Metabolic syndrome among pre- and post-menopausal rural women in Bangladesh: result from a population-based study

Metabolic syndrome predictive modelling in Bangladesh applying machine learning approach

Metabolic syndrome (MetS) is a cluster of interconnected metabolic risk factors, including abdominal obesity, high blood pressure, and elevated fasting blood glucose levels, that result in an increased risk of heart disease and stroke. In this research, we aim to identify the risk factors that have an impact on MetS in the Bangladeshi population. Subsequently, we intend to construct predictive machine learning (ML) models and ultimately, assess the accuracy and reliability of these models. In this particular study, we utilized the ATP III criteria as the basis for evaluating various health parameters from a dataset comprising 8185 participants in Bangladesh. After employing multiple ML algorithms, we identified that 27.8% of the population exhibited a prevalence of MetS. The prevalence of MetS was higher among females, accounting for 58.3% of the cases, compared to males with a prevalence of 41.7%. Initially, we identified the crucial variables using Chi-Square and Random Forest techniques. Subsequently, the obtained optimal variables are employed to train various models including Decision Trees, Random Forests, Support Vector Machines, Extreme Gradient Boosting, K-nearest neighbors, and Logistic Regression. Particularly we employed the ATP III criteria, which utilizes the Waist-to-Height Ratio (WHtR) as an anthropometric index for diagnosing abdominal obesity. Our analysis indicated that Age, SBP, WHtR, FBG, WC, DBP, marital status, HC, TGs, and smoking emerged as the most significant factors when using Chi-Square and Random Forest analyses. However, further investigation is necessary to evaluate its precision as a classification tool and to improve the accuracy of all classifiers for MetS prediction.

Metabolic Syndrome and Menopause: The Impact of Menopause Duration on Risk Factors and Components

Purpose

This study was undertaken to investigate the impact of menopause duration on the risk factors and components of metabolic syndrome (MetS).

Patients and Methods

Women aged between 45 and 60 years participated in the study. Participants were split into two groups based on the duration of menopause. Women who had been menopausal for 1 to ≤5 years constituted Group 1, while women with 6-10 years of menopause duration formed Group 2.

Results

Significant differences were observed between the two groups for various factors associated with MetS, including anthropometric measurements, biochemical markers, and blood pressure. The conicity index, weight-to-hip ratio, waist-to-height ratio, visceral adiposity index (VAI), and menopause duration were associated with increased risk of MetS. Our multivariate logistic regression model showed that women with elevated VAI had a 2.073-fold (95% CI: 1.73-2.48, p<0.001) increased risk of MetS, while women with menopause duration more than 5 years had a 6.44-fold (95% CI: 3.336-12.45, p<0.001) increased risk of MetS.

Conclusion

The duration of menopause was found to be linked to a higher risk of MetS. Our results emphasize the importance of monitoring and managing metabolic health in women during the menopausal period, particularly those with extended menopause duration.

The association of menopause with cardiometabolic disease risk factors in low- and middle-income countries: a systematic review and meta-analyses

IMPORTANCE

Menopause is an integral part of women's health, and studies in high-income countries have shown an increase in cardiometabolic disease (CMD) risk factors in postmenopausal compared with premenopausal women. However, to date, no study has combined and assessed such studies across low- and middle-income countries. This would better inform early monitoring and intervention strategies for reducing CMD risk factor levels in midlife women in these regions.

OBJECTIVE

This study aimed to evaluate evidence from the literature on differences in CMD risk factors between premenopausal and postmenopausal midlife women living in low- and middle-income countries.

EVIDENCE REVIEW

A systematic review with meta-analysis of original articles of all study designs from the databases PubMed, PubMed Central, Scopus, and ISI Web of Science was conducted from conception until April 24, 2023. Studies that met the inclusion criteria were included in the analysis. Quality assessment of the articles was done using the Newcastle-Ottawa Scale, adapted for each study design. The study protocol was registered with the International Prospective Register of Systematic Reviews and adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. For the meta-analysis, fixed-effects models were used to pool the odds ratios (OR), as measures of association.

FINDINGS

Our search identified 4,849 relevant articles: 44 for the systematic review and 16 for the meta-analysis, in accordance with our inclusion criteria. Compared with premenopausal women, the postmenopausal stage was associated with metabolic syndrome (OR, 1.18 [95% CI, 1.11-1.27]), high waist-to-hip ratio (OR, 1.22 [95% CI, 1.12-1.32]), hypertension (OR, 1.10 [95% CI, 1.04-1.16]), elevated triglycerides (OR, 1.16 [95% CI, 1.11-1.21]), and elevated plasma glucose (OR, 1.21 [95% CI, 1.15-1.28]).

