Metabolic Syndrome and its Associated Risk Factors in Healthy Adults: APopulation-Based Study in Iran

The effect of time-restricted eating on arterial stiffness indices in men with metabolic syndrome: study protocol for a randomized controlled trial

BACKGROUND

Time-restricted eating (TRE) has been shown to be associated with improvements in some aspects of the metabolic syndrome. Nevertheless, only a few studies have addressed the effect of TRE on pulse wave velocity (PWV). We thus propose a randomized controlled trial to compare the effects of TRE with standard dietary advice on PWV and thereby present the protocol.

METHODS

Forty-eight participants will be assigned to either TRE or control groups using simple randomization. The TRE group will consume their meals during a 10-h period and experience 14 h of fasting. They will also be advised to consume their last meal no later than 20:00. Both groups will receive standard dietary advice. The participants will be followed for 6 weeks. The primary outcome will be changes in PWV. Laboratory measurements, including lipid profile, liver enzyme tests, fasting blood glucose (FBG), insulin concentrations, and insulin resistance, as well as anthropometric data, blood pressure, basal metabolic rate, appetite status, physical activity level, sleep quality, cognitive function, quality of life, and calorie intake, will be evaluated throughout the study.

DISCUSSION

The outcomes of this study will allow a comparison of the effects of TRE and standard dietary recommendations on PWV and other cardiometabolic factors in individuals with metabolic syndrome (MetS).

TRIAL REGISTRATION

Iranian Registry of Clinical Trials; code: IRCT20201230049889N1; registered on August 14, 2022. The registration of the trial is accessible at: https://www.IRCT.ir/trial/64485?revision=281341 .

High Prevalence of Metabolic Syndrome and Its Related Demographic Factors in North of Iran: Results from the PERSIAN Guilan Cohort Study

INTRODUCTION

The prevalence of metabolic syndrome has increased in recent decades around the world and is currently reaching epidemic levels as it is a major public health and clinical concern. The aim of this study was to evaluate the prevalence of metabolic syndrome and its related demographic factors in a population-based study.

METHODS

In this cross-sectional study, the target population consisted of 10520 individuals aged 35-70 years in Phase 1 of the Persian Guilan cohort study (Guilan site/Some'e Sara) that was conducted in 2014-2017. Demographic, anthropometric, blood pressure, and biochemical data were used in this study. The IDF definitions were used to diagnose the metabolic syndrome.

RESULTS

The prevalence of the syndrome according to IDF and ATP definition was 42.87% (95% CI: 41.92-41.81) and 40.68% (95% CI: 39.74-41.62), respectively. The prevalence of components for central obesity, high triglyceride, HDL cholesterol, blood glucose, and hypertension components was 75.8%, 43.1%, 40.6%, 39.2% and 37.9%, respectively. All demographic variables were related to the syndrome, and among them age, gender, and residence were identified as independent and strong predictive variables in the regression model. More than 92% of the population had at least one component of the syndrome.

CONCLUSION

The results of the study show a high prevalence of metabolic syndrome risk factors. It is essential to educate healthy lifestyle behaviors and further health education in the high-risk groups identified in this study, especially the elderly, women, and rural residents.

Association of nutrient patterns and metabolic syndrome and its components in adults living in Tehran, Iran

Purpose

Identification of nutrient patterns (NPs) may be helpful to evaluate the overall quality of diet and its relation to metabolic syndrome (MetS). We investigated the association of major nutrient patterns with MetS and its components among apparently healthy adults living in Tehran.

Methods

We included 522 adults (24-83 years old) who referred to health centers in Tehran. Fasting blood samples were collected to measure glycemic indicators and lipid profile. Principal component analysis (PCA) based on the 26 nutrient items were applied. Metabolic syndrome was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III).

Results

Three major nutrient patterns were identified: "Mono and disaccharides pattern", "Macronutrient pattern" and "Antioxidant pattern". After controlling for potential confounders, serum HDL (p < 0.001) increased across tertiles of "Antioxidant pattern". A significant inverse association was observed between adherence to "Antioxidant pattern" and odds of MetS (OR: 2.36, 95% CI: 1.51, 3.69) in crude model which was disappeared after adjusting for age, sex, education, physical activity, smoking, marital status, energy and BMI. Moreover, we found that adherence to "Antioxidant pattern" was inversely related to odds of reduced levels of serum high density lipoprotein (HDL) (OR: 0.09, 95% CI: 0.02, 0.35). No association was found between "Mono and disaccharides pattern", "Macronutrient pattern", MetS and its components.

Conclusions

In general, adherence to "Antioxidant pattern "resulted in lower level of HDL concentrations. More studies are needed to investigate the possible causal relationship of these results.

