Metabolic syndrome among rural Indian adults

Prevalence and influencing factors of metabolic syndrome among rural adult population in a district of South India

Background

Metabolic syndrome has increased globally due to sedentary lifestyles, unhealthy diets and obesity, which is posing a substantial burden on healthcare systems. Understanding the determinants of metabolic syndrome like lifestyle factors, socioeconomic status and the environment are vital for devising effective prevention and management. Research into these determinants helps to identify high-risk populations and develop interventions to reduce its occurrence.

Objectives

i. To estimate the prevalence of metabolic syndrome among the adult population. ii. To determine the factors associated with metabolic syndrome among the adult population.

Methodology

A cross-sectional study was carried out among 410 adults (≥18 years). A semi-structured questionnaire was used to collect data and National Cholesterol Education Program's Adult Treatment Panel III criteria was used to diagnose metabolic syndrome. Continuous and categorical data were represented as mean and proportion, respectively. The strength of the association was determined using the prevalence ratio and adjusted prevalence ratio.

Results

The mean age of the participants was 44.97 ± 14.7, about 58.3% of them were females. Metabolic syndrome prevalence was 39.8%. Multivariate regression analysis demonstrated that being over 40 years old, marital status, higher socioeconomic status, skilled workers, physical inactivity and obesity were independently linked to metabolic syndrome.

Conclusions

The burden can be reduced by identifying the risk factors at the early stage through screening and by adopting a healthy lifestyle.

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

BACKGROUND

The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Prevalence and correlates of metabolic syndrome among women living in urban slums, Mysore, India

Metabolic Syndrome (MetSyn) is a predictor of cardiovascular disease (CVD). About a third of urban Indians suffer from MetSyn. This study examined the prevalence of MetSyn among women living in urban slums. A cross-sectional survey was carried out between October 2017 and May 2018 among a non-probability sample of slum-dwelling women, 40-64 years of age, in six government-designated slums in Mysore, India. Data were collected on demographics, diet, behavioral risks, anthropometry, blood pressure, serum glucose, hemoglobin A1c, and serum lipids. The study used a definition of MetSyn from the International Diabetes Federation Task Force on Epidemiology and Prevention with an HbA1c measure for average blood glucose. About two-fifths of the 607 participants had MetSyn (41.5%; 95% CI: 37.7-45.5). Of those, 40.9% met three criteria, 38.1% four, and 25.0%, all five criteria. Elevated BP was the most prevalent MetSyn factor (79.6%), followed by increased waist circumference (54.5%), low HDL (50.1%), elevated Hb A1c (37.1%), and elevated triglycerides (36.1%). Odds for MetSyn were 1.52 times greater for those who were 50-59 years of age compared with those 40-49 years of age (adjusted odds ratio[AOR]:1.52; 95% CI:0.96-2.40). Women with mobility issues had 1.29 times higher odds of MetSyn than those without it (AOR: 0.76, 95% CI: 0.96, 1.75). Housewives had 1.29 times greater odds of MetSyn (AOR: 1.29, 95% CI: 1.00, 1.67). There is a high prevalence of MetSyn among urban slum-dwelling women in Mysore. There is a need for interventions aimed at reducing CVD risk factors in this population.

Stepwise evaluation for the risk of metabolic unhealthiness and significant non-alcoholic fatty liver disease in India

Background

Non-communicable diseases including metabolic health disorders are becoming area of concern for low/middle income countries with poor health-care resources. Present study was planned to assess the prevalence of metabolically unhealthy (MU) subjects in the community and proportion of the MU subjects having the risk of significant Non-alcoholic Fatty Liver Disease (NAFLD) using a step-wise evaluation strategy in a resource-poor setting.

Methods

Study was performed in 19 community development blocks of Birbhum district, West Bengal, India. Every fifth member in the electoral list was included for the first step evaluation (n = 79,957/1,019,365, 7.8%) to detect any metabolic risk. Subjects with any metabolic risk in the first step (n = 9819/41,095, 24%) were taken for second step evaluation with Fasting blood glucose (FBG) and ALT. Subjects with elevated FBG and/or ALT in the second step (n = 1403/5283, 27%) were taken into third step evaluation.

