Metabolic syndrome (MS) involves pathophysiological alterations that might compromise zinc status. The aim of this study was to evaluate zinc status biomarkers and their associations with cardiometabolic factors in patients with MS. Our case control study included 88 patients with MS and 37 controls. We performed clinical and anthropometric assessments and obtained lipid, glycemic, and inflammatory profiles. We also evaluated zinc intake, plasma zinc, erythrocyte zinc, and 24-h urinary zinc excretion. The average zinc intake was significantly lower in the MS group (p < 0.001). Regression models indicated no significant differences in plasma zinc concentration (all p > 0.05) between the two groups. We found significantly higher erythrocyte zinc concentration in the MS group (p < 0.001) independent from co-variable adjustments. Twenty-four hour urinary zinc excretion was significantly higher in the MS group (p = 0.008), and adjustments for age and sex explained 21% of the difference (R2 = 0.21, p < 0.001). There were significant associations between zincuria and fasting blood glucose concentration (r = 0.479), waist circumference (r = 0.253), triglyceride concentration (r = 0.360), glycated hemoglobin concentration (r = 0.250), homeostatic model assessment—insulin resistance (r = 0.223), and high-sensitivity C-reactive protein concentration (r = 0.427) (all p < 0.05) in the MS group. Patients with MS had alterations in zinc metabolism mainly characterized by an increase in erythrocyte zinc and higher zincuria.
IntroductionPopulation aging generally accompanies an increase in chronic noncommunicable diseases, such as metabolic syndrome (MS). Nursing homes have provided a solution for the decreased ability of elderly individuals for self-care and familial difficulties in meeting the health care needs of elderly individuals.PurposeThe aim of the present study was to determine the frequency of MS and its associated factors in elderly individuals living in nursing homes.Patients and methodsThis cross-sectional study was conducted with 202 institutionalized elderly individuals. MS was diagnosed according to the National Cholesterol Education Program – Adult Treatment Panel III criteria. Sociodemographic, clinical, and lifestyle factors were assessed to verify their association with MS by logistic regression.ResultsThe MS frequency was 29.2%. The most frequent MS components were low high-density lipoprotein cholesterol level (63.9%) and abdominal obesity (42.7%). Factors associated with MS were female sex (prevalence ratio [PR]=2.16; 95% CI, 1.04–4.49), age-adjusted institutionalization time >50% (PR=2.38, 95% CI, 1.46–3.88), and high concentrations of interleukin-6 (PR=2.01; 95% CI, 1.21–3.32) and tumor necrosis factor-α (PR=1.70; 95% CI, 1.05–2.77). Moreover, it was verified that the likelihood of having MS was 1.85-fold higher (95% CI, 1.11–3.10) in the group with a diet characterized by very high energy, very low fat, and high dietary fiber.ConclusionThe occurrence of MS in institutionalized elderly individuals was higher in females, and individuals with longer age-adjusted institutionalization time, higher concentrations of immunologic biomarkers, and a dietary intake consisting of higher energy and fiber and lower total fat. The results of the study are useful for guiding health care programs aimed at institutionalized elderly individuals.
BackgroundDietary factors are important environmental factors associated with the prevalence of metabolic syndrome (MS). The objective of this study was to assess the habitual nutrient intakes of patients with MS.MethodsA cross-sectional study included 103 patients (82 % women) with MS seen at the endocrinology outpatient clinic of Hospital Universitario Onofre Lopes. Habitual nutrient intake data were collected at two 24-h dietary recalls. Macronutrient intake adequacies were classified according to the I Brazilian guidelines for the diagnosis and treatment of metabolic syndrome. The prevalence of inadequate micronutrient intake was estimated using the estimated average requirements (EAR) cut-point method after adjusting for intra- and interpersonal variances and energy.ResultsThe mean energy intake of the included patients was 1523.0 ± 592.2 kcal/d, higher in men (1884.0 vs. 1441.5 kcal/d in women; p = 0.003). The recommended percentage protein intake was exceeded in both women and men (18 % in women and 19 % in men). Although men consumed more fiber (18.8 vs. 13.3 g/d in women; p = 0.011), their intake was still inadequate. Women consumed more fat (47.6 vs. 41.3 g/d in men; p = 0.007). The prevalence of inadequate vitamin D and calcium intakes exceeded 80 % in both men and women and across all age groups. The same was observed for magnesium in men and women aged more than 30 years. The prevalence of inadequate vitamin E, riboflavin, and zinc intakes in men ranged from 50 to 75 %. The prevalence of inadequate vitamin A, vitamin C, thiamin, vitamin B6, copper, and selenium intakes in men and women was less than 50 %.ConclusionsPatients with MS had high protein intake, low fiber intake, and high a prevalence of inadequate vitamin D, magnesium, and calcium intakes.
