The metabolic syndrome: Prevalence, main characteristics and association with socio-economic status in adults living in Great Tunis

Prevalence and Factors Associated with Metabolic Syndrome among Non-Diabetic Saudi Adults: A Cross-Sectional Study

(1) Introduction: given the high prevalence of metabolic syndrome (MetS) in Saudi Arabia, especially in Jeddah, this study aims to understand the dietary and lifestyle-related risk factors among Jeddah's non-diabetic adults. (2) Material and Methods: Employing a cross-sectional design, non-diabetic adults were sourced from public healthcare centers. Demographics, lifestyle, and dietary habits were surveyed. Blood pressure, anthropometrics, and fasting blood samples measuring plasma glucose, serum triglycerides, and HDL cholesterol were collected. The age cut-off for MetS was ascertained using the receiver operating characteristic curve. Variables influencing MetS were evaluated using univariate logistic regression, and consequential factors underwent multivariate analysis, adjusted for age and sex. (3) Results: Among 1339 participants, 16% had MetS, with age being the strongest predictor (p < 0.001). The optimal age cut-off was 32 years. For those <32, elevated BP in men and waist circumference (WC) in women were most prevalent. For those >32, elevated WC was dominant in both sexes. Univariate logistic regression revealed that higher income and education correlated with lower MetS prevalence, while marriage and smoking were risk factors. Adjusting for age and sex, only very high income had a significant low-risk association (p = 0.034). (4) Conclusion: MetS is notable in the studied group, with age as the pivotal predictor. High income reduces MetS risk, while marital status and smoking could increase it. Since this was a cross-sectional study, cohort studies are needed to validate our findings.

Prevalence of the metabolic syndrome and its components in secondary school student population in the city of Douala, Cameroon

While the burden of metabolic syndrome (MetS) is still increasing in sub-Saharan Africa, there is a lack of data among young Cameroonian population. The aim of this study was to evaluate the prevalence of MetS and its components among secondary school students in Douala. This was a cross-sectional prospective study carried out on 803 students recruited from February to May 2021 in public and private secondary schools in Douala city, Cameroon. MetS was assessed according to the IDF/AHA/NHLBI 2009 consensus definition. The data collection consisted of a questionnaire on sociodemographic characteristics, measurement of anthropometric parameters (height, weight, body mass index (BMI), waist circumference) and overnight fasting blood sample. Blood pressure (BP), fasting blood glucose, HDL cholesterol and triglycerides were measured using standard methods. The mean age was 18±3 years, 73.3% female. The prevalence of MetS was 27.4%, common among participants aged ≥16 years, and higher in females compare to males (33.7% vs. 11.1%, P#x003C;0.0001). The prevalence of MetS components i.e abdominal obesity, high BP, fasting hyperglycemia, low-level HDL cholesterol and hypertriglyceridemia were 14.1, 18.1, 42.8, 51.4 and 38.6% respectively. All MetS components were significantly higher in females compared to males except for high BP which was similar among the genders. In our study population, the prevalence of MetS is high and this calls for improved monitoring to limit the evolution of associated cardiometabolic complications among young Cameroonians.

Prevalence of the metabolic syndrome in African populations: A systematic review and meta-analysis

BACKGROUND

The metabolic syndrome (MS) is a leading cause of death worldwide. Several studies have found MS to be prevalent in various African regions. However, no specific estimates of MS prevalence in African populations exist. The aim of this study was to estimate the overall prevalence of MS in the African populations.

METHODS

A systematic review was conducted in PubMed, Web of Science, Africa Index Medicus, and African Journal Online Scopus to find studies published up to the 15th of August 2022. Pooled prevalence was calculated based on six diagnostic methods. The pooled prevalence of MS was estimated using a random-effects model. Our risk of bias analysis was based on the Hoy et al. tool. A Heterogeneity (I2) assessment was performed, as well as an Egger test for publication bias. PROSPERO number CRD42021275176 was assigned to this study.

RESULTS

In total, 297 studies corresponding to 345 prevalence data from 29 African countries and involving 156 464 participants were included. The overall prevalence of MS in Africa was 32.4% (95% CI: 30.2-34.7) with significant heterogeneity (I2 = 98.9%; P<0.001). We obtained prevalence rates of 44.8% (95% CI: 24.8-65.7), 39.7% (95% CI: 31.7-48.1), 33.1% (95% CI: 28.5-37.8), 31.6% (95% CI: 27.8-35.6) and 29.3% (95% CI: 25.7-33) using the WHO, revised NCEP-ATP III, JIS, NCEP/ATP III and IDF definition criteria, respectively. The prevalence of MS was significantly higher in adults >18 years with 33.1% (95%CI: 30.8-35.5) compared to children <18 years with 13.3% (95%CI: 7.3-20.6) (P<0.001). MS prevalence was significantly higher in females with 36.9% (95%CI: 33.2-40.7) compared to males with 26.7% (95%CI: 23.1-30.5) (P<0.001). The prevalence of MS was highest among Type 2 diabetes patients with 66.9% (95%CI: 60.3-73.1), followed by patients with coronary artery disease with 55.2% (95%CI: 50.8-59.6) and cardiovascular diseases with 48.3% (95%CI: 33.5-63.3) (P<0.001). With 33.6% (95% CI: 28.3-39.1), the southern African region was the most affected, followed by upper-middle income economies with 35% (95% CI: 29.5-40.6).