Finding

At least one risk factor was found in 51.4% (n = 41,095/79,957). 63% (n = 885/1403) of the subjects with metabolic abnormality (third step) had MU state making its overall prevalence of 1.1% (n = 885/79,957). 53% of MU subjects (n = 470/885) had 'persistently elevated ALT' suggesting the risk of having significant NAFLD.

Interpretation

Step-wise evaluation strategy could detect the subjects at risk, actually having MU state and proportion of MU subjects at risk of having 'persistently elevated ALT' (surrogate of significant NAFLD) in the community with minimum utilization of scarce resources.

Funding

This study was funded by Bristol Myers Squibb Foundation, USA, under the program 'Together on Diabetes Asia' (Project Number: 1205 - LFWB).

Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association

BACKGROUND

The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Application of Indian Diabetic Risk Score (IDRS) and Community Based Assessment Checklist (CBAC) as Metabolic Syndrome prediction tools

BACKGROUND

Indian Diabetic Risk Score (IDRS) and Community Based Assessment Checklist (CBAC) are easy, inexpensive, and non-invasive tools that can be used to screen people for Metabolic Syndrome (Met S). The study aimed to explore the prediction abilities of IDRS and CBAC tools for Met S.

METHODS

All the people of age ≥30 years attending the selected rural health centers were screened for Met S. We used the International Diabetes Federation (IDF) criteria to diagnose the Met S. ROC curves were plotted by taking Met S as dependent variables, and IDRS and CBAC scores as independent/prediction variables. Sensitivity (SN), specificity (SP), Positive and Negative Predictive Value (PPV and NPV), Likelihood Ratio for positive and negative tests (LR+ and LR-), Accuracy, and Youden's index were calculated for different IDRS and CBAC scores cut-offs. Data were analyzed using SPSS v.23 and MedCalc v.20.111.

RESULTS

A total of 942 participants underwent the screening process. Out of them, 59 (6.4%, 95% CI: 4.90-8.12) were found to have Met S. Area Under the Curve (AUC) for IDRS in predicting Met S was 0.73 (95%CI: 0.67-0.79), with 76.3% (64.0%-85.3%) sensitivity and 54.6% (51.2%-57.8%) specificity at the cut-off of ≥60. For the CBAC score, AUC was 0.73 (95%CI: 0.66-0.79), with 84.7% (73.5%-91.7%) sensitivity and 48.8% (45.5%-52.1%) specificity at the cut-off of ≥4 (Youden's Index, 2.1). The AUCs of both parameters (IDRS and CBAC scores) were statistically significant. There was no significant difference (p = 0.833) in the AUCs of IDRS and CBAC [Difference between AUC = 0.00571].

CONCLUSION

The current study provides scientific evidence that both IDRS and CBAC have almost 73% prediction ability for Met S. Though CBAC holds relatively greater sensitivity (84.7%) than IDRS (76.3%), the difference in prediction abilities is not statistically significant. The prediction abilities of IDRS and CBAC found in this study are inadequate to qualify as Met S screening tools.

Association Between Anthropometric Risk Factors and Metabolic Syndrome Among Adults in India: A Systematic Review and Meta-Analysis of Observational Studies

Introduction

Several studies have explored the effect of anthropometric risk factors on metabolic syndrome. However, no systematic effort has explored the effect of overweight and obesity on the prevalence of metabolic syndrome in India. Thus, we undertook a meta-analysis to estimate the effect of anthropometric risk factors on the prevalence of metabolic syndrome.

Methods

We searched databases PubMed Central, EMBASE, MEDLINE, and Cochrane library and search engines ScienceDirect and Google Scholar, from January 1964 through March 2021. We used the Newcastle–Ottawa scale to assess the quality of published studies, conducted a meta-analysis with a random-effects model, and reported pooled odds ratios (OR) with 95% CIs.