Prevalence and Incidence of Metabolic Syndrome in Iran: A Systematic Review and Meta-Analysis

Metabolic syndrome (MetS) is a predictor of several diseases such as cardiovascular diseases, diabetes, dyslipidemia, stroke, osteoarthritis, certain cancers, and death leading to public health concern in most societies. We aimed to estimate the pooled prevalence and incidence of MetS in Iranian population through a meta-analysis study. We included cross-sectional and cohort studies to estimate the overall prevalence and incidence rates of MetS in Iran National databases including MagIran, Science Information Database, IranMedex, and international databases including Medline, Web of Sciences, and Scopus were searched up to October 2017. Finally, 125 studies were included. The total sample size was 472,401 with a mean age of 38 ± 7.8 years. The overall pooled prevalence and incidence rate among the general population of Iran was 0.26 (95% CI: 0.26, 0.29) and 97.96 (95% CI: 75.98, 131.48), respectively. The pooled prevalence of MetS was higher in females and in urban areas. The highest and lowest prevalence of MetS was obtained by the Iranian definition criteria (0.43) and the NHANES III (0.12). The highest and lowest incidence rates of MetS were obtained by IDF (144.07 per 1000) and the JIS (89.73 per 1000). The prevalence of MetS was higher in women and those living in urban areas. Furthermore, the prevalence of MetS increased with increasing age in both genders.

Factor Analysis of Metabolic Syndrome Components in an Iranian Non-Diabetic Adult Population: A Population-Based Study from the North of Iran

OBJECTIVES

The aim of this study was to explore the underlying latent factors that can explain the observed variation of components of metabolic syndrome (MetS) in Iranian non-diabetic adult population.

METHODS

The researchers performed an exploratory factor analysis (EFA) of metabolic syndrome components, including body mass index (BMI), waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), triglyceride (TG), high density lipoprotein (HDL), and Fasting blood sugar (FBS). These observed variables were measured from a representative sample of 841 non-diabetic participants in a cross-sectional population-based study of adults aged 20 to 70 years in the North of Iran.

RESULTS

Three factors were extracted by EFA in both genders. In males, the 3 generated factors were, 1) blood pressure factor underlying systolic and diastolic blood pressure, 2) obesity factor manifested by BMI and WC, 3) lipid/glucose factor underlying TG, HDL and FBS that explained 23.9%, 23.0% and 18.4% of variance in the observed data, respectively, in males. However, in females, BMI and WC were revealed as obesity factors, and systolic and diastolic blood pressure were characterized as hypertension factor, and TG, HDL and FBS appeared to be loaded on lipid/glucose factor, similar to males, and designated 25.6%, 25.4%, and 15.8% of the variance, respectively. Triglyceride and FBS were positively loaded, whereas HDL was loaded negatively with similar loading pattern in both genders. Overall, these 3 underlying latent factors explained 65.3% of the variance of observed clinical data sets in males and 66.8% in females. When TG and HDL were replaced by TG to HDL ratio and also SBP and DBP by mean arterial pressure (MAP), the two-factor model was generated in both genders.

CONCLUSIONS

The 2-and 3-factor models were characterized indicating a single pathogenesis that could not explain the unified clustering of MetS in non-diabetic adults.

Clustering of cardio metabolic risk factors in Iranian adult population: A growing problem in the north of Iran

INTRODUCTION

The clustering of components of metabolic syndrome (MetS) is a major concern in a transition population because of dramatic changing toward modern life styles. The objective of this study was to determine the prevalence of clustering of various combinations of MetS and its association with obesity.

METHODS AND SUBJECTS

In a population- based cross-sectional study, a representative samples of 1000 adults were recruited in Babol, the north of Iran. The demographic data, blood pressure, body mass index and waist circumference (WC) were measured with standard method. Fasting blood sugar, serum levels of triglycerides, high density lipoprotein were measured with enzymatic method.

RESULTS

A quarter of population had only one component of MetS. The prevalence of just two components was 30.7% and 26.2% in men and women respectively and about 67.1% of men and 73.3% of women had ≥2 risk factors (P=0.001). While the joint prevalence of three and four components was 22.0% and 12.0% in male and 27.3% and 16.5% in female respectively. The combination of high WC with any of other four components of MetS were significantly higher compared with any other joint combinations in particularly among women (P=0.001). The adjusted odds ratio for having clustering (≥2 risk factors) increased 5.6 times (95%CI: 2.15, 6.04) in obese subjects and remained at significant level after adjustment for age, sex, level of education.

CONCLUSION

An emerging high rate of clustering of joint combination of cardio metabolic risk factors highlights an urgent intervention for life style modification in public health management.

Does the low-density lipoprotein cholesterol play a key role in predicting metabolic syndrome in the Iranian adult population?

BACKGROUND

The low density lipoprotein cholestrol (LDL-C) has an important role in the pathogenesis of cardiovascular disease but its association and predictive accuracy with metabolic syndrome (MetS) remains controversial. The objective of this study was to investigate the association and predictive ability of LDL-C with MetS.

METHODS

We analyzed the data from a population-based cross-sectional study conducted on representative samples of an Iranian adult population. The demographic data, anthropometric measures and the lipid profiles were measured with standard methods, and MetS was diagnosed by ATP III criteria. Logistic regression model and ROC analysis were used to estimate the predictive accuracy of LDL-C and its association with MetS.

RESULTS

The mean age (±SD) of participants with and without MetS was 47.6±12.5 years and 39.1±12.9 years, respectively (p=0.001). All anthropometric measures (body mass index, waist circumference, waist to hip ratio, waist to height ratio), systolic blood pressure, total cholesterol, triglycerides and fasting blood glucose were significantly higher in MetS, but a significantly higher difference in LDL-C was observed only in women. Accuracy of LDL-C in predicting MetS for men and women was 0.48 (95% CI: 0.43-0.54) and 0.55 (95% CI: 0.51-0.60), respectively. The unadjusted and adjusted odds ratios of different quartiles of LDL-C compared with 1st quartile did not reach to a significant level.

