Metabolic Syndrome Severity Confers Greater Cardiovascular Risk

MedicalResearch.com Interview with:

Mark D. DeBoer, MD Associate Professor of Pediatrics Division of Pediatric Endocrinology University of Virginia Charlottesville, VA 22908

Dr. DeBoer

Mark D. DeBoer, MD
Associate Professor of Pediatrics
Division of Pediatric Endocrinology
University of Virginia
Charlottesville, VA 22908

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Worldwide there remains a need for accurate prediction of cardiovascular disease. One such predictor is the metabolic syndrome, a cluster of individual risk factors including central obesity, high blood pressure, high triglycerides, low HDL cholesterol, and high fasting glucose. Metabolic Syndrome is usually diagnosed using set criteria, where a person is diagnosed if he or she has abnormalities in at least 3 of the individual components. Using these criteria, someone with MetS (compared to without MetS) has a >50% greater chance of developing cardiovascular disease over the ensuing 10 years. The problem is that prior studies showed that having MetS did not increase risk above that seen for having the abnormalities in the individual risk factors themselves.

Our study used a continuous MetS severity score that we derived previously and assessed this score as a predictor of future cardiovascular disease in two large cohorts. We found that even when analyzed with abnormalities in the individual Metabolic Syndrome components, higher levels of the MetS severity score conferred higher risk for cardiovascular disease. This suggests the potential for following this score in individuals over time to identify those at higher risk for future cardiovascular disease.

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One Fatty Meal Results In Metabolic Disturbances

MedicalResearch.com Interview with:

Prof. Dr. Michael Roden Director, German Diabetes Center (DDZ) Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf Chair/Professor, Endocrinology and Metabolic Diseases Heinrich Heine University Düsseldorf Director, Department of Endocrinology and Diabetology University Hospital Düsseldorf Düsseldorf, Germany

Prof. Michael Roden

Prof. Dr. Michael Roden
Director, German Diabetes Center (DDZ)
Leibniz Center for Diabetes Research
at Heinrich Heine University Düsseldorf
Chair/Professor, Endocrinology and Metabolic Diseases
Heinrich Heine University Düsseldorf
Director, Department of Endocrinology and Diabetology
University Hospital Düsseldorf
Düsseldorf, Germany

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The prevalence of obesity, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) continue to increase at an alarming rate. Their occurrence has been associated with intake of saturated fats, for example that of palm oil. This study aimed to shed light on how dietary fat initiates metabolic changes which lead to the aforementioned diseases. To this end we provided 14 young healthy volunteers an oral dose of palm oil or placebo randomly, in a crossover manner, with an 8-week washout period between each intervention.

One acute dose of palm oil leads to insulin resistance in the main insulin sensitive tissues of the body: the liver, skeletal muscle and adipose tissue. In the liver, it also results in increased accumulation of triglycerides, increased production of glucose from lipid and amino acid precursors (rather than from glycogen), and increased energy metabolism, as denoted by increased hepatic adenosine triphosphate (ATP) content. Moreover, a similar experiment in mice revealed that one dose of palm oil differentially regulates genes and pathways which are known or suspected regulators of NAFLD, such as lipopolysaccharide (LPS), members of the peroxisome proliferator-activated receptor (PPAR) family and nuclear factor kappa-light-chain-enhancer of activated B-cells.

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Living at a Geographically Higher Elevation Is Associated with Lower Risk of Metabolic Syndrome

MedicalResearch.com Interview with:
“The Mountains of Spain” by Nan Palmero is licensed under CC BY 2.0
Pedro González Muniesa 
Director of International Relations of Human Nutrition and Dietetics
Universidad de Navarra
Nutrition Research Center / Dpt. Nutrition, Food Science and Physiology
School of Pharmacy / University of Navarra 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Several other studies have reported lower incidence rates of conditions linked to MetS such as obesity (Díaz-Gutiérrez et al.,2016; Voss et al., 2013; Woolcott et al., 2014), heart disease (Ezzati et al., 2012; Faeh et al., 2016), hypertension (Norboo et al., 2015) or type 2 diabetes (Woolcott et al., 2014) on subjects living at high altitudes.

To our knowledge this is the first study that has found a protective effect on living at a higher altitude against metabolic syndrome, and it is one of the very few that has found this effect at a median altitude of less than 600 meters.

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Weight Shaming Can Cause Physical As Well As Mental Harm

MedicalResearch.com Interview with:
Rebecca L. Pearl PhD
Department of Psychiatry, Center for Weight and Eating Disorders
Perelman School of Medicine
University of Pennsylvania, Philadelphia, Pennsylvania

MedicalResearch.com: What is the background for this study? 

Response: Weight bias is a pervasive form of prejudice that leads to weight-based discrimination, bullying, and the overall stigmatization of obesity. Some individuals with obesity may internalize weight bias by applying negative weight stereotypes to themselves and “self-stigmatizing.” Exposure to weight bias and stigma increases risk for poor obesity-related health (in part by increasing physiological stress), but little is known about the relationship between weight bias internalization and risk for cardiovascular and metabolic diseases.

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Aspartame May Promote Obesity By Changing Gut Enzyme

MedicalResearch.com Interview with:

Richard Hodin, MD Gastrointestinal and Endocrine Surgery Professor of Surgery, Harvard Medical School Chief of Academic Affairs, Department of Surgery, Massachusetts General Hospital Boston, Mass 02114

Dr. Richard Hodin

Richard Hodin, MD
Gastrointestinal and Endocrine Surgery
Professor of Surgery, Harvard Medical School
Chief of Academic Affairs, Department of Surgery,
Massachusetts General Hospital
Boston, Mass 02114

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Sugar substitutes like Aspartame are widely used and supposed to make people lose weight and have less diabetes, heart disease, etc. However, a number of studies indicate that theses substitutes don’t work very well. The reasons for them not working have not been clear. Our study found that the most common sugar substitute (aspartame) blocks an enzyme in our gut called Intestinal Alkaline Phosphatase (IAP). By blocking IAP, Aspartame prevents the beneficial effects of IAP which normally works to prevent obesity, diabetes, and other aspects of the metabolic syndrome.

