Decreased high-density lipoprotein cholesterol and insulin resistance were the most common criteria in 12- to 19-year-old adolescents.

BACKGROUND: Metabolic syndrome (MetS) is characterized by a group of metabolic risk factors leading to an increase in diabetes mellitus and cardiovascular diseases. It is known that the pathologic processes such as hyperinsulinemia and atherogenic risk profile associated with the development of MetS begin during childhood and adolescence. AIM OF THE STUDY: To determine the prevalence of MetS and assess the association between MetS and certain demographic and lifestyle factors in a representative adolescent population. METHODS: The study was carried out in central and ten districts located around Kayseri Province, Central Anatolia. A total of 790 adolescents aged from 12 to 19 years were selected systematically from the schools. Criteria of MetS were modified from Adult Treatment Panel III: (1) waist circumference > 90th percentile (aged between 12 and 17 years) and >102 cm in male, >88 cm in female (for aged 18 and 19 years), (2) serum triglycerides [>or=136 mg/dl (aged between 12 and 16 years) and >or=150 mg/dl (for 17 and 19 years)], (3) high-density lipoprotein cholesterol [or= 95th percentile for gender, age and height, (5) insulin resistance HOMA index < 3.16. Multivariate regression model was performed to search for the association between MetS and demographic and lifestyle factors including gender, age, body mass index, settlement, socioeconomic class, smoking habit, physical activity and family history for diseases (cardiovascular diseases and diabetes mellitus). RESULTS: The overall prevalence of MetS was found as 10.8%. The prevalence was significantly higher in males than in females (13.5 and 8.6%, respectively). Low high-density lipoprotein cholesterol and insulin resistance were the most common criteria of the syndrome. According to the analysis, only gender and high socioeconomic class were weak-positive related factors with MetS. CONCLUSIONS: High prevalence of MetS especially among overweight and obese adolescents is a serious health problem. Early identification of the syndrome would contribute greatly to the prevention of diabetes and cardiovascular diseases in youth.

Prevalence of metabolic syndrome in the Mediterranean region of Turkey: evaluation of hypertension, diabetes mellitus, obesity, and dyslipidemia.

BACKGROUND: Metabolic syndrome has become a public health challenge worldwide. The aim of this study was to determine the prevalence of and risk factors for metabolic syndrome among adults in the Mediterranean region of Turkey. METHODS: This study included a total of 767 people from 20 to 83 years old from 4 provinces calculated with respect to results of the 2000 census. People from the city centers, districts, and villages were selected by a stratified sampling method. Personal histories were recorded. Weight, height, and waist and hip circumferences were measured. Blood samples were obtained to determine glucose, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides. Components of metabolic syndrome were modified from both Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF) criteria. RESULTS: The prevalence of metabolic syndrome was 34.6% (male, 31.2%; female, 37.3%) (P > 0.05) and 28.8% (male, 23.1%; female, 33.5% (P < 0.01) according to IDF criteria and ATP III, respectively. The highest prevalence of metabolic syndrome was present in subjects aged 60-69 years; in obese people (43.2%, P < 0.001); in Hatay province (36.5%, P < 0.001); and in districts (32.2%, P > 0.05). The prevalence of metabolic syndrome criteria in all 4 provinces was as follows: type 2 diabetes mellitus, 15%; hypertension, 41.4%; obesity, 44.1%; abdominal obesity, 56.8%; low HDL-C, 34.1%; hypertriglyceridemia, 35.9%; and high LDL-C, 27.4%. CONCLUSIONS: The high prevalence of metabolic syndrome in this region is an important public health problem that may cause an increase in mortality. Urgent preventive measurements should be implemented.

Is plasma homocysteine level associated with metabolic syndrome components in adolescents?

BACKGROUND: This study investigated whether serum homocysteine (Hcy) level is associated with metabolic syndrome components, including high waist circumference (WC), hypertriglyceridemia, low high-density lipoprotein-cholesterol (HDL-C), elevated systolic blood pressure (SBP), and insulin resistance (IR) in adolescents living in Central Anatolia, Turkey. METHODS: The data of The Prevalence of Metabolic Syndrome Among Adolescents Study, a cross-sectional study carried out in two of the central and ten outlying districts of Kayseri was used. Components of metabolic syndrome were modified from the Adult Treatment Panel III (ATP III). A multivariate regression model was developed to examine the relationships between the homocysteine (Hcy) level and metabolic syndrome components. Hyperhomocysteinemia (HH) was defined as level of Hcy > or = 15 micromol/L. RESULTS: Mean plasma Hcy level of adolescents with metabolic syndrome was found to be 11.8 +/- 5.0 micromol/L. Although the Hcy level of females (11.4 +/- 5.5 micromol/L) was lower than that of males (12.0 +/- 4.7 micromol/L), the difference was not statistically significant (P > 0.05). In all, 40.5% of adolescents had Hcy levels between 10 and 15 micromol/L (mild HH) and 17.7% of adolescents had Hcy levels of > or = 15 micromol/L. The Hcy level was negative and weakly correlated with insulin resistance in females (r = -0.319, P = 0.058) and negative strongly correlated with SBP in males (r = - 0.385, P = 0.011). There were no associations between Hcy level and other components of metabolic syndrome. CONCLUSIONS: An elevated plasma Hcy level is not considered to be related to components of metabolic syndrome. But HH may be an independent risk factor, especially for diabetic adolescents or those who have cardiovascular events as in adults.

Reactive oxygen species in experimental ischemic flow-through venous flaps and effects of antioxidants on reactive oxygen species and flap survival.