CONCLUSION

Serum LDL-C level is not significantly associated with MetS but exhibits a weak ability in predicting MetS in women.

The Prevalence of Metabolic Syndrome and Different Obesity Phenotype in Iranian Male Military Personnel

Obesity, especially when concentrated in the abdominal area, is often associated with the presence of metabolic syndrome. Stress, particularly occupational stress, is one of the most important factors contributing to the increased prevalence of metabolic syndrome components among different populations. This study aimed to investigate the prevalence of overweight and obesity as well as the criteria for metabolic syndrome and its risk factors and different obesity phenotype in a population of military personnel aged 20 to 65 years. This study is a retrospective cross-sectional study in which data are extracted from the database of a military hospital (2,200 participants). The records of participants contained information such as age, marital status, educational level, weight, height, body mass index, blood pressure, waist circumference, history of drug use and smoking, as well as the results of tests including lipid profile and fasting blood glucose. The Adult Treatment Panel III criteria as well as two national criteria were used to identify metabolic syndrome among participants. Data analysis was p1erformed using SPSS version 16. The average age of participants was 33.37 (7.75) years. The prevalence of metabolic syndrome according to Iranian cutoff was 26.6% for the waist circumference >90 cm (585 persons) and 19.6% for the waist circumference >95 cm (432 persons). The rate of metabolic syndrome was identified as 11.1% (432 cases) according to Adult Treatment Panel III criteria. Results of the current study identified that the prevalence of metabolic syndrome among military individuals is less than other populations, but the prevalence of the syndrome is higher than other military personnel in other countries.

Association of metabolic syndrome with various anthropometric and atherogenic parameters in the Kazakh population in China

Background

This study aimed to evaluate the association of the metabolic syndrome (MetS) with various anthropometric and atherogenic parameters in adult Kazakh population in China.

Methods

Four thousand ninety-four Kazakhs were recruited since 2007 to 2010. MetS and its components were confirmed according to IDF criteria. Area under the curve (AUC) of each variable was compared. Sensitivity (Sen), specificity (Spe), shortest distance in receiver’s operating characteristic curve (ROC) and cutoff of each variable to diagnose MetS were calculated.

Results

28.6 % of men and 31.0 % of women had MetS in the Kazakh population. In men, WHtR had the highest AUC value 0.821, followed by BMI (0.801), TG/HDL-C (0.792), WHR (0.776) and BAI (0.666). In women, WHtR also had the highest AUC value (0.835), following by BMI (0.789), WHR (0.778), TG/HDL-C (0.778) and BAI (0.751). WHtR had the shortest ROC distance that was 0.37 and the optimal cutoff was 0.55 in men. In women, WHtR also had the shortest ROC distance of 0.35 and the optimal cutoff was 0.54.

Conclusion

WHtR is the best predictor of MetS in both Kazakh men and women according to the IDF criteria.

Pediatric-specific reference intervals in a nationally representative sample of Iranian children and adolescents: the CASPIAN-III study

BACKGROUND

This study aimed to determine for the first time the age- and gender-specific reference intervals for biomarkers of bone, metabolism, nutrition, and obesity in a nationally representative sample of the Iranian children and adolescents.

METHODS

We assessed the data of blood samples obtained from healthy Iranian children and adolescents, aged 7 to 19 years. The reference intervals of glucose, lipid profile, liver enzymes, zinc, copper, chromium, magnesium, and 25-hydroxy vitamin D [25(OH)D] were determined according to the Clinical & Laboratory Standards Institute C28-A3 guidelines. The reference intervals were partitioned using the Harris-Boyd method according to age and gender.

RESULTS

The study population consisted of 4800 school students (50% boys, mean age of 13.8 years). Twelve chemistry analyses were partitioned by age and gender, displaying the range of results between the 2.5th to 97.5th percentiles. Significant differences existed only between boys and girls at 18 to 19 years of age for low density lipoprotein-cholesterol. 25(OH)D had the only reference interval that was similar to all age groups and both sexes.

CONCLUSIONS

This study presented the first national database of reference intervals for a number of biochemical markers in Iranian children and adolescents. It is the first report of its kind from the Middle East and North Africa. The findings underscore the importance of providing reference intervals in different ethnicities and in various regions.

Serum high-sensitivity C-reactive protein as a biomarker in patients with metabolic syndrome: evidence-based study with 7284 subjects

BACKGROUND/OBJECTIVES

Metabolic syndrome (MetS) is characterized by abdominal obesity, dyslipidemia, hypertension and glucose intolerance, and is associated with an increased risk of developing cardiovascular disease (CVD), diabetes mellitus and related diseases. Circulating levels of inflammatory markers such as C-reactive-protein (CRP) have reported to be associated with CVD. Against this background, the prevalence of MetS is increasing globally, and thus predictive biomarkers are required for identification of MetS patients at an increased risk. Here we explored the value of CRP as a biomarker in 7284 subjects and also investigated which features of MetS have the greatest association with the hs-CRP level.

SUBJECTS/METHODS

The subjects were recruited from the Mashhad stroke and heart atherosclerotic disorder study. Anthropometric factors and biochemical parameters (for example, high-sensitivity CRP (hs-CRP), high-density lipoprotein/low-density lipoprotein, triglycerides (TGs) and fasting blood glucose (FBG)) were determined. Univariate and multivariate analyses were conducted to evaluate the association of hs-CRP and MetS.

