OBJECTIVES: Prior research has focused on the relationship between weight change and incidence of metabolic syndrome. Change in body mass index (BMI), components of metabolic syndrome and metabolic syndrome status were investigated over 1 year of follow-up. Methods: Subjects with metabolic syndrome from a community health screening project were recruited. Logistic regression was used to analyse the disappearance or remission of metabolic syndrome during 1 year according to changes in BMI, waist circumference, triglycerides, blood pressure, high-density lipoprotein-cholesterol (HDL-C) and fasting plasma glucose (FPG). Results: The study included 490 subjects with metabolic syndrome. After 1 year, metabolic syndrome had disappeared in 30.0% (147/490) of subjects. Decreased triglycerides, blood pressure and HDL-C were significantly associated with the 1-year disappearance of metabolic syndrome, whereas BMI, waist circumference and FPG levels were not. Conclusions: Short-term weight reduction has no impact on the status of metabolic syndrome. The disappearance of metabolic syndrome was common during a 1-year follow-up. This finding might impact on the treatment and management of people with metabolic syndrome.
Objective: To determine the rate of progression of white matter lesions and hemorrhages in a cohort with cerebral amyloid angiopathy (CAA). Methods: The authors analyzed data from 26 patients with possible (3) or probable (23) CAA, diagnosed by the Boston Criteria. Brain maps of white matter hyperintensities, normalized to head size (nWMH), were created by blinded computer-assisted segmentation of MRI images obtained at baseline and after a median follow-up interval of 1.1 year. Results: There was a substantial nWMH volume increase over the interscan interval (median 0.5 mL/year, interquartile range 0.1 to 2.8, p < 0.001). The median yearly increase, expressed as a percentage of the baseline WMH volume, was 18%. The characteristic most strongly associated with nWMH volume increase was the baseline nWMH volume (r = 0.57, p = 0.002). The volume of nWMH progression was also associated with history of cognitive impairment (median 5.0 mL/year in cognitively impaired subjects vs 0.3 mL/year in cognitively unimpaired, p = 0.02) but not age or hypertension. This association remained present in an analysis stratified by baseline WMH volume. New hemorrhages, including asymptomatic microbleeds, were seen in 46% of subjects. The number of new MRI hemorrhages correlated strongly with baseline nWMH (r = 0.53, p = 0.005) but not with nWMH progression (r = 0.22, p = 0.28). Conclusions: There is a progressive increase in white matter lesions in subjects with cerebral amyloid angiopathy. The association of white matter lesions with incident lobar hemorrhages suggests that white matter damage may reflect a progressive microangiopathy due to cerebral amyloid angiopathy.
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