors.Multivariable logistic regression analysis was performed to evaluate the relationship between CM risk and socio-demographic factors.Results About 80.8％ of adults had at least 1 risk factor,and 54.0％ had co-prevalence of risk factors.Gender,age,education level and living area were significantly associated with the prevalence of major metabolic risk factors.After adjusting for other factors,compared with men,women were more likely to have central obesity and reduced HDL-C,but not more likely to have elevated blood pressure,elevated FPG and elevated TG (P＜0.01).Compared with adults aged 18-44 years,adults aged 45-59 years were more likely to have central obesity,elevated blood pressure,elevated FPG and elevated TG (P＜0.01).The odds of having central obesity,elevated blood pressure and elevated fasting plasma glucose in the adults in eastern China were significantly higher than those in the central and western China.Conclusions In 2015,less than 20％ of the adults aged 18-59 years in China had no cardio metabolic risk factors,and more than half of them had two or more risk factors.Gender,age and living areas were the major influencing factors.It is necessary to take effective intervention measures targeting adults at high-risk for the early prevention of cardiovascular disease.

Self-management levels of diet and metabolic risk factors according to disease duration in patients with type 2 diabetes

BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998–2014). In our analysis, 4,148 patients with T2DM, aged ≥ 30 years, were categorized according to the duration of their illness (< 5 years, 5–9 years, and ≥ 10 years). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (≥ 10 years) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61–3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ≥ 10 years (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

Prevalence of cardio metabolic risk factors and related socio-demographic factors in adults aged 18-59 years in 15 provinces of China / 中华流行病学杂志

Objective To analyze the prevalence and co-prevalence of cardio metabolic (CM) risk factors in adults in China.Methods The project data of 2015 Nutritional Status and Health Transition of Chinese Residents were used,and 5 456 adults aged 18-59 years with complete sociodemographic,anthropometric,and blood biochemical data were selected as the study subjects.The definition released by the International Diabetes Federation in 2005 were used to define each CM risk factors,including central obesity,elevated TG,reduced HDL-C,elevated blood pressure and elevated FPG.The co-prevalence of the risk factors was defined as adults having ≥2 risk factors.Multivariable logistic regression analysis was performed to evaluate the relationship between CM risk and socio-demographic factors.Results About 80.8％ of adults had at least 1 risk factor,and 54.0％ had co-prevalence of risk factors.Gender,age,education level and living area were significantly associated with the prevalence of major metabolic risk factors.After adjusting for other factors,compared with men,women were more likely to have central obesity and reduced HDL-C,but not more likely to have elevated blood pressure,elevated FPG and elevated TG (P＜0.01).Compared with adults aged 18-44 years,adults aged 45-59 years were more likely to have central obesity,elevated blood pressure,elevated FPG and elevated TG (P＜0.01).The odds of having central obesity,elevated blood pressure and elevated fasting plasma glucose in the adults in eastern China were significantly higher than those in the central and western China.Conclusions In 2015,less than 20％ of the adults aged 18-59 years in China had no cardio metabolic risk factors,and more than half of them had two or more risk factors.Gender,age and living areas were the major influencing factors.It is necessary to take effective intervention measures targeting adults at high-risk for the early prevention of cardiovascular disease.

A study of post-partum persistence of glucose intolerance and its association with metabolic risk factors in gestational diabetes mellitus patients in urban South-Indian population

Background: Gestational diabetes mellitus, as a metabolic disorder affects 1%-28% of pregnancies. History of gestational diabetes is an important predictor of various metabolic disturbances later in life. This study was intended to observe the impact of the various predictors over persistence of abnormal glucose tolerance at post-partum and its association with metabolic risk factors. Materials and methods: This was a prospective study of 216 GDM women diagnosed by 75 g oral glucose tolerance test (OGTT) during index pregnancy attending diabetology OPD in Institute of social obstetrics and Kasturba Gandhi general hospital between January 2016 to March 2018. At 6-12 weeks post-partum, 75 g - 2 hr-OGTT was done to assess their glycemic status. Data for predictors and metabolic risk factors were obtained from history, clinical examination and personal records. Plasma glucose was measured by glucose-oxidase method. The results were calculated using SPSS software and expressed in percentage. Results: Of the 216 women only 173 patients came for postpartum follow up at 6- 12 weeks. Normal glucose tolerance (NGT) was seen in 58.9% and abnormal glucose tolerance (AGT) in 41.1%. The Ayyasami Revathi, Tharmaraj Ramesh Kumar. A study of post-partum persistence of glucose intolerance and its association with metabolic risk factors in gestational diabetes mellitus patients in urban South-Indian population. IAIM, 2018; 5(7): 50- 55. Page 51 frequency of abnormal glucose intolerance includes IFG: 0.9%, IGT: 24.5%, DM: 15.7%. Gestational age <20 week at detection of GDM, higher parity, insulin use during pregnancy, previous history of GDM, higher glucose levels on the diagnostic OGTT, hypertension were significantly higher in the AGT group. However positive family history of diabetes and BMI showed no statistically significant correlation. Conclusion: It is concluded that advanced age, higher parity, previous history of GDM, earlier gestational age at diagnosis of GDM and use of insulin during pregnancy are important predictors for AGT during post-partum period and hypertension as a metabolic risk factor was strongly associated with AGT. Need for early postpartum screening and implementation of various intervention program to prevent type 2 diabetes in high risk GDM women.