RESULTS

Our results illustrated that the concentration of serum hs-CRP increased progressively with the number of MetS components, and subjects who fulfilled the criteria of MetS for waist circumference, TGs, blood pressure and FBG were found to have hs-CRP of 0.53, 0.38, 0.34 and 0.71 mg/l, respectively, higher than matched-subjects. Importantly, FBG had the greatest association with hs-CRP concentration.

CONCLUSIONS

Our data demonstrate the significant association between MetS components with hs-CRP, indicating that this association was cumulative by increasing the number of the defining features of MetS, supporting further studies to explore the value of emerging marker as a novel method for detecting individuals at high risk of developing MetS.

Comparison of Anthropometric and Atherogenic Indices as Screening Tools of Metabolic Syndrome in the Kazakh Adult Population in Xinjiang

Objective: To compare the screening ability of various anthropometric and atherogenic indices for Metabolic syndrome (MetS) using three common criteria and to evaluate the validity of suitable parameters in combination for the screening of MetS among a Kazakh population in Xinjiang. Methods: A total of 3752 individuals were selected using the stratified cluster random sampling method from nomadic Kazakhs (≥18 years old) in Xinyuan county, Xinjiang, China, which is approximately 4407 km away from the capital Beijing. MetS was defined by the International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Panel III (ATP III) and Joint Interim Statement (JIS) criteria. The receiver operating characteristic curve (ROC) was used to compare the area under the ROC curve (AUC) of each index. The sensitivity, specificity, Youden’s index and cut-offs of each index for the screening of MetS were calculated. Results: According to the IDF, ATP III and JIS criteria, 18.61%, 10.51%, and 24.83% of males and 23.25%, 14.88%, and 25.33% of females had MetS. According to the IDF criteria, the waist-to-height ratio (WHtR) was the index that most accurately identified individuals with and without MetS both in males (AUC = 0.872) and females (AUC = 0.804), with the optimal cut-offs of 0.53 and 0.52, respectively. According to both the ATP III and JIS criteria, the lipid accumulation product (LAP) was the best index to discriminate between individuals with and without MetS in males (AUC = 0.856 and 0.816, respectively) and females (AUC = 0.832 and 0.788, respectively), with optimal cut-offs of 41.21 and 34.76 in males and 28.16 and 26.49 in females, respectively. On the basis of the IDF standard, Youden’s indices of WHtR and LAP serial tests for the screening of MetS were 0.590 and 0.455 in males and females, respectively, and those of WHtR and LAP parallel tests were 0.608 and 0.479, accordingly. Conclusion: According to the IDF, ATP III and JIS criteria, both the WHtR and LAP were better indices for the screening of MetS. The WHtR and LAP parallel test was the most accurate.

Prevalence of Metabolic Syndrome and Its Components in the Iranian Adult Population: A Systematic Review and Meta-Analysis

CONTEXT

Metabolic syndrome (MetS) increases the risk of most non-communicable diseases; gathering information about its prevalence can be very effective in formulating preventive strategies for metabolic diseases. There are many different studies about the prevalence of MetS in Iran, but the results and the study populations of these studies are very different; therefore, it is very important to have an overall estimation of its prevalence in Iran.

OBJECTIVES

This study systematically reviewed the findings of all available studies on MetS in the adult Iranian population and estimated the overall prevalence of MetS in this population.

DATA SOURCES

International databases (Scopus, ISI Web of Science, and PubMed) were searched for papers published from January, 2000 to December, 2013 using medical subject headings (MeSH), Emtree, and related keywords (metabolic syndrome, dysmetabolic syndrome, cardiovascular syndrome, and insulin resistance syndrome) combined with the words "prevalence" and "Iran." The Farsi equivalent of these terms and all probable combinations were used to search Persian national databases (IranMedex, Magiran, SID, and Irandoc).

STUDY SELECTION

All population-based studies and national surveys that reported the prevalence of MetS in healthy Iranian adults were included.

DATA EXTRACTION

After quality assessment, data were extracted according to a standard protocol. Because of between-study heterogeneity, data were analyzed by the random effect method.

RESULTS

We recruited the data of 27 local studies and one national study. The overall estimation of MetS prevalence was 36.9% (95% CI: 32.7 - 41.2%) based on the Adult Treatment Panel III (ATP III) criteria, 34.6% (95% CI: 31.7 - 37.6%) according to the International Diabetes Federation (IDF), and 41.5% (95% CI: 29.8 - 53.2%) based on the Joint Interim Societies (JIS) criteria. The prevalence of MetS determined by JIS was significantly higher than those determined by ATP III and IDF. The prevalence of MetS was 15.4% lower in men than in women (27.7% versus 43.1%) based on the ATP III criteria, and it was 11.3% lower in men based on the IDF criteria; however according to the JIS criteria, it was 8.4% more prevalent in men.

CONCLUSIONS

There is a high prevalence of MetS in the Iranian adult population, with large variations based on different measurement criteria. Therefore, prevention and control of MetS should be considered a priority.

What is the best biomarker for metabolic syndrome diagnosis?

AIMS

There are three definitions belong to metabolic syndrome (MetS). These definitions have some differences that make some problem for MetS diagnosis criteria. So a new diagnosis marker can help to MetS diagnosis. The aim of this study was the assess of serum levels of leptin, total adiponectin, high molecular weight (HMW) adiponectin, and their ratio with MetS.

