Nutrition & Food Science
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Item Comparison of Metabolic Syndrome Indicators in Two Samples of Central and South Americans Living in the Washington, D.C. Area in 1993–1994 and 2008–2009: Secular Changes in Metabolic Syndrome in Hispanics(MDPI, 2017-08-05) Gill, Regina; Jackson, Robert T.; Duane, Marguerite; Miner, Allison; Khan, Saira A.The Central and South American populations are growing rapidly in the US; however, there is a paucity of information about their health status. Objectives: we estimated the prevalence of metabolic syndrome (MetS) and its individual components from two cohorts of Central and South Americans. Methods: This cross-sectional, medical record extraction survey sampled 1641 adults from a Washington, D.C clinic. A questionnaire was used to collect socio-demographic, medical history, anthropometric, biochemical, and clinical data. Results: among the 1993–1994 cohort, the MetS prevalence was 19.7%. The most prevalent MetS components were low high-density lipoprotein (HDL) cholesterol (40.4% men and 51.3% women), elevated triglycerides (40.9% men and 33.1% women), and high body mass index (BMI) ≥ 25 kg/m2 (27.6% men and 36.6% women). The overall prevalence of MetS in the 2008–2009 cohort was 28%. The most common abnormal metabolic indicator was an elevated BMI ≥ 25 kg/m2 (75.6%). 43.2% of men and 50.7% of women had HDL levels below normal, while the prevalence of hypertriglyceridemia was 46.5% and 32.5% for men and women, respectively. Conclusion: the prevalence of MetS was significantly greater in 2008–2009 compared with 1993–1994 (p ≤ 0.05). Dyslipidemia and high BMI have increased. Although similar components were identified in both the 1993–1994 and 2008–2009 study populations, the risks of MetS have increased over time.Item OBESITY, METABOLIC SYNDROME, AND CARDIOVASCULAR OUTCOMES IN PEDIATRIC KIDNEY TRANSPLANT RECIPIENTS(2017) Sgambat, Kristen; Lei, David; Nutrition; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Cardiovascular (CV) disease is a leading cause of morbidity amongst children after kidney transplant. The contribution of abdominal obesity and metabolic syndrome (MS) to CV risk is not well defined in this population. A prospective controlled longitudinal cohort study was conducted to investigate contributions of obesity and MS to CV morbidity in a multiracial pediatric kidney transplant population. Aims of the study were to 1) identify prevalence of CV and metabolic abnormalities 2) evaluate effects of obesity and MS on adverse CV outcomes, defined by left ventricular hypertrophy (LVH), impaired myocardial strain and increased carotid intima-media thickness (CIMT) and 3) identify the anthropometric measure of obesity, Body Mass Index (BMI), Waist-to-Height ratio (WHr), or Waist Circumference (WC), that best predicts CV risk. Transplant recipients had standard echocardiographic measures of left ventricular size and function, strain by speckle tracking echocardiography, and CIMT measured at 1, 18, and 30 months post-transplant. 35 pre-transplant echocardiograms were analyzed retrospectively. Multivariate longitudinal regression was used to determine associations of obesity and MS with CV outcomes. Results indicated obesity and MS are prevalent among pediatric kidney transplant recipients. WHr is a more sensitive indicator of obesity-associated adverse CV outcomes compared with BMI or WC, due in part to the prevalence of short stature in this population. Obesity, MS, and hypertension are associated with post-transplant LVH. Significant predictors of impaired longitudinal strain include obesity, hypertension, and a combination of MS with elevated LDL-C cholesterol, whereas higher estimated glomerular filtration rate confers a protective effect. African American pediatric kidney transplant recipients have increased CIMT, which is negatively impacted by MS, whereas the CIMT of non-African American children appears unaffected after transplant. In conclusion, obesity and MS adversely affect CV outcomes in pediatric kidney transplant recipients, highlighting the importance of efforts to maintain healthy weight, blood pressure, and lipid profile after transplant. Further studies are needed to investigate the etiology and consequences of increased CIMT in African American transplant recipients. Imaging techniques such as speckle tracking