Clustering Of Metabolic Syndrome Components Research Articles

Heterogeneity in familial clustering of metabolic syndrome components in the multiethnic GENNID study.

Metabolic syndrome (MetS) is defined by clustering of cardiometabolic components, which may be present in different combinations. The authors evaluated clustering in individuals and extended families within and across ancestry groups. The prevalence of different combinations of MetS components (high fasting glucose, low high-density lipoprotein cholesterol, high triglycerides, high blood pressure, and abdominal obesity) was estimated in 1651 individuals (340 families) self-reporting as European American (EA), Hispanic/Mexican American (MA), African American (AA), and Japanese American (JA). Odds ratios were estimated using logistic regression with generalized estimating equations comparing individual MetS components, number, and combinations of components for each ancestry group versus EA. Clustering of all five components (Combination #16) was more prevalent in EA (29.9%) and MA (25.2%) individuals than in AA (18.7%) and JA (15.5%) individuals. Compared with EA individuals, AA individuals were 64% and 66% less likely to have high triglycerides and low high-density lipoprotein cholesterol, whereas JA individuals were 85% and 56% less likely to have abdominal obesity and high blood pressure, respectively. Compared with EA individuals, the odds of having two, four, or five components were at least 77% lower in JA individuals, whereas the odds of having three, four, or five components were at least 3.79 times greater in MA individuals. Understanding heterogeneity in MetS clustering may identify factors important in reducing health disparities.

Letter to Editor; Coronary Heart disease

The main risk factors for coronary heart disease (CHD) in adults seem to be influenced, at least in part, by behavioral habits formed in infancy. According to research, teens do not understand the risk for cardiovascular disease and do not believe they are at risk (Vanhecke et al., 2006). Teenagers' longitudinal observations reveal risk factors including obesity remain over time and are connected to the clustering of metabolic syndrome components (Berenson et al., 2005)., According to an Indian study, adolescents from middle- and upper-class families in India have a significant frequency of metabolic and dietary coronary risk factors (Gupta et al., 1998) . In light of this, the current study was conducted to determine the level of risk factor awareness among schoolchildren. The sampling frame consisted of all students enrolled in grades matric through intermediate at the School A in Pakistan.

Subclass distribution of low-density lipoprotein triglyceride and the clustering of metabolic syndrome components in Japanese children.

Recent studies demonstrated that low-density lipoprotein-tryglyceride (LDL-TG) may represent another marker of cardiovascular risks. We therefore measured LDL-TG including the low-density lipoprotein (LDL) subclass distribution and investigated the association between LDL-TG subclass profile and the clustering of metabolic syndrome (MetS) components and insulin resistance in Japanese children. The study included 237 schoolchildren (boys 115, girls 122). Four subclasses of low-density lipoprotein-tryglyceride (large, medium, small, and very small) was quantified using high-performance liquid chromatography. Total LDL-TG and TG levels in LDL subclasses were evaluated among four MetS component groups; non-abdominal obesity, abdominal obesity, pre-MetS, and MetS. Total LDL-TG (P = 0.0003, P = 0.0175) and triglyceride levels in LDL subclasses were significantly different among four MetS component groups (large: P = 0.0002, P = 0.0084; medium: P = 0.0009, P = 0.0491; small: P =0.0025, P = 0.0509; very small: P = 0.0808, P = 0.0228; boys and girls, respectively). Total LDL-TG (r = 0.411, P < 0.0001, r = 0.378. P < 0.0001) and triglyceride levels in LDL subclasses correlated positively with the homeostasis model of assessment ratio (large: r = 0.396, P < 0.0001, r = 0.346, P < 0.0001; medium: r = 0.274, P = 0.0030, r = 0.228, P = 0.0115; small: r = 0.342, P = 0.0002, r = 0.292, P = 0.0011; very small: r = 0.385, P < 0.0001, r = 0.426, P < 0.0001, boys and girls, respectively). Subclass distribution of LDL-TG was significantly associated with the clustering of MetS components in both sexes, and insulin resistance is a significant determinant of LDL-TG in all LDL subclasses. Lipoprotein-tryglyceride subclass analysis, rather than LDL-C, may provide a precise evaluation for cardiovascular disease risks in children with MetS.

