代谢综合征与脂代谢异常

代谢综合征或胰岛素抵抗综合征,是以胰岛素抵抗为背景的心血管疾病多危险因素的簇集,主要包括胰岛素抵抗或者高胰岛素血症,内脏型肥胖,高血压和糖、脂质代谢异常.脂质代谢异常是代谢综合征的一个重要的组成成分.代谢综合征与脂质代谢异常增加心血管疾病和糖尿病的发病率和死亡率,故早期积极干预非常必要.本文就代谢综合征与脂质代谢异常的一些问题进行讨论.     

代谢综合征与血管性认知障碍

代谢综合征是一组以肥胖、高血压、糖尿病和血脂异常为主要表现的症候群.胰岛紊抵抗是代谢综合征发生的主要病理生理学基础.代谢综合征及其各个组成成分与血管性认知障碍均有密切关系.文章简要回顾了代谢综合征导致血管性认知障碍的机制,概述了控制代谢综合征对预防和治疗血管性认知障碍的意义.     

代谢综合征病人的脉压及靶器官损害

目的探讨脉压(PP)与代谢综合征组分及其靶器官损害的关系.方法 283例高血压、糖尿病或代谢综合征患者用动态血压计测定PP,分析PP与体重指数(BMI)、血压、血糖、血脂的关系;同时测定165例患者颈动脉内-中膜厚度(IMT)、283例左室质量指数(LVMI)和尿白蛋白排泄率(UAER)作为判断是否存在代谢综合征靶器官损害的指标,分析PP与IMT、LVMI和UAER的关系.结果 PP随着代谢综合征组成成分BMI、收缩压(SBP)、空腹血糖(FBG)的升高而升高,相关分析显示PP与BMI、SBP、FBG呈正相关,回归分析示BMI、SBP始终与PP有密切关系;PP与IMT、LVMI、UAER呈正相关,当PP升高时,可增加代谢综合征靶器官损害的程度和范围.结论 PP不仅与代谢综合征组成成分相关,而且与靶器管损害程度密切联系.     

功能性消化不良的药物治疗现状

功能性消化不良(FD)是一种十分常见的临床症候群.根据罗马Ⅲ标准,FD是指存在被认为源自胃、十二指肠区域的症状,且无任何可以解释这些症状的器质性、系统性或代谢性疾病.罗马Ⅲ学术委员会从临床角度出发,将FD细分为:餐后不适综合征(PDS)、上腹痛综合征(EPS)[1].     

代谢综合征与冠心病

代谢综合征近年来逐渐成为一个研究热点,其各组成成分均为冠心病的重要危险因素,因而代谢综合征患者冠心病发病率与死亡率明显增高。本文主要从胰岛素抵抗、高血压、血脂异常及肥胖四方面来论述二者之间的关系,也涉及了一些因素之间的关系。目前代谢综合征的诊断标准还不统一,目前应加强基础研究,以便从本质上阐明代谢综合征,统一诊断标准。     

硫化氢和动脉粥样硬化

代谢综合征是一组能引起心血管疾病的代谢紊乱症候群.由于其发病机制至今尚不清楚,防治难度极大.糖尿病高血糖、高血压机械力以及异常高的低密度脂蛋白血症是代谢综合征的三剑客,这不仅仅是因为三者同为代谢综合征的主要成分,更重要的是因为存在共同的发病基础.阐明它们之间如何发生协同作用的机制将可能成为防治代谢综合征的一个重大突破口.     

代谢综合征的诊断和组分干预

一、概述 代谢综合征(MS)是目前大家关注的热点问题之一.早在上世纪60年代人们便观察到糖耐量受损(IGT)、糖尿病、肥胖、脂代谢紊乱和高血压等常同时出现于同一个体,当时有人称其为繁荣综合征,但在相当长时间内人们并不了解该综合征的各种成分为何先后或同时出现在同一个体或同一家族,因此又称其为X综合征.     

影响心力衰竭心肌重构因子的研究进展

慢性心力衰竭(CHF)是各种心脏结构或功能性疾病导致心室充盈和(或)射血能力受损而引起的一组综合征,是大多数心血管疾病的最终归宿,也是最主要的死亡原因.CHF可由多种因素引起,高血压等导致的心肌重构是引起CHF的重要因素之一[1].心肌重构是指心肌重量、大小和形状的改变.其特征主要是:心肌肥厚、心肌细胞及某些细胞(或肌纤细胞)凋亡、非细胞成分(胶原纤维)的异常增加和心肌代谢以及电生理的改变.随着分子生物学技术的进展,人们发现越来越多的细胞因子与心肌重构关系密切.     

