జర్నల్ ఆఫ్ మెటబాలిక్ సిండ్రోమ్

Purpose: New-onset diabetes mellitus after transplantation (NODAT) is a well-known complication of transplantation.

Materials and methods: Retrospectively, we detected CMV replication (PCR) in every month after transplantation of kidney in the first 12 months after transplantation in patients in a homogenous group from the aspect of immunosuppresion.

Results: In the group of 167 patients (control group: n = 103, NODAT group: n = 64), the average value of CMV viremia was without any significant difference between the NODAT group and the control group (P = 0.9285). In the 10th month after kidney transplantation, we recorded significantly higher CMV viremia in the NODAT group (p < 0.0001), however, in the multi variant analysis, that difference was not confirmed. Thus, in our group, CMV is of no relevance with the development of NODAT in the monitored period. The survival of patients and graft was 12 months after kidney transplantation without any statistically significant difference between the monitored groups (P = 0.6113 - survival of the patient; P = 0.5381 – survival of the graft).

Conclusion: Our analysis shows that in regular monitoring of CMV viremia and applying chemoprophylaxison the risk recipeints, CMV is not the risk factor for NODAT.

It is time we understand the need for disease/s specific programs and not just theoretical frameworks like the National Health Mission (NHM) or National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke, through mixing of programs. Off course, each of these programs can benefit from the strengths of other programs, for example, a program on diabetes can benefit from a fully operational Integrated disease surveillance program (IDSP) or vice versa. A disease specific program is also important because the numbers which diseases like Diabetes or Cardiovascular diseases throw up individually is huge. Importantly these diseases are and will continue to be major contributors of mortality.

Purpose: The purpose of the current investigation was to assess Metabolic Syndrome prevalence and risk estimates using United States nationally representative data.

Methods: Study sample was derived from 6 National Health and Nutrition Examination Survey (NHANES) cohorts from 2001-2012, N = 9,326 (male: n = 4,814; female: n = 4,512) including ages 18-59 presenting as fasted for 12 hours prior to laboratories collection. Variables included AHA/NHBLI Metabolic Syndrome classification criteria as well as additional cardiometabolic measures. Prevalence of Metabolic Syndrome and risk factors across cohorts as well as relative risk estimates were derived. Estimates were adjusted for age, race, and sex.

Results: There was no statistically significant difference between Metabolic Syndrome prevalence across cohorts. The order of Metabolic Syndrome criteria from highest to lowest risk were waist circumference, triglycerides, HDL, fasting plasma glucose, and blood pressure for the total sample and across sex, with women presenting with larger risk estimates than men. Women had larger prevalence of waist circumference, HDL, and blood pressure risk factors compared to men who had a larger prevalence of triglyceride and fasting plasma glucose risk factors. Those presenting with Metabolic Syndrome were twice as likely to have a cardiovascular event.

Conclusion: Waist circumference and triglycerides were the Metabolic Syndrome risk factors with the highest prevalence and associated risk of developing Metabolic Syndrome. Those with Metabolic Syndrome were at increased risk of having a cardiovascular event.

Objective: Risk factors development are similar to those implicated in cardiovascular diseases (cardiac failure, ischemic heart disease, and peripheral arterial disease), hypertension, diabetes mellitus, and dyslipidemia in hemodialysis (HD). Therefore, it is necessary to optimize the treatment (dyslipidemia) of these patients.

Methods: We examined changes in physiological parameters, renal function markers and lipid profiles induced by statins, such as pravastatin sodium (water-soluble, PS), atorvastatin calcium hydrate (fat-soluble, ACH) and pitavastatin calcium (fat-soluble, PC).

Results: Dyslipidemia with medication was observed in 34 (24.8%) of the 137 HD patients. The therapeutic statins used for dyslipidemia were as follows: PS was used in the nine patients, ACH was used in 11 patients and PC was used in nine HD patients. The waist circumference and body mass index were more significantly increased in the patients treated with ACH (90.9 ± 10.5 cm [mean ± standard deviation], 24.8 ± 2.9 kg/m2) than in the patients treated with PS (79.9 ± 10.3 cm, 21.0 ± 2.9 kg/m2; P < 0.05). While the serum triglyceride levels in the PS group were 103 ± 36 mg/dl, those in the ACH group were 164 ± 75 mg/dl (P < 0.05). In addition, the serum whole parathyroid hormone levels were significantly higher in the ACH group (151 ± 102 pg/ml) than in the PS group (55 ± 32 pg/ml, P < 0.05). There were no differences between the PS and the PC groups in any of the laboratory data, except for the serum creatinine levels.

Conclusion: Waist circumference, body mass index and the serum triglyceride levels were increased in the ACH HD patients. Interestingly, the serum whole PTH levels were found to be significant in the ESRD patients treated with ACH. Based on our results, PC may be an ideal statin for treating HD patients.

Objective: The purpose of this study was to investigate, whether an association between metabolic syndrome (MetS) and clinical features and affective temperaments exists or not in first manic episode of bipolar disorder (BD) with or without previous depressive episode.

