Effects of canrenone in patients with metabolic syndrome

Background: Metabolic syndrome is becoming a common disease due to a rise in obesity rates among adults.

Objectives: The aim was to evaluate the effects of canrenone compared to placebo on metabolic and inflammatory parameters in patients affected by metabolic syndrome.

A total of 145 patients were treated with placebo or canrenone, 50 mg/day, for 3 months and then 50 mg b.i.d. till the end of the study.

Blood pressure, body weight, body mass index, fasting plasma glucose (FPG), fasting plasma insulin, HOMA-IR, lipid profile, plasma aldosterone, brain natriuretic peptide, high-sensitivity C-reactive protein (Hs-CRP), tumor necrosis factor-α (TNF-α) and M value were evaluated.

Results: A decrease of blood pressure was observed in canrenone group compared to baseline; moreover, systolic blood pressure value recorded after 6 months of canrenone therapy was lower than the one recorded with placebo. Canrenone gave a significant decrease of FPI and HOMA index, and an increase of M value both compared to baseline and to placebo. Canrenone also decreased triglycerides and FPG was not observed with placebo. Canrenone also decreased plasma aldosterone, Hs-CRP and TNF-α compared to baseline and to placebo.

Conclusion: Canrenone seems to be effective in reducing some factors involved in metabolic syndrome and in improving insulin-resistance and the inflammatory state observed in these patients.     

Effect of chronic aspirin administration on an experimental model of metabolic syndrome

1. The aim of the present study was to examine the effect of chronic administration of aspirin on metabolic and cardiovascular parameters in fructose-fed rats (FFR), an experimental model of metabolic syndrome. 2. Chronic treatment of FFR with aspirin (10 mg/kg per day for 6 weeks) partially reversed the increment in systolic blood pressure. In addition, chronic aspirin treatment normalized relative heart weight and vascular remodelling of renal and carotid arteries, measured as lumen diameter: medial thickness ratio. 3. Furthermore, chronic aspirin administration completely reversed glucose intolerance and decreased the oxidative status that characterizes the FFR model, as indicated by decreased plasma levels of thiobarbituric acid-reactive substances and aortic NAD(P)H oxidase activity. 4. Prevention of oxidative stress and vascular remodelling in FFR may contribute to the protective actions attributed to aspirin in the treatment of metabolic syndrome.     

糖脂平对代谢综合征患者胰岛素敏感性及炎症因子的影响

目的：观察糖脂平对代谢综合征（ MS）患者胰岛素敏感性及超敏C反应蛋白（ hs-CRP）和肿瘤坏死因子α（ TNF-α）的影响。方法采用随机平行对照的方法将符合入选标准的70例MS者分为治疗组35例、对照组35例,治疗组在原治疗的基础上给予中药糖脂平汤药口服,对照组在原治疗的基础上给予罗格列酮口服。观察2组治疗前后胰岛素作用指数（ IAI ）、胰岛素抵抗指数（ HOMA-IR）、hs-CRP和TNF-α的变化情况。结果完成临床试验的65例中,治疗组33例,对照组32例。治疗后2组的IAI水平均升高,与本组治疗前比较,差异均有统计学意义（ P＜0．01）;组间比较差异无统计学意义（ P＞0．05）。治疗后2组的HOMA-IR水平均下降,与本组治疗前比较,差异均有统计学意义（P＜0.01）;组间比较差异无统计学意义（P＞0．05）。治疗前2组的hs-CRP均有轻度升高,治疗后2组的hs-CRP均较本组治疗前明显降低（ P＜0．01）;治疗前后组间比较差异均无统计学意义（ P＞0.05）。治疗后2组的TNF-α水平均明显降低,与本组治疗前比较,差异均有统计学意义（P＜0．01）;治疗后组间比较差异无统计学差异（P＞0．05）。结论糖脂平可有效改善MS患者的胰岛素敏感性,同时可以降低炎症因子hs-CRP和TNF-α的水平。     

老年代谢综合征患者的生活行为方式研究

目的 调查老年代谢综合征(MS)患者的生活行为方式,分析其特征及意义.方法 对318例老年人群进行全面调查后,分为MS组63例、一项代谢异常组135例、二项代谢异常组51例及对照组67例进行分析,评估各危险因素对MS的影响.结果 (1)MS组的腰围(WL)显著高于其余3组(P<0.05),体质指数(BMI)与对照组...     

