Gender differences in metabolic syndrome and its components in southern china using a healthy lifestyle index: a cross-sectional study

Prevalence and predictors of metabolic syndrome among psychiatric patients receiving antipsychotic treatment in Africa: a systematic review and meta-analysis

BACKGROUND

Antipsychotic medications, though essential for treating severe mental illnesses, are commonly associated with metabolic side effects that increase the risk of metabolic syndrome (MetS). These metabolic complications significantly undermine treatment adherence and contribute to adverse clinical outcomes. Despite the increasing utilization of antipsychotics in Africa, there remains a critical lack of region-specific data on the prevalence and determinants of metabolic syndrome in this population. This systematic review and meta-analysis aims to synthesize existing data on the prevalence and predictors of MetS among psychiatric patients receiving antipsychotic treatment in Africa.

METHOD

We looked for primary papers on PubMed/MEDLINE, Scopus, African Journal Online, PsycINFO, EMBASE, Psychiatry Online, CINAHL, Science Direct, and the Cochrane Library. We included original research articles that evaluated the prevalence of metabolic syndrome among psychiatric patients treated with antipsychotic medication. Two independent reviewers examined the articles and extracted data. The I² statistic was employed to assess statistical heterogeneity, and a random-effects meta-analysis was applied due to the observed heterogeneity. Publication bias was evaluated using a funnel plot and Egger's weighted regression test. This review has been registered with PROSPERO (ID = CRD42024558310).

RESULTS

This systematic review analyzed 25 primary studies encompassing a total of 4,064 participants. The pooled prevalence of metabolic syndrome among psychiatric patients receiving antipsychotic treatment in Africa was estimated at 22% (95% CI: 16.33-27.66). Female gender (OR = 3.28, 95% CI: 1.73-6.23), advanced age (OR = 1.07, 95% CI: 1.03-1.12), and elevated body mass index (OR = 5.33, 95% CI: 2.35-12.12) were identified as significant risk factors for metabolic syndrome in this population.

CONCLUSION

Metabolic syndrome is highly prevalent among psychiatric patients receiving antipsychotic treatment in Africa, with female sex, older age, and elevated body mass index identified as significant risk factors. These findings underscore the need for routine metabolic monitoring and timely interventions to mitigate cardiovascular risk, enhance treatment adherence, and prevent recurrence of psychiatric symptoms.

Nuclear magnetic resonance-based metabolomics and risk of pancreatic cancer: a prospective analysis in the UK Biobank

BACKGROUND

Plasma metabolite levels in patients with pancreatic cancer (PC) have changed, but the relationship between the altered plasma metabolites and the risk for PC occurrence is not fully clear, as well as the predictive value of the specific metabolites.

METHODS

In this study, we obtained the metabolomics data of 243,145 people from the UK Biobank. An extreme gradient boosting (XGBoost) model, least absolute shrinkage and selection operator (Lasso) regression, and covariate-adjusted Cox proportional hazard regression models were used to evaluate the relationship between metabolites and PC risk. We also evaluated conventional risks, metabolites, and combination models for PC risk by comparing the area under the receiver operating characteristic curve (AUC).

RESULTS

The average follow-up time was 13.8 (± 2.1) years; 1,026 of 243,145 participants developed PC. Fourteen metabolites were significantly associated with PC, including glucose-related metabolites, lipids, lipoproteins, and amino acids. Increased PC risk was associated with citrate, glucose, and the percentage of triglycerides to total lipids in intermediate-density lipoprotein or small low-density lipoprotein. Glycine, histidine, cholesterol, and cholesterol ester subclasses were associated with lower PC risk. Predicting PC risk improved when the newly identified metabolites were added to conventional PC risk factors (AUC: 0.705 vs 0.711, p = 0.037). The Kaplan-Meier cumulative incidence curves showed that these metabolites were good predictors of PC risk (all log-rank p < 0.05).