echocardiography and CIMT may provide a means of detecting subclinical myocardial dysfunction and provide opportunity for early intervention in this population.Item HYPERLEPTINEMIA, METABOLIC SYNDROME, AND MORTALITY IN OLDER ADULTS(2010) Mishra, Suruchi; Sahyoun, Nadine R; Mehta, Mira; Nutrition; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: Abdominal adiposity and fat mass increase with aging, and as does insulin resistance which is frequently associated with hyperleptinemia and leptin resistance. Serum leptin may predict risk of metabolic syndrome and mortality among older adults. Objectives: The objectives of the present study were to evaluate the relationship of serum leptin with risk of metabolic syndrome and mortality and to examine these associations in relation to the measures of body adiposity and proinflammatory cytokines. The influence of leptin receptor (I/D) gene polymorphism on diabetes as a contributing cause of mortality was also examined. Gender specific serum leptin cut off values as a biomarker for the risk of metabolic syndrome were determined. Design: The Health, Aging and Body Composition (HABC) study is a prospective cohort of 3,075 older adults aged 70 to 79 years. Body composition, demographic information, biochemical variables including, markers of systemic inflammation, and genetic variation were assessed in detail. Results: Women in quintile 2, 3, 4 and 5 of serum leptin were at significantly lower risk for metabolic syndrome as compared to those in quintile 1 after controlling for confounders. Serum leptin was independently associated with risk of metabolic syndrome after sequentially adjusting for demographic variables (p<0.0001), fat depots (p=.0024), and proinflammatory cytokines (p=.0098) in women. Among men, the association between serum leptin and risk of metabolic syndrome was explained by body adiposity. Women in quartile 2 and 3 of serum leptin were at lower risk than women in quintile 1 for all-cause mortality and mortality from cardiovascular disease independent of body fat and proinflammatory cytokines. Additionally, elevated level of serum leptin was associated with increased risk for diabetes as a contributing cause of mortality for both genders after sequentially adjusting for potential confounders, body fat and proinflammatory cytokines. Significant interaction was found between leptin receptor genotype and total percent fat (p=0.008) in association with diabetes as a contributing cause of mortality among women. The cut off serum leptin level that suggests the possible risk of metabolic syndrome was determined to be 6.45 ng/ml with 60% sensitivity and 63% specificity among men and 18.25 ng/ml with 55% sensitivity and 62% specificity among women. Conclusion: Elevated levels of serum leptin may be associated with increased risk of metabolic syndrome and risk of diabetes as a contributing cause of mortality among older women. However, intermediary levels of serum leptin may lower the risk of all-cause mortality and mortality from CVD, suggesting a paradoxical association of serum leptin with cardiovascular risk factors and mortality from CVD among older womenItem THE EFFECTS OF OBESITY ON PLASMA LEVELS OF OMENTIN, A DEPOT-SPECIFIC ADIPOCYTOKINE(2004-08-27) de Souza Batista, Celia Maria; Kantor, Mark; McLenithan, John; Nutrition; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Obesity is a chronic pathological condition and a risk factor for diabetes and cardiovascular disease. It has been demonstrated that adipose tissue functions not only as a fat storage depot but also as an endocrine organ. Omentin is a protein expressed and secreted in adipose tissue that increases insulin-stimulated glucose transport. To further elucidate omentin's physiological function, its levels were measured by quantitative western blotting in plasma from 44 healthy nondiabetic volunteers (22 women, 22 men). Participants were organized into sibling pairs based on discordant BMI (3-12 Kg/m2). Lean subjects had significantly higher omentin levels than obese/overweight subjects (independent of sex), and significantly higher omentin levels were detected in women compared to men. Omentin levels were inversely correlated with BMI and positively correlated with HDL levels. These data suggest that omentin may play a physiological role in the pathogenesis of obesity-dependent insulin resistance.