Abstract
BackgroundMetabolic syndrome (MetS) management programs conventionally focus on the adults having MetS. However, risk assessment for MetS development is also important for many adults potentially at risk but do not yet fulfill MetS criteria at screening. Therefore, we conducted this follow-up study to explore whether initial screening records can be efficiently applied on the prediction of the MetS occurrence in healthy middle-aged employees.MethodsUtilizing health examination data, a five-year follow-up observational study was conducted for 1384 middle-aged Taiwanese employees not fulfilling MetS criteria. Data analyzed included: gender, age, MetS components, uric acid, insulin, liver enzymes, sonographic fatty liver, hepatovirus infections and lifestyle factors. Multivariate logistic regression was used to estimate the adjusted odds ratios (OR) and 95% confidence interval (CI) of risk for MetS development. The synergistic index (SI) values and their confidence intervals of risk factor combinations were calculated; and were used to estimate the interacting effects of coupling MetS components on MetS development.ResultsWithin five years, 13% (175 out of 1384) participants fulfilled MetS criteria. The ORs for MetS development among adults initially having one or two MetS components were 2.8 and 7.3, respectively (both p < 0.01), versus the adults having zero MetS component count at screening. Central obesity carried an OR of 7.5 (p < 0.01), which far exceeded other risk factors (all ORs < 2.7). Synergistic effects on MetS development existed between coupling MetS components: 1. High blood pressure plus low-HDL demonstrated an OR of 11.7 (p < 0.01) for MetS development and an SI of 4.7 (95% CI, 2.1-10.9). 2. High blood pressure plus hyperglycemia had an OR of 7.9 (p < 0.01), and an SI of 2.7 (95% CI, 1.2-6.4).ConclusionMetS component count and combination can be used in predicting MetS development for participants potentially at risk. Worksite MetS screening programs simultaneously allow for finding out cases and for assessing risk of MetS development.
Highlights
Metabolic syndrome (MetS) management programs conventionally focus on the adults having MetS
Metabolic syndrome (MetS) management programs conventionally focused on the adults having MetS [1,2,3]; while risk assessment for MetS development is important for many middle-aged adults potentially at risk but do not yet fulfill MetS criteria at screening
Significant differences were found when grouping baseline data according to the MetS outcome: as shown in the upper rows of Table 1, the adults having MetS outcome had significantly unfavorable initial measurements including baseline body mass index, waist, blood pressures, blood sugar, lipid profiles, liver enzymes, uric acid and insulin
Summary
Metabolic syndrome (MetS) management programs conventionally focus on the adults having MetS. Risk assessments for MetS development by utilizing data from lifestyle investigations [4,5] or MetS components, such as elevated blood pressure, dyslipidemia and many worksites in Taiwan, we have the opportunity to observe the development of MetS among middle-aged employees. We conducted this workplacebased retrospective follow-up study to evaluate whether the readymade database from the MetS screening program is helpful in risk assessment for MetS development in middle-aged Taiwanese adults
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