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Journal of Metabolic Syndrome

ISSN: 2167-0943

Open Access

Article in Press

Volume 9, Issue 2 (2020)

    Mini Review Pages: 1 - 3

    Diabetic Care with Coronavirus

    Amira Ragab El Barky*

    The spread of coronaviruses (COVID-19) universally resulted in many deaths and hospitalizations. It affects respiratory tract and causes fatal lung disease in humans. The pandemic virus can spread from patients carrying the virus through droplets, direct contact, aerosols, touching any surface contaminated surface; closed places may be a cause of spread also. All of the people are prone to have this pandemic virus, especially diabetic patients, as the increment of their blood glucose levels enhance glycosylation end-product formation, pro-inflammatory cytokines, oxidative stress and can activate the production of adhesion molecules that mediate tissue inflammation. Monitor blood glucose level is the main cause to avoid the complication of COVID-19. This review aims to discuss the relation between COVID-19 and diabetic patients and provides some solution to manage COVID-19 and diabetes.

    Review Article Pages: 1 - 3

    COVID-19 World Tour: Glucose fan-support

    Jake Van Wyk, Nick Banfield and Kelly Gibas*

    In this unprecedented period of quarantine, countless questions are purported about COVID-19. While the scientific community searches for answers, the rest of the world is desperately waiting for evidence-based methods of prevention. Yet, one method has been known in virology for decades; viral replication depends on a glucose environment in the host. In fact, pre-existing metabolic dysregulation cripples the immune system and increases susceptibility to pathogens. According to figures by the US Department of Health (30 March, 2020), diabetes, pre-diabetes, kidney disease and obesity mark the most dangerous comorbidities in COVID-19 deaths. Patients with chronic metabolic comorbidities including strokes, CHD/CVD, unregulated diabetes and hypertension comprise 95% of New York and 99% of Italy’s COVID-19 deaths Older adults and those with serious underlying medical conditions are at the highest risk for developing the most severe complications from the Coronavirus. Complications arising from comorbidities often have their deepest roots in poor nutrition. Reversing metabolic pathology to increase systemic immunity via reversal of glucose dependency and restoration of metabolic inflexibility has been well established in the literature. The lethal impact of COVID-19 and of future viral pathogens could be greatly diminished by stabilization of metabolic fuel flux through nutritional modifications, which are easily measured and tracked via reductions in the following inexpensive blood tests: HgA1c, HOMA-IR (Homeostatic Model Assessment of Insulin Resistance-fasting blood glucose/fasting insulin), triglycerides and the triglyceride/HDL ratio. Establishing self-efficacy through patient-centered biological education with implementation of bio-individualized lifestyle coaching holds great promise to slow the worldwide trajectory of underlying metabolic conditions associated with poor COVID-19 prognosis. This review examines the physiological mechanisms of metabolic flexibility, the importance of the nutritional status of the host in viral infection and the influence of glucose dependency on viral replication, namely COVID-19.

    Volume 9, Issue 1 (2020)

      Special Issue Pages: 1 - 1

      Aerobic Glycolysis Couples Metabolic Syndrome to Alzheimer Disease

      Delia Labatt

      Alzheimer Disease is a global epidemic; every 3 seconds someone in the world develops dementia. An estimated 50 million people are living with a disease that cannot be prevented, treated or cured. Without novel breakthroughs, AD is predicted to exceed 130 million by 2050. Pharmaceuticals offer minimal relief with dismal evidence of reversing neurodegeneration. Research focuses on β-amyloid plaques and tau tangles; but, in a clinical trial, medications designed to sop-up toxic proteins in the brain fail to impede neural decline. Instead, plaques and tangles appear to be late-arrivers in the insidious progression of dementia. The recent explosion of comorbid metabolic pathologies (global prevalence of T2DM estimated @ 463 million) invites researchers into a deeper discussion of bioenergetics regulating cognitive impairment and metabolic dysregulation. Age-related energy deficits, driven by peripheral insulin resistance, exacerbate Aβ/tau accumulation, increase oxidative stress and impede mitochondrial function; work by Sergi et al. and Mastroeni et al. suggest that mitochondrial dysfunction with epigenetic impairment in oxidative respiration appear to be the earliest offenders in the progression of T2DM and AD [1,2]. This case report highlights a novel, integrated intervention with a 69-year-old male dually diagnosed with T2DM and Mild Cognitive Impairment (MCI). Physiological biomarkers were measured pre/mid/post-intervention; the MoCA (Montreal Cognitive Assessment) measured cognitive function, pre/post. Statistically significant results were observed in the metabolic risk biomarkers, memory was restored to normal ranges, and the HbA1c normalized out of the diabetic range Furthermore, the metabolic and cognitive improvements were sustained @ 3 months postintervention. These promising results suggest that dietary ketogenesis restores peripheral insulin sensitivity, mitigates T2DM and improves cognition by circumventing neural starvation via the restoration of metabolic flexibility