Sex- specific clustering of metabolic syndrome components and incidence of cardiovascular disease: A latent class analysis in a population-based cohort study.

The prevalence of metabolic syndrome (MetS) is rapidly increasing in the world; also, the importance of management of MetS to decrease the risk of cardiovascular disease (CVD) has been recognized worldwide. This study aimed to explore the clusters of participants based on MetS components and its association with CVD outcomes. We included 2598 middle-aged participants (1545 women and 1053 men), 45-65 years old, at baseline and without prior CVD history. Participants were followed up for 10years. We conducted a latent class analysis based on MetS components. Subsequently, the relationship between latent classes and the incidence of CVD was investigated using Cox regression models adjusted for the main confounders. During the study period, 393 (186 women and 207 men) new cases of CVD were identified among participants. In both genders, four distinct latent classes were identified: (1) Mets class (its prevalence rate in men: 19.6%, women: 27.7%), (2) Hypertension class (men: 12.1%, women: 13.7%), (3) Dyslipidemia class (men: 31.7%, women: 30.7%), (4) Low risk class (men: 39.3%, women: 30.5%). Compared with low-risk class, in both genders, Mets and hypertension classes were significant predictors of incident CVD. However, dyslipidemia class was a significant predictor just in women. We found four subclasses in both genders indicating the same patterns of MetS latent classes in men and women. However, the relationship between subclasses of MetS and incident CVD varied by gender. These results suggest that the etiology of MetS involve more than one pathway and giving equal weight to each component or using the same cut-off values in both genders need to be reconsidered.

Association between Metabolic Syndrome Components and Indices of Liver Steatosis and Stiffness by Transient Elastography in Patients with Type 2 Diabetes and Imaging-Confirmed Nonalcoholic Fatty Liver Disease

Background and Aims: The index of liver steatosis, controlled attenuation parameter (CAP), is a relatively new introduction to Fibroscan, an established equipment for assessing liver fibrosis, in terms of liver stiffness measurement (LSM). The relationship between CAP and/or LSM and metabolic syndrome components in diabetic patients with nonalcoholic fatty liver disease (NAFLD) was unclear, and was addressed in this study. Methods: A total of 224 patients with type 2 diabetes and NAFLD confirmed by ultrasonography were recruited. Anthropometric and serum biochemical parameters were collected. CAP and LSM were measured using transient elastography. The association between metabolic syndrome components and values of CAP and LSM was analyzed. Results: The mean age of the patients was 57.9±10.2 years, their BMI was28.6± 5.5kg/m2, and the duration of diabetes was 16.6±8.3 years. Eighty-eight percent of the patients had hypertension, and 79.5% were on lipid-lowering drugs. The mean CAP was 309.3±57.9 dB/m, and median LSM was 7.9 (5.7, 10.4) kpa. There were significant rising trends in BMI, waist circumference, waist to hip ratio, white blood cell count, HbA1c, FPG, triglyceride, ALT, AST and LSM with escalating CAP tertiles, whereas age, HDL-c, AST/ALT ratio and plasma adiponectin decreased concomitantly (all p&amp;lt;0.05). There was a larger number of metabolic syndrome components clustering in the third as compared to the first tertile of CAP (p=0.027) and LSM (p=0.035). On the other hand, with an increasing number of metabolic syndrome components, the value of CAP (p=0.001) and LSM (p=0.025) increased accordingly. Conclusion: CAP and LSM measured by transient elastography had a strong correlation with the clustering of metabolic syndrome components in NAFLD, even in patients with long-standing type 2 diabetes. Disclosure Z. Huang: None. C. Lee: None. H. Fong: None. K.S. Lam: None.

