Soluble Leptin Receptor and Soluble Receptor‐Bound Fraction of Leptin in the Metabolic Syndrome

Objective: In obesity, plasma leptin is high and soluble leptin receptor (sOb‐R) levels are low, resulting in a low fraction of bound leptin. The aim of this study was to investigate the influence of insulin resistance (IR) and the metabolic syndrome (MS) on sOb‐R concentration and the bound‐free ratio of leptin. Research Methods and Procedures: sOb‐R, leptin levels, and homeostasis model assessment (HOMA) index for IR were determined in 76 middle‐aged obese or overweight men. Results: Concentration of sOb‐R and soluble receptor‐bound fraction of leptin were lowest in the highest tertile of HOMA‐IR. sOb‐R and the bound‐free ratio of leptin correlated with HOMA‐IR, leptin concentration, and waist‐to‐hip ratio independently of age, BMI, and fat mass. Leptin and waist‐to‐hip ratio were the sole independent determinants of sOb‐R concentration, and BMI, HOMA‐IR, and visceral adipose tissue were independent determinants of the bound fractin of leptin. sOb‐R concentration and the bound fraction of leptin decreased with increasing numbers of components of the MS, resulting in lower sOb‐R concentration and a lower fraction of bound leptin in men with the MS. Discussion: IR and abdominal obesity are associated with low sOb‐R concentration and low bound‐free ratio of leptin independent of fat mass. Low sOb‐R concentration and low bound‐free ratio of leptin segregate with components of the MS. We suggest that low sOb‐R levels and a low fraction of specifically bound leptin are markers of leptin resistance, which is independently associated with IR and abdominal obesity and may constitute an additional component of the MS.     

Alcohol Consumption in the Severely Obese: Relationship with the Metabolic Syndrome

Objective: The aim of this study was to examine the association between the clinical and biochemical features of the metabolic syndrome and quantity and type of alcohol intake in the severely obese. Research Methods and Procedures: A cross‐sectional study was performed in 486 consecutive severely obese subjects. Data on alcohol consumption was collected by serial clinical interviews and a questionnaire. The relationship between alcohol intake and the clinical and serum chemistry features of the metabolic syndrome was analyzed by multiple statistical techniques. Laboratory measures included lipid profile, fasting blood glucose, hemoglobin A1c, and fasting serum insulin. An indirect index of insulin resistance was calculated using the log‐transformed fasting insulin and glucose product. Results: There were 486 subjects, 84% women, with a mean age of 40.6 ± 10 years (range, 16 to 71 years) and a body mass index of 45.3 ± 7 kg/m² (range, 34 to 77 kg/m²). Alcohol consumers (N = 276) showed a marked reduction in the adjusted odds ratio of type 2 diabetes (odds ratio = 0.29; 95% confidence interval, 0.16 to 0.55) compared with rare or nonconsumers (N = 210). There was a U‐shaped relationship between the amount and frequency of alcohol consumption and fasting triglyceride, fasting glucose, hemoglobin A1c, and index of insulin resistance measurements. Consumers of <100 g/wk had more favorable measures. The effect was attenuated when diabetics were excluded from the analysis. Timing of alcohol consumption did not influence outcome measures. Discussion: Light‐to‐moderate alcohol consumption is associated with a lower prevalence of type 2 diabetes, reduced insulin resistance, and more favorable vascular risk profile in the severely obese. We would propose that light to moderate alcohol consumption should not be discouraged in the severely obese.     