CONCLUSION

This study, regardless of the definition used, reveals a high prevalence of MS in Africa, confirming the ongoing epidemiological transition in African countries. Early prevention and treatment strategies are urgently needed to reverse this trend.

Adipocyte Metabolism and Health after the Menopause: The Role of Exercise

Postmenopausal women represent an important target population in need of preventative cardiometabolic approaches. The loss of estrogen following the menopause eliminates protections against metabolic dysfunction, largely due to its role in the health and function of adipose tissue. In addition, some studies associate the menopause with reduced physical activity, which could potentially exacerbate the deleterious cardiometabolic risk profile accompanying the menopause. Meanwhile, exercise has adipocyte-specific effects that may alleviate the adverse impact of estrogen loss through the menopausal transition period and beyond. Exercise thus remains the best therapeutic agent available to mitigate menopause-associated metabolic dysfunction and represents a vital behavioral strategy to prevent and alleviate health decline in this population.

Socioeconomic status and metabolic syndrome in Southwest Iran: results from Hoveyzeh Cohort Study (HCS)

BACKGROUND

Socioeconomic status (SES) strongly predicts morbidity and premature mortality, especially for non-communicable diseases (NCDs). However, the effect of these factors on Metabolic Syndrome (MetS) is not clear yet. This study was conducted to assess the relationship between socioeconomic indicators and MetS.

METHODS

In this prospective cohort study, 10,009 people aged 35-70 enrolled from May 2016 to August 2018. The MetS was defined according to The Standard National Cholesterol Education Program (NCEP)-adult treatment panel III (ATP III) or NCEP-ATP III criteria. Demographics and socioeconomic data were gathered face-to-face through trained interviews. Also, lab, anthropometrics, and blood pressure measurements were assayed for participants. Logistic regression was used to estimate the association between SES and MetS, adjusted for the potential confounding factors.

RESULTS

The overall prevalence of MetS in the participants was 39.1%. The crude odds ratios were statistically significant for all the assessed variables (p < 0.05). After adjustment for age, sex, physical activity, smoking, and alcohol use as potential confounders, the results indicated significant direct independent associations between skill level (p = 0.006) and Townsend index (p = 0.002) with MetS. In contrast, no significant associations between educational level and wealth status with MetS.

CONCLUSION

The results of our study showed that SES is related to MetS. Among the four assessed SES indicators, skilled levels and Townsend score are strongly associated with MetS. We recommend considering people's SES when interventional programs are planned and conducted on MetS in similar communities.

Frequency of Metabolic Syndrome and Study of Anthropometric, Clinical and Biological Characteristics in Peri- and Postmenopausal Women in the City of Ksar El Kebir (Northern Morocco)

This study aimed to determine the frequency of metabolic syndrome and to identify its predictive factors in peri- and post-menopausal women in the city of Ksar El Kebir, in northern Morocco. A total of 373 peri- and post-menopausal women between 45 and 64 years old participated in the study. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) definition. Body mass index (BMI) was calculated to assess the degree of obesity in women; anthropometric, clinical and biological parameters were collected during interviews. The mean ages of peri- and postmenopausal women were 48.84 ± 2.4 years and 56.65 ± 4.29 years, respectively. Postmenopausal women had higher means of anthropometric and biological parameters than peri-menopausal women. We also noted a predominance of metabolic syndrome in postmenopausal women (n = 158) compared to peri-menopausal women (n = 81). Waist circumference was the predominant marker in the subjects studied, whereas triglycerides were the lower marker. In the overall population, the incidence of metabolic syndrome and its associated factors were higher in postmenopausal women than in peri-menopausal women, from which it can be concluded that post menopause may be a predictor of metabolic syndrome.

Determinants of metabolic syndrome: a population survey at Bizerte military garrison in 2015-2017

Introduction:

Metabolic syndrome (MetS) is a worldwide major public health problem. In Tunisia, few studies have focused on MetS in general population and in military setting in particular.

Aim: To determine the prevalence of the MetS in a military population at Bizerte garrison (Tunisia) and to identify its associated factors.