      Lipid Metabolism & Obesity Research (2020)

        Special Issue Pages: 1 - 1

        Transdermal or Endogenous Testosterone in Men with Androgen Deficiency Syndrome and Diabetes Mellitus?

        Presiyana V. Nyagolova,

        Objective: To compare the effect of Transdermal Testosterone (TT) or Clomiphene Citrate (CC) administration on metabolic control, erectile function and quality of life in patients with T2DM.

         

        Materials and patients: The study population included 40 men with T2DM up to 60 years old, who were on metformin monotherapy at doses up to 2550 mg daily over the last three months. The patients had total testosterone values between 8 and 12 nmol/L and LH levels within the normal range. Other causes of hypogonadism were excluded. The patients were asked to answer the IIEF and the SF-36 surveys. BMI, WC, lipid profile, HbA1c, testosterone, SHBG, LH, FSH, PSA, and albuminuria were monitored at their initial visits, and on the 12th and the 24th weeks. 19 of the patients were treated with TT and 21 with CC.

         

        Results: Both groups corresponded in age, BMI, and HbA1c. Three-month administration of TT resulted in a significant increase of serum T and SHBG levels, and a reduction in BMI, HbA1c, WC, TC, TG, that extended to the 6 th month. In the group treated with CC the monitored parameters showed the same dynamics.

         

        In the group treated with TT we found significant improvement in all indicators of IIEF at the 3rd month. At the 6th month of and the overall satisfaction declined. In patients treated with CC it was found a significant improvement in all domains during the follow-up period, but without reaching statistical significance. We found significant improvement in physical and mental health and in quality of life at the 3rd month, that extended until the 6th month.

         

        onclusions: The on time initiation of treatment, that increases testosterone levels, is essential for the metabolic disorders, erectile dysfunction and quality of life. Trials of a longer duration are required to establish the benefits and risks of that therapy in patients with T2DM and Androgen Deficiency Syndrome.

        Special Issue Pages: 1 - 1

        Aerobic Glycolysis Couples Metabolic Syndrome to Dementia Disease

        Delia Labatt,

        Dementia Disease (DD) is a global epidemic; every 3 seconds someone in the world develops dementia. An estimated 50 million people are living with a disease that cannot be prevented, treated or cured. Without novel breakthroughs, AD is predicted to exceed 130 million by 2050. Pharmaceuticals offer minimal relief with dismal evidence of reversing neurodegeneration. Research focuses on β-amyloid plaques and tau tangles; but, in a clinical trial, medications designed to sop-up toxic proteins in the brain fail to impede neural decline. Instead, plaques and tangles appear to be late-arrivers in the insidious progression of dementia. The recent explosion of comorbid metabolic pathologies (global prevalence of T2DM estimated @ 463 million) invites researchers into a deeper discussion of bioenergetics regulating cognitive impairment and metabolic dysregulation. Age-related energy deficits, driven by peripheral insulin resistance, exacerbate Aβ/tau accumulation, increase oxidative stress and impede mitochondrial function; work by Sergi et al. and Mastroeni et al. suggest that mitochondrial dysfunction with epigenetic impairment in oxidative respiration appear to be the earliest offenders in the progression of T2DM and AD [1,2]. This case report highlights a novel, integrated intervention with a 69-year-old male dually diagnosed with T2DM and Mild Cognitive Impairment (MCI). Physiological biomarkers were measured pre/mid/post-intervention; the MoCA (Montreal Cognitive Assessment) measured cognitive function, pre/post. Statistically significant results were observed in the metabolic risk biomarkers, memory was restored to normal ranges, and the HbA1c normalized out of the diabetic range Furthermore, the metabolic and cognitive improvements were sustained @ 3 months postintervention. These promising results suggest that dietary ketogenesis restores peripheral insulin sensitivity, mitigates T2DM and improves cognition by circumventing neural starvation via the restoration of metabolic flexibility

