Differences in traditional and emerging cardiovascular risk factors of subjects discordantly classified by metabolic syndrome definitions of the International Diabetes Federation and the National Cholesterol Education Program

Treatment of hypertension in obese patients: focus on telmisartan

The article discusses the role of telmisartan in the treatment of arterial hypertension in patients with metabolic syndrome. Telmisartan is second-generation type 1 angiotensin II receptor blocker, which has unique pleiotropic effects due to partial affinity for receptors that activate the proliferation of subtype y peroxisomes (PPARy) located in adipose tissue. The interrelation of metaflamation, a specific chronic inflammatory process with pathogenetic mechanisms of development of cardiovascular diseases, including arterial hypertension, is also described in study. The role of the adiponectin peptide is considered, which synthesis is stimulated by partial PPARy receptor agonists (as mentioned above — telmisartan). It has a positive effect on fat and carbohydrate metabolism, as well as cardioprotective properties. The conclusion contains the results of numerous randomized studies and meta-analyzes confirming the high efficacy of telmisartan in the treatment of arterial hypertension in patients with morbid obesity.

Genetic endowments, parental resources and adult health: Evidence from the Young Finns Study

This paper uses longitudinal survey data linked to administrative registers to examine socioeconomic gradients in health, particularly whether the effects of genetic endowments interact with the socioeconomic resources of the parental household. We find that genetic risk scores contribute to adult health measured by biomarkers. This result is consistent with the findings from genome-wide association studies. Socioeconomic gradients in health differ based on biomarker and resource measures. Family education is negatively related to obesity and the waist-hip ratio, and family income is negatively related to low-density lipoprotein cholesterol and triglyceride levels. Parental resources do not modify the effects of genetic endowment on adult health. However, there is evidence for gene-family income interactions for triglyceride levels, particularly among women.

Metabolic syndrome

Metabolic syndrome is not a disease per se, but is a term that highlights traits that may have an increased risk of disease, approximately 2-fold for cardiovascular disease and 5-fold or more for type 2 diabetes mellitus. Obesity and insulin resistance are believed to be at the core of most cases of metabolic syndrome, although further research is required to truly understand the pathophysiology behind the syndrome and the gene-environment interactions that increase susceptibility. The mainstay of treatment remains lifestyle changes with exercise and diet to induce weight loss and pharmacologic intervention to treat atherogenic dyslipidemia, hypertension, and hyperglycemia.

Prevalence of metabolic syndrome and related metabolic traits in an island population of the Adriatic

BACKGROUND

Metabolic syndrome, a constellation of risk factors associated with cardiovascular disease and Type 2 diabetes, has reached epidemic proportions worldwide. Epidemiological studies in transitional societies will provide insight into the underlying factors that interact in its manifestation.

AIMS

To estimate the prevalence of metabolic syndrome, provide a comparative analysis of two metabolic syndrome definitions and assess clustering and association of metabolic traits and cardiovascular diseases in an Adriatic island population.

SUBJECTS AND METHODS

In a cross-sectional study, data on four anthropometric, blood pressure and 11 biochemical traits were obtained from 1430 adults from the island of Hvar.

RESULTS

Prevalence of metabolic syndrome was 25% and 38.5% based on Adult Treatment Panel III and International Diabetes Federation definitions, respectively. Rates of abdominal obesity, elevated blood glucose and hypertension were high. Among the traits not included in the definitions, levels of LDL, total cholesterol and fibrinogen were markedly elevated. The majority of the phenotypes were significantly associated with the syndrome, the strongest being waist circumference.

CONCLUSION

The Croatian islanders are characterized by a high prevalence of metabolic abnormalities. Central obesity is the strongest contributor of the syndrome. With a high prevalence of dyslipidemia and pro-inflammatory factors, the population is at substantial risk for cardiovascular diseases.

Change of sex gaps in total and cause-specific mortality over the life span in the United States

PURPOSE

Previous research has led to the expectation that the gap in mortality between sexes narrows in older ages as sex differences in fecundity decrease. However, the patterns and explanations of variations in sex disparities in mortality across the life span and underlying causes of death are not well understood. We conducted a population-based study to further test this hypothesis.

METHODS

By using a nationally representative sample of adults (N = 25,254) with mortality follow-ups for 18 years, we modeled age variations in sex differences in risks of mortality from leading causes of death.