Analysis of Obesity and Hyperinsulinemia in the Development of Metabolic Syndrome: San Antonio Heart Study

Objective: To use standardized cut‐offs of body mass index (BMI), waist circumference, waist‐to‐hip ratio, and fasting insulin levels to predict the development of metabolic disorders and metabolic syndrome. Research Methods and Procedures: We performed an 8‐year follow‐up study of 628 non‐Hispanic whites and 1340 Mexican Americans, ages 25 to 64 years, from the second cohort of the San Antonio Heart Study. We defined metabolic disorders as dyslipidemia (triglycerides ≥2.26 mM or high‐density lipoprotein <0.91 mM in men and <1.17 mM in women), hypertension (blood pressure ≥140/≥90 mm Hg, or receiving antihypertensive medications), and type 2 diabetes (fasting glucose ≥7.0 mM, 2‐hour test glucose ≥11.1 mM, or receiving anti‐diabetic medications). People with at least two metabolic disorders were defined as having metabolic syndrome. Results: High waist‐to‐hip ratio and fasting insulin levels were significant predictors of developing metabolic syndrome. High anthropometric indices remained significant predictors of metabolic syndrome after adjusting for fasting insulin. Waist circumference, BMI, and insulin had similar areas under the receiver operating characteristic curves (0.74 to 0.76). Further multivariate analyses combining these indices showed minimal increase in prediction. Of subjects who had a combination of high BMI (≥30 kg/m²) and high waist circumference (above “Action Level 2”), 32% developed metabolic syndrome, compared with 10% of subjects with both low BMI and low waist circumference. Discussion: These findings support the National Institutes of Health recommendations for reducing the risk of metabolic syndrome. Adjustment for baseline fasting insulin levels had only a small effect on the ability of anthropometric indices to predict the metabolic syndrome.     

Central Adiposity Determines Prevalence Differences of the Metabolic Syndrome

Objective: To compare the expression of the metabolic syndrome in Spain and San Antonio, TX, two populations with major differences regarding their cardiovascular risk profile. Research Methods and Procedures: Cross‐sectional analysis of population‐based, epidemiological surveys using the metabolic syndrome definition of the National Cholesterol Education Program. In San Antonio, we limited our analysis to non‐Hispanic whites because non‐Hispanic whites are largely of European ancestry (n = 1339 in San Antonio and 2947 in Spain) Results: In men, increased central adiposity was more prevalent in San Antonio than in Spain (29.7 vs. 23.0%, p < 0.0001); in women, it was less prevalent in San Antonio than in Spain (40.2 vs. 66.4%, p < 0.0001). The metabolic syndrome followed that same pattern: more prevalent in men (28.9 vs. 20.8%, p = 0.019) and less in women from San Antonio (27.1 vs. 30.9%, p < 0.0001). In subjects with the metabolic syndrome, most women had increased central adiposity (92.6% in San Antonio and 97.5% in Spain), and most men had either increased central adiposity or blood pressure (99.2% in San Antonio and 95.0% in Spain). Discussion: Contrary to men, the metabolic syndrome is more prevalent in Spanish women than in women from San Antonio with differences that mirror differences in central adiposity. Central adiposity and blood pressure may be used to exclude the metabolic syndrome. Considering recent secular trends in obesity, we predict there will be an increase in the prevalence of the metabolic syndrome in both populations in the coming years.     

Focus: Microbiome: Treating Obesity and Metabolic Syndrome with Fecal Microbiota Transplantation

The worldwide prevalence of metabolic syndrome, which includes obesity and its associated diseases, is rising rapidly. The human gut microbiome is recognized as an independent environmental modulator of host metabolic health and disease. Research in animal models has demonstrated that the gut microbiome has the functional capacity to induce or relieve metabolic syndrome. One way to modify the human gut microbiome is by transplanting fecal matter, which contains an abundance of live microorganisms, from a healthy individual to a diseased one in the hopes of alleviating illness. Here we review recent evidence suggesting efficacy of fecal microbiota transplant (FMT) in animal models and humans for the treatment of obesity and its associated metabolic disorders.     

