Introduction: There is epidemiological evidence indicating that the metabolic syndrome increases the risk of colorectal cancer. Since there is little information about this issue in Iran, the present study was conducted to evaluate prevalence of metabolic syndrome and its components in patients with colorectal cancer. Material and Methods: This cross-sectional survey involved 200 patients with a new diagnosis of colorectal cancer. Demographic information of patients was collected through the interview with them. Components of metabolic syndrome including fasting glucose serum, triglyceride, high density lipoprotein, blood pressure and waist circumference were measured for all of the patients. Results: A total of 72 colorectal cancer patients (36%) met metabolic syndrome criteria with rates of 76% for women and 24% for men. BMI in metabolic syndrome patients was higher than other colorectal cancer patients. Disease history including hypertension, diabetes and cardiovascular disease was most frequent in metabolic syndrome patients. Pathological characteristics of colorectal cancer were not significantly associated with the disease. Conclusion: The findings of present study indicated that the prevalence of metabolic syndrome in CRC patients is relatively high. Therefore, further analytical and multi centric studies are needed to better understand the role of metabolic syndrome in development of CRC in Iran. If this association is confirmed in future studies, metabolic syndrome patients should be considered in CRC screening programs.
Background: The aim of this study was to explore the prognostic role of metabolic response to chemotherapy, determined by FDG-PET, in patients with metastatic non-small-cell lung cancer (NSCLC). Materials and Methods: Thirty patients with metastatic NSCLC were analyzed for prognostic factors related to overall survival (OS) and progression free survival (PFS). Disease evaluation was conducted with FDG-PET/CT and contrast-enhanced CT prior to and at the end of first-line chemotherapy. Response evaluation of 19 of 30 patients was also performed after 2-3 cycles of chemotherapy. Morphological and metabolic responses were assessed according to RECIST and PERCIST, respectively. Results: The median OS and PFS were 11 months and 6.2 months, respectively. At the end of first-line chemotherapy, 10 patients achieved metabolic and anatomic responses. Of the 19 patients who had an interim response analysis after 2-3 cycles of chemotherapy, 3 achieved an anatomic response, while 9 achieved a metabolic response. In univariate analyses, favorable prognostic factors for OS were number of cycles of first-line chemotherapy, and achieving a response to chemotherapy at completion of therapy according to the PERCIST and RECIST. The OS of patients with a metabolic response after 2-3 cycles of chemotherapy was also significantly extended. Anatomic response at interim analysis did not predict OS, probably due to few patients with anatomic response. In multivariate analyses, metabolic response after completion of therapy was an independent prognostic factor for OS. Conclusions: Metabolic response is at least as effective as anatomic response in predicting survival. Metabolic response may be an earlier predictive factor for treatment response and OS in NSCLC patients.
Background: Metabolic syndrome (MetS) is a multifactorial disease characterized by impaired glucose tolerance/diabetes, obesity, high triglyceride levels, low HDL levels, and hypertension. In this study we evaluate the relationship between tumor size and grade, and presence of the metabolic syndrome in patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, radical nephrectomy was performed for 310 patients with renal tumors in our clinic and those with pathology reported renal cell carcinoma were enrolled and divided into two groups, with and without metabolic syndrome diagnosed on the basis of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. The relationship between tumor size and grade of the two groups (Fuhrman nuclear degree) was evaluated statistically. Results: The metabolic syndrome was found in 70 patients, with a mean age of 65.5 (40-87), as compared to 58.8 (31-84) years in the non-metabolic syndrome group. Tumor size over 7 cm was found in 54% and 33%, respectively, and tumor grade over Fuhrman 3 in 56% and 32% of patients. Patients with metabolic syndrome had significantly higher tumor size and grade (p<0.05). In the presence of hypertension, diabetes and high triglyceride levels, significant assocations were again observed (p<0.05). Tumor size and degree also increased with increasing body mass index but this was not statistically significant (p>0.05). Conclusions: Renal cancer is more aggressive in patients with metabolic syndrome. Lifestyle and risk factors were revealed to be significant influences in renal cancer patients.
