Journal of the cardiometabolic syndrome最新文献

{"title":"Waist Circumference, Body Mass Index, and Their Association With Cardiometabolic and Global Risk","authors":"Allison H. Christian EdD,&nbsp;Heidi Mochari MPH, RD,&nbsp;Lori J. Mosca MD, PhD","doi":"10.1111/j.1559-4572.2008.00029.x","DOIUrl":"10.1111/j.1559-4572.2008.00029.x","url":null,"abstract":"<p>Total body fat and adipose tissue distribution are associated with cardiometabolic risk, yet there are conflicting data as to whether waist circumference (WC) or body mass index (BMI) is a better predictor of cardiovascular risk. To determine whether WC or BMI was more strongly associated with cardiometabolic risk, family members of patients with cardiac disease were studied (<i>N</i>=501; mean age, 48 years; 66% female; 36% nonwhite). Height, weight, WC, BMI, blood pressure, high-density lipoprotein cholesterol, triglycerides, glucose, high-sensitivity C-reactive protein, and lipoprotein-associated phospholipase A₂ were systematically measured. Global risk was calculated using the Framingham function. Increased WC and BMI were equally strong predictors of cardiometabolic and global risk. The prevalence of cardiometabolic risk factors and their correlation with WC and BMI varied by race/ethnicity. Our data support inclusion of WC and BMI in screening guidelines for diverse populations to identify individuals at increased cardiometabolic risk.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"4 1","pages":"12-19"},"PeriodicalIF":0.0,"publicationDate":"2009-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00029.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28008107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drugs Are Not Enough: The Metabolic Syndrome—A Call for Intensive Therapeutic Lifestyle Change","authors":"Todd M. Brown MD,&nbsp;Bonnie K. Sanderson PhD, RN,&nbsp;Vera Bittner MD, MSPH","doi":"10.1111/j.1559-4572.2008.00031.x","DOIUrl":"10.1111/j.1559-4572.2008.00031.x","url":null,"abstract":"<p>Whether intensive pharmacologic cardiovascular risk factor management reduces metabolic syndrome (MetS) prevalence is unknown. The authors compared the number of secondary prevention medications and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III)–defined MetS prevalence in coronary artery disease patients entering cardiac rehabilitation from 1996 to 2001 (period 1, n=516) with those entering from 2002 to 2006 (period 2, n=609). Age, sex, and ethnicity were similar in both periods. From period 1 to period 2, participants took more secondary prevention medications (2.8±1.3 vs 3.5±1.0, P&lt;.001). Prevalence of low high-density lipoprotein cholesterol (66% vs 66%), diabetes (37% vs 38%), and hypertension (81% vs 81%) were unchanged. The prevalence of hypertriglyceridemia decreased (48% vs 36%, P&lt;.001), but the proportion meeting criteria for elevated waist circumference increased (51% vs 58%, P&lt;.05), resulting in no change in overall MetS prevalence (60% vs 59%, P=NS). More emphasis on therapeutic lifestyle change in addition to intensive pharmacologic therapy is needed to reduce MetS prevalence in patients with coronary artery disease.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"4 1","pages":"20-25"},"PeriodicalIF":0.0,"publicationDate":"2009-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00031.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28008108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Adiponectin in Obesity, Diabetes, and Cardiovascular Disease","authors":"Jordan Kawano BA,&nbsp;Rohit Arora MD, FACC","doi":"10.1111/j.1559-4572.2008.00030.x","DOIUrl":"10.1111/j.1559-4572.2008.00030.x","url":null,"abstract":"<p>Nearly 1 in 4 adults in the United States is obese. The connection between obesity and insulin resistance, type 2 diabetes, and cardiovascular disease is a well researched one. The increasing prevalence of each of these diseases has become a growing concern for the medical community. Adiponectin is a collagen-like plasma protein secreted by adipocytes that has been suggested to play a causal role in the development of insulin resistance and cardiovascular disease. The protein has been found to be decreased in cases of insulin resistance, diabetes, atherosclerosis, and coronary artery disease. Up-regulation of adiponectin and its receptor, through the use of thiazolidinediones, has been found to be partially related to insulin sensitization and thus antidiabetic effects. In this review, we discuss adiponectin’s antiatherogenic effects, its association with insulin resistance and obesity, and the possibility of using adiponectin and its receptor as a therapeutic target.