Cholesterol Education Program Adult Treatment Research Articles

IJCM_22A: Impact of Pranayama and Dhyana intervention on metabolic syndrome among women: community based repeated measures design

Background: Prevalence of metabolic syndrome among adults in India, is reported to be around 20%-25%, with significantly higher proportion among women than men. Yoga interventions has been promoted as an important non- pharmacological tool to address the growing burden of non-communicable diseases. Objectives: To assess the effectiveness of a pranayama and intervention (yoga) intervention on various components of metabolic syndrome among 30 to 60-year-old women with hypertension. Methodology: A community based repeated measures design was undertaken 156 among hypertensive women (79 intervention, 77 controls) residing in coastal part of southern India. Anthropometric measurements, blood pressure, fasting blood glucose (FBS) and lipids were measured. Six-month pranayama and dhyana intervention were administered to the intervention arm, whereas routine treatment was continued for the control arm. Follow-up was done to ensure practice of interventions while investigations were done at baseline and 6th month. Results: Majority of the women in the intervention and control arm were aged 45-60 years. In the intervention arm, using the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria, most [57(72.2%)] of the women had elevated blood pressure. Nearly half of them [38(48.1%)] had abdominal obesity, elevated FBS was seen among 39(49.4%) and 50.6% had low HDL. Hypertriglyceridemia was seen in less than a third [23(29.1%)] women. In the control arm, most [52(70.3%)] of the women had elevated blood pressure, 27(36.5%)] had abdominal obesity, half of them had elevated FBS [39(52.7%)] and low HDL [36(48.6%)]. Hypertriglyceridemia was seen in 21(28.4%) women. No significant change was noted at the end of 6th month follow-up in body mass index (BMI) (p=0.533), systolic(p=0.051) and diastolic blood pressure (p=0.485). Conclusion: There was no significant difference in the 6th month prevalence of components of metabolic syndrome compared to baseline, in both arms of the study.

Impact of metabolic syndrome on bone mineral density in men over 50 and postmenopausal women according to U.S. survey results

Metabolic Syndrome (MetS) and bone mineral density (BMD) have shown a controversial link in some studies. This research aims to study their association in males over 50 and postmenopausal females using National Health and Nutrition Examination Survey (NHANES) data. Postmenopausal females and males over 50 were included in the study. MetS was defined by the National Cholesterol Education Program Adult Treatment Panel III guidelines. BMD values were measured at the thoracic spine, lumbar spine, and pelvis as the primary outcome. Weighted multivariate general linear models have been employed to explore the status of BMD in patients with MetS. Additionally, interaction tests and subgroup analyses were conducted. Utilizing the NHANES database from 2003 to 2006 and 2011–2018, we included 1924 participants, with 1029 males and 895 females. In postmenopausal women, after adjusting for covariates, we found a positive correlation between MetS and pelvic (β: 0.030 [95%CI 0.003, 0.06]) and thoracic (β: 0.030 [95%CI 0.01, 0.06]) BMD, though not for lumbar spine BMD (β: 0.020 [95%CI − 0.01, 0.05]). In males over 50 years old, MetS was positively correlated with BMD in both Model 1 (without adjusting for covariates) and Model 2 (considering age and ethnicity). Specifically, Model 2 revealed a positive correlation between MetS and BMD at the pelvis (β: 0.046 [95%CI 0.02, 0.07]), thoracic spine (β: 0.047 [95%CI 0.02, 0.07]), and lumbar spine (β: 0.040 [95%CI 0.02, 0.06]). Subgroup analysis demonstrated that the relationship between MetS and BMD remained consistent in all strata, underscoring the stability of the findings. In postmenopausal women, after adjusting for all covariates, a significant positive correlation was observed between MetS and BMD in the pelvis and thoracic spine, whereas this correlation was not significant for lumbar spine BMD. Conversely, in males, positive correlations between MetS and BMD at the lumbar spine, thoracic spine, and pelvis were identified in Model 2, which adjusted for age and ethnicity; however, these correlations disappeared after fully adjusting for all covariates. These findings highlight the potential moderating role of gender in the impact of MetS on BMD.

Metabolic syndrome and cardiovascular disease in cancer survivors.

