Cumulative Incidence Of MetS Research Articles

Incidence of Metabolic Syndrome and Its Risk Factors in Elderly with Nonalcoholic Fatty Liver Disease.

This study aimed to determine the incidence of metabolic syndrome (MetS) and its predictors in older patients with nonalcoholic fatty liver disease. This retrospective cohort study analyzed repeated health surveillance data collected between 2009 and 2018 at Mackay Memorial Hospital, Taiwan. MetS was defined based on the modified National Cholesterol Education Program Adult Treatment Panel III (Taiwan revision). Participants were diagnosed with fatty liver disease using abdominal ultrasonography. The exclusion criteria included age <65 years, having viral hepatitis, frequent alcohol consumption, and pre-existing MetS. Logistic regression analysis was conducted, adjusting for sex and age. We enrolled 758 older participants; 457 (60.3%) with preexisting metabolic syndrome were excluded. We studied the remaining 301 participants (39.7%), with a mean age of 71.3 ± 5.4 years. The cumulative incidence of MetS was 43.5% after a mean follow-up period of 4.2 years; moreover, it was higher in women as well as in participants with diabetes and hypertriglyceridemia. After adjusting for age and sex, we identified the following risk factors for MetS: baseline high fasting plasma glucose levels (adjusted odds ratio [aOR] =1.75; 95% confidence interval [CI] 1.03-2.95), baseline hypertriglyceridemia (aOR = 2.26; 95% CI 1.15-4.47), and baseline large waist circumference (aOR =1.71; 95% CI 1.01-2.89). Furthermore, increased waist circumference and fasting plasma glucose levels at follow-up were significant risk factors. There is a high incidence of MetS among older individuals with nonalcoholic fatty liver disease; further, women and individuals with diabetes or hypertriglyceridemia are at risk of developing MetS. Moreover, waist circumference and fasting plasma glucose levels were positively associated with the risk of MetS.

Factors Related to Metabolic Syndrome Development and Recovery in Chinese Adults: A Prospective Longitudinal Study

ObjectiveThis study was a prospective assessment of the epidemiological characteristics of metabolic syndrome (MetS) in cities in Northeast China. We explored the factors that affect the occurrence and outcome of MetS according to sex.Design and MethodsThis was a longitudinal survey assessing MetS status among 750 urban community residents in China. At baseline, the intra-abdominal fat area was measured by MRI, simple anthropometric parameters (body mass index (BMI), waist circumference (WC), etc.) were used to evaluate fat distribution; blood pressure and blood lipid profile were measured; an oral glucose tolerance test (OGTT) was used to detect blood glucose; questionnaires were used to investigate lifestyles. Follow-up was conducted after 1.5 years (follow-up rate was 66.93%) to analyze the incidence of MetS and the influencing factors of MetS outcomes according to sex.ResultsThe 1.5-year cumulative incidence of MetS in the survey area was 25.40%. Men with visceral obesity were more likely to develop MetS than those with subcutaneous obesity (OR=9.778, p<0.05). Increased BMI (OR=1.379) and blood uric acid (BUA)>416 mmol/L (OR=2.318) were associated with the occurrence of MetS in men (all p<0.05). At the initial visit, BUA>356.9 mmol/L (OR=3.538), increased BMI (OR=1.212), and increased HbA1c (OR=2.577) were associated with the occurrence of MetS in women (all p<0.05). After 1.5 years, 25.37% of MetS patients no longer had MetS. Elevated diastolic blood pressure (DBP) (OR=1.097) and increased visceral fat (OR=1.023) at the initial visit made men with MetS less likely to recover from MetS (all p<0.05). Higher High-density lipoprotein cholesterol (HDL-C) at the initial visit made women with MetS more likely to recover from MetS (β: -3.509, OR=0.003, p<0.05).ConclusionThere are different risk factors for MetS in different genders. Hyperuricemia is a risk factor for the onset of MetS in both men and women.

