ObjectiveTo analyze the prevalence and risk factors of metabolic syndrome (MS) after adult liver transplantation (LT) recipients. MethodsThe clinicopathologic data of patients with survival time ≥1 year underwent LT in the People’s Hospital of Zhongshan City from January 1, 2015 to August 31, 2020 were analyzed retrospectively. The logistic regression model was used to analyze the risk factors affecting MS occurrence after LT, and the receiver operating characteristic (ROC) curve was used to evaluate the optimal cutoff value of the index of predicting MS occurrence and its corresponding evaluation effect. ResultsA total of 107 patients who met the inclusion criteria were collected in this study. Based on the diagnostic criteria of MS of Chinese Medical Association Diabetes Association, the occurrence rate of MS after LT was 32.7% (35/107). Multivariate logistic regression analysis showed that the increased age of the recipient [OR (95%CI)=1.106 (1.020, 1.199), P=0.014], preoperative increased body mass index [OR (95%CI)=1.439 (1.106, 1.872), P=0.007] and blood glucose level [OR (95%CI)=1.708 (1.317, 2.213), P<0.001], and with preoperative smoking history [OR (95%CI)=5.814 (1.640, 20.610), P=0.006] and drinking history [OR (95%CI)=5.390 (1.454, 19.984), P=0.012] increased the probability of MS after LT. The areas under the ROC curve (AUC) corresponding to these five indexes were 0.666, 0.669, 0.769, 0.682, and 0.612, respectively. The corresponding optimal cutoff values of three continuous variables (recipient’s age, preoperative body mass index, and blood glucose level) were 53 years old, 23.1 kg/m2, and 6.8 mmol/L, respectively. The AUC of combination of the above five indexes in predicting occurrence of MS was 0.903 [95%CI (0.831, 0.952)], and the sensitivity and specificity were 80.0% and 90.3%, respectively. ConclusionsIncidence of MS after adult LT recipient is not low. For recipients with preoperative hyperglycemia, obese, elderly, histories of drinking and smoking before LT need to pay attention to the early detection and early intervention of MS.
In recent years, more and more studies have shown that obstructive sleep apnea hypopnea syndrome (OSAHS) and metabolic syndrome are closely related and interact with each other, while hypertension, abnormal glucose metabolism, lipid metabolism disorders and obesity, as the main components of metabolic syndrome, have been further studied. Continuous positive airway pressure is currently the main treatment for OSAHS. This review focuses on the association between OSAHS and hypertension, glucose metabolism abnormalities, lipid metabolism disorders, obesity and the effects of treatment with positive airway pressure, aiming to provide a theoretical basis for the pathogenesis and treatment of OSAHS complicated with metabolic syndrome.
Objective To introduce the research progress on the relationship between gut microbiota dysbiosis and osteoarthritis (OA), focus on the possible mechanism of gut microbiota dysbiosis promoting OA, and propose a new therapeutic direction. Methods The domestic and foreign research literature on the relationship between gut microbiota dysbiosis and OA was reviewed. The role of the former in the occurrence and development of OA and the new ideas for the treatment of OA were summarized. Results The gut microbiota dysbiosis promotes the development of OA mainly in three aspects. First, the gut microbiota dysbiosis destroys intestinal permeability and causes low-grade inflammation, which aggravate OA. Secondly, the gut microbiota dysbiosis promotes the development of OA through metabolic syndrome. Thirdly, the gut microbiota dysbiosis is involved in the development of OA by regulating the metabolism and transport of trace elements. Studies have shown that improving gut microbiota dysbiosis by taking probiotics and transplanting fecal microbiota can reduce systemic inflammation and regulate metabolic balance, thus treating OA. Conclusion Gut microbiota dysbiosis is closely related to the development of OA, and improving gut microbiota dysbiosis can be an important idea for OA treatment.
ObjectiveTo understand the relationship between obesity, hyperglycemia, hypertension, and lipid metabolism disorder in metabolic syndrome and hepatocellular carcinoma (HCC), and to provide reference for screening, diagnosis, treatment, and prevention of HCC in clinic.MethodThe related literatures about the relationship between metabolic syndrome related factors (obesity, hyperglycemia, hypertension, and lipid metabolism disorder) and HCC were searched and summarized.ResultsObesity, hyperglycemia, hypertension, and abnormal lipid metabolism in metabolic syndrome were closely related to HCC, which were the high risk factors for leading to HCC, indicating that metabolic syndrome was closely related to the risk of HCC.ConclusionsMetabolic syndrome is closely related to the risk of HCC. It is of great significance for screening, diagnosis, treatment, and prevention of HCC to deeply understand the mechanism and determinants of HCC caused by metabolic syndrome.