Time-Restricted Feeding Prevents Obesity and Metabolic Syndrome in Mice Lacking a Circadian Clock

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儿童肥胖与代谢综合征相关性的研究进展

近年来,儿童肥胖的检出率呈逐年增长趋势,代谢综合征是以糖代谢异常、血脂异常、高血压、中心性肥胖等集聚于一体的症候群。儿童肥胖是儿童代谢综合征发生的中心因素,严重影响儿童的身心健康,应及早诊断及治疗,而控制儿童肥胖的发生和发展是预防代谢综合征,降低成人心血管疾病、糖尿病等发病率的重要因素。治疗上重在预防,建议合理饮食、加强锻炼,阻止儿童肥胖及代谢综合征的流行与发展。本文针对儿童肥胖与代谢综合征相关性的研究进展进行综述,并提出进一步研究的设想。     

Fasting-based estimates of insulin sensitivity in overweight and obesity: a critical appraisal

Objective: To identify simple methods to estimate the degree of insulin resistance. Research Methods and Procedures: The performance of a wide range of fasting‐based index estimates of insulin sensitivity was compared by receiver operating characteristic analysis (area under curves and their 95% confidence intervals) against the M value from euglycemic insulin clamp studies collected in the San Antonio (non‐Hispanic whites and Hispanic residents of San Antonio, TX) and European Group for the Study of Insulin Resistance (non‐diabetic white Europeans) databases (n = 638). Results: Insulin resistance differed substantially between lean (BMI < 25 kg/m²), overweight or obese (BMI ≥ 25 kg/m²), and type 2 diabetic individuals. Estimates of insulin resistance were, therefore, assessed in each group separately. In the overweight and obese subgroup (n = 302), the receiver operating characteristic performance of fasting‐based indices varied from 0.72 (0.62 to 0.82), in the case of the insulin/glucose ratio, to 0.80 (0.72 to 0.88) in the case of Belfiore free fatty acids. One superior method could not be identified; the confidence intervals overlapped, and no statistically significant differences emerged. All indices performed better when using the whole study population, with fasting plasma insulin, homeostatic model assessment, insulin/glucose ratio, quantitative insulin sensitivity check index, glucose/insulin ratio, Belfiore glycemia, revised quantitative insulin sensitivity check index, McAuley index, and Belfiore free fatty acids showing area under curves of 0.83, 0.90, 0.66, 0.90, 0.66, 0.90, 0.85, 0.83, and 0.86, respectively, because of the inclusion of very insulin sensitive (lean) and very insulin resistant cases (diabetic subjects). Discussion: In conclusion, a superior fasting‐based index estimate to distinguish between the presence and absence of insulin resistance in overweight and obesity could not be identified despite the use of the large datasets.     

Increased Cortisol Bioavailability,Abdominal Obesity,and the Metabolic Syndrome in Obese Women

Objective: This study was conducted to obtain a detailed profile of hypothalamo‐pituitary‐adrenal (HPA) axis activity and reactivity and its differential relationships with body fat distribution and total fat mass in premenopausal obese women. Research Methods and Procedures: Cortisol responses to stimulation (awakening, food intake, exercise) and suppression (0.25 mg dexamethasone), cortisol metabolism, and tissue sensitivity to glucocorticoids were studied in 53 premenopausal obese women grouped according to their waist‐to hip ratio: women with abdominal body fat distribution (A‐BFD; n = 31) and women with peripheral fat distribution (P‐BFD; n = 22). Results: Comparatively, A‐BFD women had 1) lower awakening salivary cortisol levels; 2) increased salivary responsiveness to a standardized lunch; 3) similar pituitary sensitivity to dexamethasone but decreased sensitivity of monocytes to dexamethasone; 4) similar 24‐hour urinary free cortisol but increased 24‐hour urinary ratio of cortisone‐to‐cortisol; and 5) no difference in corticosteroid binding protein parameters. Discussion: Although abdominal obesity is not very different from generalized obesity in terms of HPA function, subtle variations in HPA axis activity and reactivity are evidenced in A‐BFD premenopausal obese women.     

