Difference In Prevalence Of MetS Research Articles

Sex-specific-evaluation of metabolic syndrome prevalence in Algeria: insights from the 2016–2017 non-communicable diseases risk factors survey

Metabolic syndrome (MetS) is a core driver of cardiovascular diseases (CVD); however, to date, gender differences in MetS prevalence and its components have not been assessed in the Algerian adult general population. This study aimed to determine the gender differences in MetS prevalence and its components, in the general population of Algeria. Secondary analysis was performed on data from the Algerian 2016–2017 non-communicable disease risk factor survey. MetS was determined according to the harmonized Joint Interim Statement criteria. A Poisson regression model based on Generalised Estimating Equations was used to estimate the adjusted prevalence ratios (aPR) for the sex-specific factors associated with MetS. Overall, the prevalence of MetS was 34.0% (95% CI 32.4–35.6). MetS prevalence in women and men was 39.1% (95% CI 37.0–41.3) and 29.1% (95% CI 27.2–31.2), respectively. The most frequent triad was the clustering of abdominal obesity with low HDL-cholesterol and high blood pressure among women (8.9%; 95% CI [8.0–10.0]) and low HDL-cholesterol with high blood pressure and hyperglycaemia among men (5.2%; 95% CI [4.3–6.3]). Increasing age (aPR 3.21 [2.35–4.39] in men and aPR 3.47 [2.86–4.22] in women), cohabitation (aPR 1.14 [1.05–1.24]), women residing in urban areas (aPR 1.13 [1.01–1.26]), men with higher educational levels (aPR 1.39 [1.14–1.70]), and men with insufficient physical activity (aPR 1.16 [1.05–1.30]) were associated with higher risk of MetS. In this population-based study, one in three Algerian adults had MetS, and key components including abdominal obesity, low HDL-cholesterol, and high blood pressure, are very common, especially in women. Reinforcing interventions for weight management targeting married women living in urban areas and improving sufficient physical activity in men with higher socioeconomic status could provide maximal health gains and stem the CVD epidemic in Algeria.

Gender differences in metabolic syndrome and its components in southern china using a healthy lifestyle index: a cross-sectional study

BackgroundLifestyle changes are important for the prevention and management of metabolic syndrome (MetS), but studies that focus on gender differences in the lifestyle risk factors of MetS are limited in China. This research aimed to generate a healthy lifestyle index (HLI) to assess the behavioral risk factors of MetS and its components, and to explore the gender differences in HLI score and other influencing factors of MetS.MethodsA convenience sample of 532 outpatients were recruited from a general hospital in Changsha, China. The general information and HLI scores [including physical activity (PA), diet, smoking, alcohol use, and body mass index (BMI)] of the subjects were collected through questionnaires, and each patient’s height, weight, waist circumference, and other physical signs were measured. Logistic regression analysis was used to analyze the risk factors of MetS and its components.ResultsThe prevalence of MetS was 33.3% for the whole sample (46.3% in males and 23.3% in females). The risk of MetS increased with age, smoking, unhealthy diet, and BMI in males and with age and BMI in females. Our logistic regression analysis showed that lower HLI (male: OR = 0.838,95%CI = 0.757–0.929; female: OR = 0.752, 95%CI = 0.645–0.876) and older age (male: OR = 2.899, 95%CI = 1.446–5.812; female: OR = 4.430, 95%CI = 1.640–11.969) were independent risk factors of MetS, for both sexes.ConclusionLow levels of HLI and older ages were independent risk factors of MetS in both males and females. The association between aging and MetS risk was stronger in females, while the association between unhealthy lifestyles and MetS risk was stronger in males. Our findings reinforced the expected gender differences in MetS prevalence and its risk factors, which has implications for the future development of gender-specific MetS prevention and intervention programs.

Metabolic syndrome among treatment-naïve people living with and without HIV in Zambia and Zimbabwe: a cross-sectional analysis.