        Special Issue Pages: 1 - 1

        Metabolic Syndrome after Toxaemian: A Cohort Study with a Mean Follow Up of 14 Years

        Ana Ciléia Pinto Teixeira Henriques,

        Objective: To investigate the occurrence and characterization of metabolic syndrome (MetS) in the long term after pregnancies with Toxaemian. Design: Retrospective cohort study. Setting: Assis Chateaubriand Maternity Teaching Hospital - Federal University of Ceará, Fortaleza, Ceará, Brazil. Sample: 68 patients who gave birth between 1992 and 2002 at the Maternity, 34 patients with a history of Toxaemian and 34 with no history of obstetric complications.

         

        Methods: Blood pressure and body compositional indices were recorded. Fasting blood samples were tested for glucose, total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol and triglycerides. A questionnaire was used to collect demographic data including family history of diseases associated with cardiovascular diseases. Criteria for metabolic syndrome were defined by International Diabetes Federation 2005 (IDF). Main outcome measures: Occurrence and characterization of MetS.

         

        Results: There were 18 (52.9%) diagnoses of MetS in the group of women without a history of obstetric complications and 28 (82.3%) in the group of women with a history of Toxaemian, p=0.01 with a RR of 4.1 (CI 95% 1.4 - 12.2, p=0.009). The number of components to characterize MetS were, respectively, 2.7 ( ± 1.3) and 3.3 ( ± 1.3), p=0.05.

         

         

         

         

        Conclusions: Women with a history of Toxaemian have a higher prevalence of MetS 14 years after gestation.

        Editor Note Pages: 1 - 1

        Journal of Metabolic Syndrome

        Metabolic Syndrome

        Editorial Note| Journal of Metabolic Syndrome

        ISSN: 2167-0943

        About the Journa

        The Journal of Metabolic Syndrome (JMS) is an Open Access peer-reviewed journal that publishes original research works in the areas related to the field such as increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels that occur together, increasing your risk of heart disease, stroke and diabetes. Most of the disorders associated with metabolic syndrome have no symptoms, although a large waist circumference is a visible sign. If your blood sugar is very high, you might experience signs and symptoms of diabetes including increased thirst and urination, fatigue, and blurred vision.

        Journal of Metabolic Syndrome (JMS) is a scholarly publishing journal that aims to publish the most complete and reliable source of information on the discoveries and current developments in the form of original articles, review articles, case reports, short communications, etc. in all areas of the field and making them freely available through online without any restrictions or any other subscriptions to researchers worldwide.

        The journal is using Editorial Manager System for quality in peer review process. Editorial Manager is an online manuscript submission, review and tracking systems. Review processing is performed by the editorial board members of  Metabolic Syndrome or outside experts; at least two independent reviewer’s approval followed by the editor is required for the acceptance of any citable manuscript. Authors may submit manuscripts and track their progress through the system, hopefully to publication. Reviewers can download manuscripts and submit their opinions to the editor. Editors can manage the whole submission/review/revise/publish process.

        Why Special Issue

        This special issue has been introduced to recognize those researchers who are with us from the starting of the Conference and kept their believewith us regarding the quality of the conference and the publication. Their continuous support make the Conference as well as the supporting journal to the conference successful and recognized by the international experts. Here in honor to those supporters, those speakers, those submitters, those researchers we are releasing the special issue with the abstracts accepted for the conference, full length articles submitted to the conference and with the short communication submitted to the conference.

        Special Issue Pages: 1 - 1

        The Endothelial Cell Secretome as a Factor of Endothelium Reparation: The Role of Smoll particles

        Alexander E Berezin

        secretome is considered a combination of factors produced by cells due to abundant spectrum of autocrine/ paracrine triggers. All these actively synthetizing and secreting factors include proteins, adhesion and intercellular signal molecules, peptides, lipids, free DNAs, microRNAs, and microparticles (MPs). The components of secretome mutually may interact and thereby modify the MPs’ structure and functionality. As a result, communicative ability of endothelial cell-derived MPs may sufficiently impaire. Subsequently, cross talk between some components of secretome might modulate delivering cargos of MPs and their regenerative and proliferative capabilities via intercellular signaling networks. The aim of the review is to discuss the effect of various components of secretome on MP-dependent effects on endothelium.