MATERIALS AND METHODS

We searched Science direct, Pubmed, and Google Scholar for related articles in English. Review studies excluded.

RESULTS

Of 1827 articles found, 16 articles met our inclusion criteria. leptin is higher in MetS group but adiponectin is lower (<4 μg/ml) and it shows the paradoxical effect of them in MetS. Higher L/A ratio is a better biomarker for MetS diagnosis criteria than leptin and adiponectin separately. HMW adiponectin (<2.5 μg/ml) can be the most reliable biomarker for MetS diagnosis criteria.

CONCLUSION

Our systematic review showed that HMW adiponectin and Leptin to adiponectin ratio should be the best biomarkers for MetS.

Waist-to-Height Ratio and Triglycerides/High-Density Lipoprotein Cholesterol Were the Optimal Predictors of Metabolic Syndrome in Uighur Men and Women in Xinjiang, China

OBJECTIVE

This study aimed to identify the best single predictor of metabolic syndrome by comparing the predictive ability of various anthropometric and atherogenic parameters among a Uighur population in Xinjiang, northwest China.

METHODS

A total of 4767 Uighur participants were selected from the Cardiovascular Risk Survey (CRS), which was carried out from October, 2007, to March, 2010. Anthropometric data, blood pressure, serum concentration of serum total cholesterol (TC), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and fasting glucose were documented. Prevalence of metabolic syndrome and its individual components were confirmed according to International Diabetes Federation (IDF) criteria. Area under the receiver operating characteristic curve (AUC) of each variable for the presence of metabolic syndrome was compared. The sensitivity (Sen), specificity (Spe), distance in the receiver operating characteristic (ROC) curve, and cutoffs of each variable for the presence of metabolic syndrome were calculated.

RESULTS

In all, 23.7% of men had the metabolic syndrome, whereas 40.1% of women had the metabolic syndrome in a Uighur population in Xinjiang; the prevalence of metabolic syndrome in women was significantly higher than that in men (P<0.001). In men, the waist-to-height ratio (WHtR) had the highest AUC value (AUC=0.838); it was followed by TGs/HDL-C (AUC=0.826), body mass index (BMI) (AUC=0.812), waist-to-hip ratio (WHR) (AUC=0.781), and body adiposity index (BAI) (AUC=0.709). In women, the TGs/HDL-C had the highest AUC value (AUC=0.815); it was followed by WHtR (AUC=0.780), WHR (AUC=0.730), BMI (AUC=0.719), and BAI (AUC=0.699). Similarly, among all five anthropometric and atherogenic parameters, the WHtR had the shortest ROC distance of 0.32 (Sen=85.40%, Spe=71.6%), and the optimal cutoff for WHtR was 0.55 in men. In women, TGs/HDL-C had the shortest ROC distance of 0.35 (Sen=75.29%, Spe=75.18%), and the optimal cutoff of TGs/HDL-C was 1.22.

CONCLUSION

WHtR was the best predictor of metabolic syndrome in Uighur men, whereas TGs/HDL-C was the best predictor of metabolic syndrome in Uighur women in Xinjiang.

Prevalence of metabolic syndrome in patients with minor beta thalassemia and its related factors: a cross-sectional study

BACKGROUND

Atherosclerotic disorders, hypertension and lipid profile alterations are of a lower prevalence in patients with minor beta thalassemia. On the other hand, nowadays, metabolic syndrome is considered as one of the major risk factors of developing cardiovascular diseases. Therefore, the present study was performed to determine the prevalence of metabolic syndrome in patients with minor beta thalassemia.

METHODS

In this case-control study, body length, weight and waist circumference, blood pressure, fasting blood sugar [FBS], triglyceride, cholesterol, HDL, and LDL levels were determined in 150 patients with minor beta thalassemia and 300 healthy individuals as control group [matched based on age and sex]. The prevalence of metabolic syndrome was calculated based on ATPIII criteria. Data were analyzed through SPSS16 software package.

RESULTS

The prevalence of metabolic syndrome was 12.7% in the thalassemia group and 36.7% in the control group [p < 0.0001]. In the patient group, 3 ones [8.3%] of those with metabolic syndrome were male and 16 ones [14%] were female [p = 0.5]. Mean age of patients with metabolic syndrome was 39.4 ± 8.5 years and mean age of those without metabolic syndrome was 36.4 ± 7.8 years [p = 0.1]. Mean BMI of those with metabolic syndrome was 31.3 ± 4.1 kg/m(2) and that of those without metabolic syndrome was 24.2 ± 4.4 kg/m(2) [p < 0.0001].

CONCLUSIONS

The obtained results show lower prevalence of metabolic syndrome in patients with minor thalassemia. Moreover, the prevalence of metabolic syndrome in patients with minor thalassemia showed no relationship with sex and age and these patients had just higher BMI.

Association of two common polymorphisms of apolipoprotein A5 gene with metabolic syndrome indicators in a North Iranian population, a cross-sectional study

Background

Metabolic syndrome is an obesity dependent disorder with a worldwide high prevalence. Regarding the high prevalence of Metabolic syndrome in Iran we analyzed the influence of -1131T>C (rs662799) and c.56C>G (S19W, rs3135506) polymorphisms of the novel apolipoprotein gene, ApoA5, on some Metabolic Syndrome indicators in population from north of Iran.