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"4 1","pages":"44-49"},"PeriodicalIF":0.0,"publicationDate":"2009-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00030.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28008533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of the Renin-Angiotensin System in the Pathophysiology, Prevention, and Treatment of Renal Impairment in Patients With the Cardiometabolic Syndrome or Its Components","authors":"Martin A. Alpert MD,&nbsp;Gurushankar Govindarajan MD,&nbsp;Marc L.E. Del Rosario MD,&nbsp;Efrain Reisin MD","doi":"10.1111/j.1559-4572.2008.00035.x","DOIUrl":"10.1111/j.1559-4572.2008.00035.x","url":null,"abstract":"<p>Chronic kidney disease and cardiovascular disease share many risk factors, including hypertension, obesity, and insulin resistance. All of these are components of the cardiometabolic syndrome and are associated with increased risk of morbidity and mortality. One mechanism that links renal injury with the cardiometabolic syndrome is activation of the renin-angiotensin system. Chronic angiotensin II activation promotes development of renal disease through hemodynamic effects and up-regulation of inflammatory cytokines and growth factors. Inhibition of the renin-angiotensin system delays progression of renal disease and improves measures of renal function independent of blood pressure lowering in patients with the cardiometabolic syndrome or its components. Higher doses of renin-angiotensin system inhibitors may provide greater renoprotection in both normotensive and hypertensive patients with the cardiometabolic syndrome. Inhibition of the renin-angiotensin system in patients with risk factors or vascular disease with or without recognized glycemic abnormalities may be a useful strategy for preventing the progression of chronic kidney disease in patients with vascular disease and in those with the cardiometabolic syndrome or its components<i>.</i></p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"4 1","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2009-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00035.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28008534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antihypertensive Pharmacotherapy: Adverse Effects of Medications Promote Nonadherence","authors":"Icilma V. Fergus MD","doi":"10.1111/j.1559-4572.2008.00053.x","DOIUrl":"10.1111/j.1559-4572.2008.00053.x","url":null,"abstract":"","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"4 1","pages":"E1-E3"},"PeriodicalIF":0.0,"publicationDate":"2009-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00053.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28008103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Artery Calcification and Inflammation According to Various Metabolic Syndrome Definitions","authors":"Venkata Narla BA,&nbsp;Raul D. Santos MD, PhD,&nbsp;Catherine Y. Campbell MD,&nbsp;Jose A.M. Carvalho MD,&nbsp;Khurram Nasir MD, MPH,&nbsp;Matthew J. Budoff MD,&nbsp;Roger S. Blumenthal MD,&nbsp;Erin D. Michos MD, MHS","doi":"10.1111/j.1559-4572.2008.00033.x","DOIUrl":"10.1111/j.1559-4572.2008.00033.x","url":null,"abstract":"<p>A number of metabolic syndrome (MS) definitions exist, and one’s cardiovascular disease risk may depend on the definition used. The authors compared the association of subclinical atherosclerosis (coronary artery calcification [CAC] score &gt;0] and inflammation (white blood cell [WBC] count greater than or equal to the highest quartile) with 3 definitions of MS (those of the National Cholesterol Education Program Adult Treatment Panel III [NCEP ATP III], the American Heart Association/National Heart, Lung and Blood Institute [AHA/NHLBI], and the International Diabetes Federation [IDF]) in 458 asymptomatic men (mean age, 46±7 years). MS was present in 28%, 29%, and 34% according to NCEP ATP III, AHA/NHLBI, and IDF criteria, respectively. CAC was observed in 40% and high WBC count in 24%. After adjustment for age, smoking, and low-density lipoprotein cholesterol, the odds ratios for CAC scores &gt;0 with MS by NCEP ATP III, AHA/NHLBI, and IDF definitions were 1.67 (95% confidence interval [CI], 1.02–2.72), 1.67 (95% CI, 1.03–2.70), and 1.63 (95% CI, 1.03–2.57), respectively. The multivariate odds ratios for high WBC count with MS by NCEP ATP III, AHA/NHLBI, and IDF definitions were 1.69 (95% CI, 1.04–2.73), 1.84 (95% CI, 1.14–2.95), and 1.66 (95% CI, 1.05–2.62), respectively. MS is associated with increased subclinical atherosclerosis and inflammation irrespective of various definitions.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"4 1","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2009-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00033.