Bariatric surgery has evolved from a surgical measure for treating morbid obesity to an epochal remedy for treating metabolic syndrome as a whole, which is represented by type 2 diabetes mellitus. Numerous clinical trials have advocated bariatric or metabolic surgery over nonsurgical interventions because of markedly superior metabolic outcomes in morbidly obese patients who satisfy traditional criteria for bariatric surgery (body mass index [BMI] >$35kg/m^2$) and in less obese or simply overweight patients. Nevertheless, not all diabetes patients achieve the most desirable outcomes; i.e., diabetes remission after metabolic surgery. Thus, candidates for metabolic surgery should be carefully selected based on comprehensive preoperative assessments of the risk-benefit ratio. Predictors for diabetes remission after metabolic surgery may be classified into two groups based on mechanism of action. The first is indices for preserved pancreatic beta-cell function, including younger age, shorter duration of diabetes, and higher C-peptide level. The second is the potential for an insulin resistance reduction, including higher baseline BMI and visceral fat area. Several prediction models for diabetes remission have been suggested by merging these two to guide the joint decision-making process between clinicians and patients. Three such models, DiaRem, ABCD, and individualized metabolic surgery scores, provide an intuitive scoring system and have been validated in an independent external cohort and can be utilized in routine clinical practice. These prediction models need further validation in various ethnicities to ensure universal applicability.
Purpose: This study examined the validity and reliability to develop a lifestyle evaluation tool for metabolic syndrome patients. Methods: A methodological research design was used. The construct factors and preliminary items were identified by reviewing previous researches and tools related to lifestyle and reviewed by ten experts. It was tested with 195 patients with metabolic syndrome in a university hospital. The data were analyzed with SPSS/WIN 14.0. Results: To test the validity, principal component analyses were used and resulted in the extraction of six components. The convergent validity resulted r= .72 (p<.001) with Health Promotion Lifestyle Profile. The discriminant validity with Center for Epidemiologic Studies Depression Scale resulted r= -.15 (p=.004). The Internal consistency of the tool had an Cronbach's a of .92. The self-report format Lifestyle Evaluation Tool for the patients with metabolic syndrome was developed with 36 items and four-rating scales:'physical activity and weight control' eight items, 'dietary habits' sixteen items, 'drinking and smoking' three items, 'sleep and rest' two items, 'stress' three items, 'drug and health management' four items. Conclusion: This Tool will evaluate health behaviors in patients with metabolic syndrome. Also, it will contribute to the development of nursing intervention to improve the metabolic syndrome patients' lifestyle.
The purpose of this study is to investigate the relation between brachial-ankle pulse wave velocity and the features of metabolic syndrome, and differences according to sex in patients diagnosed cerebral infarction. The study group comprised 61 patients over age 30 who were diagnosed cerebral infarction, accompanied with metabolic syndrome. The brachial-ankle pulse wave velocity, blood pressure, lipid profiles, fasting blood glucose, body mass index were measured. Also we checked past history of patients. Then we analyzed the association between brachial-ankle pulse wave velocity and the features of metabolic syndrome. Pearson correlation analysis reflected the variables affecting the brachial-ankle pulse wave velocity as follows : Age, SBP(systolic blood pressure), DBP(diastolic blood pressure), FBS(fasting blood glucose) were positively correlated. As a result of regression analysis, in patients with cerebral infarction accompanied with metabolic syndrome, the brachial-ankle pulse wave velocity is affected by age to men, SBP, FBS, DBP to women. The brachial-ankle pulse wave velocity is not affected by the components of metabolic syndrome, except blood pressure, FBS, in patients with ischemic stroke.
Purpose : The purpose of this study is to verify the effectiveness of combined marine healing programs by analyzing the physical composition of elderly musculoskeletal and metabolic patients, the risk factors of metabolic syndrome and the effects of the inflammatory factors, the C -reactive protein (CRP). Methods : Individuals with musculoskeletal and metabolic diseases were identified, and marine healing programs were conducted for f our hours each day for two weeks with 11 elderly participants. A one-way RM ANOVA was conducted to determine the differences due to treatment with composite marine healing systems. The results are as follows. Results : After a two-week ocean healing program, weight decreased the most, while BMI also decreased and muscle mass increased. Waist circumference, a risk factor for metabolic syndrome and CRP, decreased, and CRP demonstrated a decreasing trend. Conclusion : The above results show that the two-week marine healing program has a positive effect on the body composition and inflammatory factors of elderly musculoskeletal and metabolic patients.
