Combinations Of Metabolic Syndrome Components Research Articles

Conservatism and divergence in the semiotics cholelithiasis

The aim of the study was to analyze the patterns associated with the risk of developing gallstone disease. Material and methods. The selection of signs of metabolic syndrome among patients of the hospital contingent with cholelithiasis, depending on gender and age, was carried out. There are 271 patients in the general population, of which 227 are women and 49 are men. Statistical processing of research results using the Statistica 8.0 applied software package. Results. Differences in etiology and pathogenesis lead to divergence of the phenotype of patients with cholelithiasis. At the same time, the conservatism of significant risk factors for the development of the disease remains. These include ethnic and sexual dimorphism: Caucasians are twice as likely to suffer from gallstone disease than the Khakass (7.3 and 3.4%, respectively). The incidence of gallstones in women is 8.6% (Caucasians - 10.9%; Khakaski - 6.2%). The indicators for women are 4.6 times higher than for men - 1.9% (Caucasians - 2.5%; Khakass - 1.3%). Older age: after 60 years, the number of patients increases exponentially, gender differences decrease. In the rating of comorbidities, the following are most often recorded: abdominal obesity (92.3% of patients), excess body weight (87.8%); violation of carbohydrate metabolism (86.4%), hypertension (81.7%), atherogenic dyslipidemia (50.6%) and NAFLD (23.6%). Conclusion. Together with conservative factors of susceptibility to gallstones that cannot be modified (age increase, female sex, heredity), a pathological phenotype known as metabolic syndrome is often formed. An increase in the frequency of gallstones is associated with variable combinations of metabolic syndrome components. Early detection of these signs can be used to predict and prevent the disease, since they are all modified to one degree or another. In addition, along with the conventional criteria for metabolic syndrome, the expression of gallstone disease has been established, which makes it possible to consider it a full-fledged sign.

Positive Additive and Multiplicative Interactions among Clustered Components of Metabolic Syndrome with Type 2 Diabetes Mellitus among Brazilian Adolescent Students.

It is still controversial whether the joint effect of Metabolic syndrome (MetS) components is greater than that expected based on their independent effects, regarding type 2 diabetes mellitus in adolescents. We evaluated additive and multiplicative interactions between pair-wise combinations of metabolic syndrome components regarding type 2 diabetes mellitus. We studied 37,815 Brazilian adolescents from a national school-based survey, The Study of Cardiovascular Risk Factors in Adolescents (Portuguese acronym, ERICA). A Poisson regression model was used to calculate sex-, age-, obesity-, smoking status-, sedentary behavior-, physical inactivity-, alcoholic consumption- and socioeconomic status-adjusted prevalence ratios to evaluate both additive and multiplicative interactions. In the comparison of observed and expected joint effects, relative excess risk due to additive interaction (RERI) for high triglycerides and low high-density lipoprotein-cholesterol, high triglycerides and elevated waist circumference, elevated waist circumference and low high-density lipoprotein-cholesterol and elevated waist circumference and high blood pressure were 2.53 (-0.41, 5.46), 2.86 (-2.89, 8.61), 1.71 (-1.05, 4.46) and 0.97 (0.15, 1.79), respectively, thus suggesting additive interactions. Multiplicative interactions for those pairs of components were also observed, as expressed by interaction ratios > 1.0. The joint presence of some of the components of MetS showed a greater association with the prevalence of type 2 diabetes mellitus in adolescents than expected from the sum of their isolated effects. From a public health perspective, preventing one of the components of the pairs that interact may result in a greater reduction in the prevalence of T2DM than focusing on an individual component that does not interact with another component.

A Cross-Sectional Study of Serum Ferritin Levels in Vietnamese Adults with Metabolic Syndrome.