CONCLUSIONS AND RELEVANCE

This study confirmed that CMD risk factors are present at higher levels in postmenopausal than premenopausal women. This demonstrates an urgent need for public health policies that focus on early monitoring and interventions targeted at reducing CMD risk and related adverse outcomes in midlife women in these nations.

Prevalence of Metabolic Syndrome and Its Association With Menopausal Symptoms in Post-Menopausal Women: A Scoping Review

Complex metabolic dysregulation leads to metabolic syndrome (MetS) causing various symptoms such as type II diabetes, central obesity, cardiovascular diseases (CVD), altered glucose metabolism, hypertension, and dyslipidemia, and is thought to be influenced by a number of factors, including migration from rural to urban areas. socioeconomic changes, and a sedentary lifestyle. Therefore, the primary goal of this scoping review was to determine the prevalence of MetS and its components as well as to understand the association between MetS and menopausal symptoms in post-menopausal women. The search strategy included articles that were published from 2010 onwards in MEDLINE/PubMed, Scopus, and Web of Science databases. The eligibility criteria included population, concept and context (PCC) format and based on it, 10 articles were included in this review. The review concluded that in comparison to pre-menopausal women, MetS is more common in post-menopausal women who are likely to experience somatic complaints and positive correlation of vasomotor symptoms with MetS. Hence, post-menopausal women can be counselled regarding menopausal symptoms related to MetS for which appropriate and adequate treatment or measures should be taken.

Elevated fasting glucose level increases the risk of fatty liver disease: a 10-year study of 31,154 individuals

OBJECTIVES

Dysglycemia promotes the occurrence of fatty liver disease (FLD). However, the process is unclear. This study aimed to analyze the median time-to-onset, cumulative prevalence and influencing factors for the occurrence of FLD in people undergoing routine screening and evaluation.

METHODS

Data from Karamay Central Hospital (September 2008-April 2017) were analyzed. Survival analysis was performed to calculate the median time and cumulative prevalence of FLD associated with normal and elevated fasting blood glucose (FBG) levels. Cox proportional hazards model was used to determine risk factors.

RESULTS

A total of 31,154 participants were included in the two cohorts of this study, including 15,763 men. The mean age was 41.1 ± 12.2 years. There were 2230 patients (1725 male) in the elevated FBG group, the median age was 53 years (range 21-85 years), the median time-to-onset of FLD was 5.2 years. The incidence of FLD was 121/1000 person-years, and the 1-, 3-, 5-, and 7-year prevalence rates were 4%, 30%, 49%, and 64%, respectively. The normal FBG group included 28,924 participants (14,038 male), the median age was 40 years (range 17-87 years), and the corresponding values were as follows: 8.3 years, 66/1000 person-years, and 3%, 16%, 28%, and 41%, respectively. The Cox proportional hazards analysis revealed that age, blood pressure, FBG, body mass index and triglycerides were independent influencing factors for FLD in individuals (P < 0.05).

CONCLUSIONS

Elevated FBG levels increase the risk of FLD and should be treated promptly.

Association of 25-hydroxyvitamin D levels and metabolic syndrome in Thai postmenopausal women

BACKGROUND AND AIMS

Low serum 25-hydroxyvitamin D [25(OH)D] levels have been reported to be associated with metabolic syndrome (MetS). In this study, we aimed to investigate the association between serum 25(OH)D levels and MetS in Thai postmenopausal women.

METHODS

A total of 340 postmenopausal women were enrolled in the study. The concentration of 25(OH)D, lipid profiles, fasting blood glucose (FBG) levels, blood pressure, and demographic and anthropometric parameters were measured. Subjects were divided into the hypovitaminosis D and vitamin D sufficiency groups. The association of serum 25(OH)D levels with MetS in postmenopausal women was analyzed using multivariate regression analysis.

