Relationship between body fat distribution and blood lipids in obese adolescents

Associations between body fat distribution, measured by waist/hip circumference ratio (WHR), and plasma lipids and lipoproteins were examined in 74 grossly obese adolescents. WHR was positively correlated in adolescent girls with total triglycerides (r = 0.44, P less than 0.01), total cholesterol (r = 0.49, P less than 0.001), and LDL-cholesterol (r = 0.59, P less than 0.001). In adolescent boys no correlation was found for total cholesterol but there were correlations for triglycerides (r = 0.41, P less than 0.05), LDL-cholesterol (r = 0.49, P less than 0.001), HDL-cholesterol (r = -0.66, P less than 0.001) and the ratio cholesterol/HDL-cholesterol (r = 0.62, P less than 0.001). Waist/hip ratio was not correlated with BMI or percentual overweight in obese girls, but a significant association was found in obese boys for both (r = -0.46, P less than 0.03 and r = 0.53, P less than 0.02). These results indicate that in obese girls a prevalence of abdominal fat distribution is correlated with increased triglycerides, serum cholesterol and LDL-C. In male adolescents total cholesterol is only slightly influenced but HDL-C concentrations are lower and LDL-C and the ratio CHOL/HDL-C higher.     

新疆哈萨克族脂蛋白脂酶基因Hind Ⅲ、S447X多态性与代谢综合征的相关研究

目的 探讨脂蛋白脂酶基因Hind Ⅲ、S447X多态性与代谢综合征(MS)的关系.方法 应用聚合酶链反应-限制性片段长度多态法检测401例研究对象(包括200例代谢综合征患者和201名对照者)的脂蛋白脂酶Hind Ⅲ、S447X基因型.结果 (1)腰围、臀围、腰臀比、体重指数(BMI)、收缩压、舒张压、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)在MS组与对照组之间差别均有统计学意义(均P<0.05).(2)代谢综合征组H+H+基因型、H+等位基因、SS基因型和S等位基因频率显著高于对照组(H+H+基因型:66.5%对54.2%,P=0.012;H+等位基因:78.0%对71.4%,P=0.031;SS基因型:89.5%对77.1%,P=0.001;S等位基因:94.5%对87.56%,P=O.001).(3)H+H_/H-H-基因型携带者腰围、臀围、腰臀比、BMI、收缩压、舒张压、TG、LDL-C、FPG水平较H+H+基因型携带者低,HDL-C水平高于H+H+基因型携带者,差别均有统计学意义(均P<0.05).SX/XX基因型携带者腰围、臀围、腰臀比、BMI、收缩压、舒张压、TC、TG、FPG水平较SS基因型携带者低,HDL-C水平高于SS基因型携带者,差别均有统计学意义(均P<0.05).(4)多因素Logistic回归分析显示吸烟、饮酒、SS基因型是MS的危险因素(OR值分别为4.289、2.268、2.597).(5)不同因素间的交互作用结果显示,吸烟者携带SS基因型的患病风险是不吸烟者携带SX/XX基因型的3.996倍.结论 脂蛋白脂酶基因S447X多态性与哈萨克族MS的危险性相关,其中SS基因型、S等位基因可能是代谢综合征的遗传危险因素,而且H+H-/H-H-和SX/XX基因型对血脂、血压产生有益的影响.SS基因型与吸烟可能存在交互作用,二者之间有相加作用.     

Clinical analysis of the relationship between cystatin C and metabolic syndrome in the elderly

ObjectiveStudies have shown that both cystatin C and metabolic syndrome (MetS) are associated with inflammation. We set out to investigate the correlation between serum cystatin C levels and MetS in the elderly.MethodsThis prospective study was conducted in 380 elderly individuals, including 135 patients with MetS, 142 patients with metabolic disturbance (MetD), and 103 healthy elderly individuals (control group). Waist–hip ratio, waist circumference, waist–height ratio, body mass index (BMI), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high-density lipoprotein (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure and cystatin C were measured and their mutual relations were analyzed.ResultsThe higher the MetS scores, the higher the serum cystatin C concentration in these patients. Serum cystatin C concentration was closely related to waist–hip ratio, waist circumference, waist–height ratio, BMI, TG, FPG, and blood pressure, not related to LDL-C levels, and negatively correlated with HDL-C levels. Logistic regression analysis indicated that cystatin C, waist–height ratio, waist circumference, FPG, TG, SBP and pulse pressure were significantly associated with MetS (OR between cystatin C and MetS 2.164, 95% CI 1.136–8.259).ConclusionCystatin C was significantly associated with MetS in the elderly. As MetS scores rose, serum cystatin C levels increased.     