BackgroundMetabolic syndrome is one of the most common public health concerns in the 21st century. Several previous studies have shown an association between increased serum ferritin levels and other components of metabolic syndrome and the risk of metabolic syndrome. They conclude that ferritin can be viewed as a predictor of metabolic syndrome risk. This study investigates some main features of metabolic syndrome and the serum ferritin levels in a Vietnamese adult cohort with metabolic syndrome.MethodsA descriptive cross-sectional study was conducted on 207 patients who were treated at the General Internal Medicine-Geriatric Department, Hue Central Hospital, from May 2018 to August 2020. Patients were divided into two groups: the study group (104 patients with metabolic syndrome) and the control group (103 patients without metabolic syndrome and no serum ferritin-mediated disease). The metabolic syndrome was diagnosed by a joint interim statement of the International Diabetes Federation/American Heart Association/National Heart, Lung, and Blood Institute/World Heart Federation/International Atherosclerosis Society/International Association for the Study of Obesity in 2009.ResultsHypertriglyceridemia–hypertension–hyperglycemia (50.9%) is the most common combination of metabolic syndrome components. The mean serum ferritin concentration was 391.62±181.97ng/mL and 124.55±63.95ng/mL in the metabolic syndrome and control groups, respectively. In the metabolic syndrome group, increased ferritin concentration accounted for 86.54% for men, the mean serum ferritin concentration was 453.064 ± 161.75ng/mL (increased ferritin concentration accounted for 96.15%) for women; the mean serum ferritin concentration was 330.17 ± 181.71 ng/mL (increased ferritin concentration accounted for 86.54%).ConclusionThe serum ferritin level is significantly increased in Vietnamese patients with metabolic syndrome.

Combinations of metabolic syndrome components and the risk of type 2 diabetes mellitus: A nationwide cohort study

ObjectiveIt remains unclear which specific combinations of metabolic syndrome (MetS) components confer a higher risk of type 2 diabetes mellitus (T2DM). This study examined the relation of each and combinations of MetS components with the risk of T2DM. MethodsWe studied the records of 19,475,643 adults aged ≥ 20 years with no history of T2DM from the database of the Korean National Health Insurance Service covering 2009 to 2012. The hazard ratios (HRs) and confidence intervals (CIs) of T2DM were estimated using Cox proportional hazards models. ResultsDuring a median follow-up of 5.13 years, 1,906,963 individuals were diagnosed with T2DM. The multivariable-adjusted HRs for T2DM were 1.86 for MetS, 1.821 for elevated fasting plasma glucose (FPG), 1.484 for elevated triglycerides, 1.415 for reduced high-density lipoprotein (HDL) cholesterol, 1.413 for elevated blood pressure (BP), and 1.17 for abdominal obesity compared with those without. In the combinations of two components excluding elevated FPG, subjects with elevated triglycerides and reduced HDL cholesterol had the highest risk of T2DM (HR 1.71; 95% CI, 1.695–1.725). In three components, the highest risk combination was elevated FPG, elevated triglycerides, and reduced HDL cholesterol (HR 3.342; 95% CI, 3.308–3.376). ConclusionsThe combination of elevated triglycerides and reduced HDL cholesterol were more strongly associated with an increased risk of T2DM than other combinations except for elevated FPG.

Metabolic syndrome in indigenous communities in Mexico: a descriptive and cross-sectional study

BackgroundAn Amerindian genetic background could play an important role in susceptibility to metabolic diseases, which have alarmingly increased in recent decades. Mexico has one of the highest prevalences of metabolic disease worldwide. The purpose of this study was to determine the prevalence of metabolic syndrome and its components in a population with high Amerindian ancestry.MethodsWe performed a descriptive, quantitative, and analytical cross-sectional study of 2596 adult indigenous volunteers from 60 different ethnic groups. Metabolic syndrome and its components were evaluated using the American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement criteria.ResultsThe overall prevalence of metabolic syndrome in the indigenous Mexican population was 50.3%. Although females had a higher prevalence than males (55.6% vs. 38.2%), the males presented with combinations of metabolic syndrome components that confer a higher risk of cardiovascular disease. The most frequent metabolic syndrome component in both genders was low HDL-cholesterol levels (75.8%). Central obesity was the second most frequent component in females (61%), though it had a low prevalence in males (16.5%). The overall prevalence of elevated blood pressure was 42.7% and was higher in males than females (48.8 vs. 40%). We found no gender differences in the overall prevalence of elevated triglycerides (56.7%) or fasting glucose (27.9%).ConclusionsWe documented that individuals with Amerindian ancestry have a high prevalence of metabolic syndrome. Health policies are needed to control the development of metabolic disorders in a population with high genetic risk.

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

BackgroundAlthough 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.MethodsThirty-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.ResultsSubjects 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.ConclusionsThe 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.

Synergistic interactions among metabolic syndrome components and homeostasis model assessment of insulin resistance in a middle-aged general population over time.