RESULTS

Waist circumference, total cholesterol levels, and triglyceride levels were significantly higher in hypovitaminosis D than in vitamin D sufficiency (p < 0.05). The prevalence of MetS, central obesity, and hypertriglyceridemia in hypovitaminosis D was significantly higher than in vitamin D sufficiency (p < 0.05). In the multivariable logistic regression model, hypovitaminosis D was associated with MetS (OR 1.85; 95% CI 1.12-3.04, p = 0.015), central obesity (OR 2.41; 95% CI 1.20-4.85, p = 0.014), and hypertriglyceridemia (OR 1.91; 95% CI 1.12-3.26, p = 0.018) compared with vitamin D sufficiency after adjusting for covariates. Serum vitamin D concentrations were significantly lower in the MetS group than in the non-MetS group (p = 0.016) and decreased with an increasing number of MetS components (p for trend = 0.034).

CONCLUSIONS

Hypovitaminosis D was associated with an increased risk of MetS, central obesity, and hypertriglyceridemia in Thai postmenopausal women.

Hypertension prevalence and its trend in Bangladesh: evidence from a systematic review and meta-analysis

Background

Hypertension, itself being a major chronic condition, is one of the most significant risk factors for premature cardiovascular diseases and mortality. Hypertension is responsible for 13% of global deaths and three-quarters of the world’s hypertensive population reside in low- and middle-income countries. Bangladesh is one of those countries that experiencing an epidemiological transition from communicable to non-communicable diseases, a nutritional transition from a traditional diet to process and fast food, and an increase in a sedentary lifestyle, resulting in increased hypertension prevalence. We carried out a systematic review and meta-analysis to identify existing research on hypertension prevalence in Bangladesh, summarize findings and assess its temporal change.

Methods

We searched MEDLINE, EMBASE and PubMed and relevant references to identify studies on the prevalence of hypertension in Bangladesh. We used Random-effects meta-analysis to pool the prevalence estimates and performed subgroup analyses. We assessed heterogeneity, a trend in prevalence of hypertension and publication bias in selected studies.

Results

Our search initially identified 735 articles and after removing duplicates, reviewing titles and abstracts, and screening full texts, 53 studies were finally selected. The studies comprised 305,432 subjects and reported overall, gender-specific, geographical location specific and criteria specific prevalence of hypertension. We identified the range of hypertension prevalence is from 1.10% to 75.0% and the overall weighted pooled prevalence of hypertension is 20.0%. An extremely high heterogeneity (I² = 99.53%; Cochran Q-statistic p < 0.001) was observed in the prevalence of hypertension. Consequently, we performed subgroup analysis based on gender, age group and geographical location of the study participants, the cut-off level used to define hypertension, and the types of hypertension reported and presented our findings accordingly. An overall increasing trend of hypertension prevalence is also observed.

Conclusions

The prevalence of hypertension is high and rising in Bangladesh. Strategies targeting prevention are required to mitigate a further increase in the prevalence and reduce the morbidity and mortality associated with it.

A Prospective Study on the Incidence of Metabolic Syndrome in Premenopausal and Postmenopausal Women

Background:

Metabolic syndrome is defined as a state of metabolic dysregulation characterized by insulin resistance, a predisposition to Type 2 diabetes mellitus and atherosclerotic vascular disease. The changing hormonal milieu with altered estrogen and testosterone ratio is the cause of metabolic syndrome at menopausal transition.

Aims and Objectives:

This study was designed to determine the incidence of metabolic syndrome and its various components in premenopausal and postmenopausal women from Punjab.

Materials and Methods:

This study was conducted on 200 females in the age group of 45–60 years attending outpatient department over a period of 2 years in the Department of Obstetrics and Gynaecology, Bebe Nanki Mother and Child Care Centre, Government Medical College, Amritsar. A detailed history and physical examination were done and recorded on a pro forma. Biochemical assessment comprising fasting blood glucose, triglycerides, and cholesterol was done. Metabolic syndrome was assessed as per the modified NCEP ATP III criteria.

Results:

Twenty-nine percent women were found to have newly onset metabolic syndrome, the incidence in premenopausal group was 16%, and in postmenopausal group was 42%. Among the components, the incidence of hypertension (58%) was the highest followed by waist circumference (42%). Maximum correlation of metabolic syndrome was found with high-density lipoprotein (odds ratio - 7.250) followed by waist circumference (odds ratio - 7.111).

Conclusion:

The incidence of metabolic syndrome was found to be higher in postmenopausal women than in premenopausal women. Currently, the need of the hour is lifestyle modification to reduce the emergence of metabolic syndrome and cardiovascular diseases.

Atherogenic index of plasma and its association with cardiovascular disease risk factors among postmenopausal rural women of Bangladesh

OBJECTIVES

There is absolute lacking of evidences on atherogenic index of plasma (AIP) and its association with cardiovascular disease (CVD) risk factors among postmenopausal women of Bangladesh. This prompted us to investigate this association between AIP and CVD risk factors among postmenopausal women in a rural setting.

