Tag Archives: metabolic syndrome

Iron metabolism and metabolic dysfunction-associated fatty liver disease

DOI: 10.2478/amma-2023-0031

Objective: The primary objective of this study was to investigate the association between biomarkers of iron metabolism and metabolic dysfunction-associated fatty liver disease in individuals with type 2 diabetes and non-diabetic individuals compared to a control group. We also examined the possible association between estimated liver fibrosis and serum ferritin levels in all three groups.
Methods: We conducted a descriptive, cross-sectional, comparative study involving subjects diagnosed with diabetes and/or metabolic dysfunction-associated fatty liver disease from an outpatient diabetology clinic and two general practices in Târgu Mureș. The patient population was divided into 3 groups: first group including diabetic patients suffering from fatty liver disease, second group including patients without fatty liver disease and third group with non-diabetic patients suffering from fatty liver disease. We compared the three groups based on specific laboratory tests.
Results: Patients with fatty liver disease had significantly higher ferritin and transferrin saturation levels than non-fatty liver disease sufferers (p<0.05). Transferrin saturation of the first group was significantly (p<0.05) higher compared to the non-diabetic fatty liver disease group. Ferritin correlated well with Fibrosis-4 index level (τ= 0.193, p<0.01) considering the whole sample and especially in the first group.
Conclusions: In our study, there was a clear association between higher ferritin levels and the presence of metabolic dysfunction-associated fatty liver disease. The higher transferrin saturation observed in diabetic patients suffering from metabolic dysfunction-associated fatty liver disease may indicate the possible etiological significance of iron overload. Higher ferritin levels in diabetes increase the risk of liver fibrosis.

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The Role of Acanthosis Nigricans in Identifying Clinical and Metabolic Features of the Metabolic Syndrome in Obese Children

Background: Acanthosis nigricans (AN) is a dermatologic marker of hyperinsulinemia and has been linked with metabolic syndrome in adults. In children, the relationship between AN and different components of the metabolic syndrome has received mixed research results. We investigated whether the clinical and metabolic profile of obese children with AN was different from those without AN.
Material and methods: We studied retrospectively the observation charts of children who were evaluated in our clinic for obesity and/or anomalies of glucose metabolism from January 1st 2005 to December 31st 2009. The study population consisted of 52 children. The analyzed data included: age, sex, body mass index (BMI), the presence or absence of AN, systolic and diastolic blood pressure, the results of the oral glucose tolerance test, triglycerides and high-density lipoprotein (HDL) cholesterol levels, baseline insulin, the homeostatic model assessment: insulin resistance (HOMA-IR), glicated hemoglobin. We divided our study population into two groups according to the presence or absence of AN. We used One-Way ANOVA to evaluate the clinical and metabolic differences between the two study groups.
Results: We found significant differences between the two groups for BMI, systolic and diastolic blood pressure, triglycerides, HDL cholesterol, baseline insulin and HOMA-IR.
Conclusions: Our study shows that AN seems to be linked with most of the features of the metabolic syndrome in children. The relationship of AN and anomalies of glucose metabolism need further testing.

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Obesity and Metabolic Syndrome as Risk Factors of Colorectal Polyps and Colorectal Cancer

Purpose: Obesity and metabolic syndrome, each represent one of the risk factors in colon cancer and colon polyps. We have studied the association between obesity, metabolic syndrome and the risk of developing colorectal cancer and colorectal polyps.
Materials and methods: Our study refers to patients with mucosal modifications at the level of the colon, hospitalized and investigated through colonoscopy in the Gastroenterology Clinic 1, Tîrgu Mureș between 2008–2011.
Results: There were 324 patients with colorectal cancer and colorectal polyps, compared with 345 control patients investigated in the same hospital. In the study group, 69 patients (21.29%) were overweight (BMI 25–29.99 kg/m2) and 71 patients (30.90%) were obese (BMI> 30 kg/m2), compared with the control group, where 53 patients (15.36%) were overweight and 32 patients (9.26%) were obese. There was a significant association between obesity and risk for colorectal cancer and colorectal polyps: BMI >30 kg/m2 – OR = 2.89, CI: 1.64–5.10. We also observed a significant increase in the risk for colorectal polyps and colorectal cancer in parallel with the increase of the number of metabolic syndrome components: 1 component – OR = 1.55, CI: 1.09–2.20; 2 components OR = 2.42, CI: 1.54–3.81; 3 components OR = 2.37, CI: 1.16–4.81; 4 or more components OR = 5.27, CI: 1.07–25.85.
Conclusions: The results of our study showed that obesity and metabolic syndrome are associated with an increased risk for the development of colorectal polyps and colorectal cancer.