复方阿司匹林抑制心血管病患者血小板聚集的24周疗效

目的:观察24周疗程中复方阿司匹林(铝镁匹林)抑制心血管病患者血小板聚集功能的效果变化。方法:选择临床需要服用阿司匹林抗血小板治疗且ADP诱导的血小板聚集率增高的心血管病患者103例,给予铝镁匹林2片(含阿司匹林162 mg)口服24周。于用药前及用药6,12,24周后分别测定血小板聚集率。结果:服用铝镁匹林后患者的血小板聚集率显著降低,6,12,24周测定血小板聚集率与基线比较有极显著差异,血小板聚集抑制率分别为-(20.49±22.35)%,-(28.10±22.88)%,-(23.23±22.68)%。12周的血小板聚集率较6周进一步下降,但24周较12周则明显升高,两个差值均有统计学差异(P<0.05)。结论:铝镁匹林可明显降低患者的血小板聚集功能,但抗血小板聚集作用在24周后较12周有明显下降。     

代谢综合征患者血清脂联素浓度与血脂的相关性研究

目的: 探讨代谢综合征患者血清脂联素水平与血脂的关系.方法: 选取代谢综合征患者35例,另选健康对照组20例,常规测量身高、体重,所有实验对象空腹采血离心取血清测定脂联素、甘油三酯(TG)、胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C).结果: 与对照组相比,代谢综合征组血清脂联素水平显著降低(P<0.01),血清TG、CHOL、HDL-C、LDL-C、BMI、显著升高(P<0.01).Pearson相关性分析显示,在代谢综合征组中血清脂联素与TG、CHOL、LDL-C、BMI、年龄呈负相关,与HDL-C呈正相关(P<0.05).结论: 低血清脂联素水平与脂类代谢紊乱密切相关.     

Ciprofibrate increases paraoxonase activity in patients with metabolic syndrome

AIMS: Diabetic dyslipidaemia with decreased high-density lipoprotein-cholesterol (HDL-C) concentration plays a key role in enhanced atherosclerosis. The antioxidant effect of HDL is due to the influence of human paraoxonase 1 (PON1) and several authors have described decreased activity of this enzyme in Type 2 diabetics and subjects with metabolic syndrome. The goal of this study was to examine the effect of daily ciprofibrate on serum PON1 and lipoprotein concentrations in patients with metabolic syndrome. METHODS: Fifty-one patients with metabolic syndrome were enrolled into the study. We examined the effect of 100 mg day(-1) ciprofibrate treatment on lipid concentrations, oxidized low-density lipoprotein (LDL), PON1 concentrations and activity. We also investigated the calculated size of LDL-cholesterol (LDL-C). RESULTS: During the 3-month study, it was observed that following treatment with ciprofibrate, the serum triglyceride concentration decreased significantly (from 2.76 +/- 0.9 mmol l(-1) to 2.27 +/- 1.6 mmol l(-1); -18%; P < 0.001), while HDL-C increased significantly (from 0.95 +/- 0.2 mmol l(-1) to 1.2 +/- 0.3 mmol l(-1); 26%; P < 0.001). The oxidatively modified LDL-C concentration decreased significantly (from 137 +/- 19 U l(-1) to 117 +/- 20 U l(-1); P < 0.001), while HDL-associated apolipoprotein A1 significantly increased (from 1.35 +/- 0.2 g l(-1) to 1.75 +/- 0.3 g l(-1); P < 0.001). The LDL-C/LDL-apoB ratio, which reflects the size of LDL, increased significantly (from 0.96 +/- 0.05 to 1.05 +/- 0.06; P < 0.05). Serum PON1 activity was significantly elevated (from 108 +/- 34 U l(-1) to 129 +/- 31 U l(-1); P < 0.05), while standardized values for HDL-C remained significantly unchanged (PON1/HDL-C) (from 114 +/- 21 to 107 +/- 20; NS). CONCLUSION: Three months of treatment with ciprofibrate favourably affected the lipid profile, increased LDL resistance to oxidation and improved antioxidant status by increasing serum paraoxonase activity in these patients.     