高血压合并代谢综合征患者血清脂联素与游离脂肪酸谱等代谢参数关系研究

目的 研究原发性高血压合并代谢综合征和未合并代谢综合征患者血清脂联素水平、游离脂肪酸谱特征及与其他糖脂代谢参数间关系.方法 用放射免疫分析法测定128例高血压合并或未合并代谢综合征患者与43例正常对照组血清脂联素,同时用气相色谱/质谱测定其游离脂肪酸成分.结果 高血压合并代谢综合征患者血清脂联素低于未合并代谢综合征组和正常对照组(P＜0.05或P＜0.01),总脂肪酸、不饱和脂肪酸(亚油酸、油酸、花生四烯酸、二十二碳六烯酸、花生三烯酸)、多不饱和脂肪酸(PUFA)和n6PUFA高于未合并代谢综合征组和正常组,差异有统计学意义(P＜0.05或P＜0.01).在研究对象中,脂联素与体重指数、腰围、腰臀比、甘油三酯呈负相关(r=-0.222,-0.235,-0.179,-0.194,P＜0.01或P＜0.05),与高密度脂蛋白胆固醇呈正相关(r=0.336,P＜0.01).总脂肪酸、多不饱和脂肪酸与体重指数、腰围、空腹血糖、平均血压呈正相关(r=0.241和0.280,0.198和0.188,0.226和0.298,0.274和0.334,P＜0.01或P＜0.05).结论 脂联素与游离脂肪酸代谢紊乱、n6系多不饱和脂肪酸升高,可能在原发性高血压合并代谢综合征的发病中起重要作用.     

代谢综合征与冠状动脉狭窄程度及心血管危险评分的关系

目的 了解代谢综合征患者冠状动脉狭窄程度及心血管危险评分的特点,以探讨代谢综合征与后两者之间的关系.方法 连续收集胸部不适并行冠状动脉CT检查的136例患者,所有患者均检查血压、空腹血糖及血脂,包括甘油三酯、总胆固醇、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇.应用美国2001年NCEP-ATPⅢ代谢综合征诊断标准,将其分为代谢综合征组及非代谢综合征组.冠状动脉狭窄程度用多层螺旋CT测量,比较两组间冠状动脉狭窄程度的差异,并对心血管危险评分中各项指标的差异进行比较.结果 冠状动脉狭窄程度代谢综合征组均较非代谢综合征组为重,两组的高血压、糖尿病患者、血脂异常及心血管危险评分存在明显差异.结论 代谢综合征患者冠状动脉狭窄程度较重,且多数心血管危险评分较高.代谢综合征可作为冠心病的重要危险因素,早期全面干预其中的各个成分有助于冠心病的防治.     

Probiotics and functional foods in gastrointestinal disorders

Probiotics are live microbial food supplements that benefit the host animal by improving intestinal microbial balance. When they are fed in yogurts, they can fall into the category of functional foods. Functional foods include these probiotics, prebiotics, and, to a certain extent, dietary fiber. Prebiotics are nondigestible food ingredients or supplements that alter the intestinal flora and stimulate the growth of healthy bacteria. Dietary fibers are part of plant foods that are nonstarch polysaccharides and are poorly digested or not digested by human enzymes. The physiologic process in which probiotics and functional foods affect the intestinal flora is through the balance of the intestinal microecology. This review looks at the four major components of intestinal microecology and describes the probiotics in use today and their clinical relevance. Although probiotics hold great promise and appear to be useful in some settings, more clinical study is needed to firmly establish the relevance of probiotic therapy.     

Functional foods in pediatrics

The philosophy that food can be health promoting beyond its nutritional value is gaining acceptance. Known disease preventive aspects of nutrition have led to a new science, the 'functional food science'. Functional foods, first introduced in Japan, have no universally accepted definition but can be described as foods or food ingredients that may provide health benefits and prevent diseases. Currently, there is a growing interest in these products. However, not all regulatory issues have been settled yet. Five categories of foods can be classified as functional foods: dietary fibers, vitamins and minerals, bioactive substances, fatty acids and pro-, pre- and symbiotics. The latter are currently the main focus of research. Functional foods can be applied in pediatrics: during pregnancy, nutrition is 'functional' since it has prenatal influences on the intra-uterine development of the baby, after birth, 'functional' human milk supports adequate growth of infants and pro- and prebiotics can modulate the flora composition and as such confer certain health advantages. Functional foods have also been studied in pediatric diseases. The severity of necrotising enterocolitis (NEC), diarrhea, irritable bowel syndrome, intestinal allergy and lactose intolerance may be reduced by using functional foods. Functional foods have proven to be valuable contributors to the improvement of health and the prevention of diseases in pediatric populations.     

