Addressing the Global Cardiovascular Risk of Hypertension, Dyslipidemia, Diabetes Mellitus, and the Metabolic Syndrome in the Southeastern United States, Part II: Treatment Recommendations for Management of the Global Cardiovascular Risk of Hypertension, Dyslipidemia, Diabetes Mellitus, and the Metabolic Syndrome

Bestermann, William H.; Houston, Mark C.; Hawkins, Ralph G.; Basile, Jan; Egan, Brent M.; Lackland, Dan; Ferrario, Carlos M.; Moore, Michael A.; Reed, James W.; Rogers, Philip; Wise, Daniel

doi:10.1097/00000441-200506000-00009

Cited by 66 publications

(49 citation statements)

References 96 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…16 New treatment strategies are being tested to tackle this risk by reducing the specifi c factors leading to the metabolic syndrome. 17 Low-grade systemic infl ammation might represent one of the aetiologic factors behind the metabolic syndrome.…”

Section: Discussionmentioning

confidence: 99%

Periodontal disease might be associated even with impaired fasting glucose

et al. 2010

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Periodontal disease might be associated even with impaired fasting glucose

et al. 2010

View full text Add to dashboard Cite

“…In a post-hoc analysis of data from an observational study involving approximately 72,000 hypertensive patients across Germany, all of whom were overweight or obese, the risk factor profile was lower in patients treated with an AT1 receptor antagonist compared with diuretics [42]. These effects of RAS inhibitors, including effects unrelated to their ability to lower blood pressure, have resulted in the recommendation to initiate antihypertensive treatment with an ACE inhibitor in patients with the metabolic syndrome [43].…”

Section: Ang II and Obesity-hypertensionmentioning

confidence: 99%

Local adipose tissue renin-angiotensin system

Cassis

Yiannikouris²,

Thatcher

2008

Current Science Inc

193

148

View full text Add to dashboard Cite

A local renin-angiotensin system (RAS) has been proposed in adipocytes. Adipocytes are a suggested source of components of the RAS, with regulation of their production related to obesity-hypertension. Both angiotensin type 1 and 2 receptors have been localized to adipocytes. Angiotensin II has been demonstrated to regulate adipocyte growth and differentiation, lipid metabolism, and expression and release of adipokines and RAS components, and to promote oxidative stress. Differences in regional expression of RAS components in visceral versus subcutaneous adipose tissue have been suggested as a link between abdominal obesity and cardiovascular disease. Finally, several studies support antihypertensive efficacy of RAS blockade in patients with type 2 diabetes and obesity. Future studies should address the role of adipocyte-specific deficiency of RAS components to definitively determine the relevance of the adipose RAS to normal physiology and to the development of hypertension.

show abstract

“…Recently, adipocytokines have been suggested to mediate obesity-associated metabolic disorder and play an important role in MS. Adiponectin, one of the adipocytokines, which has been shown to have a close relationship with type2 diabetes mellitus and coronary artery disease in adults, 6,7 is now of great interest in relationship to the childhood MS. 8 Interventions are imperative but not widely studied. Metformin has shown promise in ameliorate the blood sugar and improving insulin sensitivity, and is the only drug approved by American Diabetes Association (ADA) that can be used in children over 10 years old with type 2 diabetes, 9 but it is not widely used in children with MS.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of the metabolic syndrome in Zhejiang Chinese obese children and adolescents and the effect of metformin combined with lifestyle intervention

Liang

Zou

et al. 2006

Int J Obes

View full text Add to dashboard Cite

Objective: We aimed to evaluate the prevalence of metabolic syndrome (MS) in a group of obese children and adolescents in Zhejiang in the south of China, and to compare risk factors such as insulin resistance, adiponectin level and impaired glucose tolerance (IGT) etc with that of simple obese group (SOB) and non-obese healthy group, and also to evaluate the effect of metformin and lifestyle intervention in MS group by up to a 3-month follow-up. Methods: Three hundred and forty eight moderately or severely obese adolescents aged between 7 and 16 years were enrolled. Oral glucose tolerance test (OGTT), biochemical indicators, blood pressure and body mass index (BMI) were assessed in all of them. Three subgroups were selected (MS group, SOB and healthy control). Adiponectin levels, Whole body insulin sensitive index (WBISI), homeostasis model of insulin resistance (HOMA-IR), plasma lipid and blood pressure were compared in these three groups. Thirty out of thirty-six MS subjects with age over 10 years received metformin treatment combined with lifestyle modification. Results: (1) The prevalence of MS was 10.34% among all obese subjects, which increased with the severity of obesity and reached 22.1% in severely obese children and adolescents. The occurrence of more than one complication reached 72.13%. The incidence of type 2 diabetes and IGT were 1.44 and 1.44% respectively. (2) BMI, waist-to-hip ratio (WHR) and HOMA-IR increased stepwise in the control group, SOB and MS group, whereas serum adiponectin and WBISI decreased stepwise (all Po0.01). Systolic pressure, triglyceride, total cholesterol, low-density lipoprotein cholesterol and postprandial 2-h blood glucose in the MS group increased significantly compared to those in control and SOBs (all Po0.01). A correlation analysis showed that serum levels of adiponectin and WBISI were associated with the components of MS (all Po0.05). (3) After metformin and lifestyle intervention, clinical symptoms were ameliorated, serum adiponectin levels were actually increased and HOMA-IR was dropped in 20/30 MS children who had finished a 3-months follow-up (all Po0.01). Conclusion: The prevalence of MS in severely obese children and adolescents in Zhejiang area has reached a high level. Insulin resistance and hypoadiponectinemia were found in these MS children. Metformin combined with lifestyle modification was confirmed to be efficient and safe in treating the obese adolescents with MS.

show abstract

Cited by 66 publications

References 96 publications

Periodontal disease might be associated even with impaired fasting glucose

Periodontal disease might be associated even with impaired fasting glucose

Local adipose tissue renin-angiotensin system

Prevalence of the metabolic syndrome in Zhejiang Chinese obese children and adolescents and the effect of metformin combined with lifestyle intervention

Contact Info

Product

Resources

About