        Нe variable spectrum of paracrine factors secreted by cells due to specific and non-specific triggers with exerted biological eects on target cells is determined by secretome. By now, the secretome is considered a collection of factors consisting of transmembrane proteins and other components actively secreted by cells into the extracellular space. All these synthetizing and secreting factors include proteins, adhesion and intercellular signal molecules, peptides, lipids, free DNAs, microRNAs, and extracellular vesicles (i.e., exosomes and MPs). A significant portion (roughly 20%) of the human secretome consists of secretory proteins incorporated into microvesicles.

        Special Issue Pages: 1 - 1

        Readiness of Primary Health Care Facilities in Jimma Zone to Provide Diabetic Services for Diabetic Clients, Jimma Zone, South West Ethiopia

        Elias Teferi,

        Background: Diabetes is one of the commonest non-communicable diseases of the 21st century. Global burden of diabetes in 2010 was estimated at 285 million and projected to increase to 438 million by the year 2030, if no interventions are put in place. The primary health care facilities are the first level of contact for such rising cases of diabetes, despite of this fact there is no study done on the capabilities of primary health care facilities to accommodate diabetic services. Hence, the objective of this study is to assess the readiness of selected primary public hospitals and health centers to accommodate diabetic care in Jimma zone south west Ethiopia.

         

        Methods: Health facility based cross-sectional study design using quantitative and qualitative method of data collection was conducted from Feb 1-March 1, 2013. After checking the completeness, and coding of questionnaires, the quantitative data were entered into computer software and analyzed using SPSS version 20.0.

         

        Results: All of the facilities have at least some of the drugs and medical supplies and other resources required for the diagnosis and management of diabetes never the less there was no specific plan to deal with diabetic management at health facilities. Majority of patients were first diagnosed in other health facilities and referred to the current health institutions for follow up and there is no routine screening for diabetics in adult outpatient department in some health facilities

         

        Conclusion and recommendation: Required drugs and medical supplies are not regularly fulfilled, health facilities have no plan for diabetic management, and health workers did not get training on management of diabetics. No routine screening at adult patients at outpatient departments. Hence the Woreda and the zone have to work on the capacity of the health workers and health facilities to handle diabetic care at health center level.

        Cardiovascular Risks Associated with Metabolic syndrome (2020)

          Extended Abstract Pages: 0 - 1

          TARGET ORGAN DAMAGE AND CARDIOVASCULAR COMPLICATIONS OF HYPERTENSION IN LOW RESOURCE SETTING

          Basden J C Onwubere

          The previous one century has seen exceptional changes in the commonness and clinical results of hypertension internationally yet remarkably in Africa and creating economies by and large. This paper audits the current image of target organ harm and cardiovascular confusions in Africa utilizing accessible writing just as meta-examinations. Critical perceptions show that around 66% of people with hypertension overall live in non-industrial nations. Projections for 2025 see an expansion in this extent to 75 percent. Low mindfulness levels, late introduction, and low treatment and control levels add to the higher predominance of target organ harm and other cardiovascular entanglements in hypertensive subjects in Africa. Coordinated endeavors are prescribed to battle this scourge in Africa and other non-industrial nations all around the world. Hypertension is frequently asymptomatic and recording pulse is shrewd. A significant number of these patients are ignorant of their condition and consequently, stay untreated. Untreated or ineffectively controlled hypertension and left ventricular hypertrophy (LVH) are hazard factors for cardiovascular sicknesses (CVD), a significant reason for grimness and mortality, and abrupt demise. The absence of familiarity with the infection brings about more awful results. Various hypertensive may introduce unexpectedly with target-organ harm (TOD) including different organs. Hence at starting determination, they as of now have a hypertensive coronary illness (HHD); some with LVH, while some have a straightforward congestive cardiovascular breakdown (CHF). CHF is a deadly sickness with a helpless guess and decreased future. It forces huge wellbeing, financial, and social weight on the patient, his/her family, and the network everywhere, and it for the most part influences guys and females in their gainful center years. Significant TOD of hypertension, for example, LVH, diastolic brokenness, CHF, ischaemic coronary illness (IHD), stroke, and renal disappointment have been archived by different laborers in Nigeria and these were generally emergency clinic-based investigations. Post-mortem examination contemplates affirmed that the commonest reason for abrupt, unforeseen demise in Nigerians is hypertension. In Nigeria, little is thought about the encounters of guardians and care-chasing rehearses concerning hypertension and components affecting late introduction with TOD. A portion of the undiscovered hypertensive is distinguished unexpectedly throughout the board for other clinical conditions or during calamitous occasions. The test to the doctor along these lines is early identification and treatment of hypertension before movement 