The risk of subsequent cardiovascular disease (CVD) is high in cancer survivors. Although metabolic syndrome is an established risk factor for CVD, its association with cancer survivors has not yet been established. This study aimed to clarify whether metabolic syndrome is associated with subsequent CVD risk in patients with cancer using a nationwide epidemiological dataset. We retrospectively analysed 53510 patients with a history of breast, colorectal, or stomach cancer, which is reportedly a major site for developing cancer in Japan. Study participants were categorized into two groups based on the presence of metabolic syndrome, defined using the Japanese criteria (high waist circumference and ≥2 metabolic parameters including elevated blood pressure, elevated triglycerides, reduced high-density lipoprotein cholesterol, or elevated fasting plasma glucose). The clinical outcomes were collected between 2005 and 2021. The primary endpoint was defined as the composite CVD outcome, including myocardial infarction, angina pectoris, stroke, and heart failure. The median patient age was 54years, and 37.5% of the patients were men. Metabolic syndrome was observed in 5558 (10.4%) patients. Over a mean follow-up period of 973±791days, 3085 composite CVD outcomes were recorded. Multivariable Cox regression analyses showed that metabolic syndrome was associated with a greater risk of developing CVD events (HR=1.29, 95% CI=1.15-1.45). Metabolic syndrome was also associated with an increased risk of CVD in patients with a follow-up period ≥1year (HR=1.33, 95% CI=1.15-1.53). This relationship was also observed when metabolic syndrome was defined according to the International Diabetes Federation criteria (HR=1.34, 95% CI=1.21-1.49) and the National Cholesterol Education Program Adult Treatment Panel III criteria (HR=1.32, 95% CI=1.19-1.46). Subgroup analyses showed that the relationship between metabolic syndrome and incident CVD was more pronounced in the non-obese participants than in the obese participants. Metabolic syndrome is associated with a greater risk of developing CVD, even among cancer survivors.

Abstract P401: Association of Healthy Lifestyle Score With Metabolic Syndrome in Hong Kong Chinese Women: An Age-Matched Nested Case-Control Study

Introduction: Limited studies explored the combined effect of lifestyles on metabolic syndrome (MetS), especially in Hong Kong Chinese people. Hypothesis: We assessed the hypothesis that a combination of seven lifestyles, expressed as a healthy lifestyle score (HLS), was inversely associated with MetS. Methods: A nested case-control study was conducted in a cohort named Migraine Exposures and Cardiovascular Health in Hong Kong Chinese Women (MECH-HK). We recruited 4,221 women aged ≥30 years at baseline (2019-2021) and followed up with 3,435 subjects at the second-round survey until September 2023. The MetS was diagnosed based on the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) (2005 version). Women who developed MetS between baseline and second-round survey and had no hypertension, diabetes, hyperlipemia, myocardial infarction, stroke, or cancers at baseline were selected as cases. Age-matched controls were selected using a 1:1 ratio. Seven lifestyles were included in the HLS, each was assigned 0 or 1 point. The 1-point criteria were: smoking (never smoker), physical activity (vigorous physical activity ≥75 min/week), sleep (Pittsburgh Sleep Quality Index ≤5), stress (Perceived Stress Scale-10 ≤13), fatigue (≤ the median of a 10-point Likert scale), diet (≥ the median of a healthy diet score), and alcohol (<20g/day). The overall score ranged from 0 to 7, where a higher score indicated better health. Leave-one-out test was performed by excluding the seven items from the HLS one at a time. A weighted HLS was generated based on the coefficient of each component in multivariable analysis. Results: A total of 123 MetS patients (aged 56.6±7.5 years) and 123 controls (aged 56.9±7.8 years) were included. The number of MetS cases and total subjects for the lowest (0-2 points), middle (3-4 points), and highest (5-7 points) HLS groups were 40/64 (62.5%), 51/107 (47.7%), and 32/75 (42.7%), respectively. Compared to the lowest HLS group, the ORs (95% CIs) for the highest HLS group in univariable and multivariable analysis were 0.45 (0.23, 0.88) (P=0.021) and 0.46 (0.23, 0.94) (P=0.032), respectively. Among the seven components, smoking was the strongest contributor, followed by physical activity and diet. The results were consistent in the leave-one-out test and weighted HLS. Conclusions: Higher HLS was associated with lower MetS risk in Hong Kong Chinese women. The combined healthy lifestyles could benefit the prevention of MetS.

The worldwide metabolic syndrome prevalence in people living with HIV: a systematic review

Metabolic alterations have been reported in people living with HIV (PLHIV), related to viral infection, side effects of antiretroviral therapy, genetic, environmental and/or sociodemographic factors. We aimed to draw a global picture of prevalence of Metabolic Syndrome (MetS) in PLHIV. We performed a systematic review based on the PRISMA Statement method. We selected studies that investigated epidemiological characteristics of PLHIV who developed MetS in 4 databases: PubMed, SciELO, LILACS and Science Direct, using descriptors: HIV; prevalence; metabolic syndrome; epidemiology; antiretroviral therapy, highly active. A total of 1117 articles were identified, including 98 in the final analysis. The prevalence of MetS ranged from 7.8 to 55.8% (Internacional Diabetes Federation - IDF) and 7.1 to 58% (National Cholesterol Education Program Adult Treatment Panel III - NCEP/ATP III), being higher in African women than in African men (IDF), whereas European women and women of unknown origin were lower than women from Asia, South and North America (NCEP/ATP III). There is a high prevalence of MetS in PLHIV. The importance of multidisciplinary follow-up and encouragement of lifestyle changes in PLHIV is emphasized.

