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Chen Y, Zhao X. The mediating role of insulin resistance in the association between inflammatory score and MAFLD: NHANES 2017-2018. Immun Inflamm Dis 2024; 12:e70035. [PMID: 39364712 PMCID: PMC11450453 DOI: 10.1002/iid3.70035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 09/06/2024] [Accepted: 09/25/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND The association between inflammatory score, insulin resistance (IR), and metabolic-associated fatty liver disease (MAFLD) is inconclusive. OBJECTIVE The objective of this study was to examine the relationship between the inflammatory score and MAFLD and investigate the potential mediating effect of IR (evaluated by triglyceride-glucose index) in this association. METHODS Calculating inflammatory score was performed based on white blood cells and high-sensitivity C-reactive protein. The association between the inflammatory score and MAFLD was evaluated based on the weighted multifactor logistic regression model. Restricted cubic splines (RCS) were used to visualize the dose-response relationship between the inflammatory score and MAFLD. We also conducted a mediation analysis to assess the extent to which IR mediates this association. RESULTS Among the 1090 participants, 563 were ultimately diagnosed with MAFLD. Multivariate logistic regression results indicated a close positive association between inflammatory score and MAFLD (odds ratio = 1.235, 95% confidence interval 1.069-1.427, p = .007). The RCS results indicated a linear dose-response relationship between the inflammatory score and the risk of MAFLD after adjusting for potential confounding factors. Furthermore, the mediation analysis results showed that IR partially mediated the association between the inflammatory score and MAFLD (percent mediation = 33%). CONCLUSION Our research results indicate that the inflammatory score is positively associated with the risk of MAFLD, and IR plays a partial mediating effect in this association.
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Affiliation(s)
- Yan Chen
- Department of CardiologyThe Second Hospital of Dalian Medical UniversityDalianPeople's Republic of China
| | - Xin Zhao
- Department of CardiologyThe Second Hospital of Dalian Medical UniversityDalianPeople's Republic of China
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2
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Choe EK, Kang HY. The association between platelet-related parameters and nonalcoholic fatty liver disease in a metabolically healthy nonobese population. Sci Rep 2024; 14:6118. [PMID: 38480828 PMCID: PMC10937929 DOI: 10.1038/s41598-024-56796-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/11/2024] [Indexed: 03/17/2024] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease characterized by subclinical inflammation and is related to obesity and metabolic syndrome (MS), but it is also frequently observed in nonobese populations. We aimed to evaluate the relationship between the white blood cell count-to-mean platelet volume ratio (WBC/MPV), platelet-to-lymphocyte count ratio (PLR) and lymphocyte-monocyte ratio (LMR) in association with NAFLD, considering the presence of obesity and MS. Additionally, we aimed to investigate whether these parameters exhibited similar correlations in metabolic dysfunction-associated steatotic liver disease (MASLD) as observed in NAFLD. This cross-sectional study included subjects who underwent a comprehensive health evaluation, including blood tests and abdominal ultrasonography. Subgroup analyses were conducted based on obesity and MS. Out of a total 5929 subjects (3271 males, mean age 49.7 ± 10.6 years), 2253 (38.0%) had NAFLD. WBC/MPV was significantly higher, and PLR was significantly lower in subjects with NAFLD. In the analysis restricted to the nonobese (BMI < 25 kg/m2) population without MS, both WBC/MPV and PLR were independently associated with NAFLD: WBC/MPV (adjusted OR 3.366; 95% CI 2.238-5.066) and PLR (adjusted OR 0.997; 95% CI 0.996-0.999). When assessing the risk of NAFLD based on the WBC/MPV and PLR quartiles, the adjusted OR and 95% CI for the lowest quartile compared to the highest were 2.055 (95% CI 1.626-2.602) for WBC/MPV and 0.660 (95% CI 0.523-0.832) for PLR in the nonobese, metabolically healthy group. The levels of WBC/MPV and PLR were independently associated with NAFLD. Furthermore, in MASLD, an association with WBC/MPV, PLR and LMR was identified, similar to the results observed in NAFLD, even after adjusting for confounding variables. In conclusion, the present study demonstrated a significant association between NAFLD and platelet-related parameters, especially in nonobese, metabolically healthy subjects.
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Affiliation(s)
- Eun Kyung Choe
- Department of Surgery, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
| | - Hae Yeon Kang
- Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea.
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3
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Cong X, Li X, Xu K, Yin L, Liang G, Sun R, Pu Y, Zhang J. HIF-1α/m 6A/NF-κB/CCL3 axis-mediated immunosurveillance participates in low level benzene-related erythrohematopoietic development toxicity. ENVIRONMENT INTERNATIONAL 2024; 184:108493. [PMID: 38350257 DOI: 10.1016/j.envint.2024.108493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 02/15/2024]
Abstract
Defective erythropoiesis is one of the causes of anemia and leukemia. However, the mechanisms underlying defective erythropoiesis under a low-dose environment of benzene are poorly understood. In the present study, multiple omics (transcriptomics and metabolomics) and methods from epidemiology to experimental biology (e.g., benzene-induced (WT and HIF-1α + ) mouse, hiPSC-derived HSPCs) were used. Here, we showed that erythropoiesis is more easily impacted than other blood cells, and the process is reversible, which involves HIF-1 and NF-kB signaling pathways in low-level benzene exposure workers. Decreased HIF-1α expression in benzene-induced mouse bone marrow resulted in DNA damage, senescence, and apoptosis in BMCs and HSCs, causing disturbances in iron homeostasis and erythropoiesis. We further revealed that HIF-1α mediates CCL3/macrophage-related immunosurveillance against benzene-induced senescent and damaged cells and contributes to iron homeostasis. Mechanistically, we showed that m6A modification is essential in this process. Benzene-induced depletion of m6A promotes the mRNA stability of gene NFKBIA and regulates the NF-κB/CCL3 pathway, which is regulated by HIF-1α/METTL3/YTHDF2. Overall, our results identified an unidentified role for HIF-1α, m6A, and the NF-kB signaling machinery in erythroid progenitor cells, suggesting that HIF-1α/METTL3/YTHDF2-m6A/NF-κB/CCL3 axis may be a potential prevention and therapeutic target for chronic exposure of humans to benzene-associated anemia and leukemia.
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Affiliation(s)
- Xiaowei Cong
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Xiaoqin Li
- Yangzhou Center for Disease Control and Prevention, Yangzhou 225100, Jiangsu, China
| | - Kai Xu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Lihong Yin
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Geyu Liang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Rongli Sun
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Yuepu Pu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China.
| | - Juan Zhang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China.
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Sakboonyarat B, Rangsin R, Mittleman MA. Incidence and risk factors of metabolic syndrome among Royal Thai Army personnel. Sci Rep 2022; 12:15692. [PMID: 36127360 PMCID: PMC9489720 DOI: 10.1038/s41598-022-19024-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/23/2022] [Indexed: 11/14/2022] Open
Abstract
Metabolic Syndrome is a clustering of obesity, hyperglycemia/insulin resistance, dyslipidemia, and hypertension. We aimed to determine the incidence of metabolic syndrome among Royal Thai Army (RTA) personnel and its risk factors. We conducted a retrospective cohort study using data from 2017 to 2021. Metabolic syndrome was defined by NCEP ATP III (2005 Revision). A total of 98,264 participants were enrolled in the present study. The overall incidence rate of metabolic syndrome was 3.7 per 100 person-year (95% CI 3.7–3.8). The statistically significant risk factors for metabolic syndrome included male sex (aHR 1.40; 95% CI 1.29–1.51), age > 35 years, current alcohol consumption, and no exercise. When stratified by sex, the incidence rate of metabolic syndrome among participants aged ≥ 45 years was higher than those aged < 35 years with aHR 6.34; 95% CI 6.01–6.70 for males and aHR 9.59; 95% CI 7.55–12.19 for females. Our data demonstrated that metabolic syndrome is a common health issue, especially among RTA personnel over 35 years. Alcohol consumption and sedentary behavior played an essential role in facilitating metabolic syndrome in this study population and are potential targets for intervention to enhance primary prevention of the sequelae of metabolic syndrome.
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Affiliation(s)
- Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Murray A Mittleman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
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5
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Hedayati MT, Montazeri M, Rashidi N, Yousefi-Abdolmaleki E, Shafiee MA, Maleki A, Farmani M, Montazeri M. White blood cell count and clustered components of metabolic syndrome: A study in western Iran. CASPIAN JOURNAL OF INTERNAL MEDICINE 2021; 12:59-64. [PMID: 33680399 PMCID: PMC7919179 DOI: 10.22088/cjim.12.1.59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Background White blood cell count (WBC) is one of the objective parameters of systemic inflammation. The aim of present study was to evaluate the relationship between WBC count and metabolic syndrome. Methods In this study on Lor population in Borujerd province (West of Iran), from 2011 to 2013, 800 persons were enrolled. MetS was defined based on ATP III criteria. Differences among the quartiles of WBC were examined by one-way analysis of variance. Results Only 14.7% did not have any of the five components and 43% of all subjects had metabolic syndrome. The means of WBC count in MetS group were significantly higher than the control group (p<0.0001). In subjects without any MetS components, the means of WBC was 5.321 /µL, and it was 5.664, 5.714, 5.961, 6.302, and 6.572 /µL in subjects with 1, 2, 3, 4, and 5 components, respectively. These differences show a significant increasing trend (p<0.0001). Conclusion WBC count was associated with clustered components of metabolic syndrome. It seems that WBC counts could be considered as a predictive factor for metabolic syndrome in preventive medicine.
