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

Lifestyle Factors Influencing Metabolic Syndrome after Adjusting for Socioeconomic Status and Female Reproductive Health Indicators: A National Representative Survey in Korean Pre- and Postmenopausal Women

Metabolic syndrome (MetS) is increasing markedly among postmenopausal women. Although studies suggest multiple risk factors for its development, few have investigated changes in socioeconomic status (SES), female reproductive health indicators (menarche age, experience of pregnancy, delivery, breastfeeding, and postmenopausal status), and lifestyle factors. This study investigated lifestyle factors affecting MetS prevalence among pre- and post-menopausal women after adjusting for SES and female reproductive health indicators. Data from the Korea National Health and Nutrition Examination Survey VII (2016-2018) on 2856 pre- and postmenopausal women aged 40-59 years were analyzed. Differences in SES (e.g., age, education, and household income), female reproductive health indicators (e.g., age of menarche and menopause), and lifestyle (e.g., total calorie intake, fats, and proteins, percentage of energy from carbohydrates, fats, and proteins, smoking, physical activity, and obesity) between MetS and non-MetS groups were calculated by performing χ2 or t-tests. Consequently, current smoking, physical inactivity, overweight, and obesity were significantly associated with increased MetS after adjusting for SES and female reproductive health indicators using logistic regression analysis. Hence, health policies and programs focusing on modifiable MetS risk factors-encouraging healthy eating habits, smoking cessation, and regular exercise-must be formulated to prevent the development of MetS in pre- and postmenopausal women.

The risk of metabolic syndrome is associated with vitamin D and inflammatory status in premenopausal and postmenopausal Algerian women

BACKGROUND

This first cross-sectional study examined whether vitamin D status and proinflammatory cytokines may be associated with metabolic syndrome (MetS) in Algerian women regarding their menopausal status.

METHODS

Fasting plasma glucose (FPG), lipids, insulin, 25(OH)D, PTH, adiponectin, resistin, TNFα, and IL-6 levels were assessed in 277 participants aged 18-74 years. MetS was diagnosed according to NCEP-ATPIII criteria. The association of vitamin D deficiency, IL-6, and TNFα with components of MetS was analyzed by the logistic regression.

RESULTS

Among a cohort of 277 participants, the prevalence of MetS in 115 premenopausal vs. 162 postmenopausal women was 54.02 vs. 68.1%. Cut-offs for vitamin D deficiency were 15.7 vs. 13 ng/mL, 51.07 vs. 41 pg/mL for IL-6 and 8.28 vs. 9.33 pg/mL for TNFα, respectively. 25(OH)D levels were positively correlated with adiponectin levels, while negatively with HOMA-IR in postmenopausal-MS + women. Adjustment for age and BMI reveals a significant association between vitamin deficiency and high FPG (OR: 2.92 vs. 2.90), TG (OR:2.79 vs. 3.51), BP (OR:2.20 vs. 1.92), and low HDL-c (OR:2.26 vs. 3.42), respectively. A significant association was also detected in postmenopausal women between IL-6 and high FPG (OR5.11, p = 0.03), BP (OR:3.13, p = 0.04), and low HDL-c (OR5.01, p = 0.02), while TNFα was associated with high BP in postmenopausal women (OR: 3.70, p = 0.01), and inversely with TG in premenopausal women (OR: 0.16, p = 0.04).

CONCLUSION

This study highlighted that severe vitamin D deficiency increases MetS score and was closely associated with four components of MetS, more potently in postmenopausal women, probably related with estrogens. Abdominal obesity, as influential component of MetS, may be involved in enhancing vitamin D deficiency, and dysregulating some metabolic hormones such as adiponectin, resistin and insulin, that contributes in onset an inflammatory state, through the increase in IL-6 and TNFα levels. These findings need to be improved by expanding investigation to a large cohort of participants.