Insulin resistance is considered a hallmark feature of the metabolic syndrome, but how metabolic syndrome components and insulin resistance measures interact over time is unclear. The homeostasis model assessment of insulin resistance (HOMA-IR) is a static index of insulin resistance typically used in epidemiological studies. We explored how HOMA-IR is affected by clustering metabolic syndrome components over time in a population of middle-aged, healthy subjects. A total of 1757 subjects aged 41.3±7.5 years (39% males) free from diabetes at baseline were followed-up for a median of 5.7 years. At baseline and at the end of observation, we determined metabolic syndrome components and HOMA-IR. Cross-sectionally, HOMA-IR was synergistically increased by clustering of at least two to three metabolic syndrome components as determined at baseline and at study end by departure from additivity. Some combinations of metabolic syndrome components were associated with a significant synergic increase in HOMA-IR, and some combinations of two components entailed a synergistic risk of developing metabolic syndrome. Over time, the average change in HOMA-IR was more than additively affected by change in the number of metabolic syndrome components. Baseline HOMA-IR values were predictive of incident metabolic syndrome independent from age, sex, and each metabolic syndrome component. We show synergistic interaction between clustering metabolic syndrome components and insulin resistance, estimated by HOMA-IR, cross-sectionally and over time. This more than additive effect explains the incremental value of HOMA-IR in predicting metabolic risk.

Abstract 467: A Combination of Metabolic Syndrome Components Increased the Risk of Incident Atrial Fibrillation in a General Urban Cohort: the Suita Study

Background: Atrial fibrillation (AF), the most common chronic arrhythmia, is linked to increased risks of mortality and cardiovascular disease. Few prospective studies have examined the combined effect of metabolic syndrome (Mets) components on the incidence of AF in a general population. We investigated whether combinational Mets components increase the risk of incident AF in an urban Japanese population. Methods: The 6,659 Suita Study participants (30-84 yrs old) were initially free of AF and prospectively followed up for incident AF. Standard 12-lead ECGs were obtained from all subjects in the supine position. The participants were diagnosed with AF if AF or atrial flutter was present on ECGs obtained during a biannual routine health examination or if AF was indicated as a present illness by questionnaire, medical records, or the registration of one or more cardiovascular disease events during follow-up. The Mets components were defined as follows: higher blood pressure (HBP, systolic/diastolic BP ≥130/85 mmHg or use of antihypertensive medication), hyperglycemia (fasting plasma glucose >100 mg/dL or use of diabetes medication), hypertriglyceridemia (HTG, serum triglyceride >150 mg/dL or use of medication for HTG), lowered HDL cholesterolemia (HDL <40 mg/dL in men and <50 mg/dL in women), and central obesity (waist circumference >85 cm in men and >80 cm in women). The definition of Mets was used for the current international recommendations, which constitutes the presence of any three or more of five components. Cox proportional hazard ratios (HRs) and 95% confidence intervals (CIs) were analyzed after adjusting for age, gender, smoking, drinking, chronic kidney disease, stroke, and heart disease at baseline. Results: During the 13 years of follow-up, 242 incident AF events occurred. The adjusted HRs (95% CIs) of incident AF for central obesity, HBP, and Mets were 1.39 (1.06-1.82), 1.41 (1.08-1.85), and 1.34 (1.03-1.75), respectively. Compared with the absence of the components, the adjusted HR (95% CIs) of incident AF for subjects with any three components was 1.72 (1.11-2.67). Conclusion: Mets, central obesity, and HBP are risk factors for incident AF. Appropriate BP and body weight are important for preventing AF in the general population in Japan.

Abstract 274: Preliminary Candidate Gene Analysis In The Women’S Interagency HIV Study Shows Pleiotropic Effect Of APOB4 And Novel Associations Of BMP4 And NOS3 With Metabolic Syndrome Traits.