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Affiliation(s)
| | - Mahdi Montazeri
- Division of General Internal Medicine, Department of Medicine, Toronto General Hospital, Toronto, Canada
| | - Negin Rashidi
- Division of General Internal Medicine, Department of Medicine, Toronto General Hospital, Toronto, Canada
| | | | - Mohammad-Ali Shafiee
- Division of General Internal Medicine, Department of Medicine, Toronto General Hospital, Toronto, Canada
| | - Ali Maleki
- Department of Cardiology, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Maryam Farmani
- Department of Internal Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Montazeri
- Sarem Fertility and Infertility Research Center (SAFIR), Sarem Women's Hospital, Tehran, Iran
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Ge Y, Wei C, Wang W, Cao L. The effect of sorghum resistance resistant starch-mediated equol on the histological morphology of the uterus and ovaries of postmenopausal rats. Food Sci Nutr 2020; 8:4055-4065. [PMID: 32884687 PMCID: PMC7455943 DOI: 10.1002/fsn3.1670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 01/23/2023] Open
Abstract
Equol is a metabolite of daidzein and has a higher biological activity than daidzein. Equol, combined with estrogen receptors, can reduce the incidence of diseases such as cardiovascular disease, osteoporosis, and breast cancer; more effectively alleviate the symptoms of perimenopausal syndrome; and improve age-related decline of the uterus and ovaries. Research has shown that food composition can greatly affect the formation of equol in the intestinal tract. In the intestines, the content of nonstarch polysaccharides that can stimulate fermentation is high, thereby allowing intestinal bacteria to quickly and completely transform the daidzein into equol. This study used Sprague Dawley (SD) rats as a model, where menopause was established through direct intragastric administration of formistan. In the 6-week-long experiment, intragastric administration of RS while feeding bean pulp reduced the body weight of postmenopausal rats, reduced the efficiency of feed utilization of rats, and increased the weight of organs such as the uterus and ovaries. Routine blood indexes showed that no adverse reactions were produced by intragastric administration of RS. 16s rDNA sequencing further verified Lactobacillus and Clostridium XIVa, as the bacteria that converted daidzein into equol.
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Affiliation(s)
- Yun‐Fei Ge
- College of Food ScienceHeilongjiang Bayi Agricultural UniversityDaqingChina
| | - Chun‐Hong Wei
- College of Food ScienceHeilongjiang Bayi Agricultural UniversityDaqingChina
- National Coarse Cereals Engineering Research CenterHeilongjiang Bayi Agricultural UniversityDaqingChina
| | - Wei‐Hao Wang
- College of Food ScienceHeilongjiang Bayi Agricultural UniversityDaqingChina
- National Coarse Cereals Engineering Research CenterHeilongjiang Bayi Agricultural UniversityDaqingChina
| | - Long‐Kui Cao
- College of Food ScienceHeilongjiang Bayi Agricultural UniversityDaqingChina
- National Coarse Cereals Engineering Research CenterHeilongjiang Bayi Agricultural UniversityDaqingChina
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7
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Hematocrit levels and arterial stiffness: the Cardiometabolic Risk in Chinese (CRC) Study. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-019-00794-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Wang X, Fu J, Gu Y, Chi VTQ, Zhang Q, Liu L, Meng G, Yao Z, Wu H, Bao X, Zhang S, Liu M, Wang Y, Lu Z, Wang L, Zheng L, Wang X, Tian C, Sun S, Zhou M, Jia Q, Song K, Niu K. Relationship between serum levels of immunoglobulins and metabolic syndrome in an adult population: A population study from the TCLSIH cohort study. Nutr Metab Cardiovasc Dis 2019; 29:916-922. [PMID: 31377185 DOI: 10.1016/j.numecd.2019.05.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Metabolic syndrome (MetS) is a combination of metabolic disorders that increase the risk of developing cardiovascular disease, and inflammation is considered as a pathological basis for MetS. Immunoglobulins (Igs) are the major secretory products of the adaptive immune system. However, no large-scale population study has focused on a possible relationship between Igs and MetS. We designed a cross-sectional study to investigate the relationship between Igs and prevalence of MetS in a large-scale adult population. METHODS AND RESULTS A total of 10,289 participants were recruited among residents in Tianjin, China. Metabolic syndrome was defined in accordance with the criteria of the American Heart Association scientific statements of 2009. Serum levels of Igs were determined by immunonephelometry. Multiple logistic regression models were used to assess the relationship between the quintiles of serum levels of Igs and the prevalence of MetS. The overall prevalence of MetS was 36.1%. The mean (standard deviation) values of Igs (IgG, IgE, IgM, and IgA) were 1205.7 (249.3) mg/dL, 93.1 (238.9) IU/mL, 105.7 (57.3) mg/dL, and 236.2 (97.6) mg/dL, respectively. The adjusted odds ratios (95% confidence interval) of MetS for the highest quintile of Igs (IgG, IgE, IgM, and IgA), when compared to the lowest quintile, were 0.81 (0.70, 0.95), 0.97 (0.83, 1.12), 1.13 (0.97, 1.33), and 1.52 (1.30, 1.77), respectively. CONCLUSIONS This study demonstrated that decreased IgG and increased IgA are independently related to a higher prevalence of MetS. The results indicate that the Igs might be useful predictive factors for MetS in the general adult population.
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Affiliation(s)
- Xiaotong Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jingzhu Fu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yeqing Gu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Vu Thi Q Chi
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhanxin Yao
- Tianjin Institute of Environmental & Operational Medicine, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xue Bao
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Mingyue Liu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yanyan Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zuolin Lu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Liu Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Lixiao Zheng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaona Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Chunling Tian
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, China.
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Mahdiani A, Kheirandish M, Bonakdaran S. Correlation Between White Blood Cell Count and Insulin Resistance in Type 2 Diabetes. Curr Diabetes Rev 2019; 15:62-66. [PMID: 29357806 DOI: 10.2174/1573399814666180119143026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/16/2017] [Accepted: 01/09/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The role of chronic inflammation in insulin resistance states and the pathogenesis of metabolic syndrome, cardiovascular disease and diabetes have been reported earlier. White Blood Cell (WBC) count is an easy marker for estimation of systemic inflammation. OBJECTIVE This study is to clarify whether WBC count is associated with insulin resistance in type 2 diabetic patients. METHODS This cross sectional study was conducted in 283 patients with type 2 diabetes and in 283 healthy non diabetic subjects as control group. Data including: age, gender, blood pressure, height and weight, history of smoking were collected for each patient. Fasting blood sugar, HbA1C, insulin, lipid profiles, creatinine, Urine albumin to creatinine ratio, high sensitive C- reactive protein (HCRP) and WBC was measured for all patients. WBC count was measured in control group. Two groups were compared in WBC count. Insulin resistance was calculated with HOMA-IR formula. Association of WBC count with insulin resistance and metabolic parameters was assessed in diabetic patients. RESULTS WBC count was significantly associated with body mass index, hypertension, and triglyceride level. There was not significant association between WBC count and glycemic index and insulin resistance. CONCLUSION An elevated WBC count (even in the normal range) is closely related to various components of metabolic syndrome but not related to insulin resistance in type 2 diabetes.
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Affiliation(s)
- Armin Mahdiani
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Science, Bandar Abbas, Iran
| | - Masoume Kheirandish
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Science, Bandar Abbas, Iran
| | - Shokoufeh Bonakdaran
- Endocrine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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10
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Pietzner M, Kaul A, Henning AK, Kastenmüller G, Artati A, Lerch MM, Adamski J, Nauck M, Friedrich N. Comprehensive metabolic profiling of chronic low-grade inflammation among generally healthy individuals. BMC Med 2017; 15:210. [PMID: 29187192 PMCID: PMC5708081 DOI: 10.1186/s12916-017-0974-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 11/08/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Inflammation occurs as an immediate protective response of the immune system to a harmful stimulus, whether locally confined or systemic. In contrast, a persisting, i.e., chronic, inflammatory state, even at a low-grade, is a well-known risk factor in the development of common diseases like diabetes or atherosclerosis. In clinical practice, laboratory markers like high-sensitivity C-reactive protein (hsCRP), white blood cell count (WBC), and fibrinogen, are used to reveal inflammatory processes. In order to gain a deeper insight regarding inflammation-related changes in metabolism, the present study assessed the metabolic patterns associated with alterations in inflammatory markers. METHODS Based on mass spectrometry and nuclear magnetic resonance spectroscopy we determined a comprehensive panel of 613 plasma and 587 urine metabolites among 925 apparently healthy individuals. Associations between inflammatory markers, namely hsCRP, WBC, and fibrinogen, and metabolite levels were tested by linear regression analyses controlling for common confounders. Additionally, we tested for a discriminative signature of an advanced inflammatory state using random forest analysis. RESULTS HsCRP, WBC, and fibrinogen were significantly associated with 71, 20, and 19 plasma and 22, 3, and 16 urine metabolites, respectively. Identified metabolites were related to the bradykinin system, involved in oxidative stress (e.g., glutamine or pipecolate) or linked to the urea cycle (e.g., ornithine or citrulline). In particular, urine 3'-sialyllactose was found as a novel metabolite related to inflammation. Prediction of an advanced inflammatory state based solely on 10 metabolites was well feasible (median AUC: 0.83). CONCLUSIONS Comprehensive metabolic profiling confirmed the far-reaching impact of inflammatory processes on human metabolism. The identified metabolites included not only those already described as immune-modulatory but also completely novel patterns. Moreover, the observed alterations provide molecular links to inflammation-associated diseases like diabetes or cardiovascular disorders.