Prediction of metabolic syndrome following a first pregnancy

The prevalence of metabolic syndrome is rapidly increasing in the United States. We hypothesized that prediction models using data obtained during pregnancy can accurately predict the future development of metabolic syndrome. This study aimed to develop machine learning models to predict the development of metabolic syndrome using factors ascertained in nulliparous pregnant individuals. This was a secondary analysis of a prospective cohort study (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be Heart Health Study [nuMoM2b-HHS]). Data were collected from October 2010 to October 2020, and analyzed from July 2023 to October 2023. Participants had in-person visits 2 to 7 years after their first delivery. The primary outcome was metabolic syndrome, defined by the National Cholesterol Education Program Adult Treatment Panel III criteria, which was measured within 2 to 7 years after delivery. A total of 127 variables that were obtained during pregnancy were evaluated. The data set was randomly split into a training set (70%) and a test set (30%). We developed a random forest model and a lasso regression model using variables obtained during pregnancy. We compared the area under the receiver operating characteristic curve for both models. Using the model with the better area under the receiver operating characteristic curve, we developed models that included fewer variables based on SHAP (SHapley Additive exPlanations) values and compared them with the original model. The final model chosen would have fewer variables and noninferior areas under the receiver operating characteristic curve. A total of 4225 individuals met the inclusion criteria; the mean (standard deviation) age was 27.0 (5.6) years. Of these, 754 (17.8%) developed metabolic syndrome. The area under the receiver operating characteristic curve of the random forest model was 0.878 (95% confidence interval, 0.846-0.909), which was higher than the 0.850 of the lasso model (95% confidence interval, 0.811-0.888; P<.001). Therefore, random forest models using fewer variables were developed. The random forest model with the top 3 variables (high-density lipoprotein, insulin, and high-sensitivity C-reactive protein) was chosen as the final model because it had the area under the receiver operating characteristic curve of 0.867 (95% confidence interval, 0.839-0.895), which was not inferior to the original model (P=.08). The area under the receiver operating characteristic curve of the final model in the test set was 0.847 (95% confidence interval, 0.821-0.873). An online application of the final model was developed (https://kawakita.shinyapps.io/metabolic/). We developed a model that can accurately predict the development of metabolic syndrome in 2 to 7 years after delivery.

Body size, insulin sensitivity, metabolic health and risk of cardiovascular disease in Chinese adults: Insights from the China Cardiometabolic Disease and Cancer Cohort (4C) study.

To assess the excess risk of cardiovascular disease (CVD) associated with different criteria for metabolic health, and the interplay of body size, insulin sensitivity and metabolic health with CVD risk. We conducted a prospective study involving 115 638 participants from the China Cardiometabolic Disease and Cancer Cohort (4C) Study. Metabolic health was defined using three different definitions: (1) insulin sensitivity defined by homeostatic model assessment of insulin resistance index; (2) absence of metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III criteria; and (3) simultaneous absence of metabolic abnormalities (diabetes, hypertension, dyslipidaemia). The primary endpoint was a composite of incident CVD events comprising the first occurrence of myocardial infarction, stroke, heart failure, or cardiovascular death. During a mean 3.61-year follow-up period, obese individuals with insulin sensitivity (multivariable-adjusted hazard ratio [HR] 1.69, 95% confidence interval [CI] 1.37-2.08), or without metabolic syndrome (HR 1.46, 95% CI 1.13-1.89) still exhibited increased CVD risks, when compared to their normal-weight counterparts. Otherwise, those with obesity but simultaneous absence of metabolic abnormalities demonstrated similar CVD risk compared to normal-weight individuals (HR 0.91, 95% CI 0.53-1.59). CVD risk increased with the number of abnormalities across body mass index categories, regardless of insulin sensitivity. This study emphasizes the need for refined definitions of metabolic health and advocates for meticulous screening for metabolic abnormalities to reduce cardiovascular risks, even in individuals with normal weight and insulin sensitivity.

Relationship between Serum Total Testosterone Concentration and Metabolic Syndrome in Premenopausal Obese Women.

