Metabolic syndrome and cardiovascular risk in patients with severe mental illness

Metabolic syndrome and cardiovascular risk in patients with severe mental illness

Michele Fiorani1 Orcid, Laura OrsoliniOrcid, Umberto VolpeOrcid, Virginio SalviOrcid

1 – Department of Experimental and Clinical Medicine (DIMSC), Polytechnic University of Marche, Ancona

Corresponding Author: Virginio Salvi

virginiosalvi@gmail.com


DOI: 10.53146/lriog1202157

Abstract

People with severe mental illness such as Schizophrenia, Bipolar Disorder and Schizoaffective Disorder have a significantly increased risk of developing alterations in glucose and lipid metabolism compared to the general population, leading to weight gain, dyslipidemia, insulin resistance and diabetes. As a result, they have a two-fold increased risk of morbidity and mortality for cardiovascular disease and a life expectancy reduced by 15 years compared to the general population. Metabolic Syndrome, a cluster of risk factors such as abdominal obesity, hyperglycemia, hypertension and dyslipidemia leading to cardiovascular morbidity and mortality, has been widely investigated in patients with SMI. Numerous studies have been carried out worldwide, reporting a 58% higher risk in patients with SMI compared to the general population. The increased risk is explained by several factors more prevalent in people with SMI, such as the adoption of unhealthy lifestyles, some biological common grounds between mental and metabolic conditions, and, eventually, the use of psychopharmacological medications such as several antipsychotics, mood stabilizers and antidepressants. In this paper we will review the risk of metabolic syndrome in patients with SMI. Finally, given the mounting evidence of a specific risk, the issue of metabolic syndrome in women with SMI and the impact of related factors will also be discussed.

Keywords: severe mental illness; metabolic syndrome; cardiovascular risk; gender differences.


Available in LRIOG Nr.1 – 2022

e-ISSN: 1824-0283


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Hypovitaminosis D and metabolic syndrome

Hypovitaminosis D and metabolic syndrome

Martina Leoni1* Orcid, Marco Infante 1,2,3,4,* Orcid, Raffaele Infante 4 Orcid, Massimiliano Caprio 5,6Orcid, Andrea Fabbri1 – Orcid

1 – Transmural Complex Organizational Unit of Endocrinology & Diabetes Research Institute Federation (DRIF), Department of Systems Medicine, CTO A. Alesini & S.Eugenio Hospitals, Local Health Center Roma 2, University of Rome Tor Vergata (Rome, Italy)

2 – UniCamillus, Saint Camillus International University of Health Sciences (Roma, Italia)

3 – Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN) (Roma, Italia)

4 – Cardio Endocrino Metabolica (CEM) – Endocrine and Cardiometabolic Center (Salerno, Italia)

5 – Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University of Rome (Rome, Italy)

6 – Cardiovascular Endocrinology Laboratory, Scientific Institute for Research, Hospitalization and Healthcare, San Raffaele Rome (Rome, Italy)

*Martina Leoni e Marco Infante hanno contribuito in egual misura alla stesura del presente articolo.

Autore di riferimento: Marco Infante

marco.infante@unicamillus.org


DOI: 10.53146/lriog1202162

Abstract

Metabolic syndrome is a complex disorder characterized by the co-occurrence of several known cardiovascular risk factors, including obesity, insulin resistance, atherogenic dyslipidemia and hypertension. As such, metabolic syndrome is associated with an increased risk of cardiovascular disease and type 2 diabetes mellitus. Of note, metabolic syndrome is defined by the presence of at least three of the following conditions: abdominal obesity (or central obesity), high blood pressure (≥130/≥85 mmHg), abnormal fasting plasma glucose (≥100 mg/dL), elevated serum triglycerides (≥150 mg/dL) and low high-density lipoprotein (HDL)-cholesterol level (<40 mg/dL in men, <50 mg/dL in women). Over the last years, the global prevalence of metabolic syndrome has progressively increased as a consequence of the increasing rates of overweight/obesity, population ageing, and lifestyle changes favoring sedentary behaviors, physical inactivity and unhealthy dietary habits. On the other hand, the global prevalence of vitamin D deficiency has concurrently increased. To date, vitamin D deficiency is regarded as a global pandemic afflicting more than one billion individuals across all age groups worldwide. Since growing evidence suggests that vitamin D exerts several pleiotropic extraskeletal actions beyond its well-established role in the regulation of bone homeostasis, researchers have proposed that vitamin D deficiency may be involved in the pathophysiology of metabolic syndrome. Therefore, this brief Report article aims to summarize the current scientific evidence regarding the possible causal relationship between vitamin D deficiency and metabolic syndrome, as well as the potential favorable effects Keywords: metabolic syndrome; obesity; vitamin D deficiency; insulin resistance; type 2 diabetes mellitus; cardiometabolic risk.


Available in LRIOG Nr.1 – 2022

e-ISSN: 1824-0283


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Metabolic syndrome and birth risks