Level of adherence to diet and physical activity among menopausal women and influencing factors in Jordan: a descriptive cross-sectional study

Background

During menopause, a woman's lifestyle may change significantly, which will have implications on her quality of life. Women will experience menopause for more than a third of their life; therefore, maintaining good health during this period is crucial. A healthy diet and physical activity can help women maintain their health during menopause. Hence, assessing adherence to a healthy diet and physical activity among menopausal women is important.

Purpose

This study aims to assess the degree of adherence to a healthy diet and physical activity of menopausal women in Jordan and determine the most influential factors.

Methods

A descriptive cross-sectional design was used in this study, and an online self-administered questionnaire was sent to 299 menopausal women selected through simple random sampling. A valid and reliable questionnaire was used to assess the menopausal women's adherence to a healthy diet and physical activity. The questionnaire consisted of 14 items covering two domains: 12 questions for the diet domain and two questions for the physical activity domain. Descriptive statistics were obtained, mean weight and body mass index (BMI) were calculated, and stepwise regression was conducted for the data analysis.

Results

The overall degree of adherence to a healthy diet and physical activity of the women was moderate (49.25, SD = 7.17). Most of the participants reported eating refined food items once a month or less (n = 188, 62.9%) and not exercising weekly (n = 119, 39.8%), and only a few reported eating refined food items at least once a day (n = 5, 1.7%) and exercising 5-6 times a week (n = 15, 5%). The regression analysis showed that age (B = 0.145, p = 0.014), having two children (B = 0.123, p = 0.034) and completing primary or secondary education (B = 0.120, p = 0.038) were statistically significant and the strongest predictors of adherence. The predictors accounted for 68% of the variance in adherence to a healthy diet and physical activity (R2 = 0.068, F [343.54] = 7.123, p = 0.000).

Conclusion

The majority of the middle-aged menopausal women in this study showed moderate adherence to a healthy diet and physical activity. Age, having two children and completing primary or secondary education were associated with degree of adherence to a healthy diet and physical activity. Therefore, healthcare intervention, such as physical activity and dietary control programs, should target women in this age group and stage in life.

A Survey on Relation of Menopause to Metabolic Syndrome - SAFOMS STUDY (South Asian Federation of Menopause Societies) - Interim Analysis

Background

Metabolic syndrome (MS) is a spectrum of disorders that includes dysglycemia, dyslipidemia, central obesity, and hypertension. South Asian Indians are more prone to harbor MS at a younger age compared to Caucasians. However, there is a lack of large-scale data correlating menopause to MS in South Asian settings.

Aims and Objectives

The study aimed to determine the prevalence of MS and its components in pre- and postmenopausal women. It also assessed the relationship of age, menopausal status, personal and family history, anthropometric parameters, and biochemical markers to MS.

Materials and Methods

It was an interim analysis of a multicountry cross-sectional study in the South Asian Federation of Menopause Society (SAFOMS) countries: India, Pakistan, Bangladesh, Nepal, and Sri Lanka conducted through both online and physical methods. The survey questionnaire consisted of questions about details of personal history, demographics, and family history related to MS. Anthropometric measurements such as height, weight, basal metabolic index (BMI), waist circumference, and blood pressure readings were noted. Relevant history, history of polycystic ovarian syndrome, hypertensive disorders of pregnancy, and vasomotor symptoms were enquired. Biochemical evaluation of markers associated with MS was undertaken.

Results

In this interim analysis, 638 women were recruited. Out of them, 406 (63.6%) women were premenopausal and 232 (36.4%) were postmenopausal. 392 (61.4%) women had MS, while 246 (38.6%) women did not have MS. Increasing age, BMI, and visceral adiposity (waist circumference) were significantly correlated with incidence of MS. Raised fasting blood sugar, hemoglobin A1C, total cholesterol, low-density lipoprotein, serum triglyceride, and reduced high-density lipoprotein levels were significantly associated with the incidence of MS in both pre- and postmenopausal women. Peri- and postmenopausal hot flashes, night sweats, and sleep disturbances were also significantly associated with MS. Personal history of hypertension, diabetes, and dyslipidemia were the strongest factors to be associated with MS with a significantly high odds ratio.

