Metabolic Syndrome: The Danger Signal in Atherosclerosis

Atherosclerosis is a chronic inflammatory disease characterized by infiltration of blood vessels by lipids and leukocytes. There is a growing body of evidence that among risk factors that promote atherosclerosis, the metabolic syndrome is a powerful and prevalent predictor of cardiovascular events. The systemic inflammatory process associated with the metabolic syndrome has numerous deleterious effects that promote plaque activation, which is responsible for clinical events. Interactions between the innate immune system with lipid-derived products seem to play a major role in the pathophysiology of atherosclerosis in relation with the metabolic syndrome. The multiple links among adipose tissue, the vascular wall, and the immune system are the topics of this review, which examines the roles of oxidized low-density lipoprotein, inflammatory cytokines, and adipokines in triggering and perpetuating a danger signal response that promotes the development of atherosclerosis. Furthermore, therapeutic options that specifically target the metabolic syndrome components are reviewed in light of recent developments

Metabolic syndrome increases operative mortality in patients undergoing coronary artery bypass grafting surgery

OBJECTIVES: The aim of this study was to determine the impact of the metabolic syndrome (MS) on operative mortality after a coronary artery bypass grafting surgery (CABG). BACKGROUND: Diabetes and obesity are highly prevalent among patients undergoing CABG. However, it remains unclear whether these factors have a significant impact on operative mortality after this procedure. We hypothesized that the metabolic abnormalities associated with MS could negatively influence the operative outcome of CABG surgery. METHODS: We retrospectively analyzed the data of 5,304 consecutive patients who underwent an isolated CABG procedure between 2000 and 2004. Of these 5,304 patients, 2,411 (46%) patients met the National Cholesterol Education Program-Adult Treatment Panel III criteria for MS. The primary end point was operative mortality. RESULTS: The operative mortality after CABG surgery was 2.4% in patients with MS and 0.9% in patients without MS (p < 0.0001). The MS was a strong independent predictor of operative mortality (relative risk 3.04 [95% confidence interval (CI) 1.73 to 5.32], p = 0.0001). After adjusting for other risk factors, the risk of mortality was increased 2.69-fold (95% CI 1.43 to 5.06; p = 0.002) in patients with MS and diabetes and 2.36-fold (95% CI 1.26 to 4.41; p = 0.007) in patients with MS and no diabetes, whereas it was not significantly increased in the patients with diabetes and no MS. CONCLUSIONS: This is the first study to report that MS is a highly prevalent and powerful risk factor for operative mortality in patients undergoing a CABG surgery. Thus, interventions that could contribute to reduce the prevalence of MS in patients with coronary artery disease or that could acutely modify the metabolic perturbations of MS at the time of CABG might substantially improve survival in these patient

Precision nutrition : a review of personalized nutritional approaches for the prevention and management of metabolic syndrome

The translation of the growing increase of findings emerging from basic nutritional science into meaningful and clinically relevant dietary advices represents nowadays one of the main challenges of clinical nutrition. From nutrigenomics to deep phenotyping, many factors need to be taken into account in designing personalized and unbiased nutritional solutions for individuals or population sub-groups. Likewise, a concerted effort among basic, clinical scientists and health professionals will be needed to establish a comprehensive framework allowing the implementation of these new findings at the population level. In a world characterized by an overwhelming increase in the prevalence of obesity and associated metabolic disturbances, such as type 2 diabetes and cardiovascular diseases, tailored nutrition prescription represents a promising approach for both the prevention and management of metabolic syndrome. This review aims to discuss recent works in the field of precision nutrition analyzing most relevant aspects affecting an individual response to lifestyle/nutritional interventions. Latest advances in the analysis and monitoring of dietary habits, food behaviors, physical activity/exercise and deep phenotyping will be discussed, as well as the relevance of novel applications of nutrigenomics, metabolomics and microbiota profiling. Recent findings in the development of precision nutrition are highlighted. Finally, results from published studies providing examples of new avenues to successfully implement innovative precision nutrition approaches will be reviewed