Methods:

An analytical cross sectional study was conducted in Bizerte military garrison during the period 2015-2017. The study population was the active military persons who were presents during the time of the survey and assigned at the three main navy, air force and army units of Bizerte garrison. The adopted definition for the diagnosis of MetS was the International Diabetes Federation 2005 (IDF 2005). Multivariate analysis using a binary logistic regression model to identify independent factors to MetS (variable of interest) was performed. Data entry and analysis were performed using SPSS 20.0 Software.

Results:

During the study period, 2500 active military were enrolled among them 2418 men. The mean age was 36.6 ± 9.1 years [20.0 – 59.0]. The prevalence of MetS was 17.7%. MetS was significantly higher among participants aged 40 and above, (23.8% vs 13.1%), single (21.6% vs 13.7%), diabetic (38.5% vs 15.5%), and assigned in the air force (23.1% vs 14.6%) compared to the rest of the study population. The independent factors identified in multivariate analysis were age, armed forces' affiliation and marital status.

Conclusion:

The prevalence of MetS in our military population was relatively high despite of the medical criteria imposed before incorporation. Population and targeted approach are needed to prevent this scourge and to protect from the complications.

Metabolic syndrome amongst adults in Jordan: prevalence, trend, and its association with socio-demographic characteristics

BACKGROUND

Multiple epidemiological studies were conducted amongst a variety of ethnic groups and showed discrepancies in the prevalence of metabolic syndrome (MeS) and its individual components. This study aimed to determine the prevalence of MeS in Jordan using both the Adult Treatment Panel Guidelines (ATP III) and the International Diabetes Federation (IDF) criteria. The study also aimed to assess the changes in the prevalence of MeS over time and determine its association with sociodemographic variables.

METHODS

Data from the 2017 Cardiovascular Disease Risk Factors Survey were used for this study. Socio-demographic and clinical data were collected using a structured questionnaire. Blood samples were taken for biochemical measurements. Furthermore, anthropometric characteristics were measured by the same team of trained field researchers. A sample of 4,056 individuals aged between 18 and 90 years was included in this study. The findings from the 2017 survey were compared with the findings of a 2009 survey that adopted the same methods and procedures.

RESULTS

According to the IDF criteria, the crude prevalence of Metabolic syndrome was 48.2% (52.9% among men and 46.2% among women; p < 0.001). Using the ATP III criteria, the prevalence was 44.1% (51.4% among men and 41% among women, p < 0.001). The age-standardized prevalence rate of metabolic syndrome was 44% (95% CI 42.7, 45.4) and 39.9% (95% CI 39.6, 41.2), according to both the IDF definition and ATP III criteria, respectively. The Kappa measure of agreement showed excellent agreement between the two definitions (k = 81.9%, p < 0.001). Of all participants, 41.7% met both the IDF and ATP III diagnostic criteria, 6.6% met the IDF criteria only, and 2.5% met the ATP III criteria only. The age-standardized prevalence rate of metabolic syndrome was significantly higher in 2017 (45.7% in men and 44.5% in women) than that in 2009 survey (34.6% in men and 39.8% in women). Gender, age, occupation, region, and marital status were significantly associated with metabolic syndrome.

CONCLUSIONS

The prevalence of metabolic syndrome in Jordan is considerably high and it is increasing. Healthy lifestyle programs encouraging appropriate dietary habits and physical activity are strongly recommended in Jordan.

Epidemiological profile and clinical characteristics of metabolic syndrome in Marrakesh, Morocco

Introduction

the purpose of this study was to bring out some epidemiological and clinical characteristics of metabolic syndrome.

Methods

a total of 300 subjects willingly participated in the present study which was conducted at Ibn Zohr regional hospital in Marrakesh. We were interested in socio-demographic variables, body mass index (BMI) which assesses the degree of obesity of each subject. The blood parameters were determined by an adequate biochemistry automaton. All statistical analyses were performed using SPSS software.

Results

among the 300 subjects who participated in the study, 57.3% were females and 42.7% were males with a sex-ratio of 0.74. The average age was 51.6 ± 13.42 years old. Seventy nine of the participants (26.3%) had a metabolic syndrome, with a predominance of women: 60 women (34.9%) and 19 men (14.8%). Illiterates (33.8%) and married subjects (25.6%) were the most affected by the metabolic syndrome. The high waist circumference found in 97.5% was the predominant criteria in our study. Finally, the statistical analysis showed a significant association between high waist circumference, BMI and the presence of metabolic syndrome (P = 0.001>) and (P < 0.001) respectively.

Conclusion

the metabolic syndrome is slowly but surely setting. Implementing prevention strategies and encouraging healthy lifestyles will surely minimize serious public health problems in the city.