METHODS

This cross-sectional study recruited 265 postmenopausal women aged 40-70 years who visited a primary health-care center of Bangladesh. We used modified STEP-wise approach for the Surveillance of Noncommunicable diseases risk factors questionnaire of the World Health Organization to collect data on sociodemographic and behavioral risk factors. Physical measurements were carried out following the method described in the 'noncommunicable disease risk factors survey Bangladesh 2010'. AIP was determined by the logarithmic transformation of triglyceride to high-density lipoprotein ratio, and association with CVD risk factors were examined by multiple linear regression analysis.

RESULTS

Overall 35.5% respondents had a high risk level of AIP with a mean of 0.16 ± 0.25. After adjusting the confounders, CVD risk factors including duration of menopause (β = 0.606, p = 0.043), waist-hip ratio (β = 0.165, p = 0.003), 2-h plasma glucose (β = 0.118, p = 0.04), total cholesterol (β = 1.082, p < 0.001), low-density lipoprotein cholesterol (β = -1.044, p < 0.001), and metabolic equivalent of tasks (β = -0.171, p = 0.003) showed a significant association with AIP.

CONCLUSION

High AIP and its significant association with CVD risk factors demand proper lifestyle intervention for postmenopausal women of Bangladesh.

Physical activity levels and associated cardiovascular disease risk factors among postmenopausal rural women of Bangladesh

OBJECTIVES

The role of physical inactivity in relation to cardiovascular disease (CVD) among postmenopausal women is understudied. The main objective of this study was to measure the physical activity levels (PALs) and evaluate its relation to other CVD risk factors among postmenopausal rural women of Bangladesh.

METHODS

A cross-sectional study was conducted among 265 postmenopausal women aged 40-70 years who visited the outpatient department of a primary health-care center situated in the village Karamtola of Gazipur district. A pretested modified questionnaire of STEP-wise approach to Surveillance (STEPS) of noncommunicable disease risk factors was used to collect data on sociodemographic and lifestyle factors. PAL was determined by the Estimated Energy Requirement (EER) equation of the Dietary Reference Intakes (DRIs) Committee, and association with CVD risk factors was examined by Spearman's rank correlation.

RESULTS

More than half (58.1%) of the postmenopausal women were identified as sedentary with high prevalence of central obesity (73.2%) among them. CVD risk factors including age (r = -0.228, p < 0.01), age at menopause (r = -0.129, p < 0.05), duration of menopause (r = -0.183, p < 0.05), 2-h plasma glucose (r = -0.148, p < 0.05), total cholesterol (r = -0.138, p < 0.05), low-density lipoprotein cholesterol (r = -0.122, p < 0.05), and triglyceride (r = -0.168, p < 0.01) showed a significant as well as inverse association with Metabolic Equivalent of Task (MET) of physical activity.

CONCLUSION

Low PAL and significant inverse correlation with various CVD risk factors demand interventions to maintain higher PAL among postmenopausal women of Bangladesh.

Prevalence of metabolic syndrome in Bangladesh: a systematic review and meta-analysis of the studies

Background

Metabolic syndrome (MS) is a cluster of health problems that set the stage for serious health conditions and places individuals at higher risk of cardiovascular disease, diabetes and stroke. The worldwide prevalence of MS in the adult population is on the rise and Bangladesh is no exception. According to some epidemiological study, MS is highly prevalent in Bangladesh and has increased dramatically in last few decades. To provide a clear picture of the current situation, we conducted a systematic review and meta-analysis with an objective to assess the prevalence of metabolic syndrome among the Bangladeshi population using data already published in the scientific literature.

Methods

We searched MEDLINE, EMBASE and PubMed and manually checked references of all identified relevant publications that described the prevalence of MS in Bangladesh. Random effects meta-analysis was used to pool the prevalence. Heterogeneity was explored using formal tests and subgroup analyses. Study quality and publication bias was also explored.