So, we now have an explanation for why Aspartame may make obesity and the metabolic syndrome worse, rather than better.

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Larger Wrist Size May Suggest Unhealthy Metabolic Syndrome

MedicalResearch.com Interview with:
Ilaria Cavallari, MD
Department of Cardiovascular Sciences
University Campus Bio-Medico
Roma, Italy

MedicalResearch.com: What is the background for this study?

Response: Obesity is a well-known risk factor for metabolic and cardiovascular disease (CVD). However, more than the amount of adipose tissue, its function plays important roles in the development of CVD. Distribution of adiposity, evaluated by measuring body circumferences, is related to adipose dysfunction. Wrist circumference has been recently associated with insulin-resistance and diabetes. Therefore, body circumferences, wrist circumference in particular, are candidate easy and fast markers of cardiovascular risk, beyond the classical body mass index (BMI).

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Prehypertension in Pregnancy Linked to Postpartum Metabolic Syndrome

MedicalResearch.com Interview with:

Jian-Min Niu Department of Obstetrics Guangdong Women and Children Hospita Guangzhou , China

Dr. Jian Min Niu

Dr. Jian-Min Niu
Department of Obstetrics
Guangdong Women and Children Hospita
Guangzhou , China

MedicalResearch.com: What is the background for this study?

Response: Physiological alteration leads to the question of whether the criteria for the diagnosis of gestational hypertension are suitable because the current criteria (systolic BP [SBP] ≥140 mm Hg and diastolic BP [DBP] ≥90 mm Hg) are derived from the non-pregnant population. The optimal blood pressure levels in pregnant women remain an open question. Recent studies have demonstrated associations between prehypertension before pregnancy and hypertensive disorders during pregnancy and gestational diabetes mellitus. To our knowledge, the association between prehypertension during pregnancy and postpartum cardiovascular risk has not been addressed.

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High Fructose Diet During Pregnancy Predisposes Children to Obesity

MedicalResearch.com Interview with:

Antonio Saad, MD Fellow in Maternal Fetal Medicine University of Texas Medical Branch at Galveston.

Dr. Antonio Saad

Antonio Saad, MD
Fellow in Maternal Fetal Medicine & Critical Care Medicine
University of Texas Medical Branch at Galveston

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Saad: Recently the WHO announced an alarming news, the prevalence of diabetes has increased four fold in the past quarter-century. The major factors attributed for this increase included excessive weight, and obesity. In the US alone, two thirds of people are either overweight or obese. There are shocking numbers that should alert physicians, patients and government officials for awareness and interventions that we can alter the path away from this drastic epidemic.

In light of recent events, our group strongly believes that poor diet during pregnancy predisposes offspring in adult life to develop obesity and diabetes through fetal programming. High fructose introduction into our food chain has coincided with the obesity and diabetes epidemics. Hence, we designed an animal study where we fed pregnant mice with either regular diet or high fructose diet until delivery. Then we looked at the offspring, at 12 months of age. We looked at  their blood pressure, glucose tolerance tests, insulin resistance,  and weights. We also tested for serum marker of metabolic dysfunction and used computed tomography imaging to assess for liver fat infiltration and percent visceral adipose tissue. To our surprise, these offspring (mothers were fed high fructose diet) developed several features of metabolic syndrome.  Female offspring’s cardiovascular and metabolic function at one year of age (adulthood) had increased weight, blood pressure, visceral adiposity, liver fat infiltrates and  insulin resistance with impaired glucose tolerance).  The  male counterparts were limited to high blood pressure  and glucose intolerance. Keeping in mind that the amount of fructose given to these animals were equivalent to daily soda cans consumption in humans.

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Multiple Pregnancies May Raise Metabolic Syndrome Risk in Latina Women

MedicalResearch.com Interview with:

Catherine J. Vladutiu, PhD, MPH Research Assistant Professor, Department of Obstetrics & Gynecology Adjunct Assistant Professor, Department of Epidemiology Chapel Hill, NC

Dr. Catherine Vladutiu

Catherine J. Vladutiu, PhD, MPH
Research Assistant Professor, Department of Obstetrics & Gynecology
Adjunct Assistant Professor, Department of Epidemiology
Chapel Hill, NC

Medical Research: What is the background for this study?

Dr. Vladutiu: During pregnancy, women experience physiological changes and are at risk of pregnancy-related complications, some of which are associated with a higher risk of cardiovascular health outcomes in later life.  Physiologic adaptations occurring across successive pregnancies may be associated with an even higher risk of adverse cardiovascular outcomes. Previous studies have found an association between higher parity (i.e., number of live births) and the metabolic syndrome (MetS). However, no studies have examined this association in a Hispanic/Latina population. Hispanic women have a higher prevalence of the MetS than non-Hispanic women.  Latinos are also the fastest growing minority population in the U.S. and Hispanic/Latina women report higher fertility and birth rates than their non-Hispanic counterparts.

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Short Term High Fat Snacks Linked To Metabolic Syndrome

Suzan Wopereis, Ph.D. TNO, Microbiology and Systems Biology Group Zeist, The Netherlands

Dr. Wopereis

MedicalResearch.com Interview with:
Suzan Wopereis, Ph.D.
TNO, Microbiology and Systems Biology Group
Zeist, The Netherlands

Medical Research: What is the background for this study? What are the main findings?