We made an experimental study on rabbit ears using an ischemic flow-through venous flap model to determine the changes in levels of reactive oxygen species (ROS) in venous flaps and effects of exogenous antioxidants on endogenous antioxidant superoxide dismutase (SOD) and ROS indicator malonyldialdehyde (MDA) levels and on flap survival. Mean SOD level significantly decreased and the MDA level significantly increased after the flap elevation according to basal levels of untreated flaps. The mean flap survival rates in the exogenous SOD or glutathione (GSH)-treated groups were significantly increased with respect to the untreated group. The SOD level was increased significantly and the MDA level was decreased significantly in the SOD- or GSH-treated groups relative to the control group after the flap elevation. These results have suggested that ROS may have an important role in ischemic flow-through venous flap pathogenesis and additionally, antioxidants could enhance the rate of flap survival.

Protective effect of beta-glucan on lung injury after cecal ligation and puncture in rats.

OBJECTIVE: Understanding the biological mediators involved in the complex inflammatory response of sepsis and acute lung injury offers the possibility of future investigations targeting treatment based on these mediators. This study investigated whether macrophage activator beta-glucan has a protective effect on acute lung injury in an experimental model of sepsis. DESIGN AND SETTING: Experimental study in an experimental research center. MATERIALS: 30 rats randomized into three groups (sham, sepsis, and beta-glucan). INTERVENTIONS: Cecal ligation and puncture were performed in the beta-glucan and sepsis groups. The beta-glucan group was given a single intraperitoneal dose of beta-glucan (4 mg/kg) following cecal ligation. MEASUREMENTS AND RESULTS: Rats treated with beta-glucan had fewer circulating neutrophils, more blood monocytes, and higher serum interleukin 6 levels than septic animals. The percentages of neutrophils and lymphocytes from the bronchoalveolar lavage fluid and the myeloperoxidase activity measured in the lung tissue were lower in the beta-glucan group than in the sepsis group. Less alveolar hemorrhage and neutrophil infiltration were observed in lungs from animals in the beta-glucan group in the septic groups. CONCLUSIONS: In this rat model of intra-abdominal sepsis beta-glucan treatment partially protected against secondary lung injury, decreased lung hemorrhages, and lung neutrophilia. These results suggest that beta-glucan protects against sepsis-associated lung damage.

Lipid peroxidation and erythrocyte antioxidant enzymes in patients with Behçet's disease.

In spite of unknown etiology, it is now accepted that reactive oxygen species (ROS) produced by neutrophils may be related to the pathogenesis of Behçet's Disease (BD). The objective was to investigate whether increased production of ROS may affect erythrocyte oxidant/antioxidant system in patients with BD. The levels of malondialdehyde (MDA), one of the end products of lipid peroxidation, in plasma and erythrocyte, and the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), antioxidant enzymes, in erythrocyte, also C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured in 22 patients in active stage of the disease and also in 30 healthy controls. Increased CRP, ESR, and MDA levels in plasma and erythrocyte and increased SOD but decreased GSH-Px activities in erythrocytes were observed in the patients, when compared to the controls. In addition, significantly positive correlations between plasma and erythrocyte MDA levels, and erythrocyte MDA-CRP, MDA-ESR, MDA-SOD, SOD-ESR and SOD-CRP levels, but negative correlation between plasma MDA and erythrocyte GSH-Px, were found in BD patients. It may be suggested that increased production of ROS in BD, as reflected by higher plasma and erythrocyte MDA levels, may impair erythrocyte membrane integrity and also may lead to the alterations in the erythrocyte antioxidant defense system, as reflected by higher SOD and lower GSH-Px activities in erythrocytes.

Antioxidant potential of propylthiouracil in patients with psoriasis.

OBJECTIVE: There is growing evidence supporting the reactive oxygen species (ROS) in the pathogenesis of psoriasis. Propylthiouracil(PTU), an antithyroid drug, has been shown to have beneficial effects on psoriasis. The aim of this study was to investigate both disturbances in oxidant/antioxidant system in psoriasis and whether PTU, shown to have immunomodulatory effects and antioxidant potential, has effects on oxidant/antioxidant system and clinical improvement in psoriatics. DESIGN AND METHODS: Malondialdehyde (MDA), end product of lipid peroxidation, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and antioxidant enzymes were measured in plasma, erythrocytes and skin biopsies of psoriatics who were resistant to conventional therapy before and after 8 weeks of oral treatment with PTU (300 mg/day) or PTU/thyroxine (25 microg/day- to prevent possible hypothyroidism). The same parameters were also studied in healthy controls. Psoriasis Area and Severity Index (PASI) scores were used to evaluate the severity of the disease, and routine analyses and thyroid function tests were measured during the study. RESULTS: Increased baseline MDA in all samples were found to be lower. In addition baseline SOD and GSH-Px in skin and erythrocytes were also lower. The increased plasma SOD levels in skin and erythrocytes of the study groups was found to be higher and lower,respectively in all patients after the treatment. No tissue parameters or erythrocyte GSH-Px were different from control levels at the end of the study. Significant clinical improvement and decreased PASI scores were observed in all patients. Post treatment TSH levels were higher in all patients, but these levels were within the reference range and none had clinical hypothyroidism. CONCLUSION: These findings may provide some evidence for a potential role of increased lipid peroxidation and decreased antioxidant activity in psoriasis. PTU may be considered as treatment model in psoriasis, in particular for resistant cases, because of its antioxidant potential, and also antiproliferative and immunomodulatory effects.