Results

Electronic and grey literature search retrieved 491 potentially relevant papers. After removing duplicates, reviewing titles and abstracts and screening full texts, 10 studies were finally selected. Most of the studies were conducted in rural populations and study participants were mostly females. The weighted pooled prevalence of metabolic syndrome regardless of gender and criteria used to define metabolic syndrome, was 30.0% with high heterogeneity observed. Weighted pooled prevalence of metabolic syndrome is higher in females (32%) compared to males (25%) though not statistically significant (p = 0.434). Prevalence was highest (37%) when Modified NCEP ATP III criteria was used to define MS, while it was lowest (20%) when WHO criteria was used. In most cases, geographical area (urban/rural) was identified as a source of heterogeneity between the studies. Most of the studies met study quality assessment criteria’s except adequate sample size criteria and evidence of small study effect was also detected.

Conclusions

The prevalence of metabolic syndrome is high and rising in Bangladesh. Strategies aimed at primary prevention are required to mitigate a further increase in the prevalence and for the reduction of the morbidity and mortality associated with metabolic syndrome.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5209-z) contains supplementary material, which is available to authorized users.

Depression and Quality of Life among Postmenopausal Women in Bangladesh: A Cross-sectional Study

OBJECTIVES

The aims of the research are to examine the problems of abnormal menopausal women: the relationship between depression and menopausal-specific quality of life (MENQOL)-symptoms among postmenopausal women; the association of MENQOL-symptoms between pre- and postmenopausal female society in Bangladeshi real community.

METHODS

This cross sectional study was conducted on 435 women of Tangail, aged (≥ 17) years, using a structured questionnaire where is inaacluded the information of MENQOL and one of the main outcomes "depression" is measured by beck depression inventory.

RESULTS

Menopausal status and MENQOL symptoms (except pain) are significantly (P < 0.05) associated. By using post-hoc analysis, the proportion of menopausal women, classified as having a depressive mood of early menopause is significantly higher than natural-menopause. Among postmenopausal women, there is a significant correlation between "concentration problem" and "depression". Here mean depression score (29.40 ± 6.42) of menopausal women who have any difficulty in concentrating is higher than mean depression score (20.89 ± 6.64) of menopausal women who have no difficulty in concentrating. Another six factors (osteoporosis, heart-beating, fatigue, pressure, tingling, headaches) of MENQOL-symptoms were significantly correlated with depression and P-values are 0.000, 0.000, 0.000, 0.033, 0.006, and 0.002, respectively. Finally the presence of "difficulty in concentrating" and "fatigue" are strongly associated factors with depression score (P < 0.001).

CONCLUSIONS

The early postmenopausal women have to face more psychological problems (e.g., depression) compare to others. Among postmenopausal women, there is no significant relation between depression and vasomotor symptom (e.g., hot-flashes) perspective to menopausal female society of Bangladesh.

Effectiveness of Exercise on Visceral Adipose Tissue in Older South Asian Women

INTRODUCTION

Individuals of South Asian (SA) origin have a greater risk for type 2 diabetes and cardiovascular disease than other ethnic populations. This increased risk is in part explained by the unique obesity phenotype of elevated visceral adipose tissue (VAT) among this population. Aerobic exercise in Europeans is effective at reducing VAT, but this has not been studied in SA, who have some of the lowest levels of physical activity in the world. Therefore, the purpose of this study was to determine whether exercise can reduce VAT given the unique obesity phenotype and associated disease risk in the SA population.

METHODS

A total of 75 physically inactive, postmenopausal SA women were randomized to either culturally based (Bhangra dance), standard (gym-based), or control (nonexercise) program for 12-wk. The primary outcome was change in VAT.

RESULTS

The average attendance in the culturally based and standard program was 78% ± 33% and 67% ± 25%, respectively. After an intention-to-treat analysis, VAT was not significantly reduced in culturally based (-60 cm, 95% confidence interval [CI] = -172 to 54, P = 0.300) or standard (-98 cm, 95% CI = -216 to 21, P = 0.106) exercise compared with control after adjustment for baseline physical activity and age. In those participants who attended more than two-thirds of the exercise classes, VAT was significantly reduced compared with control (-109 cm, 95% CI = -204 to -13, P = 0.026).

CONCLUSION

In intention-to-treat analysis VAT was not significantly reduced after 12 wk of either standard or culturally based exercise. However, attendance in both standard and culturally based exercise was high, and VAT was significantly reduced among SA women who adhered to these programs.

Relationship between duration of breast-feeding and obesity in korean women: The korea national health and nutrition examination survey (KNHANES) 2010-2012

OBJECTIVE

Breast-feeding is associated with maternal health, such as electrolyte metabolism, lipid profile and body component change. The aim of this study was to evaluate the relationship between duration of breast-feeding and obesity in postmenopausal women.

