How is metabolic syndrome related to dyslipidemia?

Godine 1967. Crepaldi je prvi zapazio da se u mnogo ljudi istovremeno pojavljuju pretilost, dislipidemija, šećerna bolest i hipertenzija. Kasnih sedamdesetih godina dvadesetog stoljeća njemački su istraživači takvo nakupljanje stanja nazvali metaboličkim sindromom. Otada je taj sindrom opisivan pod nekoliko naziva kao „sindrom inzulinske rezistencije", „sindrom X", „plurime-tabolički sindrom", te „metabolički sindrom". Sindrom zapravo predstavlja višekomponentnu bolest nastalu kombinacijom načina življenja i čimbenika okoline, s time da su neke populacije pokazale genetičku podložnost za razvoj tog sindroma. Metabolički sindrom povećava rizik za kardiovaskularnu bolest i šećernu bolest tipa 2. Nacionalni program obrazovanja o kolesterolu - Panel liječenja odraslih III (engl. National Cholesterol Education Program - Adult Treatment PanelIII, NCEP-ATP III) prepoznao je metabolički sindrom kao skup abnormalnih stanja koja povećavaju rizik, kako za kardiovaskularnu bolest (KVB), tako i za šećernu bolest tipa 2. Smjernice NCEP-ATP III također su istaknule središnju ulogu abdominalne pretilosti u razvoju tog sindroma. Rastuća prevalencija sindroma ima važne zdravstvene implikacije. Svaka sastavnica metaboličkog sindroma predstavlja potvrđeni čimbenik rizika za KVB, no prisutnost mnogih komponenti rezultira većim rizikom nego zbroj rizika povezanih s pojedinačnim komponentama. Dokazano je, primjerice, da su muškarci s istodobnom prisutnošću hiperin-zulinemije nakon gladovanja, s povišenim koncentracijama apolipoproteina B, te povišenim udjelom malih LDL-čestica imali 20 puta veći rizik razvijanja KVB tijekom petogodišnjeg razdoblja praćenja u studiji, nego muškarci bez tog skupa netradicionalnih biljega rizika. Usto, rizik za KVB povezan s tom aterogenom metaboličkom trojkom ostao je značajan čak i nakon prilagodbe za tradicionalne rizične čimbenike kao što su koncentracije LDL-kolesterola, triglicerida i HDL-kolesterola. Procjena rizika uključuje listu bioloških parametara u kojoj važnu ulogu imaju lipidi, posebice trigliceridi i HDL-čestice. Tradicionalni čimbenici povezani s metaboličkim sindromom su pretilost, inzulinska rezistencija, hiperglikemija, dislipemija, hipertenzija i mikroalbuminurija.The observation that obesity, dyslipidemia, diabetes and hypertension occur simultaneously in many people was first made by Crepaldi in 1967. In the late 1970s this clustering of conditions was termed "metabolic syndrome" by German researchers. Since then the syndrome has been described under a number of guises as "Insulin resistance syndrome", "Syndrome X", "Plurimetabolic syndrome" and the "Metabolic syndrome". The syndrome is a multi-component disease brought on by combination of lifestyle and environmental factors, with some populations exhibiting a genetic susceptibility for its development. Metabolic syndrome increases the risk of cardiovascular disease and type 2 diabetes. The National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III) has recognized the metabolic syndrome as a cluster of abnormalities increasing the risk for both cardiovascular disease (CVD) and type 2 diabetes. The NCEP-ATP III guidelines have also underlined the central role of abdominal obesity in the development of this syndrome. The escalating prevalence of the syndrome has important health implications. Each component of the metabolic syndrome is an established cardiovascular disease risk factor, and the presence of multiple components confer greater risk than the sum of the risks associated with the individual ones. For instance, it has been shown that men with the simultaneous presence of fasting hyperinsulinemia, elevated apolipoprotein B concentration and an increased proportion of small LDL particles were characterized by a 20-fold increase in the risk for developing CVD over the 5-year follow-up period of the study, compared with men without this cluster of non-traditional risk markers. In addition, the risk of CVD associated with the atherogenic metabolic triad remained significant even after adjustment for traditional risk factors such as LDL-cholesterol, triglyceride and HDL-cholesterol levels. Risk assessment includes a list of biological parameters wherein lipids play an important role, especially triglycerides and HDL-particles. The traditional factors associated with the syndrome are obesity, insulin resistance, hypergl-ycemia, dyslipemia, hypertension and microalbuminuria

