Prevalence and trends of metabolic syndrome in Korea: Korean National Health and Nutrition Survey 1998-2001

Global prevalence of sexual dysfunction among women with metabolic syndrome: a systematic review and meta-analysis

Background

Sexual dysfunction is a common disorder among women, especially during menopause. Metabolic syndrome is a multifactorial disease that, according to previous studies, there is a relationship between the metabolic syndrome and sexual dysfunction among women. The aim of this systematic review and meta-analysis is to obtain the prevalence of Female Sexual Dysfunction (FSD) among women with metabolic syndrome, and to analyze available related evidence.

Methods

In this systematic review and meta-analysis, the keywords of MeSH, female sexual dysfunction, FSD, metabolic syndrome were searched in PubMed, Web of Science, Scopus, Science Direct and Google Scholar. The searches were conducted without a lower time limit and until May 2022.

Results

The prevalence of FSD among women with metabolic syndrome was found to be 39.3% (95% CI: 28.3-51.5). In the subgroup analysis and in the review of 4 studies, the prevalence of sexual dysfunction in postmenopausal women with metabolic syndrome was 49.8% (95% CI: 26.1-73.6). Analyzing the results of the meta-regression test in examining the effect of the three factors of sample size, year of the study, age, and BMI of the patients on the heterogeneity of the meta-analysis, showed that with the increase of the sample size, the prevalence of sexual dysfunction among women with metabolic syndrome decreases (p < 0.05). Moreover, the prevalence of sexual dysfunction among women with metabolic syndrome increases (p < 0.05) with the increase in the years of conducting studies and the mean of age of women with metabolic syndrome. Also, with increasing mean of BMI of female patients with metabolic syndrome, the prevalence of sexual dysfunction in these women also increases (p < 0.05).

Conclusion

Female sexual dysfunction is a global health problem that can affect women's life to a great extent. Metabolic syndrome, which is a set of factors such as obesity, high blood pressure, and diabetes, affects sexual dysfunction in women. From this study, it can be concluded that there is a close relationship between metabolic syndrome and female sexual dysfunction.

Macronutrient Intake in Adults Diagnosed with Metabolic Syndrome: Using the Health Examinee (HEXA) Cohort

Macronutrient intake is important in the prevention and management of metabolic syndrome (MetS). This study aimed to evaluate total energy and macronutrient intake of participants diagnosed with MetS at recruitment of the health examinees (HEXA) cohort, considering the plant and animal sources of each macronutrient. We included 130,423 participants aged 40-69 years for analysis. Odds ratios (OR) and 95% confidence intervals (CI) were estimated to evaluate the intake of macronutrients stratified by gender. Energy and macronutrient intake were estimated by linking food frequency questionnaire data to the Korean food composition database, and were calculated separately for plant and animal foods. Low energy (men: OR = 0.95, 95% CI: 0.92-0.98; women: OR = 0.97, 95% CI: 0.95-0.99), and fat intake (men: OR = 0.93, 95% CI: 0.90-0.96; women: OR = 0.80, 95% CI: 0.77-0.83) were observed. Only postmenopausal women had lower intake of total energy (OR = 0.95, 95% CI: 0.92-0.97), whereas low fat intake was observed in all women (OR = 0.80, 95% CI: 0.77-0.83). For carbohydrate intake, the OR were 1.14 (95% CI: 1.08-1.22) and 1.17 (95% CI: 1.08-1.27) among women in their 50s and 60s, respectively. Protein intake was low (OR = 0.90, 95% CI: 0.86-0.95; and OR = 0.88, 95% CI: 0.82-0.94) among women in their 50s and 60s, respectively. High intake of plant carbohydrates in women (OR = 1.16, 95% CI: 1.12-1.20), and plant protein in both genders (OR = 1.09, 95% CI: 1.05-1.13) were observed, but low intake of total energy, fat, and animal-source carbohydrates in both genders was also observed. Fat intake was low regardless of food source. In conclusion, high consumption of plant-source macronutrients, and low consumption of animal-source macronutrients was observed in Korean adults diagnosed with MetS. Attention should be directed to plant sources of carbohydrates and proteins when designing population interventions for metabolic syndrome reduction in Korea.

Comparison of metabolic syndrome and related factors in married pre-menopausal white- and blue-collar woman

This study aimed to identify the prevalence and associated factors of metabolic syndrome in pre-menopausal married women with white-collar and blue-collar jobs. This study analyzed 4,447 women with jobs in the Korean National Health and Nutrition Examination Survey (2010-2018). The prevalence of metabolic syndrome was higher among blue-collar women (15.3%) than among white-collar women (10.5%). Age, family type, alcohol consumption, frequency of high-risk drinking, perceived health status, and body mass index (BMI) were significantly associated with metabolic syndrome in the white-collar (p < .05). Age, family type, frequency of eating out, and BMI were associated in the blue-collar (p < .05). Blue-collar women were more vulnerable to metabolic syndrome than white-collar ones. To prevent metabolic syndrome in pre-menopausal married women with jobs, lifestyle modifications such as mitigating obesity and reducing alcohol consumption with aging are necessary.

Impact of Sociodemographic Characteristics, Lifestyle, and Obesity on Coexistence of Diabetes and Hypertension: A Structural Equation Model Analysis amongst Chinese Adults

Background

In general, given the insufficient sample size, considerable literature has been found on single studies of diabetes and hypertension and few studies have been found on the coexistence of diabetes and hypertension (CDH) and its influencing factors with a large range of samples. This study aimed to establish a structural equation model for exploring the direct and indirect relationships amongst sociodemographic characteristics, lifestyle, obesity, and CDH amongst Chinese adults.

Methods

A cross-sectional study was conducted in a representative sample of 25356 adults between June 1, 2015, and September 30, 2018, in Hubei province, China. Confirmatory factor analysis was initially conducted to test the latent variables. A structural equation model was then performed to analyse the association between latent variables and CDH.

Results

The total prevalence of CDH was 2.8%. The model paths indicated that sociodemographic characteristics, lifestyle, and obesity were directly associated with CDH, and the effects were 0.187, 0.739, and 0.353, respectively. Sociodemographic characteristics and lifestyle were also indirectly associated with CDH, and the effects were 0.128 and 0.045, respectively. Lifestyle had the strongest effect on CDH (β = 0.784, P < 0.001), followed by obesity (β = 0.353, P < 0.001) and sociodemographic characteristics (β = 0.315, P < 0.001). All paths of the model were significant (P < 0.001).

Conclusion

CDH was significantly associated with sociodemographic characteristics, lifestyle, and obesity amongst Chinese adults. The dominant predictor of CDH was lifestyle. Targeting these results might develop lifestyle and weight loss intervention to prevent CDH according to the characteristics of the population.