Dr. Wopereis: For the first time we could demonstrate the very subtle start of negative health effects caused by a high calorie snack diet in healthy men. We already knew about the negative consequences of such diets from so called epidemiologic studies. In such studies, scientists compare large populations (thousands of people) to better understand disease development. For example, by comparing  obese populations to a lean population, scientists could define various steps in the disease development related to obesity, like high cholesterol, onset of inflammation, high blood pressure, high glucose, etc. Yet, the early deviations from health  were difficult to study because human metabolism (the way we digest and metabolize our meals from a biochemical viewpoint)  is very flexible and able to efficiently deal with all kinds of daily stressors, such as a meal or intensive exercise. So, at TNO we decided to exploit  this flexibility by giving our healthy volunteers a ‘challenge test’, in the form of a high-fat milkshake. Next, we studied how multiple aspects of their metabolism react to such a challenge test. We showed that a snack diet for 4 weeks reduced many aspects of  flexibility of our healthy men, thus indicating very early changes in health. Both the high-fat challenge test and the integral study of many different outcomes form a novel approach of what “healthy” really means.

In the study we used two groups of male volunteers. One group of 10 healthy male volunteers and one group of 9 male volunteers with Metabolic Syndrome, who had a combination of 2 or more risk factors that raises your risk for heart disease and other health problems (unhealthy cholesterol levels, high blood pressure, high blood sugar, high blood lipids, and abdominal fat). In other words, subjects with Metabolic Syndrome have a suboptimal health condition. Both groups received a high-fat milk-shake, and before and up to 8 hours after consumption of this metabolic challenge-test, blood samples were taken. In these blood samples, 61 different biomarkers were measured, such as cholesterol and blood sugar. These 61 biomarkers were used for a thorough health assessment of these 2 groups in response to the challenge test. We noted that biochemical processes related to sugar metabolism, fat metabolism and inflammation function abnormal in subjects with Metabolic Syndrome. The next step was to provide the 10 healthy male volunteers with a snack diet for 4 weeks. On top of their normal diet they had to consume an additional 1300 kcal per day, in the form of sweets and savory products such as candy bars, tarts, peanuts, and crisps. After these 4 weeks the response of the same 61 biomarkers to the challenge test was evaluated. Here, we observed that signaling molecules such as hormones regulating the control of sugar and fat metabolism and inflammation were changed, resembling the very subtle start of negative health effects. Without the use of the challenge test, we would not have been able to observe that even this short period of overfeeding induces changes in the metabolism of healthy people that resemble what happens in people with metabolic syndrome.

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Some Non-Obese Adults Still Have Metabolic Syndrome

Robert Wong, M.D., M.S. Attending Physician, Gastroenterology & Hepatology Director, GI Education & Research Highland Hospital A member of Alameda Health System Oakland, CA 94602MedicalResearch.com Interview with:
Robert Wong, M.D., M.S.
Attending Physician, Gastroenterology & Hepatology
Director, GI Education & Research
Highland Hospital A member of Alameda Health System
Oakland, CA 94602

Medical Research: What is the background for this study? What are the main findings?

Dr. Wong: The rising prevalence of obesity and diabetes has led to concurrent rise in metabolic syndrome in the U.S.  Identifying metabolic syndrome is important to implement targeted treatment as metabolic syndrome contributes to cardiovascular disease, nonalcoholic fatty liver disease, and overall mortality.  However, while obesity is a major risk factor for metabolic syndrome, out study highlights the importance of considering metabolic syndrome even in individuals who do not meet criteria for obesity.  We demonstrated that nearly 20% of adults who do not meet current definitions of obesity still have metabolic syndrome in the U.S.

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Metabolic Syndrome In Youth Linked To Later Life Heart Disease

Mark DeBoerMedicalResearch.com Interview with:
Mark DeBoer, MD
Children’s Hospital’s Department of Pediatrics
University of Virginia 

Medical Research: What is the background for this study? What are the main findings?

Dr. DeBoer: We have been interested in how the severity of the metabolic syndrome relates to long term risks, both for children and adults.  We formulated a score that takes the different components of the metabolic syndrome (body mass index, blood pressure, fasting blood sugar, triglycerides and high density cholesterol) for an individual and forms a score estimating how severe the metabolic syndrome is in that individual.  When we looked at long-term data from individuals followed for 40 years, we found that children and adults with higher scores were more much likely to develop cardiovascular disease.

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Black Overweight Women Have Increased Cardiovascular Risk Even Without Metabolic Syndrome

Michelle Schmiegelow, MD, PhD-studerende Hjertemedicinsk Forskning Gentofte Universitetshospital HellerupMedicalResearch.com Interview with:
Michelle Schmiegelow, MD, PhD-student
Hjertemedicinsk Forskning
Gentofte Universitetshospital
Hellerup

Medical Research: What is the background for this study?

Dr. SchmiegelowObesity has become a worldwide epidemic, but the excess cardiovascular risk observed in obese individuals may primarily be attributable to metabolic mediators, rather than obesity per se. Several studies conducted in primarily non-Hispanic white populations suggest that obese individuals without the metabolic syndrome, defined as metabolically healthy obese, have a cardiovascular risk similar to that of normal weight metabolically healthy individuals.

We used prospectively collected data from the Women’s Health Initiative studies to evaluate whether obesity unaccompanied by metabolic abnormalities was associated with increased risk of cardiovascular disease (CVD) across racial/ethnic subgroups in postmenopausal women. Additionally, we examined whether the use of the metabolic syndrome to define the metabolically healthy obese applied to the various racial/ethnic subgroups by quantifying the number and type of metabolic syndrome components.

All women were classified by obesity level and metabolic health status at baseline. The women were thus categorized according to body mass index (BMI, kg/m2) into normal weight (BMI 18.5-24.9 kg/m2), overweight (25-29.9 kg/m2) and obese (30.0 kg/m2) women. Metabolic health status was first defined by presence of the metabolic syndrome (yes/no), and second by number of metabolic syndrome components. In accordance with the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute we defined the metabolic syndrome as any two of the following (criteria for women): increased waist circumference ≥80 cm; increased level of triglycerides ≥150 mg/dL (≥1.7 mM); decreased level of HDL-C <50 mg/dL (<1.3 mM); increased blood pressure with either systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥85 mmHg, or treatment with antihypertensive drugs; and impaired fasting serum glucose ≥100 mg/dL (6.1 mM).