Men with low testosterone levels are at an increased risk of developing metabolic syndrome, irrespective of age or obesity. However, the relationship between metabolic syndrome and testosterone levels in women remains unclear. We compared the total testosterone concentrations between premenopausal obese women with and without metabolic syndrome and identified the factors affecting these concentrations. A single-center retrospective analysis was conducted using the medical records of 580 premenopausal women with obesity. The diagnostic criteria for metabolic syndrome were established using the National Cholesterol Education Program Adult Treatment Panel III guidelines. The mean±standard deviation age, weight, and body mass index were 38.8±8.4 years, 78.0±11.8 kg, and 30.0±4.1 kg/m2, respectively. The mean total testosterone concentration was lower in the metabolic syndrome group than in the non-metabolic syndrome group (n=385 vs. n=195; 0.22±0.10 ng/mL vs. 0.24±0.11 ng/mL; P<0.001). In a model adjusted for age, body mass index, skeletal muscle mass, body fat mass, and body fat percentage, the odds ratio for metabolic syndrome with respect to the total testosterone level was 0.128 (P=0.028). Testosterone concentration was negatively correlated with age (r=-0.334), systolic blood pressure (r=-0.084), and triglyceride concentration (r=-0.093) but positively correlated with weight (r=0.144), body mass index (r=0.140), waist circumference (r=0.133), body fat mass (r=0.167), and body fat percentage (r=0.167). Stepwise regression analysis revealed that age (β=-0.004, P<0.001), body mass index (β=0.003, P=0.004), and high-density lipoprotein cholesterol concentration (β=0.001, P=0.019) were independently associated with total testosterone concentration (adjusted R2=12.6%). Metabolic syndrome and obesity may be independently associated with testosterone levels in premenopausal women with obesity.

Comparison of metabolic syndrome prevalence and characteristics using five different definitions in China: a population-based retrospective study.

Metabolic syndrome (MetS) is on the rise in developing countries and is characterized by a series of indications of metabolic disturbance. However, the prevalence of MetS varies under different definitions. The study aimed to compare five definitions of MetS in the China adult population, to explore their prevalence, characteristics and agreement. The data for the retrospective study came from the China Health and Retirement Longitudinal Study (CHARLS), consisting of 9,588 participants (≥45). MetS definitions from International Diabetes Federation (IDF) (2006), National Cholesterol Education Program Adult Treatment Panel III (ATPIII) (2005), National Cholesterol Education Program Adult Treatment Panel III (ATPIII) (2001), Chinese Diabetes society (CDS) (2004) and the World Health Organization (WHO) (1999). We used binary and multivariable logistic analysis to explore factors connected with MetS. The five definitions of MetS led to different prevalence of MetS:34.52% by IDF (2006), 38.63% by ATP (2005), 25.94% by ATP (2001), 26.31% by CDS (2004), 21.57% by WHO (1999). According to the definition of IDF (2006) (22.32% vs. 45.06%), ATPIII (2005) definition (27.99% vs. 47.82%), ATPIII (2001) definition (15.37% vs. 35.07%), CDS (2004) definition (19.96% vs. 31.80%), and WHO (1999) definition (17.44% vs. 25.14%), the prevalence of MetS in men was low but in women was high. The agreement between the five definitions for men was good except for the IDF (2006) definition and ATPIII (2001) definition (kappa = 0.51), with kappa values from 0.64 to 0.85. For women, the agreement between the five definitions was good ranging from 0.67 to 0.95, however, except for the definition of CDS (2004) and the definition of IDF (2006) (kappa = 0.44), the definition of WHO (1999) and the definition of IDF (2006) (kappa = 0.55), and the definition of WHO (1999) and the definition of ATPIII (2005) (kappa = 0.54). Binary logistic analysis indicated that although the impact and relevance varied by sex and definition, age, education, marital status, current residence, current smoking, alcohol using, taking activities and number of chronic diseases were factors connected to MetS. the prevalence and characteristics of the five definitions of MetS are different in the Chinese population. Therefore, it is vital to use the same definition for a country to diagnose MetS. On the other side, a lower prevalence in men than in women and the consistency of five MetS definitions are good in men but relatively poor in women.

Exploring the Prevalence and Components of Metabolic Syndrome in Sub-Saharan African Type 2 Diabetes Mellitus Patients: A Systematic Review and Meta-Analysis.