2061-P: Inflammation Status Is Independent Risk Factor for the Development of Metabolic Syndrome in Both Metabolically Healthy Obese and Nonobese Adults

Objectives: The fact that metabolic syndrome is accompanied by a low-grade inflammation suggests inflammation may play an important role in the etiology. The aim of our study was to assess the association between heterogeneity of inflammation status and the incidence of metabolic syndrome (MetS) in the metabolically healthy persons who are either obese or nonobese. Methods: This longitudinal study included all metabolically healthy persons who underwent four or more follow-up comprehensive health examinations either annually or biennially from August 2006 through August 2013 at the Health Promotion Center at Samsung Medical Center, Seoul, Republic of Korea. Metabolic health was defined as absence of any component of the MetS except obesity. We defined obesity using the BMI, which is classified into categories of normal (18.0-22.9 kg/m2), overweight (23-24.9 kg/m2), and obesity (25 kg/m2). Hematological indices such as WBC count or its subtypes (neutrophils, lymphocytes, monocytes) and hsCRP were measured. The outcome was the 7-year cumulative incidence of MetS. Results: The person-years follow-up were 17,786 in normal weight, 10,376 in overweight, and 7,391 in obesity group. Baseline age, sex, physical activity, smoking, exercise, fasting plasma glucose, HbA1c, blood pressure, lipid profile, hematologic parameters, hsCRP were adjusted. Cox regression multivariate analysis resulted in neutrophil count (&amp;gt; 2,750/mm3) was associated with increased incidence of MetS in normal weight (HR 1.7; CI 1.29-2.35; p &amp;lt;0.001), overweight (HR 1.59; CI 1.29-1.95; p &amp;lt;0.001), and obesity (HR 1.26; CI 1.10-1.45; p&amp;lt;0.001). Conclusion: This longitudinal analysis showed the neutrophil count is associated with the incidence of MetS in the metabolically heathy persons who are either obese or nonobese. Therefore, inflammatory status could be an independent risk factor for the development of metabolic syndrome irrespective of obesity. Disclosure K. Hur: None. M. Choi: None. S. Park: None. S. Lee: None. J. Ahn: None. J. Park: None. H. Park: None. G. Kim: None. S. Jin: None. J. Kim: None. M. Lee: None.

Evaluation of a new immunochemestry analyzer Atelica® Solution

Although alanine aminotransferase (ALT) is well known to be associated with metabolic syndrome (MetS), prospective data on longitudinal increments in ALT activities and incident cases of MetS are limited. We analyzed the impact of longitudinal increments of ALT on MetS based on a health check-up population in China.A total of 4491 subjects free of MetS who completed at least two annual health examinations during March 2010 to April 2016 were enrolled in this cohort study. The MetS was defined according to the Joint Interim Statement criteria 2009. The RRs of incident MetS were estimated by using the Cox model and the Joint model in R software.The cumulative incidence of MetS was 18.55% during the 7 years of follow-up. In the Cox model, the estimated RR of developing MetS was 1.751 (95% CI =1.532–2.000) for 1 unit augmented in LNALT-0 level. In the Joint model, the estimated RR of developing MetS was 3.626 (95% CI = 2.721–4.831) for 1 unit augmented in LNALT activity longitudinally.The longitudinal increment of individuals' ALT activity over time increased the incidence risk of MetS and the effects generated by longitudinal increments of ALT on MetS was higher than that generated by baseline ALT.

Longitudinal associations of high-density lipoprotein cholesterol or low-density lipoprotein cholesterol with metabolic syndrome in the Chinese population: a prospective cohort study

ObjectiveCurrently, most studies only reveal the relationship between baseline high-density lipoprotein cholesterol (HDL-c) or low-density lipoprotein cholesterol (LDL-c) levels and metabolic syndrome (MetS). The relationship between dynamic changes in HDL-c...

Fat-soluble micronutrients and metabolic syndrome.