Medical Research: What are the main findings?

Dr. Schmiegelow: The study population comprised 14,364 women without diabetes or prior cardiovascular disease. The women had a median age of 64 years (interquartile range 57–69), and 47% were white, 36% were black and 18% were Hispanic. Over a median follow-up of 13 years (interquartile range 12–14 years), 1,101 women (7.7%) had a first cardiovascular event.

The main findings of this study were that metabolic abnormalities appeared to confer more cardiovascular risk among black women than among white women. Consistent with other studies, among white women without the metabolic syndrome, obesity was not associated with increased cardiovascular risk compared with normal weight women. Conversely, black overweight and black obese women had increased cardiovascular risk compared with normal weight black women without the metabolic syndrome, even in absence of the metabolic syndrome.

According to number of metabolic syndrome components, black overweight or obese women with just two metabolic abnormalities had increased risk of cardiovascular disease, although they would be considered “metabolically healthy” based on the standard definition, particularly since one of these abnormalities were abdominal obesity for 79% of overweight and 98% of obese women, irrespective of race/ethnicity. White obese women with three metabolic abnormalities did not have a statistically significantly increased cardiovascular risk compared with normal weight metabolically healthy women. Thus, cardiovascular disease risk appeared to be elevated in black women by the presence of only two or three metabolic abnormalities to a degree that would require four or more metabolic abnormalities among white women. These findings did not appear to be driven by any particular combination of metabolic abnormalities.

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Prevalence of US Adults With Metabolic Syndrome Stabilizing But Still High

Robert Wong, M.D., M.S. Attending Physician, Gastroenterology & Hepatology Director, GI Research Highland Hospital   I A member of Alameda Health System Oakland, CA 94602MedicalResearch.com Interview with:
Robert Wong, M.D., M.S.
Attending Physician, Gastroenterology & Hepatology
Director, GI Research
Highland Hospital   I A member of Alameda Health System
Oakland, CA 94602

Medical Research: What is the background for this study? What are the main findings?

Dr. Wong: The main findings are that despite the stabilizing prevalence of metabolic syndrome, a large proportion of U.S. adults affected with metabolic still raises concern, especially given the significant health consequences associated with this syndrome.  In additional to cardiovascular disease, metabolic syndrome also increases the risk of concurrent nonalcoholic fatty liver disease, often considered the hepatic manifestation of metabolic syndrome.  Many studies, including work that our group has completed suggests that nonalcoholic fatty liver disease will soon become the leading etiology of chronic liver disease in the U.S.  Furthermore, our finding that metabolic syndrome increases with increasing age, reflects the increased risk for metabolic syndrome associated diseases such as hypertension, diabetes, and dyslipidemia with older age.  This is important to recognize given the aging population of the U.S.

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Night Owls May Have Increased Risk of Metabolic Syndrome and Diabetes

CDC- sleepMedicalResearch.com Interview with: Nan Hee Kim M.D., Ph.D., Professor
Korea University Ansan Hospital,
Gojan1-dong, Danwon-gu, Gyunggi-do, Korea

MedicalResearch: What is the background for this study?

Dr. Nan Hee Kim: Many individuals in modern society experience a discrepancy between social and biological time. Especially during the work or school week, we are often forced to be awake against our preferred time. In addition, the increase of light, TV, computer and internet make people stay up late at night. However, night owls (evening persons) have been reported to have more health and behavioral problems than morning persons. Evening persons experience eating disorders, negative mood and insufficient sleep compared to morning persons. They initiate sleep later in the night but need to wake up earlier than their biologic morning due to social demands. There is abundant evidence that short sleep duration and insomnia are significant risk factors for obesity and diabetes. Therefore, we feel the necessity to reveal whether evening persons are associated with metabolic abnormalities in the general population.

MedicalResearch: What are the main findings?

Dr. Nan Hee Kim: In middle-aged adults, people who stayed up late had a 1.7-fold increased risk for type 2 diabetes and metabolic syndrome, and a 3.2-fold increase in risk for sarcopenia as compared with morning persons, independent of sleep duration and lifestyle. Evening persons were associated with reduced muscle mass in men and increased fat mass including visceral fat in women.

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Nuts May Lower Odds Of Metabolic Syndrome In Adolescents

Dr. Roy Kim, MD Depts. Endocrinology and Pediatrics UT Southwestern Medical CenterMedicalResearch.com Interview with:
Dr. Roy Kim, MD
Depts. Endocrinology and Pediatrics
UT Southwestern Medical Center

Medical Research: What was the problem you were focused on?

Dr. Kim: We were focused on the problem of adolescent metabolic syndrome, a major public health problem. Our objective was to determine whether nut intake is linked with any difference in odds for metabolic syndrome in US adolescents.

Medical Research: How is metabolic syndrome defined?

Dr. Kim: In general it is diagnosed when there are 3 or more of the following things: increased belly fat, high blood pressure, high fasting glucose, elevated triglycerides, and low HDL cholesterol.

Medical Research: How did you do your study?

Dr. Kim: We used data from the National Health and Nutrition Examination Survey (NHANES), years 2003-2010, to examine health status and the diet history for 2,322 US adolescents age 12 to 19 years.

Dr. Kim: Our first major finding was that adolescents who ate at least 12.9 grams of nuts per day – this is the equivalent of about 1 ounce of nuts 3 times per week – had a dramatically lower odds for metabolic syndrome compared to adolescents who ate less than that amount. The odds for nut-consumers was only about 43% of the odds for non-consumers. This remained true after controlling for age, gender, race, income, and dietary factors including sugar, fruit, and vegetable intake.

Our second major finding was that average nut intake is very low among US adolescents – only about 5 grams per day – and more than 75% of US adolescents eat no nuts at all on a typical day.