CONCLUSION

We identified novel metabolites that were significantly associated with the occurrence of PC, which may aid in the early diagnosis of PC.

Radiomics-based prediction of recurrent acute pancreatitis in individuals with metabolic syndrome using T2WI magnetic resonance imaging data

Objective

This study sought to clarify the utility of T2-weighted imaging (T2WI)-based radiomics to predict the recurrence of acute pancreatitis (AP) in subjects with metabolic syndrome (MetS).

Methods

Data from 196 patients with both AP and MetS from our hospital were retrospectively analyzed. These patients were separated into two groups according to their clinical follow-up outcomes, including those with first-onset AP (n = 114) and those with recurrent AP (RAP) (n = 82). The 196 cases were randomly divided into a training set (n = 137) and a test set (n = 59) at a 7:3 ratio. The clinical characteristics of these patients were systematically compiled for further analysis. For each case, the pancreatic parenchyma was manually delineated slice by slice using 3D Slicer software, and the appropriate radiomics characteristics were retrieved. The K-best approach, the least absolute shrinkage and selection operator (LASSO) algorithm, and variance thresholding were all used in the feature selection process. The establishment of clinical, radiomics, and combined models for forecasting AP recurrence in patients with MetS was then done using a random forest classifier. Model performance was measured using the area under the receiver operating characteristic curve (AUC), and model comparison was done using the DeLong test. The clinical utility of these models was evaluated using decision curve analysis (DCA), and the optimal model was determined via a calibration curve.

Results

In the training set, the clinical, radiomics, and combined models yielded respective AUCs of 0.651, 0.825, and 0.883, with corresponding test sets of AUCs of 0.606, 0.776, and 0.878. Both the radiomics and combined models exhibited superior predictive effectiveness compared to the clinical model in both the training (p = 0.001, p < 0.001) and test sets (p = 0.04, p < 0.001). The combined model outperformed the radiomics model (training set: p = 0.025, test set: p = 0.019). The DCA demonstrated that the radiomics and combined models had greater clinical efficacy than the clinical model. The calibration curve for the combined model demonstrated good agreement between the predicted probability of AP recurrence and the observed outcomes.

Conclusion

These findings highlight the superior predictive power of a T2WI-based radiomics model for predicting AP recurrence in patients with MetS, potentially supporting early interventions that can mitigate or alleviate RAP.

Sex-specific impact of the COVID-19 outbreak on the incidence of metabolic syndrome: a comparative study of 2018-2019 and 2020-2021

BACKGROUND/AIMS

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, exacerbated metabolic health issues, and altered lifestyle behaviors. This study examined the sex-specific impact of the COVID-19 outbreak on the incidence of metabolic syndrome using data from the Korea National Health and Nutrition Examination Survey (KNHANES).

METHODS

Data from the KNHANES VII (2018) and VIII (2019-2021), including 15,499 participants, were analyzed. The study population was stratified by sex, and further subdivisions were conducted based on the timeframe relative to the COVID-19 outbreak. Variables such as age, education level, household income, smoking status, and high-risk drinking were analyzed to assess their influence on the prevalence of metabolic syndrome.

RESULTS

The overall prevalence of metabolic syndrome significantly increased from 28.11% before the outbreak to 29.69% after the outbreak. Both males and females reported significant increases in waist circumference and fasting glucose levels. Age and education level differentially influenced the prevalence of metabolic syndrome between the sex. Smoking was significantly associated with increased prevalence in males, whereas high-risk drinking was associated with increased prevalence in males and decreased prevalence in females.

CONCLUSION

The COVID-19 pandemic has significantly increased the prevalence of metabolic syndrome with notable sex-specific differences. These findings highlight the need for sex-specific public health interventions to mitigate the impact of the pandemic on metabolic health.

Sex differences in the prediction of metabolic abnormalities via body mass index in an Eastern Chinese population

Objective

Body mass index (BMI) is important for predicting the occurrence of metabolic abnormality, but sex differences exist. We aimed to investigate potential sex differences in the predictive value of BMI for metabolic abnormality and to calculate the optimal BMI cut-offs for predicting metabolic abnormality for each sex.