Waist circumference estimation from BMI in Japanese children

Waist circumference, not BMI, is one of the factors in the definition of metabolic syndrome in adults. In children, waist circumference is also a well known predictor of metabolic syndrome. However, waist circumference measurement is not as commonly recorded as weight and height measurements in physical examinations in schools. This means BMI data is available for every child, but waist circumference is not. Therefore, we investigated whether there is an alternative way to estimate waist circumference even in those children whose waist circumference measurement has not been taken. We evaluated the relationship between BMI and the waist circumference of schoolchildren using a relatively large-scale population-based cohort in Japan. There was a significant linear relationship between BMI and waist circumference noted in each age- and sex-divided group [9-10-year-old boys: waist=13.99+2.63BMI (r=0.940, p<0.001), 9-10-year-old girls: waist=15.09+2.61BMI (r=0.933, p<0.001), 12-13-year-old boys: waist=23.67+2.22BMI (r=0.880, p<0.001), 12-13-year-old girls: waist=23.83+2.15BMI (r=0.859, p<0.001)]. This means it is possible to estimate waist circumference from height and weight, at least among those age groups of children in Japan. This estimation could be an alternative way and useful in detecting childhood metabolic syndrome or obesity disease in which a waist circumference figure is necessary.     

The cardiovascular risk of young women with polycystic ovary syndrome: an observational, analytical, prospective case-control study

To evaluate the cardiovascular risk of polycystic ovary syndrome (PCOS), we investigated lipid profile, metabolic pattern, and echocardiography in 30 young women with PCOS and 30 healthy age- and body mass index (BMI)-matched women. PCOS women had higher fasting glucose and insulin levels, homeostasis model assessment score of insulin sensitivity, total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels, and TC/high density lipoprotein cholesterol (HDL-C) ratio and lower HDL-C levels than controls. Additionally, PCOS women had higher left atrium size (32.0 +/- 4.9 vs. 27.4 +/- 2.1 mm; P < 0.0001) and left ventricular mass index (80.5 +/- 18.1 vs. 56.1 +/- 5.4 g/m(2); P < 0.0001) and lower left ventricular ejection fraction (64.4 +/- 4.1 vs. 67.1 +/- 2.6%; P = 0.003) and early to late mitral flow velocity ratio (1.6 +/- 0.4 vs. 2.1 +/- 0.2; P < 0.0001) than controls. When patients and controls were grouped according to BMI [normal weight (BMI, >18 and <25 kg/m(2)), overweight (BMI, 25.1-30 kg/m(2)), and obese (BMI, >30 kg/m(2))], the differences between PCOS women and controls were maintained in overweight and obese women. In normal weight PCOS women, a significant increase in left ventricular mass index and a decrease in diastolic filling were observed, notwithstanding no change in TC, LDL-C, HDL-C, TC/HDL-C ratio, and TG compared with controls. In conclusion, our data show the detrimental effect of PCOS on the cardiovascular system even in young women asymptomatic for cardiac disease.     

Association between central body anthropometric measures and metabolic syndrome components in a probabilistic sample of adolescents from public schools

It was investigated the association of waist circumference (WC), abdominal circumference (AC), Waist-to-Hip ratio(WHR) and Waist-Height ratio (WHtR) adjusted by body mass index (BMI) and % body fat (BF) with metabolic syndrome components in a probabilistic sample of 610 adolescents aged 12-19 years (222 boys and 388 girls) from public schools of Niterói, Rio de Janeiro. Fasting glucose and lipids were assayed using automated enzymatic method and insulin was determined by radioimmuno assay. Systolic (SBP) and diastolic (DBP) blood pressure were measured using an automated recorder and % BF by electric bioimpedance. The association of the anthropometric measures with metabolic syndrome components was evaluated by multivariate linear regression adjusted according to the age, BMI or %BF. In boys, a positive association between WC (beta=1.03 p<0.01) and WHtR (beta= 2.33, p< 0.05; beta=2.12 and p< 0.01) with triglycerides was maintained after BMI and % BF adjusting, respectively. WC was associated with SBP after % BF adjusting both for boys (beta= 0.70 p<0.01) and girls (beta=0.68 p<0.01). In conclusion, WC was the measure of central body fat that presented the best association with components of metabolic syndrome in adolescents.     

Body composition, fat distribution and metabolic characteristics in lean and obese women with polycystic ovary syndrome