Impact of Obesity and Body Fat Distribution on Cardiovascular Risk Factors in Hong Kong Chinese

Objective: Body fat distribution has been reported to differentially contribute to the development of cardiovascular risk. We report the relative associations between general and central obesity and risk factors in 2893 Chinese subjects recruited from the Hong Kong population. Research Methods and Procedures: Anthropometric parameters [waist circumference (WC) and BMI], surrogate measures of insulin resistance (fasting plasma glucose and insulin, oral glucose tolerance test, 2 hours glucose and insulin), fasting lipids (total, low‐density lipoprotein‐cholesterol, high‐density lipoprotein‐cholesterol, and triglycerides) and systolic and diastolic blood pressure were measured. General obesity was classified as BMI ≥25.0 kg/m² and central obesity as a WC ≥80 or ≥90 cm in women and men, respectively. Results: A total of 39.2% of the population was found to be obese. Obesity per se increased the levels of the risk factors, but central adiposity contributed to a greater extent to adverse high‐density lipoprotein‐cholesterol, triglyceride, and insulin resistance levels. There was a continuous relationship between increasing obesity, both general and central, and cardiovascular risk, with lowest risk associated with the lowest indices of obesity. In the 1759 nonobese subjects divided into quartiles of BMI or WC, the levels of the cardiovascular risk factors still significantly increased with increasing quartiles of adiposity. Discussion: Central adiposity appears to contribute to a greater extent than general adiposity to the development of cardiovascular risk in this population. The relationship between obesity parameters and risk is a continuum, with risk factors significantly increasing even at levels usually considered nonobese. These observations support the proposed redefinition of overweight and obesity in Asian populations using lower cut‐off points.     

Prevalence of the Metabolic Syndrome in a Bulgarian Female Population Referred for Bone Density Testing

Objective: To investigate the prevalence of the metabolic syndrome in Bulgarian women referred for bone density screening. Research Methods and Procedures: This was a cross‐sectional clinical study. Subjects were 444 consecutive 30‐ to 75‐year‐old Bulgarian women recruited from the outpatients referred for bone density testing (mean age, 52.67 ± 15.19 years; mean BMI, 26.10 ± 5.71 kg/m²). Height (centimeters), weight (kilograms), and blood pressure were measured. BMI and waist‐to‐hip ratio were calculated. Fasting plasma glucose, blood lipids, and immunoreactive insulinemia (Bayer Corp.‐Diagnostics Div., Tarrytown, NY) were determined. Body composition was analyzed by bioimpedance on a leg‐to‐leg analyser (Tanita TBF‐215; Tanita Corporation, Tokyo, Japan). Results: Of all women, 56.76% had a BMI > 25 kg/m², 45.95% had a waist circumference > 88 cm, and 64.64% had a waist‐to‐hip ratio > 0.8; 59.90% had hypertension; 4.05% had fasting plasma glucose > 7.0 mM, and 42.79% had fasting morning immunoreactive insulinemia = 16 UI/liter; 23.65% had hypercholesterolemia; and 26.35% had hypertriglyceridemia. The prevalence of the metabolic syndrome in this sample, as defined by the National Cholesterol and Education Program‐Adult Treatment Panel III, was 34.91%, and by the modified World Health Organization definition was 37.16%. Discussion: We concluded that Bulgarian women 30 to 75 years old referred for bone density testing have a high prevalence of the metabolic syndrome. Therefore, large‐scale prevention programs are needed in this field.     

血清视黄醇结合蛋白-4同儿童肥胖和代谢综合征组分的关系

目的:探讨儿童血清视黄醇结合蛋白-4(retinol-binding protein4,RBP-4),视黄醇,甲状腺素运载蛋白(transthyretin,TTR)等维生素A相关指标与肥胖、胰岛素抵抗以及代谢综合征组分之间的关系。方法:分别随机选取本地区13-15岁体检学生,其中正常对照组和单纯性肥胖组儿童各50例,测定其血清RBP-4、视黄醇、TTR水平;利用空腹胰岛素和定量胰岛索敏感性检测指标评价其胰岛素抵抗;同时测定代谢综合征部分组分水平和亚临床炎症指标。结果:仅5%的青少年存在维生素A营养不足状态。排除年龄、性别、感染等因素的影响后,血清RBP-4水平、视黄醇、RBP-4/TTR摩尔比值以及RBP-4/视黄醇摩尔比值与体重指数、体脂含量以及体脂的中心分布(WHR)等密切相关;RBP-4与代谢综合征组分的甘油三酯水平则存在明显的正相关,而RBP-4/视黄醇摩尔比值则与空腹胰岛素水平存在显著的正相关。结论:RBP-4可能通过视黄醇依赖和/或非视黄醇依赖的方式参与肥胖和代谢综合征的病理过程。     