Purpose: To evaluate associations between candidate genes that promote pro-vasoconstriction, pro-coagulating, and pro-inflammatory vascular environment which lead to the constellation of phenotypes known as Metabolic Syndrome. Materials and Methods: 3788 women from the Women’s Interagency HIV Study were genotyped using and Illumina 5M array. Thirty two candidate genes were selected from a comprehensive literature search that promoted pro-vasoconstrictive, pro-coagulative and pro-inflammatory vascular environment. Also three genes (APOB, CETP, LPL) were selected to serve as positive control due to their established association evidence with Metabolic Syndrome and combination of Metabolic Syndrome components. Single SNP regression analysis was performed using the additive model, adjusting for age at baseline and BMI where appropriate. Nine principal components obtained from genome wide SNPs were added to the model to control for population structure. Phenotypes were derived using ATP III definition as a guideline. The baseline values of the phenotype were analyzed. 2000 SNPs were assayed within and 10kb upstream and downstream of each of the 32 gene, which results an experimental wide significance level 2.5e-05. Results: Several previously reported SNPs in the APOB gene were marginally significant for HDL cholesterol and total cholesterol traits. Previously unreported SNP rs11687484 reached experimental wide significance for both hemoglobin A1C and fasting glucose. Eight SNPs in CETP reached experimental wide significance with HDL cholesterol, and nonHDL cholesterol/HDL cholesterol ratio phenotypes. A SNP rs72680532 in BMP4 gene is also significantly associated with total cholesterol/HDL cholesterol ratio. BMP4 gene has not been reported to be associated with any Metabolic Syndrome traits or cardiovascular disease. Previously unreported association between SNP rs3918229 in NOS3 gene and HDL cholesterol reached experimental wide significance. Conclusion: Multiple genes are associated with traits contributed Metabolic Syndrome, which potentially suggests pleotropic effects.

Associations of the prevalence of cardiovascular diseases with a high level of depression in the open population of an average urbanized Siberian town

To reveal an association of the prevalence of coronary heart disease (CHD) and metabolic syndrome (MS) with a high level of depression in the open population of 25-64-year-old men in an average urbanized Siberian town. The survey was conducted on a representative sample formed from the voting list of 25-64-year-old men in one of the administrative districts of Tyumen. The standard WHO MONICA-psychosocial questionnaire was used to study associations of the prevalence of CHD and MS with a high level of depression within cardiologic screening. The age-adjusted prevalence of depression was 4.6% (a high rate) and 19% (a moderate rate) in the 25-64-year-old men of the average urbanized town of West Siberia. With advancing age, the high level of depression increased, peaking in a 55-64-year-old group. In high depression and CHD in the 25-64-year-old men, the odds ratio (OR) was 21.07 for high depression and 39.84 for a definite CHD form. High depression was significantly more common in MS patients in the open population of 25-64-year-old people of the average urbanized Siberian town and in the 55-64 year old age group. An association was found between high depression and a combination of MS components: a concurrence of abdominal obesity, hypertriglyceridemia, and lower high-density lipoprotein cholesterol (OR 13.13). The epidemiological criteria revealed by standardized survey methods for psychosocial factors, depression in particular, should be used during the preventive examinations of a male population and during the selection of able-bodied people with cardiovascular disease to undergo in-depth examination and follow-up.

Comparative assessment of cardiometabolic risk factor role in high-stress occupations

Aim. To investigate the components of metabolic syndrome (MS) and to evaluate the role of cardiometabolic risk factors (RFs) in high-stress vs. low-stress occupations, in order to enable early diagnostics of the most important factors. Material and methods. In total, 299 men were examined (mean age 43,25±7,75 years). Group I worked as train drivers (n=185), while Group II included railway track workers (n=114). All participants underwent clinical examination, measurement of body mass index, waist circumference (WC), office blood pressure (BP), blood glucose, and lipid profile. MS was diagnosed according to the criteria by IDF (2005), ATP III (2005), and the Society of Cardiology of the Russian Federation (2009). Results. Group I, compared to Group II, demonstrated higher prevalence (p<0,05) of smoking (+22%); abdominal obesity (AO), as denoted by WC ≥94 cm (+28%) or WC 94-102 cm (+16%); elevated systolic BP, SBP (+36%); total cholesterol, TCH (+12%) and very low density lipoprotein cholesterol, VLDL-CH (+16%). The most prevalent combination of MS components among individuals in a high-stress occupation was AH and AO. In Group I, MS prevalence ranged from 30% to 49% (p<0,05) and was 2,5-2,7 times higher than in Group II (p<0,001). Conclusion. Individuals in high-stress occupations demonstrated high prevalence of cardiometabolic RFs and MS. Based on strict MS criteria, early preventive measures among people in high-stress occupations should target individuals with WC 94-102 cm combined with other cardiovascular RFs.