The polycystic ovary syndrome (PCOS), characterized by chronic anovulation and hyperandrogenism, has many features of metabolic syndrome and can be considered a metabolic disease. Approximately 50% of patients with PCOS are overweight or obese with abdominal fat accumulation. Some metabolic alterations and abdominal fat distribution have also been reported in lean women with PCOS. The aim of this study was to evaluate the effect, if any, of obesity on metabolic features, body composition and fat distribution in patients with PCOS. Body composition and abdominal fat distribution (evaluated by DEXA), waist circumference, blood pressure, lipid profile, glucose tolerance and homeostasis model assessment index were determined in 23 lean [mean age 23 +/- 5 yr, mean body mass index (BMI) 22 +/- 2 kg/m2] and 27 overweight-obese (mean age 21 +/- 5 yr, mean BMI 32 +/- 5 kg/m2) patients with PCOS and in 20 age- and weight-matched eumenorrhoic women. Patients exhibited slight but non-significant differences in metabolic parameters, waist circumference, blood pressure and total and abdominal fat content compared with weight-matched controls. None of the lean subjects suffered from metabolic syndrome according to the National Cholesterol Education Program--Adult Treatment Panel III (NCEP-ATPIII) criteria as opposed to 10 overweight-obese patients and three overweight-obese control subjects (37% and 33.3% of each subgroup, respectively). Our data do not show significant metabolic alterations in lean PCOS women. Results indicate that obesity seems to underpin the metabolic alterations exhibited by the overweight-obese patients. However, since women with PCOS are at increased cardiovascular risk, further studies are needed to evaluate metabolic alterations and body composition in these patients.     

Adolescent girls with polycystic ovary syndrome have an increased risk of the metabolic syndrome associated with increasing androgen levels independent of obesity and insulin resistance

CONTEXT: Adult women with polycystic ovary syndrome (PCOS) have an increased prevalence of the metabolic syndrome (MBS). The prevalence of MBS is also increasing in adolescents. OBJECTIVE: Our objective was to test the hypothesis that the prevalence of MBS is increased in adolescent girls with PCOS compared with the general population and to determine the factors associated with an increased risk of the MBS in PCOS. DESIGN AND SETTING: We conducted a cross-sectional case-control study at academic medical centers with general clinical research centers. PARTICIPANTS: Participants included 49 adolescent girls with PCOS and 165 girls from the Third National Health and Nutrition Examination Survey (NHANES III) adolescent population of similar age and ethnic background. MAIN OUTCOME MEASURE: We assessed the prevalence of MBS according to currently proposed adolescent MBS criteria. RESULTS: Thirty-seven percent of adolescent girls with PCOS had MBS compared with 5% of NHANES III girls (P < 0.0001). None of the girls of normal body mass index (BMI) had MBS, whereas 11% of overweight and 63% of obese girls with PCOS had MBS compared with 0 and 32% of NHANES III girls, respectively. Girls with PCOS were 4.5 times more likely to have MBS than age-matched NHANES III girls after adjusting for BMI (odds ratio, 4.5; 95% confidence interval, 1.1-17.7; P = 0.03). The odds of having the MBS were 3.8 times higher for every quartile increase in bioavailable testosterone in girls with PCOS after adjusting for BMI and insulin resistance (odds ratio, 3.8; 95% confidence interval, 1.4-10.2; P = 0.008). CONCLUSIONS: Adolescent girls with PCOS have a higher prevalence of MBS than the general adolescent population. Hyperandrogenemia is a risk factor for MBS independent of obesity and insulin resistance.     

高尿酸血症与冠心病及危险因素的相关性分析

目的 通过对高尿酸血症与冠心病及危险因素的横断面研究,分析高尿酸血症与冠心病及危险因素的相关性.方法 入选太原市中心医院心内科符合标准患者150例,依据尿酸水平分为高尿酸血症组(80例)及非高尿酸血症组(70例).记录年龄、性别、身高、体重、腰围、臀围、血压及血生化指标等基本资料,通过横断面研究高尿酸血症与冠心病及危险因素的关系.结果 高尿酸血症组与非高尿酸血症组比较,在吸烟年限、收缩压(SBP)、舒张压(DBP)、腰围、腰臀比、体重指数(BMI)、三酰甘油、总胆固醇、空腹血糖等均有统计学意义(P＜0.05).高尿酸与冠心病间存在相关性.针对高尿酸血症危险因素空腹血糖(FBG)、低密度脂蛋白胆固醇(LDL - C)、BMI以及代谢综合征(MS)四者进行多元Logistic回归分析,并校正年龄、性别、吸烟、饮酒后分析表明,MS(校正前OR=1.110,校正后OR=1.111,P＜0.001)及FBG(校正前OR=2.586,校正后OR=2.685,P＜0.001)是高尿酸血症的独立危险因素,而LDL -C(校正前OR=0.638,校正后OR=0.642,P＜0.05)则是高尿酸血症的保护因素.BMI的Logistic回归分析无统计学意义(校正前OR=0.795,校正后OR=0.757).结论 高尿酸血症与冠心病存在一定的协同作用;在高尿酸血症的危险因素中MS、FBG是高尿酸血症的独立危险因素,LDL -C是高尿酸血症的保护因素.     