Cardio-metabolic risk factors in Tunisia: state of the art

Cardiometabolic risk factors in Tunisia are growing fast. The main risk factor is metabolic syndrome which is a global health issue in both developing and developed countries. It is resulting from a new phase of epidemiological transition characterised by ageing and an increase in non-communicable diseases. It is common in both genders with some disparities between urban and rural regions, educational levels and social classes. Hypertension and diabetes are also additional risk factors predicting alarming mortality rates. We propose here a review of the determinants of metabolic syndrome in Tunisia and the overall cardiometabolic risk factors.

Socio-economics status and metabolic syndrome: A meta-analysis

OBJECTIVE

The metabolic syndrome (MetS) is responsible for an increased risk of type 2 diabetes, cardiovascular diseases and is associated with all-cause and cardiovascular mortality. Economic and social vulnerability is not an easy concept to grasp, but some studies investigate the association between MetS and socioeconomic and demographic factors, deprivation (more often correlations rather than causal one due to data). This work aims to assess the association between MetS and socio-economic gradient (SEG) in the literature by performing a meta-analysis.

DESIGN

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for systematic reviews were followed.

SETTING

The raw list of studies extracted from PubMed as regard to the inclusion/exclusion criteria was imported in Word. Studies were filed with regard to our three definitions of SEG and their title.

PARTICIPANTS

Subgroup analysis were performed considering several definitions of Mets: NCEP-ATPIII and IDF2006.

RESULTS

The overall multivariable-adjusted OR showed that the risk of MetS was significantly increased in association with SEG The results of the subgroup analysis showed an increased risk of MetS in association with SEG when IDF definition was considered.

CONCLUSIONS

Targeted interventions must be implemented in a specific way as prevention campaigns aimed at the general population are generally not adapted to this particular vulnerable population.

Síndrome metabólica, componentes e fatores associados em adultos de 40 anos ou mais de um município da Região Sul do Brasil

Resumo Objetivo Estimar a prevalência de síndrome metabólica (SM), de seus componentes e fatores associados em adultos de 40 anos ou mais. Métodos Estudo transversal, de base populacional, com 1.180 residentes em um município brasileiro de médio porte da Região Sul. Realizaram-se entrevistas domiciliares, avaliações antropométricas e exames laboratoriais. A SM foi definida de acordo com o critério harmonizado de 2009. Foram analisadas variáveis sociodemográficas, comportamentais e de utilização de serviços de saúde. Utilizaram-se o teste de qui-quadrado, exato de Fisher e teste de Wald na análise de múltiplos fatores pela regressão de Poisson. Resultados Entre os entrevistados, 959 (81,3%) realizaram exames laboratoriais e medidas antropométricas. A prevalência de SM foi de 53,7%, mais elevada em mulheres e em idades mais avançadas. A presença de cinco componentes da SM foi observada em 12% dos participantes (15,8% mulheres e 7,3% homens). Após ajustes, apenas a idade se associou à SM. Conclusão A elevada prevalência de SM e de seus componentes, distinta em cada sexo e grupo etário, aponta a necessidade de ações de enfrentamento com abordagens coletivas e estabelecimento de metas terapêuticas individuais.

Prevalence of Metabolic Syndrome and its Related Risk Factors in the City of Oran, Algeria: the ISOR Study

BACKGROUND

Aging and lifestyle changes had led to an epidemiological transition, with a significant impact on the incidence of cardiovascular diseases in North Africa.

OBJECTIVE

The aim of this study was to determine the prevalence of metabolic syndrome and its associated factors, which were unknown, among an urban population in Algeria.

METHODS

During 2007-2009, 787 individuals aged 30-64 years, randomly selected from the list of insured persons residing in the city of Oran, participated in a clinical, anthropometric and biological survey. Participants were classified according to the National Cholesterol Education Program - Adult Treatment Panel (NCEP-ATP) III definition of metabolic syndrome.

RESULTS

The prevalence of metabolic syndrome was 20%, higher in women than men (25.9 vs 13.7%; P<.0001). Among the components of the syndrome, the most common risk factors observed in women were a low high-density lipoprotein (HDL) cholesterol concentration (60.4% vs 44.2% in men) and abdominal obesity (46.8% vs 30.1% in men) whereas men displayed more high blood pressure (42.5% vs 34.8% in women). In men, metabolic syndrome was more frequent in married and highly educated participants. In contrast, women with a high level of education and who had an intermediate level of physical activity seemed to be protected.

CONCLUSIONS

Metabolic syndrome, prevalent in the urban population of North Algeria, is associated with a high proportion of low HDL-cholesterol and abdominal obesity, especially among women. There is a need for prevention strategies involving promotion of physical activity for the whole population and screening for hypertension among men.