METHODS

We analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012, a cross-sectional study in a Korean population. A total of 6621 postmenopausal women were analyzed.

RESULTS

Body mass index and waist circumference were greater in women who had breast-fed for 6 months or more than in those who had not (BMI: 23.7±0.1 vs 24.5±0.1, P<0.0001; WC: 80.6±0.4 vs 82.8±0.3, P<0.001). This association persisted after adjustment for confounding factors (BMI: odds ratio[OR]1.54, 95% confidence interval[CI] 1.19-2.0; WC: OR1.67, 95% CI 1.29-2.17). The duration of breast-feeding tended to increase with increasing BMI and WC (P for trend, 0.001 for each). The proportions of women with greater BMI and WC increased with increasing duration of breast-feeding (27.3% in ≤6 months vs 41.2% in >18months, P<0.0001).

CONCLUSION

The results of this study suggest that prolonged breast-feeding may be associated with greater BMI and WC among postmenopausal women.

Metabolic syndrome and its components in postmenopausal women living in southern Italy, Apulia region

OBJECTIVES

The goal of our study was to determine the prevalence of metabolic syndrome (MetS) and all its components, in a population of postmenopausal women aged over 45 years, consecutively accessed to our Heart Station, during 2014, for their first cardiac examination,furthermore to estimate their cardiovascular risk and the achievement of target blood values of main risk factors, according to current Guidelines.

METHODS

We screened 1257 postmenopausal women. MetS was assessed according to the National-Cholesterol-Education-Program-Adult-Treatment-Panel III definition. Cardiovascular risk was calculated by the Systematic Coronary Risk Evaluation (<65 years).

RESULTS

MetS was assessed on 834 women (66.4%). Prevalence of each component was: hypertension on 767 women (91.9%), central obesity 758 women (90.9%), low high-density lipoproteins cholesterol (HDLc) increased levels 612 women (73.3%), high triglyceride levels 428 women (51.3%), glucose levels higher than 110mg/dl or diabetes 404 women (48.5%). Cardiovascular risk was moderate until 65 years, but it increases after. Metabolic control in postmenopausal women was poor for glucose, only 82 women (9.8%) presented glucose levels lower than 110mg/dl, it was better for systolic blood pressure, that was normal in 564 women (67.6%) and worse for lipid levels.

CONCLUSION

The prevalence of metabolic syndrome in our population of postmenopausal women is high. Hypertension and central obesity are the more common components. The cardiovascular risk is moderate-high, the achievement of target values for glycemic and lipid levels is unsatisfactory, while systolic blood pressure is enough well controlled but however it is mandatory to improve this goal. An early MetS diagnosis and an early educational intervention are useful to decrease cardiovascular risk of postmenopausal women affected by metabolic syndrome.

Metabolic Syndrome: Can We Keep Check?

BACKGROUND

Metabolic syndrome (MetS) is on the rise due to the epidemic increase of obesity. It increases the risk of atherosclerotic cardiovascular diseases and type II diabetes mellitus.

AIMS

To study the prevalence of MetS and its components in premenopausal and postmenopausal women.

DESIGN

Cross-sectional comparative study.

MATERIAL AND METHOD

Five hundred premenopausal women and 500 postmenopausal women in the age group 40-65 years, attending OPD of Obstetrics and Gynecology Department of Pt. J.N.M. Medical College, Raipur from September 2012 to August 2014 were analyzed and assessed for the MetS risk factors and evaluated according to the NCEP ATP III criteria.

RESULTS

The prevalence of MetS in postmenopausal women was 48.6 %, nearly 1.7 times the prevalence in premenopausal women (27.4 %). Except for central obesity and low HDL cholesterol, the frequency of hyperglycemia, high blood pressure, and hypertriglyceridemia were significantly higher in postmenopausal than in premenopausal women. All the five factors of NCEP ATP III criteria were present in 5 % of postmenopausal women in contrast to 0.4 % in premenopausal women.

CONCLUSION

Prevention is better than cure. The need of the hour is to target premenopausal women who are at risk of developing MetS in their postmenopausal age. It will delay and prevent them from future morbidities.

Assessment of Menopausal Symptoms among Early and Late Menopausal Midlife Bangladeshi Women and Their Impact on the Quality of Life

OBJECTIVES

Every physical abnormal criterion has an impact on the health. Late menopause causes different physiological problems which alike early menopause. The research interest is associated with both early and late menopausal women of Bangladesh as only few menopausal studies available in South East Asia especially in Bangladesh. The aims of this study are not only to assess the symptoms of menopausal abnormality but also to determine the impact of these symptoms on the quality of life (QOL) of the female society in Bangladesh.