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Affiliation(s)
- Maik Pietzner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Str. NK, 17475, Greifswald, Germany. .,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany.
| | - Anne Kaul
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Str. NK, 17475, Greifswald, Germany
| | - Ann-Kristin Henning
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Str. NK, 17475, Greifswald, Germany
| | - Gabi Kastenmüller
- Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München, Ingolstädter Landstraße 1, D-85764, Neuherberg, Germany
| | - Anna Artati
- Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, Ingolstädter Landstraße 1, D-85764, Neuherberg, Germany
| | - Markus M Lerch
- Department of Medicine A, University Medicine Greifswald, Ferdinand-Sauerbruch-Str. NK, 17475, Greifswald, Germany
| | - Jerzy Adamski
- Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, Ingolstädter Landstraße 1, D-85764, Neuherberg, Germany.,Lehrstuhl für Experimentelle Genetik, Technische Universität München, 85350, Freising-Weihenstephan, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Str. NK, 17475, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Str. NK, 17475, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
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11
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Pan W, Miao L, Lin Y, Huang X, Ge X, Moosa SL, Liu B, Ren M, Zhou Q, Liang H, Zhang W, Pan L. Regulation mechanism of oxidative stress induced by high glucose through PI3K/Akt/Nrf2 pathway in juvenile blunt snout bream (Megalobrama amblycephala). FISH & SHELLFISH IMMUNOLOGY 2017; 70:66-75. [PMID: 28882793 DOI: 10.1016/j.fsi.2017.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 08/23/2017] [Accepted: 09/01/2017] [Indexed: 06/07/2023]
Abstract
This study was conducted to investigate the effects of oral administration of a high concentration of glucose on the respiratory burst, antioxidant status, and hepatic gene expression of heme oxygenase-1 (ho1) and PI3K/Akt/Nrf2-related signaling molecules in juvenile blunt snout bream (Megalobrama amblycephala). Blunt snout bream juveniles with an initial body weight of 19.94 ± 0.58 g were orally fed with a high concentration of glucose (3 g/kg body weight). The results indicated that plasma glucose exhibited a biphasic response. Acute and persistent hyperglycemia due to the oral glucose administration significantly reduced (P < 0.05) the white blood cell count, red blood cell count, and hemoglobin content and caused oxidative stress (significantly increased alanine aminotransferase, aspartate transaminase, alkaline phosphatase, and glucose levels) and early apoptosis of hepatocytes in the fish. Hepatic superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase activities increased rapidly (P < 0.05) as protection from oxidative stress and were downregulated (P < 0.05) because of persistent hyperglycemia. Blood respiratory burst was significantly reduced (P < 0.05) because of hyperglycemia and showed a trend that was opposite to that of plasma glucose. Slight upregulation of nrf2 mRNA and antioxidants acts as a compensative protection mechanism, and the downregulated PI3K/Akt pathway blocked this function of Nrf2. In conclusion, the PI3K/Akt pathway and Nrf2 mediated the antioxidative mechanism independently in the blunt snout bream juveniles subjected to the oral administration of a high glucose concentration.
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Affiliation(s)
- Wenjing Pan
- Wuxi Fisheries College, Nanjing Agricultural University, 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China
| | - Linghong Miao
- Key Laboratory of Freshwater Fisheries and Germplasm Resources Utilization, Ministry of Agriculture, Freshwater Fisheries Research Center (FFRC), Chinese Academy of Fishery Sciences (CAFS), 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China
| | - Yan Lin
- Key Laboratory of Freshwater Fisheries and Germplasm Resources Utilization, Ministry of Agriculture, Freshwater Fisheries Research Center (FFRC), Chinese Academy of Fishery Sciences (CAFS), 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China
| | - Xin Huang
- Wuxi Fisheries College, Nanjing Agricultural University, 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China
| | - Xianping Ge
- Wuxi Fisheries College, Nanjing Agricultural University, 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China; Key Laboratory of Freshwater Fisheries and Germplasm Resources Utilization, Ministry of Agriculture, Freshwater Fisheries Research Center (FFRC), Chinese Academy of Fishery Sciences (CAFS), 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China.
| | - Silli Laban Moosa
- Wuxi Fisheries College, Nanjing Agricultural University, 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China
| | - Bo Liu
- Wuxi Fisheries College, Nanjing Agricultural University, 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China; Key Laboratory of Freshwater Fisheries and Germplasm Resources Utilization, Ministry of Agriculture, Freshwater Fisheries Research Center (FFRC), Chinese Academy of Fishery Sciences (CAFS), 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China
| | - Mingchun Ren
- Key Laboratory of Freshwater Fisheries and Germplasm Resources Utilization, Ministry of Agriculture, Freshwater Fisheries Research Center (FFRC), Chinese Academy of Fishery Sciences (CAFS), 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China
| | - Qunlan Zhou
- Key Laboratory of Freshwater Fisheries and Germplasm Resources Utilization, Ministry of Agriculture, Freshwater Fisheries Research Center (FFRC), Chinese Academy of Fishery Sciences (CAFS), 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China
| | - Hualiang Liang
- Wuxi Fisheries College, Nanjing Agricultural University, 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China
| | - Wuxiao Zhang
- Wuxi Fisheries College, Nanjing Agricultural University, 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China
| | - Liangkun Pan
- Key Laboratory of Freshwater Fisheries and Germplasm Resources Utilization, Ministry of Agriculture, Freshwater Fisheries Research Center (FFRC), Chinese Academy of Fishery Sciences (CAFS), 9 Shanshui East Road, Wuxi, Jiangsu 214081, PR China
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Ostovar R, Kiani F, Sayehmiri F, Yasemi M, Mohsenzadeh Y, Mohsenzadeh Y. Prevalence of metabolic syndrome in Iran: A meta-analysis. Electron Physician 2017; 9:5402-5418. [PMID: 29238477 PMCID: PMC5718841 DOI: 10.19082/5402] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 06/02/2017] [Indexed: 12/13/2022] Open
Abstract
Background Metabolic syndrome) MetS( is a complex risk factor which increases the risk of cardiovascular diseases and type 2 diabetes. There are many studies with various populations and results about the prevalence of MetS in Iran; in order to authenticate these studies and have an overall estimation of its prevalence in Iran, performing a meta-analysis seems to be necessary. Objective This study aimed to investigate the prevalence of MetS and its components in Iran via meta-analysis method. Methods All associated published papers in national and international journals of PubMed, Scopus, Web of Science, Magiran, Iranmedex, Science Direct, Medlib, and SID databases were searched from January, 2000 to October, 2016. All types of studies, including local and national surveys that reported the prevalence of MetS among healthy populations in Iran were reviewed. The effects of age, sample size and publication date as possible sources of heterogeneity among the study findings was examined by meta-regression. P-values less than 0.05 were considered as significant in heterogeneity tests. All analysis was done by R Ver. 3.2.1 and STATA (version 10). Results Seventy eligible studies were selected for meta-analysis. The overall estimation of MetS prevalence was 25% (95% CI: 22-29%) based on the Adult Treatment Panel III (ATP III) criteria, 30% (95% CI: 25-36%) according to the International Diabetes Federation (IDF), and 39% (95% CI: 26-52%) based on the Joint Interim Societies (JIS) criteria. The prevalence of MetS was lower in men than in women (26.9% versus 35.7%). The prevalence of various MetS components including High TG (triglyceride), Low HDL-C, High BP and High FBS (fasting blood sugar) was 43%, 54%, 38% and 22% among the adult population. Conclusion Findings from the present meta-analyses study displayed a high prevalence of metabolic syndrome in Iran, especially in women, which increases with age in both sexes. It alerts health care providers and policy makers to find solutions in order to take action to reduce MetS risk in society.
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Affiliation(s)
- Rahim Ostovar
- PhD, Associate Professor, Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Faezeh Kiani
- Msc, Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Fatemeh Sayehmiri
- PhD, Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masood Yasemi
- MD, Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yazdan Mohsenzadeh
- MSc, Department of Paramedical Sciences, Faculty of Emergency Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Yousof Mohsenzadeh
- MD, Assistant Professor, Department of Cardiology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
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13
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Evaluating of associated risk factors of metabolic syndrome by using decision tree. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s00580-017-2580-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Cho AR, Choi WJ, Kim SH, Shim JY, Lee YJ. Joint Effect of Cigarette Smoking and Body Mass Index on White Blood Cell Count in Korean Adults. Korean J Fam Med 2017; 38:75-80. [PMID: 28360982 PMCID: PMC5371587 DOI: 10.4082/kjfm.2017.38.2.75] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 06/08/2016] [Accepted: 06/09/2016] [Indexed: 11/24/2022] Open
Abstract
Background White blood cell count is an independent risk factor for cardiovascular disease. Several lifestyle and metabolic factors such as cigarette smoking and obesity are known to be associated with an elevated white blood cell count. However, the joint effect of cigarette smoking and obesity on white blood cell count has not yet been fully described. Methods We explored the joint effect of cigarette smoking and obesity on white blood cell count using multiple logistic regression analyses after adjusting for confounding variables in a population-based, cross-sectional study of 416,065 Korean adults. Results Cigarette smoking and body mass index have a dose-response relationship with a higher white blood cell count, but no synergistic interaction is observed between them (men, P for interaction=0.797; women, P for interaction=0.311). Cigarette smoking and body mass index might have an additive combination effect on high white blood cell count. Obese male smokers were 2.36 times more likely and obese female smokers 2.35 times more likely to have a high white blood cell count when compared with normal body mass index non-smokers. Conclusion Cigarette smoking and body mass index are independently associated with an elevated white blood cell count in both men and women.