Conclusion

The study has highlighted the role of BMI and waist circumference as the first warning signs, which will encourage to go for regular biochemical screening through lipid profile and fasting blood glucose measurements. Our study is a stepping stone for all future studies for relation of menopause to MS.

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.

Dynamic Evolution of Cardiac Function and Glucose and Lipid Metabolism in Ovariectomized Rats and the Intervention Effect of Erxian Decoction

Aims

Abnormal changes in cardiac function have been reported in menopausal women, but there are few clinical studies on this topic. Erxian decoction (EXD) is a classic prescription that is widely used in the treatment of female menopausal diseases. The purpose of this study was to investigate the dynamic evolution of cardiac function and glucose and lipid metabolism in ovariectomized (OVX) rats and the intervention effect of EXD.

Materials and Methods

The OVX climacteric rat model was established by bilateral ovariectomy. After successful modeling, the rats were randomly divided into four groups: the sham operation (SHAM) group (equal volumes of purified water), OVX group (equal volumes of purified water), estradiol (E₂) group (1.8 × 10^-4 g/kg), and EXD group (9 g/kg). Each group of rats was treated for 16 weeks. At the 4^th, 8^th, 12^th, and 16^th weeks after treatment, the cardiac function of the rats in each group was evaluated by ultrasound. The coaxial method was used to measure blood pressure (BP). Serum endothelin-1 (ET-1) and angiotensin-2 (Ang II) levels were determined by the enzyme-linked immunosorbent assay (ELISA). The strip method was used to measure fasting blood glucose (FBG). The serum total cholesterol (TC) and triglyceride (TG) levels of rats were measured with the oxidase method. Direct methods were used to measure serum high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) levels. At week 16 of dosing, serum E₂ levels were determined by E₂ radioimmunoassay. The myocardium and uterus of the rats in each group were stained with HE (hematoxylin-eosin). The ultrastructure of the rat myocardium was observed by electron microscopy.

Results

After the 16^th week of treatment, the serum E₂ level decreased (P < 0.05), and the uterus was atrophied in OVX rats. The cardiac ejection fraction (EF%) decreased at 4 weeks after treatment, and systolic and diastolic function decreased after 12 weeks. After the 16^th week, the EF%, which reflects the "pump" function of the heart, decreased significantly (P < 0.05 or P < 0.01). At the 4^th, 8^th, 12^th, and 16^th weeks of treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean pressure (MBP) of the rats in the OVX group increased with time (P < 0.05 or P < 0.01). The serum ET-1 and Ang II levels of rats in the OVX group increased (P < 0.05 or P < 0.01). In the OVX group, FBG was increased (P < 0.05 or P < 0.01), and blood lipids, especially LDL-C, were significantly increased (P < 0.05 or P < 0.01). After the 16^th week of treatment, the myocardial tissue of OVX rats showed obvious pathological changes. EXD significantly increased serum E₂ levels (P < 0.01), decreased ET-1 and Ang II levels (P < 0.01), reduced the cardiac function risk factors BP, FBG, and blood lipids, and significantly improved cardiac function and structural changes in OVX rats (P < 0.05 or P < 0.01).

Conclusions

EXD can improve abnormal cardiac structure and function in OVX rats.

Metabolic Syndrome and Its Components: A Cross-Sectional Analysis of Its Distribution among Pre- and Post-Menopausal Women from Northern India

Aim

This study aims to determine the prevalence of Metabolic Syndrome (MS) and recognize its abnormal components in pre and postmenopausal women. We also aim to recognize the abnormal components in postmenopausal women with regard to duration since menopause.

Materials and Methods

The cross-sectional study was undertaken among pre- and post-menopausal women between 40 and 65 years. Women with MS were identified as per the modified National Cholesterol Education Program Adult Treatment Panel III.