Predicting length of stay and mortality among hospitalized patients with type 2 diabetes mellitus and hypertension

BACKGROUND

Type 2 diabetes mellitus (T2DM) and hypertension (HTN), both non-communicable diseases, are leading causes of death globally, with more imbalances in lower middle-income countries. Furthermore, poor treatment and management are known to lead to intensified healthcare utilization and increased medical care costs and impose a significant societal burden, in these countries, including Indonesia. Predicting future clinical outcomes can determine the line of treatment and value of healthcare costs, while ensuring effective patient care. In this paper, we present the prediction of length of stay (LoS) and mortality among hospitalized patients at a tertiary referral hospital in Tasikmalaya, Indonesia, between 2016 and 2019. We also aimed to determine how socio-demographic characteristics, and T2DM- or HTN-related comorbidities affect inpatient LoS and mortality.

METHODS

We analyzed insurance claims data of 4376 patients with T2DM or HTN hospitalized in the referral hospital. We used four prediction models based on machine-learning algorithms for LoS prediction, in relation to disease severity, physician-in-charge, room type, co-morbidities, and types of procedures performed. We used five classifiers based on multilayer perceptron (MLP) to predict inpatient mortality and compared them according to training time, testing time, and Area under Receiver Operative Curve (AUROC). Classifier accuracy measures, which included positive predictive value (PPV), negative predictive value (NPV), F-Measure, and recall, were used as performance evaluation methods.

RESULTS

A Random forest best predicted inpatient LoS (R2, 0.70; root mean square error [RMSE], 1.96; mean absolute error [MAE], 0.935), and the gradient boosting regression model also performed similarly (R2, 0.69; RMSE, 1.96; MAE, 0.935). For inpatient mortality, best results were observed using MLP with back propagation (AUROC 0.899; 69.33 and 98.61 for PPV and NPV, respectively). The other classifiers, stochastic gradient descent with regression loss function, Huber, and random forest models all showed an average performance.

CONCLUSIONS

Linear regression model best predicted LoS and mortality was best predicted using MLP. Patients with primary diseases such as T2DM or HTN may have comorbidities that can prolong inpatient LoS. Physicians play an important role in disseminating health related information. These predictions could assist in the development of health policies and strategies that reduce disease burden in resource-limited settings.

Genetic correlation and causal relationships between cardio-metabolic traits and lung function impairment

BACKGROUND

Associations of low lung function with features of poor cardio-metabolic health have been reported. It is, however, unclear whether these co-morbidities reflect causal associations, shared genetic heritability or are confounded by environmental factors.

METHODS

We performed three analyses: (1) cardio-metabolic health to lung function association tests in Northern Finland Birth cohort 1966, (2) cross-trait linkage disequilibrium score regression (LDSC) to compare genetic backgrounds and (3) Mendelian randomisation (MR) analysis to assess the causal effect of cardio-metabolic traits and disease on lung function, and vice versa (bidirectional MR). Genetic associations were obtained from the UK Biobank data or published large-scale genome-wide association studies (N > 82,000).

RESULTS

We observed a negative genetic correlation between lung function and cardio-metabolic traits and diseases. In Mendelian Randomisation analysis (MR), we found associations between type 2 diabetes (T2D) instruments and forced vital capacity (FVC) as well as FEV1/FVC. Body mass index (BMI) instruments were associated to all lung function traits and C-reactive protein (CRP) instruments to FVC. These genetic associations provide evidence for a causal effect of cardio-metabolic traits on lung function. Multivariable MR suggested independence of these causal effects from other tested cardio-metabolic traits and diseases. Analysis of lung function specific SNPs revealed a potential causal effect of FEV1/FVC on blood pressure.

CONCLUSIONS

The present study overcomes many limitations of observational studies by using Mendelian Randomisation. We provide evidence for an independent causal effect of T2D, CRP and BMI on lung function with some of the T2D effect on lung function being attributed to inflammatory mechanisms. Furthermore, this analysis suggests a potential causal effect of FEV1/FVC on blood pressure. Our detailed analysis of the interplay between cardio-metabolic traits and impaired lung function provides the opportunity to improve the quality of existing intervention strategies.

Prevalence Risk of Metabolic Syndrome Associated with Alcohol Use Behavior in Korean Women

OBJECTIVE

Considerable research has been conducted on the relationship between alcohol consumption and metabolic syndrome. Although various standards for the amount and frequency of alcohol consumption have been suggested, a tool to measure individual alcohol use behavior against a consistent standard is required. Moreover, the association of alcohol use behavior with health should be examined on the basis of such a standard. In this study, we examined the relationships between alcohol use behavior according to the Alcohol Use Disorders Identification Test (AUDIT) and metabolic syndrome and its components in Korean women.

METHODS

This study utilized data from the fifth Korean National Health and Nutrition Examination Survey, which was administered from 2010 through 2012. We investigated the relationships between alcohol use behavior and metabolic syndrome and its components in a sample of 2,906 women by using analysis of covariance and logistic regression analysis.

RESULTS

After adjusting for confounding variables, alcohol use behavior was significantly associated with metabolic syndrome [odds ratio (OR) 2.877; 95% confidence interval (CI) 1.523-5.435 in the problem use group]. AUDIT score also was significantly related to abdominal obesity (OR 2.263; 95% CI 1.704-4.459 in the problem use group), hypertension (OR 3.377; 95% CI 1.871-6.095 in the problem use group), hypertriglyceridemia (OR 3.204; 95% CI 1.800-5.702 in the problem use group), and impaired fasting glucose (OR 3.034; 95% CI 1.721-5.348 in the problem use group).

CONCLUSION

In this study, positive associations were observed between AUDIT score and risk of metabolic syndrome and its components.

Association of peptic ulcer disease with obesity, nutritional components, and blood parameters in the Korean population

Objectives

Peptic ulcer disease (PUD) is a common disorder, but whether an association exists between PUD and anthropometric indicators remains controversial. Furthermore, no studies on the association of PUD with anthropometric indices, blood parameters, and nutritional components have been reported. The aim of this study was to assess associations of anthropometrics, blood parameters, nutritional components, and lifestyle factors with PUD in the Korean population.

Methods

Data were collected from a nationally representative sample of the South Korean population using the Korea National Health and Nutrition Examination Survey. Logistic regression was used to examine associations of anthropometrics, blood parameters and nutritional components among patients with PUD.

Results

Age was the factor most strongly associated with PUD in women (p = <0.0001, odds ratio (OR) = 0.770 [0.683–0.869]) and men (p = <0.0001, OR = 0.715 [0.616–0.831]). In both crude and adjusted analyses, PUD was highly associated with weight (adjusted p = 0.0008, adjusted OR = 1.251 [95%CI: 1.098–1.426]), hip circumference (adjusted p = 0.005, adjusted OR = 1.198 [1.056–1.360]), and body mass index (adjusted p = 0.0001, adjusted OR = 1.303 [1.139–1.490]) in women and hip circumference (adjusted p = 0.0199, adjusted OR = 1.217 [1.031–1.435]) in men. PUD was significantly associated with intake of fiber (adjusted p = 0.0386, adjusted OR = 1.157 [1.008–1.328], vitamin B2 (adjusted p = 0.0477, adjusted OR = 1.155 [1.001–1.333]), sodium (adjusted p = 0.0154, adjusted OR = 1.191 [1.034–1.372]), calcium (adjusted p = 0.0079, adjusted OR = 1.243 [1.059–1.459]), and ash (adjusted p = 0.0468, adjusted OR = 1.152 [1.002–1.325] in women but not in men. None of the assessed blood parameters were associated with PUD in women, and only triglyceride level was associated with PUD in men (adjusted p = 0.0169, adjusted OR = 1.227 [1.037–1.451]).