METHODS

Data mining techniques are used to rank the 22 factors (conducted with questionnaire) commonly associated with menopause. Among the participants menstruation that stops before 45 years was considered as early menopausal status and after 50 years as late menopausal. The mean of age and mean length of time in years, since menopause for all participants were 61.55±10.7 and 14.13±11.17, respectively. Recorded data indicated 67% were early menopausal women and 33% were late menopausal women.

RESULTS

Results indicated that feeling tired or lacking in energy and dizziness (83%) and depression (82%) have worst impact on QOL among all factors, respectively. The next prevalent symptoms included hot flashes (64%), osteoporosis (72%), sweating at night (63%), concentration problem (75%), irritability (63%), feeling tense (77%), headache (66%). However, less frequent factors included breathing problems (33%), loss of feeling (31%), coherent heart disease (13%) and type2 diabetics (9%).

CONCLUSION

Our study indicates that early menopausal women are facing more physiological problems than the late menopausal women on their QOL.

Prevalence of metabolic syndrome in pre- and post-menopausal women: A prospective study from apex institute of North India

Background:

The metabolic syndrome (MS) (syndrome X, insulin resistance syndrome) is a constellation of metabolic abnormalities and a complex predisease state that predicts future development of type 2 diabetes mellitus and cardiovascular disease. Menopausal transition and postmenopausal state are considered as a vulnerable period for developing MS, and this increased risk has been attributed to decreasing estrogen levels with an increasing risk of insulin resistance following menopause.

Aims and Objectives:

This study aimed to determine the prevalence of MS and its components in pre- and post-menopausal women from North India.

Methodology:

This is a cross-sectional study of 350 women in the age group of 45–55 years attending gynecology clinic in a tertiary center of North India. Details of sociodemographic data, menopausal history, reproductive, and medical profile were obtained. Then, waist circumference, body mass index (BMI), and blood pressure were recorded. A venous blood sample was collected for fasting blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. MS was defined according to the modified National Cholesterol Education Program Adult Treatment Panel III criteria.

Results:

The mean age was 49.09 ± 2.2 years in premenopausal and 49.54 ± 2.8 years in postmenopausal women. The prevalence of MS in the study group was 62.6%. Occurrence of MS was higher in older and obese women. Abnormal waist circumference was the most prevalent component (87%) of MS and in terms of odd ratio, correlation was highest for BMI followed by total cholesterol and waist-hip ratio.

Conclusion:

We should target obesity and deranged lipid profile by bringing out changes in lifestyle and dietary habits to decrease the higher prevalence of MS and the risk of cardiovascular diseases.

Metabolic Syndrome and Menopause: Pathophysiology, Clinical and Diagnostic Significance

Menopause is a risk factor for cardiometabolic diseases, including metabolic syndrome (MetS), type 2 diabetes, and cardiovascular diseases. MetS is a constellation of interdependent factors such as insulin resistance, abdominal obesity, dyslipidemia, and hypertension. The prevalence of MetS in postmenopause is due to loss of the protective role of estrogens and increased circulating androgens resulting in changes to body fat distribution and development of abdominal obesity. Excessive visceral adipose tissue plays an important role due to synthesis and secretion of bioactive substances such as adipocytokines, proinflammatory cytokines, reactive oxygen species, prothrombotic, and vasoconstrictor factors. MetS may also impact risk assessment of breast cancer, osteoporosis and chronic kidney disease, and quality of life during the menopausal transition. Increased MetS has stimulated the exploration of new laboratory tests for early detection and therapies.

Comparison of the prevalence of metabolic syndrome and its association with diabetes and cardiovascular disease in the rural population of Bangladesh using the modified National Cholesterol Education Program Expert Panel Adult Treatment Panel III and International Diabetes Federation definitions

Aims/Introduction

To compare the prevalence of metabolic syndrome (MS) using the modified National Cholesterol Education Program Adult Treatment Plan III (NCEP) and the International Diabetes Federation (IDF) definitions and, using both definitions, determine and compare the association of MS, prediabetes, type 2 diabetes, hypertension (HTN) and cardiovascular disease risk (CVD).

Materials and Methods

A total of 2,293 randomly selected participants (aged ≥20 years) in a rural community in Bangladesh were investigated in a population-based cross-sectional study. Sociodemographic and anthropometric characteristics, blood pressure, blood glucose, and lipid profiles were studied. Age-adjusted data for MS and cardiometabolic risk factors were assessed, and their relationships were examined.

