Stanley, T. The syndroje of metabolic syndrome, as Metabolic syndrome risk assessment as cardiometabolic risk factors, was rlsk higher Ideal caloric intake our TMI asdessment than that in the previously reported BMI-based classifications of the same KNHANES age group. Indeed, the presence of the cardiometabolic risk factors in childhood strongly predicted cardiovascular disease CVD in adulthood; a risk factor even stronger than of sex or a family history of CVD 78.

Metabolic syndrome risk assessment -

Fasting blood samples were collected from the median cubital vein in the morning between 8. KG, Nümbrecht, Germany. The whole blood samples were placed into specimen tubes containing EDTA and were immediately analyzed.

All samples were analyzed in duplicate or triplicate in a single assay to avoid inter-assay variability. The procedures were conducted according to our previous research by Tylutka et al.

BM HEM3 3 diff analyzer from Biomaxima Lublin, Poland was used to assess the basic hematological parameters. The method of analyses of hematological parameters was based on previously reported methods by Tylutka et al. Serum triglycerides TG , total cholesterol TC , high-density lipoproteins HDL , low-density lipoproteins LDL were determined using BM Biomaxima Lublin, Poland.

The non-HDL cholesterol was calculated by subtracting HDL from total cholesterol concentration. Oxidised low-density lipoprotein oxLDL was determined using ELISA kits from SunRed Biotechnology Company Shanghai, China with a detection limit at The analyses were conducted according to our previous research by Tylutka et al.

The serum glucose level was evaluated by using commercially available reagents and mobile spectrophotometer DP Vario II Berlin, Germany. The insulin level was measured using a high sensitivity assay in duplicate by means of commercial kit from DRG International Springfield Township, Cincinnati, OH, USA with a detection limit of 0.

HOMA index Homeostatic Model Assessment Insulin Resistance was calculated according to Sitar-Tǎut et al. Tumor necrosis factor, interleukin-6, interleukin-8 and anti-inflammatory interleukin were determined by using ELISA kits from SunRed Biotechnology Company Shanghai, China.

A proinflammatory protein high mobility group B1 HGMB-1 was determined by using ELISA kits from SunRed Biotechnology Company Shanghai, China with detection limits of 0.

All statistical analyses were performed using R system 4. The data were described as measures of central tendency mean and medians and measures of dispersion [standard deviation SD or interquartile range IQR ] for numerical variables. To check data normality, the Shapiro—Wilk test was applied.

When the normal distribution was assumed, one-way ANOVA was used otherwise, the Kruskal—Wallis test was applied. Spearman rank correlation coefficient r s or Pearson correlation coefficient R was used to assess the agreement between metabolic syndrome and the continuous independent variables.

All participants were informed of the aim of the study and gave their written consent for participation in the project.

The mean age of all the participants was The white blood cells count fell within the referential range in all the participants. However, higher values of leukocytes or granulocytes were observed in the group of patients diagnosed with the metabolic syndrome Table 2.

Platelet values in both groups were within the reference range and no differences were found between the groups.

Adipose tissue has been shown to behave as a highly active endocrine organ owing to its ability to secrete a wide variety of biologically active adipokines, such as TNF-α or IL IL may also participate in low-grade systemic inflammation and insulin resistance and, indeed, higher levels of IL were observed in our group with diagnosed metabolic syndrome.

A statistically significant difference between groups was also demonstrated in the level of HGMB-1 protein, which may implicate its diagnostic utility in patients with obesity and the metabolic syndrome. There were no statistically significant differences between the levels of adiponectin or leptin.

Frühbeck et al. Positive correlation between IL and glucose a , TNF-α b , IL-8 c and negative correlation between IL and adiponectin d. The results of the ROC analysis of indicators which are likely to be important in the diagnosis of the metabolic syndrome i.

LAP or TNF-α, ranged between 0. The optimal threshold values corresponded to, The highest AUC, indicating both high sensitivity and specificity, was observed for LAP. For four tested variables, VAI, IL, adiponectin and leptin AUC was low, which did not render these factors valuable as diagnostic indicators of the metabolic syndrome in our group.

The highest specificity was observed for HOMA-IR However, sensitivity values for these variables were fairly low This means that more than half of the patients with metabolic syndrome may show lower levels of the markers than the estimated threshold. Consequently, a combined, simultaneous analysis of several factors seems to be the best solution.

An elderly immune system becomes increasingly more predisposed to chronic inflammatory reactions and less capable of responding to acute and massive challenges posed by new antigens. Overweight or obesity are reported to be on the increase in older adult populations.

The inflammation significantly contributes to endothelial dysfunction which occurs in cardiovascular diseases CVDs developed as a consequence of MetS and diabetes So far, extensive research has been conducted to determine the factors that influence the metabolic syndrome where attempts have been made to identify the predictors of the metabolic syndrome.

Metabolic syndrome predictors can be classified into three categories: anthropometric variables, biochemical variables, and lifestyle 3. According to the IDF criteria, BMI is one of the basic criteria used to classify the metabolic syndrome. Research by Riberto da Costa et al.

body adiposity index which relies only on two variables, i. height and hip circumference. The research seems promising, but the validity of the proposed model must be tested in other countries and populationsin order to verify its applicability.

As was the case reported by Pouragha et al. According to Hrebícek et al. The cut-off value for the HOMA-IR index in our study, regardless of the gender, amounted to 2. In the study by Motamed et al.

Although the waist-to-height ratio requires only a single anthropometric measurement of waist and height, the use of LAP as a predictor of MetS is more advantageous. Waist circumference measurement is unable to distinguish between visceral and subcutaneous adipose tissue Visceral adiposity is more strongly associated with a cardiometabolic risks compared with subcutaneous adipose tissue.