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28008110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Significance of Cardiometabolic Risk Factors in Children With Type 1 Diabetes","authors":"Sowmya Krishnan MD,&nbsp;Kevin R. Short PhD","doi":"10.1111/j.1559-4572.2008.00034.x","DOIUrl":"10.1111/j.1559-4572.2008.00034.x","url":null,"abstract":"<p>Type 1 diabetes (T1D) is a common disease of childhood with a current prevalence of almost 2 cases per 1000 adolescents, according to the third National Health and Nutrition Examination Survey. Modern insulin treatment has resulted in improved quality of life for children with this chronic disorder. However, T1D continues to carry a long-term burden of increased microvascular and macrovascular complications and mortality risk. Compared to the nondiabetic population, patients with T1D are more likely to have ≥1 cardiovascular risk factor and often at an earlier age. Since the prevalence of cardiovascular risk factors increases with age in young persons with T1D, there is a clear need for early screening and counseling to prevent their occurrence and manage long-term health ramifications. The purpose of this review is to describe how traditional risk factors for cardiovascular disease such as an abnormal lipid profile, hypertension, obesity, and insulin resistance contribute to the accelerated atherosclerosis seen in young persons with T1D. A summary is given of the guidelines and recommendations published for clinical care for these patients.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"4 1","pages":"50-56"},"PeriodicalIF":0.0,"publicationDate":"2009-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00034.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28008535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic Analyses of the Effects of Carvedilol vs Metoprolol on Glycemic Control and Insulin Sensitivity in Patients With Type 2 Diabetes and Hypertension in the Glycemic Effects in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives (GEMINI) Study","authors":"Robert A. Phillips MD, PhD,&nbsp;Vivian Fonseca MD,&nbsp;Richard E. Katholi MD,&nbsp;Janet B. McGill MD,&nbsp;Franz H. Messerli MD,&nbsp;David S.H. Bell MD,&nbsp;Philip Raskin MD,&nbsp;Jackson T. Wright Jr MD, PhD,&nbsp;Malini Iyengar PhD,&nbsp;Karen M. Anderson PhD,&nbsp;Mary Ann Lukas MD,&nbsp;George L. Bakris MD,&nbsp;for the GEMINI Investigators","doi":"10.1111/j.1559-4572.2008.00017.x","DOIUrl":"10.1111/j.1559-4572.2008.00017.x","url":null,"abstract":"<p>In the Glycemic Effects in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives (GEMINI) trial, carvedilol added to angiotensin-converting enzyme inhibitors and angiotensin receptor blockers had neutral or beneficial effects on glycemic measures compared with metoprolol tartrate. For the 1235 diabetic hypertensive GEMINI patients, the authors assessed treatment differences by race (white/black/other), age (continuous variable), and sex on hemoglobin A_1c, insulin resistance (homeostasis model assessment–insulin resistance [HOMA-IR]), and blood pressure. Both treatments significantly reduced blood pressure in all subgroups, but the metabolic effects of carvedilol were more beneficial in subgroups of race and sex. Carvedilol did not affect hemoglobin A_1c but improved HOMA-IR results in all subgroups, significantly in males and “other race” subgroups. Metoprolol significantly increased hemoglobin A_1c in all subgroups except “other race,” with no effect on HOMA-IR findings. Differences vs metoprolol significantly favored carvedilol for hemoglobin A_1c in white and female subgroups and favored carvedilol for HOMA-IR in black, “other race,” and male subgroups. Carvedilol effects were favorable to adjustment of age as a covariate. In hypertensive patients with diabetes, carvedilol may be a more appropriate choice when β-blockade is indicated.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 4","pages":"211-217"},"PeriodicalIF":0.0,"publicationDate":"2008-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00017.