Probiotics and Functional Foods in Gastrointestinal Disorders

Opinion statement Probiotics are live microbial food supplements that benefit the host animal by improving intestinal microbial balance. When they are fed in yogurts, they can fall into the category of functional foods. Functional foods include these probiotics, prebiotics, and, to a certain extent, dietary fiber. Prebiotics are nondigestible food ingredients or supplements that alter the intestinal flora and stimulate the growth of healthy bacteria. Dietary fibers are part of plant foods that are nonstarch polysaccharides and are poorly digested or not digested by human enzymes. The physiologic process in which probiotics and functional foods affect the intestinal flora is through the balance of the intestinal microecology. This review looks at the four major components of intestinal microecology and describes the probiotics in use today and their clinical relevance. Although probiotics hold great promise and appear to be useful in some settings, more clinical study is needed to firmly establish the relevance of probiotic therapy.     

Tackling metabolic syndrome by functional foods

The metabolic syndrome is one of the most vibrant and widely prevailing health concerns worldwide. It is characterized by several metabolic abnormalities, which involve obesity, insulin resistance, dyslipidemia, enhanced oxidative stress; hypertension and increased pro-inflammatory state that ultimate contribute towards poor health. The prevalence of metabolic syndrome in Pakistan according to different definitions is reported to be from 18 % to 46 %. Fifty percent of Pakistani population is at high risk of metabolic syndrome as being hypertensive. In studying dyslipidemia in Pakistan, hypertriglyceridemia is found in 27–54 % of the population, whereas 68–81 % has low levels of high-density lipoprotein (HDL). Population likes to eat healthier diet without changing their fundamental dietary pattern. Nutrition science has moved on from the classical concepts of avoiding nutrient deficiencies and basic nutritional adequacy to the concept of positive or optimal nutrition. Many traditional food products including fruits, vegetables, flaxseed, oat, barley, whole grains, soy and milk have been found to contain component with potential health benefits. Nowadays, functional foods are used in the prevention and amelioration of several chronic diseases, such as the metabolic syndrome. The relation of the consumption of certain functional foods and the improvement in health status is regulated through health claims. This review focuses on the different features of the metabolic syndrome and the influence of functional foods on these aspects, involving dyslipidemia, improvement of insulin sensitivity, serum lipid profile, antioxidant status, anti-inflammatory status and weight management of humans.     

Metabolically active functional food ingredients for weight control

The scale of the obesity epidemic creates a pressing consumer need as well as an enormous business opportunity for successful development and marketing of food products with added benefits for weight control. A number of proposed functional food ingredients have been shown to act post‐absorptively to influence substrate utilization or thermogenesis. Characteristics and supporting data on conjugated linoleic acid, diglycerides, medium‐chain triglycerides, green tea, ephedrine, caffeine, capsaicin and calcium, are reviewed here, giving examples of how these could act to alter energy expenditure or appetite control. Consideration is also given to other factors, in addition to efficacy, which must be satisfied to get such ingredients into foods. We conclude that, for each of the safe, putatively metabolically active agents, there remain gaps in clinical evidence or knowledge of mechanisms, which need to be addressed in order to specify the dietary conditions and food product compositions where these ingredients could be of most benefit for weight control.     

Hidden presence of cow's milk proteins in foods.

Cow's milk is one of the first foreign proteins ingested by infants and is one of the most common and potent food allergens. The presence of cow's milk is widespread due also to its unlabelled inclusion as an ingredient, or to errors in cooking, processing and preparation, and in restaurant food. As several foods may contain cow's milk in a hidden form, foods for allergic babies should be prepared at home or with food items with all their ingredients listed on the label. Parents should be provided with appropriate material and instructed how to detect potential sources of hidden cow's milk by judiciously reading food labels to avoid possible untoward reactions. A study on products with potential hidden forms of cow's milk or its proteins is reported herein.     

