Metabolic Syndrome

From Mechanisms to Interventions

1st Edition - November 10, 2023
Imprint: Academic Press
Editors: Satinath Mukhopadhyay, Sunetra Mondal
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 8 5 7 3 2 - 1
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 8 5 6 5 8 - 4

Metabolic Syndrome: From Mechanisms to Interventions covers all aspects of this complex and multifactorial disease, providing a cutting-edge understanding of the problem of MetS,… Read more

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Metabolic Syndrome: From Mechanisms to Interventions covers all aspects of this complex and multifactorial disease, providing a cutting-edge understanding of the problem of MetS, with a particular focus on its prevention and clinical management. The book discusses practical implementable approaches to its reversal in clinical practice, encompassing the entire spectrum of MetS, from molecular understanding to clinical therapeutics and prevention. This book is a valuable resource for clinicians in multiple specialties, including endocrinologists, diabetologists, hepatologists, gynecologists and researchers in related fields who need a deep understanding of the full range of scientific and clinical aspects of metabolic syndrome.

Cover image
Title page
Table of Contents
Copyright
Dedication
Contributors
Foreword
Chapter 1. Metabolic syndrome—A glance through the sands of time
Early days—Ripples on the surface
Middle age—Obesity takes center stage
The birth of metabolic syndrome—Putting it all together
Syndrome X and beyond
Modern times: Confusion to consensus
Chapter 2. Beyond the metabolic syndrome: Adverse influences of insulin resistance on the aging process
Prolog
Metabolic syndrome background
Important criteria for diagnosing metabolic syndrome
Historic events behind the concept of insulin resistance
The battle between dietary sugars and fat
Along came Yudkin
The metabolic syndrome in people without diabetes
Correlating FBG (IR) and age to various components of MS in non-diabetics during periods of Continuum of Risks and Aging Paradox
Importance of the ageing paradox in comprehending the role of IR in influencing life cycle and appreciating use of potential preventive measures to extend longevity
Sum up: Benefits of caloric restriction on IR strengthens the proposed hypothesis
Chapter 3. Intrauterine malnutrition and future risk of metabolic syndrome
Metabolic syndrome—Introduction
Intrauterine origins of metabolic syndrome—Global evidence
Mechanistic aspects
Early origins of metabolic syndrome—The Indian perspective
Evidence from Indian cohort studies
Interventions to address intra-uterine malnutrition
Conclusions
Chapter 4. Intervening at the stage of metabolic syndrome to prevent type 2 diabetes—Is it justified?
What is MetS?
Progression of MetS to T2DM
Concept of T2DM remission/reversal
Concept of prevention
Role of lifestyle modifications
Reversal by physical exercise
Reversal by diet
Reversal by low calorie diet (LCD)
Reversal by low cardohydrate diet (LC)
Reversal by pharmacological interventions
Reversal by bariatric surgery
Conclusion
Chapter 5. Dietary fats and their effects on metabolic syndrome and its components
Introduction
Metabolic syndrome and cardiovascular risk factors
Dietary fats and metabolic syndrome
Effects of long-chain fatty acids on metabolic syndrome
Effects of medium-chain fatty acids on metabolic syndrome
Diacylglycerols and phospholipids and their effects on metabolic syndrome
Effects of dietary fats on endothelium function
Conclusions
Chapter 6. Epidemiology of metabolic syndrome: global scenario
Introduction
Metabolic syndrome risk factors
Global prevalence of MetS
MetS in Africa
MetS in the Americas
MetS prevalence in Asia
MetS prevalence in Brazil
MetS prevalence in Europe
MetS in the Middle East
MetS in indigenous, native people and underserved populations
Final considerations
Chapter 7. Epidemiology of metabolic syndrome in South and South-East Asia
Introduction
Prevalence of metabolic syndrome in India
Prevalence of metabolic syndrome in Pakistan
Prevalence of metabolic syndrome in Bangladesh
Prevalence of metabolic syndrome in Sri Lanka
Prevalence of metabolic syndrome in Nepal
Prevalence of metabolic syndrome in Singapore
Prevalence of metabolic syndrome in Malaysia
Prevalence of metabolic syndrome in Indonesia
Prevalence of metabolic syndrome in Philippines
Prevalence of metabolic syndrome in Vietnam