Results

A total of 220 women were enrolled comprising 112 premenopausal and 108 postmenopausal women, the prevalence of MS among them being 33% and 51.85%, respectively. Postmenopausal status was found to be independently associated with MS when adjusted for potential confounders (adjusted odds ratios = 14.77, 95% confidence intervals: 1.77-23.33). All the components were proportionately higher in postmenopausal group, the rise in blood pressure (BP) (P = 0.003) and low high-density lipoprotein (HDL) (0.027) being statistically significant. The risk of MS, abdominal obesity, and high BP were highest in <5 years since menopause and decreased thereafter. The risk for low HDL and high triglyceride increased with the number of years since menopause, reaching the peak level in the 5-9-year group and then decreased while the risk of high fasting blood sugar increased reaching peak in the 10-14 years' group.

Conclusion

The prevalence of MS is significantly high in postmenopausal women. Screening of women in premenopausal period will give an opportunity to intervene and prevent the menace of MS in Indian women predisposed to abdominal obesity, insulin resistance, and cardiovascular adverse events.

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

Introduction

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

Methods

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

Results

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

Conclusion

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

Aerobic exercise with diet induces hormonal, metabolic, and psychological changes in postmenopausal obese women

Physical activity and diet are recommended lifestyle strategies to improve human health. Consequently, this study aimed to investigate the impact of aerobic exercise combined with dietary restriction on hormonal, metabolic, and psychological variables in postmenopausal women. Eligible 60 women were enrolled and assigned into two equal groups; the experimental group performed aerobic exercise three times per week for 12 weeks with diet restriction, and the control group only received the same diet program. Serum levels of sex hormones, insulin resistance, and depression scores were measured before and after the intervention.

Results

All measured variables were significantly changed in the experimental group compared to the control group (P = 0.001).

Conclusion

Changes in sex hormones are a biological marker of metabolic complications such as insulin resistance, which can be reduced with exercise and diet. In addition, they are effective therapeutic interventions in the treatment of mild depression.

Trial registration

Registration identifier number of this study is: NCT05136742 on https://register.ClinicalTrials.gov.

Metabolic Syndrome in Breast Cancer Patients: An Observational Study

Background:

The reported association between metabolic syndrome (MetS) and breast cancer may have a significant impact on the incidence and mortality related to breast cancer. We undertook this study to find if the disease is different in patients with MetS.

Materials and Methods:

Patients with biopsy-proven breast cancer were divided into groups based on the presence or absence of MetS (according to the IDF definition of 2006) and also based on menopausal status. The presence of known risk and prognostic factors were also recorded, and the groups were compared.

Results:

A total of 305 patients were recruited, of which 191 (62.6%) had MetS. Patients with MetS were older than those without (52.1 versus 48.3 years, P = .014) and had a lower incidence of nulliparity (4.1% vs 12.8%, P = .005) and dense breasts (2.9% in MetS vs 10.8% in no MetS, P = .009). On further dividing into premenopausal and postmenopausal, these differences persisted only in premenopausal patients. MetS group had a lower number of HER2-positive tumours (14.3% for MetS, 23.9% for no MetS; P = .036). After dividing into premenopausal and postmenopausal, significant differences were observed in distant metastases (5.4% in MetS vs 16.1% in no MetS, P = .045) and in grade (higher grade in MetS, P = .05) in premenopausal patients. In postmenopausal patients, difference was observed in HER2 positivity (12.3% in MetS vs 28.8% in no MetS, P = .008).

Conclusions:

Breast cancer in patients with MetS may not be significantly different from breast cancer in patients without MetS.

The Relationship Between Menopause and Metabolic Syndrome: Experimental and Bioinformatics Analysis