Results

We analyzed 26 studies with a total of 37,965 participants. Most studies had good to satisfactory quality on the Newcastle–Ottawa scale. Participants who were overweight (pooled OR, 5.47; 95% CI, 3.70–8.09) or obese (pooled OR, 5.00; 95% CI, 3.61–6.93) had higher odds of having metabolic syndrome than those of normal or low body weight. Sensitivity analysis showed no significant variation in the magnitude or direction of outcome, indicating the lack of influence of a single study on the overall pooled estimate.

Conclusion

Overweight and obesity are significantly associated with metabolic syndrome. On the basis of evidence, clinicians and policy makers should implement weight reduction strategies among patients and the general population.

Rural-urban and gender differences in metabolic syndrome in the aging population from southern India: Two parallel, prospective cohort studies

BACKGROUND

Despite the growing evidence of metabolic syndrome as a major risk factor for cardiovascular and cerebrovascular disease, there are limited studies from India on its prevalence, especially in the aging population. We aimed to estimate the prevalence of metabolic syndrome and associated comorbidities in two prospective, aging cohorts from rural and urban India.

METHODS

In these two parallel, prospective, aging (≥ 45 years) cohorts, the samples included 2171 people from rural India (Srinivaspura Aging, Neuro Senescence and COGnition, SANSCOG cohort; April 23, 2018 to Sept 25, 2021) and 332 people from urban India (Tata Longitudinal Study on Aging, TLSA cohort; July 8, 2015 to Oct 23, 2021). Using cross-sectional data from baseline clinical and biochemical assessments, we calculated metabolic syndrome prevalence using two well established criteria, namely consensus criteria and National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III) criteria; further, rural-urban, gender, and age-wise differences were compared.

FINDINGS

Proportions of metabolic syndrome were 46.2 and 54.8% as per consensus criteria in rural and urban participants, respectively; corresponding numbers using NCEP-ATP III criteria were 40.3 and 45.1%. Rural-dwelling older adults had a significantly lesser prevalence of all individual metabolic syndrome parameters except impaired triglycerides and high-density lipoprotein levels. Rural women had a significantly higher prevalence of metabolic syndrome than rural men, whereas there was no significant difference among urban participants. We did not observe any consistent age-wise trend when comparing both cohorts. There was high burden of comorbidities among both groups, mostly undiagnosed in rural participants.

INTERPRETATION

Roughly one in two older adults had metabolic syndrome, urban significantly more than rural, reaching an alarming 63.1% among urban participants aged 65-74 years. The very high prevalence of undiagnosed co-morbidities among rural adults is extremely concerning, calling for urgent public health measures in this marginalised and health-disparate population.

FUNDING

SANSCOG study is funded through the Centre for Brain Research (CBR), Indian Institute of Science (IISc) by Pratiksha Trust, the philanthropic arm of Mr. Kris Gopalakrishnan. TLSA is funded by Tata Trusts.

Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association

BACKGROUND

The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association

BACKGROUND

The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease.

RESULTS

Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Non-communicable diseases are the leading cause of mortality in rural Birbhum, West Bengal, India: a sex-stratified analysis of verbal autopsies from a prospective cohort, 2012-2017

OBJECTIVES

There is a dearth of data on causes of death in rural India, which impedes identification of public health priorities to guide health interventions. This study aims to offer insights from verbal autopsies, to understand the pattern and distribution of causes of death in a rural area of Birbhum District, West Bengal, India.

DESIGN

Causes of death data were retrieved from a prospective vital event surveillance system.

SETTING

The Birbhum Population Project, a Health and Demographic Surveillance System, West Bengal, India.

PARTICIPANTS

Between January 2012 and December 2017, all deaths were recorded.

MAIN OUTCOME MEASURES

Trained Surveyors tracked all deaths prospectively and used a previously validated verbal autopsy (VA) tool to record causes of death. Experienced physicians reviewed completed VA forms, and assigned cause of death using the 10th version of International Classification of Diseases. In addition to cause-specific mortality fraction, cause-specific crude death rate (CDR) among males and females were estimated.