Discussion

We found that obesity was associated with PUD in the Korean population; additionally, the association between nutritional components and PUD was greater in women than in men.

The association between intraocular pressure and different combination of metabolic syndrome components

BACKGROUND

Although the association between metabolic syndrome and intraocular pressure is well known, the relationship between the intraocular pressure and different combination of the components of metabolic syndrome has not been actively researched yet. The study aimed to investigate the relationship between the intraocular pressure and metabolic syndrome components with their different combinations.

METHODS

Thirty-one thousand two hundred seventy one healthy people aged 19-79 who attended a community hospital for a health check-up between January 2011 and December 2013 were enrolled in the study. Subjects with a history of intraocular disease, at least in one eye and those receiving medical treatment for glaucoma were excluded. Metabolic syndrome was diagnosed following the criteria defined in Circulation 2009.

RESULTS

Subjects with combination of three metabolic syndrome components of triglycerides, abdominal obesity, and fasting glucose had the highest intraocular pressure. And subjects with the combination of four components of blood pressure, high-density lipoproteins, triglycerides, fasting glucose had a significantly higher intraocular pressure than ones with the combination of all five metabolic syndrome components.

CONCLUSIONS

The difference in the risk of high intraocular pressure according to the different combination of the metabolic syndrome components could be confirmed. If additional follow-up studies are conducted, the findings can be used as an indicator for predicting intraocular pressure increases in patients with metabolic syndrome.

Low-carbohydrate-diet score and metabolic syndrome: An epidemiologic study among Iranian women

OBJECTIVE

Epidemiologic studies linking carbohydrate consumption and risk for metabolic syndrome (MetS) are limited. The association between low-carbohydrate-diet score and MetS has not been investigated. The aim of this study was to investigate low-carbohydrate-diet score in relation to MetS among a group of Iranian women.

METHOD

This cross-sectional study was conducted with 442 Iranian female teachers >20 y of age. Usual dietary intakes were assessed using a validated, dish-based semiquantitative food frequency questionnaire. Metabolic syndrome was defined according to the American Heart Association/National Heart, Lung, and Blood Institute/International Diabetes Federation definition guidelines.

RESULTS

The prevalence of MetS in the lowest and highest quintile of low-carbohydrate-diet score was 17.5% and 18.8%, respectively (P = 0.97). There was no statistically significant difference in the prevalence between extreme quartiles low-carbohydrate-diet score and MetS (odds ratio, 0.93; 95% confidence interval, 0.38-2.28). After controlling for age, energy intake, and other potential confounders, low-carbohydrate-diet score was not significantly associated with MetS. A significant association was observed between this score and abnormal fasting plasma glucose. We failed to find a significant relationship between this score and other components of MetS.

CONCLUSIONS

Diets with lower amounts of carbohydrate and higher contents of fat and protein were not significantly associated with the risk for MetS in a cross-sectional study with a group of Iranian women. More longitudinal studies are needed to confirm these results.

Prevalence and determinants of metabolic syndrome among adults in a rural area of Northwest China

OBJECTIVES

To evaluate the prevalence and determinants of metabolic syndrome (MetS) among adults in a rural area of Northwest China.

METHODS

A population-based cross-sectional study was conducted in 2010 among adults aged 18 to 80 years in rural areas of Hanzhong, in Northwest China. Interview, physical and clinical examinations, and fasting blood glucose and lipid measurements were completed for 2990 adults. The definitions of MetS proposed by the Third Report of the National Cholesterol Education Program Expert Panel (Adults Treatment Panel III, ATP III) and the International Diabetes Federation (IDF), and the modified ATP III definition for Asian population were used and compared. Proportions were adjusted for age and sex.

RESULTS

The prevalence of MetS was 7.9%, 10.8% and 15.1% according to ATP III, IDF and modified ATP III criteria, respectively. Agreement between ATP III and IDF criteria and that between ATP III and modified ATP III criteria were moderate (Kappa = 0.52 and 0.64, respectively), whereas agreement between IDF and modified ATP III criteria was good (Kappa = 0.83). The prevalence of MetS increased with age, and was higher in women than in men (10.4% versus 5.4%, 13.6% versus 8.1% and 17.4% versus 12.8%, according to ATP III, IDF and modified ATP III criteria, respectively). The most common MetS component was high blood pressure. Having family history of hypertension, lack of physical activity, high economical level, overweight and obesity were positively associated with MetS.

CONCLUSIONS

MetS is prevalent among rural adults in Northwest China and high blood pressure is the most common MetS component. Prevention and treatment of hypertension and MetS should be a public health priority to reduce cardiovascular diseases in rural areas of Northwest China. More attention should be given to the elderly, women, people with family history of hypertension and obese people who are at high risk of MetS.

Prevalence of the Metabolic Syndrome among Korean Workers by Occupational Group: Fifth Korean National Health and Nutrition Examination Survey (KNHANES) 2010

OBJECTIVES

The prevalence of the metabolic syndrome has increased rapidly in South Korea over the past 10 years. However, the occurrence of the metabolic syndrome in workers grouped according to the specific type of work is not well understood in Korea. In this study, we assessed the differences in the prevalence of the metabolic syndrome by occupational group and evaluated the risk of the metabolic syndrome among occupational groups.

METHODS

From the Fifth Korean National Health and Nutrition Examination Survey (2010), 3,303 employed participants were included in this study. The unadjusted and age-adjusted prevalences of the metabolic syndrome were estimated and multiple logistic regression analysis was conducted using the presence of the metabolic syndrome as a dependent variable, and adjusting for age, education level, household income, drinking behavior, smoking status, physical activity, work hours, and work scheduling pattern.

RESULTS

Among male workers, non-manual workers had the greatest age-adjusted prevalence (26.4%, 95% CI: 22.3-30.5%) among the occupational groups. In a logistic regression analysis, male manual workers had a significantly lower odds ratio for the metabolic syndrome relative to non-manual workers (0.59, 95% CI: 0.41-0.85).

CONCLUSION

Our study demonstrated differences in the prevalence of the metabolic syndrome by occupational group and identified the greatest risk for the metabolic syndrome in male non-manual workers.