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Surrogate Measures of Insulin Resistance in Middle-aged Non-diabetic Subjects

DOI: 10.2478/amma-2013-0064

Objective: Insulin resistance has been shown to be a risk factor for type 2 diabetes and cardiovascular disease. The assessment of insulin sensitivity in the clinical practice, however, faces several difficulties. The study proposes to analyze surrogate measures of insulin resistance based on fasting insulin levels in central Romania, and check whether the diagnosis of the metabolic syndrome is an adequate strategy to identify middle-aged persons with reduced insulin sensitivity.
Methods: Anthropometric measurements, metabolic profile, and surrogates measures of insulin sensitivity (GIR, HOMA, QUICKI, FIRI, Belfiore, Bennett, Raynaud, McAuley index) based on fasting insulin levels were assessed in 233 non-diabetic middle aged subjects.
Results: Cutoff values, determined as the lowest quartile of insulin sensitivity for fasting insulin, HOMA, IRI (1/QUICKI), FIRI and Belfiore’s, Bennett’s, Raynaud’s and McAuley’s insulin sensitivity indices were 10.49 mU/L, 2.1, 3.01, 2.32, and 0.03, 1.34, 3.81, 6.29, 5.82. Components of the metabolic syndrome showed moderate but significant correlations with the surrogate measures of insulin resistance (r = 0.22–0.56, p <0.05). HOMA-IR and McAuley indices were the best predictors of clustered cardiometabolic risk factors (AUC – 0.83, 0.81 and 0.82). The metabolic syndrome diagnosis performed well in identifying patients with reduced insulin sensitivity (McAuley 2: sensitivity – 0.78, specificity – 0.84).
Conclusion: Fasting insulin derived insulin sensitivity indices may help the recognittion of insulin resistant states predicting cardiometabolic disorders. Actively looking for insulin resistance by these simple indices, or by diagnosing the metabolic syndrome, those at increased risk can be recognized.

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Prevalence of Metabolic Syndrome in Psoriatic Arthritis and Rheumatoid Arthritis

DOI: 10.2478/amma-2014-0041

Introduction: The psoriatic patients have an increased number of associated comorbidities. Of these, cardiovascular diseases present the highest incidence and severity. The understanding of the cardiovascular risk in patients with psoriatic arthritis was supported from the rheumatoid arthritis studies that suggested that patients with psoriatic arthritis have a risk of cardiovascular diseases similar to patients presenting rheumatoid arthritis. The presence of the metabolic syndrome further increases the risk of cardiovascular disease. The purpose of this study was to determine the prevalence of metabolic syndrome and its components in two groups of patients: those presenting psoriatic arthritis and those with rheumatoid arthritis.
Material and method: The study included two groups of patients: group one – 40 patients with psoriatic arthritis defined by Moll and Wright criteria, respectively the group two – 51 patients with rheumatoid arthritis defined by American College of Rheumatology (ACR) criteria. The metabolic syndrome was defined according to the consensus definition (incorporating IDF and American Heart Association/National Heart, Lung and Blood Institute -AHA/NHLBI definitions).
Results: We enrolled in the study 91 patients having a mean age of 57.7±10.4SD (54.7±10.2 SD psoriatic arthritis, 60.01±10.0 SD rheumatoid arthritis). The mean disease duration (years) was 4.12±4.1SD for psoriatic arthritis and 6.7±7.8SD for rheumatoid arthritis. The prevalence of the metabolic syndrome was 67.5% in the group with psoriatic arthritis and 37.2% in patients with rheumatoid arthritis. The psoriatic patients had a higher prevalence of impared fasting glucose (52.5% vs 27.4%, p=0.018), and elevated trygliceride values as compared with those presenting rheumatoid arthritis (25% vs 11% p=0.0004).
Conclusions: The prevalence of metabolic syndrome is increased in patients with psoriatic arthritis as compared to patients with rheumatoid arthritis.

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Association of Heart Failure with Preserved Ejection Fraction and Components of Metabolic Syndrome

DOI: 10.1515/amma-2015-0078

The aim of the current study was to find any possible associations between elements of metabolic syndrome and echocardiographic characteristics (grade of diastolic dysfunction) in normoponderal and overweight patients with heart failure with preserved ejection fraction. A retrospective observational analytical study was performed on 130 patients presenting heart failure with documented ejection fraction over 50%. They were divided into two groups based on their body mass index. The first group included 56 normal weight patients and the second group included 74 overweight patients. Elements of the metabolic syndrome analysed in the current study were arterial hypertension, high triglyceride levels, low HDL-cholesterol and diabetes. None of the components of metabolic syndrome alone had a role in the evolution of diastolic dysfunction in either group. Three or four elements present in obese patients were negatively associated with grade 2 diastolic dysfunction, high values of blood pressure (over 180/110 mmHg) were more often encountered in obese patients with first and second grade of diastolic dysfunction.

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