Special Issue "Metabolic Syndrome and Cardiovascular Disease"

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Mechanisms of Diseases".

Deadline for manuscript submissions: closed (30 July 2023) | Viewed by 4264

Special Issue Editor

Department of Cardiology, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece
Interests: childhood obesity; heart failure; cardiotoxicity; exercise; marathon running; cardiovascular physiology

Special Issue Information

Dear Colleagues,

Metabolic syndrome is defined as the concurrence of at least three of the following metabolic risk factors:

  • Atherogenic dyslipidemia (elevated serum levels of triglycerides, or low levels of high-density lipoprotein (HDL) cholesterol);
  • Elevated blood pressure;
  • Elevated glucose levels (insulin resistance and/or impaired glucose tolerance);
  • Abdominal obesity expressed by increased waist circumference.

Early diagnosis and management, both pharmacological and nutritional, of the metabolic syndrome are crucial for public health in modern societies, as each component thereof is an independent risk factor for cardiovascular disease (CVD). The combination of these risk factors elevates the prevalence and severity of a spectrum of cardiovascular conditions, including microvascular dysfunction, coronary atherosclerosis and calcification, cardiac dysfunction, myocardial infarction, and heart failure.

The plethora of mechanisms and modes of action implicated in the cardiovascular complications of metabolic syndrome are not yet fully elucidated, and remain incompletely understood. A causal relationship between insulin resistance and other metabolic risk factors is less certain. The prothrombotic state induced by abdominal obesity promotes the development of atherosclerosis or participates in the development of acute atherosclerotic CVD events. Perhaps the most attractive candidate for enhanced atherogenicity associated with coagulation and fibrinolytic abnormalities is endothelial dysfunction.

In this Special Issue, we intend to highlight current knowledge regarding the pathophysiologic consequences of the metabolic syndrome on cardiovascular function and disease, including considerations of potential physiologic and molecular mechanisms that may contribute to these adverse outcomes. In addition, interventions to minimize the adverse effects of metabolic syndrome risk factors on the cardiovascular system will also be discussed.

Dr. Konstantinos Tsarouhas
Guest Editor

Manuscript Submission Information

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Keywords

  • obesity
  • hypertension
  • dyslipidemia
  • insulin resistance
  • endothelial dysfunction
  • prothrombotic state

Published Papers (5 papers)