Metabolic syndrome among overweight and obese adults in Palestinian refugee camps

BackgroundMetabolic syndrome (MetS) is one of the main reasons for elevated cardiovascular morbidity and mortality worldwide. Obese and overweight individuals are at high risk of developing these chronic diseases. The aim of this study was to characterize and establish sex-adjusted prevalence of metabolic syndrome and its components.MethodsA cross-sectional study was conducted in 2015, 689 (329 men and 360 women) aged 18–65 years from three refugee camps in the West Bank. International Diabetes Federation and modified National Cholesterol Education Program-Third Adult Treatment Panel definitions were used to identify MetS.ResultsThe overall prevalence of obesity and overweight was high, 63.1%; Obesity (42 and 29.2% in women men; respectively and overweight 25.8 and 28.9% in women and men; respectively. The prevalence of MetS among obese and overweight was significantly higher (69.4%) according to IDF than NCEP definition (52%) (p < 0.002) with no significant differences between men and women using both definitions; (IDF; 71.8% men vs. 67.6% women, and (NCEP/ATP III; 51.9% men vs. 52.2% women). The prevalence of MetS increased significantly with increasing obesity and age when NCEP criterion is applied but not IDF. The prevalence of individual MetS components was: high waist circumference 81.3% according to IDF and 56.5% according to NCEP, elevated FBS 65.3% according to IDF and 56% according to NCEP, elevated blood pressure 48%, decreased HDL 65.8%, and elevated triglycerides 31.7%. Based on gender differences, waist circumferences were significantly higher in women according to both criteria and only elevated FBS was higher in women according to IDF criteria. Physical activity was inversely associated with MetS prevalence according to NCEP but not IDF. No significant associations were found with gender, smoking, TV watching, and family history of hypertension or diabetes mellitus.ConclusionIn this study, irrespective of the definition used, metabolic syndrome is highly prevalent in obese and overweight Palestinian adults with no gender-based differences. The contribution of the metabolic components to the metabolic syndrome is different in men and women. With the increase of age and obesity, the clustering of metabolic syndrome components increased remarkably. More attention through health care providers should, therefore, be given to the adult population at risk to reduce adulthood obesity and subsequent cardiovascular diseases.

Study on the prevalence rate and optimal waist circumference cut-off points of obesity for the components of metabolic syndrome in Uygur from Xinjiang

Objective To investigate the prevalence of metabolic syndrome and appropriate cut-off point of waist circumference of abdominal obesity for components of metabolic syndrome in Uygur population in Xinjiang. Methods A questionnaire-based survey, physical examination, and blood testing were conducted according to cluster random sampling in Uygur residents above 18 years old in Xinjiang. There were 3 542 samples collected, based on the International Diabetes Federation (IDF) standard of metabolic syndrome, the relativities of clustering of metabolic syndrome components and different strata of waist circumference for Uygur were analyzed, and looking for the appropriate cut-off points for identifying two or more components of metabolic syndrome within the shortest distance of receiver operating characteristic (ROC) curve. Results According to IDF standard, the waist circumference (85 cm for men, 82 cm for women) corresponded to the shortest distance in ROC curve, at these cut-offs of abdominal obesity for component of metabolic syndrome, the prevalences of metabolic syndrome were 21.3%, 19.5% in men, while 23.0% in women, the prevalence of women was higher than that of men (P<0.05). The prevalences of ≥1, ≥2 components of metabolic syndrome were shown an increasing trend with the increasing size of waist circumference, and the odds ratio of clustering of metabolic syndrome components were also increased significantly. Conclusion The prevalence of metabolic syndrome among Xinjiang Uygur population was higher than that of national level. The cut-off points of waist circumference (85 cm for men, 82 cm for women) combining other components definition of IDF standard were recommended for identifying metabolic syndrome of Uygurs. (Chin J Endocrinol Metab, 2018, 34: 211-216) Key words: Metabolic syndrome; Uygur; Component of obesity; Cut-off points of waist circumference; Prevalence rate

Metabolic syndrome in overweight and obese young Palestinian students at An-Najah National University: a cross-sectional study