Menopausal hormonal changes have been associated with the emergence of the metabolic syndrome (MetS) and its consequences such as type 2 diabetes (T2D) and cardiovascular diseases (CVD). The common gene signature and the associated signaling pathways of MetS, T2D, CVD and menopause status have not been widely studied. We analyzed a total of 314 women aged between 35 and 75 years. The sample was divided into two groups: Group I, including women in the premenopausal period and Group II, comprising women in the post-menopausal period. The presence of MetS and its components were evaluated, as well as occurrence of T2D and CVD in both groups. We also exploited the translational bioinformatics approach to choose the common gene signatures for MetS, T2D, CVD and the menopause status. The frequency of the MetS was significantly higher in postmenopausal women than in premenopausal ones (67.1 vs. 27.2%, p < 0.001). Gene mining analysis revealed that a total of 47 genes were commonly associated with MetS, T2D, CVD and the menopausal changes. The gene enrichment analysis showed that these genes were markedly enriched in biological processes, including positive regulation of binding, positive regulation of leukocyte cell-cell adhesion, regulation of lipid localization. Furthermore, P53 signaling pathway, prolactin signaling pathway, parathyroid hormone synthesis, secretion and action were the top enriched pathways. Additionally, network analysis revealed TGFB1, SPP1, MMP2, MMP9, CCL2, IGF1, EGFR, ICAM1, TNF and IL6 as important hub genes with significant interacting partners. These hub genes identified in our study may play key role in menopausal changes and influence the risks of MetS, T2D and CVD.

Effect of Menopause on Arterial Stiffness and Central Hemodynamics: A Pulse Wave Analysis-Based Cross-sectional Study from Gujarat, India

Background:

Menopause, a cardiovascular risk in mid-life women, is studied in terms of blood pressure mostly. Arterial stiffness (AS) and central hemodynamics (CH) are direct surrogates measured by pulse wave analysis (PWA) with no study from our region.

Objective:

We studied AS, CH in relation to menopause using PWA.

Materials and Methods:

A cross-sectional study was performed in 134 middle-aged females divided into groups with or without menopause. Oscillometric PWA done by Mobil-o-Graph (IEM, Germany) gave – AS like augmentation pressure, augmentation index at heart rate (HR) 75, aortic pulse wave velocity (aPWV), and total AS pulse pressure amplification; CH like aortic blood pressure, cardiac output and related parameters, peripheral resistance, stroke work, prevalent brachial/central hypertension, and raised central pulse pressure. They were further compared between groups, in relation to body mass index (BMI) and by multiple regressions with P < 0.05 as statistical significance.

Results:

Postmenopausal women were significantly elder, physically inactive with comparable BMI and showed higher AS (only aPWV was significantly different) and CH. BMI was unrelated to AS or CH in postmenopausal group. Age (except for aPWV), BMI, and HR (except for AIx@75) were insignificant predictors, while systolic blood pressure (SBP) in premenopausal and diastolic blood pressure (DBP) in postmenopausal group was major AS predictors. Age, HR, and BMI were insignificant predictors, while SBP more than DBP was significant predictors of CH.

Conclusions:

In obese, predominantly sedentary midlife Gujarati women, menopause negatively affects AS and hemodynamics, central more than peripheral. Menopause accelerates cardiovascular aging, independent of BMI, and age that calls for further studies.

Gender Bias in Cardiovascular Disease Prevention, Detection, and Management, with Specific Reference to Coronary Artery Disease

Even though cardiovascular disease (CVD) kills more women than men each year and remains a leading cause of death in women, it is a common misconception that women are less likely to develop CVD. Considerable sex difference exists between men and women with regard to prevention, investigations, and management of CVD. Coronary artery disease (CAD) is a major contributor to CVD morbidity and mortality and hence is specifically addressed in this article. With an explosive increase in the incidence of conventional risk factors for coronary artery disease in India, there has been an alarming increase in women's coronary events as much as men. A false sense of gender-based protection by estrogen leads to less aggressive and late prevention or management strategies that contribute to women's CAD. Metabolic syndrome (MetS) is an important contributor to future development of CAD and is also an indicator for earlier interventions for prevention. Due to physical inactivity and central obesity, MetS is more prevalent in women, especially postmenopausal. With estrogen loss, menopause marks a critical cardiovascular biological transition, with a significantly increased CVD risk in women aged >55 years. Certain female-specific risk factors, such as history of polycystic ovarian syndrome, pregnancy-induced hypertension, and gestational diabetes, also seem to play an essential role in the development of CVD in later life. Certain vascular and biological factors, such as smaller coronary vessel size, higher prevalence of small vessel disease, and lesser development of collateral flow, also play an important role. This review article is an attempt to provide important information on gender differences in CVD with specific emphasis on CAD.