          Extended Abstract Pages: 1 - 2

          CXCR4-stem cell therapy in old myocardial infarction

          Jose Luis Aceves

          For cell therapy on myocardial infarction, many kinds of cells have been studied. In our experience since 2001, the implant of mesenchyme stem cells CD34+ obtained from peripheral blood showed inconsistent improvement in the contractile function of infarcted myocardial tissue, but better survival in long term. For improved cell therapy, in 2014 we characterized the kind of cells that were mobilized to peripheral blood in patients with acute myocardial infarction, which were identified as a response of bone marrow to myocardial insult. In 2015, we began a clinical trial with CXCR4-stem cells and specific cell markers in patients with old myocardial infarction and reduced LVFE. Cells with specific markers were separated with immune-magnetic auto MACS Pro Separator machine and implanted on infarcted myocardial tissue guided by epicardial ultrasound.

           

          Extended Abstract Pages: 2 - 3

          Extent: a completely new method of treatment of patients with Marfan syndrome

          Jan Pirk

          Marfan syndrome is the most common genetic disorder of connective tissue. One complication that threatens the lives of patients is progressive dilatation of the ascending aorta with the development of aortic valve regurgitation or the emergence of dissection, often leading to sudden death. Until now, these patients were operated on only after dilatation of the ascending aorta causing hemodynamically significant regurgitation of the aortic valve. The surgery consisted of the replacement of the ascending aorta and aortic valve or valve-sparing procedure. This new method is a preventive operation. The method involves creating a custom made external support of the root and the ascending portion of the aorta. Based on the CT examination, a prosthesis Extent is created. The surgery is performed from the longitudinal median sternotomy without cardiopulmonary bypass. The entire aortic root is dissected to its origin from the left ventricle, Ostia of the coronary arteries are encircled, the prosthesis is pulled underneath and fixed to the root and then sutured longitudinally. It is interesting that the prosthesis was developed and as the world’s first have it sewn on himself (Mr. Tal Golesworthy), 13 years ago in Oxford. Neither he nor the other 100 patients operated in this department with this disease had dilation or dissection throughout the study. It is because the prosthesis grows over time into the aortic wall thereby enforces it while maintaining the elastic properties of the wall. At our institute, we have so far experience with operations of 20 patients, with good results. This operation moves the care of patients with Marfan syndrome to a qualitatively higher level.

          Extended Abstract Pages: 3 - 4

          The utility of genetic testing in cardiac arrhythmias

          Bijal Vyas Bhatia

          Introduction: The common life-threatening cardiac arrhythmias, Long QT (LQTS type 1-13) and Brugada (BrS type 1-12) present with syncope/palpitations/ seizures/aborted cardiac arrest. They have incomplete penetrance and variable expressivity. The three common genes (KCNQ1, KCNH2, and SCN5A) account for 75% of all LQTS cases and the SCN5A gene in BrS accounts for 25% of all cases.

          Aim: To identify the causative variation in the associated genes responsible for causing cardiac channelopathies in Indian patients.

          Materials & Methods: Hundred patients who fulfilled the inclusion criteria of the study were enrolled. Mutation analysis was performed in the most probable candidate gene by direct sequencing using primers flanking exon-intron boundaries. If a mutation was not identified, NGS was performed to identify mutations in other cardiac genes in patients. Parents and siblings were screened if a mutation was identified in the proband. Novel mutations were evaluated for pathogenicity using ACMG guidelines, bioinformatics, and molecular modeling software.

