Abstract
Background Metabolic syndrome is a combination of cardiovascular risk factors (i.e., visceral obesity, dyslipidaemia, glucose intolerance, and hypertension), which entails critical issues in terms of medical management and public health. Methods The aim of the present cross-sectional study was to investigate the age-related changes of the single IDF (International Diabetes Federation) diagnostic criteria for metabolic syndrome (waist circumference, WC; high-density lipoprotein cholesterol, HDL-C; triglycerides; glucose; systolic and diastolic blood pressure, SBP and DBP) in a large population of (Italian) obese women (n = 1.000; body mass index, BMI >30 kg/m2; age: 18–83 yrs), subdivided into two subgroups depending on the presence (n = 630) or absence (n = 370) of metabolic syndrome. Parallelly, the percentages of treatment with hypolipidaemic drugs, hypoglycaemics, and antihypertensives and, among the treated subjects, of control of the underlying condition in accordance with the cut-offs of IDF criteria for dyslipidaemia, hyperglycaemia, and hypertension were determined over six age ranges (i.e., 18–30, 31–40, 41–50, 51–60, 61–70, and > 70 yrs). Results The prevalence of metabolic syndrome increased with advancing age. In the subgroup with metabolic syndrome, an age-dependent increase in HDL-C, glycaemia, and SBP occurred, while the visceral adiposity was stable. In the same subgroup, triglycerides and DBP decreased age-dependently. In the subgroup without metabolic syndrome, an age-dependent increase in WC, HDL-C, glycaemia, SBP, and DBP was observed. A progressive age-dependent increase in the percentage of patients pharmacologically treated for the cardiometabolic abnormalities was detected in patients with metabolic syndrome, a similar trend being also observed in patients without metabolic syndrome only for the antihypertensives. A clear-cut disproportion between treated versus adequately controlled women (with pharmacotherapy) was detected in the whole population. Conclusions At least in an Italian context of obese females, the age-dependent worsening of glycaemia and BP exerts a fundamental pathophysiological role in the progressive increase of metabolic syndrome with advancing age, which appears to be not adequately treated in a large part of obese subjects. The results of the present study might be useful for public health decision-makers for programming future more extensive and aggressive non-pharmacological and pharmacological interventions in the obese population.
Highlights
Metabolic syndrome is a combination of cardiovascular risk factors, including visceral obesity, dyslipidaemia, glucose intolerance, and hypertension [1]
From January 2017 to December 2019, a population of 1.000 obese women was recruited at the Division of Metabolic Diseases, Istituto Auxologico Italiano, Piancavallo (VB), where they were hospitalized for a three-week multidisciplinary integrated body weight reduction program (BWRP), entailing hypocaloric diet, nutritional education, psychological counselling, and moderate physical activity
body mass index (BMI) and Body mass fat index (BMFI) significantly decreased with advancing age in obese women with metabolic syndrome; this pattern was not recorded in those without metabolic syndrome
Summary
Metabolic syndrome is a combination of cardiovascular risk factors, including visceral obesity, dyslipidaemia, glucose intolerance, and hypertension [1]. the prevalence of obesity is pandemic [2], there is still scarce awareness/evidence of metabolic syndrome, which remains underdiagnosed, insufficiently treated, and unsuccessfully controlled [3, 4]. e long-term consequences to which an obese patient with (uncontrolled) metabolic syndrome is exposed are well known, including atherosclerosis, acute coronary syndrome, stroke, type 2 diabetes mellitus, non-alcoholic fatty liver disease, and kidney chronic disease [5].body weight reduction programs allow us to reduce visceral obesity, improve glucometabolic homeostasis, and control hypertriglyceridemia and hypertension [6,7,8,9]; effective pharmacological interventions are available to treat dyslipidaemia, hyperglycaemia, and hypertension in clinical practice [10].One of the main reasons for this disheartening contradiction is the missing “holistic” view of any obese patient seeking for clinical help to lose body weight, which, in most patients’ opinion, is primarily thought to be an “aesthetic” problem, without paying attention to the associated cardiometabolic comorbidities [11].Metabolic syndrome is a condition evolving over time, with a progressive increase in the number of cardiovascular risk factors in parallel with the natural history of the obese state, characterized by low-grade chronic inflammation, accelerated aging, and metabolic dysregulation [12].To the best of our knowledge, while epidemiological analysis of cardiovascular risk factors in large populations of children/adolescents and adults was fundamental to diagnostically define metabolic syndrome, few authors have separately and collectively investigated the age-dependent changes of IDF (International Diabetes Federation) diagnostic criteria for metabolic syndrome in large study populations [13, 14]. Metabolic syndrome is a combination of cardiovascular risk factors, including visceral obesity, dyslipidaemia, glucose intolerance, and hypertension [1]. Metabolic syndrome is a combination of cardiovascular risk factors (i.e., visceral obesity, dyslipidaemia, glucose intolerance, and hypertension), which entails critical issues in terms of medical management and public health. E aim of the present cross-sectional study was to investigate the age-related changes of the single IDF (International Diabetes Federation) diagnostic criteria for metabolic syndrome (waist circumference, WC; high-density lipoprotein cholesterol, HDL-C; triglycerides; glucose; systolic and diastolic blood pressure, SBP and DBP) in a large population of (Italian) obese women (n 1.000; body mass index, BMI >30 kg/m2; age: 18–83 yrs), subdivided into two subgroups depending on the presence (n 630) or absence (n 370) of metabolic syndrome. At least in an Italian context of obese females, the age-dependent worsening of glycaemia and BP exerts a fundamental pathophysiological role in the progressive increase of metabolic syndrome with advancing age, which appears to be not adequately treated in a large part of obese subjects. e results of the present study might be useful for public health decisionmakers for programming future more extensive and aggressive non-pharmacological and pharmacological interventions in the obese population
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