Disparities in medication adherence (MA) associated with African American (AA) adults may be related to a dynamic interplay between personal factors, behavioral capability, and environmental factors. The purpose of the study was to examine this relationship in AA adults with metabolic syndrome (MetS). A cross-sectional, correlational analysis was conducted from baseline data from a larger intervention study. Constructs from the Social Cognitive Theory were used to predict MA. The sample of 91 AA adults with MetS was primarily middle-aged (age range 45-70 years old; M 53, SD 6.3), female (79%), relatively well-educated, and married. Despite being on antihypertensive medications, 53% of the participants presented with uncontrolled high blood pressure (≥130/90 mmHg). Although the vast majority (95%) of the sample displayed adequate health literacy (HL), 30% of the sample was non-adherent to their medication regimen. A positive significant relationship was found between age and MA [χ2 (1, n = 90) = 6.71, p = .01)]. Stress [χ2 (1, n = 90) = 6.28, p = .012)] and social support (SS) [χ2 (1, n = 90) = 4.10, p = .04)] were the only significant relationships among environmental factors, barriers and hypertension MA. Highly stressed AA adults were significantly more likely to be non-adherent or had a 15% reduction in the odds of hypertension MA. Similarly, adults with a low income were 5.8 times more likely to be non-adherent (OR 5.828, 95% CI, 1.014-33.493, p= .0482), while those with low SS had a 9% reduction in the odds of MA; SS trended toward significance (OR.914. 95% CI .823-1.016, p =.09). With increasing age, AA adults were more likely to be non-adherent (OR 1.12, 95% CI 1.028-1.220, p =.0096). Most of the participants reported a high degree of autonomy, satisfaction with their health care climate, and the availability of SS. Although increasing age, adequate SS, high stress, and adequate HL appeared to influence MA in AA adults with MetS, the research questions were only partially answered. Further investigation of the relationships and potential mediating pathways between personal characteristics, environmental factors, behavioral capability and hypertension MA in AA adults with MetS is needed.

Resistin is an adipocytokine derived from adipose tissue. Studies showed that resistin is not only related to insulin resistance, but also possibly an important factor related to activating of inflammation and atherosclerosis. It influences the endothelial cells and the function of vessel. To investigate whether or not resistin play a role in the metabolic syndrome and ischemic stroke. we examined the plasma resistin concentrations as well as the 3¡¦ untranslated region +62 G/A polymorphism of resistin gene in a Taiwan population. In the first part of this study, 112 patients with ischemic cerebral vascular disease and 110 healthy subjects were included and analyses of demographic and biochemical parameter, high sensitive C-reactive protein and plasma resistin concentration measurements were performed. In the second part, 594 patients with ischemic cerebral vascular disease and 799 healthy control were examined for resistin 3¡¦ untranslated region +62 G/A polymorphism. Resistin concentration was analyzed by EIA method, and resistin 3¡¦ untranslated region +62 G/A polymorphism was done by PCR and RFLP. The mean plasma resistin concentration of 112 patients with ischemic cerebral vascular disease was significantly lower than that of the 110 controls (32 ¡Ó 59.7 ng/ml and 55.7 ¡Ó 82.5 ng/ml, p < 0.001).When the concentration of resistin was divided into 4 groups and analyzed as continuous variable, it was found that decreased plasma resistin concentration is associated with increased risk of ischemic cerebral vascular disease. After the multiple adjustment by logistic analysis, the adds ratio for the first, second and third quadrate were 7.8, 5.0 and 0.1, respectively). The genotype analysis of 594 patients with ischemic cerebral vascular disease and 799 healthy controls show that the resistin genotype was related statistically to the risk of ischemic stroke. In multiple regression analysis, resistin 3¡¦ untranslated region +62 G/A polymorphism was significantly associated with diastolic blood pressure (GA + AA : GG = 142.2 ¡Ó 19.2 : 139.3 ¡Ó 20.7 mmHg, p = 0.044) and fasting plasma sugar (GA + AA : GG : 83.4 ¡Ó 13.1 : 81.1 ¡Ó 13.1 mg/dl , p = 0.005). Our results indicated that resistin may be related to metabolic syndrome and ischemic cerebral vascular disease and possibly play a role in the development of atherosclerosis.

No description available.