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Affiliation(s)
- A-Ra Cho
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Won-Jun Choi
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Shin-Hye Kim
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Yong Shim
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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15
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Chung GE, Yim JY, Kim D, Kwak MS, Yang JI, Chung SJ, Yang SY, Kim JS. Associations between White Blood Cell Count and the Development of Incidental Nonalcoholic Fatty Liver Disease. Gastroenterol Res Pract 2016; 2016:7653689. [PMID: 28070183 PMCID: PMC5187485 DOI: 10.1155/2016/7653689] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/10/2016] [Accepted: 11/17/2016] [Indexed: 02/06/2023] Open
Abstract
Aims. Chronic low-grade inflammation is thought to be associated with the pathogenesis of nonalcoholic fatty liver disease (NAFLD). This study aimed to determine the association between serum white blood cell (WBC) counts and the development of incidental NAFLD. Methods. In this retrospective longitudinal cohort study, we recruited participants who underwent abdominal ultrasonography and blood samplings during medical checkups in both 2005 and 2010. A total of 2,216 subjects were included in our analyses. Results. The prevalence of NAFLD in 2010 increased steadily in conjunction with increasing WBC counts in 2005 after adjustment for body mass index (BMI) [odds ratio (OR) 2.44, 95% confidence interval (CI) = 1.49-4.00 for women and OR 2.42, 95% CI = 1.61-3.63 for men, lowest quartile versus highest quartile]. Multivariate regression analysis after adjusting for age, BMI, hypertension, smoking, triglycerides, HDL cholesterol, and glucose levels revealed that NAFLD was significantly associated with the highest WBC quartile compared to the lowest quartile [OR 1.85, 95% CI, 1.10-3.10 for women and OR 1.68, 95% CI, 1.08-2.61 for men]. Conclusions. We demonstrated that the risk of developing NAFLD was significantly associated with WBC counts independently of metabolic factors. This finding provides novel evidence indicating that serum WBC counts may be potential surrogate markers of NAFLD.
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Affiliation(s)
- Goh Eun Chung
- Department of Internal Medicine, Healthcare Research Institute, Gangnam Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeong Yoon Yim
- Department of Internal Medicine, Healthcare Research Institute, Gangnam Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Min-Sun Kwak
- Department of Internal Medicine, Healthcare Research Institute, Gangnam Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jong In Yang
- Department of Internal Medicine, Healthcare Research Institute, Gangnam Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Su Jin Chung
- Department of Internal Medicine, Healthcare Research Institute, Gangnam Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sun Young Yang
- Department of Internal Medicine, Healthcare Research Institute, Gangnam Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Joo Sung Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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Zhou P, Meng Z, Liu M, Ren X, Zhu M, He Q, Zhang Q, Liu L, Song K, Jia Q, Tan J, Li X, Liu N, Hu T, Upadhyaya A. The associations between leukocyte, erythrocyte or platelet, and metabolic syndrome in different genders of Chinese. Medicine (Baltimore) 2016; 95:e5189. [PMID: 27858856 PMCID: PMC5591104 DOI: 10.1097/md.0000000000005189] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Leukocyte, erythrocyte or platelet and metabolic syndrome (MS) are closely correlated, and there exist gender differences. We aimed to explore the associations between the hematological parameters and MS in different genders of Chinese. This cross-sectional study included 32,900 participants (20,733 males, 12,167 females) who were enrolled in a health examination. Clinical data including anthropometric measurements and serum parameters were collected. The associations between hematological parameters and MS of both genders were analyzed separately. Odds ratio (OR) of MS was calculated by binary logistic regression models. All hematological parameters were related to MS. With leukocyte and erythrocyte counts rising, the risks of developing MS increased in both genders, which was more obvious in women. For instance, in model 3, the ORs of MS in leukocyte quartiles in females were from 1.333 to 2.045 (P < 0.01), while in males, from 1.238 to 1.675 (P < 0.01). Platelet seemed as a protective factor in males. Model 1 and model 3 in quartile 2 demonstrated ORs of 0.922 (P < 0.05) and 0.912 (P < 0.05). However, platelet acted as risk factor in female. For instance, the ORs were 1.253 (P < 0.01), 1.461 (P < 0.01), and 1.322 (P < 0.01) in platelet quartile 4 of all 3 models in female. Gender has influences on the associations between leukocyte, erythrocyte or platelet, and MS. In both genders, higher levels of leukocyte and erythrocyte increased risks of MS. For men, platelet was a protective factor, but for women, platelet seemed as a risk factor.
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Affiliation(s)
| | - Zhaowei Meng
- Department of Nuclear Medicine
- Correspondence: Zhaowei Meng, Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, Peoples Republic of China (e-mail: )
| | - Ming Liu
- Department of Endocrinology and Metabolism
| | | | - Mei Zhu
- Department of Endocrinology and Metabolism
| | - Qing He
- Department of Endocrinology and Metabolism
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, Peoples Republic of China
| | - Li Liu
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, Peoples Republic of China
| | - Kun Song
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, Peoples Republic of China
| | | | | | - Xue Li
- Department of Nuclear Medicine
| | - Na Liu
- Department of Nuclear Medicine
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Vichinsartvichai P, Sirirat S. Hematologic parameters as the predictors for metabolic syndrome in perimenopausal and postmenopausal women living in urban area: a preliminary report. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2016; 15:90-5. [PMID: 27582683 PMCID: PMC4993983 DOI: 10.5114/pm.2016.61191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 06/07/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Prevalence of metabolic syndrome increases drastically during menopausal transition. Chronic inflammation is proposed as the basic pathophysiology of metabolic syndrome (MetS). AIM OF THE STUDY To compare mean white blood cell count between perimenopausal and postmenopausal women with and without MetS and find the prevalence of MetS in this patient group. MATERIAL AND METHODS A total of 140 healthy perimenopausal and postmenopausal women were interviewed and underwent anthropometric measurements, biochemical investigations for MetS and hematologic parameters. MetS was defined according to the Joint Interim Statement 2009 criteria. The outcome measures were the hematologic parameters between women with and without MetS, correlation of hematologic parameters with MetS components and optimum cutoff for MetS prediction. RESULTS The mean age of participants was 50 years. 63.6% were perimenopausal and 36.4% were postmenopausal ones. The prevalence of MetS was 21.4% (95% CI: 15.0-27.9). The women with MetS had a significantly higher level of white blood cell (WBC) counts (7,466.7 and 6,514.6; p = 0.006) and total lymphocyte counts (2,572.0 and 2,207.7; p = 0.003). The optimum cutoff of WBC counts and total lymphocyte counts for prediction of metabolic syndrome was 6,750 cells/ml (sensitivity = 0.633; specificity = 0.591, p = 0.019) and 2,232 cells/ml (sensitivity = 0.667; specificity = 0.518, p = 0.016), respectively. CONCLUSION White blood cell and total lymphocyte counts were higher in perimenopausal and postmenopausal women with MetS. However, both hematologic parameters were poor predictors for MetS in peri- and postmenopausal women.
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Affiliation(s)
- Patsama Vichinsartvichai
- Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Siriwan Sirirat
- Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
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Wang S, Zhang C, Zhang G, Yuan Z, Liu Y, Ding L, Sun X, Jia H, Xue F. Association between white blood cell count and non-alcoholic fatty liver disease in urban Han Chinese: a prospective cohort study. BMJ Open 2016; 6:e010342. [PMID: 27251683 PMCID: PMC4893843 DOI: 10.1136/bmjopen-2015-010342] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The white blood cell (WBC) count is a simple and convenient marker of inflammation for use in medical practice; however, its association with non-alcoholic fatty liver disease (NAFLD) has not been determined. We examined the relationship between WBC and NAFLD to provide a convenient and useful marker for the prediction of NAFLD. SETTING A longitudinal cohort participating in a large health check-up programme for the Chinese population was selected and followed up from 2005 to 2011. PARTICIPANTS A total of 21 307 male and female participants without NAFLD who underwent health check-ups at least twice between 2005 and 2011 were included in this study. 15 201 participants (7286 men and 7915 women) were eligible for inclusion. RESULTS The baseline distribution of age, WBC, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), serum total protein (TP), albumin (ALB) and globin (GLO) and the prevalence of males, hypertension, hyperglycaemia, smoking and regular exercise were significantly different between the incident NAFLD and non-NAFLD groups (p<0.05). Cox proportional hazards regression analysis was performed to estimate the HRs and 95% CIs of WBC, which predicted the occurrence of NAFLD. Compared with the lowest WBC quartile (Q1), the HRs and 95% CIs of the other WBC quartiles (Q2, Q3 and Q4) for incident NAFLD were 1.090 (0.978 to 1.215), 1.174 (1.055 to 1.305) and 1.152 (1.035 to 1.281), respectively, after adjusting for age, gender, smoking, regular exercise, BMI, hypertension, hyperglycaemia, TC, TG, HDL-C, LDL-C, ALB and GLO. CONCLUSIONS Our study clearly showed that WBC count was a significant factor associated with incident NAFLD in Han Chinese.