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Cocoa May Improve Mental and Physical Health

Prof. Giovambattista Desideri Università degli Studi dell'Aquila Direttore  UOC Geriatria e Lungodegenza Geriatrica Scuola di Specializzazione in Geriatria Scuola di Specializzazione in Medicina d'Emergenza-UrgenzaMedicalResearch.com Interview with:
Prof. Giovambattista Desideri
Università degli Studi dell’Aquila
Direttore  UOC Geriatria e Lungodegenza Geriatrica
Scuola di Specializzazione in Geriatria
Scuola di Specializzazione in Medicina d’Emergenza-Urgenza

Medical Research: What is the background for this study? What are the main findings?

Dr. Desideri: Over the past decade, there has been an accumulating body of evidence that indicates that the consumption of cocoa flavanol-containing products can improve vascular function. Though much research has focused on the cardiovascular system, there is reason to believe that some of the benefits of cocoa flavanol consumption could extend also to the brain which is a heavily vascularized tissue that depends on regular blood flow to meet its metabolic demands. Thus, the current study tested the hypothesis that the regular inclusion of cocoa flavanols for 8 weeks could positively affect cognitive function in cognitively-intact older adults. The effects of cocoa flavanol ingestion on various cardiometabolic endpoints, including blood pressure and insulin sensitivity, were also evaluated given consistent evidence of positive effects of flavanols on these outcomes and the potentially influential role of these outcomes on cognitive function.

Medical Research: What are the main findings?

Dr. Desideri:The study enrolled 90 men and women aged 61-85 years with no evidence of cognitive dysfunction who were assigned to one of three flavanol groups, consuming a drink containing high (993 mg), intermediate ( 520 mg) or low (48 mg) amounts of cocoa flavanols every day for 8 weeks. Among those individuals who regularly consumed either the high-or intermediate-flavanol drinks, there were significant improvements in some measures of age-related cognitive dysfunction.  In the high- and intermediate-flavanol groups, both systolic and diastolic blood pressures were reduced and insulin resistance was significantly improved.   It is not yet fully understood how cocoa flavanols bring about improvements in cognitive function, but the study results suggest that the improvements in insulin resistance and blood pressure could be revealing.
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Inflammatory Gut Microbes May Drive Metabolic Syndrome

Dr. Andrew Gewirtz PhD Professor & Associate Chair  Department of Biology Georgia State UniversityMedicalResearch.com Interview with:
Dr. Andrew Gewirtz PhD
Professor & Associate Chair
Department of Biology
Georgia State University

Medical Research: What is the background for this study?

Dr. Gewirtz: 2010 science paper that discovered that loss of toll-like receptor 5 altered gut microbiota to drive metabolic syndrome

Medical Research: What are the main findings?

Dr. Gewirtz: It is loss of tlr5 on epithelial cells that alters the microbiota to make it more pro-inflammatory that drives metabolic syndrome.
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Brief Mediterranean Diet Intervention May Have Long Term Benefits

MedicalResearch.com Interview with:
Dr. Markos Klonizakis
Centre for Sports and Exercise Science
Sheffield Hallam University, UK

Medical Research: What is the background for this study? What are the main findings?

Dr. Klonizakis: It is widely accepted that populations in the Eastern Mediterranean sea have historical lower rates of cardiovascular disease, diabetes and cancer. This has been attributed to a great extent, at following a diet based on dishes and ingredients, which are common in this region and are collectively known as “Mediterranean diet”.  Taking into consideration that cardiovascular disease is on the rise, particularly in the Western world, it did make sense to see if such a diet can be adapted for a population that has a largely different culinary tradition and what the results would be if this is combined with exercise of moderate-intensity. We therefore, designed and implemented an 8-week intervention, aiming at older, healthy but previously untrained people, comparing an exercise-only group vs one where exercise was combined with Mediterranean diet. Our work has shown that benefits of this intervention are still evident in the vascular function (measured by the function of the inner vein lining, called the endothelium) and the cardiopulmonary fitness, one year after the end of the intervention.

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Type 2 Diabetes: U-shaped Association of BMI With All-Cause Mortality

Gang Hu, MD, MPH, PhD, FAHA Assistant professor & Director, Chronic Disease Epidemiology Lab Adjunct assistant professor, School of Public Health, LSU Health Sciences Center Pennington Biomedical Research Center, Baton Rouge, LouisianaMedicalResearch.com Interview with:
Gang Hu, MD, MPH, PhD, FAHA
Assistant professor & Director
Chronic Disease Epidemiology Lab
Adjunct assistant professor, School of Public Health
LSU Health Sciences Center
Pennington Biomedical Research Center,
Baton Rouge, Louisiana
Medical Research: What is the background for this study? What are the main findings?

Dr. Hu: Many previous studies had small samples, and thus lacked adequate statistical power when the analysis was focused on those who are extremely obese (BMI ≥40 kg/m2). In addition, most epidemiological studies only use a single measurement of BMI at baseline to predict risk of all-cause mortality, which may produce potential bias. The current study indicated a U-shaped association of BMI with all-cause mortality risk among African American and white patients with type 2 diabetes. A significantly increased risk of all-cause mortality was observed among African Americans with BMI<30 kg/m2 and BMI ≥35 kg/m2, and among whites with BMI<25 kg/m2 and BMI ≥40 kg/m2 compared with patients with BMI 30-34.9 kg/m2.

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Not All Fat Contributes Equally To Metabolic Syndrome Risk

MedicalResearch.com Interview with:
Venkatesh L. Murthy, MD, PhD
Department of Medicine (Cardiovascular Medicine Division) and Department of Radiology (Nuclear Medicine and Cardiothoracic Imaging Divisions),
University of Michigan, Ann Arbor, Michigan and

Dr. Ravi Shah MD
Cardiology Division, Department of Medicine
Massachusetts General Hospital, Boston, Massachusetts

Medical Research: What is the background for this study? What are the main findings?

Response: Prior studies in Framingham, MESA and other cohorts have demonstrated that obesity is an important risk factor for the metabolic syndrome. However, the observations that many non-obese individuals develop metabolic syndrome and diabetes and, conversely, that not all obese individuals develop these complications has motivated the search for better markers of risk than BMI. More recently, it has been shown that the location of adipose tissue is an important factor. The amount of visceral fat, which is thought to be more harmful from a metabolic perspective, can be accurately quantified with CT imaging. In many prior studies, waist circumference has been used as an approximate measure of visceral adiposity.