Association of Polymorphisms in the Interleukin 6 Receptor Complex with Obesity and Hyperandrogenism

Objective: Interleukin‐6 (IL‐6), is an inflammatory cytokine that may influence the pathogenesis of obesity and hyperandrogenism. IL‐6 exerts its actions through a heterodimeric receptor consisting of two membrane‐bound glycoproteins: an 80‐kDa IL‐6 binding unit (IL6R‐α) and a 130‐kDa IL‐6 signal transducer (gp130). Genetic variability at these loci might contribute to explain the development of obesity and hyperandrogenism. Research Methods and Procedures: We have evaluated the possible association of several polymorphisms in the IL6R‐α and gp130 genes with obesity and/or hyperandrogenism in a case‐control study involving 143 hyperandrogenic patients and 45 healthy women from Spain. Results: A microsatellite CA‐repeat polymorphism in the IL6R‐α locus was associated with obesity. The frequency of the common 149‐bp allele was markedly increased in obese women compared with controls when considering patients and controls as a whole (0.41 vs. 0.29, χ² = 17.085, p < 0.050). On the other hand, the uncommon Arg148 allele of the Gly148Arg polymorphism in the gp130 gene was more frequent in controls compared with hyperandrogenic patients (0.17 vs. 0.08, χ² = 5.605, p = 0.026). Controls carrying Arg148 alleles had lower 11‐deoxycortisol and 17‐hydroxyprogesterone concentrations, a lower response of androstenedione to 1–24 adrenocorticotropin, and an almost significant decrease in free testosterone levels, suggesting that Arg148 alleles in the gp130 gene have a protective effect against androgen excess and adrenal hyperactivity. Discussion: Polymorphisms in the gp130 and IL6R‐α loci influence hyperandrogenism and obesity, respectively. Our present results further suggest that proinflammatory genotypes are involved in the pathogenesis of these common metabolic disorders.     

Alcohol Consumption and Metabolic Syndrome: Does the Type of Beverage Matter?

Objective: To examine the association between total and beverage‐specific alcohol consumption and the prevalence odds of metabolic syndrome (MS). Research Methods and Procedures: Using a cross‐sectional design, we studied 4510 white participants of the National Heart, Lung, and Blood Institute Family Heart Study. We used generalized estimating equations adjusting for age, education, risk group, smoking, physical activity, diabetes mellitus, coronary heart disease, energy intake, energy from fat, fruits, and vegetables, dietary cholesterol, dietary fiber, and use of multivitamins to estimate the prevalence odds of MS by alcohol intake. Results: Compared with never‐drinkers, multivariate odds ratios (95% confidence interval) for MS were 1.12 (0.85 to 1.49), 0.68 (0.36 to 1.28), 0.72 (0.50 to 1.03), 0.66 (0.44 to 0.99), and 0.80 (0.55 to 1.16) among men who were former drinkers and who were current drinkers of 0.1 to 2.5, 2.6 to 12.0, 12.1 to 24.0, and >24.0 g/d of alcohol, respectively (p for linear trend 0.018). Corresponding values for women were 0.86 (0.69 to 1.09), 0.80 (0.43 to 1.34), 0.47 (0.33 to 0.66), 0.47 (0.30 to 0.74), and 0.39 (0.21 to 0.74), respectively (p for trend < 0.0001). The reduced prevalence odds of MS was observed across all beverage types: compared with never‐drinkers, multivariate adjusted odds ratios (95% confidence interval) of MS were 0.32 (0.14 to 0.73), 0.42 (0.23 to 0.77), 0.57 (0.30 to 1.09), and 0.56 (0.36 to 0.88) for subjects who consumed >7 drinks/wk of wine only, beer only, spirits only, and more than one type of beverage, respectively. Discussion: Our data indicate that alcohol consumption is associated with a lower prevalence of MS irrespective of the type of beverage consumed. Prospective studies are needed to confirm these findings and to assess the influence of drinking patterns on the alcohol‐MS association.     