Methods

Participants (n = 4,623) who attended a health check-up centre continuously in Eastern China between January 2022 and December 2023 were evaluated for metabolic abnormalities. We calculated the proportions of different metabolic abnormalities in different sexes. Receiver operating characteristic (ROC) curves were calculated to determine the optimal BMI cut-off values for predicting metabolic abnormality in males and females. The recognition rate of each metabolic abnormality using different BMI cut-off values for men and women were evaluated.

Results

Among 4,623 participants (2,234 men and 2,389 women), the age-adjusted prevalence of all metabolic abnormalities was significantly greater among males than among females (p < 0.001). The optimal cut-off values for predicting metabolic abnormalities were 23.5 kg/m2 (males) and 21.8 kg/m2 (females). When BMI ≥24 kg/m2 was used as the cut-off value the recognition rates of each abnormal metabolic factor in the male group were all above 50%, while they were mostly below 50% in the female group, except for the recognition of hyperglycaemia and hypertriglyceridemia. However, in females, when BMI ≥22 kg/m2 was used as the cut-off value, the recognition rates for each abnormal metabolic factor were all above 50%, greater than that when BMI ≥24 kg/m2 was used (p < 0.001).

Conclusion

There were sex differences in the BMI thresholds for predicting metabolic abnormalities in the health check-up population.

Combined lifestyle factors and metabolic syndrome risk: a systematic review and meta-analysis

BACKGROUND/OBJECTIVES

The metabolic syndrome is a complex condition influenced by many factors including lifestyle. Recently, more and more studies explored the relationships between combined lifestyle factors (often measured as lifestyle scores/indices) and metabolic syndrome due to the co-occurrence of these factors. These scores/indices considered potential interactions among lifestyle factors, offering a more comprehensive understanding of their relationship with metabolic syndrome. However, no review/meta-analysis has been conducted to summarize existing evidence. Thus, this study aimed to synthesize the associations between lifestyle scores/indices and metabolic syndrome in cross-sectional and cohort studies.

SUBJECTS/METHODS

A literature search was performed in Embase and Medline. Multivariable-adjusted estimates were synthesized using random-effects models. In research where higher scores indicated better health, we used original estimates directly. In studies where higher scores denoted poorer health, we first calculated the coefficients and standard errors based on original estimates. Afterward, we reversed coefficients' directions and recalculated new estimates. Thus, the pooled estimates compared the healthiest with the least-healthy lifestyles (the highest vs. lowest scores/indices). Subgroup analyses were conducted based on study design, region, baseline time, baseline age, sex, health status, metabolic syndrome diagnosis, and lifestyles' number. Sensitivity analyses were performed by including only high-quality studies and employing leave-one-out analyses.

RESULTS

Nineteen studies from 16 publications were included. Physical activity, diet, and smoking were the top three included lifestyle factors. Compared to participants with the least-healthy lifestyles, those with the healthiest lifestyles had a 43% lower metabolic syndrome risk (95% confidence interval = 0.41-0.73). In subgroup analyses, healthy lifestyle scores/indices were inversely associated with both metabolic syndrome prevalence in cross-sectional studies (Odds ratio = 0.62; 95% confidence interval = 0.51-0.73) and metabolic syndrome incidence in cohort studies (Odds ratio = 0.40; 95% confidence interval = 0.11-0.68). The inverse association was consistent in other subgroup and sensitivity analyses.

CONCLUSIONS

Adherence to a healthy lifestyle pattern was beneficial to metabolic syndrome prevention.