Type 2 diabetes mellitus and metabolic syndrome represent two closely intertwined public health challenges that have reached alarming epidemic proportions in low- and middle-income countries, particularly in sub-Saharan Africa. Therefore, the current study aimed to determine the weighted pooled prevalence of metabolic syndrome and its components among individuals with type 2 diabetes mellitus in sub-Saharan Africa as defined by the 2004 National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III 2004) and/or the International Diabetes Federation (IDF) criteria. A systematic search was conducted to retrieve studies published in the English language on the prevalence of metabolic syndrome among type 2 diabetic individuals in sub-Saharan Africa. Searches were carried out in PubMed, Embase, Scopus, Google Scholar, African Index Medicus, and African Journal Online from their inception until July 31, 2023. A random-effects model was employed to estimate the weighted pooled prevalence of metabolic syndrome in sub-Saharan Africa. Evidence of between-study variance attributed to heterogeneity was assessed using Cochran's Q statistic and the I2 statistic. The Joanna Briggs Institute quality appraisal criteria were used to evaluate the methodological quality of the included studies. The summary estimates were presented with forest plots and tables. Publication bias was checked with the funnel plot and Egger's regression test. Overall, 1421 articles were identified and evaluated using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, and 30 studies that met the inclusion criteria were included in the final analysis. The weighted pooled prevalence of metabolic syndrome among individuals with type 2 diabetes mellitus in sub-Saharan Africa was 63.1% (95% CI: 57.9-68.1) when using the NCEP-ATP III 2004 criteria and 60.8% (95% CI: 50.7-70.0) when using the IDF criteria. Subgroup analysis, using NCEP-ATP III 2004 and IDF criteria, revealed higher weighted pooled prevalence among females: 73.5% (95% CI: 67.4-79.5), 71.6% (95% CI: 60.2-82.9), compared to males: 50.5% (95% CI: 43.8-57.2), 44.5% (95% CI: 34.2-54.8), respectively. Central obesity was the most prevalent component of metabolic syndrome, with a pooled prevalence of 55.9% and 61.6% using NCEP-ATP III 2004 and IDF criteria, respectively. There was no statistical evidence of publication bias in both the NCEP-ATP III 2004 and IDF pooled estimates. The findings underscore the alarming prevalence of metabolic syndrome among individuals with type 2 diabetes mellitus in sub-Saharan Africa. Therefore, it is essential to promote lifestyle modifications, such as regular exercise and balanced diets, prioritize routine obesity screenings, and implement early interventions and robust public health measures to mitigate the risks associated with central obesity.

Traditional Atlantic Diet and Its Effect on Health and the Environment

The universal call to action for healthier and more sustainable dietary choices is the framework of the United Nations's Sustainable Development Goals. The Atlantic diet, originating from the northwest of the Iberian Peninsula, represents an example of a traditional diet that aligns with these principles. To explore a 6-month intervention based on the Atlantic diet's effects on metabolic and environmental health, assessing metabolic syndrome (MetS) incidence and the carbon footprint. The Galician Atlantic Diet study was a 6-month randomized clinical trial designed to assess the effects of this regional traditional diet on families' eating habits. The study was conducted from March 3, 2014, to May 29, 2015, at a local primary health care center in the rural town of A Estrada in northwestern Spain and involved a multisectoral collaboration. Families were randomly selected from National Health System records and randomized 1:1 to an intervention or control group. This secondary analysis of the trial findings was performed between March 24, 2021, and November 7, 2023. Over 6 months, families in the intervention group received educational sessions, cooking classes, written supporting material, and foods characteristic of the Atlantic diet, whereas those randomized to the control group continued with their habitual lifestyle. The main outcomes were MetS incidence, defined per National Cholesterol Education Program Adult Treatment Panel III guidelines, and carbon footprint emissions as an environmental metric using life cycle assessment with daily dietary intake as the functional unit. Initially, 250 families were randomized (574 participants; mean [SD] age, 46.8 [15.7] years; 231 males [40.2%] and 343 females [59.8%]). The intervention group included 126 families (287 participants) and the control group, 124 families (287 participants). Ultimately, 231 families completed the trial. The intervention significantly reduced the risk of incident cases of MetS (rate ratio, 0.32; 95% CI, 0.13-0.79) and had fewer MetS components (proportional odds ratio, 0.58; 95% CI, 0.42-0.82) compared with the control condition. The intervention group did not have a significantly reduced environmental impact in terms of carbon footprint emissions compared with the control group (-0.17 [95% CI, -0.46 to 0.12] kg CO2 equivalents/person/d). These findings provide important evidence that a family-focused dietary intervention based on a traditional diet can reduce the risk of incident MetS. Further research is needed to understand the underlying mechanisms and determine the generalizability to other populations, taking into account regional cultural and dietary variations. ClinicalTrials.gov Identifier: NCT02391701.