Prevalence of metabolic syndrome in Thailand
Conclusion
Chapter 8. Barker hypothesis and metabolic syndrome
Introduction
Barker hypothesis
Low birth weight cohorts across the globe
Proposed mechanisms behind Barker hypothesis and its impact on low birth weight
Barker hypothesis and diabetes mellitus
Barker hypothesis and cardiovascular risk
Clinical consequences
Conclusion
Chapter 9. Understanding the complexities of metabolic syndrome in First Nations Australians
Introduction
Metabolic syndrome: definitions and limitations
Prevalence of obesity and metabolic syndrome in First Nations Australians
Prevalence of diabetes mellitus in First Nations Australians
Cardiovascular disease and metabolic syndrome in First Nations Australians
Impact of chronic kidney disease and metabolic syndrome in First Nations Australians
Metabolic-associated fatty liver disease in First Nations Australians
The burden of polycystic ovarian syndrome in First Nations Australians
Management challenges
Conclusion
Take home points
Chapter 10. Nutrition in the pathogenesis of metabolic syndrome: Roles of sugar, salt and fat
Metabolic syndrome: An introduction
Effects of dietary components on metabolic syndrome
Mechanistic insight into insulin resistance
Inflammatory response associated with MetS
Role of lipid in diets
Effect of dietary sugar
Effect of dietary salt
Management of MetS
Novel nutraceutical-based formulations
Conclusion
Chapter 11. Vitamin D deficiency and metabolic syndrome—Is there a causality?
Introduction
Metabolic syndrome
Vitamin D and metabolic syndrome
Vitamin D and obesity
Association between vitamin D deficiency and hypertension
Vitamin D and insulin resistance
Vitamin D and dyslipidemia
Vitamin D and cardiovascular risk
Vitamin D and PCOS
Vitamin D and NASH
Effects of vitamin D supplementation
Interventional studies in children
Conclusion
Chapter 12. Role of inflammation in the pathogenesis of metabolic syndrome
Introduction
Inflammation
Activation of inflammatory pathways
Pathophysiology of metabolic syndrome
Role of inflammation in obesity
Role of inflammation in insulin resistance
Role of inflammation in dyslipidemia
Role of inflammation in hypertension
TB and diabetes
Conclusion
Chapter 13. Role of oxidative stress in the pathogenesis of metabolic syndrome
Introduction
Oxidative stress
Oxidative stress in metabolic syndrome
Oxidative stress in diabetes
Oxidative stress in hypertension
Oxidative stress and dyslipidemia
Circulating oxidative stress markers in metabolic syndrome
Therapeutic aspects of targeting oxidative stress in metabolic syndrome
Conclusion
Chapter 14. Mitochondrial dysfunction and metabolic syndrome
Epidemiology of metabolic syndrome
Pathophysiology of metabolic syndrome
Mitochondria—the powerhouse of the cell
Mitochondria as a source of reactive oxygen species (ROS)
Overnutrition and physical inactivity: a major driving force for ROS production in mitochondria
Mitochondrial redox signaling in metabolic syndrome
ROS-induced insulin resistance
Mitochondrial function and insulin resistance
Regulation of mitochondrial biogenesis and metabolic syndrome
Leptin resistance associated with mitochondrial dysfunction
Leptin resistance
Leptin resistance and mitochondrial dysfunction
Studies to show the role of mediators linking leptin resistance and mitochondrial dysfunction
Conclusion
Chapter 15. The entero-insular axis and metabolic syndrome
Introduction
Historical perspective
The “entero-insular” axis and “incretin” concept
The neural component of the “entero-insular” axis
The “incretin” candidates
Glucose-dependent insulinotropic polypeptide (GIP)
Glucagon-like peptide 1 (GLP-1)
Incretins and metabolic syndrome
Incretin, bariatric surgery, and glycemic control
Therapeutic implications of the incretin effect on metabolic syndrome
Future directions
Chapter 16. Type I interferons in metabolic syndrome
Introduction
Type 1 interferons
Type 1 interferons and atherosclerosis
Type 1 interferons and type 2 diabetes mellitus
Type 1 interferon in non-alcoholic fatty liver disease
Conclusion
Chapter 17. Role of circadian rhythms in metabolic syndrome
Introduction
Circadian orchestra—coupling between the master and peripheral clocks
Circadian rhythms in metabolic pathways
Circadian disruption and metabolic syndrome
Conclusive remarks
Chapter 18. The role of genetic and epigenetic factors in familial clustering of metabolic syndrome
Introduction
