[Show abstract][Hide abstract] ABSTRACT: Objectives: This study set out to investigate the relationship among the factors of metabolic syndrome diagnosis criteria, their risk factors including general characteristics, and the distribution of the diagnosis criteria and risk among the adult residents of a rural community. Methods: Among 1,968 residents, those who had three or more of the risk factors of metabolic syndrome, which include blood pressure, blood glucose, triglyceride, abdominal obesity, and HDL-C, were categorized as the metabolic syndrome group. And their correlations were analyzed. Results: As for the risk ratio with five factors of the metabolic syndrome diagnosis criteria, it was high according to age and smoking. In addition, the results show that body fat percentage, hs-CRP, insulin, BMI, PP2, total cholesterol, and W/Ht also had much impact on increasing the risk ratio of the metabolic syndrome diagnosis criteria. It turned out that metabolic syndrome was affected by the body mass index(BMI), insulin, waist to height ratio(W/Ht), and hs-CRP. It was 2.51 times crude odds ratio that BMI over the 25kg/m2 in the ratio of the fact of metabolic syndrome and adjusted for sex odds ratio 2.50times and W/Ht was 3.31times, adjusted for sex odds ratio 3.25 times. Conclusion: BMI, W/Ht and smoking of the general characteristics seem to have close relationships with high correlations between the metabolic syndrome diagnosis criteria and the risk factors. Thus there is an urgent need to evaluate them and take interventions and monitoring measures for the clustering of risk factors.
[Show abstract][Hide abstract] ABSTRACT: Currently the world faces epidemic of several closely related conditions: obesity, metabolic syndrome and type 2 diabetes (T2DM). The lipid profile of these patients and those with metabolic syndrome is characterized by the concurrent presence of qualitative as well as quantitative lipoprotein abnormalities: low levels of HDL, increased triglycerides, and prevalence of LDL particles that are smaller and denser than normal. This lipid phenotype has been defined as atherogenic dyslipidemia. Overwhelming evidences demonstrate that all components of the atherogenic dyslipidemia are important risk-factors for cardiovascular diseases. Optimal reduction of cardiovascular risk through comprehensive management of atherogenic dyslipidemias basically depends of the presence of efficacious lipid-modulating agents (beyond statin-based reduction of LDL-C). The most important class of medications which can be effectively used nowadays to combat atherogenic dyslipidemias is the fibrates. From a clinical point of view, in all available 5 randomized control trials beneficial effects of major fibrates (gemfibrozil, fenofibrate, bezafibrate) were clearly demonstrated and were highly significant in patients with atherogenic dyslipidemia. In these circumstances, the main determinant of the overall results of the trial is mainly dependent of the number of the included appropriate patients with atherogenic dyslipidemia. In a meta-analysis of dyslipidemic subgroups totaling 4726 patients a significant 35% relative risk reduction in cardiovascular events was observed compared with a non significant 6% reduction in those without dyslipidemia. However, different fibrates may have a somewhat different spectrum of effects. Currently only fenofibrate was investigated and proved to be effective in reducing microvascular complications of diabetes. Bezafibrate reduced the severity of intermittent claudication. Cardinal differences between bezafibrate and other fibrates are related to the effects on glucose metabolism and insulin resistance. Bezafibrate is the only clinically available pan - (alpha, beta, gamma) PPAR balanced activator. Bezafibrate decreases blood glucose level, HbA1C, insulin resistance and reduces the incidence of T2DM compared to placebo or other fibrates. Among major fibrates, bezafibrate appears to have the strongest and fenofibrate the weakest effect on HDL-C. Current therapeutic use of statins as monotherapy is still leaving many patients with atherogenic dyslipidemia at high risk for coronary events because even intensive statin therapy does not eliminate the residual cardiovascular risk associated with low HDL and/or high triglycerides. As compared with statin monotherapy (effective mainly on LDL-C levels and plaque stabilization), the association of a statin with a fibrate will also have a major impact on triglycerides, HDL and LDL particle size. Moreover, in the specific case of bezafibrate one could expect neutralizing of the adverse pro-diabetic effect of statins. Though muscle pain and myositis is an issue in statin/fibrate treatment, adverse interaction appears to occur to a significantly greater extent when gemfibrozil is administered. However, bezafibrate and fenofibrate seems to be safer and better tolerated. Combined fibrate/statin therapy is more effective in achieving a comprehensive lipid control and may lead to additional cardiovascular risk reduction, as could be suggested for fenofibrate following ACCORD Lipid study subgroup analysis and for bezafibrate on the basis of one small randomized study and multiple observational data. Therefore, in appropriate patients with atherogenic dyslipidemia fibrates- either as monotherapy or combined with statins -- are consistently associated with reduced risk of cardiovascular events. Fibrates currently constitute an indispensable part of the modern anti-dyslipidemic arsenal for patients with atherogenic dyslipidemia.
[Show abstract][Hide abstract] ABSTRACT: Objectives This study is to investigate the related factors to contribute the metabolic syndrome according to Sasang Constitution. Methods Nine hundred twenty six persons out of 1774 persons, over 40 years old, participated in community-based cohort in Wonju City of South Korea from June 2006 to August 2009. The diagnosis of metabolic syndrome was carried out by NCEP-ATP III(National Cholesterol Education Program in Adult Treatment Panel III) and Asian Pacific Criteria for abdominal obesity. The related factors were checked using questionnaire and blood samples. Sasang Constitution was verified by a Sasang Constitution specialist using the results of PSSC(Phonetic System for Sasang Constitution), facial pictures and simplified Sasang Constitutional questionnaires. Metabolic syndrome incidence rate according to Sasang Constitution and binary logistic regression analysis were performed with SPSS 19.0. Results Metabolic syndrome incidence rate was 30.3% and the majority of newly categorized as metabolic syndrome was Taeeumin(40.7%). There were significant risk factors like systolic blood pressure, fasting blood sugar, triglyceride and female and a significant defense factor like HDL-cholesterol. In terms of constitutional view, there were significant risk factors like waist circumference, systolic blood pressure, triglyceride in Soyangin, female, waist circumference, systolic blood pressure, fasting blood sugar, triglyceride in Taeeumin, female, waist circumference, systolic blood pressure, triglyceride in Soeumin. And there was a significant defense factor like HDL-cholesterol in only Taeeumin. Conclusions Regimens on metabolic syndrome were considered to be changed according to Sasang Constitution. Taeeumin female and Soeumin female should be cautious of body weight and metabolic syndrome when elderly. There are more cautious risk factors in each constitution; systolic blood pressure and triglyceride in Soyangin and fasting blood sugar and serum lipids levels in Soeumin and Taeeumin.
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