T he metabolic syndrome is a constellation of cardiovascular and metabolic risk factors associated with insulin resistance, which predisposes individuals to diabetes, and appears to be a multifactorial risk factor for cardiovascular disease, although its clinical significance remains controversial (1). Since it may become useful to be able to predict who will develop metabolic syndrome, we explored the value of lipid accumulation product (LAP), a novel index of central lipid accumulation, which has been associated with cardiovascular disease (2) and diabetes (3). LAP is based on a combination of waist circumference and triglyceride: [LAP ϭ (WC Ϫ 65) ϫ TG for men and (WC Ϫ 58) ϫ TG for women] (2), where TG is triglyceride and WC is waist circumference.We conducted a cross-sectional population-based survey on metabolic syndrome in Argentinian healthy individuals in order to identify single parameter/ index as LAP/surrogates of insulin resistance, with high efficiency in predicting metabolic syndrome. After obtaining ethics committee approval, we recruited (from the Department of Hemotherapy of the Hospital "José de San Martín," University of Buenos Aires) 601 healthy, unrelated male blood donors who had normal findings on medical examinations and were not taking antihypertensive medications. Their ages ranged between 18 and 65 years (mean Ϯ SD 36.9 Ϯ 10.8 years). Clinical and biochemical (lipids, glucose, and insulin) measurements were performed using standardized procedures. Metabolic syndrome was assessed using the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ ATP III) criteria (1). Homeostasis model assessment (HOMA), quantitative insulin sensitivity check index (QUICKI), and LAP were calculated.The prevalence of NCEP/ATP IIIdefined metabolic syndrome was 26.3%.Receiver operating characteristic curves were built for 552 men. The LAP showed the best area under the curve (AUC) for metabolic syndrome (0.91) and was significantly higher than all variables including HOMA of insulin resistance (P Ͻ 0.0001), QUICKI (P Ͻ 0.0001), and triglyceride-to-HDL cholesterol ratio (P ϭ 0.0385). The overall performance of the LAP was similar when individuals were stratified into quartiles for age: quartile 1 (18 -28 years; AUC 0.95), quartile 2 (28 -36 years; 0.93), quartile 3 (36 -45 years; 0.81), and quartile 4 (45-65 years; 0.91). Analysis across quartiles demonstrated that AUCs of LAP were significantly higher than those of fasting insulin, HOMA of insulin resistance, and QUICKI, but not significantly higher than AUCs of triglyceride-to-HDL cholesterol ratio. The AUC of triglyceride-to-HDL cholesterol ratio was the second-highest AUC in the whole sample (0.86) and in quartiles 2 (0.89), 3 (0.78), and 4 (0.89).These findings were confirmed using 20,000 bootstrap samples. The cutoff 53.63 of LAP showed the highest diagnostic accuracy for metabolic syndrome (sensitivity 0.83, specificity 0.83, Younden's index 0.66, predictive value of positive test 0.62, and predictive value of negative test 0.93), and t...

Shortened leukocyte telomere length (LTL) is a novel biomarker for age and age-related diseases. Several epidemiological studies have examined the association between telomere length in surrogate tissues (for example, blood cells) and hypertension, and meanwhile the majority of studies reported an association some individual studies do not. We carried out a systematic review and meta-analysis to address the hypothesis that, in humans, telomere length is related with hypertension. Searches were conducted in Pubmed by September 2015 and reference lists of retrieved citations were hand searched. Eligible studies measured telomeres for both hypertensive and normotensive subjects. No restrictions were placed on sample size, publication type, age or gender. We calculated summary estimates using fixed and random effects meta-analysis. Publication bias and heterogeneity among studies were further tested. Meta-analyses from 3097 participants (1415 patients with hypertension and 1682 control subjects) showed a significant standardized mean difference between LTL in hypertensive patients and controls, either in the fixed (P<5 × 10) or the random model (P<0.005). Heterogeneity among studies was substantial (Q-statistic P-value <0.001, I 97.73%). Sensitivity analysis indicated that no single study changed the standardized mean difference qualitatively (0.022> random model P-value >0.002). Egger's test for asymmetry of effect sizes (intercept±s.e.=-7.278±3.574; P=0.072) did not show evidence for strong study publication bias. Leukocyte telomeres may be shorter in hypertensive than in normotensive individuals. Larger studies controlling for confounder effects are needed to confirm these findings and further explore sources of heterogeneity.

Numerous rodent studies have evaluated the effects of a maternal high-fat diet (HFD) on later in life susceptibility to Metabolic Syndrome (MetS) with varying results. Our aim was to quantitatively synthesize the available data on effects of maternal HFD around gestation on offspring’s body mass, body fat, plasma leptin, glucose, insulin, lipids and systolic blood pressure (SBP). Literature was screened and summary estimates of the effect of maternal HFD on outcomes were calculated by using fixed- or random-effects models. 362 effect sizes from 68 studies together with relevant moderators were collected. We found that maternal HFD is statistically associated with higher body fat, body weight, leptin, glucose, insulin and triglycerides levels, together with increased SBP in offspring later in life. Our analysis also revealed non-significant overall effect on offspring’s HDL-cholesterol. A main source of variation among studies emerged from rat strain and lard-based diet type. Strain and sex -specific effects on particular data subsets were detected. Recommendations are suggested for future research in the field of developmental programming of the MetS. Despite significant heterogeneity, our meta-analysis confirms that maternal HFD had long-term metabolic effects in offspring.