Free triiodothyronine and thyroid stimulating hormone are directly associated with waist circumference, independently of insulin resistance, metabolic parameters and blood pressure in overweight and obese women

OBJECTIVE: To examine whether obesity, body fat distribution and insulin resistance have an independent effect on serum TSH and free thyroid hormones (FT3 and FT4) in a cohort of euthyroid women, represented by overweight and obese patients. DESIGN AND PATIENTS: A total of 201 women, aged 18-68 years, with body mass index (BMI) > or = 25.0 kg/m(2) and TSH levels < 4.0 mU/l were investigated. MEASUREMENTS: Fasting TSH, FT3, FT4, insulin, glucose, and serum lipid concentrations, and the level of insulin resistance, estimated by the homeostasis model assessment for insulin resistance (HOMA-IR). Waist circumference was measured as an indirect parameter of central fat accumulation. RESULTS: FT3 was directly associated with BMI (P < 0.01) and waist circumference (P < 0.01), and negatively correlated with age (P < 0.001). FT4 was negatively associated with HOMA-IR (P < 0.05) and fasting insulin levels (P < 0.05). TSH was positively correlated with waist circumference (P < 0.05) and negatively associated with age (P < 0.05). When multiple regression analysis was performed with FT3 as the dependent variable, and waist circumference, HOMA-IR, blood pressure levels and serum lipid concentrations as independent variables, FT3 maintained an independent association only with waist circumference (positive, P < 0.05) and age (negative, P < 0.001). When multiple regression analysis was performed with TSH as the dependent variable, and the above parameters as independent variables, TSH maintained an independent association only with waist circumference (positive, P < 0.05) and age (negative, P < 0.05). By contrast, when multiple regression analysis was performed with FT4 as the dependent variable, FT4 did not maintain an independent association with any of the independent parameters. CONCLUSIONS: Progressive central fat accumulation is associated with an increase in both FT3 and TSH serum levels, independently of insulin sensitivity, metabolic parameters and blood pressure. These results suggest that (1) progressive central fat accumulation is associated with a parallel increase in FT3 levels, possibly as an adaptive thermogenic phenomenon, and (2) the control of TSH secretion by free thyroid hormones is possibly impaired in obesity.     

Association of waist circumference with ApoB to ApoAI ratio in black and white Americans.

BACKGROUND: Although numerous studies have demonstrated obesity as an aspect of the insulin resistance syndrome in cardiovascular disease (CVD), the mechanism is not clear. Central adiposity, acting through many CVD risk factors, including, plasma glucose, insulin, total cholesterol, low density lipoprotein-cholesterol (LDL-C) and lipoprotein moities-apolipoprotein B (ApoB), apolipoprotein A-I (ApoAI), by atherogenic and thrombotic mechanisms has been proposed as a possible mechanism. In this study, we examined the relationship between central fat distribution (defined by waist circumference) and the ratio of these lipoproteins (ApoB/ApoAI). SUBJECTS AND METHODS: Association between ApoB/ApoAI ratio and waist circumference was compared in Blacks (n = 854) and Whites (n = 2552) using the NHANES III population-based samples. Correlation analyses and multiple regression analyses were used to determine the association between ApoB/ApoAI and waist circumference, controlling for age, body mass index (BMI), race, gender, plasma glucose, insulin, serum triglyceride and total cholesterol. RESULTS: Adjusting for age, ApoB/ApoAI was significantly correlated with waist circumference (Black men: r = 0.38, White men: r = 0.26, Black women: r = 0.20, White women: r = 0.36) (all P < 0.01). Adjusting for age and triglyceride or insulin, waist circumference was also positively correlated with CVD risk factors including, ApoB, LDL-C, plasma glucose and fasting insulin, and inversely correlated with ApoAI and HDL-C in Blacks and Whites (P < 0.05). Overall, triglyceride and total cholesterol were the strongest predictors of ApoB/ApoAI in Blacks and Whites adjusting for age, BMI and insulin, than waist girth (P < 0.01). CONCLUSIONS: The result of this study suggests the need to investigate ApoB/ApoAI as another possible facet in the insulin resistant syndrome.     

Urinary epinephrine and norepinephrine interrelations with obesity, insulin, and the metabolic syndrome in Hong Kong Chinese