Effect of healthy lifestyle score trajectory on all-cause mortality in the late middle-aged and older population: Finding from 17-year retrospective cohort study

PURPOSE

Recently, the World Health Organization has emphasized the importance of a healthy lifestyle in reducing severe illnesses and premature mortality. To evaluate this, the Healthy Lifestyle Score (HLS), which focuses on health protecting behaviors (e.g., smoking, alcohol consumption, physical activity, body mass index), is widely used. However, as HLS may fluctuate over time, there is increasing focus on monitoring HLS trends. Accordingly, this study aims to track HLS trajectories (HLST) and examine their association with mortality among middle-aged and older Koreans.

METHODS

After excluding missing values, data from 6249 participants were analyzed using the group-based trajectory model (GBTM) to classify HLST, based on the first to fourth waves of the Korean Longitudinal Study of Aging (KLoSA). The chi-square test and Cox proportional hazards model were employed to examine the association between HLST and all-cause mortality over a 10-year follow-up period (December 31, 2012, to December 31, 2022; 3650 days).

RESULTS

Three HLST groups were identified in the GBTM analysis. These were the Poor HLST (17.8 %), Average HLST (42.9 %), and Good HLST (39.4 %) groups. Compared to the good HLST, the poor HLST had higher mortality at 1 year (hazard ratio [HR]: 1.98, p: 0.029), 3 years (HR: 1.78, p: 0.001), 5 years (HR: 1.52, p: 0.002), 7 years (HR: 1.39, p: 0.002), and 10 years (HR: 1.40, p: 0.000). Furthermore, stratified analysis by sex, age, marital status and residential region showed that male, ≥65 years, single and urban area groups had a strong association between HLST and all-cause mortality.

CONCLUSION

The findings of this study underscore the necessity of policies and institutional measures grounded in community networks to mitigate the risk of all-cause mortality among vulnerable groups with persistently poor HLST.

Predictive Accuracy of Biochemical and Anthropometric Indices for Metabolic Syndrome in Children with Obesity: A Comparative Study

Children with obesity, regardless of gender, are a high-risk population that requires ongoing monitoring not only for present obesity and metabolic syndrome (MetS) but also future risks of metabolic, cardiac, musculoskeletal, and psychiatric complications. Data from a cohort of 185 obese children who underwent a second follow-up in 2019 were used for this retrospective study. The study cohort consisted of 94 boys and 91 girls who were elementary school students with a mean age of 10.2 ± 0.5 years. Following anthropometric and biochemical assessments, the cardio metabolic index (CMI), visceral adiposity index (VAI), triglyceride-glucose index (TyGI), and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. The overall prevalence of MetS was 19.5% (12.8% in boys and 26.4% in girls). According to the receiver operating characteristic curve analysis, CMI, VAI, and TyGI performed significantly better than HOMA-IR in identifying MetS. CMI was the most accurate predictor of MetS, as indicated by the highest area under the curve value, in both genders. In conclusion, our findings suggest that the CMI can serve as a practical, efficient, and affordable screening tool for the ongoing monitoring of childhood obesity in both daily endocrine clinical practice and primary care settings.

Health-related quality of life in adults with metabolic syndrome: a multi-level analysis of family and individual level variation

PURPOSE

The current study aimed to investigate the associations between metabolic syndrome (MetS) with health-related quality of life (HRQoL) using multilevel analysis among the Iranian adult population.

METHODS

This cross-sectional study was conducted in the framework of the Tehran Lipid and Glucose Study (TLGS). Participants were 6113 participants (3318 women and 2795 men) aged≥20 years of the TLGS seventh phase who had completed data on HRQoL and MetS. HRQoL was assessed using the short-form 12-item health survey V.2 and MetS defined based on the guidelines outlined in the Joint Interim Statement. The two-level model was fitted to assess the association between MetS and HRQoL.