Methods

199 volunteers from Babol city-Iran were divided in two groups of low (N = 99, TG ≤ 103 mg/dl) and high (N = 100, TG ≥ 150 mg/dl) serum levels of Triglycerides (TG). We amplified the gene fragments containing -1131T>C and c.56C>G polymorphisms by PCR method and revealed the polymorphisms by RFLP analysis.

Results

We found a significant association (p = 0.016, Independent t-test) between high levels of TG and -1131T>C polymorphism but not between this polymorphism and serum HDL-C concentrations. Carriers of the C allele had a 1.97 times higher odds ratio to be in the high-TG group than those of the TT genotype (95%, CI = 1.05-3.68). We observed no association between -1131T>C polymorphism with either Waist-to-Hip Ratio (WHR) or Body-Mass-Index (BMI). In the case of c.56C>G polymorphism, although it showed a significant relationship with WHR (p = 0/040, Independent t-test), but failed to correlate with either levels of TG (p = 0.594) or HDL-C (p = 0.640) in serum.

Conclusion

Our study confirms that ApoA5 gene polymorphisms, -1131T>C and c.56C>G are associated with the two criteria of Metabolic Syndrome, TG and WHR, respectively.

Metabolic syndrome and its correlated factors in an urban population in South West of Iran

BACKGROUND

This study was designed to assess the prevalence of metabolic syndrome and its correlated factors in an urban population in Ahvaz.

METHODS

This descriptive analytical study performed with random cluster sampling method in 6 health centers in Ahvaz. In each selected center, 55 households were randomly selected. A questionnaire included: age, sex, marital status, ethnicity, education level, family history of diabetes (DM), Hypertension (HTN) and obesity, smoking and parity and previous history of gestational diabetes Mellitus in women were filled for each person.Blood pressure, weight, height, body mass index (BMI), abdominal and waist circumference were measured in each participant. Fasting blood glucose (FBS), serum total cholesterol, triglyceride and high density lipoprotein (HDL) level were measured in fasting blood sample.

RESULTS

The mean age of all participants was 42.27 ± 14 years (44.2 ± 14.26 years in men and 40.5 ± 13.5 in women). From total 912 participant, 434(47.2%) were men and 478(52.8%) women. Prevalence of metabolic syndrome based on ATPIII criteria (update2005) was 22.8% (15.9% in men and 29.1% in women) that showed significant difference (P = 0.0001). Prevalence of each component of MS in studied population was: 29.4% for abdominal obesity, 40.7% for high TG level, 40.2% for low HDL, 15.4% for hypertension and 37.8% for abnormal FBS. Among these factor, age of patients, BMI, sex had significant differences between persons with or without Ms (P = 0.0001). Ethnicity (Arab or Persian), cigarette smoking and family history of diabetes mellitus, hypertension and obesity, marital statues, education level, parity and previous history of GDM in women showed no significant differences between persons with MS and without MS.

CONCLUSION

Metabolic syndrome has high prevalence in our population and its prevalence increases with increasing age and BMI. Women are at higher risk for metabolic syndrome than men.

The effect of 12 weeks Anethum graveolens (dill) on metabolic markers in patients with metabolic syndrome; a randomized double blind controlled trial

BACKGROUND

The clustering of metabolic abnormalities defined as metabolic syndrome is now both a public health and a clinical problem .While interest in herbal medicine has greatly increased, lack of human evidence to support efficacies shown in animals does exist. This clinical trial study designed to investigate whether herbal medicine, Anethum graveolens (dill) extract, could improve metabolic components in patients with metabolic syndrome.

METHODS

A double-blind, randomized, placebo-controlled trial using a parallel design was conducted. 24 subjects who had metabolic syndrome diagnostic criteria (update of ATP III) were randomly assigned to either dill extract (n = 12) or placebo (n = 12) for 3 months.

RESULTS

Across lipid component of metabolic syndrome, no significant differences in triglyceride (TG) concentration and high density lipoprotein cholesterol were seen between the two groups. However TG improved significantly from baseline (257.0 vs. 201.5p = 0.01) with dill treatment but such a significant effect was not observed in placebo group. Moreover, no significant differences in waist circumference, blood pressure and fasting blood sugar were seen between two groups after 3 months follow up period.

CONCLUSION

In this small clinical trial in patients with metabolic syndrome, 12 weeks of dill extract treatment had a beneficial effect in terms of reducing TG from baseline. However dill treatment was not associated with a significant improvement in metabolic syndrome related markers compared to control group. Larger studies might be required to prove the efficacy and safety of long-term administration of dill to resolve metabolic syndrome components.

Gender differences in association between metabolic syndrome and carotid intima media thickness

BACKGROUND

Metabolic syndrome (Mets) is a cluster of cardiovascular risk factors which can predicts cardiovascular disease (CVD). Carotid intima-media thickness (CIMT) is known as a surrogate measure of subclinical atherosclerosis and predictor of CVD. Although, it has shown the association between Mets and CIMT, this relation regarding sex differences is limited. We aimed to find out whether gender differences in this association.

METHODS

In this cross-sectional study, we recorded height, weight, waist circumference (WC), blood pressure, and lipid profiles. We used Mets; defined based on NCEP ATP III definition, and traditional cardiovascular risk factors; age, body mass index (BMI), WC, hyperlipidemia, and hypertension, in multivariate regression models which including;. The CIMT measurement < 0.73 or ≥0.73 mm was considered as low- or high risk to CVD.