Fat balance and ageing : results from the Québec family study

The aim of the present study was to evaluate changes in participation in physical activity and in fat and alcohol intake associated with ageing. This issue was examined in adults (n 207) who were tested between 1978 and 1982 and re-tested 12 years later. These adults were 42.3 (sd 4.9) years of age at baseline. Their children (n 122) were tested over the same follow-up period. They were, on average, 12.5 (sd 1.9) years at entry into the study. A decrease in the proportion of daily energy intake as fat and an increase in participation in vigorous physical activities were observed over the 12-year period in both groups. The proportion of dietary energy as alcohol remained stable in adults whereas it increased markedly in children. Correlation analyses between baseline and follow-up levels were significant for dietary fat and alcohol intake in adults. In children, the levels of these variables in the growing years did not predict the levels attained 12 years later. Even though the adults displayed changes in fat balance generally following current public health recommendations, a substantial increase in skinfold thicknesses was observed in these subjects during follow-up. This observation suggests that there is a strong effect of age-related factors on fat balance

Eating behaviors, dietary profile and body composition according to dieting history in men and women of the Québec Family Study

The purpose of the present cross-sectional study was to compare eating behaviours (cognitive dietary restraint, disinhibition and susceptibility to hunger), dietary profile and physiological variables according to the practice of dieting: current dieting; history of dieting in the 10-year period that preceded the study; no dieting during the same period. Dieting history, anthropometric markers of adiposity, RMR, dietary profile (3 d food record) and eating behaviours (three-factor eating questionnaire) were determined in a sample of 244 men and 352 women. A greater proportion of women (31.8 %) than men (16.8 %) reported that they had been on a diet over the past 10 years(P=0.0001). In both genders, current and past dieters had a higher BMI (P<0.05) than non-dieters and current dieters had lower reported energy intakes than past dieters and non-dieters (only in women) (P<0.05). Current and past dieters also had higher scores for all eating behaviours and their subscales (P<0.05; except for susceptibility to hunger in men) compared with non-dieters (adjusted for age, reported energy intake, percentage of dietary fat, BMI and RMR). Moreover, for each dieting-history category, women had significantly higher scores for cognitive dietary restraint than men (P<0.05). In conclusion, the present study showed that current and past dieters had higher scores for cognitive dietary restraint and disinhibition compared with non-dieters. As disinhibition has previously been associated with a greater risk of subsequent weight gain, interventions aimed at preventing an increase in disinhibition may be promising for longterm weight maintenance

Past dieting is related to rigid control and disinhibition in adolescents from the Québec Family Study

Eating behaviour traits of rigid control and disinhibition have been associated with body weight in both adults and adolescents. Moreover, adults reporting a dieting history have increased levels of unhealthy eating behaviours. Against this background, the present study aimed to examine the relationship between dieting history and eating behaviour traits in adolescents. For the purpose of this research, a total of sixty adolescents (aged 15 (sem 2·4) years) from the Québec Family Study completed the Three-Factor Eating Questionnaire (TFEQ) and a questionnaire regarding eating habits. Self-reported current and past dieting were analysed against eating behaviour traits measured by the TFEQ, including all subscales. As the results revealed, few adolescents reported currently dieting (n 3). Adolescents who reported a dieting history (23·3 %) were older (16·9 v. 14·4 years, P < 0·001), were more likely to be female (78·6 v. 41·3 %, P < 0·05) but did not have a significantly higher BMI z-score (1·5 v. 0·9, P = 0·10), although they were more likely to be either overweight or obese (P < 0·01). After correcting for sex, BMI and age, adolescents who reported a dieting history had higher levels of rigid control and disinhibition (P < 0·05–0·0001) than those reporting no dieting history. A greater proportion of adolescents characterised by high rigid control and high disinhibition were past dieters, compared to those characterised by low levels of both behaviour traits (53 v. 4 %). The study arrived at the following conclusions: as observed in adults, adolescents with a history of dieting present unfavourable eating behaviour traits. These behavioural traits may represent an additional challenge to the long-term regulation of body weight