Ultra-processed food consumption and increased risk of metabolic syndrome in Korean adults: A cross-sectional analysis of the KNHANES 2016–2020

ObjectiveThis study aimed to investigate the association between ultra-processed food (UPF) intake and the risk for metabolic syndrome (MetS) in Korean adults. MethodsThe study consisted of 22 688 Korean adults ≥19 y of age from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016–2020. The NOVA classification categorizes foods according to the nature, extent, and purpose of industrial processing. MetS was defined based on the National Cholesterol Education Program Adult Treatment Panel III criteria and a modified waist circumference cut-off for Korean adults. We estimated the usual percent total food intake from UPFs. We used multivariate logistic regression to assess the association between UPFs and risk for MetS, adjusted for age, sex, education level, income level, smoking status, alcohol drinking, physical activity, and total energy intake. We further analyzed the association of UPFs with each component of MetS. ResultsThe median usual percent total food intake from UPFs was 22%, and the midpoint of intake ranged from 3% (quartile 1) to 48% (quartile 4). The group with the highest UPF consumption had a 19% higher risk for developing MetS than the lowest quartile of UPF consumption (odds ratio [OR],1.19; 95% confidence interval [CI], 1.06–1.33; Ptrend = 0.006). In analysis of the relationship between UPF intake and MetS components, a higher UPF was associated with an increased risk for hypertension (OR, 1.13; 95% CI, 1.01–1.26; Ptrend = 0.037) and abdominal obesity (OR, 1.19; 95% CI, 1.07–1.33; Ptrend = 0.001), but had no significant association with other components (hyperglycemia, hypertriacylglycerolmia, and low high-density lipoprotein cholesterol, all P > 0.05). ConclusionHigher UPF contribution to total daily food intake is associated with an increased risk for MetS, particularly with a higher risk for hypertension and abdominal obesity.

Epidemiology and Prevalence of Dyslipidemia Among Adult Population of Tehran: The Tehran Cohort Study.

Dyslipidemia is among the leading risk factors for cardiovascular diseases (CVDs), with an increasing global burden, especially in developing countries. We investigated the prevalence of dyslipidemia and abnormal lipid profiles in Tehran. We used data from 8072 individuals aged≥35 from the Tehran Cohort Study (TeCS) recruitment phase. Fasting serum total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and triglyceride were measured. Dyslipidemia was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria, and high LDL/HDL was defined as a ratio>2.5. The age-sex standardized prevalence rates were calculated based on the 2016 national census. Furthermore, the geographical distribution of dyslipidemia and lipid abnormalities was investigated across Tehran's zip code districts. The age-sex standardized prevalence was 82.7% (95% CI: 80.1%, 85.0%) for dyslipidemia, 36.9% (95% CI: 33.8%, 40.1%) for hypertriglyceridemia, 22.5% (95% CI: 19.9%, 25.4%) for hypercholesterolemia, 29.0% (95% CI: 26.1%, 32.1%) for high LDL-C, 55.9% (95% CI: 52.6%, 59.2%) for low HDL-C, and 54.1% (95% CI: 50.9%, 57.3%) for high LDL/HDL ratio in the Tehran adult population. The prevalence of dyslipidemia, low HDL-C, and high LDL/HDL ratio was higher in the northern regions, hypercholesterolemia was higher in the southern half, and high LDL-C was more prevalent in the middle-northern and southern areas of Tehran. We found a high prevalence of dyslipidemia, mainly high LDL/HDL in the Tehran adult population. This dyslipidemia profiling provides important information for public health policy to improve preventive interventions and reduce dyslipidemiarelated morbidity and mortality in the future.

Metabolic Syndrome in Psoriasis Patients-an Observational Study.

Our observational study included on 54 patients with PsO, evaluated into the Dermatology Department of the Emergency County Hospital Craiova, Romania, between August 2023 and January 2024, and 40 controls. Our research proposed determining the prevalence of MetS in a cohort of PsO patients, and its relationship to subclinical atherosclerosis, evaluated by carotid ultrasound. Metabolic syndrome (MetS) was established according to National Cholesterol Education Program (NCP) Adult Treatment Panel (ATP) III criteria for MetS for 35 of the patients (64.81%) vs. 11 of the control group (27.5%), p=0.0003. An overview of each component of MetS depending on the diagnostic criteria for MetS showed that waist and total cholesterol exerted significant differences. Carotid ultrasound evaluation revealed an increased ITM, of over 0.9mm, for 19 (35.18%) or PsO patients, significantly increased compared to controls, as well as the presence of carotid plaques in significantly different percentages (37.03% PsO vs. 17.5% controls, p=0.001). We also noted that for patients with MetS, US examination displayed increased results for IMT compared to those without MetS. The prevalence of carotid atheroma plaque was augmented in patients with MetS and PsO. In our PsO group IMT exerted a positive inter-relation with: age, MetS, blood glucose, disease duration, and PASI. Important to note is that after multiple linear regression analysis, age and MetS were independent indicators of IMT (p=0.02 for age and p=0.001 for MetS). Our findings sustain a firm relationship between MetS and psoriasis and the major consequence of this observation is the inherent risk of cardiovascular events.

Association between the composite dietary antioxidant index and metabolic syndrome: evidence from NHANES 2003-2018.