Metabolic syndrome and birth risks

Nicoletta Di Simone1 Orcid, Gloria LalliOrcid, Greta Barbaro3 Orcid

1 – MD, PhD at Humanitas University, Milan

2 – MD at Humanitas University, Milan

3 – MD at Università Cattolica del Sacro Cuore, Rome

Corresponding Author: Nicoletta Di Simone

nicoletta.disimone@hunimed.eu


DOI: 10.53146/lriog1202156

Abstract

Metabolic syndrome is a condition characterized by the simultaneous presence of a cluster of risk factors leading to an increased cardiovascular risk. During pregnancy this syndrome has important repercussions on the maternal and fetal well-being and can cause important risks at the time of delivery. Pregestational hypertension increases the risk of preeclampsia, intrauterine fetal growth restriction and abruptio placentae. Also type II diabetes is a risk factor for preeclampsia and hypodevelopment but may also involve the appearance of fetal macrosomia and polyamnios. Fetal macrosomia is responsible for an increased risk of shoulder dystonia and polyamnios can determine the umbilical cord prolapse at the time of rupture of the membranes. Obesity is another element of metabolic syndrome. The obese pregnant patient has an increased risk of premature childbirth, she has a lower probability of response to the medical induction of labor and requires higher doses of oxytocin. In addition, the management of these patients is also complicated from an anesthesiological point of view: the placement of the peridural catheter is more difficult and they have a higher risk that it will displace, therefore getting a good epidural analgesia in these patients is not always easy. In obese patients, the risk of performing an urgent cesarian section is higher and leads to increased anaesthetic complications (tough intubation and difficult mechanical ventilation), intraoperative complications (increased bleeding and difficult fetal extraction) and post-operative (increased risk of surgical site infection). Still unclear are the effects of a dyslipidic state on pregnancy, although the change in lipidic profile is, within certain limits, physiological. Metabolic syndrome is therefore a condition that must be intercepted before pregnancy arises, as all the factors that compose it are modifiable.

Keywords: metabolic syndrome; pregnancy; obesity; hypertension; diabetes; delivery.


Available in LRIOG Nr.1 – 2022

e-ISSN: 1824-0283


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Parathyroid disease, bone health and metabolic syndrome

Parathyroid disease, bone health and metabolic syndrome

Roberta ModicaOrcid, Giuseppe Cannavale1 Orcid, Alessia Liccardi1 Orcid, Renata Simona Auriemma1 Orcid, Annamaria Colao1,2,4Orcid

1 – Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi Federico II Napoli

2 – Cattedra Unesco Educazione alla salute e allo Sviluppo Sostenibile, Università degli Studi Federico II Napoli

Corresponding Author: Roberta Modica

robertamodica@libero.it


DOI: 10.53146/lriog1202153

Abstract

BACKGROUND: Parathyroid diseases are related to parathyroid hormone (PTH) dysregulation by parathyroid cells or alteration of PTH function. They include hypoparathyroidism (PTH deficiency), pseudohypoparathyroidism (PTH resistance) and hyperparathyroidism (PTH excess). They are known to al- ter calcium metabolism and consequently bone health. Little is known about correlation between parathyroid diseases and metabolic syndrome. METHODS: Aim of this paper is to analyse the literature to identify the role of parathyroid diseases in bone health and metabolic syndrome.
RESULTS: Hypoparathyroidism and pseudohypoparathyroidism reduce bone remodelling, destroying mineral density with increase of fracture risk. Con- versely, hyperparathyroidism induces increase of bone reabsorption with increased fracture risk. Metabolic syndrome may negatively influence pa- rathyroid diseases and worsen bone health.
CONCLUSIONS: Available data confirm the role of parathyroid diseases in worsening bone health and highlight an important relationship between pa- rathyroid diseases, especially hyperparathyroidism, and metabolic syndrome, which is increasingly widespread.

Keywords: parathyroid hormone; hyperparathyroidism; hypoparathyroidism; bone; calcium; metabolic syndrome.


Available in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283


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Metabolic syndrome in menopause

Metabolic syndrome in menopause

Roberta Scairati1 Orcid, Renata Simona AuriemmaOrcid, Annamaria Colao1,2 Orcid, Alessandra Graziottin3,4 – Orcid

1 – Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy

2 – United Nations Educational, Scientific and Cultural Organization (UNESCO), Chair for Health Education and Sustainable Development, University Federico II, Naples, Italy

3 – Director of the Center for Gynecology and Medical Sexology, H. San Raffaele Resnati, Milan

4 – President of the Graziottin Foundation for the treatment of pain in women – Non profit organization

Corresponding Author: Roberta Scairati

robertascairati@gmail.com


DOI: 10.53146/lriog1202149

Abstract

Background: Menopause is associated with a high risk for cardiometabolic diseases, including metabolic syndrome (MetS), cardiovascular disease (CVD) and type 2 diabetes (DMT2).
Insulin resistance, abdominal obesity, dyslipidemia and hypertension are in- terdependent factors associated with menopause. The increase in the syste- mic inflammation is the common denominator of MetS. The purposes of this review are i) to clarify how the natural cessation of ovarian function, which is characterized by the decline of female sexual hormones and the relative in- crease of androgens, could explain the relationship between MetS, increase of the inflammatory indexes and menopause; ii) to understand how surgical menopause could influence the onset of MetS; iii) to highlight the role of hormone replacement therapy.
Methods: We revised the published literature in english language on PubMed database, from year 1992 to year 2021, by searching the following keywords, including 1) a refined definition of metabolic syndrome 2) relationship betwe- en metabolic syndrome and systemic inflammation 3) relationship between metabolic syndrome and obesity, insulin resistance, hypertension, osteoporo- sis and hypothyroidism, 4) surgical menopause and metabolic syndrome, 5) effects of HRT on the components of the MetS in post-menopausal women. Results: Derived evidences suggest an increased incidence of metabolic syn- drome in menopause, probably due to woman aging and hormonal chan- ges in menopause, worsened by hypothyroidism, inappropriate lifestyles and lack of timely initiated HRT.
Conclusions: Menopause plays a crucial role in the development of MetS and surgical menopause; sudden cessation of ovarian function can lead to a hi- gher incidence of MetS and systemic inflammation than physiological me- nopause. Hormone replacement therapy (HRT) and a healthy lifestyle may positively influence some aspects of Mets. Our observations can help in the clinical management of menopause-related MetS.

Keywords: menopause; surgical menopause; metabolic syndrome; inflammation; hormone replacement therapy.


Available in LRIOG Nr.4 – 2021

e-ISSN: 1824-0283


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