Acute Exercise Increases Adiponectin Levels in Abdominally Obese Men

Objective. To examine the effect of acute and short-term (~1 week) aerobic exercise training on plasma adiponectin levels in inactive, abdominally obese men. Materials and Methods. Inactive and abdominally obese men (n = 38, waist circumference ≥102 cm) recruited from Kingston, Canada were randomly allocated to perform three bouts of aerobic treadmill exercise at either low (50% VO2 peak) or high (75% VO2 peak) intensity during a 1-week period. Blood samples were taken before and after the first exercise session and 24–72 hours following the completion of the final exercise session. Results. Adiponectin levels were elevated immediately following an acute bout of exercise at both high and low intensities (High: 5.79 ± 0.42 versus 5.05 ± 0.41 ug/mL; Low: 5.24 ± 0.44 versus 4.37 ± 0.44 ug/mL, P < 0.05) and remained elevated following 30 minutes of rest. In comparison to baseline, adiponectin levels were also elevated 24–72 hours following the final exercise session (High: 5.47 ± 0.48 versus 4.88 ± 0.48 ug/mL; Low: 5.18 ± 0.49 versus 4.47 ± 0.49 ug/mL, P < 0.05). Conclusion. Both acute and short-term aerobic exercise result in a significant increase in plasma adiponectin levels in inactive, abdominally obese men independent of intensity

Acute Exercise Increases Adiponectin Levels in Abdominally Obese Men

Objective. To examine the effect of acute and short-term (~1 week) aerobic exercise training on plasma adiponectin levels in inactive, abdominally obese men. Materials and Methods. Inactive and abdominally obese men (n = 38, waist circumference ≥102 cm) recruited from Kingston, Canada were randomly allocated to perform three bouts of aerobic treadmill exercise at either low (50% VO2 peak) or high (75% VO2 peak) intensity during a 1-week period. Blood samples were taken before and after the first exercise session and 24–72 hours following the completion of the final exercise session. Results. Adiponectin levels were elevated immediately following an acute bout of exercise at both high and low intensities (High: 5.79 ± 0.42 versus 5.05 ± 0.41 ug/mL; Low: 5.24 ± 0.44 versus 4.37 ± 0.44 ug/mL, P < 0.05) and remained elevated following 30 minutes of rest. In comparison to baseline, adiponectin levels were also elevated 24–72 hours following the final exercise session (High: 5.47 ± 0.48 versus 4.88 ± 0.48 ug/mL; Low: 5.18 ± 0.49 versus 4.47 ± 0.49 ug/mL, P < 0.05). Conclusion. Both acute and short-term aerobic exercise result in a significant increase in plasma adiponectin levels in inactive, abdominally obese men independent of intensity

Adipose tissue attenuation and adipocyte size

Objective: To assess the ability of CT-derived measurements including adipose tissue attenuation and area to predict fat cell hypertrophy and related cardiometabolic risk. Methods: Abdominal adipose tissue areas and radiologic attenuation were assessed using 4 CT images in 241 women (age: 47 years, BMI: 26.5 kg/m2). Fat cell weight was measured in paired VAT and SAT samples. Fasting plasma lipids, glucose and insulin levels were measured. Results: Adipose tissue attenuation was negatively correlated with SAT (r=-0.46) and VAT (r=-0.67) fat cell weight in the corresponding depot (p<0.0001 for both). Women with visceral adipocyte hypertrophy had higher total-, VLDL-, LDL- and HDL-triglyceride and apoB levels as well as a higher cholesterol/HDL-cholesterol ratio, fasting glucose and insulin levels compared to women with smaller visceral adipocytes. Adjustment for VAT area minimized these differences while subsequent adjustment for attenuation eliminated all differences, with the exception of fasting glycaemia. In SAT, adjustment for VAT area and attenuation eliminated all adipocyte hypertrophy-related alterations except for fasting hyperglycaemia. Conclusion: CT-derived adipose tissue attenuation and area both contribute to explain variation in the cardiometabolic risk profile associated with the same biological parameter: visceral fat cell hypertrophy