ObjectiveTo explore the effect of metabolic syndrome (MS) on postoperative pulmonary infection in patients with colorectal cancer (CRC) and to construct a risk prediction model for postoperative pulmonary infection in CRC patients. MethodsRetrospective collection of clinical data from 291 CRC patients who underwent surgical treatment at Department of General Surgery, Suzhou Ninth People’s Hospital in the period of January 2020 to August 2024. To explore the risk factors of postoperative pulmonary infection in patients with CRC and to establish a nomogram model. ResultsAmong the 291 CRC patients enrolled, there were 58 MS patients (19.93%) and 233 non-MS patients (80.07%). Compared with patients without MS, CRC patients with MS had longer surgery time (P<0.001) and higher incidence of postoperative pulmonary infection (P<0.001). The results of multiple logistic regression analysis showed that smoking history [OR=2.184, 95%CI (1.097, 4.345), P=0.026], body mass index (BMI)≥25 kg/m2 [OR=2.662, 95%CI (1.241, 5.703), P=0.012], MS [OR=2.770, 95%CI (1.415, 5.425), P=0.003], increased surgical time [OR=4.039, 95%CI (1.774, 9.197), P<0.001] and increased intraoperative bleeding [OR=2.398, 95%CI (1.246, 4.618), P=0.009] were all risk factors for postoperative pulmonary infection in CRC patients. Based on these risk factors, a nomogram model was constructed. The area under the curve (AUC) was 0.845 [95%CI (0.769, 0.906)], and the sensitivity and specificity were 84.2% and 87.5% respectively. The internal verification of Bootstrap test showed that the simulated curve and the actual curve had good consistency. The clinical decision curve analysis showed that when the threshold probability was in the range of 8%–84%, the net benefit of the model for patient diagnosis was higher. ConclusionsMS increases the risk of postoperative pulmonary infection in CRC patients. At the same time, smoking history, BMI≥25 kg/m2, long operation time, and more intraoperative blood loss are also risk factors for postoperative pulmonary infection in patients with CRC. Building a model based on this can effectively evaluate the risk of postoperative pulmonary infection in CRC patients.
Cardiovascular disease is a severe threat to human health and life. Among many risk factors of cardiovascular disease, genetic or gene-based ones are drawing more and more attention in recent years. Accumulated evidence has demonstrated that the loss or mutation of ataxia telangiectasia mutated (ATM) gene can result in DNA damage repair dysfunctions, telomere shortening, decreased antioxidant capacity, insulin resistance, increased lipid levels, etc., and thus can promote the occurrence of cardiovascular risk factors, such as aging, atherosclerosis and metabolic syndrome. In this review, we discusses the possible mechanisms between ATM gene and cardiovascular risk factors, which could be helpful to the related research and clinical application.
ObjectiveTo explore therapeutic mechanisms and clinical application prospects of novel weight-loss medications in patients with obesity complicated by cardiovascular-kidney-metabolic (CKM) syndrome, aiming to provide theoretical support and therapeutic strategies for personalized precision management of CKM syndrome. MethodsRecent domestic and international studies were retrospectively reviewed, focusing on the mechanisms of action, clinical research outcomes, and application progress of novel weight-loss medications, including glucagon-like peptide 1 (GLP-1) receptor agonists, dual glucose-dependent insulinotropic peptide (GIP)/GLP-1 receptor agonists, triple GIP/GLP-1/glucagon receptor agonists, and amylin analogues. Special emphasis was placed on their comprehensive effects on cardiovascular, renal, and metabolic parameters. ResultsNovel weight-loss medications have demonstrated significant weight reduction and multisystem benefits through precise regulation of central appetite pathways, insulin sensitivity, and lipid metabolism. Among these medications, GLP-1 receptor agonists (e.g., semaglutide) and dual receptor agonists (e.g., tirzepatide) have been confirmed in phase Ⅲ clinical trials to effectively reduce cardiovascular event risks, slow renal function deterioration, and markedly improve glycemic control in obese patients with CKM syndrome. Triple receptor agonists (e.g., retatrutide) and combination medication regimen (e.g., CagriSema regimen) have further enhanced weight-loss efficacy, providing novel therapeutic avenues for obesity-related diseases. Additionally, these medications usually require combined application with traditional chronic disease medications, such as sodium-glucose linked transporter 2 inhibitors and renin-angiotensin-aldosterone system blockers, to achieve comprehensive therapeutic outcomes in CKM syndrome patients. However, further studies are needed to address long-term safety in real-world settings, optimization of drug formulations, and application in precision medicine. ConclusionsNovel weight-loss medications offer promising strategies for personalized precision treatment of obesity with CKM syndrome due to their significant weight-loss efficacy and multisystem synergistic effects. Although current clinical trials demonstrate substantial therapeutic potential, the complexity of CKM syndrome and individual patient variability necessitate additional in-depth research to facilitate broader clinical adoption and optimization of these medications.