Prevalence of metabolic syndrome among newly diagnosed hypertensive patients in the hills of Himachal Pradesh, India

To study the prevalence of metabolic syndrome (MS) among newly diagnosed hypertensive patients in a tertiary care hospital in the northern hilly state of Himachal Pradesh, India, located in western Himalayas at a moderate altitude of 2200 m above mean sea level. One hundred and eighteen newly diagnosed hypertensive patients above the age of 20 years were studied in a hospital-based cross-sectional study. MS prevalence was estimated by International Diabetes Federation (IDF) criteria and modified National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria. Student's t-test was used to compare the mean of the continuous variables. Chi-square test was used to compare discrete variables. The prevalence of MS in hypertensive patients was 68.6% (modified NCEP-ATP III) and 63.6% (IDF criteria). The most common phenotype of MS with the component of hypertension was the coexistence of waist circumference (90.1%), low high-density lipoprotein (HDL; 70.4%), and high triglycerides (67.9%) as per the modified NCEP-ATP III criteria, and low HDL (76.2%) and high triglycerides (66.4%) as per the IDF criteria. Fasting blood glucose (33.2% as per the modified NCEP-ATP III criteria and 32.6% as per the IDF criteria) was the least significant factor having an association with MS. The prevalence of MS among hypertensive patients was high and indicates the need for metabolic screening in all hypertensive patients at the first diagnosis.

Associations of the PTEN -9C>G polymorphism with insulin sensitivity and central obesity in Chinese

BACKGROUND

Phosphatase and tensin homolog on chromosome 10 gene (PTEN) is known as a tumor-suppressor gene. Previous studies demonstrated that PTEN dysfunction affects the function of insulin. However, investigations of PTEN single nucleotide polymorphisms (SNPs) and IR-related disease associations are limited. The aim of the present study was to investigate whether its polymorphism could be involved in the risk of metabolic syndrome (MetS).

METHODS

The genotype frequency of PTEN -9C>G polymorphism was determined by using a Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) method in 530 subjects with MetS and 202 healthy control subjects of the Han Ethnic Chinese population in a case-control analysis.

RESULTS

The PTEN -9C>G polymorphism was not associated with MetS or its hyperglycemia, hypertension and hypertriglyceridemia components. In the control individuals aged <60 years or ≥60 years, the CG genotype individuals had lower insulin sensitivity than CC individuals (P<0.05). In the <60-year-old MetS group and normal glucose tolerance (NGT) subgroup, the CG individuals had lower insulin sensitivity and higher waist circumference (WC) and waist-height-ratio (WHtR) than CC individuals (P<0.05). Multiple linear regression analysis showed that the PTEN polymorphism (P=0.001) contributed independently to 4.2% (adjusted R(2)) of insulin sensitivity variance (estimated by Matsuda ISI), while age (P=0.004), gender (P=0.000) and the PTEN polymorphism (P=0.032) contributed independently to 5.6% (adjusted R(2)) of WHtR variance.

CONCLUSIONS

The CG genotype of PTEN -9C>G polymorphism was not associated with MetS and some of its components as well. However, it may not only decrease insulin sensitivity in the healthy control and MetS in pre-elderly or NGT subjects, but may also increase the risk of central obesity among these MetS individuals.

What about non-alcoholic fatty liver disease as a new criterion to define metabolic syndrome?

Non-alcoholic fatty liver disease (NAFLD) is currently not a component of the diagnostic criteria for metabolic syndrome (MetS); however, the development of NAFLD has some common mechanisms with the development of MetS, as they share the pathophysiologic basis of insulin resistance. It is also recognized that NAFLD is the hepatic manifestation of MetS. To define MetS, the presence of at least three of the proposed criteria is required, and sometimes it is sufficient to have only one laboratory value, modified by diet or drugs, for the classification of MetS. Ultrasonographically-detected NAFLD (US-NAFLD) is more stable, only changing during the middle- to long-term. Although controversies over MetS continue, and considering that abdominal ultrasonography for diagnosing NAFLD has high specificity and guidelines to modify the natural course of NAFLD by diet composition or lifestyle have not yet been established, why should we not introduce US-NAFLD as a new criterion to define MetS?

Prevalence of the metabolic syndrome in the Yan-an region of northwest China

OBJECTIVES

To evaluate the prevalence of the metabolic syndrome in a sample population from northwest China, and to determine the optimal cut-off point for waist circumference for diagnosing the metabolic syndrome in this population.

METHODS

A total of 1290 residents of the Yan-an region of China completed a cross-sectional survey, physical examination and laboratory tests. The International Diabetes Federation (IDF), Chinese Diabetes Society (CDS), and the National Cholesterol Education Program Adults Treatment Panel-III (NCEP-ATPIII) criteria were used to assess the prevalence of the metabolic syndrome and its relationship with age and gender.

RESULTS

According to the NCEP-ATPIII, CDS and IDF diagnostic criteria, the prevalence of the metabolic syndrome was 15.8%, 20.4% and 26.4%, respectively. The optimal cut-off point for waist circumference was ≥ 86.5 cm for men and ≥ 80.5 cm for women.

CONCLUSIONS

The prevalence of the metabolic syndrome in the Yan-an region was significantly higher than that in other regions of China, and participants with the metabolic syndrome were much younger than those in other Chinese regions.

The prevalence and correlation of carotid artery calcification on panoramic radiographs and peripheral arterial disease in a population from the Republic of Korea: the Dong-gu study

OBJECTIVES

The aim of this study was to determine the prevalence of carotid artery calcification (CAC) detected on panoramic radiographs and peripheral arterial disease (PAD), and to evaluate the difference in the prevalence of PAD between patients with CAC and patients without CAC detectable by panoramic radiograph.

METHODS

The surveyed population consisted of 4078 subjects aged 50 years and older (1410 males and 2668 females) who underwent medical and dental examination in Gwangju city, South Korea. Two oral and maxillofacial radiologists interpreted the panoramic radiographs for the presence of carotid artery calcification. A trained research technician measured the ankle-brachial index (ABI). An ABI <0.9 in either leg was considered evidence of PAD.

RESULTS

The prevalence of CAC on panoramic radiographs was 6.2% and that of PAD was 2.6%. Subjects with CAC had a significantly higher prevalence of PAD than those without CAC (5.5% vs 2.4%, respectively). The presence of CAC on panoramic radiographs was associated with PAD (odds ratio 1.84; 95% confidence interval 1.01-3.36) after adjusting for potential confounders.

CONCLUSION

CACs detected on panoramic radiographs were positively associated with PAD in middle-aged and older Korean adults.

Association of colorectal adenoma with components of metabolic syndrome

PURPOSE

Recently, some studies have shown that diabetes mellitus and metabolic syndrome increase the risk of colorectal neoplasms. Although the mechanism is not known, those have been proposed to contribute to this phenomenon, including insulin resistance, oxidative stress, and adipokine production. The objective of this study was to assess the association between metabolic risk factors and colorectal neoplasm.

METHODS

Study participants visited the National Cancer Center, Korea, for screening (2007-2009). A total of 1,771 diagnosed adenoma patients and 4,667 polyp-free controls were included. The association between risk factors and colorectal neoplasm was evaluated using logistic regression models.