BackgroundMetabolic syndrome is one of the main reasons for elevated mortality worldwide. The aim of this study was to characterise and establish sex-adjusted prevalence of metabolic syndrome in young Palestinian adults. MethodsThis cross-sectional study was done at An-Najah National University in 2014 using International Diabetes Federation (IDF) and modified National Cholesterol Education Program-Third Adult Treatment Panel (NCEP) definitions. Approval was obtained from the Institutional Review Board, and written informed consent was obtained from all participants. FindingsOf 850 students (352 men, 498 women) aged 18–24 years, 178 (21%) were overweight, and 45 (5%) were obese. 154 students were enrolled in this study (89 [58%] men, 65 [42%] women). 114 [74%] participants were overweight, and 40 [26%] participants were obese. Metabolic syndrome was more prevalent when the IDF definition was used (44 [29%] participants) than when the modified NCEP definition was used (37 [24%] participants; p<0·001), with no differences between men and women (p>0·05). Metabolic syndrome was more prevalent in participants with obesity than in students with overweight according to the IDF definition (16 [40%] vs 29 [25%]) and the modified NCEP definition (14 [35%] vs 23 [20%]). The prevalence of individual metabolic syndrome components was: 111 (72%) for central obesity (48 [43%] men, 63 [57%] women) according to the IDF definition, and 66 (43%) participants (18 [27%] men, 48 [73%] women) according to the modified NCEP definition; 46 [30%] for increased blood pressure (33 [72%] men, 13 [28%] women); 28 [18%] for high triglycerides (24 [86%] men, four [14%] women); 115 [75%] for low HDL-cholesterol (72 [63%] men, 43 [37%] women); and 37 (24%) for impaired fasting glucose (22 [59%] men, 15 [41%] women). Low HDL-cholesterol, central obesity, and raised blood pressure were the leading three common metabolic abnormalities in participants. InterpretationIrrespective of the definition used, metabolic syndrome is highly prevalent in Palestinian young adults. With the increase of obesity, the clustering of metabolic syndrome components was remarkably increased. More attention should therefore be given to the adult population at risk to reduce adulthood obesity and subsequent cardiovascular disease. FundingNone.

Waist to Stature (height) Ratio and Clustering of Metabolic Syndrome Components in Chilean Children and Adolescents

Obesity in children and adolescents is associated with increased risk of presenting metabolic syndrome (MS) and cardiovascular risk in the long term. Waist to stature (height) ratio (WSR) is a good marker of MS in adults and children and may become a simple parameter to predict the clustering of MS components in subjects at risk. Aims: To determine whether higher values of WSR are associated with the progressive aggregation of MS components among Chilean school-aged children. Methods and results: Cross-sectional study in 618 children from urban Santiago. Weight, height, waist circumference, systolic and diastolic blood pressure, and fasting lipid profile and glycemia were determined. Diagnosis of MS was based on the presence of 3 or more out of 5 components of MS defined by Cook et al. (increased waist circumference and blood pressure, hypertriglyceridemia, low HDL cholesterol and hyperglycemia). ROC curves and proportional odds were used to analyze the relationships between WSR and MS and its components. Mean age of the children was 11± 2 years old, 52% female. MS prevalence was 15%. Mean WSR was 0.53 ± 0.1. The best WSR cutoff to diagnose MS was 0.55 (72% sensitivity and 70% specificity). Using a proportional odds model, for each 0.01 increment in WSR, the OR of increasing one or more component of the MS was 1.27 (IC 95%: 1.22-1.32).

Interleukin 10 and clustering of metabolic syndrome components in pediatrics

Interleukin 10 (IL-10) has multifaceted anti-inflammatory properties that are known to regulate insulin sensitivity and atherosclerotic development. However, studies in children are limited and have yielded conflicting results. The aim of this study was to evaluate whether changes in this circulating anti-inflammatory cytokine is a marker for metabolic syndrome. This cross-sectional study involved children and young adolescents from eight elementary schools and two junior high schools located in Taipei and New Taipei City. A total of 553 children ages 8, 11 and 13 years old were included in the analysis. Parameters for obesity, anti- and pro-inflammatory cytokines, and metabolic risk profiles were evaluated. Overweight/obese children had lower serum IL-10 concentrations compared with normal weight children in the same age group (all P < 0·001). IL-10 quartiles were negatively associated with body mass index (BMI) and percentage (%) body fat (all P < 0·05). Multivariate regression analysis showed significant inverse relationship between IL-10 concentrations and % body fat (β = -0·009, P < 0·0001), and total cholesterol (β = -0·726, P = 0·003), and a small positive correlation between IL-10 and systolic blood pressure (β = 0·980, P = 0·027). In normal weight children, IL-10 concentrations were independently associated with fasting plasma insulin (β = 0·2912, P = 0·001) and waist circumference (β = 0·0069, P = 0·022). By contrast, % body fat (β = -0·016, P = 0·0009) was independently associated with IL-10 concentrations in overweight and obese children. Association between IL-10 and fasting plasma insulin concentrations was weaker in overweight/obese children compared with normal weight (β = 0·283, P = 0·011 vs. β = 0·2912, P = 0·001). Our data indicate that changes in circulating IL-10 concentrations are marker of metabolic risk in children.