RESULTS

Male excesses in mortality decrease at older ages significantly for some but not all causes. Differential exposures to social, physiological, and morbidity risk factors account for the late life reductions of the sex mortality gaps completely in circulatory diseases, partially or minimally in the other causes of death. Social status and relationship are more important risk factors for mortality in younger ages, health behaviors are significant for all ages, and physiological dysregulation is more predictive of mortality in older ages.

CONCLUSIONS

Sex differences in the risk of mortality have strong age variations and are cause specific. Additional studies of age acceleration of cancer mortality risk are needed.

Age at menarche and its association with the metabolic syndrome and its components: results from the KORA F4 study

OBJECTIVE

The metabolic syndrome is a major public health challenge and identifies persons at risk for diabetes and cardiovascular disease. The aim of this study was to examine the association between age at menarche and the metabolic syndrome (IDF and NCEP ATP III classification) and its components.

DESIGN

1536 women aged 32 to 81 years of the German population based KORA F4 study were investigated. Data was collected by standardized interviews, physical examinations, and whole blood and serum measurements.

RESULTS

Young age at menarche was significantly associated with elevated body mass index (BMI), greater waist circumference, higher fasting glucose levels, and 2 hour glucose (oral glucose tolerance test), even after adjusting for the difference between current BMI and BMI at age 25. The significant effect on elevated triglycerides and systolic blood pressure was attenuated after adjustment for the BMI change. Age at menarche was inversely associated with the metabolic syndrome adjusting for age (p-values: <0.001 IDF, 0.003 NCEP classification) and additional potential confounders including lifestyle and reproductive history factors (p-values: 0.001, 0.005). Associations remain significant when additionally controlling for recollected BMI at age 25 (p-values: 0.008, 0.033) or the BMI change since age 25 (p-values: 0.005, 0.022).

CONCLUSION

Young age at menarche might play a role in the development of the metabolic syndrome. This association is only partially mediated by weight gain and increased BMI. A history of early menarche may help to identify women at risk for the metabolic syndrome.

Prevalence of metabolic syndrome in Murcia Region, a southern European Mediterranean area with low cardiovascular risk and high obesity

Background

Metabolic syndrome (MS) is associated with subsequent appearance of diabetes and cardiovascular disease. As compared to other Spanish regions, Murcia (southern Spain) registers increased obesity as well as cardiovascular morbidity and mortality. The aim of this study was to assess the prevalence of MS and its components, awareness of obesity as a health risk and associated lifestyles.

Methods

A population-based, cross-sectional study was conducted in 2003, covering a sample of 1555 individuals 20 years and over. MS was defined according to the Revised National Cholesterol Education Program Adult Treatment Panel III (R-ATPIII), International Diabetes Federation (IDF) and Joint Interim Statement (JIS) criteria. Both low (94/80) and high (102/88) waist circumference (WC) thresholds were considered.

Results

Prevalence of MS was 27.2% (95%CI: 25.2-29.2), 32.2% (95%CI: 30.1-34.3) and 33.2% (95%CI: 31.2-35.3) according to the R-ATPIII, IDF and JIS94/80 respectively. It increased with age until reaching 52.6% (R-ATPIII) or 60.3% (JIS94/80) among persons aged 70 years and over, and was higher in persons with little or no formal education (51.7% R-ATPIII, 57.3% JIS94/80). The most common risk factors were hypertension (46.6%) and central obesity (40.7% and 66.1% according to high and low WC cut-off points respectively). Although most persons were aware that obesity increased health risks, regular exercise was very unusual (13.0% centrally obese, 27.2% non-centrally obese). Adherence to dietary recommendations was similar among centrally obese and non-centrally obese subjects.

Conclusions

Prevalence of MS is high in our population, is comparable to that found in northern Europe and varies with the definition used. Adherence to preventive recommendations and to adequate weight promotion is very low. In the absence of a specific treatment for MS, integrated intervention based on a sustained increase in physical activity and changes in diet should be reinforced.

Sex differences in age trajectories of physiological dysregulation: inflammation, metabolic syndrome, and allostatic load

There is a paucity of knowledge from population data about sex differences and their age variation in physiological determinants of longevity. This study fills this gap using nationally representative samples of 38,000 individuals aged 17+ from the National Health and Nutrition Examination Survey (1988-2006). It examines sex differences in the age trajectories of 14 markers of physiological functions across multiple systems and three summary indices including inflammation burden, metabolic syndrome, and allostatic load. Statistical analyses show substantial sex differences, age variations, and sex by age interaction effects for all variables examined. These patterns remain robust after adjustment of risk factors and shed light on the biological base of the reduction of sex difference in mortality in the post-reproductive life span.