Metabolic flexibility is conserved in diabetic myotubes

The purpose of this study was to test the hypothesis that metabolic inflexibility is an intrinsic defect. Glucose and lipid oxidation were studied in human myotubes established from healthy lean and obese subjects and patients with type 2 diabetes (T2D). In lean myotubes, glucose oxidation is raised by increasing glucose concentrations (0-20 mmol/l) and acute insulin stimulation (P < 0.05), whereas it is inhibited by palmitate (PA). PA oxidation is raised by increasing PA concentrations (0-0.6 mmol/l), whereas 1.0 mmol/l PA inhibits its own oxidation (P < 0.05). Furthermore, PA oxidation is increased by acute insulin stimulation (P < 0.05) and inhibited by glucose. Even 0.05 mM PA and 2.5 mM glucose significantly reduce glucose and PA oxidation (P < 0.05), respectively. Glucose and PA oxidation are insulin-sensitive in myotubes established from lean (46% and 17% glucose and PA oxidation, respectively; P < 0.05 vs. basal), obese (31% and 14%; P < 0.05), and T2D (17% and 8%; P < 0.05) subjects. PA supplementation reduces both basal and insulin-stimulated glucose oxidation by 33-44% (P < 0.05), and myotubes are still insulin-sensitive in all three groups (P < 0.05). Therefore, the metabolic inflexibility described in obese and diabetic patients is not an intrinsic defect; rather, it is based on an extramuscular mechanism (i.e., the inability to vary extracellular fatty acid concentrations during insulin stimulation). Thus, skeletal muscles are metabolic-flexible per se.     

The Quantitative Relationship Between “The Metabolic Syndrome” and Abdominal Obesity in Women

Abdominal obesity is closely associated with the presence of metabolic risk factors and elevated blood pressure in selected materials. This has, however, never been analyzed quantitatively in a non-selected cohort. Therefore, in a population-based study of 1462 Swedish women, four selected risk factors for non-insulin dependent diabetes mellitus (NIDDM) and cardiovascular disease (CVD), serum triglycerides, blood glucose and systolic blood pressure and also serum insulin in a subsample, were examined in relation to regional and overall obesity. This was performed by subdividing the age adjusted sample into quintiles of waist to hip circumference ratio (WHR) or body mass index (BMI) as indicators of abdominal distribution of body fat and overall obesity, respectively. The risk factors serum triglycerides, blood glucose, blood pressure and serum insulin were defined as being elevated when the value of the risk factor was higher than the mean plus one or two standard deviations of the total age-adjusted cohort. The percentage of women with elevated risk factors according to this definition was then calculated in each of these quintiles. Having a risk factor which was elevated according to the definition was significantly correlated to WHR and BMI (p<0.0001) independent of age. The presence of one or several of these elevated risk factors was clearly higher than expected in the fifth quintile of WHR, and to a lesser extent in the fifth quintile of BMI while this was not the case in the lower quintiles of WHR and BMI. When studying the combination of the WHR and BMI, the presence of risk factors higher than the mean plus two standard deviations increased gradually with WHR in all five quintiles of BMI. A significant association was observed between WHR and presence of risk factors independent of BMI (p<0.0001) but BMI did not remain significantly correlated to presence of risk factors when controlling for WHR (p=0.09). These results indicate that abdominal distribution of body fat in women independently of general obesity is closely associated with metabolic risk factors including elevated blood pressure, a metabolic syndrome with increased risk for cardiovascular disease and non-insulin dependent diabetes mellitus.     