Which Liver Enzymes Are Better Indicators of Metabolic Syndrome in Adolescents: The Fifth Korea National Health and Nutrition Examination Survey, 2010

This study aimed to examine the relationships of liver enzyme levels with metabolic syndrome in adolescents. A total of 808 adolescents (430 males and 378 females, aged 10-19 years) participated in the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1) in 2010, the relationships between liver enzymes [aspartate aminotransferase (AST), alanine aminotransferase (ALT), ratio of AST to ALT (AST/ALT), and γ-glutamyltransferase (GGT)] and metabolic syndrome defined by the International Diabetes Federation criteria were assessed using logistic regression and receiver operating characteristic (ROC) curve analyses. After adjusting for age, higher ALT and GGT levels and a lower AST/ALT level were associated with clustering of metabolic syndrome components, whereas AST level was not associated with it in both sexes. The strength of association between the liver enzymes and clustering of metabolic syndrome components was higher in females than in males. In the non-overweight group, higher AST, ALT, and GGT levels and a lower AST/ALT level were associated with clustering of metabolic syndrome components, whereas none of the liver enzymes was associated with metabolic syndrome in the overweight group. The area under the ROC curve (AUC) of AST to determine metabolic syndrome was not significant and was significantly lower than AUCs of ALT, AST/ALT, and GGT in both sexes. The cutoff values of ALT, AST/ALT, and GGT to determine metabolic syndrome were higher in males than in females. ALT, AST/ALT, and GGT were found to be associated with clustering of metabolic syndrome components, and the relationships appear to be sex- and weight group-specific.

Clustering and combining pattern of metabolic syndrome components in a rural Brazilian adult population.

CONTEXT AND OBJECTIVE Metabolic syndrome is characterized by clustering of cardiovascular risk factors such as obesity, dyslipidemia, insulin resistance, hyperinsulinemia, glucose intolerance and arterial hypertension. The aim of this study was to estimate the probability of clustering and the combination pattern of three or more metabolic syndrome components in a rural Brazilian adult population. DESIGN AND SETTING This was a cross-sectional study conducted in two rural communities located in the Jequitinhonha Valley, Minas Gerais, Brazil. METHODS The sample was composed of 534 adults (both sexes). Waist circumference, blood pressure and demographic, lifestyle and biochemical characteristics were assessed. The prevalences of metabolic syndrome and its components were estimated using the definitions of the National Cholesterol Education Program - Adult Treatment Panel III. A binomial distribution equation was used to evaluate the probability of clustering of metabolic syndrome components. The statistical significance level was set at 5% (P < 0.05). RESULTS Metabolic syndrome was more frequent among women (23.3%) than among men (6.5%). Clustering of three or more metabolic syndrome components was greater than expected by chance. The commonest combinations of three metabolic syndrome components were: hypertriglyceridemia + low levels of HDL-c + arterial hypertension and abdominal obesity + low levels of HDL-c + arterial hypertension; and of four metabolic syndrome components: abdominal obesity + hypertriglyceridemia + low levels of HDL-c + arterial hypertension. CONCLUSION The population studied presented high prevalence of metabolic syndrome among women and clustering of its components greater than expected by chance, suggesting that the combination pattern was non-random.