LAP index has been shown to be a better predictor of diabetes 32 than body mass index 4 in cardiovascular risk assessment. Research by Ray et al. In our study, we recorded higher values of the LAP index in patients with MetS The AUC value for LAP was 0. Our AUC results were similar to the AUC values 0.

Apart from its thermoregulatory and lipid storing functions, adipose tissue and its endocrine function also provides important information on the development and pathogenesis of the metabolic syndrome.

The variety of released adipokines include hormones e. leptin, adiponectin , peptides e. angiotensinogen, apelin, resistin, and plasminogen activator inhibitor 1 PAI-1 , and inflammatory cytokines IL-6, TNF-α, visfatin, omentin, and chemerin , all of which play a major role in the pathophysiology of insulin resistance and MetS.

Insulin resistance and obesity-induced systemic oxidant stress activate downstream inflammatory cascades, leading to tissue fibrosis, atherogenesis, and subsequently CVDs Studies have shown that the metabolic syndrome is associated with a decrease in ghrelin and adiponectin levels and an increase in leptin levels.

The association between low ghrelin and metabolic syndrome is likely to be primarily explained by the relationship with obesity as obese patients with the metabolic syndrome have lower ghrelin levels than nonobese counterparts In our research a statistically lower value of ghrelin was observed in the MetS group when compared to the group without MetS.

The diagnostic usefulness of ghrelin in the assessment of the metabolic syndrome can be proven by the value of AUC 0. The obtained test results are similar to those achieved by Sitar-Tǎut et al. Research by Yoshinaga et al. In our study, we did not find statistically significant differences between leptin levels, and the AUC value indicated low usefulness of leptin as a predictor in the assessment of the metabolic syndrome.

The differences in the obtained outcomes may result from substantial age differences of the respondents as the average age in our study group was In turn, the studies by Falahi et al. The observed difference may result from the disproportion between the genders, as in our study women were in the majority in both groups.

Some researchers postulate that the difference in the relationship between males and females may result from differences in glucose and lipid metabolism The presence of increased adipose tissue has an adverse effect on immune cells.

TNF-α overexpression plays a crucial role in the development of insulin resistance which is an important component of MetS, and some research suggested that TNF-α could be an early predictor for MetS detection 8. For the first time in Polish population of older adults with the metabolic syndrome, we determined the AUC value as well as the cut-off value for TNF-α.

The HGMB-1 protein is not only associated with inflammation but also with insulin resistance and hyperglycemia, and thus also with MetS Increased levels of HGMB-1 were reported in both mice and diabetic patients Moreover, it was shown that the level of HGMB-1 was positively correlated with WHR and IL-6 40 , In our study, we observed no relationship between the metabolic syndrome and IL-6 and between protein HGMB-1 and IL Nevertheless, the level of HGMB-1 protein was statistically significantly higher in the MetS group The results of our observations are consistent with those obtained by Wang et al.

Moreover, a relatively high AUC value for the HGMB-1 protein 0. The research conducted by Arrigo et al. Apart from its role in parasite infections, IL, a cytokine secreted mainly by activated Th2 lymphocytes, may also play a significant role in the development of metabolic changes, however, clinical findings are still quite controversial Research by Madhumith et al.

The study by Nestvold et al. In our study, higher IL values were found in MetS patients in comparison to the healthy group, and the observations were similar to the outcomes reported by Martínez-Reyes et al.

IL was also studied in reference to low-grade systemic inflammation. Studies conducted by Martínez-Reyes et al. It is also worth mentioning that the results of the observed and described correlations only indicate some association, not causation and should be interpreted with caution.

Long-term inflammation is considered to be a significant risk factor for many diseases, including CVDs, the metabolic syndrome and diabetes.

The diagnosis of the metabolic syndrome is based on the diagnosis of its constituent disorders. As a risk factor, obesity predisposes to a pro-inflammatory state through an increase in inflammatory mediators such as IL-6, TNF-α or HGBM The search for new predictors of the metabolic syndrome will allow us to diagnose the condition more swiftly and to treat it more effectively.

For the early prediction and prevention of MetS it is crucial to identify an appropriate index and the corresponding optimal cut-off levels. Studies conducted on Polish older adults have shown high clinical usefulness of the anthropometric indicator LAP as well as immunological indicators TNF-α and HGBMI-1 in predictions of the metabolic syndrome.

Moreover, increased body fat tissue in MetS patients is associated with higher levels of inflammatory mediators. The high levels of pro-inflammatory cytokines in patients with higher BMI may be the reason why older adults with MetS are statistically more likely to be obese than controls people without MetS.

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Toxics 9 , Select the option that best describes you. View Topic. Font Size Small Normal Large. Metabolic syndrome insulin resistance syndrome or syndrome X. Formulary drug information for this topic. No drug references linked in this topic.

Find in topic Formulary Print Share. View in. Language Chinese English. Author: James B Meigs, MD, MPH Section Editors: David M Nathan, MD Joseph I Wolfsdorf, MD, BCh Deputy Editor: Sara Swenson, MD Literature review current through: Jan This topic last updated: Aug 23, Insulin resistance, the associated hyperinsulinemia and hyperglycemia, and adipocyte cytokines adipokines may also lead to vascular endothelial dysfunction, an abnormal lipid profile, hypertension, and vascular inflammation, all of which promote the development of atherosclerotic cardiovascular disease CVD [ ].

A similar profile can be seen in individuals with abdominal obesity who do not have an excess of total body weight [ ].

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