RESULTS

The prevalence of MetS and its components was higher in men, and regardless of metabolic status, men exhibited higher HRQoL values. The deleterious impact of MetS on HRQoL was more pronounced in women, while the detrimental effects of MetS on men's HRQoL were confined to specific subscales. These results were obtained through multilevel analysis, considering both familial and individual variation levels. Moreover, our investigation highlighted the positive influence of leisure-time physical activity on both the physical and mental component summaries (PCS and MCS, respectively), regardless of gender. Education had a greater positive impact on PCS in both sexes. Additionally, a history of cardiovascular diseases was associated with a decline in mental and physical HRQoL, while age was linked to a decline in PCS and MCS, and smoking was associated with a decline in MCS.

CONCLUSION

This study revealed the significant influence of gender, as well as the unique characteristics and circumstances of individuals, on the relationship between MetS and HRQoL in a general population with low/middle income.

Association of a healthy lifestyle index with anthropometric indices and obesity in Hong Kong Chinese women: Evidence from the MECH-HK cohort study

AIM

This cross-sectional study aimed to examine the associations of a healthy lifestyle index (HLI) with several anthropometric indices and obesity among Hong Kong Chinese women.

SUBJECTS/METHODS

A total of 3174 women (56.16 ± 8.43 years) were included. The HLI consisted of diet, physical activity, sedentary time, sleep duration, skipping breakfast, smoking, and alcohol. Each factor was scored as 0 (unhealthy) or 1 (healthy). The overall HLI was the sum of these points, ranging from 0 (the least healthy) to 7 (healthiest). Percent body fat (PBF), body fat mass (BFM), fat free mass (FFM), waist circumference (WC), waist-to-hip ratio (WHR), height, and weight were measured using the InBody 270 device.

RESULTS

The number of women with 0-2, 3, 4, 5, 6-7-point HLI groups were 551, 759, 954, 645, and 265, respectively. As HLI increased, most anthropometric indices declined while FFM increased. The adjusted βs (95 % confidence intervals (95 % CIs)) for PBF (%), BFM (kg), WC (cm), WHR, height (cm), weight (kg), BMI (kg/m^2), and FFM (kg) were -0.653 (-0.829, -0.476), -0.582 (-0.751, -0.414), -0.719 (-0.971, -0.467), -0.005 (-0.006, -0.004), -0.181 (-0.347, -0.015), -0.602 (-0.850, -0.355), -0.188 (-0.282, -0.095), and 0.339 (0.213, 0.465), respectively. Additionally, compared to the 0-2-point group, the odds ratios (95 % CIs) of the 6-7-point groups were 0.54 (0.38-0.75) for central obesity and 0.55 (0.37-0.82) for general obesity.

CONCLUSIONS

HLI was inversely associated with PBF, BFM, WC, WHR, height, weight, BMI, central obesity, and general obesity, but was positively associated with FFM.

Frequency and Sex-Specific Associations of Metabolic Syndrome in Rwandans Seeking Outpatient Care: A Cross Sectional, Single Centre Study

Background

The prevalence of cardiometabolic diseases is escalating in sub-Saharan Africa (SSA) alongside the prevailing high burden of communicable diseases. Although many countries in SSA, including Rwanda, have existing data on the prevalence of individual components of the MetS, many SSA countries have insufficient data to guide policy makers on the magnitude of MetS. This study sought to determine the magnitude of MetS and its associated risk factors by sex at a referral teaching hospital in Rwanda.

Methods

A cross-sectional, study was conducted among adults aged 35 to 65 years presenting at Ruhengeri Referral Teaching Hospital, Rwanda. We collected socio-clinicodemographic data using the World Health Organization (WHO) STEPwise tool for non-communicable diseases. We used the National Cholesterol Education Program Adult Treatment Panel III criteria for MetS.