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27865647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Metabolic Syndrome Among Patients Undergoing Cardiac Catheterization in Jordan","authors":"Yousef Khader BDS, MSc, MSPH, MHPE, ScD,&nbsp;Moawiah Khatatbeh RN, MSc,&nbsp;Khalid EL-Salem MD,&nbsp;Zouhair Amarin MD, MSc,&nbsp;Anwar Bateiha MD, DrPH","doi":"10.1111/j.1559-4572.2008.00020.x","DOIUrl":"10.1111/j.1559-4572.2008.00020.x","url":null,"abstract":"<p>This study was conducted to determine the prevalence of the metabolic syndrome (MeS) and its associated factors among patients undergoing cardiac catheterization in north Jordan. A cross-sectional study was conducted among patients who underwent cardiac catheterization at King Abdullah University Hospital in north Jordan. Data from 360 patients were collected through personal interview, medical records, and anthropometric measurements. MeS was defined using National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF) criteria. The prevalence of MeS among patients undergoing cardiac catheterization in north Jordan was 64.7% according to NCEP ATP III criteria and 76.7% according to IDF criteria. About 96.7% of the participants had at least 1 metabolic abnormality. Sex, body mass index, and family history of cardiovascular disease were the only variables significantly associated with MeS. The prevalence of MeS among patients undergoing cardiac catheterization in north Jordan is considerably high, especially among women.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 4","pages":"224-228"},"PeriodicalIF":0.0,"publicationDate":"2008-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00020.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27865649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strain Imaging Using Speckle Tracking in the Cardiometabolic Syndrome: Method and Utility","authors":"Jeanette St. Vrain RDCS,&nbsp;Kyle Bilhorn RDCS,&nbsp;Suraj Kurup MD,&nbsp;Linda R. Peterson MD","doi":"10.1111/j.1559-4572.2008.00025.x","DOIUrl":"10.1111/j.1559-4572.2008.00025.x","url":null,"abstract":"During the past twenty years, there has been a dramatic increase in obesity and the cardiometabolic syndrome (CMS). In the United States alone, there are an estimated 42 million persons affected by CMS.1 In addition to complications from diabetes and hypertension, this population is at risk for the development of both ischemic and non-ischemic heart failure.2 Although it is fairly well accepted that obesity and other aspects of CMS contribute to left ventricular (LV) remodeling and diastolic dysfunction, controversy does exist as to the effects of CMS on systolic function.2 This is partly due to the fact that obesity is associated with an increase in plasma volume.2 Thus, any load-dependent measures of systolic function, e.g., cardiac output, are necessarily affected by alterations in volume as well as contractility. Different methods for indexing LV systolic function measures in obese subjects may also affect systolic function results. For example, cardiac output may be increased in obesity but when indexed for body surface area, cardiac index may be low. Thus, newer, more load-independent noninvasive methods are necessary for better characterizing LV systolic function. \u0000 \u0000Tissue Doppler imaging (TDI), an echocardiographic method previously described in the Images in CMS section of the Journal of the Cardiometabolic Syndrome, is considered to be relatively load-independent.3 Although, TDI is relatively easy to perform and measure, it does have some limitations. TDI provides a longitudinal assessment of the function of an entire wall rather than of a segment, so localization of the segmental wall motion abnormalities using TDI is limited.4 Additionally, because it is a Doppler-derived parameter, it is necessarily angle-dependent, and so TDI-derived measures of function are angle-dependent. \u0000 \u0000A new echocardiographic technique called strain imaging, overcomes some of the limitations of TDI. Like TDI, strain imaging is thought to be relatively load-independent, but strain imaging has other advantages as well. Strain imaging allows for segmental wall motion quantification and (when quantified using speckle tracking) is not angle-dependent. \u0000 \u0000In order to explain this technique it is first important to define “strain” as it pertains to LV systolic function. Strain means deformation and is calculated as the change in length divided by the original length.4 As such, strain is dimensionless and typically represented as a negative fractional or percentage change in dimension. Since LV contraction in systole causes LV deformation (strain), strain is a measure of contractility.4 (The rate at which the LV deforms may also be measured echocardiographically and is termed “strain rate,” but this imaging article will focus on strain). LV contraction is a three-dimensional process that involves radial and longitudinal cardiac muscle fibers. As longitudinal fibers shorten the ventricle, radial fibers squeeze in and twist in a clockwise direction at the base and c","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 4","pages":"258-261"},"PeriodicalIF":0.0,"publicationDate":"2008-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00025.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27865654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}