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Research

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Article
Skinfold Thickness as a Cardiometabolic Risk Predictor in Sedentary and Active Adult Populations
J. Pers. Med. 2023, 13(9), 1326; https://doi.org/10.3390/jpm13091326 - 29 Aug 2023
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Abstract
Studies report that increased body fat can lead to health risks for individuals. However, some methods used for analyzing adiposity did not identify its distribution in the human body because they are typically measured using bioimpedance scales. This study aims to associate the [...] Read more.
Studies report that increased body fat can lead to health risks for individuals. However, some methods used for analyzing adiposity did not identify its distribution in the human body because they are typically measured using bioimpedance scales. This study aims to associate the presence of cardiometabolic risk factors in sedentary and active adult populations through anthropometric methods based on skinfold thickness measurements. A cross-sectional study was conducted on 946 adults aged between 18 and 79 years with prior informed consent. Clinical, anthropometric, and biochemical parameters, as well as some cardiometabolic risk factors, were evaluated. Almost half of the population (45.1%; n = 427) is sedentary. A significant association was found between the sum of the skinfolds (bicipital, tricipital, subscapular, and suprailiac) and the cardiometabolic risk factors evaluated, highlighting the cardiovascular risk associated with abdominal obesity, risk of insulin resistance, as well as the development of hyperglycemia, and hypertriglyceridemia. The bicipital fold was thicker (19.67 mm) in the population with a sedentary lifestyle than in the physically active population (18.30 mm). Furthermore, the skinfolds that predict higher metabolic risks were suprailiac and subscapular in sedentary and active populations. Thus, these skinfold measurements could be considered in assessing the adult population for early cardiometabolic risk detection, even in healthy and physically active people. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Cardiovascular Disease)
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Article
Chlorogenic Acid Attenuates Doxorubicin-Induced Oxidative Stress and Markers of Apoptosis in Cardiomyocytes via Nrf2/HO-1 and Dityrosine Signaling
J. Pers. Med. 2023, 13(4), 649; https://doi.org/10.3390/jpm13040649 - 10 Apr 2023
Cited by 1 | Viewed by 1045
Abstract
(1) Background: Doxorubicin (DOX) is extensively used for cancer treatments; however, its clinical application is limited because of its cardiotoxic adverse effects. A combination of DOX and agents with cardioprotective properties is an effective strategy to ameliorate DOX-related cardiotoxicity. Polyphenolic compounds are ideal [...] Read more.
(1) Background: Doxorubicin (DOX) is extensively used for cancer treatments; however, its clinical application is limited because of its cardiotoxic adverse effects. A combination of DOX and agents with cardioprotective properties is an effective strategy to ameliorate DOX-related cardiotoxicity. Polyphenolic compounds are ideal for the investigation of novel cardioprotective agents. Chlorogenic acid (CGA), an essential dietary polyphenol found in plants, has been previously reported to exert antioxidant, cardioprotective, and antiapoptotic properties. The current research evaluated CGA’s in vivo cardioprotective properties in DOX-induced cardiotoxicity and the probable mechanisms underlying this protection. (2) Methods: CGA’s cardioprotective properties were investigated in rats that were treated with CGA (100 mg/kg, p.o.) for fourteen days. The experimental model of cardiotoxicity was induced with a single intraperitoneal (15 mg/kg i.p.) injection of DOX on the 10th day. (3) Results: Treatment with CGA significantly improved the DOX-caused altered cardiac damage markers (LDH, CK-MB, and cTn-T), and a marked improvement in cardiac histopathological features accompanied this. DOX downregulated the expression of Nrf2/HO-1 signaling pathways, and the CGA reversed this effect. Consistently, caspase-3, an apoptotic-related marker, and dityrosine expression were suppressed, while Nrf2 and HO-1 expressions were elevated in the cardiac tissues of DOX-treated rats after treatment with the CGA. Furthermore, the recovery was confirmed by the downregulation of 8-OHdG and dityrosine (DT) expressions in immunohistochemical findings. (4) Conclusions: CGA demonstrated a considerable cardioprotective effect against DOX-induced cardiotoxicity. One of the possible mechanisms for these protective properties was the upregulation of the Nrf2/HO-1-dependent pathway and the downregulation of DT, which may ameliorate oxidative stress and cardiomyocyte apoptosis. These findings suggest that CGA may be cardioprotective, particularly in patients receiving DOX-based chemotherapy. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Cardiovascular Disease)
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Review