阿司匹林抵抗对心血管疾病高危患者预防用阿司匹林疗效的影响

阿司匹林防治血栓栓塞性血管疾病临床应用广泛.阿司匹林抗血小板作用的个体差异、阿司匹林抵抗(AR)对心血管疾病高危患者预防用阿司匹林疗效的不利影响等临床面临的问题亟需解决.本文综述AR的机制及其对各类心血管疾病高危惠者预防用阿司匹林疗效的影响.     

噻氯匹定和阿司匹林降低血液粘度和抗血小板作用的比较

目的：比较噻氯匹定和阿司匹林对冠心病病人血液粘度、血小板聚集率和血凝系统的作用。方法：噻氯匹定（０ ．２５ ｇ , ｐｏ,ｂｉｄ） 治疗４４ 例病人。阿司匹林（５０ ｍｇ , ｐｏ,ｂｉｄ） 治疗４５ 例病人。均连续用药４ ｗｋ 。结果：２ 组均有降低全血粘度、血浆粘度、血小板聚集率、延长活化的部分凝血活酶和凝血酶原时间等作用。组间比较：Ｐ＞ ０ ．０５ 。结论：２ 药均有降低血液粘度、血小板聚集率和抑制凝血功能的作用。     

Serial changes in adipocytokines and cardiac function in a rat model of the metabolic syndrome

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Preventing cardiovascular and renal complications in the management of hypertension and metabolic syndrome

This editorial discusses the history, definition and prevelance of the metabolic syndrome. Pathophysiological factors, such as girth, blood pressure, glucose, triglycerides, HDL-cholesterol, obesity, raised levels of plasma insulin and insulin resistance are outlined as being components of the syndrome. The paper examines the relationship of cardiovascular and all-cause mortality to the metabolic syndrome, and discusses the risk of cardiovascular disease associated with the metabolic syndrome. In addition, the article explores the link between metabolic syndrome, kidney function, insulin resistance and chronic kidney disease. Finally, the article discusses the issue of managing metabolic syndrome.     

社区代谢综合征患者心理健康状况评估

目的：调查社区代谢综合征患者心理健康状况,为全科医生开展心理干预提供依据。方法：2015年12月采取随机抽样方法选取凌云街道社区卫生服务中心代谢综合征管理库中120例患者进行自编基本情况问卷调查,用症状自评量表（SCL-90）进行心理健康状况评分,根据量表结果评估心理健康状况。结果：除了偏执和精神病性两个因子差异无统计学意义外,SCL-90其余各因子差异均有统计学意义（P＜0.05）。代谢综合征患者的躯体化、强迫症状、抑郁、焦虑、敌对、恐怖等因子分明显高于全国常模,而患者人际关系敏感因子分则明显低于常模。结论：社区代谢综合征患者易出现心理健康问题,全科医生应重视其心理问题的早期筛查与干预。     

保龄汤治疗老年代谢综合征临床观察

目的观察保龄汤治疗老年代谢综合征（MS）患者的临床疗效。方法将80例老年MS患者完全随机分为2组,对照组40例给予控制血压、血糖、血脂等基础治疗,治疗组40例在控制血压、血糖、血脂等治疗基础上给予口服中药复方保龄汤,12周后比较2组患者胰岛素敏感指数（ISI）、糖化血红蛋白（HbA1c）、三酰甘油、高密度脂蛋白胆固醇（HDL C）及尿酸的变化情况。结果治疗组治疗后ISI升高,与本组治疗前及对照组治疗后比较差异均有统计学意义（-5.7±0.5比-6.3±0.3、-6.0±0.3,均P〈0.05）,HbA1c、三酰甘油、尿酸下降,与本组治疗前及对照组治疗后比较差异有统计学意义［HbA1c：（6.9±0.3）mmol/L比（8.2±0.5）mmol/L、（7.2±0.4）mmol/L;三酰甘油：（1.4±0.4）mmol/L比（1.8±0.9）mmol/L、（1.8±0.8）mmol/L;尿酸：（436±41）μmol/L比（513±68）μmol/L、（477±57）μmol/L;均P〈0.01］;对照组治疗后尿酸下降,与本组治疗前比较差异有统计学意义［（477±57）μmol/L比（511±78）μmol/L,P〈0.05］;2组HDL C变化差异无统计学意义（P〉0.05）。结论保龄汤能够改善老年MS患者胰岛素敏感性、降低HbA1c、三酰甘油及尿酸,疗效优于对照组,表明保龄汤可能为治疗老年MS的有效中药复方,值得进一步研究。     