<p>Metabolic syndrome is taking epidemic proportions, especially in developed countries. Each risk factor component of the syndrome independently increases the risk of developing coronary artery disease. The risk factors are obesity, dyslipidemia, hypertension, diabetes type 2, insulin resistance, and microalbuminuria. Nuclear receptors is a family of receptors that has recently received a lot of attention due to their possible involvement in metabolic syndrome. Putting the receptors into context with their co-factors and ligands may reveal therapeutic targets not found by studying the receptors alone. Therefore, in this thesis, interactions between genes in nuclear receptor pathways were analysed with the goal of investigating if these interactions can supply leads to biomarkers for metabolic syndrome. Metabolic syndrome donor gene expression data from the BioExpressä, database was analysed with the APRIORI algorithm (Agrawal et al. 1993) for generating and mining association rules. No association rules were found to function as biomarkers for metabolic syndrome, but the resulting rules show that the data mining technique successfully found associations between genes in signaling pathways.</p>

Thesis (M. D.)--University of Hong Kong, 2009. / Includes bibliographical references (leaves 168-215). Also available in print.

Thesis (Ph. D.)--University of North Texas, May, 2009. / Title from title page display. Includes bibliographical references.

Background Metabolic syndrome refers to a cluster of metabolic dysfunctions denoting a high risk of developing cardiovascular disease (CVD) and diabetes. The key risk factors include insulin resistance and obesity. In recent decades psychological factors, including Type A personality, Type D personality, anxiety, and depression, have been found to be additional risk factors of metabolic syndrome. As people‘s behaviours and personalities are often influenced by cultural values, it would seem to be necessary to examine the associations between Type A and Type D personalities and metabolic syndrome within the context of culture. This study specifically examines the issue in the context of Chinese culture. In addition, people with Type A personality who tend to feel impatience or time urgency, anger or hostility, and competitiveness, were reported to be positively associated with anxiety. People with Type D personality who would easily have negative affectivity and social inhibition were reported to be positively associated with anxiety as well as depression. Therefore, anxiety or depression might have an effect on the associations between Type A and Type D personalities. However, to my best knowledge, no previous studies have examined the associations among Type A and Type D personalities, metabolic syndrome, and anxiety/depression. Objective This study examines associations among Type A and Type D personalities, metabolic syndrome, and anxiety/depression. It includes: 1) validating the Chinese versions of the Type A personality scale (Adolescent/Adult Type A Behaviour Scale, AATABS-3) and Type D personality scale (DS-14); 2) assessing the associations between Type A and Type D personalities with metabolic syndrome; 3) investigating the associations between anxiety/depression and metabolic syndrome; 4) measuring the association between Type A personality and anxiety; 5) testing the association between Type D personality and anxiety, as well as depression; and 6) determining the associations among Type A and Type D personalities, metabolic syndrome, and anxiety/depression. Methods A cross-sectional questionnaire survey was conducted on a random community sample of 741 adults in Hong Kong recruited by cluster sampling. Participants meeting the screening criteria of metabolic syndrome were offered further physical examination for confirming the diagnosis. Results For the Chinese version AATABS-3 scale (revised-AATABS-3), exploratory factor analysis (EFA) produced an 11-item 3-factor solution. The three factors were: 1) impatience/time urgency; 2) hostility/anger; and 3) competitiveness. The revised-AATABS-3 scale showed satisfactory internal consistency (Cronbach‘s alpha = 0.74). For the Chinese version DS-14 scale (revised-DS-14), EFA provided a 10-item 2-factor solution. The two factors were: negative affectivity and social inhibition. The revised-DS-14 scale showed good internal consistency (Cronbach‘s alpha = 0.90). Gender differences appeared in the associations between Type A and Type D personalities and metabolic syndrome. In the total population and female participants, there were no significant associations between Type A personality and metabolic syndrome. However, male participants with Type A personality were positively associated with metabolic syndrome. In the total participants, there were no significant associations between Type D personality and metabolic syndrome. However, female participants with Type D personality were positively associated with metabolic syndrome; whereas male participants with Type D personality were negatively associated with metabolic syndrome. Anxiety affected the association between Type A personality and metabolic syndrome in males only, whereas it affected the association between Type D personality and metabolic syndrome both in females and males. Depression affected the association between Type D personality and metabolic syndrome both in females and males. Conclusion and Discussion The revised-AATABS-3 and revised-DS-14 scales showed satisfactory psychometric properties. They might be more convenient and acceptable than the original scales for measuring Type A and Type D personalities in future research. Since EFA was a preliminary method for scale validation, further validation studies for these two scales are needed, for examples, on concurrent and discriminant validity. Gender differences occurred in the associations between Type A and Type D personalities and metabolic syndrome. The key findings were: *Type A personality was a risk factor of metabolic syndrome in male participants. *Type D personality was a risk factor of metabolic syndrome in female participants, but it exhibited a protective effect for preventing metabolic syndrome in male participants. *Anxiety played a protective effect in the associations between Type A and Type D personalities and metabolic syndrome in male participants. *Depression had a protective effect on Type D personality for developing metabolic syndrome in female participants, and it reduced the protective effect of Type D personality for preventing metabolic syndrome in male participants. The results of this study may give directions to future studies pursuing further investigations on metabolic syndrome, particularly in regard to personality traits, lifestyles, mental health issues, and coping strategies in cultural and social contexts, as well as gender differences related to the endocrine system. / published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Metabolic Syndrome (MetS), the clustering of obesity, high blood pressure, and disordered glucose and lipid/lipoprotein metabolism within a single individual, is associated with poorer cognitive function and dementia in later life. It has been hypothesized that cognitive impairment in MetS occurs primarily within the context of inflammation. MetS risk factors are also associated with thinning of the cerebral cortex. However, the mechanisms by which MetS and inflammation affect the brain are poorly understood. The present study used statistical mediation to examine the relationship between MetS risk factors, cortical thickness in a priori regions of interest (ROIs) and inflammation. ROIs in the inferior frontal, superior temporal, middle frontal, supra marginal, anterior cingulate and middle occipital regions were chosen from the previous literature. Serum levels of pro-inflammatory markers (interleukin 1, interleukin 2, interleukin 6 and C-Reactive Protein) were measured using enzyme-linked immunosorbent assays. Forty-three adults between the ages of 40 and 60 years underwent a health screen, neuropsychological testing and structural magnetic resonance imaging. A higher number of MetS risk factors was associated with thinning in the inferior frontal ROI (β=-0.35, p = 0.019). A higher number of MetS risk factors was also associated with higher levels of serum interleukin 2 (β=0.31, p=0.04). A higher level of serum interleukin 2 was also associated with reduced thickness in the inferior frontal ROI (β=-0.41, p=0.013). After accounting for the effects of interleukin 2, the number of MetS risk factors was no longer associated with cortical thickness in the inferior frontal ROI indicating successful statistical mediation and pointing towards a potentially important role for imflammation in linking MetS to cortical thinning and cognitive vunlerability. / text

