Plasma Fibrinogen: A New Factor of the Metabolic Syndrome: A population-based study

Imperatore, G.; Riccardi, Gabriele; Iovine, C; Rivellese, Angela Albarosa; Vaccaro, Olga

doi:10.2337/diacare.21.4.649

Cited by 122 publications

(76 citation statements)

References 27 publications

(21 reference statements)

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“…76 Patients with insulin resistance frequently manifest several alterations in coagulation mechanisms that predispose them to arterial thrombosis. These alterations include increased fibrinogen levels, 79 increased plasminogen activator inhibitor-1, 80 and various platelet abnormalities. 81 …”

Section: Prothrombotic Statementioning

confidence: 99%

Diabetes and Cardiovascular Disease

Grundy¹,

Benjamin²,

Burke³

et al. 1999

Circulation

1,848

531

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Section: Prothrombotic Statementioning

confidence: 99%

Diabetes and Cardiovascular Disease

Grundy¹,

Benjamin²,

Burke³

et al. 1999

Circulation

1,848

531

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“…Some of these findings are in agreement with data reported by other investigators, although the latter did not focus exactly on subjects with the Metabolic Syndrome according to the WHO or the NCEP-ATPIII criteria. [28][29][30][31][32][33] Subjects with the Metabolic Syndrome also showed higher serum leptin levels in spite of having, on average, an excess of body fat. This finding is consistent with a state of leptin resistance.…”

Section: Discussionmentioning

confidence: 99%

Metabolic Syndrome: epidemiology and more extensive phenotypic description. Cross-sectional data from the Bruneck Study

et al. 2003

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OBJECTIVES:The present study aimed at evaluating the prevalence of the Metabolic Syndrome and at identifying its additional clinical features. RESEARCH DESIGN AND METHODS: Within a prospective population-based survey examining 888 subjects aged 40-79 y, subjects were identified fulfilling the WHO and the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) criteria for diagnosing the Metabolic Syndrome. In these subjects and in the rest of the sample (controls), several metabolic and nonmetabolic biochemical parameters were compared. RESULTS: The prevalence of the Metabolic Syndrome by WHO criteria was 34.1% (95% CI 31.0-37.2) and by NCEP-ATPIII criteria 17.8% (15.5-20.3). The prevalence was significantly higher in older subjects and in those less physically active. Subjects with the Metabolic Syndrome either by WHO or by NCEP-ATPIII criteria showed higher levels of oxidized low-density lipoprotein, apolipoprotein B, urate, leptin, fibrinogen, leukocytes, erythrocyte sedimentation rate, GOT, gamma-GT and soluble endothelial adhesion molecules (E-selectin, vascular adhesion molecule-1 and intercellular adhesion molecule-1) and lower apolipoprotein A concentrations. Insulin resistance, as assessed by the Homeostasis Model Assessment, increased with the increase in the number of traits composing the syndrome found within the single individual. Subjects with insulin resistance had more pronounced abnormalities in several parameters, including the additional features of the syndrome (eg fibrinogen and soluble adhesion molecules). CONCLUSIONS: The Metabolic Syndrome occurs very frequently in the general population aged 40-79 y, and is associated with several additional metabolic and nonmetabolic abnormalities that likely contribute to an increased cardiovascular risk. Insulin resistance seems to play a major role in classic and additional abnormalities featuring the Metabolic Syndrome.

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“…76 A consistent body of data about the pathogenetic role of systemic indices of 'low-grade inflammation' in co-morbidity is now available. 12,13,22,[77][78][79][80] However, at the present time, they were not considered for the MS diagnosis. Emerging data on elevated C-reactive protein in obese children 22,81 suggest it is an early candidate index, but efforts should be pursued to fill the pathophysiological gap uncovered by insulin resistance in the evolution of MS.…”

Section: Minor Concernsmentioning

confidence: 99%

Metabolic risk-factor clustering estimation in children: to draw a line across pediatric metabolic syndrome

et al. 2007

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Background: The diagnostic criteria of the metabolic syndrome (MS) have been applied in studies of obese adults to estimate the metabolic risk-associated with obesity, even though no general consensus exists concerning its definition and clinical value. We reviewed the current literature on the MS, focusing on those studies that used the MS diagnostic criteria to analyze children, and we observed extreme heterogeneity for the sets of variables and cutoff values chosen. Objectives: To discuss concerns regarding the use of the existing definition of the MS (as defined in adults) in children and adolescents, analyzing the scientific evidence needed to detect a clustering of cardiovascular risk-factors. Finally, we propose a new methodological approach for estimating metabolic risk-factor clustering in children and adolescents. Results: Major concerns were the lack of information on the background derived from a child's family and personal history; the lack of consensus on insulin levels, lipid parameters, markers of inflammation or steato-hepatitis; the lack of an additive relevant effect of the MS definition to obesity per se. We propose the adoption of 10 evidence-based items from which to quantify metabolic risk-factor clustering, collected in a multilevel Metabolic Individual Risk-factor And CLustering Estimation (MIRACLE) approach, and thus avoiding the use of the current MS term in children. Conclusion: Pediatricians should consider a novel and specific approach to assessing children/adolescents and should not simply derive or adapt definitions from adults. Evaluation of insulin and lipid levels should be included only when specific references for the relation of age, gender, pubertal status and ethnic origin to health risk become available. This new approach could be useful for improving the overall quality of patient evaluation and for optimizing the use of the limited resources available facing to the obesity epidemic.

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Plasma Fibrinogen: A New Factor of the Metabolic Syndrome: A population-based study

Abstract: The finding suggests that hyperfibrinogenemia may be considered a component of the metabolic syndrome. This may also explain the increased cardiovascular risk associated with hyperinsulinemia/insulin resistance.

Cited by 122 publications

References 27 publications

Diabetes and Cardiovascular Disease

Diabetes and Cardiovascular Disease

Metabolic Syndrome: epidemiology and more extensive phenotypic description. Cross-sectional data from the Bruneck Study

Metabolic risk-factor clustering estimation in children: to draw a line across pediatric metabolic syndrome

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