Social class and metabolic syndrome in populations from Tunisia and Spain

BACKGROUND

There is an increasing prevalence of obesity and metabolic syndrome (MS) in developing countries. It has been shown the relationship between social class and MS in developed countries. The objective of our study was to compare the association of social class with the prevalence of MS in a developing country (Tunisia, region of Cap-Bon) and a developed one (Spain, Canary Islands).

METHODS

Cross-sectional study of 6729 Canarian and 393 Tunisian individuals. Social class was measured with the income, crowding and education (ICE) model, which includes family income, household crowding and education level. Logistic regression models adjusted by age estimated the risk by odds ratio (OR) and confidence interval (CI 95 %) of MS according to social class.

RESULTS

MS prevalence was higher in Tunisian (50 %) than in Canarian women (29 %; p = 0.002), with no significant differences between men. For Canarian women, being in the highest social class was a protective factor against MS (OR = 0.39; CI 95 % 0.29-0.53) and all its components. The Canarian population and the Tunisian women, showed a significant linear trend (p < 0.001) of MS to decrease when social class increased.

CONCLUSION

High social class is a protective factor from MS and its components within the Canarian population and the Tunisian women. Our results suggest that the socioeconomic transition in a developing country like Tunisia can improve the population health in a sex-specific manner.

Gender-dependent associations between socioeconomic status and metabolic syndrome: a cross-sectional study in the adult Saudi population

Background

To determine the gender-dependent association of socio-economic status variables with the prevalence of metabolic syndrome (MetS) in the adult Saudi population.

Methods

A total of 9164 adult Saudis (aged 18–70 years) were included in this cross-sectional study. Marital status, income, education, and occupation were used as socio-economic indicators while behavioral factor like physical exercise was also taken into account. MetS was defined using the criteria based from the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III).

Results

In males, the odds ratio (OR) of harboring MetS was higher in married [OR1.6 (Confidence Interval (CI) 1.1, 2.4); p < 0.03], and high income class [OR 2.3(CI 1.5, 3.5); p < 0.001] and lowest in retired and unemployed individuals [1.4(1.0, 1.9); p < 0.04, 0.61(0.45, 0.82); p < 0.001] respectively. In females, MetS was inversely related to high income [OR 0.70 (CI 0.46, 1.1); p < 0.09] and education level [OR 0.38 (CI 0.26, 0.56); p < 0.001], and was significantly higher in the unemployed class [OR 1.6 (CI 1.2, 2.2); p < 0.004].

Conclusions

The prevalence of MetS is significantly high among retired, married and high-earning Saudi males while in females, high earners and high education seem to confer a protective effect against MetS.

Menopause and metabolic syndrome in tunisian women

Objectives. This study aimed to evaluate the effect of menopausal status on the risk of metabolic syndrome (MetS) in Tunisian women. Methods. We analyzed a total of 2680 women aged between 35 and 70 years. Blood pressure, anthropometric indices, fasting glucose, and lipid profile were measured. The MetS was assessed by the modified NCEP-ATPIII definition. Results. The mean values of waist circumference, blood pressure, plasma lipids, and fasting glucose were significantly higher in postmenopausal than in premenopausal women, a difference that was no longer present when adjusting for age. Except for hypertriglyceridaemia, the frequency of central obesity, hyperglycemia, high blood pressure, and high total cholesterol was significantly higher in postmenopausal than in premenopausal women. After adjusting for age, the significance persisted only for hyperglycemia. The overall prevalence of MetS was 35.9%, higher in postmenopausal (45.7% versus 25.6%) than in premenopausal women. A binary logistic regression analysis showed that menopause was independently associated with MetS (OR = 1.41, 95% CI 1.10–1.82) after adjusting for age, residence area, marital status, family history of cardiovascular disease, education level, and occupation. Conclusions. The present study provides evidence that the MetS is highly prevalent in this group of women. Menopause can be a predictor of MetS independent of age in Tunisian women.

[Urinary disorders and metabolic syndrome: prospective study]

OBJECTIVE

Metabolic syndrome (MS) risk factors are potentially implicated in the development of lower urinary tract symptoms (LUTS). The goals of this study were to analyze the prevalence of the LUTS in patients presenting with MS and to evaluate the correlation between the MS components and LUTS.

METHODS

A prospective study was conducted on a group of 34 patients with MS according to the criteria of the NCEP ATP III. Urinary symptom profile (USP) questionnaire was used to evaluate LUTS. The physical examination included: weight, waist circumference, body mass index (BMI) and blood pressure looking for orthostatic hypotension. The following laboratory data were obtained: fasting blood sugar, postprandial glycemia, glycosylated hemoglobin (HbA1c), HDL-cholesterol, LDL-cholesterol, triglycerides and total cholesterol.