Role of genetics in familial aggregation and heritability of metabolic syndrome
Identification of specific genes predisposing to MetS
Epigenetics
Conclusion and future perspective
Chapter 19. Endocrine disruptors in the pathogenesis of metabolic syndrome
Introduction
Overview of endocrine disruptors
Endocrine disruptors—routes and sources of exposure
Endocrine disruptors and potential pathways of metabolic disruption
Endocrine disruptors and obesity
Endocrine disruptors and glucose intolerance
Endocrine disruptors and dyslipidemia
Endocrine disruptors and hypertension
Conclusions
Chapter 20. Atherosclerotic cardiovascular disease in metabolic syndrome
Introduction
Definition of metabolic syndrome
Prevalence data on MetS
Cardiovascular risk association of single components of MetS
Role of insulin resistance and visceral adipose tissue in cardiovascular risk
Metabolic syndrome and cardiovascular risk
Metabolic syndrome as a tool for cardiovascular risk
Hemodynamic effects of the components of MetS
Conclusion
Chapter 21. Atherosclerosis is the outcome of adaptive complexity in the Arterial Endothelial Microenvironment
Introduction
Chapter 22. NAFLD, the hepatic manifestation of the metabolic syndrome
Introduction
Progress in NAFLD assessment
Diagnostic tools
NAFLD epidemiology and relation with metabolic syndrome
Pathogenesis of NAFLD and the role of insulin resistance
NAFLD outcome
NAFLD and risk of comorbidities
Treatment of MetS-associated features in patients with NAFLD
Conclusion
Chapter 23. Obesity associated hypogonadism—a growing concern in metabolic syndrome
Introduction
Metabolic syndrome, visceral adiposity, and hypogonadism—The common pathway
Role of SHBG
Role of adipocytokines and estrogen
Role of inflammatory markers
When to test for hypogonadism in men with metabolic syndrome?
Biochemical evaluation of hypogonadism in obesity and MS—Basic facts
Diagnosis of hypogonadism in MS
Role of lifestyle management in treatment of obesity-induced hypogonadism
Role of testosterone replacement therapy
Role of testosterone replacement in preventing the evolution of T2D from prediabetic state and reversal of metabolic syndrome—Evidence from larger RCTs
Testosterone therapy … route of choice?
Monitoring of benefits/side effects of testosterone treatment: When to stop
Conclusion
Chapter 24. Sleep apnea—A cause or a consequence of metabolic syndrome?
Introduction
Etiology of obstructive sleep apnea
Arguments in favor of metabolic syndrome causing obstructive sleep apnea (obesity/weight-dependent mechanisms)
Physiology-dependent (weight independent) mechanisms leading to OSA
Arguments in favor of OSA causing metabolic syndrome
Bidirectional relationship between OSA and components of the metabolic syndrome—Glycemic control
Bidirectional relationship between OSA and components of the metabolic syndrome—Insulin resistance
Bidirectional relationship between OSA and components of the metabolic syndrome—Leptin
Tissue-specific effects of chronic intermittent hypoxia—Adipose tissue
Tissue-specific effects of chronic intermittent hypoxia—Liver
Tissue-specific effects of chronic intermittent hypoxia—Muscle
Tissue-specific effects of chronic intermittent hypoxia—Gut microbiota
Conclusion and future directions
Chapter 25. Renal manifestations of metabolic syndrome: the link between obesity and chronic kidney disease
Why is obesity in CKD important? Epidemiology
Obesity in CKD: cause or consequence
Metabolically healthy obesity
Clinical and histological phenotype of obesity-associated CKD
Molecular mechanisms of obesity-related CKD
What is the best measurement for obesity in CKD?
Obesity in early and advanced CKD—a paradox
Obesity in transplant recipients
Does reversing obesity reduce the risk for obesity-associated nephropathy?
Conclusion
Chapter 26. Metabolic syndrome and periodontitis: pathophysiologic links and clinical implications
Introduction
Periodontitis and MetS: a bidirectional association
Pathophysiological links
Clinical implications
Conclusions
Chapter 27. Insulin resistance and risk of osteoporosis
Introduction
Evidence available from animal studies
Evidence available from human studies
Conclusions
Chapter 28. Glucagon and the metabolic syndrome
Case
Introduction to glucagon
Glucagon production
Glucagon secretion
The glucagon receptor
Glucagon and the pathogenesis of type 2 diabetes
Glucagon receptor antagonists
Pharmacologic therapies for type 2 diabetes and effects on glucagon