Metabolic syndrome and all-cause mortality, cardiac events, and cardiovascular events: a follow-up study in 25,471 young- and middle-aged Japanese men

The association between subjects with metabolic syndrome (MS) who were considered not to require medication by their attending physicians and all-cause mortality, ischemic heart disease (IHD) and cardiovascular disease (CVD) remains unknown and should be clarified. This is an observational longitudinal cohort study with a median follow-up of 7.5 years performed for 25,471 Japanese men aged 20-61 years who were not on medication. We used a modified definition of MS from the Japanese Society of Internal Medicine and the NCEP ATPIII, both of which employed body mass index instead of waist circumference. MS was associated with increased rates of all-cause death (adjusted hazard ratio (HR): 4.88 [95% confidence interval, 2.96-7.66]), IHD (3.17 [1.06-7.65]), and CVD (2.63 [1.32-4.72]). In contrast, overweight subjects with no component or one component had similar rates to subjects of normal weight. Any combination of the three MS components was associated with significantly greater rates of all-cause mortality (HR: 3.18-11.2) and IHD (HR: 3.17-8.24), whereas blood pressure elevation plus dyslipidaemia was associated with a significantly higher rate of CVD (HR: 3.27). In any endpoint, MS defined by Japanese criteria had higher HRs than defined by NCEP ATP III criteria. Young and middle-aged Japanese men with MS who had been viewed as not needing medication already showed increased rates of all-cause mortality, IHD and CVD. Additionally, the event rate depended on the specific combination of metabolic syndrome components.

Metabolic Syndrome Components Are Associated with Future Medical Costs Independent of Cardiovascular Hospitalization and Incident Diabetes

Higher medical care costs have been associated with the number of metabolic syndrome components present, but the association with future medical costs has not been described. Furthermore, the independent cost contribution of each component alone and in combination with other components is unknown. We identified 57,420 nondiabetic adults aged ≥30 with all metabolic syndrome components measured in 2003-2004 and with 5 years of follow-up data available. We calculated and compared total annualized direct medical costs across the number of metabolic syndrome components present and for all possible combinations of metabolic syndrome components. The independent contribution to costs of each component was isolated by adjusting for age, sex, the other metabolic syndrome components, incident diabetes, number of years with diabetes, cardiovascular (CVD) hospitalization, and years after hospitalization. Annualized age- and sex-adjusted medical costs incurred over follow-up increased with each additional metabolic syndrome component present. After full adjustment, hypertension ($550), obesity ($366), low high-density lipoprotein (HDL) ($363), and high triglycerides ($317) were significantly associated with higher annual costs (P < 0.001 for all), but impaired fasting glucose was not. Further analysis indicated that costs were significantly elevated for each of these components only among those who did not develop diabetes or were not hospitalized for CVD. Incident diabetes or CVD hospitalizations accounted for the association between each metabolic syndrome component and future costs when these events occurred, but the elevated costs associated with metabolic syndrome components were observed even when these events did not occur. Further research is needed to understand the underlying morbidity that is driving the increased costs.

Blood Pressure Levels Constitute the Most Important Determinant of the Metabolic Syndrome in a Mediterranean Population: A Discrimination Analysis

The aim of the study was to evaluate the relative importance of the determinants of the metabolic syndrome in a sample with metabolic syndrome from the Greek population. A random sample of 824 male (56 ± 11 years) and 1,199 female (58 ± 10 years) subjects with metabolic syndrome [National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III)], but without diabetes mellitus or established cardiovascular disease, was selected from all over Greece. Principal components analysis (PCA) was applied to evaluate the interrelationships between the inherent characteristics of the metabolic syndrome. Among the participants, 87.6% had elevated blood pressure levels, 79.9% had hypertriglyceridaemia, 62.6% had low high-density lipoprotein cholesterol (HDL-C) levels, 71.4% had impaired fasting glucose (FG), and 91.5% had abdominal obesity. The most common combination was elevated blood pressure levels, abdominal obesity, impaired fasting glucose (FG), and hypertriglyceridemia (14.2%). PCA revealed three main components that explained 68.4% of the total variation. The first one was heavily loaded by blood pressure (28.6% of the total variation explained), followed by a component characterized by lipid variables (21.7%) and a component characterized by FG and waist circumference measurements (18.1% explained variation). The most dominant characteristic of metabolic syndrome participants from a Mediterranean country (Greece) was elevated blood pressure levels, which were present in all eight of the most common combinations of metabolic syndrome components, rendering the "hypertensive aspect" of metabolic syndrome the most common one. Because a significant proportion of hypertensive subjects with metabolic syndrome receive no treatment, or are poorly controlled, targeting blood pressure levels in the general population may assist in better preventing metabolic syndrome and its complications.