RESULTS

The mean age was 56.2 years (±9.2). Twenty of the patients (58.8%) were females. All patients underwent diabetic and hypertension therapy. The mean BMI was 30.2±4.8 and waist circumference was 107.8±9.3 cm. USP total score was 8.3±6. Besides, 29 (85.2%) patients had overactive bladder symptom, and 13 (38.2%) patients presented with urinary stress incontinence. The overactive bladder USP score was significantly correlated with age, waist circumference, BMI and postprandial glycemia. The other parameters of MS were not correlated with urinary symptoms.

CONCLUSION

The most frequent urinary symptom in the MS was overactive bladder symptoms and urinary incontinence. The components of MS that influenced the USP score were abdominal obesity and hyperglycemia. The hypothesis of a link between MS and overactive bladder in diabetic patients with MS is plausible.

Influence of education in the prevalence of obesity in Iranian northern adults

BACKGROUND

The main aim of this study was to evaluate whether prevalence of obesity in educational levels is different and some related factors in Iranian northern adults.

MATERIALS AND METHODS

This was a cross-sectional descriptive study based on population and 2452 cases (1224 men and 1228 women) aged 15-65 years were chosen by cluster and stratify sampling. Subjects were randomly chosen from 125 clusters and each cluster included 20 cases. Interviewers recorded the data using a multidimensional questionnaire including socio-demographic indexes.

RESULTS

As a whole, the prevalence of obesity was seen in 24% of subjects (15.5% in male and 32.5% in female) and significantly was seen in 3.1% and 14.1% of uneducated people more than in 1-9 year schooling and in high school or college-educated people, respectively (P = 0.001). The risk of obesity was 2.294 (P = 0.001) in uneducated compared to high school or college-educated people, 1.668 (P = 0.001) in urban area compared to rural area, 2.619 (P = 0.001) in 40-65 year people compared to 15-40 year people, and 1.534 (P = 0.003) in good economic compared to poor economic groups. After adjusted for location area, gender, age, and economic stats, the risk of obesity was 2.044 (P = 0.001) in uneducated people compared to high school or college-educated subjects.

CONCLUSION

The obesity as a health problem in Iranian northern adults supported in this study and it was negatively associated with educational levels. Public health programs that aim to reduce obesity should primarily focus on the illiterate and low-educated people.

Sociodemographic disparities in the composition of metabolic syndrome components among adults in South Korea

OBJECTIVE Metabolic syndrome (MetS) is becoming a serious public health concern in many countries, including South Korea, which has faced remarkable changes in lifestyles and disease patterns in recent decades. We examined sex and socioeconomic status (SES) disparities in MetS and its components among South Koreans using recent, nationally representative data. RESEARCH DESIGN AND METHODS Data from the 2007-2008 Korea National Health and Nutrition Examination Surveys for 7,289 adults 19-65 years of age were used to examine the patterns of MetS components (defined using International Diabetes Federation criteria), and regression models were used to study the association of MetS with SES, indicated by education and family income levels. RESULTS MetS prevalence increased with age, from 4.6% at age 19-29 years to 25.0% at age 50-65 years. More men had MetS than women (15.8 vs. 11.6%); men had worse levels of all MetS components. In women, the low-income and low-education group was more likely to have MetS (odds ratio 2.75 [95% CI 1.75-4.31]); the high-income and high-education group was 52% less likely to have MetS (0.48 [0.25-0.89]) compared with the middle-income and middle-education group. The most common combination of MetS components was central obesity + low HDL cholesterol (HDL-C) + hypertriglyceridemia, which occurred in 15.5% of all MetS patients and in 3.4% of all South Korean adults (4.1% in men and 2.9% in women). CONCLUSIONS Those who were older and male as well as low-SES female had higher rates of MetS and its components in South Korea. The SES-MetS association was not found in men. Central obesity + low HDL-C + hypertriglyceridemia was the most common MetS pattern regardless of the SES.

Adiponectin and metabolic syndrome in a Tunisian population

The aim of this study was to investigate the relationship between the adiponectin levels and various characteristics of the metabolic syndrome (MS) in a sample of the Tunisian population. Three hundred and fifty-four individuals were included in this study. Body mass index, blood pressure, HDL-cholesterol, triglycerides, glucose, insulin, and adiponectin concentrations were measured. Insulin resistance was assessed by homeostasis model assessment of insulin resistance (HOMA-IR). MS was identified with the NCEP-ATP III criteria. Subjects with MS showed significantly lower adiponectin levels compared to those without MS. For both genders, the prevalence and the number of MS components increased significantly as the adiponectin concentrations decreased. Subjects with the lowest adiponectin quartile had an increased risk of MS adjusted for age, gender, and HOMA-IR. Our findings suggest that hypoadiponectinemia is strongly associated with the risk of MS independent of insulin resistance.