Bariatric surgery
Glucagon raises resting energy expenditure
Glucagon increases satiety
Oxyntomodulin
Glucagon improves dyslipidemia
Glucagon and hepatic steatosis
Clinically relevant extremes in glucagon in humans
Glucagon's role in upcoming obesity therapies
Conclusion
Chapter 29. Assessment of insulin resistance: From the bench to bedside
Introduction
Defining insulin resistance
Molecular mechanisms underlying insulin resistance
Estimating insulin resistance: From bench to bedside
Measures of insulin resistance (Table 29.1)
Utilizing OGTT to derive hepatic and peripheral insulin sensitivity
Surrogate markers for insulin resistance
Uses of insulin resistance in common diseases
Summary
Chapter 30. Role of exercise in the prevention and treatment of metabolic syndrome
Introduction
Twenty-four-hour energy expenditure
Physical activity, exercise, and metabolic syndrome
Exercise and metabolic syndrome
Exercise and blood pressure
Exercise and adipose tissue
Exercise and lipid metabolism
Exercise and glucose metabolism
Chapter 31. Pharmacologic therapies in metabolic syndrome with special reference to non-alcoholic fatty liver disease
Epidemiology of NAFLD and metabolic syndrome
Chapter 32. Role of newer anti-diabetes drugs in prediabetes: A systematic review
Introduction
Methods
Results
Discussion
Chapter 33. Management of insulin resistance in PCOS
Introduction and epidemiology
Diagnosis of PCOS
Pathophysiology
Investigations
Insulin resistance in PCOS
Assessment of insulin resistance
Association of insulin resistance and PCOS
Management of insulin resistance in PCOS
Conclusion
Chapter 34. The role of bariatric surgery in the management of metabolic syndrome
Introduction
Indications of bariatric surgery
Preoperative management
Mechanisms by which bariatric procedures help in management of metabolic syndrome
Adjustable gastric band
Sleeve gastrectomy (SG)
Roux–en–Y gastric bypass (RYGB)
Endoscopic bariatric therapies
Indications of EBT
Contraindications of EBT
Conclusion
Chapter 35. Anti-inflammatory interventions to mitigate the cardiovascular risk in metabolic syndrome
Myocardial dysfunction due to diabetes mellitus
Hypertension in metabolic syndrome
Role of atherosclerosis in the progression of MetS
MetS and thrombosis
MetS and stroke
Chapter 36. Management of new onset dysglycemia in transplant recipients
Introduction
Pathophysiology
Outcomes
Management of new onset dysglycemia
Immunosuppression modification
Pharmacological management
Reviews, guidelines, and expert reports for treatment of new onset dysglycemia
Conclusion
Chapter 37. Management of lipid abnormalities in metabolic syndrome
Introduction
Pathogenesis
Management
Other avenues of management of dyslipidemia in metabolic syndrome
Conclusion
Chapter 38. Overview of metabolic syndrome in children and adolescents—an Indian perspective
Introduction
Burden of disease
Definition
Risk factors
Assessment
Future research
Conclusions
Key points
Chapter 39. Metabolic syndrome in children and adolescent: South Asian perspective
Introduction
Definition and its controversies and prevalence
Risk factors
South Asian phenotype and its significance
Is the SA phenotype evident in childhood?
Various theories are postulated for this ethnic difference/pathophysiology
Screening
Comorbidities
Treatment
Conclusion
Chapter 40. Inter-relationship between polycystic ovary syndrome and metabolic syndrome
Introduction
Prevalence of MS in women with PCOS
Characteristics of metabolic syndrome in PCOS
Pathogenesis of metabolic syndrome in PCOS
Consequences of PCOS with MS
Management of the metabolic syndrome in PCOS
Conclusion
Chapter 41. Metabolic syndrome—definition
History
Purpose of definition
Components of the definition
Metabolic syndrome in childhood
Does everything fit?
Do we really need it?
Conclusion
Chapter 42. Metabolic syndrome and cancer risk
Introduction
Conclusion
Chapter 43. Obesity-mediated insulin resistance in target tissues: role of adiponectin, fetuin-A, and irisin
Introduction
Obesity-mediated insulin resistance in target tissues
The key players—adipokines, hepatokines, and myokines
Adiponectin—a potent insulin sensitizing adipokine
Fetuin-A—a hepato-adipokine with proinflammatory attributes
Irisin—a thermogenic adipo-myokine that is induced by exercise
Inter-organ crosstalk mediated by adiponectin, fetuin-A, and irisin
Future perspective—potential biomarkers of insulin resistance and MetS
Abbreviations
