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positive correlation, whereas heart rate did not  although there was a trend (p0.10). The following blood chemistries were signicantly positively correlated with glucose: HbA1C, insulin, and the liver enzyme ALT. AST and alkaline phosphatase demonstrated a statistical trend, i.e., a tendency to increase with elevation of circulating glucose (p0.10). Concerning blood count, white blood cell count (p0.05), and neutrophil count (p0.01) displayed a signicant positive correlation, whereas the red blood cell count showed a trend in that direction (p0.10). No statistically signicant correlations with platelet count occurred.


For the purpose of corroboration and to expand the number of correlations to include highly sensitive C reactive protein (hsCRP) levels and information about circulating lipids, a second set of data was examined. This datum set also included information from males. As mentioned earlier, since the various studies had diverse objectives, differences in number of subjects (n) in the different parameters occurred. For example, only about one half the individuals in the second set of data had body composition and cardiac dynamic readings.


Concerning body composition in the second datum set, scale weight demonstrated a signicant positive correlation with fasting glucose levels while body fat and bone mineral density showed trends.


the examination of systolic and diastolic blood pressures revealed a signicant positive correlation with increasing fasting glucose levels. Highly sensitive C-reactive protein (hsCRP), an inammatory marker, showed a signicant positive correlation. Of great importance, the correlations of glucose level with triglycerides and HDL-cholesterol were statistically signicant. Ttriglyceride association being positive and HDL-cholesterol association being negative. The data concerning the lipid correlations will be described in more detail in Fig. 1. Regarding hepatic values, again ALT showed a positive association with fasting glucose levels, but AST, alkaline phosphatase and bilirubin did not. Serum globulin was positively correlated with glucose. Fasting glucose concentrations had no signicant correlation with various manifestations of kidney function (BUN, creatinine and GFR). As for blood cell counts, WBC and neutrophil counts correlated signicantly, while RBC, lymphocyte, monocyte, and platelet counts did not.


Because of smaller numbers of subjects in the second group analyzed for body composition and cardiac dynamics, data from the rst and second sets were com- bined to give us well over 100 datum points for each of these parameters. Results are illustrated in Table 3. Combining the data resulted in no major changes in interpretation. Body weight and body fat increased signicantly with the rise in glucose levels. Bone mineral density showed a positive slope upward, while fat free mass and percent fat showed no signicant relationship to glucose levels. Although heart rate demonstrated no signicant correlation with glucose concentrations, systolic and diastolic blood pressures continued to do so.


80 Table 3 As for cardiac dynamics, both Table 2


Figure 1A, 1B, and 1C


Using the various cholesterol estimations, namely total cholesterol (Fig.1A), HDL-cholesterol (Fig.1B), and total cholesterol minus HDL-cholesterol (Fig.1C) as independent variables, we examined correlations with several parameters from the second datum set. Each bar represents 192 datum points.


Examining r values of selected dependent variables, we found that when total cholesterol was the independent variable (Fig.1A), body weight, body fat, systolic and diastolic blood pressures, CRP, WBC, and neutrophil counts displayed signicantly negative correlations. Similarly, HDL-cholesterol also showed signicant correlations in a negative fashion in contrast to positive correlations emanating from glucose comparisons (Fig.1B). With a rise in HDL-cholesterol, body weight and fat triglycerides CRP, WBC and neutrophils and systolic and diastolic BP all decreased signicantly. Measuring cholesterol minus HDL-cholesterol showed only one strong correlation  that with triglycerides (Fig.1C). In the latter, the correlation was positive rather than negative as seen with HDL-cholesterol.


Table 4 To strengthen conclusions gathered from the correlation data, the statistical differences between the averages of the lowest (67-86 mg/dl) and highest quartiles (98- 125 mg/dl) of the fasting glucose levels in the various parameters were examined. For the most part, these ndings gathered from combining the two sets of data corroborated the correlation data. In the area of body composition -- body weight, body fat, and bone mineral density showed signicantly higher values in the uppermost quartile. Systolic and diastolic blood pressures were signicantly higher in the highest quartile. The same was true for circulating levels of HbA1C, insulin, hsCRP, ALT, triglycerides, and globulins. HDL- cholesterol values were signicantly lower in the highest quartile. Unlike ALT, values for AST missed statistical signicance. WBC and neutrophil counts were greater in the uppermost quartile as was RBC.


DISCUSSION


syndrome include overweight/obesity, insulin resistance/ diabetes mellitus, cardiovascular disorders like hyper- tension, and dyslipidemias such as high circulating levels of triglycerides and low circulating levels of high-density lipoproteins (HDL-cholesterol).26,35,42-48


and clinicians continue to examine this syndrome closely hoping to gain clues to safely prevent, ameliorate, or eliminate the various perturbed health disorders.43


incidence of many of the above conditions during World (Continued on next page)


Due to rarity or virtual lack of most of these chronic metabolic disorders in some primitive societies, many observers have focused on nutrition in the pathophysiology.49-54


In support of this possibility, the THE ORIGINAL INTERNIST JUNE 2016 Many researchers


A popular concept is that as a consequence of the modern lifestyle in the industrialized world, numerous chronic health perturbations, some commonly linked together as the metabolic syndrome, have increased alarmingly.1,2,23-27,38-41


The elements composing the


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