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Affiliation(s)
- Shukang Wang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Chengqi Zhang
- Health Management Center, Shandong Provincial QianFoShan Hospital, Jinan, China
| | - Guang Zhang
- Health Management Center, Shandong Provincial QianFoShan Hospital, Jinan, China
| | - Zhongshang Yuan
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Yanxun Liu
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Lijie Ding
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Xiubin Sun
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Hongying Jia
- The Second Hospital of Shandong University, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
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Ashtari S, Pourhoseingholi MA, Zali MR. Non-alcohol fatty liver disease in Asia: Prevention and planning. World J Hepatol 2015; 7:1788-1796. [PMID: 26167252 PMCID: PMC4491908 DOI: 10.4254/wjh.v7.i13.1788] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 12/03/2014] [Accepted: 05/05/2015] [Indexed: 02/06/2023] Open
Abstract
AIM To review all of epidemiological aspects of non-alcoholic fatty liver disease (NAFLD) and also prevent this disease is examined. METHODS We conducted a systematic review according to the PRISMA guidelines. All searches for writing this review is based on the papers was found in PubMed (MEDLINE), Cochrane database and Scopus in August and September 2014 for topic of NAFLD in Asia and the way of prevention of this disease, with no language limitations. All relevant articles were accessed in full text and all relevant materials was evaluated and reviewed. RESULTS NAFLD is the most common liver disorder in worldwide, with an estimated with 20%-30% prevalence in Western countries and 2%-4% worldwide. The prevalence of NAFLD in Asia, depending on location (urban vs rural), gender, ethnicity, and age is variable between 15%-20%. According to the many studies in the world, the relationship between NAFLD, obesity, diabetes mellitus, and metabolic syndrome (MS) is quiet obvious. Prevalence of NAFLD in Asian countries seems to be lower than the Western countries but, it has increased recently due to the rise of obesity, type 2 diabetes and MS in this region. One of the main reasons for the increase in obesity, diabetes and MS in Asia is a lifestyle change and industrialization. Today, NAFLD is recognized as a major chronic liver disease in Asia. Therefore, prevention of this disease in Asian countries is very important and the best strategy for prevention and control of NAFLD is lifestyle modifications. Lifestyle modification programs are typically designed to change bad eating habits and increase physical activity that is associated with clinically significant improvements in obesity, type 2 diabetes and MS. CONCLUSION Prevention of NAFLD is very important in Asian countries particularly in Arab countries because of high prevalence of obesity, diabetes and MS.
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Affiliation(s)
- Sara Ashtari
- Sara Ashtari, Mohamad Amin Pourhoseingholi, Mohamad Reza Zali, Gastroenterology and Liver Disease Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran 1985717413, Iran
| | - Mohamad Amin Pourhoseingholi
- Sara Ashtari, Mohamad Amin Pourhoseingholi, Mohamad Reza Zali, Gastroenterology and Liver Disease Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran 1985717413, Iran
| | - Mohamad Reza Zali
- Sara Ashtari, Mohamad Amin Pourhoseingholi, Mohamad Reza Zali, Gastroenterology and Liver Disease Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran 1985717413, Iran
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Bahadır A, Baltacı D, Türker Y, Türker Y, Iliev D, Öztürk S, Deler MH, Sarıgüzel YC. Is the neutrophil-to-lymphocyte ratio indicative of inflammatory state in patients with obesity and metabolic syndrome? Anatol J Cardiol 2014; 15:816-22. [PMID: 25592102 PMCID: PMC5336968 DOI: 10.5152/akd.2014.5787] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective: Obesity causes subclinical inflammation. Leukocyte count and high-sensitivity C-reactive protein (hs-CRP) are used to indicate inflammation in clinical practice. Also, inflammatory markers are evaluated as important indicators of cardiovascular risk in patients with obesity and metabolic syndrome (MetS). We aimed to investigate the usage of the neutrophil-lymphocyte ratio (NLR) as an inflammatory marker in obese patients with and without MetS. Methods: The study included a total of 1267 patients. The patients were assigned groups according to degree of obesity and status of MetS. Metabolic and inflammatory markers were compared between groups, and correlation analysis was performed. Results: Leukocyte count and hs-CRP were significantly different (p<0.001), but NLR was not different between body mass index (BMI) groups (p=0.168). Both lymphocyte and neutrophil counts were significantly increased with increased degree of obesity (p<0.001, p=0.028, respectively). Leukocyte, neutrophil, and lymphocyte counts and hs-CRP level showed a significant correlation with BMI (r=0.198, p<0.001; r=0.163, p<0.001; r=0.167, p<0.001; r=0.445, p<0.001, respectively), whereas NLR was not correlated with BMI (r=0.017, p=0.737). Only a significant association between a MetS severity of 5 and 4 with hs-CRP level was observed (p=0.028), whereas there was no statistically significant association for leukocyte count and NLR (p=0.246; p=0.643, respectively). Conclusion: NLR was not a good indicator of inflammation, while leukocyte and hs-CRP were more useful biomarkers to indicate inflammation in non-diabetic patients with obesity and MetS.
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Affiliation(s)
- Anzel Bahadır
- Department of Biophysics, Faculty of Medicine, Düzce University, Düzce-Turkey.
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In prehypertension leukocytosis is associated with body mass index but not with blood pressure or incident hypertension. J Hypertens 2014; 32:251-9. [PMID: 24275841 DOI: 10.1097/hjh.0000000000000032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previous studies reported increased white blood cell counts (WBCCs), an inflammatory marker, in hypertension, prehypertension and metabolic syndrome. Evidence suggests that inflammation precedes blood pressure (BP) elevation and may contribute to incident hypertension. Angiotensin receptor blockers (ARBs) may reduce inflammation. We analyzed WBCC trends in TRial Of Preventing HYpertension (TROPHY) to determine if this inflammatory marker predicted incident hypertension in prehypertensive individuals and whether randomized assignment to the ARB candesartan (391 individuals) for 2 years, lowered WBCC compared with placebo-treated controls (381 individuals). METHODS A new analysis of TROPHY trial data. RESULTS In the total population, baseline BMI correlated with WBCC (r = 0.185, P < 0.0001), neutrophils (r = 0.135, P < 0.001) and lymphocytes (r = 0.204, P < 0.0001). Baseline triglycerides also correlated significantly with inflammatory markers. Despite a wide range of home BP (HBP) values, HBP did not correlate with baseline WBCC counts. After 2 years, candesartan decreased placebo corrected HBP by -5.5/-2.5 mmHg, (P < 0.0001), but WBCC, neutrophil and lymphocyte counts were not different in placebo and in candesartan groups. Baseline WBCC, neutrophils and lymphocyte counts did not predict incident hypertension in the placebo group. CONCLUSION In TROPHY, candesartan lowered BP but did not alter WBCC. Baseline WBCC did not predict incident hypertension. Our findings do not support the hypothesis that inflammation contributes to incident hypertension or that ARB treatment suppresses inflammation. The significant independent association of WBCC with baseline BMI and triglycerides is consistent with the evidence that obesity and insulin resistance are associated with inflammation. The findings highlight the importance of effective lifestyle modification in prehypertension to reduce inflammatory cardio-metabolic risk and suppress transition to hypertension.
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Jung CH, Lee WY, Kim BY, Park SE, Rhee EJ, Park CY, Oh KW, Mok JO, Kim CH, Park SW, Kim SW, Kang SK. The risk of metabolic syndrome according to the white blood cell count in apparently healthy Korean adults. Yonsei Med J 2013; 54:615-20. [PMID: 23549805 PMCID: PMC3635622 DOI: 10.3349/ymj.2013.54.3.615] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Considerable amount of interest has been focused on the positive relationship between inflammation and the metabolic syndrome (MS). However, few studies have been performed to evaluate the relationship between baseline white blood cell (WBC) count and future risk for developing MS. Therefore, we investigated whether the baseline plasma levels of WBC count could be associated with future risk for MS in apparently healthy Korean. MATERIALS AND METHODS A total of 1135 subjects (781 men and 354 women with a mean age of 49 years), who underwent health examinations at Kangbuk Samsung Hospital in both 2002 and 2005 were enrolled. The presence of MS was defined using the modified criteria of the National Cholesterol Education Program Adult Treatment Panel III using BMI instead of waist circumference. RESULTS The baseline levels of WBC count were significantly higher among incident MS cases than among subjects without MS. The relative risks of incident MS were 1.4, 3.2 and 2.7 for WBC quartiles 2, 3, and 4, respectively, when compared with the first quartile (p-value for trend<0.001). These positive associations persisted after adjustment for baseline body mass index, blood pressure, fasting glucose, high density lipoprotein-cholesterol, triglyceride and homeostatic model assessment-insulin resistance; adjusted relative risk of incident MS for the 2nd, 3rd and 4th quartile groups vs. the lowest quartile were 1.2, 2.4 and 1.7, respectively (p-value for trend=0.011). CONCLUSION This retrospective cohort study suggests that an elevated WBC count could be associated with incident MS, suggesting that baseline inflammation mirrored by WBC level can impact future MS development.
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Affiliation(s)
- Chan-Hee Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Won-Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Bo-Yeon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Se Eun Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Jung Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheol-Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki-Won Oh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Oh Mok
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Chul-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Sung-Woo Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun-Woo Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung-Koo Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon, Korea
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Na KS, Kim WH, Jung HY, Ryu SG, Min KJ, Park KC, Kim YS, Yoon JS, Ahn YM, Kim CE. Relationship between inflammation and metabolic syndrome following treatment with paliperidone for schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39:295-300. [PMID: 22796278 DOI: 10.1016/j.pnpbp.2012.06.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 06/28/2012] [Accepted: 06/30/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Metabolic syndrome and antipsychotic medications are associated with inflammation. This study investigated the relationship between inflammation and metabolic syndrome in patients with schizophrenia. It also examined the effects of paliperidone extended release (ER) treatment on metabolic parameters. METHODS Data were analyzed from schizophrenic patients who participated in a multi-center, open-label, non-comparative clinical trial. Anthropomorphic measurements (i.e., weight, waist circumference, and blood pressure) were assessed along with fasting laboratory values, including white blood cell (WBC) count, glucose, high-density lipoprotein, and triglycerides. RESULTS Among the 225 patients at baseline, the group with the highest WBC count displayed a 5.9-fold risk for metabolic syndrome compared with that of the lowest group. An increase of 10(3)WBCs/μL was associated with a 1.4-fold increased risk for metabolic syndrome. After 24weeks of treatment with paliperidone ER, significant increases were observed in waist circumference and body weight. Changes in WBC count were positively correlated with changes in waist circumference. CONCLUSIONS Schizophrenic patients with high levels of inflammation should be carefully monitored for metabolic syndrome. Moreover, strategies to reduce inflammation and obesity may prevent metabolic syndrome in patients with schizophrenia who take atypical antipsychotic medication.