The N363S Polymorphism of the Glucocorticoid Receptor and Metabolic Syndrome Factors in Men

Objective: To test the associations between the N363S polymorphism of the glucocorticoid receptor gene (NR3C1) and factors related to the metabolic syndrome in middle‐aged men with and without juvenile‐onset obesity. Research Methods and Procedures: This study included two groups of middle‐aged men, who were originally identified at 20 years of age at the draft boards. One group (n = 208; age, 48 ± 6 years) was selected on the basis of juvenile‐onset obesity (BMI ≥ 31 kg/m²). The other group consisted of mainly nonobese men randomly sampled from the same population in parallel with the obese men (n = 299; age, 50 ± 7 years). The subjects were genotyped for the N363S polymorphism by polymerase chain reaction‐restriction fragment length polymorphism. Body composition was measured by DXA. Glucose metabolism was evaluated by an oral glucose tolerance test, and the Matsudas index was calculated as a proxy for insulin sensitivity. Serum triglycerides and total and high‐density lipoprotein‐cholesterol were measured in the fasting state. Results: Among the men with juvenile‐onset obesity, carriers (n = 17) of the 363S allele had a lower whole body fat percentage, after accounting for differences in BMI and higher Matsudas index, compared with the noncarriers. The difference in Matsudas index lost statistical significance after the difference in body fat was accounted for. In the randomly sampled men, these variables did not relate to genotype. No relationship between carriers and noncarriers was found in body fat distribution or serum lipids. Discussion: This study suggests that, in men developing obesity early in life, the 363S allele is associated with less adiposity at a given BMI, leading to higher insulin sensitivity.     

饥荒造成的营养不良对成年后患代谢综合征的影响

研究生命早期因食物短缺造成的营养不良对成年后患代谢综合征（Metabolic syndrome,MS）的影响．探讨成年人慢性病的起因．为制订妇女儿童营养改善政策提供科学依据．对2005—2008年上半年重庆医科大学附属第一医院体检中心体检资料进行整群抽样．选出14917例样本．将三年自然灾害（1959～1961年）出生的研究对象3650例（G2组）作为受灾害影响人群,将灾害之前（1955～1957年）出生的4497例体检人群（G1组）和灾害之后（1963～1965年）6770例体检人群作为未受灾害影响人群（G3组）,比较3组人群体质指数、血糖值、血压值及血脂值4项MS各分项判断指标．运用SAS9．1分析MS发生情况．G1组检出MS463例,占G1组总人数的10．30％：G2组检出MS403例,占G2组总人数的11．04％：G3组检出MS609侧．占G3组总人数的9．00％．组间比较有统计学意义．男性检出MS1326例．患病率为14．06％．女性检出MS149例,患病率为2．72％．饥荒造成的机体早期营养不良与成年后患MS有关,对MS影响严重程度依次为血脂紊乱〉体质指数超标〉血压超标〉血糖超标．且男性比女性受影响显著,差异有统计学意义．故在选择孕妇、乳母以及婴幼儿饮食上,科学的供给和合理的配比显得尤为重要．可以借以提高整体人群的生存质量．     

Effects of Dairy on Metabolic Syndrome Parameters: A Review

Metabolic syndrome (MetS), characterized by central obesity, dyslipidemias, hypertension, and hyperglycemia, impacts 34 percent of the U.S. adult population. MetS has been demonstrated to be affected by dietary components. Data from epidemiological studies and clinical interventions suggest that one or more dairy components might directly affect MetS parameters. For example, calcium has been postulated to reduce body weight by modulating vitamin D concentrations in plasma and therefore attenuating intracellular calcium effects in activating genes involved in fatty acid synthesis and reducing those involved in lipolysis. Peptides present in milk have been associated with the inhibition of angiotensin converting enzyme and, therefore, with blood pressure reductions. Branched chain amino acids may increase post-prandial insulin secretion and regulate plasma glucose levels, and leucine, an abundant amino acid in milk, may be responsible for decreased plasma glucose through modulation of mTOR. Through different proposed mechanisms, dairy nutrients may target all components of MetS.