For this study, we analyzed data from the Multi-Ethnic Study of Atherosclerosis (MESA). We found that the amount of visceral fat (as quantified by CT) was an important predictor of metabolic syndrome, even after adjusting for weight, waist circumference, gender, race, smoking, exercise, serum lipids and glucose. Each additional 100 cm2/m of height of visceral fat was associated with a 29% increase in the risk of developing metabolic syndrome. In contrast, subcutaneous fat burden (also quantified by CT) was a much weaker predictor.

One of the very novel findings of our study arises from an analysis of subjects who had multiple CTs longitudinally in MESA. Using these data, we found that change in visceral fat burden was associated with a corresponding 5% increase in the risk of metabolic syndrome. In part, this is because very small changes in weight could result in very large changes in visceral fat.
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Shift Work May Reduce Cognitive Performance

Dr. Philip Tucker Department of Psychology | Yr Adran Seicoleg College of Human and Health Sciences | Coleg y Gwyddorau Dynol ac lechyd Swansea University | Prifysgol Abertawe Singleton Park | Parc Singleton Swansea | Abertawe  Medical Research: What is the background for this stuMedicalResearch.com Interview with:
Dr. Philip Tucker
Department of Psychology | Yr Adran Seicoleg
College of Human and Health Sciences | Coleg y Gwyddorau Dynol ac lechyd
Swansea University | Prifysgol Abertawe
Singleton Park | Parc Singleton Swansea | Abertawe

Medical Research: What is the background for this study? What are the main findings?

Dr. Tucker: Shift work, like jet-lag, is known to disrupt workers’ normal circadian rhythms (i.e. their body clocks) and their social life. It is also associated with greater risk of developing ulcers, cardiovascular disease, metabolic syndrome, breast cancer and reproductive problems. Several studies have also shown that shift workers experience heightened fatigue and sleepiness, particularly at night, and this may affect job performance and safety. However, very little is known about the long-term consequences of shift work on cognitive abilities. We followed a large sample of shift workers and non-shift workers over 10 years, testing their cognitive performance every 5 years. We found that the shift workers’ cognitive performance was lower than that of the day workers.  The difference was greatest for those who had worked shifts for more than 10 years. The shift workers’ cognitive function recovered after they quit shift work, but this recovery took at least 5 years from time that they stopped working shifts. The effects could not be attributed to poorer sleep quality among shift workers. Rather, it seems likely that the findings reflect the disruption of the shift workers’ circadian rhythms, which as been shown by other researchers to have an impact on brain structures involved in cognition and mental health over the lifespan.

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High Fat Diets Worse for Male Brains

Deborah Clegg, PhD Research Scientist, Diabetes and Obesity Research Institute Associate Professor, Department of Biomedical Science Cedars-Sinai Medical Center Los Angeles, CA 90048MedicalResearch.com Interview with:
Deborah Clegg, PhD
Research Scientist, Diabetes and Obesity Research Institute
Associate Professor, Department of Biomedical Science
Cedars-Sinai Medical Center
Los Angeles, CA 90048

Medical Research: What are the main findings of the study?

Dr. Clegg: The main findings are that males and females differ with respect to how they process and respond to diets high in fat!!!!  Males following consumption of a diet that is 42% of the calories coming from saturated fat (it would be analogous to eating a big mac and having a coke), gained the same amount of weight as did the females BUT the males had increased markers of inflammation in their brains and the females did not.  With the elevated markers of inflammation, the males had dysregulation in glucose homeostasis and alteration in cardiovascular function – yet the females did not!!
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Olive Oil and Mediterranean Diet May Improve Metabolic Syndrome

Jordi Salas-Salvadó Professor of Nutrition Human Nutrition Unit Department of Biochemistry & Biotechnology IISPV School of Medicine. Rovira i Virgili University CIBERobn, Instituto Carlos IIIMedicalResearch.com Interview with:
Jordi Salas-Salvadó Professor of Nutrition
Human Nutrition Unit Department of Biochemistry & Biotechnology
IISPV School of Medicine.
Rovira i Virgili University CIBERobn, Instituto Carlos III

Medical Research: What are the main findings of the study?

Response: In this large, multicenter, randomized clinical trial conducted in Mediterranean individuals at high cardiovascular risk, Mediterranean-diet supplemented with extra-virgin olive oil was associated to a lower increase in the prevalence of metabolic syndrome compared to the advice on a control low-fat diet. However, no beneficial effect of Mediterranean-diet on the incidence of metabolic syndrome among participants free of this condition at baseline was observed. Therefore, the lower increase in prevalence was especially due to the reversion of metabolic syndrome in those individuals with metabolic syndrome at baseline.
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For Cardiorespiratory Fitness, Measure Lean Body Mass Rather Than Total Weight

MedicalResearch.com Interview with:
Tuomo Tompuri, MD
Clinical Physiology and Nuclear Medicine
Kuopio University Hospital, Finland

Medical Research: What are the main findings of the study?

Dr. Tompuri: Measures of the cardiorespiratory fitness should be scaled by lean mass instead of body weight, while aiming to enable comparison between the subjects. Our result is physiologically logical and confirms earlier observations of the topic. Scaling by body weight has been criticized, because body fat, per se, does not increase metabolism during exercise. We did observe that scaling by body weight introduces confounding by adiposity.

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Hidradenitis Suppurativa Linked To Increased Risk of Metabolic Syndrome

MedicalResearch.com Interview :
Iben Marie Miller, MD
Department of Dermatology
Roskilde Hospital, Roskilde
Department of Health and Medical Sciences,
University of Copenhagen, Copenhagen, Denmark

Medical Research: What are the main findings of the study?