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Review
Metabolic Syndrome and Atrial Fibrillation: Different Entities or Combined Disorders
J. Pers. Med. 2023, 13(9), 1323; https://doi.org/10.3390/jpm13091323 - 28 Aug 2023
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Abstract
Obesity, hypertension, insulin resistance, and dyslipidemia are all clusters of an entity called “Metabolic Syndrome”. The global trends of this syndrome’s incidence/prevalence continue to increase reciprocally, converting it into a massive epidemic problem in the medical community. Observing the risk factors of atrial [...] Read more.
Obesity, hypertension, insulin resistance, and dyslipidemia are all clusters of an entity called “Metabolic Syndrome”. The global trends of this syndrome’s incidence/prevalence continue to increase reciprocally, converting it into a massive epidemic problem in the medical community. Observing the risk factors of atrial fibrillation, a medical condition that is also converted to a scourge, almost all parts of the metabolic syndrome are encountered. In addition, several studies demonstrated a robust correlation between metabolic syndrome and the occurrence of atrial fibrillation. For atrial fibrillation to develop, a combination of the appropriate substrate and a trigger point is necessary. The metabolic syndrome affects the left atrium in a multifactorial way, leading to atrial remodeling, thus providing both the substrate and provoking the trigger needed, which possibly plays a substantial role in the progression of atrial fibrillation. Due to the remodeling, treatment of atrial fibrillation may culminate in pernicious sequelae, such as repeated catheter ablation procedures. A holistic approach of the patient, with simultaneous treatment of both entities, is suggested in order to ensure better outcomes for the patients. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Cardiovascular Disease)
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Review
Childhood and Adolescent Obesity with Somatic Indicators of Stress, Inflammation, and Dysmetabolism before and after Intervention: A Meta-Analysis
J. Pers. Med. 2023, 13(9), 1322; https://doi.org/10.3390/jpm13091322 - 28 Aug 2023
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Abstract
There have been numerous attempts to establish a correlation between obesity and stress, inflammatory, and dysmetabolism biomarkers in children and adolescents. Here, we performed a meta-analysis of existing studies to shed light on the elusive correlations of childhood and adolescent obesity with physiological [...] Read more.
There have been numerous attempts to establish a correlation between obesity and stress, inflammatory, and dysmetabolism biomarkers in children and adolescents. Here, we performed a meta-analysis of existing studies to shed light on the elusive correlations of childhood and adolescent obesity with physiological indicators of stress, inflammation, and metabolism before and after lifestyle interventions. Observational studies, meta-analyses, narrative and systematic reviews were excluded. From a total of 53 articles, 11 were selected according to specific criteria. The biomarkers examined were circulating glucose, insulin, HDL, LDL, triglycerides, adiponectin, leptin, CRP, TNF-alpha, interleukin (IL)-6, systolic and diastolic blood pressure, and HOMA-IR. All analyses were performed using IBM SPSS Statistics Version 28.0.1.0 (142). The current meta-analysis provides evidence of a beneficial effect of a lifestyle intervention and/or drugs in children and adolescents living with obesity or overweight, consistent with a significant reduction in body fat—but not in BMI or waist circumference—an increase in circulating adiponectin and/or a reduction in serum insulin levels and diastolic blood pressure, and a trend towards a reduction of circulating leptin and glucose levels, as well as of the HOMA-IR. This meta-analysis indicates that lifestyle interventions could reduce overweight-/obesity-associated systemic inflammation and dysmetabolism even without an apparent decrease in BMI. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Cardiovascular Disease)
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Review
Cardiovascular Magnetic Resonance Imaging as an Adjunct to the Evaluation of Cardiovascular Involvement in Diabetes Mellitus
J. Pers. Med. 2023, 13(5), 724; https://doi.org/10.3390/jpm13050724 - 25 Apr 2023
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Abstract
Diabetes mellitus (DM) is a new epidemic which has presented an immense increase in recent decades, due to the rapid increase in obesity. Cardiovascular disease (CVD) significantly reduces life expectancy and is the main cause of death in type 2 diabetes mellitus (T2DM). [...] Read more.
Diabetes mellitus (DM) is a new epidemic which has presented an immense increase in recent decades, due to the rapid increase in obesity. Cardiovascular disease (CVD) significantly reduces life expectancy and is the main cause of death in type 2 diabetes mellitus (T2DM). Strict glycemic control is a well-established method to combat microvascular CVD of type 1 diabetes mellitus (T1DM); its role against CVD of the T2DM risk has not been well documented. Therefore, the most efficient prevention is multifactorial risk factor reduction. Recently, the European Society of Cardiology published its 2019 recommendations on CVD in DM. Although all clinical points were discussed in this document, only a few comments were presented about when and how we should recommend cardiovascular (CV) imaging. Currently, CV imaging is the “must” in CV noninvasive evaluation. Alterations in CV imaging parameters can lead to early recognition of various types of CVD. In this paper, we briefly discuss the role of noninvasive imaging modalities, emphasizing the benefits of including cardiovascular magnetic resonance (CMR) in the evaluation of DM. CMR, in the same examination, can provide an assessment of tissue characterization, perfusion and function, with excellent reproducibility and without radiation or limitations, due to the body habitus. Therefore, it can play a dominant role in the prevention and risk stratification of DM. The suggested protocol for DM evaluation should include routine annual echocardiographic evaluation of all DM patients and CMR assessment of those with poorly controlled DM, microalbuminuria, heart failure, arrhythmia and recent alterations in clinical or echocardiographic evaluation. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Cardiovascular Disease)
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