RESULTS

High waist circumference, blood pressure, and serum triglyceride levels were associated with an increased risk of colorectal adenoma. Metabolic syndrome (MS) was associated with an increased risk of adenoma (OR = 1.44, 95 % CI = 1.23-1.70). The association between MS and colorectal adenoma was observed regardless of advanced/low-risk adenoma, and multiplicity. MS affected right colon adenomas (OR = 1.50, 95 % CI = 1.22-1.85), left colon adenomas (OR = 1.36, 95 % CI = 1.05-1.76), and adenomas in multiple anatomical locations (OR = 1.59, 95 % CI = 1.19-2.12), but was not associated with rectum.

CONCLUSION

Central obesity, triglyceride level, and MS are risk factors for colorectal adenoma including advanced adenoma and multiplicity.

Alcohol consumption and its relation to visceral and subcutaneous adipose tissues in healthy male Koreans

AIMS

The purpose of the present study is to investigate the association of alcohol with visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) distribution and metabolic syndrome (MetS).

DESIGN

We conducted a cross-sectional study in 951 healthy male Korean participants who underwent health checkups. We measured the cross-sectional areas of VAT and SAT by computed tomography of the abdomen and performed a study of alcohol consumption based on questionnaire responses and a 24-hour dietary recall assessment. We analyzed the relationship of alcohol consumption with VAT, SAT, and MetS.

RESULTS

Alcohol consumption showed a negative association with SAT (β = -18.76, p = 0.047) but a positive association with VAT (β = 17.70, p = 0.037), independent of other factors. The adjusted odds ratios for MetS for those who consumed <7, 7 to <14, 14 to <28, and ≥28 standard drinks per week were 0.99 (0.59-1.68), 1.49 (0.84-2.63), 1.95 (1.10-3.45), and 1.99 (1.07-3.70), respectively (p for linear trend = 0.042).

CONCLUSIONS

Alcohol consumption is associated with decreased SAT and increased VAT accumulation. Further, alcohol consumption of ≥14 standard drinks is associated with an increased risk of MetS. Light-to-moderate drinking, which has been regarded to lower the risk of cardiovascular diseases, did not show a protective effect on adipose tissue accumulation.

Metabolic syndrome in the Mediterranean region: Current status

Metabolic syndrome (MetS) is a cluster of metabolic abnormalities including abdominal obesity, impaired fasting glucose, hypertension and dyslipidemia. It seems to affect about one-fourth to one-fifth of the Mediterranean population, and its prevalence increases with age, being similar for both sexes and depending on the region and the definition used, with the National Cholesterol Education Program-Adult Treatment Panel-III (NCEP-ATPIII) definition being the most effective in the identification of glucose intolerance and cardiovascular risk. Except for these, MetS is associated with fatty liver disease, some forms of cancer, hypogonadism, and vascular dementia. The Mediterranean diet seems to be an ideal diet in patients with MetS, being rich in fibre, monounsaturated and polyunsaturated fats, and low in animal protein; and decreases the prevalence of MetS and cardiovascular disease risk. Except for weight loss, multifactorial intervention including insulin resistance reduction and normoglycemia, management of dyslipidemia, optimizing blood pressure and administration of low-dose aspirin for patients at high or moderately high cardiovascular disease (CVD) risk are additional targets. The present review provides current understanding about MetS in the Mediterranean region, focusing on its prevalence, clinical significance, and therapeutic strategy.

Evaluation of metabolic syndrome in patients with chronic low back pain: using the fourth Korea national health and nutrition examination survey data

The aim of this study was to investigate the frequency of the metabolic syndrome in patients with chronic lower back pain in Korea and to evaluate the differences in clinical characteristics in chronic lower back pain patients with and without metabolic syndrome. This was a cross-sectional study using data from the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) 2008. The sample consisted of 1085 participants with chronic lower back pain. The diagnosis of metabolic syndrome was made according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and the Korean Society for the Study of Obesity. The prevalence of metabolic syndrome among chronic lower back pain patients was 36.2% (30.2% male, 38.6% female). According to our results, female sex, advanced age, and high BMI were risk factors for metabolic syndrome. These results from a representative sample show that metabolic syndrome is common in chronic lower back pain patients in Korea. Clinicians managing chronic lower back pain should consider the risk factors for metabolic syndrome.

Causes of different estimates of the prevalence of metabolic syndrome in Korea

BACKGROUND/AIMS

Reports of the prevalence of and trends in metabolic syndrome in Korea have been inconsistent. Thus, we investigated the reasons underlying these inconsistencies.

METHODS

We estimated the prevalence of metabolic syndrome using different diagnostic criteria, exclusion criteria, and sampling weights among 5,509 respondents, aged 20-79, who participated in the 2001 Korean National Health and Nutrition Examination Surveys (KNHANES). Trends in metabolic syndrome were assessed by examining the 1998 (n = 6,747), 2001 (n = 4,337), and 2005 (n = 5,139) KNHANES.

RESULTS

The estimated prevalence of metabolic syndrome in 2001 ranged from 1.6 to 29.6% in males and from 10.1 to 32.8% in females, depending on the diagnostic criteria used. The exclusion criteria and sampling weights did not significantly affect the prevalence estimates. The prevalence of metabolic syndrome first significantly increased and then decreased between 1998, 2001, and 2005 in males (26.2, 29.6, and 27.2%, respectively) and females (29.2, 32.8, and 24.7%, respectively). Among the individual metabolic variables, triglyceride levels in 2001 were significantly higher than in 1998 and 2005, whereas other variables remained relatively constant during the same period. The exceptionally high triglyceride levels in 2001 might have contributed to the increased prevalence of metabolic syndrome between 1998 and 2001.

CONCLUSIONS

Different diagnostic criteria for metabolic syndrome represent a major cause of the inconsistent estimates of prevalence, and the absence of standardized laboratory methods might have affected the trend estimates.

Metabolic syndrome is associated with increased risk of recurrent colorectal adenomas in Korean men

OBJECTIVE

Because of the high incidence of recurrent colorectal adenomas, regular surveillance by colonoscopy is recommended. However, there is still a shortage of information on the factors that influence the incidence of recurrent colorectal adenomas in patients with a history of these lesions. The aim of this study was to determine the association between the development of recurrent colorectal adenomas, metabolic syndrome and obesity.

SUBJECTS AND METHODS

The hospital-based cohort was composed of 193 patients who had recurrent colorectal adenomas removed between January 2002 and December 2003. The Cox proportional hazard model was used to determine hazard ratio (HR) and 95% confidence interval (CI) between obesity, metabolic syndrome and other factors, and the incidence of recurrent adenomatous polyps.

RESULTS

The mean follow-up period was 4.8 person-years. In all, 78 of the patients (40.4%) had recurrent colorectal adenomas. In the overall recurrent adenoma group, significant associations between metabolic syndrome (HR, 1.33; 95% CI, 1.02-1.73), waist circumference (WC) ≥ 90 cm (HR, 1.42; 95% CI, 1.06-1.90) and waist-hip ratio (WHR) ≥ 0.9 (HR, 2.03; 95% CI, 1.55-2.68) were found. Moreover, advanced adenomas were significantly associated with metabolic syndrome (HR, 2.81; 95% CI, 1.86-4.25), body mass index ≥ 25 kg m(-2) (HR, 2.69; 95% CI, 1.64-4.42), WC (HR, 2.16; 95% CI, 1.31-3.54) and WHR (HR, 1.99; 95% CI, 1.28-3.11). In addition, current smoking (HR, 2.60; 95% CI, 1.09-6.25) and alcohol consumption (HR, 2.20; 95% CI, 1.10-4.39) were also significantly associated with recurrent advanced adenoma.