Sex Hormone-Binding Globulins and Testosterone Levels as a Risk Marker for Type 2 Diabetes Mellitus among Postmenopausal Women

BACKGROUND

Endogenous sex hormones and sex hormone-binding globulins (SHBG) determine the risk of occurrence of Type 2 diabetes mellitus (T2DM) in postmenopausal (PM) women.

AIMS

To investigate the association between sex hormones (estradiol and testosterone) and SHBG with plasma glucose, fasting insulin levels, HbA1c, and homeostasis model assessment insulin resistance (HOMA-IR) and also to investigate independent role of sex hormones in the occurrence of T2DM among PM.

SETTINGS AND DESIGN

Cross-sectional case-control study.

SUBJECTS AND METHODS

The present study was conducted in Endocrinology department Guwahati, Medical College, Assam, India. The participants included cases - PM women with T2DM (n = 100) and controls - Healthy PM women (n = 86). The medical history, clinical examination, and investigations including total testosterone, serum estradiol, SHBG, free testosterone index, high sensitivity C-reactive protein (hs-CRP), lipid profile, fasting insulin, fasting plasma glucose (FPG), and postprandial plasma glucose (PPPG) were done and analyzed. HOMA-IR was calculated.

STATISTICAL ANALYSIS

Pearson correlation between sex hormone level and SHBG with plasma glucose, HbA1c, fasting insulin, hs-CRP, and HOMA-IR was seen. Multivariance logistic analysis was done to find the independent association between sex hormones/SHBG and the occurrence of T2 DM. P < 0.05 was considered statistically significant.

RESULTS

Among the cases, a significant positive correlation was found between total testosterone/free testosterone index with waist circumference, FPG PPPG, HbA1c, fasting insulin, and HOMA-IR, and a significant negative correlation was found between SHBG and FPG, PPPG, HbA1c, fasting insulin, and HOMA-IR (P < 0.01). The logistic analysis showed total testosterone levels and SHBG are independently associated with the occurrence of T2 DM among PM (P < 0.01).

CONCLUSION

SHBG and testosterone levels in PM can be a risk marker for the development of T2DM.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

The Relationship between the IFNG (rs2430561) Polymorphism and Metabolic Syndrome in Perimenopausal Women

Background and Objectives: Metabolic syndrome (MetS) is a multiple risk factor for atherosclerosis, cardiovascular disease, type 2 diabetes and strokes. One-third of middle-age women are at risk of MetS, which predisposes them to type 2 diabetes and cardiovascular disease. Changes in the regulation of anti-inflammatory cytokines―which play an important role in pathologic processes―may contribute to inflammatory disorders. Cytokine polymorphisms are known to have an impact on gene expression. The purpose of this study was to search for the relationship between the IFNG polymorphisms and the levels of proinflammatory cytokines. Materials and Methods: This study, conducted in West Pomeranian Voivodeship, Poland, involved 416 women. Of these women, 33.6% of them had primary education, 44.8% lived in cities with a population of over 100,000, and 82.7% were married. Of the participants, 28.4% met the criteria for MetS. The study involved: interview performed to collect sociodemographic and medical data, anthropometric measurements, as well as venous blood collection for biochemical analysis, genetic testing and the measurement of inflammatory markers. Results: The link between the IFNG (rs2430561) polymorphism and serum PIC (proinflammatory cytokines) levels was tested with regard to MetS. In the MetS+ subgroup, the T/T and A/T genotypes of the IFNG gene were accompanied by higher IL-6 levels than in the MetS− subgroup. Conclusion: Our study has not confirmed a direct link between the IFNG polymorphisms and the levels of inflammatory biomarkers. Nevertheless, the T/T and A/T genotypes of the IFNG gene may predispose to elevated IL-6 levels.