Nutraceuticals and Prevention of Atherosclerosis: Focus on ω‐3 Polyunsaturated Fatty Acids and Mediterranean Diet Polyphenols

Nutraceuticals are potentially healthful foods that play a role in maintaining human well being, enhancing health and preventing, or even treating, specific diseases. More than for any other diseases, cardiovascular diseases occur in association with risk factors that are amenable to prevention or treatment by nutraceutical interventions. Several ingredients marketed for use in dietary supplements address such risk factors. The ability of nutraceuticals to favorably influence cardiovascular risk factors and atherosclerotic vascular disease should be recognized as an enormous opportunity for the prevention or treatment of this common condition. In this review, we attempt at summarizing some of the recent research findings on ω‐3‐polyunsaturated fatty acids and antioxidant polyphenols that have beneficial cardiovascular effects to update the practicing clinicians on the potential benefits of nutraceuticals in this area.     

The search for compounds that stimulate thermogenesis in obesity management: from pharmaceuticals to functional food ingredients

The concept of managing obesity through the stimulation of thermogenesis is currently a focus of considerable attention by the pharmaceutical, nutraceutical and functional food industries. This paper first reviews the landmark discoveries that have fuelled the search for thermogenic anti-obesity products that range from single-target drugs to multi-target functional foods. It subsequently analyses the thermogenic and fat-oxidizing potentials of a wide array of bioactive food ingredients which are categorized under methylxanthines, polyphenols, capsaicinoids/capsinoids, minerals, proteins/amino acids, carbohydrates/sugars and fats/fatty acids. The main outcome of this analysis is that the compounds or combination of compounds with thermogenic and fat-oxidizing potentials are those that possess both sympathomimetic stimulatory activity and acetyl-coA carboxylase inhibitory property, and are capable of targeting both skeletal muscle and brown adipose tissue. The thermogenic potentials of products so far tested in humans range from marginal to modest, i.e. 2-5% above daily energy expenditure. With an increasing number of bioactive food ingredients awaiting screening in humans, there is hope that this thermogenic potential could be safely increased to 10-15% above daily energy expenditure - which would have clinically significant impact on weight management, particularly in the prevention of obesity and in improving the long-term prognosis of post-slimming weight maintenance.     

Étiquetage des aliments allergéniques : ce qui change

Here we review the new rules concerning labelling of foods, in particular, allergenic foods. These rules indicate that all the ingredients must be clearly indicated on the label and especially that no exemption to this rule can be made when it is a question of known allergens. The list of the most common foods/ingredients has been established and it is periodically updated on the basis of the most up-to-date scientific and clinical information. It is important to note that not only are these foods covered by these rules but also any products that can be derived from them by technical means are covered. In order that the ingredients listed on the label would be useful and pertinent to allergic individuals, case-by-case exceptions might be allowed on the basis of adequate justification. As a result, a temporary exemption has been granted to about 20 well-characterized derivative products for which it has been established that the transformation process that had been used (for example, extensive refining) had resulted in a loss of their potential allergen and that the risk of provoking an allergic reaction under the proposed conditions of use would be very low. Based on confirmation by appropriate studies (notably clinical studies), the temporary labelling exemptions allowed until November 2007 could become permanent.     

Diets,functional foods,and nutraceuticals as alternative therapies for inflammatory bowel disease: Present status and future trends

Inflammatory bowel disease(IBD) is a serious health concern among western societies. The disease is also on the rise in some East Asian countries and in Australia. Health professionals and dietitians around the world are facing an unprecedented challenge to prevent and control the increasing prevalence of IBD. The current therapeutic strategy that includes drugs and biological treatments is inefficient and are associated with adverse health consequences. In this context, the use of natural products is gaining worldwide attention. In vivo studies and clinical evidence suggest that wellplanned dietary regimens with specific nutrients can alleviate gastrointestinal inflammation by modulating inflammatory cytokines, such as tumor necrosis factor α(TNF-α), interleukin 1(IL-1), IL-6, IL-1β, and IL-10. Alternatively, the avoidance of high-fat and highcarbohydrate diets is regarded as an effective tool to eliminate the causes of IBD. Many functional foods and bioactive components have received attention for showing strong therapeutic effects against IBD. Both animal and human studies suggest that bioactive functional foods can ameliorate IBD by downregulating the pro-inflammatory signaling pathways, such as nuclear factor κB, STAT1, STAT6, and pro-inflammatory cytokines, including IL-1β, IL-4, IL-6, COX-2, TNF-α, and interferon γ. Therefore, functional foods and diets have the potential to alleviate IBD by modulating the underlying pathogenic mechanisms. Future comprehensive studies are needed to corroborate the potential roles of functional foods and diets in the prevention and control of IBD.