Results

Overall, 99 (23.5%) males and 322 (76.5%) female participants with mean ± SD age 47.5 ± 8.2 years were enrolled. The overall frequency of MetS was 51.9% (95% CI: 47.0-56.8) and was significantly higher (p < 0.001) in females 193 (59.4%) compared to males 26 (26.3%). Significant differences by sex were also noted in the proportions of visceral obesity; 70.4% vs 7.1% (p < 0.001), hypoalphalipoproteinaemia 36.1% vs 69.7% (p < 0.0001), type 2 diabetes mellitus; 18.4% vs 31.6% (p = 0.020) and body mass index 25.9 ± 15.6 vs 28.2 ± 6.4 (p = 0.032). On multivariate logistic regression, older age (odds ratio (OR) 1.05; 95% confidence interval ((CI) 1.01-1.10)), higher body weight (OR 1.06; 95% CI 1.04-1.08) and higher total cholesterol (1.25; 95% CI 1.05 -1.74) were significantly associated with MetS in females; whereas only higher body weight (OR1.10; 95% CI 1.04-1.18) was significantly associated with MetS in males.

Conclusion

A high frequency of MetS was observed in the present study, which was higher among females. Our findings emphasize the need for tailored prevention and intervention strategies to mitigate the long-term impact of MetS.

Iron Homeostasis-Related Parameters and Hepcidin/Ferritin Ratio: Emerging Sex-Specific Predictive Markers for Metabolic Syndrome

Metabolic syndrome (MetS) is a worldwide public health challenge. Accumulating evidence implicates elevated serum ferritin and disruptions in iron metabolism as potential elements linked to an increased risk of MetS. This study investigates the relationship between iron homeostasis-including hepcidin levels, serum iron concentration, unsaturated iron-binding capacity (UIBC), and the hepcidin/ferritin (H/F) ratio-and MetS. In this descriptive cross-sectional study, 209 participants aged 24-70 were categorized into two groups: 103 with MetS and 106 without MetS. All participants underwent medical assessment, including anthropometric measures, indices of glycemic control, lipid profiles, and iron-related parameters. Participants were further stratified by the Homeostasis Model Assessment-Insulin Resistance index into three subgroups: insulin-sensitive (IS) (<1.9), early insulin resistance (EIR) (>1.9 to <2.9), and significant insulin resistance (SIR) (>2.9). Notable increments in serum ferritin and hepcidin were observed in the SIR group relative to the IS and EIR groups, with a significant association between metabolic parameters. The UIBC and serum ferritin emerged as significant predictors of MetS, particularly in men, with an area under the curve (AUC) of 0.753 and 0.792, respectively (p ≤ 0.001). In contrast, hepcidin was notably correlated with MetS in women, with an AUC of 0.655 (p = 0.007). The H/F ratio showed superior predictive capability for MetS across both sexes (at cutoff level = 0.67). Among women, this ratio had an AUC of 0.639 (p = 0.015), and for men, it had an AUC of 0.792 (p < 0.001). Hypertension proved an independent risk factor for MetS, affirming its role in metabolic dysregulation. The findings highlight a significant interconnection between iron homeostasis parameters and MetS, with sex-specific variations underscoring the importance of personalized diagnostic criteria. The crucial role of the H/F ratio and the UIBC as emerging predictive markers for MetS indicates their potential utility in identifying at-risk individuals. Further longitudinal research is essential to establish causality and explore the interplay between these biomarkers and MetS.

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 .

The impact of lifestyle, measured with the HLPCQ questionnaire on the prevalence of metabolic syndrome in Poland: a multicenter study

Metabolic syndrome is one of the most common health problems for people around the world. The aim of our study was to assess the prevalence of metabolic syndrome among adults without prior diagnosis of cardiovascular disease, diabetes, and chronic kidney disease. We also plan to assess the influence of certain lifestyle components on prevalence of metabolic syndrome. The study involved cardiovascularly healthy patients undergoing lab tests, measurements, and the HLPCQ questionnaire (The Healthy Lifestyle and Personal Control Questionnaire). The data were used to diagnose metabolic syndrome. Out of 1044 patients from 10 primary care facilities, 23.3% met the metabolic syndrome criteria, showing a strong link with increased blood pressure, cholesterol, and fasting glucose. Lower scores in the Organized physical exercise subscale of the HLPCQ questionnaire were noted in those with metabolic syndrome. Comparing the subscale of HLPCQ questionnaire, the lower results in Organized physical exercise subscale were found among the participants with metabolic syndrome, both male and females. Metabolic syndrome, a significant risk factor for cardiovascular disease, should be screened for actively, even in apparently healthy populations. Results obtained in our study from analysis of HLPCQ show that screening for metabolic syndrome should be preceded by prevention based on regular physical activity and proper eating habits.