Results

The age-adjusted prevalence of MS was 30.7% (males 30.5%; females 30.5%) using the NCEP definition, and 24.5% (males 19.2%, females 27.5%) using the IDF definition. The prevalence of MS using the NCEP definition was also higher in study participants with prediabetes, type 2 diabetes, HTN and CVD risk. The agreement rate between both definitions was 92% (k = 0.80). The NCEP definition had a stronger association with type 2 diabetes and HTN (odds ratio 12.4 vs 5.2; odds ratio 7.0 vs 4.7, respectively) than the IDF definition. However, the odds ratios for prediabetes and CVD risk were not significantly different.

Conclusions

The prevalence of MS was higher using the NCEP definition, and was more strongly associated with prediabetes, type 2 diabetes, HTN and CVD in this Bangladeshi population.

The prevalence of metabolic syndrome in premenopausal and postmenopausal women in Southern Thailand

OBJECTIVE

To assess the prevalence of metabolic syndrome (MetS) in premenopausal and postmenopausal women in Southern Thailand.

METHODS

A cross-sectional study was conducted with 361 healthy women (218 premenopausal women and 143 postmenopausal women) in Southern Thailand. Blood pressure, anthropometric indices, fasting plasma glucose and serum lipid levels were measured. MetS was defined according to criteria of the "National Cholesterol Education Program Adult Panel Treatment III" (NCEP ATPIII). Logistic regression analysis was used to evaluate factors associated with MetS.

RESULTS

Waist circumference, systolic blood pressure, diastolic blood pressure, and levels of total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and fasting plasma glucose (FPG) were significantly higher in postmenopausal women, when compared with premenopausal women (p < 0.05). The prevalence of MetS in postmenopausal women (29.37%), was significantly higher than that of premenopausal women (16.97%) (p = 0.005). The most frequent component of MetS in postmenopausal women was central obesity (58.74%), followed by hypertension (58.04%), high triglyceride (27.97%), low HDL-C (23.08%), and high FPG (11.19%). Multivariate analysis revealed that age and higher body mass index (BMI) increased the risk of developing MetS.

CONCLUSION

The prevalence of MetS is higher in postmenopausal women than in premenopausal women, and its significant predictors include age and BMI.

Association between metabolic syndrome and chronic kidney disease in perimenopausal women

The purpose of the study was to explore the association between metabolic syndrome (MetS) and chronic kidney disease (CKD) in perimenopausal women. A cross-sectional study was conducted in Zhuhai from June to October 2012. Perimenopausal women (n = 685) were included in the study. All participants were divided into three subgroups: Group 1, 40 years old ≤ Age < 50 years old; Group 2, 50 years old ≤ Age < 60 years old; Group 3, 60 years old ≤ Age ≤ 65 years old. MetS was associated with CKD (p < 0.01) in the unadjusted analyses in total subjects. After adjusting the potential confounders, the odd ratios of CKD for MetS was 2.66 (95% CI 1.56 to 4.49, p < 0.001). There was no relationship between MetS and CKD in both Group 1 and Group 3. MetS was associated with CKD (p < 0.001) in the unadjusted analyses in Group 2. After adjusting for potential confounders, MetS was significantly associated with CKD. The odd ratios for MetS was 6.79 (95% CI 2.30 to 20.09, p < 0.001). There was no relationship between elevated blood pressure, elevated fasting glucose, abdominal obesity, Low HDL cholesterol, elevated triglycerides and CKD in both Group 1 and Group 3. Elevated blood pressure was associated with CKD in Group 2 (unadjusted Odds ratio: 4.52 (1.28-16.02), p = 0.02). After adjusting for potential confounders, there was no relationship between elevated blood pressure and CKD (p = 0.78). Elevated fasting glucose was associated with CKD in Group 2 (unadjusted Odds ratio: 3.69 (1.10-12.38), p = 0.03). After adjusting for potential confounders, there was no relationship between elevated fasting glucose and CKD (p = 0.15). There was no relationship between abdominal obesity, Low HDL cholesterol, elevated triglycerides and CKD in Group 2. These findings suggest that in perimenopausal women aged from 50 or older to 60 MetS was associated with CKD. There is no relationship between MetS and CKD in perimenopausal women aged from 40 or older to 50 and aged from 60 or older to 65.