Chronic viral replication has been linked to an increased risk of cardiovascular and metabolic diseases in people living with HIV (PLWH), but few studies have evaluated this association in Southern Africa. We explored the determinants of metabolic syndrome (MetS) among treatment-naïve adults living with and without HIV in Southern Africa. Treatment-naïve PLWH and people living without HIV (PLWOH) ≥30 years were consecutively enrolled from primary care clinics in Zambia and Zimbabwe. PLWOH were seronegative partners or persons presenting for HIV testing. We defined MetS as the presence of central obesity plus any two of the following: raised blood pressure, impaired fasting glucose, reduced high-density lipoprotein cholesterol and raised triglycerides, as defined by the International Diabetes Federation. We used logistic regression to determine factors associated with MetS. Between August 2019 and March 2022, we screened 1285 adults and enrolled 420 (47%) PLWH and 481 (53%) PLWOH. The median age was similar between PLWH and PLWOH (40 vs. 38 years, p < 0.24). In PLWH, the median CD4+ count was 228 cells/mm3 (IQR 108-412) and the viral load was 24,114 copies/ml (IQR 277-214,271). Central obesity was present in 365/523 (70%) females and 57/378 males (15%). MetS was diagnosed in 172/901 (19%, 95% confidence interval [CI] 17-22%), and prevalence was higher among females than males (27% vs. 9%). In multivariable analyses, HIV status was not associated with MetS (adjusted odds ratio [aOR] 1.05, 95% CI 0.74-1.51). Risk factors for MetS included age older than 50years (aOR 2.31, 95% CI 1.49-3.59), female sex (aOR 3.47, 95% CI 2.15-5.60), highest income (aOR 2.19, 95% CI 1.39-3.44) and less than World Health Organization recommended weekly physical activity (aOR 3.35, 95% CI 1.41-7.96). We report a high prevalence of MetS and central obesity among females in urban Zambia and Zimbabwe. Lifestyle factors and older age appear to be the strongest predictors of MetS in our population, with no evident difference in MetS prevalence between treatment-naïve PLWH and PLWOH.

Association Between Metabolic Syndrome, Its Components, and Knee Osteoarthritis in Premenopausal and Menopausal Women: A Pilot Study.

Objective: This pilot study aimed to determine the correlation of metabolic syndrome (MetS), its components, and increased LDL (low-density lipoprotein) and total cholesterol levels with osteoarthritis (OA). In addition, our goal was to establish the association between MetS and the degree of handicap measured by the Lequesne index of functionality and severity of knee osteoarthritis.Materials and methods: The pilot study included 25 subjects with knee OA and 19 subjects without knee OA. All subjects were menopausal or premenopausal women. MetS was diagnosed according to the National Cholesterol Education Program, Adult Treatment Panel III. OA was diagnosed if Kellgren-Lawrence ≥ 2.Results: MetS was detected in 80% of subjects with OA. In the non-OA group, MetS was detected in 26% of subjects. The difference in MetS prevalence between the two groups was significant (p=0.000). The presence of each MetS component was significant in the OA group, except for central obesity, which presence was marginally significant (p=0.054). Prevalence of increased total (p=0.019) and LDL cholesterol (p=0.000) was also significant in the OA group. A significant difference between OA and the non-OA group was detected in the prevalence of all five MetS components (p=0.016). In the OA group, the Lequesne index of functionality and severity of knee osteoarthritis was not significantly altered between subjects with and without MetS.Conclusion: Metabolic syndrome, its components, increased LDL, and total cholesterol are correlated with osteoarthritis in premenopausal and menopausal women. MetS is not correlated with the degree of handicap in the knee joint measured by the Lequesne index.

Low serum pepsinogen II levels are closely linked with a risk of metabolic syndrome among healthy individuals with asymptomatic Helicobacter pylori infection: a cross-sectional study.

Aim:Helicobacter pylori (Hp) infection has a connection with metabolic syndrome (MetS). Pepsinogen II (PGII) is a marker for gastric epithelial function. The present research was aimed at determining the associations among serum PGII levels, Hp infection and MetS in healthy subjects. Methods: This cross-sectional study enrolled 1242 healthy people, including 545 subjects with asymptomatic Hp infection and 697 subjects without Hp infection. Based on the number of MetS components present, subjects with Hp infection were assigned to the following groups: group 1, no component (126 subjects); group 2, one or two components (260 subjects); and group 3, three or more components (159 subjects). Physical measurements and biochemical indices were recorded. Serum PGII levels were recorded using ELISA. SPSS and GraphPad Prism were used for statistical analyses. Results: Among subjects with Hp infection, serum PGII was evidently downregulated in group 3 compared with group 1 (14.95±8.24 vs 17.97±9.08μg/l; p=0.015). Serum PGII levels were correlated with an increased risk of MetS (odds ratio: 0.867; 95% CI: 0.772-0.974; p=0.016), as indicated by the multivariate logistic regression analysis. Grouping subjects with Hp infection according to quartiles of serum PGII levels identified an evident difference in MetS prevalence among the four quartile-based groups (p=0.047). Conclusions: Among healthy subjects with asymptomatic Hp infection, serum PGII levels were lower in those with MetS than in those without MetS. Serum PGII levels showed an independent and negative correlation with the risk of MetS in healthy subjects with Hp infection.