RESULTS

Overall, 150 subjects were enrolled to study that their ages were 36-75 years. The 47.3% of them (71 subjects) had Mets. CIMT was increased in Mets group compared non-Mets group (P = 0.001). In logistic regression analysis, a significant association was found between Mets and CIMT in women, but not in men (p = 0.002, and p = 0.364, respectively). After adjustment to age, WC, BMI, hypertension and hyperlipidemia, this association was significant just in women (p = 0.011) independent of WC, BMI, hyperlipidemia and hypertension.

CONCLUSION

Our data showed that MetS is a stronger risk factor for subclinical atherosclerosis in women than in men. So, we suggest the assessment of CIMT along with definition Mets in middle-aged women could be lead to earlier detection of at risk individuals to CVD.

Elevated alanine aminotransferase activity is not associated with dyslipidemias, but related to insulin resistance and higher disease grades in non-diabetic non-alcoholic fatty liver disease

OBJECTIVE

To explore demographic and metabolic factors associated with increased alanine aminotransferase (ALT) activity in non-diabetic non-alcoholic fatty liver disease (NAFLD) patients.

METHODS

Overall 372 patients who consecutively attended to Gastroenterology Clinic of Baqiyatallah University of Medical Sciences, Tehran, Iran awere diagnosed as NAFLD entered into analysis. Exclusion criteria were having diabetes mellitus and fasting blood glucose over 126 mg/dL, active hepatitis B virus infection, having hepatitis C virus positive serology, and to be under corticosteroid therapy. ALT levels were considered pathologically high when it was over 30 IU/L for men and over 19 IU/L for women.

RESULTS

Bivariate analyses using t test and chi-square test showed that patients with pathologically augmented ALT levels had significantly higher NAFLD grades in their ultrasonographic evaluations (P=0.003). Moreover, these patients represented significantly higher homeostatic model assessment levels (P=0.003), levels of serum insulin (P=0.002), fasting blood glucose (P<0.001), and uric acid (P=0.02). The prevalence of insulin resistance was also higher in patients with increased serum ALT concentrations. Multifactorial logistic regression models showed that ultrasonographic grading of NAFLD (P=0.027) and insulin resistance (P=0.013) were the only variables significantly associated with abnormal ALT levels.

CONCLUSIONS

This study shows that the associations of increased ALT serum levels in NAFLD patients are different from what are supposed before. By excluding diabetic patients from our population, we find that increased ALT levels are not associated with dyslipidemias but are independently associated with insulin resistance and NAFLD grading on ultrasonographic evaluations. Further studies are needed to confirm our results.

Incidence of Metabolic Syndrome and Its Risk Factors among Type 2 Diabetes Clinic Attenders in Isfahan, Iran

Aim. At present, little data exist about incidence and the risk factors associated with metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (T2DM). The objectives of present study were to assess the incidence and risk factors of MetS in people with T2DM. Methods. During the mean (SD) follow-up period of 11.7 (4.8) years, 3,047 patients with T2DM and free of MetS at baseline have been examined to determine incidence and predictors of progression to MetS. A modified the National Cholesterol Education Program-Adult Treatment Panel III definition with body mass index (BMI) instead of waist circumference was used for the MetS. Results. The prevalence of MetS was 63.2% (95% CI: 62.3, 64.1). The incidence of MetS was 28.5 (95% CI: 26.8, 30.2) (25.9 men and 30.9 women) per 1,000 patient-years based on 35,677 patient-years of follow-up. Multivariate analysis revealed that higher BMI and education, lower HbA(1c) and treatment with oral agent or insulin were associated with MetS. Conclusion. These are the first estimate of incidence and risk factors of MetS in patients with T2DM in Iran. These findings showed that the natural course of MetS is dynamic. The clinical management of patients with T2DM will contribute significantly to MetS prevention.

Metabolic syndrome in first degree relatives of patients with type 2 diabetes: Incidence and risk factors

AIMS

First degree relatives (FDRs) of people with type 2 diabetes are at greater cardiovascular and diabetes risk. It is not known whether they are also at greater risk of metabolic syndrome (MetS). The objectives of present study were to assess the incidence of and risk factors for the development of MetS in FDRs of patients with type 2 diabetes.

METHODS

A total of 3217 (842 men and 2375 women) FDRs of consecutive patients with type 2 diabetes aged 30-70 years in 2003-2005 were followed through 2010. At baseline participants underwent a standard 75g 2-h standard OGTT and HbA1c measurements. MetS was defined by the NCEP-ATP III. The study group consisted of 734 participants without MetS and history of known diabetes at baseline and had at least one subsequent review in mean (SD) follow-up period of 5.5 (1.2) years.

RESULTS

The prevalence of MetS was 35.8% (95% CI: 34.2, 37.5). The incidence of MetS was 4.3% (95% CI: 3.7, 4.9) (4.6% men and 4.2% women) per year. Multivariate analysis revealed that impaired glucose tolerance (IGT) (RR 1.89 (95% CI: 1.28, 2.79)), impaired fasting glucose (IFG) (RR 1.39 (95% CI: 1.10, 1.73)) and lower HDL (RR 1.34 (95% CI: 1.12, 1.60)) were associated with MetS.