Dr. Miller: Using a cross-sectional design based on data from a Hidradenitis Suppurativa (HS) group recruited from the hospital (32 individuals), an HS group recruited from the general population (326 individuals) and 14,851 individuals without Hidradenitis Suppurativa, we investigated a possible association of Hidradenitis Suppurativa and the metabolic syndrome. We found that the HS groups had 2 to 4 times odds of having the metabolic syndrome when compared to individuals without HS leaving Hidradenitis Suppurativa patients at a high cardiovascular risk. Furthermore, we found that the odds were higher for the HS group from the hospital in comparison to the Hidradenitis Suppurativa group from the general population.

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Faster Resting Heart Rate Linked To Metabolic Syndrome

Dr Weiguo Zhang, MD PhD Cardiovascular and Neurological Institute 6771 San Fernando, Irving, TX 75039, USAMedicalResearch.com Interview with:
Dr Weiguo Zhang, MD PhD
Cardiovascular and Neurological Institute
6771 San Fernando,
Irving, TX 75039, USA


Medical Research: What are the main findings of the study?

Prof. ZhangHigher heart rate has emerged as a cardiovascular risk factor and is associated with higher mortality rate. However the mechanistic link between heart rate and mortality outcome in population has been missing.

The main findings of the present study in a relatively large population are two-fold: Firstly, there is a strong and positive association between resting heart rate and metabolic syndrome, which is defined when an adult has 3 of the following: obesity (waist circumference ≥90 cm for men or ≥80 for women)hypertriglyceridemia (triglycerides ≥1.7 mmol/L)low plasma level of high-density lipoprotein <1.03 mmol/L for men or <1.30 mmol/L for women)hypertension (systolic blood pressure/ diastolic blood pressure≥130/85 mmHg or current use of antihypertensive medications); hyperglycemia (fast blood glucose ≥5.6 mmol/L or previously diagnosed type 2 diabetes or current use of hypoglycaemic agents or insulin).

Secondly and more importantly, those without metabolic syndrome but with higher resting heart rate will have greater risk in developing metabolic syndrome in the near future. As such, the findings from both cross-sectional and longitudinal studies provide evidence that resting heart rate is an independent risk factor for existing metabolic syndrome and a powerful predictor for its future incidence.
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Prostate Cancer Risk May Be Lower With Lycopene, Tomato Intake

Vanessa Er PhD School of Social and Community Medicine University of Bristol and Bristol Nutrition BRUMedicalResearch.com Interview with:
Vanessa Er PhD
School of Social and Community Medicine
University of Bristol and Bristol Nutrition BRU

Medical Research: What are the main findings of the study?

Dr. Er: We found that men who had optimal intake of three nutrients- calcium, selenium and foods rich in lycopene– had a lower risk of prostate cancer.  Mainly, men who ate over 10 servings/week of tomatoes and tomato-based products had 18% reduction in risk of developing prostate cancer.  We also found that the risk of prostate cancer was lower in men who had high intake of fruits and vegetables.

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Depressed Patients With Prostate Cancer Have Worse Outcomes

MedicalResearch.com with:
Sandip M. Prasad MD Assistant Professor Medical University of South Carolina, Charleston, SCSandip M. Prasad MD
Assistant Professor
Medical University of South Carolina, Charleston, SC and

Scott E. Eggener, MD Associate Professor of Surgery Co-Director, Prostate Cancer Program Director of Translational and Outcomes Research, Section of Urology University of Chicago Medical Center, Chicago, IL;Scott E. Eggener, MD
Associate Professor of Surgery
Co-Director, Prostate Cancer Program
Director of Translational and Outcomes Research, Section of Urology
University of Chicago Medical Center, Chicago, IL;

Medical Research: What are the main findings of the study?

Answer: Depressed men with a diagnosis of intermediate- or high-risk prostate cancer have worse overall outcomes than those without baseline depression and are less likely to undergo definitive therapy. The difference in overall survival between men with and without a depression diagnosis was independent of prostate cancer treatment type.
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Obesity, Lack of Exercise Linked to COPD

MedicalResearch.com Interview with:
Dr Gundula Behrens
Department of Epidemiology and Preventive Medicine
University of Regensburg
Franz-Josef-Strauss-Allee 11
93053 Regensburg, Germany

Medical Research: What are the main findings of the study?

Dr Behrens: We studied the relations of obesity and physical activity to the incidence of chronic obstructive pulmonary disease (COPD) among more than 100,000 middle-aged to elderly men and women living in the U.S. People with a large waist circumference (43.5 inches (110 cm) or over in women and 46.5 inches (118 cm) or over in men) had a 72% increased risk of COPD as compared to people with a normal waist circumference. In contrast, individuals who were physically active five times or more per week had a 29% decreased risk of COPD as compared to their physically inactive counter-parts.
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Metabolic Syndrome May Increase Risk of Aggressive Prostate Cancer

Katharine N. Sourbeer, BS Institute for Medical Research Durham, N.C.MedicalResearch.com Interview with:
Katharine N. Sourbeer, BS

Institute for Medical Research
Durham, N.C.

MedicalResearch: What are the main findings of the study?

Answer: In a study where biopsies were conducted independent from PSA, more metabolic syndrome components were found to be associated with more high-grade prostate cancers.
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Mutated Gene Associated with Metabolic Syndrome

MedicalResearch Interview with:
Arya Mani, M.D. Department of Internal Medicine and Genetics Yale Cardiovascular Research Center Yale, New Haven CT Arya Mani, M.D.
Department of Internal Medicine and Genetics
Yale Cardiovascular Research Center
Yale, New Haven CT

MedicalResearch: What are the main findings of the study?