Diabetes incidence for all possible combinations of metabolic syndrome components

Aims Because metabolic syndrome (MetS) is defined as any three of five criteria, not all persons with MetS have the same risk factors. Whether the combinations of criteria confer equal diabetes risk is unknown. Methods We identified 58,056 non-diabetic adults age >=30 with all MetS components measured in 2003–2004. We estimated age- and sex-adjusted diabetes incidence over 5 years for all possible combinations of MetS components. Results The overall incidence rate of diabetes was 12.5/1000 person-years (95% CI 12.1–12.9). Although incidence increased with the MetS factor count, incidence varied by >9-fold in patients with 3 risk factors, >5-fold in patients with 4 factors, and >54-fold in patients with <3 factors. All two-factor combinations that included hyperglycemia had higher incidence rates than three- or four-factor combinations that did not. For example, incidence in patients with only hyperglycemia and obesity was 21.7/1000 person-years (95% CI 17.4–27.1), compared to 11.4 (9.8–13.4) among those with four components without hyperglycemia. Conclusions Diabetes risk increases exponentially with MetS factor count, but varies substantially depending upon which factors are present. Hyperglycemia, regardless of the presence of MetS, is a much stronger predictor of incident diabetes than MetS without hyperglycemia.

Lower BMI cutoff for assessing the prevalence of metabolic syndrome in Thai population

This article investigates the prevalence of metabolic syndrome (MS) and the benefits of lowered body mass index (BMI) cutoff point for assessing MS prevalence in a large, nationally representative population sample comprising of 15,365 Thai adults from metropolitan Bangkok who received annual checkup. Prevalence of MS was characterized using the International Diabetes Federation criteria and BMI ≥ 25 kg/m(2) as cutoff revealed that 26.63% of male and 14.90% of female subjects had MS and the prevalence was age dependent. Traditional BMI cutoff of ≥ 30 kg/m(2) underestimated MS prevalence in Thai population while BMI ≥ 25 kg/m(2) was found to be a suitable solution. Common combinations of MS components were identified in order to find common occurrences that may be implicated in the development of diabetes and/or cardiovascular diseases.

Impact of metabolic syndrome with hyperglycemia on prevalence of stroke in Chinese

To investigate the impact of metabolic syndrome (MS) with or without hyperglycemia on stroke prevalence compared to that of diabetes alone. 44 100 subjects, 20 570 males and 23 530 females, aged 25 - 75, who had participated in the Chinese Residents Nutrition and Health Examination Survey held in the mainland of China 2002, underwent anthropometry, measurement of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), high density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), and 2 hour plasma glucose (2 h PG) after 75 g oral glucose tolerance test (OGTT). 22 570 subjects, 10 698 males and 11 872 females, were divided into 5 groups: control group without MS risk factors (n = 17 518), Group of diabetes mellitus (DM) without MS (n = 638), group of MS with normoglycemia (n = 2501), Group of MS with mild hyperglycemia (n = 1058), and group MS with DM (n = 855). The relationship between MS and stroke was studied by multiple logistic regression analysis. The prevalence of MS increased along with age. The MS prevalence rates of the subjects with FPG > or = 5.6 mmol/L in the age groups 25 - 34, 35 - 44, 45 - 54, and > or = 55 were 23.5%, 37.2%, 45.7%, and 53.0% respectively, all significantly higher than those of the subjects with the FPG < 5.6 mmol/L (2.2%, 4.7%, 7.8%, and 9.5% respectively, all P < 0.01). The prevalence rates of stroke of the groups of DM, normal blood sugar with MS, mild hyperglycemia with MS, and DM with MS were 2.94%, 2.27%, 2.89%, and 4.11%, respectively, all significantly higher than that of the control group (0.19%, all P < 0.01). After adjustment for age, sex, smoking status, and LDL-C, no significant difference was observed between the neighboring MS groups (all P > 0.05). Compared to the group of MS with normoglycemia, the OR value for stroke of the DM with MS was 1.84 (95% CI 1.20 - 2.83, P < 0.01), which was still significant after adjusting for LDL-C (P < 0.05). (1) People with glucose intolerance had very high prevalence of stroke than novmoglgcemic people. (2) Hyperglycemia in MS has an extremely important role in the impact of MS on stroke in Chinese. (3) Diabetes by itself has the same significance as the combination of MS components in the development of stroke.