Association of Hypovitaminosis D with Metabolic Syndrome in Postmenopausal Women

The prevalence of vitamin D deficiency and metabolic syndrome is spreading like a pandemic globally; postmenopausal women are particularly vulnerable population. Hypovitaminosis D is reported to predispose to various components of metabolic syndrome like dyslipidemia, hypertension, diabetes and obesity. The purpose of this review is to highlight the recently published evidence, evaluating the association of vitamin D deficiency with metabolic syndrome in postmenopausal women. Besides, it emphasizes the long-term risks involved with low vitamin D levels and importance of vitamin D supplementation. Data were obtained from PubMed, Google Scholar and individual searches.

Health conditions associated with overweight in climacteric women

This study aims to investigate the association between health conditions and overweight in climacteric women assisted by primary care professionals. It is a cross-sectional study conducted with 874 women from 40 to 65 years of age, selected by probabilistic sampling between August 2014 and August 2015. In addition to the outcome variable, overweight and obesity, other variables such as sociodemographic, reproductive, clinical, eating and behavioural factors were evaluated. Descriptive analyses of the variables investigated were performed to determine their frequency distributions. Then, bivariate analyses were performed through Poisson regression. For the multivariate analyses, hierarchical Poisson regression was used to identify factors associated with overweight and obesity in the climacteric period. The prevalence of overweight and obesity was 74%. Attending public school (PR: 1.30-95% CI 1.14-1.50), less schooling (PR: 1.11-95% CI 1.01-1.23), gout (PR: 1.18-95% CI 1.16-1.44), kidney disease (PR: 1.18-95% CI 1.05-1.32), metabolic syndrome (MS) (PR: 1.19-95% CI 1.05-1.34) and fat intake (PR: 1.12-95% CI 1.02-1.23) were considered risk factors for overweight. Having the first birth after 18 years of age (PR: 0.89-95% CI 0.82 to 0.97) was shown to be a protective factor for overweight and obesity. The presence of overweight and obesity is associated with sociodemographic, reproductive, clinical and eating habits.

Menopause and metabolic syndrome in the Middle East countries; a systematic review and meta-analysis study

INTRODUCTION

Metabolic syndrome (MetS) prevalence that is associated with increasing risk of diabetes and cardiovascular diseases (CVD) has accelerated with age. Since, menopause is known as a partial cause of CVD accelartion with againg among women, determining the prevalence of MetS is important in this condition. We aimed to assess critically the prevalence rate of MetS among menopaused women in the Middle East Countries in this systematic review meta-analysis study.

METHODS & MATERIALS

International webdata bases including Scopus, ISI web of Science and PubMed were systematically searched using Medical Subject Headings terms from January 2000 to February 2017. We included all cross-sectional conducted in the Middle East that reported prevalence of MetS in menopause status regardless of MetS definition. Quality assessment was considered for each included study. The pooled prevalence of MetS based on the Adult Treatment Panel III (ATP III) was estimated using random effect method due to between-study heterogeneity by STATA software, version 11.0 (StataCorp, USA).

RESULTS

Within 60 studies, 21 and 17 studies were included in qualitative synthesis and meta-analysis respectively. The prevalence of MetS among menopaused women was estimated 54.87% (95% CI: 53.76-55.97) in the Middle East countries. In sub-group analysis based on country the prevalence rate of MetS in Iran and Turkey was estimated 58.78% (95% CI: 57.54-60.02), and 39.02% (95% CI: 36.57-41.47), respectively.

CONCLUSIONS

MetS was highly prevalent as an alarming sign among menopaused women in the Middle East countries. Thus, it is an emergency requirement to promote healthy lifestyle. Also, early detection and treatment of women who reach menopause and are at great risk of developing MetS is necessary for prevention of diabetes and CVD in the region.

The association between metabolic syndrome and asymptomatic carotid artery stenosis in menopausal women: a cross-sectional study in a Chinese population

Background

To examine the association of metabolic syndrome (MetS) with carotid artery stenosis (CAS), especially in menopausal women in China.