N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE AND METABOLIC RISK FACTORS / Шинэ санаа Шинэ нээлт

@#BACKGROUND. Heart failure is public health burden in developed countries. There are currently 6.5 million adults in the US who heart failure and this number is expected to rise to more than 8 million people by 2030. AHA and ESC recommend natriuretic peptide biomarker-based screening and interventions aimed at modifying risk factors for patients at risk of developing heart failure as these can be useful in prevention of left ventricular dysfunction or new onset heart failure. OBJECTIVE: To investigate the level of NT-proBNP and its association with metabolic risk factors and possible early detection of chronic heart failure in general population. MATERIAL AND METHODS. In the study, 194 participants aged from 35 to 65 were enrolled. We measured metabolic risk factors and level of NT-proBNP of participants. The two group of participants who have positive and negative NT-proBNP results were compared by the metabolic risk factors. RESULTS. NT-proBNP results were positive in 16.49% (n=32) of the participants. The mean values of age, frequencies of hypertension, systolic and diastolic blood pressure significantly increased in participants with positive NT-proBNP results, while mean values of BMI, frequencies of diabetes, total cholesterol and LDL decreased in participants with negative NT-pro BNP results. CONCLUSION: NT-proBNP was positively related to age, arterial hypertension, sistolic and diastolic blood pressure and inversely related to body mass index, obesity, diabetes, cholesterol, LDL.BACKGROUND. Heart failure is public health burden in developed countries. There are currently 6.5 million adults in the US who heart failure and this number is expected to rise to more than 8 million people by 2030. AHA and ESC recommend natriuretic peptide biomarker-based screening and interventions aimed at modifying risk factors for patients at risk of developing heart failure as these can be useful in prevention of left ventricular dysfunction or new onset heart failure. OBJECTIVE: To investigate the level of NT-proBNP and its association with metabolic risk factors and possible early detection of chronic heart failure in general population. MATERIAL AND METHODS. In the study, 194 participants aged from 35 to 65 were enrolled. We measured metabolic risk factors and level of NT-proBNP of participants. The two group of participants who have positive and negative NT-proBNP results were compared by the metabolic risk factors. RESULTS. NT-proBNP results were positive in 16.49% (n=32) of the participants. The mean values of age, frequencies of hypertension, systolic and diastolic blood pressure significantly increased in participants with positive NT-proBNP results, while mean values of BMI, frequencies of diabetes, total cholesterol and LDL decreased in participants with negative NT-pro BNP results. CONCLUSION: NT-proBNP was positively related to age, arterial hypertension, sistolic and diastolic blood pressure and inversely related to body mass index, obesity, diabetes, cholesterol, LDL.

Actividad física, condición física y factores de riesgo cardio-metabólicos en adultos jóvenes de 18 a 29 años / Physical activity, physical condition and cardio-metabolic risk factors in young adults aged 18 to 29

Introducción. La actividad física y condición física son determinantes de los factores de riesgo cardiometabólicos, pudiendo influenciar en la incidencia de enfermedades crónicas no transmisibles. Objetivos. Analizar la asociación entre nivel de actividad física, condición física y factores de riesgo cardio-metabólicos en adultos jóvenes. Diseño. Estudio observacional, analítico y transversal. Lugar. Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Participantes. Estudiantes de pregrado de las escuelas académico profesionales. Intervenciones. La muestra fue no probabilística, seleccionada por conveniencia, estuvo conformada por 149 hombres y mujeres que consintieron voluntariamente su participación. Se excluyó aquellos con patología cardiaca, metabólica o discapacidad física que impidiera realizar las evaluaciones. Principales medidas de resultados. Nivel de actividad física (NAF), condición física, factores de riesgo cardio-metabólicos. Resultados. El 48,9% de participantes presentó NAF alta; 53,7% tenía uno o dos factores de riesgo alterados: HDL-colesterol bajo (43%), hipertensión (8,7%), hiperglicemia (4%), hipertrigliceridemia (2,7%). El 40,9% de mujeres y 35,6% de varones lograron resultados óptimos en la evaluación de resistencia cardio-respiratoria. El 49% de varones y 34,9% de mujeres alcanzaron resultados óptimos en la evaluación de fuerza abdominal. El 94,6% y 53,7% de participantes tuvieron resultados regulares o deficientes en las evaluaciones de fuerza de miembros inferiores y superiores, respectivamente. Conclusiones. El nivel de actividad física alto estuvo asociado al sexo masculino, presión arterial alta, hipertrigliceridemia, sobrepeso/obesidad, y resultados óptimos de resistencia cardio-respiratoria y fuerza abdominal, en los sujetos estudiados.

Introduction: Physical activity and physical condition are determinants of cardio-metabolic risk factors, and may influence the incidence of chronic non-communicable diseases. Objectives: To analyze the association between physical activity level, physical condition and cardio-metabolic risk factors in young adults. Design: Observational, analytical and transversal study. Setting: Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Participants: Graduate students from professional academic schools. Interventions: The sample was non-probabilistic, selected by convenience, it was formed by 149 men and women who voluntarily consented to participate. Those with cardiac, metabolic or physical disability which prevented the evaluation were excluded. Main outcome measures: Physical activity level (PAL), physical condition, cardio-metabolic risk factors. Results: 48.2% of the participants had high PAL. 53.7% had one or two altered cardio-metabolic risk factors: low HDL-cholesterol (43%), hypertension (8,7%), hyperglycemia (4%),hypertriglyceridemia (2.7%). 40.9% of women and 35.6% of men achieved optimal results in the evaluation of cardio-respiratory resistance. 49% of males and 34.9% of females obtained optimal results in abdominal strength assessment. 94.6% and 53.7% of participants achieved regular or deficient results in strength assessments of lower and upper limbs, respectively. Conclusions: In the subjects studied, high physical activity level was associated with the male sex, arterial hypertension, hypertriglyceridemia, overweight / obesity, and optimal results of cardio-respiratory resistance and abdominal muscle strength tests.