Prevalence and determinants of the metabolic syndrome among Tunisian adults: results of the Transition and Health Impact in North Africa (TAHINA) project

OBJECTIVE

To determine the prevalence of metabolic syndrome (MetS) and its components and to evaluate the relationship between this diagnosis and cardiovascular risk factors, demographic and socio-economic variables.

DESIGN

A cross-sectional study using a questionnaire including information on sociodemographic and CVD risk factors. Blood pressure, anthropometric indices, fasting glucose and lipid profile were measured. MetS was defined according to the criteria of the National Cholesterol Education Program, Adult Treatment Panel III.

SETTING

The whole Tunisian territory; Transition and Health Impact in North Africa (TAHINA) project.

SUBJECTS

A total of 4654 individuals (1840 men and 2814 women), aged 35 to 74 years, who participated in the Tunisian national survey.

RESULTS

The overall prevalence of MetS was 30·0 %, higher in women (36·1 %) than in men (20·6 %; P < 0·001). In both genders MetS prevalence increased significantly with age (P < 0·001), but this increase was more important in women. Multiple regression analyses showed that the odds for MetS increased significantly with urban area for both men and women (P < 0·05 and P < 0·001, respectively). The multivariate models showed also that the odds for MetS increased significantly with increasing level of education and in those with a family history of CVD for men (both P < 0·05) and after the menopausal transition for women (P < 0·05).

CONCLUSIONS

The study highlights the MetS problem in a middle-income developing country. There is an urgent need for a comprehensive, integrated, population-based intervention programme to ameliorate the growing problem of MetS in Tunisians.

Prevalence of metabolic syndrome among an urban population in Kenya

OBJECTIVE

Developing countries are undergoing an epidemiologic transition accompanied by increasing burden of cardiovascular disease (CVD) linked to urbanization and lifestyle modifications. Metabolic syndrome is a cluster of CVD risk factors whose extent in Kenya remains unknown. The aim of this study was to determine the prevalence of metabolic syndrome and factors associated with its occurrence among an urban population in Kenya.

RESEARCH DESIGN AND METHODS

This was a household cross-sectional survey comprising 539 adults (aged ≥18 years) living in Nairobi, drawn from 30 clusters across five socioeconomic classes. Measurements included waist circumference, HDL cholesterol, triacylglycerides (TAGs), fasting glucose, and blood pressure.

RESULTS

The prevalence of metabolic syndrome was 34.6% and was higher in women than in men (40.2 vs. 29%; P < 0.001). The most frequently observed features were raised blood pressure, a higher waist circumference, and low HDL cholesterol (men: 96.2, 80.8, and 80%; women: 89.8, 97.2, and 96.3%, respectively), whereas raised fasting glucose and TAGs were observed less frequently (men: 26.9 and 63.3%; women: 26.9 and 30.6%, respectively). The main factors associated with the presence of metabolic syndrome were increasing age, socioeconomic status, and education.

CONCLUSIONS

Metabolic syndrome is prevalent in this urban population, especially among women, but the incidence of individual factors suggests that poor glycemic control is not the major contributor. Longitudinal studies are required to establish true causes of metabolic syndrome in Kenya. The Kenyan government needs to create awareness, develop prevention strategies, and strengthen the health care system to accommodate screening and management of CVDs.

Relationship of C-reactive protein with components of the metabolic syndrome in a Tunisian population

BACKGROUND

C-reactive protein (CRP) is an independent risk factor of diabetes and cardiovascular disease and it is proposed as a component of metabolic syndrome (MS). This study was undertaken to investigate the relationship between CRP and various characteristics of the MS in a sample of the Tunisian population

METHODS

One hundred and forty nine patients with MS and 152 controls, aged 35-70 years were recruited. Waist circumference (WC), blood pressure, HDL-cholesterol (HDL-C), triglycerides (TG), glucose, insulin and CRP were measured. Insulin resistance was assessed by homeostasis model assessment of insulin resistance (HOMA-IR). MS was defined by NCEP-ATPIII report

RESULTS

CRP levels were significantly higher in MS group (4.41±3.73 mg/L vs. 2.68±2.59 mg/L, p<0.001) compared to without MS group. For both sexes, CRP increased as the number of MS components increased (p=0.015 for men and p<0.001) after adjustment for age, smoking, alcohol intake and, for women, menopause. There were statistically significant positive correlations for log CRP with WC, log TG, and log HOMA-IR in both sexes adjusted for confounding factors listed above. A significant negative correlation was found between HDL-C and log CRP only in women. In both sexes, WC was identified, by multiple linear regression models, as significant independent predictor of CRP level variability. HDL-C showed also a significant contribution only in women

CONCLUSIONS

The present study provides evidence that CRP levels are elevated in MS subjects. In addition, WC and HDL-C are significant predictors of the CRP elevation.