CONCLUSION

Metabolic syndrome and obesity were significantly associated with the development of recurrent colorectal adenomas in Korean adult males. Furthermore, these associations were more strongly associated with advanced adenomas.

Association between metabolic syndrome and pelvic floor dysfunction in middle-aged to older Korean women

OBJECTIVE

The purpose of this study was to evaluate the association of metabolic syndrome (MS) with female pelvic floor dysfunction in middle-aged to older Korean women.

STUDY DESIGN

A prospective cross-sectional study was performed that included a total of 984 Korean women (≥ 40 years old) who visited a comprehensive medical screening clinic. Pelvic floor dysfunction was assessed by the Pelvic Floor Distress Inventory-20 (PFDI-20); higher scores indicated a greater symptom burden.

RESULTS

The adjusted mean score on the PFDI-20, and especially the Urinary Distress Inventory-6 subscale, was significantly higher in subjects with MS than those without MS. Furthermore, the PFDI-20 and all 3 subscales were significantly increased in correlation with the number of MS components that were present (P < .05). In the multivariable analysis, MS was associated significantly with PFDI-20 (P = .002) and the 3 subscores (P < .05).

CONCLUSION

MS was significantly associated with the pelvic floor dysfunction among middle- to old-aged Korean women. Physicians should pay more attention to the pelvic floor symptoms for the patients with MS.

Leptin:adiponectin ratio and metabolic syndrome in the general Japanese population

Background

Circulating leptin:adiponectin ratio (L:A) is a potential surrogate marker for cardiometabolic diseases; however, the relationship of the L:A with the occurrence of metabolic syndrome (MetS) has not yet been fully explored in the general Japanese population.

Methods

We enrolled 678 Japanese subjects (208 men and 470 women, mean age: 58.8±14.4 [SD] yr; mean body mass index: 23.6±3.3 kg/m²) in this study, and determined their MetS status by using the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) recommendations with minor modifications for the Japanese population. Biochemical markers such as leptin and adiponectin present in blood were measured. The statistical analyses performed were gender-based.

Results

A in subjects with MetS was significantly higher than that in subjects without MetS, regardless of gender. The L:A also showed a significant and gradual increase corresponding to the increase in the number of components of MetS present in both the genders (trend P<0.01). The cut-off level of the L:A to detect MetS was 0.59 (sensitivity: 0.72, specificity: 0.70) in men and 1.04 (sensitivity: 0.72, specificity: 0.69) in women.

Conclusions

These results suggest that the L:A can serve as a clinically useful marker for detecting MetS characteristics in the general Japanese population. The clinical application of this laboratory index for detecting MetS should be assessed in future studies.

The metabolic syndrome: prevalence, associated factors, and impact on survival among older persons in rural Bangladesh

Objectives

To describe the prevalence of the metabolic syndrome (MetS) among older persons in rural Bangladesh, to investigate whether the prevalence varies by age, sex, literacy, marital status, nutritional status and socio-economic status, and to assess the impact of MetS on survival.

Methods

The study consisted of 456 persons who were aged ≥60 years living in a rural area of Bangladesh during July 2003–March 2004. Data were collected through interview, clinical examination, and laboratory tests, and their survival status until 30^th June 2009 was ascertained through the Matlab surveillance system. We defined MetS following the NCEP ATP III criteria, with minor modifications, i.e., presence of any three of the following: hypertension (BP ≥130/85 mm Hg); random blood glucose (RBG) level ≥7.0 mmol/L; hyper-triglyceridemia (≥2.28 mmol/L); low level of HDL-cholesterol (<1.04 mmol/L for men and <1.29 mmol/L for women); and BMI ≥25.0 kg/m². Data were analysed with logistic regressions for the influential factors of MetS, and with Cox models for the association of MetS with the survival status.

Findings

The overall prevalence of MetS was 19.5%, 20.8% in women, and 18.0% in men. Asset-index and nutritional status were independently associated with MetS. During 4.93 years of follow-up, 18.2% died. In the presence of high RBG, MetS has a significant negative effect on survival (69.4% vs 95.2%, log rank p = 0.02).

Conclusion

This study highlights the importance of the metabolic syndrome in rural Bangladesh. Our findings suggest that there is a need for screening programmes involving the metabolic syndrome to prevent diabetes and cardiovascular diseases.

The association of serum vitamin D level with presence of metabolic syndrome and hypertension in middle-aged Korean subjects

OBJECTIVE

To examine the association of serum vitamin D level with metabolic syndrome (MetS) and hypertension (HTN) in middle-aged Korean subjects.

DESIGN AND SUBJECTS

We conducted a population-based, cross-sectional survey of 1330 participants aged over 40 years (median age 65.8 years) in Chungju, Korea, in 2007. The 324 subjects, who were normotensive in 2003 and who attended a follow-up visit 4 years later, were included in an analysis of the association of serum vitamin D level with the risk of HTN.

MEASUREMENTS

Serum 25-hydroxy-vitamin D [25(OH)D] and PTH were measured in a central laboratory, using chemiluminescence assays.

RESULTS

The overall prevalence of the MetS in participants of this study was 45.3%. After adjusting for various covariates, subjects in the highest quintile group (61.4-116.8 nmol/l) compared with the lowest quintile group (10.0-29.7 nmol/l) of 25(OH)D had an odds ratio (OR) for having MetS of 0.35 (95% confidence intervals, CI, 0.22-0.56; P for trend <0.001). The median level of 25(OH)D was 46.8 nmol/l among 324 subjects who were normotensive in 2003. After multiple adjustment, the OR was substantially higher for new HTN (OR 2.74; 95% CI 1.40-5.34) in subjects with serum 25(OH)D levels below the median value compared with those above median. The inverse associations of vitamin D and MetS/HTN were unchanged after adjustment for PTH and serum calcium levels. There was no association between PTH and MetS.

CONCLUSIONS

We found a strong inverse association of 25(OH)D levels with MetS and HTN in this middle-aged Korean population. Having vitamin D deficiency was associated with an increased risk of having MetS and HTN in this demographic group.

Sociodemographic risk factors of diabetes and hypertension prevalence in republic of Korea

This study examined the relationships between SES and diabetes and hypertension for Korean adults using the Korean National Health and Nutritional Examination Survey. To handle the four dummy dependent variables: Diabetes and Hypertension, Diabetes alone, Hypertension alone, and Diabetes or Hypertension, four different logistic models were conducted. The descriptive statistics showed a considerable amount of comorbidity between the combined dependent variable of diabetes and hypertension. To gauge more realistic measures of SES, education and income were combined together as four dummy categories. The SES factor indeed had significant impacts on diabetes and hypertension. Socioeconomically disadvantaged groups demonstrated to have increased likelihood of having these diseases. However, we could not find the strong compensating effect between education and income; the higher level of education but lower income variable was only significant in having both diseases, and the higher income but lower level of education variable was only significant in having hypertension alone and either one of the diseases. Only the highest SES one, the one with a higher level of education and a higher income, was significantly lowering the likelihood of having these diseases in all models. Therefore, public policy and intervention programs should focus on individuals matching these socioeconomic characteristics.