A healthy and nutritional diet has been considered a promising approach to improve many adverse clinical outcomes. However, current evidence of the association of the intake of composite dietary antioxidants with metabolic syndrome (MetS) is limited. The current study was performed to explore the effect of the composite dietary antioxidant index (CDAI) on MetS and its components based on the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018. The dietary consumption was evaluated using the 24-hour diet recall method, and a previously validated approach that included six antioxidants was used to calculate CDAI. The National Cholesterol Education Program-Adult Treatment Panel III (NCEP ATP III) was applied to evaluate MetS. ORs and 95%CIs were computed by logistic regression. The association between CDAI and MetS was determined by subgroup analyses and restricted cubic spline (RCS) regressions. This study included 24,705 individuals; approximately 18,378 (74.39%) participants were determined to be without MetS and 6,327 (25.61%) with MetS. After considering all confounders, compared to individuals of the lowest quartile of CDAI, those of the highest quartile showed a 31% lower risk of MetS (OR, 0.69, 95% CI: 0.57-0.82). RCS revealed a non-linear relationship between CDAI and MetS risk. A non-linear association was found between CDAI and decreased MetS risk, which indicated that selective combined intake of antioxidants could be a promising and effective approach to preventing MetS for the public.

Evaluation of potential association of metabolic syndrome in obese and non-obese PCOS women

BackgroundPolycystic ovary syndrome is an escalating endocrinal and reproductive disorder among women of reproductive age and is considered the foremost health burden. Therefore, the present study is an attempt to estimate the potential association of metabolic syndrome in obese and non-obese PCOS women. A total of 250 PCOS women ranging in age from 18 to 45 years and living in the Chandigarh Capital Region were selected from the OPD, PGIMER, Chandigarh, (North India). Rotterdam Criteria (2003) was employed to diagnose polycystic ovary syndrome among women.ResultsThe prevalence of metabolic syndrome (MS) as assessed by the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III) was found to be 30% (4% in non-obese and 26% in obese) in PCOS women. Waist circumference > 88 cm is the most prevalent feature in PCOS women (67.2%) followed by HDL < 50 mg/dL (56.8%). The multivariate logistic regression analysis exhibited that visceral adiposity index (VAI) was a significant determinant of metabolic syndrome in obese (OR = 1.17, p < 0.01) and non-obese (OR = 1.2, p < 0.01) PCOS women. Results of ROC analysis further established visceral adiposity index as a potential determinant in metabolic syndrome in both the groups of PCOS women. In obese PCOS women, the W/H ratio also depicted accuracy in predicting metabolic syndrome risk.ConclusionsVisceral adiposity index is a significant tool to assess the metabolic syndrome in both groups, i.e., obese and non-obese. However, the waist/hip ratio can be considered as a predictive tool in obese women only. Thus, it could be used as a significant and inexpensive tool in clinical practices for early detection of metabolic syndrome in PCOS women.

Association of Metabolic Syndrome with Macular Thickness and Volume in Older Adults: A Population-Based Optical Coherence Tomography Study.

Background: To explore the associations of the metabolic syndrome (MetS) and individual components with macular thickness and volume among rural-dwelling Chinese older adults. Methods: This population-based cross-sectional study included 705 participants (age ≥60 years) derived from the MIND-China study. In 2018-2019, we collected data through face-to-face interview, clinical examination, optical coherence tomography (OCT) examination, and blood test. We measured macular thickness and volume using spectral-domain OCT. MetS was defined following the International Diabetes Federation (IDF) criteria, the IDF/American Heart Association (AHA) criteria, the National Cholesterol Education Program-Adult Treatment Panel III criteria, and the Chinese Diabetes Society (CDS) criteria. Data were analyzed with multivariable general linear models. Results: MetS was significantly associated with thinner macula in central (multivariable-adjusted β = -5.29; 95% confidence interval: -9.31 to -1.26), parafoveal (-2.85; -5.73 to 0.04) and perifoveal regions (-4.37; -6.79 to -1.95) when using the IDF criteria, in the perifoveal regions (-3.82; -6.18 to -1.47) when using the IDF/AHA criteria, and in the central region (-5.63; -10.25 to -1.02) when using the CDS criteria, and with reduced macular volume when using the IDF (-0.16; -0.26 to -0.07) and IDF/AHA (-0.13; -0.22 to -0.04) criteria. In the parafoveal region, the IDF-defined MetS was significantly associated with thinner retina in men (β = -6.25; -10.94 to -1.56) but not in women. Abdominal obesity (-2.83; -5.41 to -0.25) and elevated fasting blood glucose (-2.65; -5.08 to -0.21) were associated with thinner macular thickness in the perifoveal region. Conclusion: MetS is associated with macular thinning and reduced macular volume among rural-dwelling older adults, and the associations vary by the defining criteria of MetS.