CONCLUSIONS

The findings of this study illustrate for the first time the incidence of MetS in FDRs of patients with type 2 diabetes in Iran. Risk of MetS may increases with IGT, IFG and lower HDL.

Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study

OBJECTIVE

To examine the validity and reproducibility of food groups in the semi-quantitative food frequency questionnaire (FFQ) developed for the Tehran Lipid and Glucose Study (TLGS).

METHODS

To evaluate the reproducibility of food groups included in the FFQ, 132 subjects (61 men and 71 women) aged 20 years or older twice completed a 168-item FFQ (FFQ1, FFQ2), with a 14-month interval between FFQ1 and FFQ2. Over the 1-year interval, 12 dietary recalls (DRs) were collected (1 each month) to assess the validity of the FFQ. Seventeen food groups were derived from the FFQ based on methods described in previous studies. Age-adjusted and deattenuated Spearman correlation coefficients were used to assess the validity of the FFQ.

RESULTS

The mean (SD) age and body mass index of subjects were 35.5 (16.8) years and 25.5 (5.2) kg/m(2), respectively. Validity correlation coefficients ranged from 0.03 (liquid oil) to 0.77 (simple sugars) in men (median, 0.44), and from 0.12 (snacks) to 0.79 (simple sugars) in women (median, 0.37). The energy-adjusted intraclass correlation coefficient, which reflects the reproducibility of the FFQ, was 0.51 in men and was highest for tea and coffee (0.91); in women it was 0.59 and was highest for simple sugars (0.74). The highest percentage of complete agreement and disagreement was observed for snacks and desserts (60.6%) and potatoes and dairy products (12.8%), respectively, in men, and tea and coffee (62.9%) and legumes (15.7%) in women.

CONCLUSIONS

The FFQ that was designed for the TLGS was found to be reliable and valid for assessing the intake of several food groups.

Prevalence of metabolic syndrome and factors associated with its components in Chinese adults

The purpose of this study was to assess the prevalence of metabolic syndrome (MetS) and its components among middle-aged and elderly adults in Jiangsu province, China. Moreover, factors associated with MetS were also assessed. A population-based cross-sectional survey was conducted with 4 randomly selected areas including both urban and rural areas from Jiangsu province, China. After the procedure, 3914 adults aged 35 to 74 years were included in the study. Metabolic syndrome was defined by the modified National Cholesterol Education Program Adult Treatment Panel III report. Data were collected by interviewer-administered questionnaire, biophysical assessment, and biochemical examination. Crude and age-standardized prevalence of MetS was 31.5% and 30.5%, respectively. Prevalence rate increased significantly with age in female but not in male subjects, whereas this was true for both sexes with increased body mass index. High blood pressure was the most prevalent component of MetS (45.2%), followed by elevated triglycerides (40.1%) and low high-density lipoprotein cholesterol (40.1%). Multivariate ordinal regression analysis revealed that women had significantly higher risk of MetS than men (odds ratio = 1.72, P < .001). Older age, living in urban area, income, family history of diabetes, and family history of hypertension were positively associated with MetS risk. However, higher education and tea drinking everyday were found to be negatively associated with MetS (P < .05). Moreover, substantial agreement (kappa = 0.79) was found between the International Diabetes Federation and modified Adult Treatment Panel III criteria among 3 comparisons of MetS definitions. Metabolic syndrome was highly prevalent in middle-aged and elderly Chinese population in Jiangsu province. Community-based strategies for diet and lifestyle modifications are strongly suggested, especially in women and the elderly.

Dietary patterns, insulin resistance, and prevalence of the metabolic syndrome in women

BACKGROUND

Although individual foods and nutrients have been associated with the metabolic syndrome, whether dietary patterns identified by factor analysis are also associated with this syndrome is not known.

OBJECTIVE

We aimed to evaluate the association of major dietary patterns characterized by factor analysis with insulin resistance and the metabolic syndrome among women.

DESIGN

Usual dietary intakes were assessed in a cross-sectional study of 486 Tehrani female teachers aged 40-60 y. Anthropometric and blood pressure measurements were performed, and fasting blood samples were taken for biomarker assessment. The metabolic syndrome was defined according to Adult Treatment Panel III guidelines, and insulin resistance was defined as the highest quartile of the homeostasis model assessment scores.

RESULTS

We identified 3 major dietary patterns by factor analysis: the healthy dietary pattern, the Western dietary pattern, and the traditional dietary pattern. After control for potential confounders, subjects in the highest quintile of healthy dietary pattern scores had a lower odds ratio for the metabolic syndrome (odds ratio: 0.61; 95% CI: 0.30, 0.79; P for trend < 0.01) and insulin resistance (0.51; 0.24, 0.88; P for trend < 0.01) than did those in the lowest quintile. Compared with those in the lowest quintile, women in the highest quintile of Western dietary pattern scores had greater odds for the metabolic syndrome (1.68; 1.10, 1.95; P for trend < 0.01) and insulin resistance (1.26; 1.00, 1.78; P for trend < 0.01). Higher consumption of traditional dietary pattern was significantly associated only with abnormal glucose homeostasis (1.19; 1.04, 1.59; P < 0.05).

CONCLUSION

Significant associations exist between dietary patterns identified by factor analysis, the metabolic syndrome, and insulin resistance.