Increasing frequency and burden of cerebral artery atherosclerosis in Korean stroke patients

PURPOSE

Koreans have been undergoing rapid lifestyle changes that may have an effect on patterns of cerebral artery atherosclerosis. This study was aimed at determining the frequency and distribution of atherosclerosis in the cerebral arteries and associated temporal changes over the past eight-year period among Korean stroke patients.

MATERIALS AND METHODS

By using stroke registry data registered between April 1999 and March 2007, we investigated the presence, severity, and location of cerebral artery atherosclerosis as determined by angiographic findings. Their annual patterns and association with vascular risk factors were investigated.

RESULTS

Of 1,955 patients, 1,517 patients (77.6%) demonstrated atherosclerosis in one or more arteries. A significantly increasing trend of atherosclerosis was observed during the past eight years, which was ascribed to an increase of combined extracranial (EC) and intracranial (IC) atherosclerosis. The number of atherosclerotic arteries increased as the number of risk factors increased. In the multivariate analysis, the year and vascular risk factors were independent predictors of the presence of atherosclerosis.

CONCLUSION

We found that the atherosclerotic burden has been increasing for the past eight years in Korean stroke patients, particularly the combined EC and IC subtype. Lifestyle changes and increase in vascular risk factors may be contributing factors.

Metabolic syndrome as a risk factor for postoperative kidney injury after off-pump coronary artery bypass surgery

BACKGROUND

Metabolic syndrome (MetS) is a clustering of risk factors, including dyslipidemia, hypertension, and increased plasma glucose levels, which increase the risk of cardiovascular disease and renal impairment. We retrospectively analyzed the relationship between MetS and acute kidney injury (AKI) after off-pump coronary artery bypass surgery (OPCAB).

METHODS AND RESULTS

Patients who underwent isolated OPCAB between January 2006 and December 2008 were identified. Patients were grouped by using the National Cholesterol Education Program-Adult Treatment Panel III criteria with body mass index instead of waist circumference. From a total of 740 patients, 320 patients (43.2%) were in the MetS group, and 420 patients (56.8%) were in the non-MetS group. Postoperative AKI occurred in 84 patients (26.2%) in the MetS group and 44 patients (10.5%) in the non-MetS group (P<0.05). Multivariate logistic regression identified diabetes mellitus (odds ratio (OR), 1.83; 95% confidence interval (CI), 1.12-3.00; P=0.02), chronic kidney disease (OR, 4.79; 95%CI, 2.85-8.07; P<0.001), MetS (OR, 3.14; 95%CI, 1.79-5.49; P=0.001), and emergency surgery (OR, 5.08; 95%CI, 1.01-25.6; P=0.05) as independent risk factors for AKI after OPCAB.

CONCLUSIONS

MetS is a prevalent risk factor for postoperative AKI after OPCAB, and aggressive treatments of its components could have reduced operative morbidity.

The cutoff values of visceral fat area and waist circumference for identifying subjects at risk for metabolic syndrome in elderly Korean: Ansan Geriatric (AGE) cohort study

Background

In Korea, the cutoff values of waist circumference (WC) for the identification of metabolic syndrome (MetS) were suggested to be 90 cm for men and 85 cm for women based on the analysis mainly in middle-aged adults. As aging is associated with increased fat, especially abdominal visceral fat, the cutoff value of WC may differ according to age. In addition, the usefulness of visceral abdominal fat area (VFA) to predict MetS in the elderly has not been studied yet. We aimed to suggest WC and VFA criteria and to compare the predictability of WC and VFA to identify people at risk for MetS.

Methods

A total of 689 elderly subjects aged ≥63 years (308 men, 381 women) were chosen in this cross-sectional study from an ongoing, prospective, population-based study, the Ansan Geriatric (AGE) cohort study. VFA was measured by single slice abdominal computed tomography scanning. The metabolic risk factors except WC (plasma glucose, blood pressure, serum triglycerides and HDL cholesterol levels) were defined using modified NCEP-ATP III criteria. We estimated the accuracy of VFA and WC for identifying at least two of these factors by receiver operating characteristic (ROC) curve analysis.

Results

Two hundred three of 308 men and 280 of 381 women had ≥2 metabolic risk factors. The area under the ROC curve (AUC) value for VFA to predict the presence of ≥2 metabolic risk factors was not significantly different from that for WC (men, 0.735 and 0.750; women, 0.715 and 0.682; AUC values for VFA and WC, respectively). The optimal cutoff points for VFA and WC for predicting the presence of ≥2 metabolic risk factors were 92.6 cm² and 86.5 cm for men and 88.9 cm² and 86.5 cm for women.

Conclusion

WC had comparable power with VFA to identify elderly people who are at risk for MetS. Elderly Korean men and women had very similar cutoff points for both VFA and WC measurements for estimating the risk of MetS. Age-specific cutoff point for WC might be considered to identify subjects at risk for MetS.

Heritabilities of the metabolic syndrome phenotypes and related factors in Korean twins

CONTEXT

The genetic studies of metabolic syndrome (MetS), individual components, or latent factors of MetS phenotypes, in Asian populations are limited.

OBJECTIVE

This study aimed to estimate heritability of MetS and its components, and to identify latent factors clustering individual components among Korean twins and their families.

DESIGN

Data were derived from the Healthy Twin Study, an ongoing cohort study, from April 2005 to December 2008.

PARTICIPANTS

A total of 1942 Korean adult same-sex twins and their families (728 men, 1214 women; 795 monozygotic and 229 dizygotic twin individuals with 918 nontwin family members).

MAIN OUTCOME MEASURES

MetS phenotypes measured were waist circumference (WC), mean blood pressure (MBP), glucose, high-density lipoprotein cholesterol (HDL), and triglycerides (TG) as continuous and discrete traits. MetS was defined using Adult Treatment Panel III and International Diabetes Federation criteria. Heritability, bivariate analyses, interclass correlation, concordances, and factor analyses were conducted.

RESULTS

Significant differences in interclass correlation for WC, MBP, HDL, and glucose and in concordance rate for high WC and low HDL among monozygotic and dizygotic twins were found. MetS had heritabilities of 51-60% (P < 0.001), and phenotypes showed adjusted heritabilities ranging from 46% (for TG) to 77% (for low HDL). Factor analysis indicated two latent factors (factor 1, TG/WC/HDL; factor 2, WC/MBP/glucose) with significant heritabilities of 60-63%. Bivariate analyses exhibited different genetic and environmental interrelationships between phenotype pairs, although WC and TG showed significant genetic correlations with all other phenotypes.

