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Clinical Management and Challenges in Metabolic Syndrome
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Clinical Management and Challenges in Metabolic Syndrome

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (10 October 2022) | Viewed by 5726

Special Issue Editor

Dr. Giorgio Radetti

E-Mail Website
Guest Editor
Marienklinik, via Claudia de' medici, 2 39100 Bolzano Italy
Interests: thyroid; growth hormone; obesity; bone disorders

Special Issue Information

Dear Colleagues,

Following the pandemic rise of obesity, a significant increase has been observed in the prevalence of metabolic syndrome (MetS), which represents a strong risk factor for atherosclerotic cardiovascular disease and type 2 diabetes mellitus (T2DM). However, the risk of developing MetS is not limited to the obese population, as it can be present in a significant percentage of normal-weighted individuals. There are several problems in the management of MetS that must be addressed. First, as far as the obese population is concerned, it should be clarified at which level should we start the investigations aimed at identifying the presence of primary or secondary metabolic/endocrine changes. This is very important in order to balance the high costs and the inconvenience to patients undergoing these investigations with the need to promptly detect the level of obesity triggering the development of MetS. Therefore simple tools such as clinical or biochemical parameters should be identified, which would suggest the need for the investigations. Recently a consensus has been reached on new criteria for the definition of high blood pressure. Should the old criteria should be replaced when defining MetS? Furthermore, what is the role of non-traditional cardiovascular risk factors in the definition of MetS? Another point is whether adolescents with MetS, resistant to the classical changes in lifestyle, should be offered bariatric surgery similar to adults, since long-term follow-ups are lacking. Finally, should the approach to patients with genetic obesity be similar to that employed with the “normal” obese populations, or should we survey them more intensively?

All these are problems and doubts that must be solved in the near future.

Dr. Giorgio Radetti
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Related Special Issue

Published Papers (4 papers)