Purpose of reviewMetabolic syndrome (MetS) is associated with increased risk of obesity, type 2 diabetes mellitus and cardiovascular diseases. MetS prevalence has been associated with diet inadequacy. Conversely, the cumulative incidence of MetS has been inversely associated with a Mediterranean-style diet that includes many different health-beneficial nutrients. Adherence to a Mediterranean-style diet could reduce or at least stabilize metabolic risk factors.Recent findingsLow serum level of fat-soluble micronutrients, such as carotenoids, vitamin (vit) A, D and E, has been linked to MetS. Fat-soluble micronutrients could contribute to prevent MetS thanks to their antioxidant and anti-inflammatory properties (vit E, carotenoids) or to their central role as hormone regulators (vit D) and/or lipid metabolism and glucose homeostasis sensors (vit D and E).SummaryThis review summarizes recent epidemiological studies linking fat-soluble micronutrients to MetS and highlights new evidence on their mechanisms of actions.

Incidence of post-partum metabolic syndrome (Mets) in women with gestational diabetes mellitus (GDM) in tertiary care hospital Lahore 2013–2014

Background: Gestational diabetes mellitus is characterized by high blood glucose levels during pregnancy. The reported prevalence of GDM is 7% worldwide while 8% in Pakistan. About 19.5% of the women with GDM develop post-partum metabolic syndrome. Methods: A prospective cohort study carried out at tertiary-care hospital in Lahore from Jan 2013 - Dec 2014 to determine the incidence of Mets in women with GDM. After informed consent, women with and without GDM were enrolled during 28th week of pregnancy. Demographic and personal data were recorded. Presence of Mets was evaluated 6 months after delivery measuring their blood pressure, anthropometry, fasting blood sugar (FBS) and triglycerides. Cumulative incidence of Mets, means of blood pressure, anthropometric measures were calculated. Comparisons of general characteristic and component of metabolic syndrome were done by student t-test. Results: 102 women with GDM and 104 without GDM were followed. The Cumulative Incidence of Mets was 33% in GDM while 15.4% in non-GDM (P-value = 0.002). GDM group were significantly older than non-GDM group (P-Value &lt; 0.001). In GDM group 29 (28.4%) had impaired FBS while in non-GDM group 7 (7%) had impaired FBS. Diabetes developed in 27 (26.5%) of GDM group while none of non-GDM group. BMI blood pressure fasting glucose, and triglycerides were significantly higher in GDM group than non-GDM group. Conclusion: The study highlights that GDM group has more risk of developing Mets. They should be monitored as high risk for other cardiovascular diseases along with diabetes after delivery. Keywords: metabolic syndrome, gestational diabetes mellitus, postpartum period

Working hours and incidence of metabolic syndrome and its components in a Mediterranean cohort: the SUN project.

Metabolic syndrome (MetS) is an important and priority public health problem globally. Long working hours have been proposed as a modifiable risk factor for MetS, despite sparse epidemiological evidence. Thus, the aim of this study was to prospectively evaluate the associations between working hours and incidence of MetS and each of its components. We assessed 6845 participants of a Spanish dynamic prospective cohort of university graduates (the SUN project), initially free of any specific criteria of MetS, and followed-up for a median of 8.3 years. Weekly working hours were collected at baseline and grouped into four categories: >0-24, 25-39, 40-49 and ≥50 h. MetS was defined according to the updated harmonizing criteria. We estimated multivariable adjusted Relative Risks (RR) of MetS and their 95% Confidence Intervals (95% CI), using Poisson regression models. The cumulative incidence of MetS was 6.0%. Working hours were not independently related to MetS (25-39 h/week = RR: 1.42, 95% CI 0.90-2.25; 40-49 h/week = RR: 1.45, 95% CI 0.91-2.30; ≥50 h/week = RR: 1.49, 95% CI 0.91-2.42, P for trend = 0.235) nor to any of its individual definition criteria. Our findings do not suggest that long working hours increase the risk of MetS development or each of its components. Further longitudinal studies in general population should be conducted to confirm these results.