CONCLUSIONS

Significant genetic contributions for MetS, its related phenotypes, and latent factors comprising MetS are confirmed.

Third national Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007) in Iran: methods and results on prevalence of diabetes, hypertension, obesity, central obesity, and dyslipidemia

BACKGROUND

The burden of non-communicable diseases is rising globally. This trend seems to be faster in developing countries of the Middle East. In this study, we presented the latest prevalence rates of a number of important non-communicable diseases and their risk factors in the Iranian population.

METHODS

The results of this study are extracted from the third national Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007), conducted in 2007. A total of 5,287 Iranian citizens, aged 15-64 years, were included in this survey. Interviewer-administered questionnaires were applied to collect the data of participants including the demographics, diet, physical activity, smoking, history of hypertension, and history of diabetes. Anthropometric characteristics were measured and serum biochemistry profiles were determined on venous blood samples. Diabetes (fasting plasma glucose >or= 126 mg/dl), hypertension (systolic blood pressure >or= 140 mmHg, diastolic blood pressure >or= 90 mmHg, or use of anti-hypertensive drugs), dyslipidemia (hypertriglyceridemia: triglycerides >or= 150 mg/dl, hypercholesterolemia: total cholesterol >or= 200 mg/dl), obesity (body mass index >or= 30 kg/m2), and central obesity (waist circumference >or= 80 cm in females and >or= 94 cm in males) were identified and the national prevalence rates were estimated.

RESULTS

The prevalence of diabetes, hypertension, obesity, and central obesity was 8.7% (95%CI = 7.4-10.2%), 26.6% (95%CI = 24.4-28.9%), 22.3% (95%CI = 20.2-24.5%), and 53.6% (95%CI = 50.4-56.8%), respectively. The prevalence of hypertriglyceridemia and hypercholesterolemia was 36.4% (95%CI = 34.1-38.9%) and 42.9% (95%CI = 40.4-45.4%), respectively. All of the mentioned prevalence rates were higher among females (except hypertriglyceridemia) and urban residents.

CONCLUSION

We documented a strikingly high prevalence of a number of chronic non-communicable diseases and their risk factors among Iranian adults. Urgent preventive interventions should be implemented to combat the growing public health problems in Iran.

Prevalence of metabolic syndrome and its association with obesity indices in a Chinese population

BACKGROUND

To investigate the prevalence of metabolic syndrome in an urbanizing community in Qingpu, a suburb of Shanghai, and to determine which obesity indices, including body mass index, waist circumference (WC), and waist:hip (WHpR), and waist:height (WHtR) ratios, are most closely associated with metabolic syndrome.

METHODS

We conducted a cross-sectional health survey of 1634 individuals (age 15-87 years) in the Jinhulu community located in Qingpu. The National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP ATP III) criteria were used to define metabolic syndrome, with central obesity defined according to Asia-Pacific (APC) region criteria.

RESULTS

The age-standardized prevalence of metabolic syndrome was 3.6% in men and 7.2% in women. Using the criterion of central obesity in the APC, the age-standardized prevalence of metabolic syndrome increased to 8.3% in men and 10.9% in women. Regardless of age, WHtR consistently showed a higher odd ratios (OR) after adjustment for confounding factors of 2.17 (95% confidence interval [CI] 1.12-4.20; P = 0.022) in subjects<52 years of age and 1.92 (95% CI 1.18-3.11; P = 0.008) in those ≥52 years of age. In men, the WHtR was the only significant predictor (OR 2.42; 95% CI 1.15-5.08; P = 0.02) of metabolic syndrome after adjustment, whereas in women WHtR (OR 1.87; 95% CI 1.37-2.85; P =0.0088) was slightly inferior to WHpR and WC.

CONCLUSION

Metabolic syndrome is prevalent in an urbanizing rural area in Qingpu. Of the anthropometric parameters commonly used to identify metabolic syndrome, WHtR may be the best.

The metabolic syndrome in East Asians

The metabolic syndrome is an emerging epidemic in developing nations, including East Asian countries such as China, Japan, and Korea. Studies examining the metabolic syndrome have used different definitions, with prevalence often highly dependent on the cut points for abdominal obesity utilized, which have been recommended by the International Diabetes Federation to be lower than standards used in Caucasians and other ethnic groups. Prevalence rates have generally varied from 8% to 13% in men and 2% to 18% in women, depending on ethnic group and definition used, and are consistently lower than most Western Caucasian populations. While recent dramatic changes in lifestyle from Westernization of dietary habits and reduced physical activity present challenges, an emphasis on healthful lifestyle changes remains the cornerstone for metabolic syndrome management. In addition, clinical management focusing on control of obesity, elevated blood pressure, dyslipidemia, and hyperglycemia, with consideration of pharmacologic therapy issues unique to certain Asian populations, remains important for reducing associated cardiometabolic risks.

The increasing prevalence of metabolic syndrome among Finnish men and women over a decade

OBJECTIVE

Our objective was to assess a 10-yr change in the prevalence of the metabolic syndrome defined by the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) among Finnish men and women.

DESIGN AND SUBJECTS

Two cross-sectional population surveys were performed in Finland in 1992 and 2002. A total of 3495 participants aged 45-64 yr were included in the analysis.

RESULTS

In both years the metabolic syndrome was more common among men than women. In men the prevalence of the metabolic syndrome tended to increase slightly between 1992 and 2002, from 48.8-52.6% (P=0.139) based on the NCEP definition, and from 51.4-55.6% based on the IDF definition (P=0.102). In women the prevalence of the metabolic syndrome increased significantly from 32.2-39.1% based on the NCEP definition (P=0.003), and from 38.0-45.3% based on the IDF definition (P=0.002). In both sexes the prevalence of high blood pressure decreased, but the abnormalities in glucose metabolism increased between 1992 and 2002. The prevalence of central obesity increased in women between 1992 and 2002.

CONCLUSIONS

In Finland the prevalence of the metabolic syndrome, based both on the NCEP and IDF definitions, is higher in men than women. However, the increase in the prevalence of the metabolic syndrome, from 1992-2002, was significant only among women.

Metabolic syndrome and the menopause

The metabolic syndrome consists of a combination of risk factors that include abdominal obesity, atherogenic dyslipidaemia, hypertension and insulin resistance. It increases the risk of cardiovascular disease and type 2 diabetes. The increased risk of cardiovascular disease is higher in women than in men. The first manifestation of metabolic syndrome may occur in pregnancy presenting as gestational diabetes or preeclampsia. Both conditions are associated with increased insulin resistance. Also metabolic syndrome is more common in polycystic ovarian syndrome. It has been suggested that there is a metabolic syndrome resulting from the menopause due to estrogen deficiency, as many of the risk factors are more prevalent in postmenopausal women. Also estrogen replacement improves insulin sensitivity and reduces the risk of diabetes. The key elements in managing the metabolic syndrome are weight reduction, increasing physical activity and diet modification. If blood pressure, lipid and glycaemic control are not achieved through these interventions then pharmacological therapy will be required.