The metabolic syndrome is characterized by a clustering of cardiovascular risk factors including type 2 diabetes mellitus, hypertension, dyslipidemia, and obesity. Elevated plasma insulin and urinary norepinephrine (noradrenaline) and reduced urinary epinephrine (adrenaline) excretion are associated with obesity in Caucasian populations. We examined the interrelationships between obesity, plasma insulin, and urinary catecholamine excretion in Chinese subjects with various components of the metabolic syndrome. A total of 577 Chinese subjects (aged 38 +/- 10 years; 68% with type 2 diabetes mellitus, hypertension, dyslipidemia, obesity, and/or albuminuria and 32% healthy subjects) were studied, all of whom had a plasma creatinine less than 150 micromol/L. The blood pressure, height, weight, waist and hip circumference, and fasting plasma glucose, insulin, lipid, and creatinine levels were measured. A 24-hour urine sample was collected for measurement of albumin and catecholamine excretion. The body mass index (BMI) and waist circumference were used as measures of general and central obesity, respectively. The insulin resistance index was estimated by the calculated product of fasting plasma insulin and glucose concentrations. Patients with an increasing number of components of the metabolic syndrome (type 2 diabetes mellitus, hypertension, dyslipidemia, obesity, and/or albuminuria) were more obese, hyperglycemic, dyslipidemic, and albuminuric and had higher blood pressure, plasma insulin, insulin resistance indices, and 24-hour urinary norepinephrine excretion but lower urinary epinephrine output (all P < .005). Increasing quintiles of BMI in the whole population or waist circumference in both sexes were associated with increasing trends for adverse lipid profiles, plasma insulin, insulin resistance indices, and urinary norepinephrine excretion but a decreasing trend for urinary epinephrine output (all P < .001). There were close associations between age, obesity, blood pressure, fasting plasma glucose, lipid, insulin, insulin resistance indices, and urinary catecholamine excretion. Using stepwise multiple regression analysis (all P < .001), 34% of the variability of the BMI and 45% of that of the waist circumference were independently related to gender (waist higher in males and BMI higher in females), increased plasma insulin, triglyceride, and urinary norepinephrine excretion, and decreased high-density lipoprotein (HDL) cholesterol and urinary epinephrine output. In Chinese subjects with different manifestations of the metabolic syndrome, hyperinsulinemia, insulin resistance, elevated norepinephrine, and reduced epinephrine excretion were closely associated with general and central obesity. Based on these findings, we postulate that complex interactions between the insulin and sympathoadrenal systems may lead to the development of obesity and the metabolic syndrome.     

Metabolic syndrome, plasma lipid, lipoprotein and glucose levels, and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

To clarify the role of metabolic factors in endometrial carcinogenesis, we conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), and examined the relation between prediagnostic plasma lipids, lipoproteins, and glucose, the metabolic syndrome (MetS; a cluster of metabolic factors) and endometrial cancer risk. Among pre- and postmenopausal women, 284 women developed endometrial cancer during follow-up. Using risk set sampling, 546 matched control subjects were selected. From conditional logistic regression models, high-density lipoprotein cholesterol (HDL-C) levels were inversely associated with risk body mass index (BMI)-adjusted relative risk (RR) for top versus bottom quartile 0.61 (95% confidence intervals (CI) 0.38-0.97), P(trend) = 0.02). Glucose levels were positively associated with risk (BMI-adjusted RR top versus bottom quartile 1.69 (95% CI 0.99-2.90), P(trend) = 0.03), which appeared stronger among postmenopausal women (BMI-adjusted RR top versus bottom tertile 2.61 (95% CI 1.46-4.66), P(trend) = 0.0006, P(heterogeneity) = 0.13) and never-users of exogenous hormones (P(heterogeneity) = 0.005 for oral contraceptive (OC) use and 0.05 for hormone replacement therapy-use). The associations of HDL-C and glucose with risk were no longer statistically significant after further adjustment for obesity-related hormones. Plasma total cholesterol, Low-density lipoprotein cholesterol (LDL-C), and triglycerides were not significantly related to overall risk. The presence of MetS was associated with risk (RR 2.12 (95% CI 1.51-2.97)), which increased with the number of MetS factors (P(trend) = 0.02). An increasing number of MetS factors other than waist circumference, however, was marginally significantly associated with risk only in women with waist circumference above the median (P(interaction) = 0.01). None of the associations differed significantly by fasting status. These findings suggest that metabolic abnormalities and obesity may act synergistically to increase endometrial cancer risk.     

老年人代谢综合征与良性前列腺增生的关系

目的 回顾性分析老年代谢综合征(MS)与良性前列腺增生(BPH)的关系.方法 老年男性859名,其中单纯MS患者8例,单纯BPH患者619例,两种疾病并存者192例,未患病者40例.检测空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),并计算体质指数(BMI)、前列腺体积及前列腺年增长率(PG),分析代谢性危险因素与BPH的相关性.结果 BPH患者MS组与非MS组相比收缩压、舒张压、体质量、BMI、TG及FBG偏高(t=6.15、5.99、13.12、15.56、10.63、9.94,均P＜0.01),HDL-C浓度偏低(t=-7.57,P＜0.01);随着MS组分个数的增加,前列腺体积增加(F=2.98,P=0.031);随着年龄、体质量、BMI、收缩压、PG的增加,前列腺体积增大(t值分别为-6.39、-2.39、-2.36、-2.13、-25.85,均P＜0.05);前列腺体积与年龄、收缩压、体质量、BMI、血压升高呈正相关(r值分别为0.229、0.079、0.090、0.089、0.088,均P＜0.05);非条件Logistic回归分析校正混杂因素后,年龄、体质量和收缩压＞130 mm Hg(1 m Hg=0.133 kPa)为前列腺增生的独立相关因素(OR值分别为1.07、1.03、1.34,均P＜0.05).结论 老年患者BPH与MS有关,MS可能参与老年人BPH的发生发展过程,但其机制尚有待进一步研究.