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Diet plays an important role in the development of chronic metabolic diseases (diabetes, obesity, cardiovascular disease) and as dietary fat consumption has increased, so has the incidence of these disorders. Metabolic syndrome, a clustering of risk factors that includes central obesity, increased plasma triacylglycerol (TG), elevated fasting glucose and glucose intolerance is perhaps the most notorious and aggressive. Animal and human studies indicate that bioactive fatty acids can influence cellular energy metabolism. Using susceptible rodent models (apoE-/- and LDLr-/- mice and Syrian Golden hamsters) this project investigated whether supplementation of a western type diet (WD) with bioactive fatty acids could improve hepatic lipid metabolism, plasma lipoprotein profiles or liver markers of lipogenesis. In mice, dietary supplementation with t-10, c-12 conjugated linoleic acid (CLA) decreased the weight gain induced by high fat diet compared with WD (p<0.01) and was accompanied by hyperinsulinemia (p<0.05) in the ApoE-/- and hypoadiponectinemia (p<0.01) in both mice strains. Although t-10, c-12 CLA supplementation increased plasma lipids and was associated with profound liver steatosis there was a reduction in atherosclerotic lesions in both mouse models (p<0.05). Analysis of mRNA and protein levels in the liver suggested that the differences in liver and plasma lipids may reflect inappropriate lipogenic response to t-10,c-12 CLA. In the high fat and fructose-fed hamster, the modulating role of fish fatty acids was investigated. The addition of DHA increased weight gain and adiposity compared to EPA and c-9, t-11 CLA supplementation. However, glucose tolerance was improved after 6 weeks of DHA supplementation (p? 0.01). Using [35S]methionine radiolabelling, DHA supplementation decreased apolipoprotein B100 synthesis and secretion. Newly synthesized cellular and secreted TG, as measured by [3H]glycerol incorporation, were also decreased with DHA supplementation. Although the effects of EPA were similar to those with DHA, the magnitude was generally lower. These results suggest that supplementation with fish fatty acids can improve several of the risk factors of the metabolic syndrome. Taken together, these observations indicate that some, but not all, bioactive fatty acids may be useful supplements for mediating cardiovascular risk factors.