Thyroid autoimmunity and metabolic syndrome: a nationwide population-based study.

Recent studies have reported that thyroid hormone levels are associated with metabolic syndrome (MetS) even in euthyroid subjects. However, the association between thyroid autoimmunity and MetS is uncertain. This study aimed to investigate the relationship between thyroid autoimmunity and MetS in a large cohort study of euthyroid subjects. A total of 4775 participants aged ≥19 years from the Korea National Health and Nutrition Examination Survey VI (2013-2015) with anti-thyroid peroxidase antibody (TPOAb) results and normal thyroid functions were included in this study. Subjects were grouped according to thyroid autoimmunity (positivity of TPOAb). We estimated the odds ratios (ORs) for MetS according to TPOAb positivity using logistic regression models, adjusted for potential confounders. Of the study subjects, 25% (n = 1206) were diagnosed with MetS. Subjects with MetS showed higher median TPOAb levels (6.3 vs 6.8 IU/mL, P < 0.001) and higher positivity of TPOAb (5 vs 7%, P = 0.002) than those without MetS. There was a significant difference in prevalence of MetS depending on the TPOAb positivity (25% vs 33%, P = 0.002). Subjects with TPOAb positive had a significantly greater risk of abdominal obesity (OR 1.675, 95% CI: 1.302-2.154, P < 0.001), low high-density lipoprotein cholesterol (OR: 1.603, 95% CI: 1.244-2.066, P < 0.001) and elevated blood pressure (OR: 1.418, 95% CI: 1.099-1.829, P = 0.007) as compared to those with TPOAb negative. Positivity of TPOAb was a significant risk factor for MetS even after adjusting for confounding variables including age, sex, household income, education, smoking, alcohol consumption, walking activity, thyroid-stimulating hormone and free thyroxine (OR: 1.389, 95% CI: 1.048-1.841, P = 0.022). In euthyroid subjects, thyroid autoimmunity is associated with MetS. Further large longitudinal studies are needed to clarify causality.

Mexican immigrant health advantage in metabolic syndrome? Examining the contributions of demographic, socioeconomic, and health behavior characteristics

Although Mexican immigrants to the United States (US) have historically held health and mortality advantages over US-born groups, evolving population dynamics in Mexico paired with shifts in Mexico-US immigration patterns and policy regimes have raised new concerns about the metabolic health of recent cohorts of Mexican immigrants. Using a nationally representative sample of adults aged 20-years and older (n = 10,833) from the National Health and Nutrition Examination Study (NHANES, 1999–2016), we assess and seek to explain differences in metabolic syndrome (MetS) risk by race-ethnicity, country of origin, and duration of residence in the US and evaluate whether recent Mexican immigrants continue to exhibit a metabolic health advantage. We decompose the difference in MetS prevalence between US-born whites (45.5%) and recent Mexican immigrants (29.5%) to determine how demographic, socioeconomic, and health behavior characteristics contribute to the patterning of metabolic health. Findings reveal that recent Mexican immigrants hold a metabolic health advantage over all groups, which is accounted for by their younger age structure. Yet recent Mexican immigrants would retain a sizable age-adjusted MetS advantage if they were to achieve parity with US-born whites on education, income, and food security. To ensure that newly-arrived Mexican immigrants continue to experience historically favorable health and mortality prospects, modest policy changes could offer health-promoting protections in the form of increased economic and food security, as well as improved educational opportunities for younger immigrants.