Acanthosis nigricans predicts the clustering of metabolic syndrome components in Hispanic elementary school-aged children

Acanthosis nigricans (AN) is a dermatologic condition associated with hyperinsulinemia, a marker of insulin resistance that is the principal abnormality in metabolic syndrome (MetS). We examined the association of AN with the clustering of MetS components. A cross-sectional study was conducted in an urban school-based health center in New Mexico. Students without diabetes were evaluated for AN, a family history of type 2 diabetes, body mass index (BMI), and MetS components. The clustering of MetS components by BMI category and AN status was assessed by comparing the group means of summed average z-scores of fasting insulin, triglycerides, high-density lipoprotein-cholesterol, and systolic blood pressure among the students. A multivariate model with BMI category and AN status controlling for Tanner stage was performed to identify the variables associated with the clustering of MetS components. Complete data were available for 90 children (age, 9.7±1.4 years; 94% Hispanic; 60% female). In multivariate modeling of MetS cluster z-score, significant differences were found between the students with BMI <85th percentile [-0.27; 95% confidence interval (95% CI)=-0.42 to -0.11] and (a) the students with BMI 85th-94.9th percentile with AN (0.74; 95% CI=0.17-1.31) and (b) the students with BMI ≥95th percentile with AN (0.86; 95% CI=0.54-1.18). No significant differences in the MetS cluster z-score were seen between the students with BMI <85th percentile and those with BMI 85th-94.9th percentile without AN (0.24; 95% CI=-0.33 to 0.81) or those with BMI ≥95th percentile without AN (0.31; 95% CI=-0.13 to 0.75). Overweight/obese Hispanic elementary school-aged children with AN exhibit clustering of MetS components and could benefit from early intervention.

Clustering of Metabolic Syndrome Components Attenuates Coronary Plaque Regression During Intensive Statin Therapy in Patients With Acute Coronary Syndrome

The JAPAN-ACS (Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome) trial showed that intensive statin therapy could induce significant coronary plaque regression in acute coronary syndrome (ACS). We evaluated the impact of metabolic syndrome (MetS) and its components on coronary plaque regression in the JAPAN-ACS patients. Serial intravascular ultrasound measurements over 8-12 months were performed in 242 ACS patients receiving pitavastatin or atorvastatin. Patients were divided into groups according to the presence of MetS or the number of MetS components. Although the percent change in plaque volume (%PV) was not significantly different between the MetS (n=119) and non-MetS (n=123) groups (P=0.50), it was significantly associated with an increasing number of MetS components (component 0: -24.0%, n=7; components 1: -20.8%, n=31; components 2: -16.1%, n=69; components 3: -18.7%, n=83; components 4: -13.5%, n=52; P=0.037 for trend). The percent change in body mass index (%BMI) significantly correlated with %PV (r=0.15, P=0.021), especially in the MetS components 4 group (r=0.35, P=0.017). In addition, %BMI was an independent predictor of plaque regression after adjustment for the changes of low- and high-density lipoprotein cholesterol, triglycerides and HbA(1c). The clustering of MetS components, but not the presence of MetS itself, could attenuate coronary plaque regression during intensive statin therapy in ACS patients. Therefore, to achieve a greater degree of plaque regression, it is necessary to treat to each MetS component and use lifestyle modification.

Android Fat Depot Is More Closely Associated with Metabolic Syndrome than Abdominal Visceral Fat in Elderly People

BackgroundFat accumulation in android compartments may confer increased metabolic risk. The incremental utility of measuring regional fat deposition in association with metabolic syndrome (MS) has not been well described particularly in an elderly population.Methods and FindingsAs part of the Korean Longitudinal Study on Health and Aging, which is a community-based cohort study of people aged more than 65 years, subjects (287 male, 75.9±8.6 years and 278 female, 76.0±8.8 years) with regional body composition data using Dual energy X-ray absorptiometry for android/gynoid area, computed tomography for visceral/subcutaneous adipose tissue (VAT/SAT), and cardiometabolic markers including adiponectin and high-sensitivity CRP were enrolled. We investigated the relationship between regional body composition and MS in multivariate regression models. Mean VAT and SAT area was 131.4±65.5 cm2 and 126.9±55.2 cm2 in men (P = 0.045) and 120.0±46.7 cm2 and 211.8±65.9 cm2 in women (P<0.01). Mean android and gynoid fat amount was 1.8±0.8 kg and 2.5±0.8 kg in men and 2.0±0.6 kg and 3.3±0.8 kg in women, respectively (both P<0.01). VAT area and android fat amount was strongly correlated with most metabolic risk factors compared to SAT or gynoid fat. Furthermore, android fat amount was significantly associated with clustering of MS components after adjustment for multiple parameters including age, gender, adiponectin, hsCRP, a surrogate marker of insulin resistance, whole body fat mass and VAT area.ConclusionsOur findings are consistent with the hypothesized role of android fat as a pathogenic fat depot in the MS. Measurement of android fat may provide a more complete understanding of metabolic risk associated with variations in fat distribution.

