Metabolic Syndrome and Related Disorders

This study aimed to investigate health-related quality of life (HRQOL) and related factors in Hangzhou, China, in patients with non-alcoholic fatty liver disease (NAFLD).

The Chinese version of the EQ-5D-5L questionnaire was employed to assess HRQOL in 594 patients. A standardized questionnaire was employed to gather data regarding demographics, clinical characteristics, and lifestyle. This study employed Tobit regression models alongside multiple linear regression to examine the components influencing HRQOL, encompassing utility values and the EQ visual analogue scale (EQ-VAS).

This study included 594 participants with a mean age of 42.03 ± 13.83 years. The median utility index was 0.951 (P25-P75: 0.934–1.000), and the median EQ-VAS score was 76 (P25-P75: 66–82). Anxiety and depression were the predominant entry (31.9%) among the five health dimensions. Tobit regression models indicated that retirement (P = 0.011), monthly income >6000 (P = 0.002), alcohol consumption (P = 0.012), low-intensity activity (P = 0.002), obesity (P = 0.004), and cirrhosis (P = 0.038) were correlated with diminished HRQOL. The outcomes of multiple linear regression analyses indicated that regular exercise (β = 3.200; P = 0.003) and alcohol consumption (β = 2.466; P = 0.049) exhibited significant positive correlations with EQ-VAS scores, whereas obesity (β = −4.259; P = 0.005) and severe hepatic steatosis (β = −3.912; P = 0.036) demonstrated significant negative correlations.

The anxiety/depression dimension was the most prevalent problem. The current investigation identified a notable correlation between HRQOL and low-intensity activity, obesity, and cirrhosis. Obesity and severe hepatic steatosis exhibited a substantial negative correlation with the EQ-VAS score. Future efforts should focus on enhancing the mental health and lifestyle of NAFLD patients.

Metabolic syndrome (MetS) is increasingly prevalent globally and is linked to inflammation in cardiac tissues. Cardiac allograft vasculopathy (CAV) is a significant inflammatory condition and a leading cause of graft failure after orthotopic heart transplantation (OHT). The relationship between MetS and CAV remains poorly understood.

A literature search was conducted from inception to September 2024, including studies that reported associations between MetS or its components (obesity, hypertension, dyslipidemia, and diabetes mellitus) and CAV. The primary endpoint was the development of CAV after OHT. Results were presented as odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI), employing both random and fixed-effect models based on heterogeneity.

A total of 16 studies involving 3,366 patients were included. The prevalence of MetS was high before OHT (32%, 95% CI: 24–41%, I ² = 75%) and increased after OHT (37%, 95% CI: 18–61%, I ² = 83%). MetS was significantly associated with CAV (OR = 1.99, 95% CI: 1.28–3.09, I ² = 36%). Key components of MetS linked to CAV included obesity (OR = 1.54, 95% CI: 1.11–2.13, I ² = 0%) and dyslipidemia (OR = 1.87, 95% CI: 1.49–2.36, I ² = 0%). New-onset diabetes mellitus after transplantation increases the risk of CAV with an HR of 1.71 (95% CI: 1.56–1.88, I ² = 0%).

The high prevalence of MetS both before and after OHT is associated with an increased risk of CAV, highlighting the need for targeted interventions to manage MetS in heart transplant recipients.

Obesity is the most important factor in obstructive sleep apnea (OSA). Even if metabolic surgery (MS) weight loss is achieved, the therapeutic effect has not been proven for OSA. This study compared the apnea–hypopnea index (AHI) before surgery (T0), 1 year after surgery (T1), and 2 years after surgery (T2), assuming that the effect of MS on the AHI is influenced by the ANB angle (formed by point A, nasion, and point B), which reflects the anteroposterior relationship between the maxilla and mandible.

The study included 47 patients with a body mass index ≥35 kg/m² who underwent MS. To compare the AHI before and after surgery, we classified participants into three groups based on the ANB angle at the initial examination: skeletal Class I (>1° and <4°), II (≥4°), and III (≤1°).

The mean AHI of all participants was 56.8 events/hr at T0, 26.5 at T1, and 23.7 at T2. Both postsurgical values were significantly lower than the presurgical value at T0. The mean AHI in skeletal Class I was 19.1 at T1 and 15.1 at T2, which was a significant decrease compared with T0 (50.4). Although the mean AHI was 38.8 at T1 and 38.8 at T2 in the skeletal Class II, which were lower than that at T0 (65.9), no significant difference was observed. The mean AHI was 20.0 at T1 and 15.3 at T2 in the skeletal Class III, which were significantly decreased as compared with that at T0 (53.5).

Measuring the ANB angle prior to surgery is useful for predicting the postoperative effect.

Recent studies have identified a U-shaped association between sleep duration and both poor cardiovascular health (CVH) and metabolic syndrome (MetS). However, the extent to which sleep quality affects cardiometabolic health remains understudied. Here, we examined associations of sleep quality with CVH and MetS.

In a nationally representative cross-sectional study of US adults (n = 3,293), we assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI), operationalized as a continuous score (range 0–23 points) and binary (good vs. poor sleep quality) variable. We derived CVH score (range 0–100 points) using the Life’s Essential 8 construct, and defined MetS using the National Cholesterol Education Program Adult Treatment Panel III criteria. We examined associations via regression models, adjusting for sociodemographic and lifestyle factors.

In fully adjusted models, a 1-point higher PSQI score was associated with lower CVH scores (β −0.61; 95% CI −0.72, −0.51) and higher odds of MetS (OR 1.02; 95% CI 1.00, 1.03). Similarly, poor (vs. good) quality sleep was associated with lower CVH scores (β −4.1; 95% CI −5.4, −2.8) and higher odds of MetS (OR 1.27; 95% CI 1.04, 1.56). The associations with CVH score and MetS appeared to be driven primarily by health behaviors metrics and hypertriglyceridemia, respectively. No significant interactions were seen with age or gender.

In this cross-sectional study, individuals with poor sleep quality were found to have worse CVH scores and higher odds of MetS. Future studies could explore whether strategies promoting better quality sleep would help improve CVH and prevent MetS.

We conducted an observational study on how profound hypothyroidism affects circulating citrate, a potential biomarker of mitochondrial dysfunction linked to mortality.

Sixteen differentiated thyroid carcinoma patients were first studied during hypothyroidism, i.e., 4–6 weeks after total thyroidectomy, and subsequently after 20 weeks of thyroid hormone supplementation. 5 patients were also studied during euthyroidism, i.e., before total thyroidectomy. Circulating citrate and total ketone bodies were measured by nuclear magnetic resonance spectroscopy.

During profound hypothyroidism (mean thyroid stimulating hormone [TSH] 106 ± 77 mU/L), circulating citrate was 72% higher (95% CI: 48%–96%), reaching 157 ± 48 µmol/L, compared to 93 ± 25 µmol/L during thyroid hormone administration (mean TSH 0.20 ± 0.53 mU/L). This increase remained significant after adjusting for estimated glomerular filtration rate (eGFR) (P < 0.001) and body mass index (BMI) (P < 0.001). Citrate during hypothyroidism was also higher compared to five euthyroid patients studied before total thyroidectomy (P = 0.014). Total ketone bodies did not significantly change during hypothyroidism (P = 0.62).

Short-term profound hypothyroidism gives rise to a major increase in circulating citrate, also when adjusted for changes in eGFR and BMI, conceivably attributable to hypothyroidism-related mitochondrial dysfunction. It is suggested that thyroid function status should be taken into consideration when evaluating the association of circulating citrate with adverse health outcomes.