Plasma fatty acids profile and estimated elongase and desaturases activities in Tunisian patients with the metabolic syndrome

This study aimed to determine plasma fatty acids pattern and to estimate desaturases activities in Tunisian subjects with metabolic syndrome (MetS). A total of 1975 adults were randomly selected from the Great Tunis region (Tunisia). MetS was defined according to the International Diabetes Federation criteria. Saturated and monounsaturated fatty acids levels and delta 9 desaturase activity were increased, but polyunsaturated fatty acids (PUFA) levels and delta 5 desaturase activity were decreased in patients with MetS. Using multivariate analysis, MetS was found inversely associated with PUFA; compared to first quartile, multi-adjusted odd ratios (95% confidence interval) of MetS were 0.80 (0.54-1.17), 0.47 (0.27-0.81) and 0.32 (0.15-0.68) for second, third and fourth quartiles of PUFA, respectively. Altered fatty acids pattern in MetS is likely related to both dietary and metabolic changes.

Metabolic syndrome is associated with gastroesophageal reflux disease based on a 24-hour ambulatory pH monitoring

Several studies have focused on the relationship between metabolic syndrome and gastroesophageal reflux disease (GERD). They were based on GERD complications, whereas little is known about the association between metabolic syndrome and objectively measured esophageal acid exposure. The aim of our study was to assess the relationship between metabolic syndrome and GERD based on a 24-hour pH testing. It was a cross-sectional study including 100 consecutive patients who underwent a 24-hour pH-metry monitoring and were assessed for the five metabolic syndrome components as well as for body mass index (BMI). Among the 100 patients, 54 had a pathological acid GERD. The 46 GERD-free patients represented control group. Sex distribution was comparable between both groups but GERD patients were older than controls (44.59 vs. 37.63 years, P= 0.006) and more often obese or with overweight (83.3 vs. 60.9%, P= 0.01). Frequency of metabolic syndrome as a whole entity was higher among patients with GERD than those without GERD (50 vs. 19.56%; P= 0.002) with a crude odds ratio of 4.11 (95% confidence interval: 1.66-10.14). Multivariate regression analysis showed that metabolic syndrome as well as an age ≥ 30 years were independent factors associated to GERD but not BMI and sex. Abnormal waist circumference and fasting glucose level ≥ 100 mg/L were the only independent factors among the five components of metabolic syndrome. Metabolic syndrome but not BMI was an independent factor associated to GERD. These results confirm the hypothesis that central obesity is associated to GERD.

Metabolic syndrome in Tunisian psoriatic patients: prevalence and determinants

BACKGROUND

A significant association between psoriasis and the metabolic syndrome (MetS) has been frequently reported.

OBJECTIVE

The aim of this study was to specify the main factors that determine the MetS in psoriatic Tunisian patients.

METHODS

A case-control study has included 164 psoriatic patients and 216 controls.

RESULTS

The prevalence of MetS was higher in cases than in controls but without statistical differences [35.5% vs. 30.8%, odds ratio (OR): 1.39 CI: 0.88-2.18; P=0.095]. According to gender, the prevalence of MetS was significantly increased only in psoriatic women (47.4% vs. 30%, OR: 1.89, CI: 1.11-3.21; P=0.01). A multiple logistic regression, considering the effect of age, and gender, showed that the prevalence of MetS was significantly higher in cases than in controls (OR: 1.73, CI: 1.06-2.82; P=0.03). MetS components analysed seperately showed a significantly higher prevalence of decreased high-density lipoprotein cholesterol (HDLc) (60.9% vs. 35.9%, OR: 2.77, CI: 1.8-4.27, P<0.001) and for increased hypertension (50% vs. 40%, OR: 1.48, CI: 0.97-2.257, P=0.04) in psoriatic patients. According to gender, HDLc was significantly decreased in both genders (male: OR: 2.075, CI: 1.24-3.47, P=0.004; female: OR: 3.58, CI: 2.07-6.19, P<0.0001), while hypertension was increased only in psoriatic men (OR: 2.09, CI: 1.24-3.51, P=0.004) and abdominal obesity only in psoriatic women (OR: 2.31, CI: 1.30-4.11, P=0.002).

CONCLUSION

Decreased HDLc is the main biological abnormality that characterized MetS in Tunisian psoriatic patients. Moreover, contrary to men, psoriatic women have shown a significantly higher prevalence of MetS, which is, in addition to decreased HDLc, mainly attributed to abdominal obesity.