Methods: Diagnosed with dipolar disorder type I according to DSM-IV criteria fifty four patients who were had a least one previous depressive episode (PDE) and 87 patients who were experiencing their first manic episode (FME) evaluated consecutively for inclusion. Comorbid axis I disorders and alcohol or substance use were excluded. NCEP ATP III formulated an operational definition of MetS based on the presence of three or more of the following characteristics: abdominal obesity (waist circumference), hypertriglyceridemia, low HDL or being on an antilipidemic agent, high blood pressure or being on an antihypertensive agent, and fasting hyperglycemia or being on antiglycemic agent. The patients who had been in remission period for at least 8 weeks were evaluated with SCIP-TURK and TEMPS-A. Remission was defined as YMRS score<5.

Results: MetS was found to be more frequent in these patients than the patients who didn’t have a PDE. PDE, negative family history, childhood trauma and seasonality are determined as the predictors of MetS. Anxious temperament scores were higher in MetS (+) FME patients of both groups. Irritable temperament scores were higher only in MetS (+) FME patients without PDE group.

Conclusion: The presence of MetS seems to be correlated with the onset and progression of BD. This may also contribute to the discovery of biological markers, increase in our diagnostic tools, development of protective and individual-spesific treatment options.

Metabolic Syndrome is associated with an increased risk of cardiovascular disease, increases after menopause and it is probably more frequent in HIV women.

Objective: To assess MetS and associated factors in HIV seropositive and seronegative middle-aged women.

Methods: Cross-sectional study with 537 women (273 HIV seropositive and 264 HIV seronegative), between 40 and 60 years’ old receiving follow-up care in two medical centers in Brazil. MetS was diagnosed based on IDF criteria. Sociodemographic, clinical, and behavioral factors were evaluated.

Results: The prevalence of MetS in the HIV group was 46.9% and 42.2% in the seronegative group (P=0.340). Multiple regression analysis showed MetS association with body mass index (BMI)>25 kg/m² (PR=2.34; 95% CI: 1.70- 3.21; P<0.001), aging (PR: 0.05, 95% CI: 1.02-1.07; P<0.001), and the use of highly active retroviral therapy (HAART) (PR: 1.48; 95% CI: 1.13-1.94; P=0.005). Conclusions: There was no association between MetS and HIV status overall. Although HAART was associated with MetS, it seems that HIV-positive women in good immunological status, after early institution of HAART and its effective use, have traditional factors associated with MetS like being overweight and having older age.

Background and objective: Metformin is often used as a first-line therapy for Type 2 diabetes mellitus (T2DM), but the glycemic response to metformin is variable in patients. Here, we aimed to assess the inter-patient variability in terms of glycemic response to metformin in the state of West Bengal, India.

Material and methods: We enrolled newly diagnosed treatment naïve 113 patients with T2DM. Patients were subjected to assay of glycated hemoglobin (HbA1c), fasting blood glucose (FBG), postprandial blood glucose (PP) and measurement of body mass index (BMI), waist circumstances (WC) before and after the end of 3 months of immediate release metformin (2000mg/day) therapy.

Results: Out of 113 patients, 111 (58 male and 53 female; average age 43.13 years) were provided with 3 months of metformin therapy. 102 individuals responded to metformin, but HbA1c levels of 9 patients did not improve after 3 months of drug therapy. Conclusions: In the present study, metformin lead to improvements in glycemic control in 92% of newly diagnosed T2DM patients but in 8% does not which is much less in this part of India.

Background: There is few evidence of CNR2 SNPs and obesity. The role of CNR2 gene variants on weight loss after a dietary intervention remained uninvestigated.

Objective: Our aim was to analyze the effects of rs3123554) of CNR2 receptor gene polymorphism on body weight, metabolic parameters and serum adipokine levels after a Mediterranean hypocaloric diet.

Design: A Caucasian population of 82 obese patients was analyzed before and after 3 months on a Mediterranean hypocaloric diet.

Results: In non A allele carriers, the decrease in weight -3.2 ± 1.9 kg (-2.2 ± 1.0 kg : p=0.02), BMI -1.0 ± 0.1 kg (-1.2 ± 0.5 kg : p=0.01), fat mass -2.5 ± 1.0 kg (-1.2 ± 0.8 kg : p=0.003), waist circumference -2.9 ± 1.1 cm (-2.1 ± 3.1 cm : p=0.004), systolic blood pressure were -5.9 ± 3.9 mmHg (-2.9 ± 2.2 mmHg), total cholesterol -25.1 ± 5.3 mg/dl (-6.4 ± 4.7 mg/dl : p=0.005), LDL- cholesterol -19.1 ± 9.5 mg/dl (-6.2 ± 8.5 mg/dl : p=0.003), glucose -5.2 ± 2.5 mg/dL (-0.1 ± 1.1 mg/dL : p=0.004), insulin -2.8 ± 1.3 mUI/L (-0.2 ± 1.0 mUI/L:p=0.01), HOMA-IR -0.9 ± 0.3 ( ± 0.1 ± 0.1 : p=0.01), IL-6 -0.7 ± 0.5 ng/dL (-0.1 ± 0.4 ng/dL:p=0.02) and CRP -2.8 ± 1.5 ng/dL ( ± 0.1 ± 0.2 ng/dL:p=0.02) were higher than A allele carriers.

Conclusion: Non A allele carriers has a better improvement after a Mediterranean hypocaloric diet in body weight, fat mass, waist circumference, level of insulin, HOMA-IR, total cholesterol, LDL cholesterol, IL-6 and CRP than A allele carriers.