Materials and methods

A cross-sectional study of menopause women aged ≥40 years were enrolled from the Jidong community of Tangshan City between 2013 and 2014 to examine the association between MetS and CAS. Logistic regression analyses were performed to analyze the association between MetS and the presence of CAS.

Results

A total of 762 menopause women with mean age 59.3±5.6 years were enrolled in our analysis. Of all the people, 111 participants in CAS group (n=159) and 297 participants in no CAS group (n=603) were diagnosed with MetS meantime. Menopausal women with MetS had increased risk of CAS (OR, 2.383; 95% CI, 1.639–3.464), and the association was further verified by adjusting for confounding factors (OR, 1.949; 95% CI, 1.269–2.994). In addition, age, physical activity (never or moderate), body mass index (>24 kg/m²), and family income (<3,000 RMB) were independent important factors to CAS development in those with MetS.

Conclusion

MetS is associated with CAS especially in women after menopause.

The prevalence of metabolic syndrome in postmenopausal women: A systematic review and meta-analysis in Iran

Metabolic syndrome is a set of cardiovascular risk factors that increase the risk of cardiovascular disease, diabetes and mortality. Women are at risk of developing metabolic syndrome as they enter the postmenopausal period. The present systematic review and meta-analysis was conducted to estimate the prevalence of metabolic syndrome in Iranian postmenopausal women. In this systematic review and meta-analysis, 16 national articles published in Persian and English were gathered without time limit. National databases such as SIDs, IranMedex and MagIran, and international databases such as Web of Science, Google Scholar, PubMed and Scopus were used to search the relevant studies. We searched for articles using the keywords "menopause", "postmenopausal", "metabolic syndrome", "MetSyn", and their combinations. Data were analyzed using the meta-analysis method and the random effects model. Analysis of 16 selected articles with a sample size of 5893 people showed that the prevalence of metabolic syndrome in Iranian postmenopausal women was 51.6% (95% CI: 43-60). The prevalence of metabolic syndrome based on ATP III and IDF criteria was 54% (95% CI: 59-63) and 50% (95% CI: 45-56), respectively. Based on the results of univariate meta-regression analysis, the increase in the mean age of postmenopausal women (p = 0.001) and sample size (p = 0.029), the prevalence of metabolic syndrome increased significantly. More than half of postmenopausal women in Iran suffer from metabolic syndrome. Providing training programs for postmenopausal women to prevent and control cardiovascular disease and its complications seems to be necessary.

Dietary Intake, Physical Activity and Body Mass Index among Postmenopausal Women

Context:

Nutrition plays a vital role in the quality of life in postmenopausal women.

Aim:

The aim is to determine the dietary intake, physical activity, and assess the body mass index (BMI) among postmenopausal women.

Settings and Design:

A community-based sample survey.

Materials and Methods:

The present study included 140 postmenopausal women (40–70 years) from Udupi, Manipal areas of Karnataka. The study was carried out between July and December 2013. Sociodemographic data were collected using a questionnaire. Anthropometric data included height, weight, waist, and hip circumference. Dietary intake was determined using 24 h dietary recall. Physical activity information was collected.

Statistical Analysis Used:

Data were analyzed using SPSS version 16 software. Paired t-test was performed to determine the dietary adequacy.

Results:

Obesity was 42.1% among the study participants. Increased WHR and waist circumference were 82.1% and 77.1%. Mean daily intake of calcium and saturated fatty acids were significantly higher than recommended dietary allowance (RDA) (P < 0.001). Mean intake of energy, protein, carbohydrate, mono and poly unsaturated fatty acid, fiber and sodium were significantly lower than RDA (P < 0.001). Average daily intake of cereals, pulses, roots and tubers, meat and products, fats and oils, green leafy, and other vegetables were significantly (P < 0.001) lower than RDA. Intake of fruits, milk and milk products, and sugar was significantly higher (P < 0.001) than RDA. Only 37.1% of women performed moderate or active exercises regularly.

Conclusions:

Even though, nutrient and food group deficiencies were observed among postmenopausal women physical inactivity and effects of menopausal transition instigate increased BMI imposing a need to educate on nutrition and physical activity.