6,11-Dihydro­dibenz[b,e]oxepin-11-one

In the title compound, C14H10O2, the seven-membered oxepine ring adopts a twist-boat conformation with a dihedral angle between the mean planes of the two fused benzene rings of 42.0 (1)°. In the crystal, mol­ecules are linked into chains propagating along the c axis by inter­molecular C—H⋯O hydrogen bonds and the chains are arranged in layers parallel to (100)

11-[3-(Dimethyl­amino)prop­yl]-6,11-dihydro­dibenzo[b,e]thiepin-11-ol

There are two independent mol­ecules (A and B) in the asymmetric unit of the title compound, C19H23NOS. In each mol­ecule, the seven-membered thiepine ring is bent into a slightly twisted V-shape. The dihedral angles between the mean planes of the two benzene rings fused to the thiepine ring are 75.7 (5) in mol­ecule A and 73.8 (4)° in mol­ecule B. In both mol­ecules, an intra­molecular O—H⋯N hydrogen bond occurs. In the crystal, weak inter­molecular C—H⋯O and C—H⋯π-ring inter­actions are observed

3-(2-Chloro­ethyl)-2-methyl-4H-pyrido[1,2-a]pyrimidin-4-one

In the title mol­ecule, C11H11ClN2O, the pyrido[1,2-a]pyrimidine ring system is planar (maximum deviation = 0.0148 Å) and the methyl C and carbonyl O atoms are nearly coplanar to it. The chloro­ethyl side chain is in a synclinal conformation, nearly orthogonal to the pyrimidine ring, with a dihedral angle between the chloro­ethyl side chain and the pyrimidine ring of 88.5 (1)°. Weak inter­molecular C—H⋯N and C—H⋯Cl hydrogen bonds along with π–π inter­actions between the pyrimidine and pyridine rings [centroid–centroid distance is 3.538 (2) Å] form a three-dimensional network. The crystal is a racemic twin with a 0.68 (12):0.32 (12) domain ratio. MOPAC AM1 and density functional theory (DFT) theoretical calculations at the B3-LYP/6–311+G(d,p) level support these observations

Declines in sexual activity and function predict incident health problems in older adults: prospective findings from the English Longitudinal Study of Ageing

The objective of this study was to investigate cross-sectional and longitudinal associations between declines in sexual activity and function and health outcomes in a large population-based sample of older adults. Data were from 2577 men and 3195 women aged ≥ 50 years participating in the English Longitudinal Study of Ageing. Past-year changes in sexual desire, frequency of sexual activity, and ability to have an erection (men)/become sexually aroused (women) were assessed at baseline by self-completion questionnaire. Health outcomes (self-rated health, limiting long-standing illness, doctor-diagnosed diseases of the vascular system, and cancer) were self-reported at baseline (2012/2013) and 4-year follow-up (2016/2017). Data were analyzed using logistic regression, adjusted for sociodemographics, health behaviors, and depressive symptoms. Prospectively, men who reported a decline in sexual desire had higher odds of incident limiting long-standing illness (OR 1.41, 95% CI 1.04–1.91) and incident cancer (OR 1.63, 95% CI 1.06–2.50) than those who maintained their sexual desire. Men who reported a decline in the frequency of sexual activities had higher odds of deterioration in self-rated health (OR 1.47, 95% CI 1.04–2.08) and incident limiting long-standing illness (OR 1.69, 95% CI 1.20–2.37). In women, a decline in frequency of sexual activities was associated with deterioration of self-rated health (OR 1.64, 95% CI 1.07–2.51). Erectile dysfunction was longitudinally associated with poorer health outcomes including incident cancer (OR 1.73, 95% CI 1.11–2.70), coronary heart disease (OR 2.29, 95% CI 1.29–4.07), and fair/poor self-rated health (OR 1.66, 95% CI 1.19–2.32). Practitioners should be mindful that a decline in sexual activity, desire, or function in older age may be an important indicator of future adverse health outcomes