Abstract：

Objective To retrospectively analyze the relationship between benign prostatic hyperplasia (BPH) and metabolic syndrome (MS) in senior patients. Methods The 859 male senior patients including 619 cases with BPH and 8 cases with MS were enrolled in this study, and there were 192 cases with both diseases and 40 controls. The levels of fasting blood glucose (FBG), total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were measured. The body mass index (BMI), prostate volume and annual prostate growth rate were determined or calculated. The correlations of BPH with other metabolic risk factors were analyzed. Results The levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), body weight, BMI, TG and FPG were higher (t=6.15, 5.99, 13.12, 15.56, 10.63 and 9.94, all P＜0.01), while serum HDL-C level was lower (t=-7.57,P＜0.01) in BPH patients with MS than without MS. As the number of components of MS was increased, the prostate volume was increased (F=2.98, P=0.031). As the age, body weight, BMI, SBP and PG were increased, the prostate volume was increased (t=-6.39,-2.39,-2.36,-2.13,-25.85,all P＜0.05). Spearman analysis showed that prostate volume was positively correlated with age, SBP, body weight, BMI and hypertension (r=0.229, 0.079, 0.090, 0.089 and 0.088, all P＜0.05). And age, body weight and SBP were the independent risk factors for BPH (OR=1.07, 1.03 and 1.34, all P＜0.05). Conclusions The present study demonstrates a relationship between BPH and MS in senior patients. Future studies are needed to confirm our results and to explain underlying mechanisms.     

Relative androgen deficiency in relation to obesity and metabolic status in older men

BACKGROUND: Although androgen deficiency in men has been linked with obesity and the metabolic syndrome, whether it predisposes to, or is a consequence of, type 2 diabetes mellitus (T2DM) is still unclear. OBJECTIVE: To determine the relationship between plasma androgen levels, obesity, metabolic status and T2DM in men of 70 years or older. DESIGN AND METHODS: A sample of 195 men from the Australian Longitudinal Study of Ageing with a mean age of 76.2 +/- 0.3 years were followed up for 8 years. Total testosterone (TT), fasting plasma glucose (FPG), urate, serum creatinine, total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), triglycerides (TG), blood pressure (BP), body mass index (BMI), waist circumference (WC) and diabetic status were assessed at baseline. Self-reported diabetic status was obtained after 8 years. Metabolic syndrome was diagnosed based on the Third National Cholesterol Education Program Adult Treatment Panel clinical criteria. RESULTS: TT levels were lower in diabetic men compared with non-diabetic men (12.1 +/- 0.7 vs. 14.2 +/- 0.4 nmol/l, p = 0.026). TT levels in healthy, non-diabetic men over 80 years of age were lower (11.9 +/- 0.8 vs. 15.0 +/- 0.5 nmol/l, p = 0.002) than TT levels in those aged 70-79 years, inversely related to BMI (r = -0.26, p = 0.001), WC (r = -0.30, p < 0.001) and TG (r = -0.22, p = 0.005) and positively related to LDL-C (r = 0.25, p = 0.002). Men with the metabolic syndrome had significantly lower levels of TT and HDL-C, and higher values of BP, FPG, TG, BMI and WC, compared with those without. However, no significant difference in plasma TT levels was noted between men with incident T2Dm and healthy men. Stepwise linear regression analysis revealed that only LDL-C and WC related significantly to the variance of TT. Multiple logistic regression revealed FPG to be the only independent predictor of incident diabetes (odds ratio = 60.2, p = 0.003). CONCLUSIONS: Testosterone levels continue to decline even in healthy men over the age of 80 years. Although TT levels were inversely related to visceral obesity and several components of the metabolic syndrome, our data do not support a predictive or causative role for decreasing TT levels in the development of incident T2Dm. Androgen deficiency is consequent upon, rather than a cause of, poor metabolic status.     

体重及脂肪分布与高血压病关系的流行病学研究

目的:探讨体重及脂肪分布与高血压病的相关性。方法:采取整群随机抽样的方法选择徐州市大屯社区259位中年居民为调查对象,运用病例对照研究,测量体重指数(BM I)、腰臀比(WHR)、腰围(W C)、臀围(HC)等参数数值,并作统计学处理。结果:(1)高血压组中的体重、体重指数、腰围、臀围、腰臀比高于对照组(P<0.05);高血压合并冠心病组中的腰围、臀围高于对照组(P<0.05);(2)腰臀比与年龄、收缩压、舒张压、尿酸、血糖、甘油三酯、体重呈正相关(r=0.17~0.305,P<0.05);体重指数与收缩压、舒张压、尿酸、甘油三酯、腰围、臀围呈正相关(r=0.299~0.670,P<0.05);(3)腹部肥胖型在各病例组中所占的比例明显高于对照组(P<0.05)。结论:超重、肥胖尤其是腹部肥胖型是高血压病的危险因素。     

Associations of obesity markers, insulin, and sex hormones with HDL-cholesterol levels in Turkish and German individuals.