Dr. Mani: Our group has identified a gene that when mutated it causes a form of truncal (central) obesity that is associated with a cluster of coronary artery disease risk factors, including high blood pressure, insulin resistance and possibly elevated blood lipids. These associated risk factors are collectively known as the metabolic syndrome, which may lead to development of diseases such as diabetes and coronary artery disease, both of which were very prevalent in the populations we studied. All identified mutations by our group have been so far gain of function mutations, which means they increased the activity of the gene in pathways related to adipogenesis and gluconeogenesis.
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Sleep Quality and Quantity Affects Cardimetabolic Markers in Children

MedicalResearch.com Interview with:
Nina Berentzen
Centre for Nutrition, Prevention and Health Services
National Institute for Public Health and the Environment Bilthoven
The Netherlands

MedicalResearch.com: What are the main findings of the study?

Answer: This study in 11-12 year old children shows that self-reported characteristics of sleep quality were not associated with blood pressure and HbA1c; and that in girls, but not in boys, some sleep characteristics were associated with anthropometric outcomes (BMI, waist circumference) and cholesterol levels. More specifically, in girls, longer time in bed was associated with lower BMI and waist circumference; having night-time awakenings with higher total cholesterol, going late to bed while rising early with higher total and HDL cholesterol; and feeling sleepy/tired during daytime with lower HDL cholesterol and with higher total-to-HDL cholesterol ratio. We report new findings for daytime outcomes of sleep quality that were not studied before in relation to cardiometabolic risk; e.g. difficulty with getting up in the morning, feeling rested after waking, and feeling sleepy or tired during the day. Our study therefore offers insight not only in characteristics of sleep at night, but also in consequences of sleep during the day.

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Obstructive Sleep Apnea: Gender-Specific Adiposity and Metabolic Syndrome

MedicalResearch.com Interview with:

MedicalResearch.com Interview with:
Dr. Emilia Mazzuca
Biomedical Department of Internal and Specialistic Medicine (DIBIMIS)
Section of Pneumology and

Dr. Maria R Bonsignore, MD
Associate Professor in Respiratory Medicine
University of Palermo, Palermo, Italy

MedicalResearch.com: What are the main findings of the study?

Answer: Our main goal was to investigate gender-related interactions between obstructive sleep apnea (OSA) and obesity while taking associated metabolic abnormalities into account. We analyzed 423 men and 105 women previously studied for the association of OSA and the Metabolic Syndrome (MetS) (Bonsignore et al, Eur Respir J, 2012), to assess whether markers of general and visceral obesity were differently associated with OSA in men and women. Multivariate analysis showed that in men the apnea-hypopnea index (AHI), an indicator of OSA severity, was associated with waist circumference, a marker of visceral obesity, and body mass index (BMI); conversely, in women AHI was associated with hip circumference, a marker of subcutaneous fat deposition, and neck size.  The results were similar when patients without a diagnosis of MetS were analyzed; conversely, in patients with MetS, waist circumference was the only significant marker of OSA in both genders.
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PCOS – Polycystic Ovary Syndrome: Should it be Renamed?

Professor Helena Teede MBBS, PhD, FRACP Director Monash Centre for Health Research and Implementation -- MCHRI, And Head Womens Public Health Research, School Public Health and Preventive Medicine Monash University, in partnership with Monash Health Head Diabetes and Vascular Medicine, Monash Health President Elect- Endocrine Society of Australia NHMRC Practitioner Fellow 43-51 Kanooka Grove, Clayton, Victoria 3168 AustraliaMedicalResearch.com Interview with:
Professor Helena Teede MBBS, PhD, FRACP
Director Monash Centre for Health Research and Implementation — MCHRI,
And Head Womens Public Health Research, School Public Health and Preventive Medicine Monash University, in partnership with Monash Health
Head Diabetes and Vascular Medicine, Monash Health
President Elect- Endocrine Society of Australia
NHMRC Practitioner Fellow
43-51 Kanooka Grove, Clayton, Victoria 3168 Australia

MedicalResearch.com: What are the main findings of the study?

Dr. Teede: PCOS is a historical but histopathologically inaccurate name for a common condition that is a source of confusion for women and primary health care providers.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Teede: The unexpected findings were that many women and primary care providers do not have a good understanding of the features of PCOS outside of reproductive features. These include the metabolic (diabetes risk) and psychological factors in PCOS.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Teede: An awareness that the condition is inappropriately named and that it is caused by hormonal changes which underpin PCOS and cause metabolic and reproductive features including secondary functional ovary changes.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Teede: Further research needs to explore other suitable names for the syndrome and needs to assess the results of new guidelines and education programs to improve consumer and clinician understanding of PCOS.

Citation:

Helena Teede, Melanie Gibson-Helm, Robert J. Norman, and Jacqueline Boyle

Polycystic Ovary Syndrome: Perceptions and Attitudes of Women and Primary Health Care Physicians on Features of PCOS and Renaming the Syndrome JCEM jc.2013-2978; doi:10.1210/jc.2013-2978

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Obesity: Gene Ecscr is New Target for Treatment of Metabolic Syndrome

MedicalResearch.com Interview with:
Koji Ikeda, MD, PhD
Assistant Professor
Department of Cardiology
Graduate School of Medical Science,
Kyoto Prefectural University of Medicine
Kyoto, Japan

MedicalResearch.com: What are the main findings of the study? 

Dr. Ikeda: The main findings of this study is the identification of a novel mechanism that regulates glucose homeostasis and energy metabolism, provided by Ecscr. Consequently, Ecscr modifies the insulin sensitivity and the progression of obesity, indicating that Ecscr is a new target for the treatment of metabolic syndrome.
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Outcomes of transplantation using various hematopoietic cell sources in children with Hurler’s syndrome after myeloablative conditioning

MedicalResearch.com Interview with Dr. Boelens

Pediatric Blood and Marrow Transplantation Program,
University Medical Center Utrecht, Utrecht, Netherlands

MedicalResearch.com: What are the main findings of the study?

Dr. Boelens: For children with Hurler’s syndrome, the receipt of a hematopoietic cell transplant (HCT) early in life with the best available human leukocyte antigen (HLA)-matched donor offers the best event free survival (EFS). Also, HCT with a well matched unrelated cord blood unit is particularly attractive as the unit is readily available.
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