Association between metabolic syndrome and risk of cardiovascular disease, using different criteria and stratified by sex

AbstractAimThe purpose of this study is to determine the association between the components used to define metabolic syndrome and cardiovascular risk using different criteria stratified by sex.MethodsA cross-sectional study with 608 subjects enrolled at the out-patients department of the Thai Internal Medicine Clinic was performed between October 2006 and September 2007. Included subjects had metabolic syndrome as defined by WHO, NCEP III, or IDF. The demographic and laboratory characteristic of the subjects including BMI, waist circumference, waist/hip ratio, fasting blood glucose, 2h postprandial blood glucose, triglyceride, HDL, blood pressure, and microalbuminuria, were measured and recorded by chart review. Cardiovascular risk was determined by pulse wave velocity. The sensitivity and specificity of the component of metabolic syndrome according to the three criteria were stratified by sex.ResultsThe HDL sensitivity was higher in females than in males. Among the different component of metabolic syndrome, blood pressure gave the strongest association with cardiovascular risk, with odds ratios of 13.6, 11.97, and 10.5 for the criteria of IDF, NCEP III, and WHO, respectively. Moreover, when analyzing by sex, the odds ratio for female subjects were about two times higher than that of males. The rest of the components in each of criteria exceptional HDL gave odds ratios of 2–4.ConclusionsThe appropriate components to predict cardiovascular risks are: high blood pressure and cut off point of waist circumference in females, as defined by the IDF criterion, and high triglyceride in males, as defined by the IDF criterion

Transcription factor NRF2 as a therapeutic target for chronic diseases: a systems medicine approach

Systems medicine has a mechanism-based rather than a symptom- or organ-based approach to disease and identifies therapeutic targets in a nonhypothesis-driven manner. In this work, we apply this to transcription factor nuclear factor (erythroid-derived 2)-like 2 (NRF2) by cross-validating its position in a protein-protein interaction network (the NRF2 interactome) functionally linked to cytoprotection in low-grade stress, chronic inflammation, metabolic alterations, and reactive oxygen species formation. Multiscale network analysis of these molecular profiles suggests alterations of NRF2 expression and activity as a common mechanism in a subnetwork of diseases (the NRF2 diseasome). This network joins apparently heterogeneous phenotypes such as autoimmune, respiratory, digestive, cardiovascular, metabolic, and neurodegenerative diseases, along with cancer. Importantly, this approach matches and confirms in silico several applications for NRF2-modulating drugs validated in vivo at different phases of clinical development. Pharmacologically, their profile is as diverse as electrophilic dimethyl fumarate, synthetic triterpenoids like bardoxolone methyl and sulforaphane, protein-protein or DNA-protein interaction inhibitors, and even registered drugs such as metformin and statins, which activate NRF2 and may be repurposed for indications within the NRF2 cluster of disease phenotypes. Thus, NRF2 represents one of the first targets fully embraced by classic and systems medicine approaches to facilitate both drug development and drug repurposing by focusing on a set of disease phenotypes that appear to be mechanistically linked. The resulting NRF2 drugome may therefore rapidly advance several surprising clinical options for this subset of chronic diseases

Nutraceutical therapies for atherosclerosis

Atherosclerosis is a chronic inflammatory disease affecting large and medium arteries and is considered to be a major underlying cause of cardiovascular disease (CVD). Although the development of pharmacotherapies to treat CVD has contributed to a decline in cardiac mortality in the past few decades, CVD is estimated to be the cause of one-third of deaths globally. Nutraceuticals are natural nutritional compounds that are beneficial for the prevention or treatment of disease and, therefore, are a possible therapeutic avenue for the treatment of atherosclerosis. The purpose of this Review is to highlight potential nutraceuticals for use as antiatherogenic therapies with evidence from in vitro and in vivo studies. Furthermore, the current evidence from observational and randomized clinical studies into the role of nutraceuticals in preventing atherosclerosis in humans will also be discussed