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Research

9 pages, 608 KiB  
Article
Vitamin D Status and Steatohepatitis in Obese Diabetic and Non-Diabetic Patients
by Laura Taban, Dana Stoian, Bogdan Timar, Daniela Amzar, Calin Adela, Alexandru Motofelea, Andreea Borlea, Romain Frisoni and Nadege Laguerre
J. Clin. Med. 2022, 11(18), 5482; https://doi.org/10.3390/jcm11185482 - 18 Sep 2022
Viewed by 1599
Abstract
Background and Aims: The presence of steatohepatitis in obese patients can be multifactorial. The current study tries to determine the differences between diabetic and non-diabetic patients regarding the presence of steatohepatitis. We evaluated sequential liver samples and collected the times of bariatric surgery [...] Read more.
Background and Aims: The presence of steatohepatitis in obese patients can be multifactorial. The current study tries to determine the differences between diabetic and non-diabetic patients regarding the presence of steatohepatitis. We evaluated sequential liver samples and collected the times of bariatric surgery to assess the presence of NASH in patients with obesity, in the circuit of bariatric surgery. Methods: We performed a retrospective study of 49 patients presenting high-grade obesity in the circuit of bariatric surgery, with liver biopsy. The patients underwent bariatric surgery at a single center in France and were followed for 2 years. The liver biopsies were performed intraoperatively on all 49 patients before the bariatric surgery. The primary endpoint of the study was to evaluate the relationships between steatohepatitis/liver fibrosis and the presence of diabetes and to evaluate the current relationships between the biochemical work-ups. Special importance was accorded to the correlations between vitamin D levels and the presence of hepatic steatosis, due to the antifibrogenic pattern in the liver, as shown in many important papers in the field. Results: Significant correlations were found between the presence of liver fibrosis and the presence of diabetes (p = 0.022), but not regarding the antidiabetic treatment. An important correlation was found between the vitamin D levels and the presence of liver fibrosis, as well as with the levels of A1C hemoglobin and LDL cholesterol levels. Conclusions: Vitamin D deficiency presents a strong correlation with hepatic steatosis in individuals with morbid obesity. Correcting vitamin D deficiency may present a beneficial role in treating hepatic steatosis, diabetes, and cardiovascular risk in patients with morbid obesity. Full article
(This article belongs to the Special Issue Clinical Management and Challenges in Metabolic Syndrome)
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12 pages, 1195 KiB  
Article
High Tg/HDL-Cholesterol Ratio Highlights a Higher Risk of Metabolic Syndrome in Children and Adolescents with Severe Obesity
by Giorgio Radetti, Graziano Grugni, Fiorenzo Lupi, Antonio Fanolla, Diana Caroli, Adele Bondesan and Alessandro Sartorio
J. Clin. Med. 2022, 11(15), 4488; https://doi.org/10.3390/jcm11154488 - 1 Aug 2022
Cited by 3 | Viewed by 1845
Abstract
Few data are currently available on the reliability of the different anthropometric, instrumental and biochemical indexes in recognizing the presence of metabolic syndrome (MetS) in children and adolescents with severe obesity. Therefore, the objective of our study was to find out the simplest [...] Read more.
Few data are currently available on the reliability of the different anthropometric, instrumental and biochemical indexes in recognizing the presence of metabolic syndrome (MetS) in children and adolescents with severe obesity. Therefore, the objective of our study was to find out the simplest and most accurate predictive index of MetS in this population at-risk. In 1065 children and adolescents (563 f, 502 m), aged 14.6 ± 2.1 years (range 10–17), with severe obesity [BMI-SDS 3.50 ± 0.36 (range 3.00–5.17)], the following indexes were evaluated: BMI, BMI-SDS, Tri-Ponderal Mass Index, Waist-to-Height ratio, TG/HDL-Cholesterol ratio, Cardiometabolic Index (CMI), and Visceral Adiposity Index (VAI). For each subject, all the components of MetS, defined according to the IDF criteria, were determined. Overall, the presence of MetS was found in 324 patients (30.4%), 167 males (33.3%) and 157 females (27.9%). According to the ROC analysis, three indexes (VAI, CMI and TG/HDL-Cholesterol ratio), performed significantly better than the other ones in identifying MetS, with no difference among them. In conclusion, the TG/HDL ratio, which just needs the evaluation of two simple biochemical parameters, offers the same accuracy as other more sophisticated indexes in recognizing MetS in children and adolescents with severe obesity, thus making it the best predictor to be easily used. Full article
(This article belongs to the Special Issue Clinical Management and Challenges in Metabolic Syndrome)
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9 pages, 1279 KiB  
Article
Status and Risk of Noncompliance of Adherence to Medications for Metabolic Diseases According to Occupational Characteristics
by Heeyun Kim, Wanhyung Lee and Jung-Wan Koo
J. Clin. Med. 2022, 11(12), 3484; https://doi.org/10.3390/jcm11123484 - 17 Jun 2022
Cited by 3 | Viewed by 1409
Abstract
Thus far, little attention has been paid to adherence to medications focusing on the workers and occupational characteristics. This study aimed to assess the status and risk of noncompliance among workers compared to nonworkers, and the association between nonadherence to medication of metabolic [...] Read more.
Thus far, little attention has been paid to adherence to medications focusing on the workers and occupational characteristics. This study aimed to assess the status and risk of noncompliance among workers compared to nonworkers, and the association between nonadherence to medication of metabolic diseases and occupational characteristics. Self-reported adherence to medications for hypertension, diabetes, or dyslipidemia and occupational characteristics were evaluated using the Korea Health Panel Study (2008–2018). The status of adherence to medications was evaluated based on working status, with detailed reasons provided for noncompliance. The risk of noncompliance was estimated using the generalized estimating equation, and a subgroup analysis with age-standardized prevalence ratio according to occupational characteristics was also conducted. During the follow-up period, 19,660 (13.9%) person years were noncompliant with medication adherence for 141,807 person years. Workers had a higher prevalence (15.0%) of noncompliance than nonworkers (13.0%). Workers (OR:1.10, 95% CI:1.04–1.14) showed an increased risk of noncompliance compared to nonworkers. Workers who were manual, unpaid family workers, irregular, or dispatched workers showed an increased prevalence of noncompliance. This study found that workers were susceptible to nonadherence to metabolic disease medication. Future research on the role of working conditions in medication adherence would benefit metabolic disease prevention. Full article
(This article belongs to the Special Issue Clinical Management and Challenges in Metabolic Syndrome)
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15 pages, 1600 KiB  
Article
A Multivariate Analysis of “Metabolic Phenotype” Patterns in Children and Adolescents with Obesity for the Early Stratification of Patients at Risk of Metabolic Syndrome
by Valeria Calcaterra, Giacomo Biganzoli, Simona Ferraro, Elvira Verduci, Virginia Rossi, Sara Vizzuso, Alessandra Bosetti, Barbara Borsani, Elia Biganzoli and Gianvincenzo Zuccotti
J. Clin. Med. 2022, 11(7), 1856; https://doi.org/10.3390/jcm11071856 - 27 Mar 2022
Cited by 7 | Viewed by 1986
Abstract
Background: Metabolic syndrome (MS) is closely linked to obesity; however, not all individuals with obesity will develop obesity-related complications and a metabolically healthy obesity (MHO) group is also described. Objective: To perform a multivariate analysis (MVA) of the anthropometric and biochemical data in [...] Read more.
Background: Metabolic syndrome (MS) is closely linked to obesity; however, not all individuals with obesity will develop obesity-related complications and a metabolically healthy obesity (MHO) group is also described. Objective: To perform a multivariate analysis (MVA) of the anthropometric and biochemical data in pediatric patients with obesity to reveal a “phenotype” predictive for MS. Methods: We analyzed 528 children with obesity (OB) and 119 normal-weight pediatric patients (NW). Adiposity indices were recorded, and MS was detected. MVA was performed. Results: Analysis of the structure of correlation of the variables showed that the variables of waist circumference (WC), body mass index (BMI), and estimated fat mass (eFM) were positively correlated with each other as a whole. In addition, the variables of the triglycerides (TG), triglyceride–glucose (TyG) index, and visceral adiposity index were positively correlated with each other as a whole, although none were correlated with the variables of BMI z-score, waist-to-height ratio, WC, eFM, or weight. The variables that related to insulin resistance (IR) and dyslipidemia were crucial for the early stratification of patients at risk of MS. Conclusions: Independently of body weight, IR, dyslipidemia, hypertriglyceridemia, and fat distribution seem to be the strongest MS risk factors. The early detection of and intervention in these modifiable risk factors are useful to protect children’s health. Full article
(This article belongs to the Special Issue Clinical Management and Challenges in Metabolic Syndrome)
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