Prevalence of metabolic syndrome in patients with end-stage renal disease: a systematic review and meta-analysis

BACKGROUND

Metabolic syndrome, a significant risk factor for cardiovascular mortality in patients with end-stage renal disease, profoundly impacts patient prognosis and survival. Despite its clinical importance, the prevalence of metabolic syndrome remains unexplored in this population. Therefore, the objective of this study was to systematically assess the prevalence of metabolic syndrome among patients with end-stage renal disease and raise awareness among healthcare professionals.

METHODS

We conducted a comprehensive search in CNKI, WANFANG, WeiPu, CBM, PubMed, Web of Science, EMBASE, and The Cochrane Library databases. The search time was until August 21, 2023. Standardized tables were employed for data extraction and imported into Stata 16.0 software for subsequent meta-analysis. A random-effects model was employed to estimate combined prevalence and 95% confidence intervals. Subgroup and sensitivity analyses were conducted to explore potential sources of heterogeneity, while publication bias was evaluated using a funnel plot and Egger's test. This study has been registered with PROSPERO under the registration number CRD42023456284.

RESULTS

This meta-analysis comprised 35 studies involving a total of 14,202 participants. The pooled prevalence estimate for metabolic syndrome was 49.0% [95% CI (46.0,53.0)]. We conducted subgroup analyses based on participant characteristics, gender distribution, publication year, national economic status, diagnostic criteria employed, and components of metabolic syndrome.

CONCLUSIONS

The prevalence of metabolic syndrome is higher among patients with end-stage renal disease, necessitating early prevention and control measures to reduce its incidence and delay the progression of the disease, thereby improving patient life expectancy.

Associations of combined lifestyle index with migraine prevalence and headache frequency: a cross-sectional study from the MECH-HK study

BACKGROUND

Prior research has shown that individual lifestyles were associated with migraine. Yet, few studies focused on combined lifestyles, particularly in Chinese populations. This cross-sectional study aimed to investigate the relationships of a combined lifestyle index with migraine in Hong Kong Chinese women.

METHODS

Baseline data from a cohort study named Migraine Exposures and Cardiovascular Health in Hong Kong Chinese Women (MECH-HK) were used for analysis. In total 3510 women aged 55.2 ± 9.1 years were included. The combined lifestyle index comprised eight lifestyle factors: smoking, physical activity, sleep, stress, fatigue, diet, body mass index, and alcohol. Each component was attributed a point of 0 (unhealthy) or 1 (healthy). The overall index was the sum of these points, ranging from 0 (the least healthy) to 8 points (the healthiest). Migraine was diagnosed by the International Classification of Headache Disorders 3rd edition. Additionally, for women with migraine, the data on migraine attack frequency (attacks/month) was collected.

RESULTS

A total of 357 women with migraine (10.2%) were identified. The prevalence of migraine for the 0-3-point, 4-point, 5-point, 6-point, and 7-8-point groups were 18.0% (162/899), 10.9% (86/788), 6.6% (51/776), 6.0% (38/636), and 4.9% (20/411), respectively. In the most-adjusted model, compared to the 0-3-point group, the odds ratios and 95% confidence intervals for the 4-point, 5-point, 6-point, and 7-8-point groups were 0.57 (0.43-0.75), 0.33 (0.24-0.46), 0.30 (0.21-0.44), and 0.25 (0.15-0.41), respectively (all p < 0.001). For each component, migraine was significantly associated with sleep, stress, fatigue, and diet; but was unrelated to smoking, physical activity, body mass index, and alcohol. Among women with migraine, per point increase in the combined lifestyle index was associated with a reduced migraine attack frequency (β = - 0.55; 95% confidence interval = - 0.82, - 0.28; p < 0.001).