Dietary indexes, food patterns and incidence of metabolic syndrome in a Mediterranean cohort: The SUN project

We prospectively assessed the association between adherence to several a priori defined healthy food patterns and risk of metabolic syndrome (MetS). We assessed 6851 participants of a Spanish dynamic prospective cohort of university graduates, initially free of any MetS-specific definition criteria, and followed-up for a median of 8.3 years. We calculated the adherence to thirteen different a priori defined food patterns or dietary indexes. MetS was classified according to the updated harmonizing criteria. We estimated multivariable-adjusted Incidence Rate Ratios (IRR) of metabolic syndrome and their 95% Confidence Intervals (95% CI), using Poisson regression models. The cumulative incidence of MetS was 5.0%. Moderate adherence to the Pro-Vegetarian Diet (PVEG) was significantly associated with a lower risk for developing MetS (IRR = 0.75, 95% CI = 0.59-0.97). Among women, an inverse association with the PVEG was significant not only for a moderate adherence (IRR = 0.54, 95% CI = 0.36-0.82), but also for higher adherence (IRR = 0.63, 95% CI = 0.43-0.93). A higher adherence to the Dietary Approaches to Stop Hypertension (DASH) diet showed an inverse association with the MetS among participants, but only if they had low alcohol intake (RR = 0.41, 95% CI = 0.20-0.85). Our findings support the adoption of a PVEG dietary pattern for the reduction of MetS risk. The same statement can be applied in relation to the DASH diet, insofar a limited consumption of alcoholic beverages is also maintained.

Prevention of the metabolic syndrome in IGT subjects in a lifestyle intervention: Results from the SLIM study

Background and aimsThe Study on Lifestyle intervention and Impaired glucose tolerance Maastricht (SLIM), a randomized controlled trial, directed at diet and physical activity in impaired glucose tolerant subjects was effective to improve glucose tolerance and prevent type 2 diabetes. The aim of this study was to determine the effects of the SLIM lifestyle intervention on the incidence and prevalence of the metabolic syndrome (MetS) during the active intervention and four years thereafter. Methods and resultsMetS was diagnosed according to the NCEP ATP III criteria. At baseline, 66.4% of all participants (n = 146, age 57 ± 7 years, BMI 29.7 ± 3.6, 51.3% female) fulfilled the criteria for MetS. No significant difference in MetS prevalence was observed between the intervention (63.9%) and control group (68.9%). At the end of active intervention (average duration 4.2 ± 2.0 years), prevalence of MetS was significantly lower in the intervention group (52.6%, n = 57) compared to the control group (74.6%, n = 59) (p = 0.014).Furthermore, in participants without MetS at baseline, cumulative incidence of MetS was 18.2% in the intervention group at the end of active intervention, compared to 73.7% in the control group (Log-rank test, p = 0.011). Four years after stopping active intervention, the reduced incidence of MetS was maintained (Log-rank test, p = 0.002). ConclusionIn conclusion, a combined diet-and-exercise intervention to improve glucose tolerance, not only prevented type 2 diabetes, but also reduced the prevalence of MetS and prevented MetS development, showing the long-term impact of lifestyle intervention on cardiovascular risk reduction.Clinical trial registration number: NCT 00381186 (www.clincialtrials.gov).

Predictive value of body mass index and waist circumference for metabolic syndrome in 6–12‐year‐olds

To determine the predictive value of body mass index (BMI) and waist circumference (WC) and their optimal cut-off points for metabolic syndrome (MetS), and also the incidence of MetS. This study included 888 children, aged 6-12 years, who were followed for a mean of 6.6 years. BMI, WC and their optimal cut-off points to predict MetS were investigated. The cumulative incidence of MetS was 10.7%. The adjusted ORs for age, sex and family history to predict MetS for BMI and WC z-scores were 2.6 (95% CI, 2.0-3.5) and 2.6 (95% CI, 1.9-3.5), respectively. In their correspondent models, area under the receiver operating characteristic (ROC) curve was 0.73 (95% CI, 0.68-0.79) for BMI z-scores and 0.72 (95% CI, 0.67-0.78) for WC z-scores with no statistically significant difference. The optimal cut-off values for BMI were 16.5 kg/m(2) for boys and 16.3 kg/m(2) for girls and those for WC were 57.5 cm for boys and 56.5 cm for girls. Our findings suggest that both BMI and WC have the same power to predict MetS and also children with higher BMI or WC are more susceptible to MetS. Moreover, a high incidence of MetS in children highlights the importance of interventional strategies during early childhood.