RESULTS

A total of 2320 deaths (1348 males and 972 females) were recorded. An estimated CDR was 708/100 000. Over half of all deaths (1176 deaths, 50.7%) were attributed to non-communicable diseases (NCDs), with nearly 30% of all deaths attributed to circulatory system disorders; whereas 24.2% and 3.9% deaths were due to cerebrovascular diseases and ischaemic heart disease, respectively. Equal percent (13%) of males died from external causes and from infectious and parasitic diseases, and 11% died from respiratory system-related diseases. Among females, 12% died from infectious and parasitic diseases. Among children aged 0-4 years, 50% of all male deaths and 45% of all female deaths were attributed to conditions in the perinatal period.

CONCLUSIONS

NCDs are the leading cause of death among adults in a select population of rural Birbhum, India. Health programmes for rural India should prioritise plans to mitigate deaths due to NCDs.

Prevalence of metabolic syndrome among adult population in India: A systematic review and meta-analysis

OBJECTIVE

This review was done to determine the prevalence of metabolic syndrome (MS) among adult general population in India. We also wanted to find the gender, setting, and region-wide distribution of MS in India.

METHODS

We conducted systematic searches in various databases including Medline, ScienceDirect, Cochrane library and Google Scholar from inception until August 2019. We included studies conducted in India reporting the prevalence of MS among adults aged 18 years or more. We used the Newcastle Ottawa scale to assess the quality of included studies. We carried out a meta-analysis with random-effects model and reported pooled prevalence with 95% confidence intervals (CIs). We used the Funnel plot to assess publication biases.

RESULTS

In total, we analysed 113 data from 111 studies with 133,926 participants. Majority of the included studies (76 out of 111) had low risk of bias. We found significant heterogeneity among the included studies (p<0.001). We also found a symmetrical funnel plot indicating an absence of publication bias. The prevalence of MS among adult population in India was 30% (95%CI: 28%-33%). There was a steady increase in the burden across the age groups from 13% (18-29 years group) to 50% (50-59 years). We also found that people living in urban areas (32%; 95%CI: 29%-36%) had higher prevalence when compared to tribal (28%; 95%CI: 21%-36%) or rural adults (22%; 95%CI: 20%-25%). Gender distribution of MS showed that the females had higher prevalence (35%; 95%CI: 31%-38%) when compared to males 26% (95%CI: 22%-29%).

CONCLUSION

Almost one in three adults in India suffer from MS. Females, people living in urban areas and in northeast region had higher prevalence of MS. Development and implementation of policies and protocols for the screening of MS would enable us in early diagnosis and treatment with special focus towards the vulnerable and high-risk groups.

Prevalence and correlates of metabolic syndrome among rural women in Mysore, India

Aims

Metabolic Syndrome (MetS) is a strong predictor of Coronary Heart Disease (CHD). Studies in urban India have found about one-third of Indians suffer from MetS. Less is known about the prevalence of MetS in rural areas, where 70% of the population reside. This study examined the prevalence of Metabolic Syndrome in a population of rural women in India.

Methods

Data were gathered in a community-based study of 500 rural and tribal women residing in the Mysore district, between the age of 30–59 years. The study used the WHO STEPS approach, in which information on demographics and behavioral risk factors were collected. Along with anthropometric measurements, blood pressure, blood glucose, lipids were measured. A harmonized definition of MetS recommended by International Diabetes Federation Task Force on Epidemiology and Prevention was used in this study.

Results

Three out of five study participants were found to have MetS (47.1%, n = 223). Of those, 56.5% met 3 of the 5 criteria, 32.2% met 4 criteria, and 11.2% met all 5 criteria. Among the entire sample, low HDL was the most prevalent criterion (88.4%), followed by elevated glucose (57.9%), elevated triglycerides (49.3%), elevated BP (41.5%), and increased waist circumference (15.3%). In this sample, women with METS were generally older (p < 0.001), housewives (p = 0.001), that consumed salty highly processed foods (p = 0.020) and had low physical activity (p = 0.015).

Conclusions

This study showed a high prevalence of MetS in rural women. There is a compelling need for interventions aimed at reducing CHD risk factors in this population.

Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association

BACKGROUND

The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association's 2020 Impact Goals.

RESULTS

Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Metabolic syndrome: The Indian public health perspective

Metabolic Syndrome (MetS) is a clustering of specific risk factors, namely, central obesity, raised blood pressure, impaired fasting glucose, raised triglycerides, and low levels of high-density lipoprotein-cholesterol (HDL-C). This constellation is triggered by insulin resistance and its resultant hyperinsulinemia. The two most important and universally agreed causes of insulin resistance are increased body fat (particularly central obesity) and physical inactivity. Other causes include certain genetic/pro-genetic factors, unhealthy atherogenic diet, tobacco use, and excessive alcohol intake. Within 3 decades of the initial description of MetS by Reaven, various defining criteria have been developed by now, by leading international professional bodies, the most commonly used being the one given by the Adult Treatment Panel III (ATP III) report of the National Cholesterol Education Program (NCEP) [NCEP-ATP-III], the updated guidelines recently released by the American College of Cardiology (ACC) and the American Heart Association (AHA). MetS has been well documented to increase the risk of ischemic heart disease (IHD) by two to three times and of type 2 diabetes mellitus (T2DM) by five times. The world-wide prevalence is on the increase, with the overall global prevalence estimated to be 20%-25% of the adult population. In our country, various epidemiological studies undertaken across the country have consistently shown a high prevalence, which is likely to be as much as one-quarter of the adult population, with increasing age and female gender being at higher risk. The occurrence has also been recorded among the Armed Forces personnel as well as in adolescents. MetS has therefore become a priority issue for both, the public health providers as well as for the clinicians in our country, and needs concerted, all-round efforts for its prevention, early detection, management, and research. Against this background, the various public health measures for prevention and control of MetS have been suggested in this review.

Prevalence of metabolic syndrome and associated factors in adults living in Fernando de Noronha, Brazil

Metabolic Syndrome (MetS) is multivariate disease, clustered with socioeconomic and behavioral risk factors. Investigations about epidemiology estimative could be a prevention strategy.

AIM

to investigate the prevalence of metabolic syndrome and its associated factors in adult population in Fernando de Noronha Archipelago (PE-Brazil).

METHODS

A cross-sectional study was performed on a representative sample (N = 375) of adult residents of the region, aged 24-59 years, were harmonized according to the International Diabetes Federation (IDF) criteria.

RESULTS

The prevalence of metabolic syndrome was 45 (12%) and, the age was associated with MetS, which increases the chances to MetS development around 3% respectively (OR: 1.03; CI 95%: 1.002-1.070 P 0.0384). Waist circumference was elevated in female population 266 (70.74%), however, levels of fasting blood glucose (304 [80.85%]), blood pressure (375 [100%]), TG (302 [80.32]), and low HDLc (297 [78.99]) presented normal biochemical values. There is no significative difference for male and female gender and, the social and behavior factors did not present significative association.

CONCLUSION

The Fernando de Noronha presents lower prevalence of MetS thus, shows associations for elderly people. The waist circumference was elevated on female population. The results of this study provide further evidence and underscore the need for public health strategies that include education about MetS, promotion of cardiometabolic health, and prevention of undesirable outcomes such as diabetes and cardiovascular disease.

Origination, change, and modulation of geriatric disease-related gut microbiota during life

The age-related changes in the diversity and composition of the gut microbiota are well described in recent studies. These changes have been suggested to be influenced by age-associated weakening of the immune system and low-grade chronic inflammation, resulting in numerous age-associated pathological conditions. Gut microbiota homeostasis is important throughout the life of the host by providing vital functions to regulate various immunological functions and homeostasis. Based on published results, we summarize the relationship between the gut microbiota and aging-related diseases, especially Parkinson's disease, immunosenescence, rheumatoid arthritis, bone loss, and metabolic syndrome. The change in composition of the gut microbiota and gut ecosystem during life and its influence on the host immunologic and metabolic phenotype are also analyzed to determine factors that affect aging-related diseases. Approaches to maintain host health and prevent or cure geriatric diseases are also discussed.