Turkish men and women have about 20% lower mean levels of HDL-C and apoA-I than German individuals. To obtain some information on the metabolic basis of this difference, we compared anthropometric data as well as serum levels of leptin, insulin, testosterone (T), estradiol (E2), and sex hormone binding globuline (SHBG) in 289 German and 120 Turkish men as well as in 108 German and 182 Turkish women aged 20-60. Individuals who smoke, take hormones, have overt diabetes mellitus, BMI > 30 kg/m2, triglycerides > 400 mg/dl, or LDL-cholesterol > 200 mg/dl were excluded. In both sexes, Turks had significantly lower levels of HDL-C, apoA-I, Lp(a), and SHBG than Germans. Moreover, German men had a larger waist circumference, lower levels of E2 and a lower ratio of T/SHBG. German women also had a lower BMI, smaller waist circumference, lower insulin levels and higher T levels. Mean values of age, waist-hip-ratio (WHR), leptin, triglycerides, LDL-C, and apoB did not differ significantly among Germans and Turks. Upon univariate analysis HDL-C had inverse correlations with BMI, waist circumference, WHR, leptin, and insulin as well as positive correlations with SHBG in both sexes. Upon multivariate analysis, most of the different levels of HDL-C and apoA-I between Germans and Turks were explained by ethnicity, independently of obesity markers, insulin, and sex hormones.     

Incidence and treatment of metabolic syndrome in newly referred women with confirmed polycystic ovarian syndrome

In 138 oligo-amenorrheic white women with polycystic ovary syndrome (PCOS) (31+/-9-years-old), our first specific aim was to assess the incidence of the metabolic syndrome and to compare metabolic syndrome abnormalities in women with PCOS to those in the National Health and Nutrition Examination Survey (NHANES) III cohort of 1,887 white women. Our second aim was to determine whether metformin (2.55 g/d) and a diet of 1,500 calories, 26% protein, 44% carbohydrate (42% of carbohydrate complex), 30% fat (polyunsaturate/saturate ratio [P/S]=2/1), would ameliorate metabolic syndrome abnormalities in women with both PCOS and metabolic syndrome. The metabolic syndrome was present in 64 (46%) of the women with PCOS. In these 64 women, there were abnormalities in waist circumference (98%), high-density lipoprotein cholesterol (HDL-C) (95%), blood pressure (70%), triglycerides (56%), and glucose (11%). In these 64 women, mean +/- SD waist circumference was 116+/-15 cm, triglyceride 192+/-152 mg/dL, HDL-C 39+/-7 mg/dL, systolic blood pressure 131+/-13 mm Hg, diastolic blood pressure 83+/-7 mm Hg, and serum glucose 94+/-22 mg/dL. Serum insulin was high (>17 microU/mL) in 42 of the 64 women (66%). After age adjustment, 46.4%+/-4.2% of women with PCOS had the metabolic syndrome (> or =3 abnormalities) versus 22.8%+/-1.1% of NHANES III women, P<.0001 versus 6% of 20 to 29-year-old and 15% of 30 to 39-year-old NHANES III women. Of the 64 women with both PCOS and the metabolic syndrome, 50 had follow-up studies after an average of 6 months on metformin and diet. At 6 months follow-up, mean percent reductions were as follows: body weight 4.7% (111 to 106 kg, P<.0001), triglycerides 14% (197 to 136 mg/dL, P=.0001), systolic blood pressure 5.2% (131 to 124 mm Hg, P=.0002), diastolic blood pressure 6% (83 to 77 mm Hg, P=.0007), and insulin 31% (25 to 17 microU/mL, P<.0001); mean percent HDL-C increased 6% (39 to 41 mg/dL, P=.013). Of these 50 women, 29 had pretreatment baseline abnormal triglycerides (> or =150 mg/dL), 47 had low HDL-C (<50 mg/dL), 26 had high systolic blood pressure (> or =130 mm Hg), 16 had high diastolic blood pressure (> or =85 mm Hg), and 5 had glucose > or = 110 mg/dL. On metformin plus diet at 6 months, triglycerides moved within guidelines in 10 of 29 (34%) women, HDL-C in 6 of 47 (13%), systolic blood pressure in 16 of 26 (62%), diastolic blood pressure in 10 of 16 (63%), and glucose in 3 of 5 (60%). Metformin and diet ameliorate many of the features of the metabolic syndrome, present in 46% of women with PCOS in the current study, and should reduce risk for atherothrombosis and type 2 diabetes mellitus (DM) in PCOS.     