代谢综合征患者血清脂联素水平与胰岛素抵抗的相关性研究

目的:探讨代谢综合征患者血清脂联素水平与胰岛素抵抗的关系。方法:选取代谢综合征患者35例,另选健康对照组20例,所有实验对象空腹采血离心取血清测定脂联素、胰岛素、血糖、胰岛素敏感性指数、胰岛素抵抗指数。结果:与对照组相比,代谢综合征组血清脂联素水平、胰岛素敏感性指数显著降低(P<0.01),血清胰岛素、血糖显著升高(P<0.01)。在代谢综合征组中,血清脂联素与胰岛素、血糖、胰岛素抵抗指数呈负相关,与胰岛素敏感性指数呈正相关(P<0.05)。结论:低血清脂联素水平与胰岛素抵抗密切相关。     

家庭因素对代谢综合征患者运动行为的影响

目的：探讨家庭因素对代谢综合征患者运动行为的影响。方法：2007年6月对上海豫园社区3个居委的134例代谢综合征患者进行问卷调查。结果：有运动的家庭中的代谢综合征患者参加运动的比例为86．5％,明显高于非运动组代谢综合征患者参加运动的比例（36．6％）,P〈0．05;家庭功能良好组的代谢综合征患者参加运动的比例为87．4％,明显高于家庭功能障碍组（32．3％）,P〈0．05。结论：良好的家庭功能、家庭成员有规律参加运动可以对代谢综合征患者参加运动的比例的增加产生积极影响。     

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目的：观察常规治疗联合培菲康对2型糖尿病合并代谢综合征患者血糖、血脂、血压、体重控制的临床疗效。方法：收集2015年4月1日—2015年6月30日期间在甘泉街道社区卫生服务中心门诊就诊的2型糖尿病合并代谢综合征患者100例,采用1：1配对分组（年龄、性别、基础疾病）法分为对照组和试验组各50例,对照组给予常规降糖、降脂、降压治疗,试验组加用培菲康840 mg,2次/d口服,疗程为6周。比较治疗前后两组血糖、血脂、血压、体重变化以及停药后6周的疗效差异。结果：6周后试验组与对照组相比血糖、血压、血脂、体质均未见明显差异（P>0.05）;然而停药6周后,两组空腹血糖、餐后2 h血糖、总胆固醇数值下降具有统计学意义（P<0.05）。结论：调节肠道菌群,能够改善代谢综合征患者血糖、血脂指标,远期疗效值得期待。     

The concentration of uric acid in patients with metabolic syndrome and cardiovascular diseases

The association of elevated serum uric acid (hyperuricemia, gout) with the presence of classical coronary risk factors and coronary artery disease (CAD) or myocardial infarction (MI) has been analysed in many epidemiological studies. Numerous studies have revealed that hypertension, high body mass index (BMI), lipid disorders (especially raised triglyceride (TG) levels and low high dense lipoprotein cholesterol (HDL-C) level), and increased creatinine or insulin levels have caused hyperuricemia. Gout has often occurred with typical disorders for the metabolic syndrome X. Significant correlation of the serum uric level and the CAD presence and severity of coronary atherosclerosis confirmed by coronary angiography has been observed in women. Hyperuricemia has also indirect influence on progress of CAD by physical activity restriction, what causes sedentary mode of life and lead to obesity. Therefore, we conducted our study in order to estimate uric acid levels in patients with metabolic syndrome and coexisting cardiovascular system diseases.     

莘庄社区60岁以上高血压患者代谢综合征患病分析

目的：分析社区老年高血压人群中代谢综合征（MS）及其各组分的患病现况。方法：对2010年莘庄社区60岁以上老人体检的3161例高血压患者进行分析,根据国际糖尿病联盟2004年度推荐的有关中国人MS的标准诊断和组分分类。结果：MS患病率为33.5%,男性为29.2%,女性为36.8%。以中心性肥胖＋高甘油三酯为主要表现,占总患病人数的45.0%;其次为中心性肥胖＋高血糖,占36.6%。结论：社区老年高血压人群中MS的患病率较高,要加强干预。