Effect of Metabolic Syndrome on Anatomy and Function of the Lower Urinary Tract Assessed on MRI

To investigate the relationship between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) with functional and anatomic changes of the lower urinary tract with MRI. The bladder and prostate of 95 subjects (56M, 39F) were segmented on T2-weighted pelvic MRI using Materialize Mimics 3D software. Bladder wall volume (BWV), post-void residual (PVR) and prostate volume (PV) were quantified from the 3D renderings. LUTS were quantified using validated questionnaires administered at the time of MRI. Wilcoxin rank sum, win ratio and chi-square tests were used to correlate symptom scores, BWV, PVR and PV in patients 1) without vs with MetS, 2) with mild (IPSS or UDI-6: 0-7) vs moderate-severe (IPSS: 8-35 or UDI-6: ≥8) and 3) normal vs enlarged prostates (>40cm3). Multivariate linear regression was used to determine predictors for BWV, PVR and PV. Men with MetS had increased BWV (66.8 vs 51.1cm3, P=.003), higher PVR (69.1 vs 50.5cc, P= .05) and increased PV (67.2 vs 40.1cm3, P= .01). Women without and with MetS had similar BWV, PVR and LUTS (P= .3-.78). There was no difference in prevalence of MetS, BWV, PVR or PV in men or women with mild vs moderate-severe LUTS (P=.26-.97). Men with enlarged prostates were more likely to have MetS (P=.003). There was no difference in BWV, PVR and LUTS for men with normal vs enlarged prostates (P= .44-.94). In men, BWV was highly correlated with MetS (P=.005) on regression analysis. MetS leads to detrusor hypertrophy and may contribute to impaired bladder function, likely related to the effect on the prostate.

The IDF Definition Is Better Suited for Screening Metabolic Syndrome and Estimating Risks of Diabetes in Asian American Adults: Evidence from NHANES 2011-2016.

Objective: extensive effort has been made to better define metabolic syndrome (MetS). Whether current definitions accurately diagnose MetS and predict risk of cardiovascular disease (CVD) or diabetes in diverse ethnic groups remains largely unknown. The objective of this study was to compare the prevalence of MetS and risk of CVD and diabetes among Asian American adults using two MetS definitions, one proposed by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) and one by the International Diabetes Federation (IDF). Methods: we obtained a nationally representative sample of 2121 Asian American adults in the noninstitutionalized civilian population of the United States from the National Health and Nutrition Examination Survey (2011–2016). We computed age-adjusted, gender-specific MetS prevalence and each MetS component using ATP III and IDF definitions. Results: based on the IDF definition, MetS prevalence was 39.26% among Asian American men and 39.66% among Asian American women included in the study sample. Based on the ATP III definition, MetS prevalence in our sample was 39.38% among men and 36.11% among women. We found good concordance between the IDF and the ATP III definitions in identifying MetS in Asian American adults. Those with MetS defined only by the IDF definition had significantly higher body mass index (BMI) and waist circumference than those with MetS defined only by the ATP III definition. The IDF definition also better predicted elevated fasting insulin. Conclusions: the IDF definition is more pertinent than the ATP III definition for screening and estimating risk of CVD and diabetes in Asian American adults. Future studies should examine differences in MetS prevalence across Asian ethnic groups to facilitate the development of culturally tailored strategies improve MetS prevention and detection in Asian Americans.

Occupational distribution of metabolic syndrome prevalence and incidence differs by sex and is not explained by age and health behavior: results from 75 000 Dutch workers from 40 occupational groups

IntroductionThis study examines the association between 40 occupational groups and prevalence and incidence of metabolic syndrome (MetS), separately for male and female workers, and whether age and health behaviors can...

Metabolic Syndrome Prevalence in Students Attending West Virginia University.

Metabolic Syndrome (MetS) contributes to the development of cardiovascular disease (CVD) and type II diabetes mellitus (T2DM). Few studies have investigated the MetS risk of young adults (18–24 years old). This study aims to determine the prevalence of MetS in Appalachian and non-Appalachian students attending West Virginia University. The prevalence of MetS in this population was 15%. There was no difference in MetS prevalence between male students and female students (18.8% males and 11.1% females, p-value = 0.30), or between Appalachian students and non-Appalachian students (17.7% Appalachian and 10.0% non-Appalachian, p-value = 0.33). Identification of MetS early in life is needed in order to reduce the onset of chronic disease. Therefore, implementing a screening process to identify at-risk young adults will help tailor more effective behavioral interventions.