CONCLUSIONS

A combined lifestyle index was inversely associated with migraine and migraine attack frequency in Hong Kong Chinese women. Adhering to a healthy lifestyle pattern might be beneficial to the prevention of migraine attacks. Conversely, it is also plausible that women with migraine might have a less healthy lifestyle pattern compared to those without headaches.

Combined Influence of Eight Lifestyle Factors on Metabolic Syndrome Incidence: A Prospective Cohort Study from the MECH-HK Study

Although previous studies have shown significant associations between individual lifestyles and metabolic syndrome, limited studies have explored the combined effect of lifestyles. The purpose of this study was to investigate whether a combined lifestyle score was associated with metabolic syndrome incidence in Hong Kong Chinese women. This prospective cohort study included 1634 women (55.9 ± 8.6 years) without baseline metabolic syndrome, diabetes, myocardial infarction, or stroke. Eight lifestyle factors (smoking, physical activity, sedentary time, sleep, stress, fatigue, diet, and alcohol) were included by assigning 0 (unhealthy) or 1 point (healthy). The overall score was the sum of these points, ranging from 0 (the least healthy) to 8 points (the healthiest). Metabolic syndrome was diagnosed by the joint interim statement. During a 1.16-year follow-up, 179 (11.0%) new metabolic syndrome cases were identified. The incidences for the 0-3-point, 4-point, 5-point, and 6-8-point groups were 12.8% (79/618), 11.5% (42/366), 9.4% (29/309), and 8.5% (29/341), respectively. Compared to the lowest combined lifestyle score group, the highest group had a 47% reduced metabolic syndrome incidence, with an adjusted odds ratio and 95% confidence interval of 0.53 (0.33-0.86) (p = 0.010). These findings indicate that a higher combined lifestyle score was associated with a lower metabolic syndrome incidence in this population.

Metabolic syndromes increase significantly with the accumulation of bad dietary habits

BACKGROUND

The association between dietary habits and metabolic syndrome (MetS) has not been well documented, due to the complexity and individualization of dietary culture in the Chinese population.

OBJECTIVE

To construct a composite score from various bad dietary habits and to evaluate their comprehensive association with the prevalence of MetS and its components among Chinese men and women across various age groups.

SETTING

Serial cross-sectional studies.

METHODS

Twenty-three dietary habits were assessed through face-to-face interviews with 98,838 males and 83,099 females in health check-up programs from 2015 to 2021, among which eighteen bad dietary habits were observed to be associated independently with total MetS. The total score of bad dietary habits was composed of four categories via variable clustering analysis, including irregular dietary habits, unhealthy dietary flavors, unbalanced dietary structure, and high-fat diet. The 2016 Chinese guideline for the management of dyslipidemia in adults was used to define MetS.

RESULTS

Men had a higher score of bad dietary habits than women (9.63 ± 3.11 vs. 8.37 ± 3.23), which decreased significantly with increasing age in both males and females (Pinteraction<0.01). The prevalence of total MetS increased significantly with the cumulative score of bad dietary habits in both males (highest quintile vs. lowest quintile: OR, 1.90; 95% confidence interval [CI], 1.80-2.00; Plinear<0.01) and females (OR, 2.23; 95% CI, 2.02-2.46; Plinear<0.01) after adjusted for age, education, smoking status, alcohol consumption, and physical activities. These linear trends were also observed for each MetS component (all Plinear<0.01). The role of irregular dietary habits and high-fat diet on MetS prevalence are much higher in males than in females, while unhealthy dietary flavors and unbalanced dietary structure had a greater influence on females.

CONCLUSIONS

The accumulation of bad dietary habits contributes to the MetS developments. Thus, individualized lifestyle interventions are needed to correct bad dietary habits with regard to gender differences.