Urban and rural variation in clustering of metabolic syndrome components in the Thai population: results from the fourth National Health Examination Survey 2009

BackgroundInformation on the distribution of Metabolic syndrome (MetS) and its combinations by urban/rural areas in lower-middle income countries has been limited. It is not clear how the various combinations of MetS components varied by urban/rural population and if particular combinations of MetS are more common. This study aimed to estimate the prevalence of MetS and combinations of MetS components according to sex and urban/rural areas from a nationally representative sample of Thai adults.MethodsData from the fourth National Health Examination Survey of 19,256 Thai adults aged 20 years and over were analyzed. MetS was defined using the harmonized criteria of six international expert groups with Asian-specific cut-point for waist circumference.ResultsThe prevalence of MetS was 23.2% among adults aged ≥ 20 years (19.5% in men and 26.8% in women). Among men, the prevalence of MetS in urban was higher than those in rural areas (23.1% vs 17.9%, P < 0.05), but among women, the prevalence was higher in rural areas (27.9% vs 24.5%, P < 0.05). Overall, an individual component of low high density lipoprotein (HDL) and hypertriglyceridemia were more common in rural areas, while obesity, high blood pressure and hyperglycemia were more common in urban areas. The most common combination of MetS components in men was the clustering of low HDL, hypertriglyceridemia, and high blood pressure (urban: 3.4% vs. rural: 3.9%, adjusted OR 0.9, 95%CI 0.7, 1.1). Among women, the most common combination was the clustering of obesity, low HDL, and hypertriglyceridemia (urban: 3.9% vs rural: 5.9%, adjusted OR 0.8, 95%CI 0.6, 0.9), followed by the clustering of these three components with high blood pressure (urban: 3.1% vs. rural 4.5%, adjusted OR 0.8, 95%CI 0.7, 0.9).ConclusionMetabolic syndrome affects both urban and rural population with different pattern of MetS combinations. Dyslipidemia and obesity were the most common components among women in rural areas, hence, interventions to prevent and control these factors should be strengthened.

Relationships of Birthweight and Postnatal Growth with Metabolic Risk Factors in Junior School Children in Korea

We investigated the relationships of birthweight and postnatal growth with the components of metabolic syndrome and their clustering in young schoolchildren in Korea. The subjects comprised 261 children aged 7-9 years who were recruited from an elementary school. Information on birthweight was obtained from their parents using a questionnaire, and data were also collected via anthropometric measurement, and biochemical examinations including blood. The current body mass index (BMI) and change in weight SD score were associated with clustering of metabolic risk factors. Those in the lowest birthweight group ( < 2.5kg) had an approximately sixfold increased risk of clustering of metabolic syndrome components compared to the others when adjusted for gender, age, current BMI, and maternal factors. Accelerated growth was also associated with an approximately tenfold increased risk for adverse effect regarding clustering of metabolic risk factors than those with normal growth patterns, even in children aged 7-9 years. Systolic and diastolic blood pressures (BPs) were the only components that were positively associated with weight SD score change and current BMI. The results of this study suggest that monitoring growth throughout childhood is necessary to reduce the risk of metabolic syndrome.