The Metabolic Syndrome and Health Behaviors in School Children Aged 13–16 Years in Ubon Ratchathani: UMeSIA Project

Although metabolic syndrome (MetS) has become a significant public health problem worldwide, little evidence exists to describe the prevalence of MetS in school children using MetS different classifications, and its association with health-related behaviors. Using data on 393 children and adolescents aged 13-16 years participating in the Ubon Ratchathani Metabolic Syndrome in Adolescent (UMeSIA) Project, the prevalence of MetS was determined using the International Diabetes Federation (IDF) 2007 definition and other three classifications reported in the previous literature. The prevalence of the MetS was compared across sex, a family history of diabetes, type of schools, and health behaviors using chi-square test. The prevalence of MetS and proportion of abnormalities in MetS components were compared across different MetS classifications using Cochran Q test. The prevalence of MetS in Thai school children was 3.1%, 5.8%, 6.9%, and 11.2% when using IDF, Cook's, Ford's, and De Ferranti's classifications respectively (Difference in MetS prevalence across the four MetS classifications, P < 0.001). Using IDF classification, prevalence was higher in male than female students (5.9% and 1.2%, respectively, P < 0.001) and higher in those with a family history of diabetes than those without (8.5% and 2.3%, respectively, P < 0.001). Students from a sports school had considerably lower MetS prevalence than those from conventional schools (1.9% and 3.5% respectively, P < 0.001). Those with MetS spent significantly longer time watching TV than those without (median (interquartile range) time to watch TV 180.0 (120.0, 240.0) and 120.0 (60.0, 180.0) min per day respectively, P = 0.002). The prevalence of MetS in Thai school children was modest and varied greatly when different MetS definitions were applied. Interventions to optimize time spent watching TV and increase physical activity may be beneficial in reducing the risk of the MetS in children and adolescents.

Prevalence of metabolic syndrome and its related factors among North Korean refugees in South Korea: a cross-sectional study

ObjectivesTo determine the prevalence of metabolic syndrome (MetS) and its related factors among North Korean refugees (NKR) in South Korea.DesignCross-sectional study conducted using a questionnaire and anthropometric and biochemical data...

The Association Between Subclinical Hypothyroidism and Metabolic Syndrome as Defined by the ATP III Criteria.

The association between subclinical hypothyroidism (SCH) and metabolic syndrome (MetS) is a matter of debate. In this study, we aimed to examine the risk of MetS in SCH through a systematic review and meta-analysis. A systematic search of published literature up to September 2015 was conducted. General population studies were included if they had considered SCH as the independent variable. After data extraction, a meta-analysis was run to assess the odds ratio (OR) of MetS and its components between subclinical hypothyroid and euthyroid groups. Only studies employing Adult Treatment Panel III (ATP III) criteria for MetS were included in the meta-analysis. In the SCH group, female gender was more prevalent [OR = 1.65, 95% confidence interval (95% CI) 1.29-2.13]. Meta-analysis showed no significant difference in MetS prevalence between SCH and euthyroid individuals (OR = 1.13, 95% CI 0.95-1.34). However, the prevalence of central obesity (OR = 1.43, 95% CI 1.04-1.96) was significantly higher in the SCH group. On the other hand, hypertriglyceridemia was more prevalent in the female-only SCH subgroup. In conclusion, although we found some MetS components to be more prevalent in SCH, the prevalence of MetS as defined by ATP III criteria was not increased in SCH. Considerable heterogeneity observed may have influenced the results on MetS components.

Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis.

Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The primary aim of this systematic review and meta-analysis was to assess the prevalence of MetS and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder, comparing subjects with different disorders and taking into account demographic variables and psychotropic medication use. The secondary aim was to compare the MetS prevalence in persons with any of the selected disorders versus matched general population controls. The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%-34.4%; N = 198; n = 52,678). Relative risk meta-analyses established that there was no significant difference in MetS prevalence in studies directly comparing schizophrenia versus bipolar disorder, and in those directly comparing bipolar disorder versus major depressive disorder. Only two studies directly compared people with schizophrenia and major depressive disorder, precluding meta-analytic calculations. Older age and a higher body mass index were significant moderators in the final demographic regression model (z = -3.6, p = 0.0003, r(2) = 0.19). People treated with all individual antipsychotic medications had a significantly (p<0.001) higher MetS risk compared to antipsychotic-naïve participants. MetS risk was significantly higher with clozapine and olanzapine (except vs. clozapine) than other antipsychotics, and significantly lower with aripiprazole than other antipsychotics (except vs. amisulpride). Compared with matched general population controls, people with severe mental illness had a significantly increased risk for MetS (RR = 1.58; 95% CI: 1.35-1.86; p<0.001) and all its components, except for hypertension (p = 0.07). These data suggest that the risk for MetS is similarly elevated in the diagnostic subgroups of severe mental illness. Routine screening and multidisciplinary management of medical and behavioral conditions is needed in these patients. Risks of individual antipsychotics should be considered when making treatment choices.