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Affiliation(s)
- Kyoung-Sae Na
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
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Xu Y, Zhao Z, Li X, Bi Y, Xu M, Ning G. Relationships between C-reactive protein, white blood cell count, and insulin resistance in a Chinese population. Endocrine 2011; 39:175-81. [PMID: 21076976 DOI: 10.1007/s12020-010-9425-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Accepted: 10/25/2010] [Indexed: 12/21/2022]
Abstract
This study is to clarify whether C-reactive protein (CRP) and white blood cell (WBC) count influence insulin homeostasis to the same degree. Serum CRP and peripheral WBC were measured in 739 subjects with normal glucose regulation, 512 with impaired glucose regulation, and 502 newly diagnosed diabetic patients. Levels of insulin resistance (IR) were assessed using the index of homeostasis model (HOMA-IR). Serum CRP and WBC were significantly correlated with HOMA-IR and risk factors of IR. Relative risks of IR for each 1-SD increase of Ln (CRP) and Ln (WBC) were 1.28 (1.10-1.47) and 1.15 (1.01-1.31), respectively after adjustment for age, sex, obesity measurements, and other traditional risk factors. Additional adjustment for WBC slightly attenuated the association between CRP and IR [1.25 (1.08-1.45); P = 0.003] whereas adjustment for CRP substantially attenuated the association of WBC with IR toward null (P = 0.134). Moreover, individuals with both high levels of CRP and WBC were at higher risks of IR than those with high CRP or WBC alone. Both CRP and WBC were significantly associated with risks of IR. CRP might be a more effective biomarker in terms of the association with IR.
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Affiliation(s)
- Yu Xu
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, The State Key Laboratory of Medical Genomics, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, China
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Indhavivadhana S, Rattanachaiyanont M, Wongvananurak T, Kanboon M, Techatraisak K, Leerasiri P, Tanmahasamut P, Angsuwathana S. Predictors for metabolic syndrome in perimenopausal and postmenopausal Thai women. Climacteric 2011; 14:58-65. [DOI: 10.3109/13697137.2010.481735] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Lee YJ, Lee HR, Shim JY, Moon BS, Lee JH, Kim JK. Relationship between white blood cell count and nonalcoholic fatty liver disease. Dig Liver Dis 2010; 42:888-94. [PMID: 20472517 DOI: 10.1016/j.dld.2010.04.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Revised: 03/05/2010] [Accepted: 04/03/2010] [Indexed: 12/11/2022]
Abstract
BACKGROUND Higher levels of white blood cell (WBC) count are known to be associated with metabolic syndrome and insulin resistance. Nonalcoholic fatty liver disease (NAFLD) is also considered a hepatic manifestation of insulin resistance. AIMS The present study aimed to determine the relation between WBC count and the presence of NAFLD based on abdominal sonographic findings. METHODS A cross-sectional study with 3681 healthy subjects (2066 men, 1615 women) undergoing medical check-up was conducted. The odds ratios (ORs) and 95% confidence intervals (CIs) for NAFLD were calculated using multivariate logistic regression analyses across WBC quartiles. RESULTS A graded independent relationship between higher levels of WBC count and the prevalence risk of NAFLD was observed. After adjusting for age, smoking status, regular exercise, body mass index (BMI), blood pressure, fasting plasma glucose, triglyceride, and HDL-cholesterol, the ORs (95% CIs) for NAFLD according to WBC quartiles were 1.00, 1.48 (1.10-1.98), 1.59 (1.18-2.14), and 1.84 (1.35-2.51) for men and 1.00, 1.15 (0.67-1.96), 1.88 (1.13-3.11), and 2.74 (1.68-4.46) for women. CONCLUSIONS WBC count was found to be independently associated with the presence of NAFLD regardless of classical cardiovascular risk factors and other components of metabolic syndrome.
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Affiliation(s)
- Yong-Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Gkrania-Klotsas E, Ye Z, Cooper AJ, Sharp SJ, Luben R, Biggs ML, Chen LK, Gokulakrishnan K, Hanefeld M, Ingelsson E, Lai WA, Lin SY, Lind L, Lohsoonthorn V, Mohan V, Muscari A, Nilsson G, Ohrvik J, Chao Qiang J, Jenny NS, Tamakoshi K, Temelkova-Kurktschiev T, Wang YY, Yajnik CS, Zoli M, Khaw KT, Forouhi NG, Wareham NJ, Langenberg C. Differential white blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies. PLoS One 2010; 5:e13405. [PMID: 20976133 PMCID: PMC2956635 DOI: 10.1371/journal.pone.0013405] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Accepted: 09/01/2010] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Biological evidence suggests that inflammation might induce type 2 diabetes (T2D), and epidemiological studies have shown an association between higher white blood cell count (WBC) and T2D. However, the association has not been systematically investigated. RESEARCH DESIGN AND METHODS Studies were identified through computer-based and manual searches. Previously unreported studies were sought through correspondence. 20 studies were identified (8,647 T2D cases and 85,040 non-cases). Estimates of the association of WBC with T2D were combined using random effects meta-analysis; sources of heterogeneity as well as presence of publication bias were explored. RESULTS The combined relative risk (RR) comparing the top to bottom tertile of the WBC count was 1.61 (95% CI: 1.45; 1.79, p = 1.5*10(-18)). Substantial heterogeneity was present (I(2) = 83%). For granulocytes the RR was 1.38 (95% CI: 1.17; 1.64, p = 1.5*10(-4)), for lymphocytes 1.26 (95% CI: 1.02; 1.56, p = 0.029), and for monocytes 0.93 (95% CI: 0.68; 1.28, p = 0.67) comparing top to bottom tertile. In cross-sectional studies, RR was 1.74 (95% CI: 1.49; 2.02, p = 7.7*10(-13)), while in cohort studies it was 1.48 (95% CI: 1.22; 1.79, p = 7.7*10(-5)). We assessed the impact of confounding in EPIC-Norfolk study and found that the age and sex adjusted HR of 2.19 (95% CI: 1.74; 2.75) was attenuated to 1.82 (95% CI: 1.45; 2.29) after further accounting for smoking, T2D family history, physical activity, education, BMI and waist circumference. CONCLUSIONS A raised WBC is associated with higher risk of T2D. The presence of publication bias and failure to control for all potential confounders in all studies means the observed association is likely an overestimate.
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Affiliation(s)
| | - Zheng Ye
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Andrew J. Cooper
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Stephen J. Sharp
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Robert Luben
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Mary L. Biggs
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Liang-Kung Chen
- Department of Family Medicine, Taipei Veterans General Hospital, National Yang Ming University School of Medicine, Taipei, Taiwan
| | - Kuppan Gokulakrishnan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Markolf Hanefeld
- Centre for Clinical Study, Gesellschaft für Wissens- und Technologietransfer, Technisches Universität Dresden GmBH, Dresden, Germany
| | - Erik Ingelsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Wen-An Lai
- Department of Family Medicine, Kuang Tien General Hospital, Taichung City, Taiwan
| | - Shih-Yi Lin
- Division of Endrocrinology and Metabolism, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Lars Lind
- Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Vitool Lohsoonthorn
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Antonio Muscari
- Department of Internal Medicine, Aging and Nephrological Diseases, University of Bologna, Bologna, Italy
| | - Goran Nilsson
- Centre for Clinical Research, Uppsala University, Vasteras, Sweden
| | - John Ohrvik
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Nancy Swords Jenny
- Department of Pathology, College of Medicine, University of Vermont, Burlington, Vermont, United States of America
| | - Koji Tamakoshi
- Department of Nursing, Nagoya University School of Health Sciences, Nagoya, Japan
| | - Theodora Temelkova-Kurktschiev
- Centre for Clinical Study, Gesellschaft für Wissens- und Technologietransfer, Technisches Universität Dresden GmBH, Dresden, Germany
- Medicobiological Unit, International Scientific Institute, National Sports Academy and “Robert Koch” German Medical Center, Sofia, Bulgaria
| | - Ya-Yu Wang
- Department of Family Medicine, Kuang Tien General Hospital, Taichung City, Taiwan
| | | | - Marco Zoli
- Department of Internal Medicine, Aging and Nephrological Diseases, University of Bologna, Bologna, Italy
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Nita G. Forouhi
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Claudia Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom
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Park JT, Chang TI, Kim DK, Choi HY, Lee JE, Kim HW, Chang JH, Park SY, Kim E, Yoo TH, Han DS, Kang SW. Association of white blood cell count with metabolic syndrome in patients undergoing peritoneal dialysis. Metabolism 2009; 58:1379-85. [PMID: 19501862 DOI: 10.1016/j.metabol.2009.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 04/16/2009] [Accepted: 05/01/2009] [Indexed: 02/07/2023]
Abstract
Metabolic syndrome is associated with an increased risk of diabetes and cardiovascular disease. Although some data suggest that the prevalence of metabolic syndrome is higher in patients undergoing peritoneal dialysis (PD), the factors related to this increased risk are not well elucidated. We therefore examined whether peripheral white blood cell (WBC) count is correlated with the risk of metabolic syndrome in nondiabetic PD patients. We enrolled 104 nondiabetic PD patients without current infections or chronic inflammatory diseases. Complete blood cell count, anthropometry, blood pressure, fasting glucose, insulin, and lipid profiles were measured. Metabolic syndrome was defined in accordance with the National Cholesterol Education Program (Adult Treatment Panel III) criteria. Metabolic syndrome was present in 49 patients (47.1%). Patients with metabolic syndrome had a higher WBC count and high-sensitivity C-reactive protein level. As the number of metabolic syndrome components increased, WBC count increased significantly. White blood cell count was significantly positively correlated with body mass index, insulin, homeostasis model assessment of insulin resistance, and triglyceride and negatively correlated with high-density lipoprotein cholesterol. The risk of metabolic syndrome increased significantly with a higher WBC count, resulting in an adjusted odds ratio of 1.65 (per 10(3)/muL increase, P = .002). These findings demonstrate that metabolic syndrome is prevalent among nondiabetic PD patients and that WBC count is strongly associated with metabolic syndrome and its components.