          Results: Mutations were identified in 23 of 100 (23%) patients by Sanger sequencing, 20 had LQTS, and 3 had BrS. Among the LQT syndromes, mutations were identified in 17 in KCNQ1 (LQTS1), one in KCNH2 (LQTS2), and two in SCN5A (LQTS3). Among the LQTS1 patients, ten were identified with biallelic mutations. The three BrS patients had mutations in SCN5A (BrS1). Ten of 23 mutations were novel. NGS identified mutation in 22 (49%) of 45 patients negative for mutations by Sanger and with significant family history and/or strong clinical indication. Of which, 20 had LQTS and two had BrS. Out of these 46 mutations, 18 were novel. Cascade screening identified mutations in two symptomatic and forty asymptomatic family members. Genetic counseling was provided to the proband and family members.

          Conclusion: Genotyping is important for confirming the type of LQTS/BrS, which has implications for management, cascade screening, and risk assessment.

          Extended Abstract Pages: 4 - 5

          Desialylated Atherogenic Low-Density Lipoprotein in Atherosclerosis

          Alexander N. Orekhov

          Pathogenesis of atherosclerosis and the search for novel therapies and diagnostic markers remain major problems of modern medicine. Currently available therapeutic approaches are often not sufficiently effective, probably due to the complexity of the disease mechanisms. This review focuses on the evaluation of low-density lipoprotein (LDL) as risk factor for atherosclerosis. We summarize the current paradigm of LDL involvement in atherogenesis. We question the currently widely accepted hypothesis of the central role of oxidized LDL in atherogenesis and present an alternative concept of multiple modifications of LDL that confers its pro-atherogenic properties. According to a series of studies conducted with blood serum and LDL from atherosclerotic patients, desialylation is one of the earliest if not the first atherogenic modification of LDL. Desialylation occurs in the bloodstream and is followed by a cascade of other modifications, including the reduction of LDL particle size and increase of its density, acquisition of negative electrical charge, oxidation, and formation of highly atherogenic complexes.

          Extended Abstract Pages: 5 - 6

          Antioxidative effects of complementary therapy with Salvia miltiorrhiza in ischemic heart disease

          Yu-Chiang Hung

          Background: Salvia miltiorrhiza (SM) is a Chinese herb widely used for ischemic heart diseases (IHD), yet little is known about the cellular mechanisms. The aims of this study were to investigate the mechanisms of SM.

          Methods: The rat A10 cells line, a vascular smooth muscle cells line isolated from rat thoracic embryonic aorta was as a study model. The SM roots aqueous extract, MTT assay, cytotoxicity assay, two-dimensional electrophoresis coupled with MALDI-TOF mass spectrometry, western blot analysis, and biological network analysis were applied for the elucidation of protein changes characterizing the response of the rat A10 cells into the homocysteine(Hcy) -induced oxidative stress.

          Results: Our study showed that a low dose (0.015 mg/mL) of the SM significantly inhibited growth (>60%, p < 0.05) of the Hcy stimulated rat A10 cells. In addition, the concentration of intracellular reactive oxygen species obviously decreased in the rat A10 cells after its incubation with SM in terms of catalase increasing activity. Next, marked down-regulation of protein kinase C beta-1 and phosphorylated mitogen-activated protein kinase expression suggest that the observed inhibitory effect of the SM on the Hcy-induced growth of rat A10 cells was realized via the PKC/p44/42 MAPK- dependent pathway. The intensity changes of 10 protein spots in the response of the rat A10 cells to the Hcy-induced oxidative damage as alpha-4-tropomyosin, vimentin, F1F0- ATP synthase (beta subunit), glucose-regulated protein 75, actin (fragment), prohibitin, capping protein, plakoglobin, an endoplasmic reticulum protein 29, and peptidylprolyl isomerase A, were detected with statistical significance (p < 0.05). Meanwhile, it was shown that used here SM resists carbonylation of vimentin, alpha-4-tropomyosin, and GRP75, respectively, leading to phenotype transformations in the rat A10 cells.

          Conclusion: These data suggest that SM may exert its protective effect in IHD through circulating ROS suppression and subsequent modulation of protein carbonylation in rat aortic smooth muscle cells.

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