Chapter 44. Gut microbiota and metabolic syndrome: What's new?
Background
Nutrition and the gut microbiome
Gut microbiota targeted therapies in MetS
Naturopathic medicine
Conclusions
Chapter 45. Metabolic syndrome and COVID-19: An unholy alliance
Metabolic syndrome and risk of COVID-19
Pathogenic mechanisms
Therapeutic implications
Preventive implications
Metabolic health in the COVID and post-COVID era
Chapter 46. MicroRNA modulation in metabolic syndrome: A novel insight into cardiometabolic diseases
Introduction
miRNA biogenesis and nomenclature
miRNA in the endothelium and atherosclerosis
Cardiometabolic syndrome: Endothelial miRNAs, type 2 diabetes (T2D)
miRNA-transcription factor interaction in cardiometabolic diseases
Therapeutic potential
Conclusion
Chapter 47. Role of artificial intelligence in tackling the metabolic syndrome pandemic
Introduction
Diagnostic criteria for MetS
The challenges of tackling the metabolic syndrome pandemic
Lifestyle
Non-alcoholic fatty liver disease
Type 2 diabetes mellitus and cardiovascular disease
Gut microbiota
Insulin resistance
Computational biology and medicines perspective
Artificial intelligence
Application of AI in the biomedical field
Several common machine learning methods
Decision tree
Random Forest
Artificial neural network
Artificial intelligence versus traditional methods
Conclusion
Chapter 48. Glucose handling by the brain and its implication in metabolic syndrome
Introduction
Role of brain in glucose homeostasis
Pathophysiological basis of role of brain in diseases of glucose homeostasis
Therapeutic implications
Conclusion
Chapter 49. Hypoglycemia, insulin resistance, and cardiovascular disease: A possible link
Introduction
Definition and epidemiology of hypoglycemia
Hypoglycemia and cardiovascular risk
Mechanistic links between hypoglycemia and cardiovascular risk
Hypoglycemia, insulin resistance, and the metabolic syndrome: Possible cardiovascular risk
Conclusions and future directions
Chapter 50. Dietary interventions to combat obesity in metabolic syndrome - Role of time restricted eating
Introduction
Circadian rhythm, feeding timeframe, and metabolic health
Time restricted eating—A potential pragmatic approach to obesity management
TRE and other health benefits
Is TRE feasible/sustainable?
Conclusion
Chapter 51. Systemic inflammation in psoriasis: Sequel of metabolic syndrome
Introduction
Endothelial cell dysfunction and inflammation: Role in atherosclerosis
Toll-like receptors, cell trafficking, inflammation, cardiovascular disease, and diabetes mellitus
CRP: C-reactive protein
Lp-PLA2 (Lipoprotein-Associated Phospholipase A2)
Psoriasis, psoriatic arthritis, systemic inflammation, and risk of ASCVD
Adipocytokines in obesity, insulin resistance, and in the inflammatory cascades of psoriatic disease
Medical interventions and clinical outcomes
Future directions
Chapter 52. Abdominal obesity and adipose tissue depots: Focus on intra-abdominal versus subcutaneous adipose tissue depots in Asian Indians
Background
Prevalence of abdominal obesity in the South Asia and in India
Various measures of abdominal obesity
Body composition and “the Reference Man”
Visceral and subcutaneous adipose tissue compartments
Implications of abdominal obesity on metabolic parameters and CVD in Asian Indians
Intra-abdominal visceral adipose tissue (IAAT) versus subcutaneous abdominal adipose tissue (SCAT) and its implications on health
Differences in body fat and adipose tissue compartments between South Asians versus Caucasians
Conclusion
Chapter 53. The immediate and long-term metabolic implications of maternal obesity and gestational weight gain
Introduction
Pathophysiology and outcomes of maternal obesity and GWG
Effects of pre-pregnancy BMI on offspring weight—what is the evidence?
Effect of excess GWG on the mother and the fetus
Recommendations for GWG
IOM recommendations for GWG—can it be applied universally
GWG—important aspects in monitoring and interventions
Conclusion
Chapter 54. Managing the metabolic syndrome in a general practice setting in the UK (by a general practitioner practising among a high risk South Asian population)
Index

Life Sciences

Physical Sciences & Engineering

Social Sciences & Humanities

Health

Metabolic Syndrome

From Mechanisms to Interventions

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Satinath Mukhopadhyay

Sunetra Mondal

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