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Affiliation(s)
- Jung Tak Park
- Department of Internal Medicine, College of Medicine, Brain Korea 21 for Medical Science, Yonsei University, Seoul 120-752, Korea
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Kang YH, Min HG, Kim IJ, Kim YK, Son SM. Comparison of alanine aminotransferase, white blood cell count, and uric acid in their association with metabolic syndrome: a study of Korean adults. Endocr J 2008; 55:1093-102. [PMID: 18753705 DOI: 10.1507/endocrj.k08e-077] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim of this study is to investigate the respective associations of alanine aminotransferase (ALT), white blood cell (WBC) count, and uric acid with metabolic syndrome and compare the magnitude in their association with metabolic syndrome, using modified Adult Treatment Panel III (ATP III) and its components. We studies 5,020 Korean adults (20-70 years of age; 2,501 men and 2,519 women) who visited Center for Health Promotion in Pusan National University Hospital for routine health examinations. Metabolic parameters and biochemical markers including ALT, WBC count, and uric acid were obtained. Alcohol intake, smoking status, and the presence of fatty liver were also evaluated. The prevalence of metabolic syndrome was 17.3%. In the partial correlation coefficients adjusted for age, alcohol consumption, smoking status, and presence of fatty liver, ALT was correlated significantly with all components of metabolic syndrome among three markers in men and women respectively. Moreover, ALT showed the highest correlation with HOMA-IR (r=0.311, P<0.001 in men and r=0.285, P<0.001 in women) in both genders. With the increase in the number of metabolic syndrome components, the mean values of all three markers were also significantly increased. In addition, the adjusted mean values of each marker were all significantly increased in metabolic syndrome. In ALT, the adjusted mean values were significantly increased in subjects with all metabolic component disorders. When we calculated odd ratios (ORs) for metabolic syndrome prevalence of the highest quartiles in three markers using multivariate logistic regression analyses, ALT was associated most strongly with metabolic syndrome in both genders (OR 5.65 [95% CI, 3.80 to 8.40]; P<0.001 in men, OR 3.23 [95% CI, 2.15 to 4.86]; P<0.001 in women). The cut-off value for ALT using the ROC curve was 27 IU/L (area under the curve=0.717, sensitivity 62.5%, specificity 70.4%, P<0.001) in men and 18 IU/L (area under the curve=0.735, sensitivity 61.3%, specificity 72.3%, P<0.001) in women. In conclusion, ALT, WBC count, and uric acid play important role as an additional markers for metabolic syndrome. Among three markers, in overlap the multiple risk factors, ALT might have a strong association with metabolic syndrome in Korean adults.
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Affiliation(s)
- Yang Ho Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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Tian JY, Yang Y, Cheng Q, Huang HE, Li R, Jiang GX, Liu SY, Li XY, Ning G. Association of WBC count and glucose metabolism among Chinese population aged 40 years and over. Diabetes Res Clin Pract 2008; 82:132-8. [PMID: 18691786 DOI: 10.1016/j.diabres.2008.05.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2007] [Revised: 05/19/2008] [Accepted: 05/30/2008] [Indexed: 10/21/2022]
Abstract
Chronic subclinical inflammation may be involved in the pathogenesis of Type 2 diabetes. We examined whether elevated WBC count, a marker of inflammation, was associated with worsening of glucose tolerance among Chinese population aged 40 years and over. Based on the 75g OGTT, 1016 subjects aged from 40 to 88 years were classified into four groups: NFG/NGT (n=299), isolated IFG (n=213), IGT (n=213) and Type 2 diabetes (n=291). We compared the WBC count among the four groups and investigated relevant variables associated significantly with the WBC count. The IGT and Type 2 diabetes groups had a significantly higher WBC count than the NFG/NGT and isolated IFG groups. By stepwise regression analyses, we found that waist circumference, DBP, total cholesterol, HDL cholesterol and 2-h PG showed an independent association with the WBC count. In the analysis stratified by sex and smoking status, WBC count was independently associated with age and triglycerides in males, whereas it was associated with BMI, SBP, triglycerides and 2-h PG in females. BMI, SBP, triglycerides and 2-h PG showed an independent association with WBC count in subjects who never smoked. We concluded that an increase in WBC count was associated with the deterioration of glucose tolerance. WBC count was associated with lipid metabolism in males and with various components of the metabolic syndrome in females and subjects who never smoked.
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Affiliation(s)
- Jing-Yan Tian
- Ruijin Hospital affiliated to Shanghai JiaoTong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, 197 Ruijin Er Lu, Shanghai 200025, China
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Ingelsson E, Hulthe J, Lind L. Inflammatory markers in relation to insulin resistance and the metabolic syndrome. Eur J Clin Invest 2008; 38:502-9. [PMID: 18489581 DOI: 10.1111/j.1365-2362.2008.01962.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Inflammation has repeatedly been demonstrated to be associated with the metabolic syndrome (MetS) and insulin resistance, but the relative importance of different aspects of the inflammatory process is largely unexplored. DESIGN We measured circulating interleukins (IL-1alpha, IL-1beta, IL-2, IL-4, IL-6, IL-8, IL-10); other cytokines (tumour necrosis factor-alpha, interferon gamma and monocyte chemotactic protein-1), cell adhesion molecules [vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1, E-selectin, P-selectin, l-selectin], and systemic inflammation markers [C-reactive protein (CRP) and leukocyte count] in 943 70 year old participants (50% women) of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. We related these biomarkers to MetS and the homeostasis model assessment insulin resistance index (HOMA-IR). RESULTS In a multivariable model including all inflammatory markers conjointly together with sex, log VCAM-1 [odds ratio (OR), 1.45; 95% confidence interval (CI), 1.22-1.72 per 1 SD increase; P < 0.0001], log E-selectin (OR, 1.33; 95% CI, 1.12-1.57 per 1SD increase; P = 0.001), and log CRP (OR, 1.41; 95% CI, 1.20-1.66 per 1-SD increase; P < 0.0001) were independently associated with MetS. These biomarkers were also independently associated with HOMA-IR. CONCLUSIONS Among 17 inflammatory biomarkers, most of them previously not examined in relation to MetS and insulin resistance, VCAM-1, E-selectin and CRP demonstrated the strongest associations with MetS and insulin resistance in our community based sample of the elderly. The relative importance of these biomarkers in predicting the development of MetS, insulin resistance and cardiovascular disease needs to be further examined in a longitudinal setting.
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Affiliation(s)
- E Ingelsson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
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Kotani K, Saiga K, Adachi S, Sakane N. Associations of sleep status and metabolic syndrome on leukocyte count. Arch Med Res 2008; 39:360-1. [PMID: 18279712 DOI: 10.1016/j.arcmed.2007.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2007] [Accepted: 11/15/2007] [Indexed: 12/01/2022]
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Abstract
The metabolic syndrome is a multiplex risk factor that consists of several risk correlates of metabolic origin. In addition, to dyslipidemia, hypertension, and hyperglycermia, the syndrome carries a prothrombotic state and a proinflammatory state. Persons with the metabolic syndrome are at essentially twice the risk for cardiovascular disease compared with those without the syndrome. It further raises the risk for type 2 diabetes by about 5-fold. Although some investigators favor keeping risk factors separate for purposes of clinical management, others believe that identifying individuals with an aggregation of risk factors provides additional useful information to guide clinical management. In particular it focuses attention on obesity and sedentary life habits that are the root of the syndrome. This review addresses the prevalence of this clustering phenomenon throughout the world. Such seems appropriate because of the increasing prevalence of obesity in almost all countries. The available evidence indicates that in most countries between 20% and 30% of the adult population can be characterized as having the metabolic syndrome. In some populations or segments of the population, the prevalence is even higher. On the other hand, in parts of developing world in which young adults predominate, the prevalence is lower; but with increasing affluence and aging of the population, the prevalence undoubtedly with rise.
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Affiliation(s)
- Scott M Grundy
- Center for Human Nutrition, Department of Clinical Nutrition, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Y3.206, Dallas, TX 75390-9052, USA.
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Ryu SY, Kim KS, Park J, Kang MG, Han MA. The Association Between Circulating Inflammatory Markers and Metabolic Syndrome in Korean Rural Adults. J Prev Med Public Health 2008; 41:413-8. [DOI: 10.3961/jpmph.2008.41.6.413] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- So Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Ki Soon Kim
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Jong Park
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Myeng Guen Kang
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Mi Ah Han
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
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Eldin WS, Ragheb A, Klassen J, Shoker A. Evidence for increased risk of prediabetes in the uremic patient. Nephron Clin Pract 2007; 108:c47-55. [PMID: 18087172 DOI: 10.1159/000112529] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
A prediabetic state is defined as a higher than normal blood glucose level but not yet high enough to meet the diagnosis of overt diabetes mellitus. While patients with advanced diabetic nephropathy are vulnerable to hypoglycemia, we believe that there is sufficient evidence that uremic nondiabetic patients are susceptible to hyperglycemia, which calls for more attention that uremia is a prediabetic state. It is, therefore, intriguing to identify these uremic factors which lead to prediabetes. Such a study may have significance to improve uremic patients' outcomes. To raise the awareness of the uremic prediabetic state, this review will, therefore, elaborate on the analysis of factors important in the development of prediabetes in uremia and will delineate whether their modification leads to an improved patient outcome.