Relationship of adiponectin to serum paraoxonase 1

Correlation of the plasma levels of insulin-sensitizing, anti-inflammatory and anti-atherosclerotic adiponectin with HDL has been demonstrated. However, its relation to HDL-bound paraoxonase 1 (PON1) has not been clarified. The association of serum PON1 activity with findings of metabolic syndrome was investigated in three age and sex-matched groups: (1) non-diabetic overweight subjects with BMI 28-39.9 kg/m(2) (n=25); (2) non-diabetic obese subjects with BMI>or=40 kg/m(2) (n=25); and (3) healthy, normal-weight controls (n=24). Of the parameters investigated, PON1 activity correlated positively with concentrations of HDL-C and adiponectin, and correlated negatively with BMI, waist circumference, systolic BP, levels of HbA(1C), and insulin, HOMA-IR, and TBARS. The positive correlation between adiponectin and PON1 remained significant even after adjustments for age, gender, BMI, blood pressure, HOMA-IR, HDL-C, LDL-C, and lipid peroxidation. CONCLUSIONS: PON1 activity shows negative association with markers of metabolic syndrome. We demonstrate that adiponectin is an independent variable of serum PON1, which may contribute to the anti-atherosclerotic effect of adiponectin.     

非酒精性脂肪性肝病患者基本特征及诊疗规范的调查研究

目的 了解非酒精性脂肪性肝病(NAFLD)患者中代谢相关指标的异常情况及日常诊疗的规范性.方法 收集中国12个地区21个医院门诊的成年NAFLD患者的临床基本信息,包括人口学特征(身高、体质量、腰围等),血压、血糖、血脂、肝功能,肝脏B超检查,记录患者的日常生活方式及诊疗情况,并参照我国2006年<非酒精性脂肪性肝病诊疗指南>进行评估.根据资料不用采用t检验、单因素方差分析或Pearson x2检验进行统计学分析.结果 1656例NAFLD患者参与此项调查性研究,其中男性1146例,女性510例,平均年龄(45.8±12.6)岁,病程为(47.2±47.7)个月.可以进评估的1587例NAFLD患者中有712例伴有代谢综合征,占44.9%.血压升高者和高密度脂蛋白胆固醇降低者中心性肥胖组分别为54.2%(605/1116)和38.2%(426/1116),无中心性肥胖组分别为45.4%(214/471)和31.6%(149/471),两组比较,x2值分别为10.2149及4.7975,P值均<0.05,差异有统计学意义.41.8%患者ALT异常,其人体质量指数、男女腰围、甘油三酯、低密度脂蛋白、空腹胰岛素、HOMA指数均高于ALT正常组,t值分别为5.1999、2.2255、2.3216、2.420、2.4950,4.4578、3.3397,P值均<0.05;而高密度脂蛋白胆固醇和舒张压低于ALT正常组,t值分别为3.5033和3.5626,P值均<0.05.人体质量指数、女性腰围、甘油三酯,空腹胰岛素、HOMA指数、ALT、AST等指标随B超脂肪肝轻、中、重程度呈升高趋势,而高密度脂蛋白胆固醇呈下降趋势.患者实际日常诊疗规范程度低于指南要求,其中使用胰岛素增敏剂和调脂药的分别仅达指南要求的15.3%和23.8%.结论 近半数NAFLD患者合并代谢综合征,日常诊疗现状距"非酒精性脂肪性肝病诊疗指南"要求差距较大.

Abstract：

Objective To assess the characteristics and daily treatment compliance of non-alcoholic fatty liver disease (NAFLD) patients in China. Methods NAFLD adult patients from 21 clinics of 12 cities in China were enrolled in this registry. Physical examination such as demographic characteristics (height,weight, waist circumference measurement), blood pressure and clinical laboratory and ultrasonographic examination of liver were undertaken. Daily practice including life style and medication were recorded and assessed in accordance with 2006 Chinese NAFLD treatment guidelines. Results A total of 1656 patients were enrolled (1146 male and 510 female), mean of 45.8 ± 12.6 years old, mean duration of NAFLD history was (47.2 ± 47.7) months. 44.9% of NAFLD were suffering from metabolic syndromes. Patients with central obesity have higher incidence of hypertension and lower level of high-density lipoprotein cholesterol (HDL-C) than those without central obesity, P < 0.05. Body mass index (BMI), waist circumference, triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) in ALT abnormal group were higher than those in ALT normal group (P < 0.05), HDL-C was lower in ALT abnormal group (P < 0.05). Significant differences existed between the BMI, female waist circumference, TG, fast insulin, HOMA index, ALT, AST and HDLC among subgroups with mild, moderate and severe steatosis. Majority of the patients did not follow recommendations of NAFLD treatment guidelines. Among targeted population only 15.3% of patients used insulin sensitizers and 23.8% took lipid lowering medicine according to the guideline. Conclusion Data indicated that nearly half of NAFLD patients co-morbid with metabolic disorders. Therapy compliance was unsatisfactory and the gap between current practice and Chinese NAFLD treatment guidelines was not optimal.