Associations between Components of Metabolic Syndrome and Demographic, Nutritional, and Lifestyle Factors.

To evaluate the associations between individuals with and without changes in components of metabolic syndrome (MetS) and demographic, nutritional, and lifestyle factors. A cross-sectional study was conducted with 224 individuals followed-up at a public hospital in Northeast Brazil. We used National Cholesterol Education Program-Adult Treatment Panel III (NCEP) criteria to diagnose MetS. We assessed components of MetS as dependent variables, while sex, age, food consumption, smoking, alcohol intake, physical activity, anthropometric parameters, and sleep hours were independent variables. Comparing individuals with and without changes in components of MetS, the logistic regression models revealed that female sex was predictive of increased waist circumference and low HDL-c levels while advanced age was predictive of increased blood pressure and blood glucose levels. BMI emerged as a predictor for waist circumference and a protective factor for triglyceride levels. In addition, potassium intake, physical activity, and sleep duration were protective against decreased HDL-c, elevated triglyceride, and elevated blood pressure levels, respectively. This study demonstrated that sex, age, BMI, dietary potassium intake, physical activity, and hours of sleep are factors to be targeted in public health actions for prevention and treatment of MetS.

Prevalence and correlates of metabolic syndrome among adults in Freetown, Sierra Leone: A comparative analysis of NCEP ATP III, IDF and harmonized ATP III criteria

BackgroundMetabolic syndrome (MetS) is a global health concern, especially for low and middle-income countries with limited resources and information. The study's objective was to assess the prevalence of MetS in Freetown, Sierra Leone, using the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), International Diabetes Federation (IDF) and Harmonize ATP III. Additionally, we aimed to establish the concordance between these three different criteria used. MethodsThis community-based health screening survey was conducted from October 2019 to October 2022. A multistage stratified random design was used to select adults aged 20 years and above. Mean, interquartile range (IQR), and logistic regression were used for statistical analysis. The kappa coefficient statistics resolved the agreement between these defined criteria. ResultsThe prevalence for NCEP ATP III, Harmonize ATP III and IDF criteria was 11.8 % (95 % CI: 9.0–15.15), 14.3 % (95 % CI: 11.3–18.0), and 8.5 % (95 % CI: 6.2–11.2), respectively for the 2394 selected adults. The kappa coefficient (κ) agreement between the MetS is: Harmonized ATP III and IDF criteria = [(208 (60.8 %); (κ = 0.62)]; Harmonized ATP III and NCEP ATP III = [(201 (58.7 %); (κ = 0.71)]; while IDF and NCEP ATP III was [(132 (38.6 %); (κ = 0.52)]. In the multivariable regression analysis, waist circumference correlated with all three MetS criteria: ATP III [AOR = 0.85; C.I 95 %: (0.40–1.78), p = 0.032], Harmonized ATP III [AOR = 1.14; C.I 95 %: (0.62–2.11), p = 0.024], IDF [AOR = 1.06; C.I 95 % (0.52–2.16), p = 0.018] ConclusionWe reported a high prevalence of MetS in Freetown, Sierra Leone and identified waist circumference as a major risk factor for MetS. This underscores the crucial role of health education and effective management of MetS in Sierra Leone.

THYROID FUNCTION ABNORMALITIES IN PATIENTS WITH METABOLIC SYNDROME: AN OBSERVATIONAL STUDY

Objective: The objective of the study is to study the presence of thyroid function abnormalities in cases with metabolic syndrome. Methods: This was a prospective observational study done in the department of biochemistry of a tertiary care medical college. 60 patients fulfilling the criteria for metabolic syndrome as per the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria were included in this study. Demographic details of all the patients were noted. A detailed history was taken and thorough clinical examination was done. Thyroid function test was done in all cases. The presence of thyroid function test abnormalities was analyzed. Statistical analysis was done using SSPS 21.0 software and p&lt;0.05 was taken as statistically significant. Results: Out of these 60 cases, there were 37 (61.67%) males and 23 (38.33%) females with a M: F ratio of 1:0.62. The mean age of male and female patients was found to be 47.96±14.78 and 45.78±13.26 years, respectively. The mean age of male and female patients was found to be comparable with no statistically significant difference. Skin changes were present in 23 (38.33%) cases followed by tiredness (36.67%), constipation (25.00%), weight gain (21.67%), and pallor (15%). 29 (48.33%) were euthyroid whereas subclinical and clinical hypothyroidism was present in 18 (30%) and 10 (16.67%), respectively. 3 (5%) patients were found to have subclinical hyperthyroidism whereas there was no patient with clinical hyperthyroidism. Conclusion: Thyroid function abnormalities are common in patients with metabolic syndrome. It is therefore important to screen patients for thyroid function abnormalities so that appropriate interventions can be undertaken if necessary.