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Affiliation(s)
- Walid Shehab Eldin
- Division of Nephrology, Department of Medicine, Royal University Hospital, University of Saskatchewan, Saskatoon, Canada
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Jung CH, Lee WY, Kim SY, Shin HS, Kim HD, Rhee EJ, Park CY, Oh KW, Park SW, Kim SW. The risk of metabolic syndrome according to the high-sensitivity C-reactive protein in apparently healthy Koreans. Int J Cardiol 2007; 129:266-71. [PMID: 17988754 DOI: 10.1016/j.ijcard.2007.07.092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2006] [Revised: 05/08/2007] [Accepted: 07/06/2007] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recently, considerable interest has been focused on the positive relationship between inflammation and the metabolic syndrome (MS). Therefore, we investigated whether the baseline plasma levels of the high-sensitivity C-reactive protein could be associated with future risk for MS in apparently healthy Koreans. METHODS A total of 1132 subjects (767 men, 365 women with a mean age of 49 years), who underwent health examination at this hospital in both 2002 and 2005 were enrolled. The criteria for metabolic syndrome followed that of NCEP-ATP III guideline except waist circumference. Instead, BMI (>/=25 kg/m(2)) was used for the measurement for obesity. RESULTS AND CONCLUSIONS The relative risks of future MS in the highest quartile of high-sensitivity C-reactive protein at baseline were 2.4 (95% confidence interval [CI], 1.3-4.2) as compared to the subjects in the lowest quartile. Positive associations persisted after adjustment for age, sex and smoking; multivariate relative risks for the highest vs lowest quartiles were 2.3 (95% CI, 1.3-4.1; P for trend=0.005). This retrospective study suggests that elevated levels of high-sensitivity C-reactive protein could be associated with incident MS.
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Affiliation(s)
- Chan-Hee Jung
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Pyung-dong, Seoul 110-746, South Korea
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Ruggiero C, Cherubini A, Najjar SS, Ferrucci L. Reply. J Am Coll Cardiol 2007. [DOI: 10.1016/j.jacc.2007.07.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lohsoonthorn V, Jiamjarasrungsi W, Williams MA. Association of Hematological Parameters with Clustered Components of Metabolic Syndrome among Professional and Office Workers in Bangkok, Thailand. Diabetes Metab Syndr 2007; 1:143-149. [PMID: 19543435 PMCID: PMC2699274 DOI: 10.1016/j.dsx.2007.05.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND: Accumulating evidence documents associations between alterations in hematological parameters, indicative of prothrombotic and proinflammatory states, and risk of metabolic syndrome (MetS). We investigated associations of hematological parameters with MetS and individual criteria of the syndrome among Thai professional and office workers. METHODS: Study subjects were 1,314 patients (531 men and 783 women) who participated in annual health examinations during the period of August through December 2001. MetS was defined using the modified ATP III criteria. Multivariable logistic regression procedures were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) of MetS risk according to quartiles of each hematological parameter with the lowest quartile specified as the referent group. RESULTS: WBC counts increased with increasing numbers of MetS components in both men and women. Among women, platelet counts, hemoglobin and hematocrit concentrations increased with increasing numbers of MetS components (p<0.05). No similar trends were observed for men. Of the hematological parameters studied, elevated platelet and WBC were statistically significantly associated with MetS among men (OR=1.86, 95% CI: 1.03-3.36; OR=2.26, 95% CI: 1.27-4.02), respectively. Among women, MetS risk increased across successive quartiles of hemoglobin (1.00, 2.63, 3.59 and 4.36; p for trend = 0.002), hematocrit (1.00, 2.35, 3.04 and 5.70; p-for trend <0.001), platelet (1.00, 2.37, 2.83 and 3.11; p-for trend = 0.014) and WBC counts (1.00, 2.97, 4.09 and 5.41; p-for trend < 0.001). CONCLUSIONS: Our data are consistent with an emerging literature demonstrating altered hematological status in patients at high risk of MetS.
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Affiliation(s)
- Vitool Lohsoonthorn
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Wiroj Jiamjarasrungsi
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michelle A. Williams
- Department of Epidemiology, Multidisciplinary International Research Training Program, University of Washington School of Public Health and Community Medicine, Seattle, Washington, USA
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Bibliography. Current world literature. Diabetes and the endocrine pancreas II. Curr Opin Endocrinol Diabetes Obes 2007; 14:329-57. [PMID: 17940461 DOI: 10.1097/med.0b013e3282c3a898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kolovou GD, Anagnostopoulou KK, Salpea KD, Mikhailidis DP. The Prevalence of Metabolic Syndrome in Various Populations. Am J Med Sci 2007; 333:362-71. [PMID: 17570989 DOI: 10.1097/maj.0b013e318065c3a1] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The insulin resistance/metabolic syndrome is characterized by the variable co-existence of hyperinsulinemia, obesity, dyslipidemia (small dense low-density lipoprotein, hypertriglyceridemia, and decreased high-density lipoprotein cholesterol), and hypertension. The pathogenesis of the syndrome has multiple origins. However, obesity and sedentary lifestyle coupled with diet and still largely unknown genetic factors clearly interact to produce the syndrome. This multifactorial and complex trait of metabolic syndrome leads to increased risk of cardiovascular disease. The scope of this review is to examine the differences in prevalence of the metabolic syndrome in various groups (eg, according to age, sex, ethnicity, social status, or presence of obesity) that could help with the better understanding of the pathogenesis of this syndrome. This review also considers the impact of metabolic syndrome on cardiovascular disease.
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Choi KM, Kim SM, Kim YE, Choi DS, Baik SH, Lee J. Prevalence and cardiovascular disease risk of the metabolic syndrome using National Cholesterol Education Program and International Diabetes Federation definitions in the Korean population. Metabolism 2007; 56:552-8. [PMID: 17379016 DOI: 10.1016/j.metabol.2006.12.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2006] [Accepted: 12/20/2006] [Indexed: 10/23/2022]
Abstract
To compare the prevalence of the metabolic syndrome using the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) definitions and to contrast the association between the prevalence of cardiovascular disease and the metabolic syndrome using both definitions in the Korean population, we used data from the 2001 Korean Nation Health and Nutrition Survey, which is a nationally representative survey of the noninstitutionalized civilian population. The age-adjusted prevalence of the metabolic syndrome was 18.8%+/-0.5% (men, 17.8%+/-0.8%; women, 20.5%+/-0.7%) using the NCEP definition and 19.5%+/-0.5% (men 15.0%+/-0.8%, women 23.9%+/-0.7%) using the IDF definition among participants 20 years or older. The agreement rate, which is the percentage of participants who were classified as either having or not having the metabolic syndrome by both definitions of the metabolic syndrome, was 84.6%+/-0.5% (kappa=0.54). The prevalence of the metabolic syndrome using the NCEP definition was higher in participants with lower body mass index, whereas the prevalence using the IDF definition was higher in subjects with higher body mass index. The odds ratio (OR) for coronary artery disease was 3.5 (95% confidence interval [CI], 2.0-6.1) for participants with the metabolic syndrome defined by the NCEP definition, whereas it was 2.8 (95% CI, 1.6-5.0) for those with the metabolic syndrome defined by the IDF definition. Similarly, the OR for stroke was higher using the NCEP definition (OR, 3.0; 95% CI, 1.7-5.2) compared with that of the IDF definition (OR, 2.3; 95% CI, 1.3-4.0). However, the CIs by both definitions overlapped considerably. In conclusion, the prevalence of the metabolic syndrome using the IDF definition was higher than that using the NCEP definition, whereas the NCEP definition was more closely associated with cardiovascular disease in the Korean population.
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Affiliation(s)
- Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul 136-701, South Korea
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Hussein G, Nakagawa T, Goto H, Shimada Y, Matsumoto K, Sankawa U, Watanabe H. Astaxanthin ameliorates features of metabolic syndrome in SHR/NDmcr-cp. Life Sci 2007; 80:522-9. [PMID: 17074368 DOI: 10.1016/j.lfs.2006.09.041] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2006] [Revised: 09/25/2006] [Accepted: 09/28/2006] [Indexed: 12/12/2022]
Abstract
Glucose and lipid metabolic parameters play crucial roles in metabolic syndrome and its major feature of insulin resistance. This study was designed to investigate whether dietary astaxanthin oil (ASX-O) has potential effects on metabolic syndrome features in an SHR/NDmcr-cp (cp/cp) rat model. Oral administration of ASX (50 mg/kg/day) for 22 weeks induced a significant reduction in arterial blood pressure in SHRcp. It also significantly reduced the fasting blood glucose level, homeostasis index of insulin resistance (HOMA-IR), and improved insulin sensitivity. The results also showed an improved adiponectin level, a significant increase in high-density lipoprotein cholesterol, a significant decrease in plasma levels of triglycerides, and non-esterified fatty acids. Additionally, ASX showed significant effects on the white adipose tissue by decreasing the size of the fat cells. These results suggest that ASX ameliorates insulin resistance by mechanisms involving the increase of glucose uptake, and by modulating the level of circulating lipid metabolites and adiponectin.
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Affiliation(s)
- Ghazi Hussein
- International Research Center for Traditional Medicine, Toyama, Toyama Prefecture 939-8224, Japan.
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