Background: Triphasic waves are one of the electroencephalographic patterns that can be usually seen in metabolic encephalopathy. The aim of this study is to compare the clinical and electrophysiologic profiles between patients with and without triphasic waves in metabolic encephalopathy, and reassess the significance of triphasic waves in metabolic encephalopathy. Methods: We recruited 127 patients with metabolic encephalopathy, who were admitted to our hospital. We divided these admitted patients into two groups; those with and without triphasic waves. We analyzed the difference of duration of hospitalization, mortality rate during admission, Glasgow Coma Scale, severity of electroencephalographic alteration, and presence of acute symptomatic seizures between these two groups. Results: Of the 127 patients with metabolic encephalopathy, we excluded 67 patients who did not have EEG, and 60 patients finally met the inclusion criteria for this study. Patients with triphasic waves had more severe electroencephalographic alterations, lower Glasgow Coma Scale, and more acute symptomatic seizures than those without triphasic waves. After adjusting the clinical variables, Glasgow Coma Scale and acute symptomatic seizures were only significantly different between patients with and without triphasic waves. Conclusions: We demonstrated that patients with triphasic waves in metabolic encephalopathy had more significant impairment of the brain function.
Glucagon regulates glucose and fat metabolism as well as being involved in the production of ketone bodies. The new antidiabetic drug, a sodium-glucose co-transporter-2 inhibitor, increases glucagon, and reduces the risk of cardiovascular death and hospitalization due to heart failure. The presence of metabolic syndrome is an important risk factor for cardiovascular diseases(CVD) in type 2 diabetes(T2DM) patients. We, thus, investigated the association between glucagon levels and metabolic syndrome in T2DM patients. This cross-sectional study involved 317 T2DM patients. Fasting and postprandial (30 min after ingestion of a standard mixed meal) glucagon levels were measured. Metabolic syndrome was defined according to the criteria of the International Diabetes Federation. A multiple regression logistic analysis was employed for statistical evaluation. A total of 219 (69%) subjects had metabolic syndrome. The fasting and postprandial glucagon levels did not differ between the group with metabolic syndrome and the group without. Postprandial glucagon levels increased significantly with the increase in the number of metabolic syndrome components, but the fasting levels did not. However, a hierarchical logistic regression analysis revealed that the postprandial glucagon levels did not contribute significantly to metabolic syndrome even after adjusting for other covariates. Fasting and postprandial glucagon levels are not associated with metabolic syndrome in T2DM patients. However, further studies are needed to investigate the relationship between glucagon and cardiovascular risk in patients with T2DM.
Purpose: Infantile hypertrophic pyloric stenosis (IHPS) is a common gastrointestinal disease in neonates and hypochloremia metabolic alkalosis is a typical laboratory finding in affected patients. This study aimed to analyze the clinical characteristics of infants with IHPS and evaluate the association of clinical and laboratory parameters with ultrasonographic findings. Methods: Infants diagnosed with IHPS between January 2017 and July 2022 were retrospectively evaluated. Results: A total of 67 patients were included in the study. The mean age at diagnosis was 40.5±19.59 days, and the mean symptom duration was 11.97±9.91 days. The mean pyloric muscle thickness and pyloric canal length were 4.87±1.05 mm and 19.6±3.46 mm, respectively. Hyponatremia and metabolic alkalosis were observed in five (7.5%) and 36 (53.7%) patients, respectively. Serum sodium (p=0.011), potassium (p=0.023), and chloride levels (p=0.015) were significantly lower in patients with high bicarbonate levels (≥30 mmol/L). Furthermore, pyloric canal length was significantly higher in patients with high bicarbonate levels (p=0.015). To assess metabolic alkalosis in IHPS patients, the area under the receiver operating characteristic curve of pyloric canal length was 0.910 and the optimal cutoff value of the pyloric canal length was 23.5 mm. Conclusion: We found a close association between laboratory and ultrasonographic findings of IHPS. Clinicians should give special consideration to patients with pyloric lengths exceeding 23.5 mm and appropriate fluid rehydration should be given to these patients.
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