Menopause: clustering of metabolic syndrome components and population changes in insulin resistance

Aim The incidence of the metabolic syndrome (MS) in women rises rapidly during the menopause, substantially increasing their cardiovascular risk and mortality. The aim of the study was to analyze menopausal changes in individual MS components and the parameter of insulin resistance (HOMA-IR).Methods A random population sample of 909 women aged 45–54 years, resident in Prague 4, was examined in an epidemiological study. After excluding women with gynecological hormone therapy or surgical therapy, the two groups of women were compared: women of reproductive age (REPRO, n == 245) vs. naturally postmenopausal women (POSTm, n == 149).Results The incidence of MS rose significantly in menopause (REPRO/POSTm 22.9 ± 2.6%%/38.3 ± 4.0%%; p < 0.001). However, a detailed analysis among the five components defining MS showed that increases were only seen in waist circumference (p < 0.0001) and triglycerides (p < 0.001). There was no increase in the other components or HOMA-IR. A detailed analysis showed an increase in HOMA-IR at levels above the median (REPRO/POSTm: low HOMA-IR 0.9/0.9, not significant; high HOMA-IR 1.8/2.1, p < 0.001) and an increase in the incidence of MS just in these high levels of HOMA-IR and those rising during menopause (REPRO/POSTm: low HOMA-IR 13.8%%/18.7%%, not significant; high HOMA-IR 30.9%%/57.3%%, p < 0.0001). In menopause, there was an increase in the clustered incidence (accompanying MS) of each of the five MS components at the expense of isolated incidence (not accompanying MS).Conclusion The acceleration of MS incidence at the onset of menopause may be accompanied by an increase in insulin resistance only in the population at highest risk. Reproductive women entering the menopause with an isolated MS component are at high risk for developing additional risk factors during menopause.

Study on the optimal waist circumference cut-off points of metabolic syndrome in Kazakh

Questionnaire-based survey, physical examination, and blood testing were conducted according to cluster random samplings in Kazakh residents in Xinjiang.2 760 samples were collected to analyze the association of different strata of waist circumference and clustering of metabolic syndrome (MS) components.Accoding to International Diabetes Federation standard, the prevalence of ≥1and ≥2 components of MS showed increasing trend with the increase of waist circunference, and odds ratio of clustering of MS components also increased significantly.The distance of receiver operating characteristic curve was the shortest and the prevalence of MS was 22.1% ;22.4% in men, and 21.9% in women;when the waist circumference was ≥91 cm for men, and ≥88 cm for women. Key words: Metabolic syndrome; Kazakh; Cut-off points of waist circumfernce

Clustering of metabolic syndrome components in a Middle Eastern diabetic and non-diabetic population.

BackgroundMetabolic syndrome (MetS) encompasses a cluster of coronary heart disease and diabetes mellitus risk factors. In this study, we aimed to elucidate the factors underlying the clustering of MetS components in diabetic and non-diabetic individuals.MethodsFactor analysis was performed on 2978 (1652 non-diabetic and 1326 diabetic) participants. Entering waist circumference, homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides, high-density lipoprotein-cholesterol (HDL-C) and systolic blood pressure (SBP), we performed exploratory factor analysis in diabetic and non-diabetic individuals separately. The analysis was repeated after replacing triglycerides and HDL-C with triglycerides to HDL-C ratio (triglycerides/HDL-C). MetS was defined by either adult treatment panel III (ATPIII), international diabetes federation (IDF) criteria, or by the modified form of IDF using waist circumference cut-off points for Iranian population.ResultsThe selection of triglycerides and HDL-C as two distinct variables led to identifying two factors explaining 61.3% and 55.4% of the total variance in non-diabetic and diabetic participants, respectively. In both diabetic and non-diabetic subjects, waist circumference, HOMA-IR and SBP loaded on factor 1. Factor 2 was mainly determined by triglycerides and HDL-C. Factor 1 and 2 were directly and inversely associated with MetS, respectively. When triglycerides and HDL-C were replaced by triglycerides/HDL-C, one factor was extracted, which explained 47.6% and 38.8% of the total variance in non-diabetic and diabetic participants, respectively.ConclusionThis study confirms that in both diabetic and non-diabetic participants the concept of a single underlying factor representing MetS is plausible.