Background Vitamin D deficiency can play a role in extraskeletal functions that are involved with a set of risk factors associated with metabolic syndrome (MetS). The purpose of this review is to investigate the impact of vitamin D supplementation on fasting glucose, dyslipidemia, blood pressure, and abdominal obesity among patients with MetS. Methods EMBASE, Medline, Web of Science, Lilacs, the Cochrane Central Register of Controlled Trials, clinicaltrials.gov databases, and grey literature will be systematically searched for randomized controlled trials (RCTs) of vitamin D supplementation compared with placebo, through December 2020. We will include in the study patients with MetS diagnosed by the criteria set forth by the National Cholesterol Education Program Adult Treatment Panel III or the International Diabetes Federation. The effect of oral vitamin D supplementation on lipid profile improvement (triglycerides, high-density lipoprotein cholesterol—HDL-C) is this review’s primary outcome. The systematic review will be performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study screening, data extraction, and quality assessment will be fulfilled by two independent reviewers according to the Cochrane Risk of Bias tool (RoB 2.0). The results of the systematic review will be provided according to the type of intervention, characteristics of the target population, the methods of measurement of vitamin D, the calculated vitamin D concentrations, types of biological samples, and types of outcomes. Meta-analyses will be conducted where appropriate. The Cochran’s Q test and the I 2 -heterogeneity test will be used to assess the presence of heterogeneity and whether the fixed or the random-effects model would be appropriate for combining study results using the inverse variance method or the DerSimonian-Lair method, respectively. Publication bias will be evaluated using funnel plots and Egger’s and Begg’s tests. The strength of the evidence will be assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Discussion This systematic review will assess the effects of vitamin D supplementation on fasting glucose and triglyceride levels, waist circumference and mean blood pressure, and HDL-C among individuals with MetS. These findings may assist with decision-making within a clinical setting. Systematic review registration PROSPERO registration number CRD42019123212
BackgroundThe risk of metabolic syndrome can be influenced by inadequate vitamin D levels, and exposure to sunlight is the main external source of vitamin D. The present study assessed the influence of environmental, biological, and nutritional factors in relation to seasonal 25-hydroxyvitamin D (25OHD) concentration in individuals with metabolic syndrome.MethodsThis cross-sectional study enrolled 180 individuals with metabolic syndrome aged between 18 and 80 years. The 25OHD concentration was considered the dependent variable; independent variables included age, sex, skin color, use of sunscreen, skin type, sun exposure score, ultraviolet radiation index, geographic location, season, body mass index, waist:hip ratio, waist circumference, parathyroid hormone level, total serum calcium level, and calcium and vitamin D intake.ResultsThe average vitamin D in individuals evaluated in summer 32 ± 10 ng/mL was greater than in the winter 26 ± 8 ng/mL (p < 0.017). HDL-cholesterol was the only component of the MetS that differed significantly between the seasons (p < 0.001), showing higher concentrations in autumn 45 ± 8 mg/dL than in summer 35 ± 8 mg/dL. In the multiple regression model, gender, WHR, sun exposure score, and winter vs. summer explained 10% of the variation in 25OHD concentration (p = 0.004).ConclusionsSex, waist:hip ratio, sun exposure, and summer season were predictors of 25OHD status among individuals with metabolic syndrome. HDL-cholesterol was the only component of metabolic syndrome that differed significantly between the seasons.Electronic supplementary materialThe online version of this article (10.1186/s13098-018-0346-1) contains supplementary material, which is available to authorized users.
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