Association of stroke and different combinations of metabolic syndrome components in Chinese adults

To analyze the association of stroke and metabolic syndrome as well as its component combinations in Chinese adults. Logistic regression was used to analyze the data, including anthropometric measurement, fasting plasma glucose (FPG), blood lipids, and histories of smoking, drinking, and anamnesis, of 47,414 subjects, 22,305 males and 25,105 females, aged 20-75, obtained from Chinese National Health and Nutrition Survey in 2002. (1) Blood pressure and waist circumference were the most important factors associated with stroke. Along with the clustering of the risk factors, the subjects became more liable to suffer from stroke. Logistic regression showed that after adjustment for age, sex, smoking status, and LDL-C level, the odd ratio (OR) values of the individuals with one, two, three, and four or more factors were 3.01 (1.89-4.81) ,4.37 (2.72-7.01), 9.20 (5.75-14.73), and 13.09 (7.98-21.49) respectively. (2) The combinations of raised hypertension plus hyperglycemia and low LDL-C and central obesity were the most hazard groups, with the OR values of 16.58 (95% CI 8.78-31.32) for stroke. The OR value for the full metabolic syndrome was 10.79 (95% CI 6.81-17.10). Hypertriglyceridemia was not an independent risk factor of stroke. (3) The relationships of metabolic risk factors and stroke were various among different age groups. Stroke was not related with blood glucose, blood pressure, serum lipids, and obesity in the subjects under 35; in those aged 35-55, diastolic Bp and low HDL-C were most significantly related to stroke; as for those above 55, systolic Bp and waist circumference were most significantly related to stroke. Central obesity cored metabolic syndrome is an important risk factor of stroke. Different combinations of the components attribute variously to stroke. In people above middle age, stroke is related to metabolic risk factors.

Metabolic Syndrome and Its Components as Predictors of Ischemic Stroke in Type 2 Diabetic Patients

The available data regarding the association between metabolic syndrome (MS) or MS components and ischemic stroke in type 2 diabetics are limited and inconsistent. This study aimed to investigate these associations. Five hundred ninety-nine consecutive type 2 diabetic patients (mean age 60.4+/-9.6 years, 54% men) were followed-up for 10.1 years (median period). Baseline clinical and laboratory characteristics and the occurrence of a first-ever ischemic stroke during follow-up were recorded. Seventy-eight patients developed a first-ever ischemic stroke. According to Cox proportional hazard model, waist circumference (hazard ratio, HR:1.006, 95% CI:1.002 to 1.010, P=0.003) and age (HR:1.061, 95% CI:1.002 to 1.125, P=0.04) were significant predictors. After incorporating various combinations of MS components in multivariate models, only age and waist circumference remained significant. MS per se at baseline or combinations of its components do not predict the development of ischemic stroke in type 2 diabetic patients. Waist circumference represents an independent prognostic factor and could be used as a clinical tool for stroke prevention in this population.

Metabolic syndrome and its components as predictors of all-cause mortality and coronary heart disease in type 2 diabetic patients

Background There is no consistent evidence regarding the prognostic value of metabolic syndrome (MS) in predicting all-cause mortality and coronary heart disease (CHD) risk among type 2 diabetic patients. We sought to investigate whether individual or various combinations of MS components have a different predictive value than the presence of MS in this setting. Methods Six hundred type 2 diabetic patients (mean age 60.4 ± 9 years, 54% males) without known CHD were prospectively followed-up for a mean period of 10.06 years. The presence of MS was examined using the National Cholesterol Education Program (NCEP) definition. Statistical analyses were performed using Kaplan–Meier estimator and Cox proportional Hazard models. Results MS was present in 62.4% of the patients while 142 died during follow-up. Significant predictors for all-cause mortality were the presence of MS (HR 1.75), sex (HR 1.69), age (HR 1.09), and diabetes duration (HR 1.02). Regarding CHD incidents, HDL (HR 0.98), systolic blood pressure (HR 1.01), sex (HR 2.05), and total cholesterol (HR 1.005) were significant predictors while the presence of MS was not. Subjects fulfilling the triad consisting of diabetes, hypertension, and low HDL or the combination of diabetes, hypertension, low HDL, and high triglyceride levels had the highest probability for developing CHD events (HR 1.79, 1.73, respectively). Conclusions The presence of MS in type 2 diabetic patients without known CHD reduces the 10-year survival while specific combinations of its components have different impact on CHD risk.