The prevalence of metabolic syndrome among low-income South Asian Americans.

The purpose of the present paper is to examine the prevalence of metabolic syndrome (MetS) and its components using the harmonized definition in an interviewed sub-sample of diverse, low-income, adult South Asians (SA) of both sexes residing in Maryland. We also wanted to derive a BMI cut-off value that was highly correlated with the recommended waist circumference (WC) that we could apply to a larger sample of SA Americans for whom only BMI values were available from clinic files. We also examined differences in MetS prevalence among various Asian ethnic groups (defined by country of origin) and the clustering pattern of their MetS components. Clinical data extraction on subjects (n 1002) and interviewees (n 401) were used in a cross-sectional study of SA Americans. Two community health centres in Montgomery and Baltimore County, MD, USA. SA adult males and females (n 1403) aged 20-68 years. The prevalence of MetS using harmonized WC cut-offs (90 cm in men and 80 cm in women) was 47% in men and 54% in women. Using a BMI of 23.0 kg/m2 gave a similar prevalence of MetS for males (48%) and females (47%). Of the five MetS components, the prevalence pattern differed among the ethnic groups, particularly for SA Indians. The prevalence of MetS in a diverse, low-income, SA American immigrant group using the harmonized definition was 51%. Derived lowered BMI cut-off of 23.0 kg/m2 should be used by clinicians in studies on SA when WC values are not available for detecting metabolic risk. SA Indians had a higher prevalence of abnormal TAG and blood glucose values compared with other SA, and therefore results for SA Indians should not be generalized to all SA ethnic groups.

Metabolic syndrome among psychiatric inpatients with schizophrenia in Indonesia

Despite the fact that antipsychotic medication increases the risk of metabolic syndrome (MetS), the rate of MetS among psychiatric patients in Indonesia is rarely reported. This study aimed to investigate the prevalence of MetS among inpatients with schizophrenia in Indonesia. Eighty-six hospitalised psychiatric patients with schizophrenia were randomly recruited, and underwent physical examination including a blood test. MetS was assessed based on the International Diabetes Federation (IDF) criteria for South Asia. Among the sample, only eight patients (9.3%) met the IDF criteria for MetS. Women have a higher rate of MetS than men (23.8% vs 4.6%; p=0.02). Reduced high-density lipoprotein (HDL) cholesterol was the most frequent (81.4%) metabolic abnormality among them, followed by central obesity (29.1%), raised triglycerides (23.3%), raised fasting plasma glucose (12.8%), and raised blood pressure (10.5%). Among the various antipsychotics, no differences in MetS prevalence were observed in this population. The rate of MetS among the psychiatric inpatients in this study is lower compared both to the previously reported rate in the general population and to the findings among psychiatric patients with schizophrenia in developed countries. Several factors related to the reduced rate of MetS in this psychiatric inpatient population will be discussed.

Prevalence of Metabolic Syndrome and Its Components among Overweight and Obese Secondary School Adolescent in SFAX, Tunisia

<b>Objective</b><b>: </b>The metabolic syndrome (MetS) has become one of the major public-health challenges worldwide. Early identification of metabolic complications consist an essential target for youth public health. We aimed to evaluate the prevalence of MetS and its components among overweight and obese adolescents. <b>Methods: </b>This cross-sectional study concerned 51 overweight and obese adolescents. Anthropometric assessments, blood pressure measurement and biochemical assessment were done. MetS was defined according to the International Diabetes Federation (IDF) criteria. All data were collected during one academic school year in 2012 and 2013. <b>Results: </b>The prevalence of the MetS was 21.6%. There was no gender difference in prevalence of MetS (P=0.09). Obese subjects had the highest proportion of MetS than overweight (25% vs. 15.8%; p=0.04). 35.3% of subjects had at least two abnormalities of MetS. Abdominal obesity was the most common individual component of the MetS (91.3 %) followed by low HDL cholesterol (58.8%). Body mass index (BMI), Waist circumference (WC), Waist to hip ratio (WRH) and Neck circumference (NC) had partial positive correlation with Blood pressure (BP), and Triglyceride. Similarly, (BP), Triglyceride and HDL cholesterol were significantly higher in subjects with metabolic syndrome than that of subjects without metabolic syndrome (<i>p </i>< 0.05). <b>Conclusion</b><b>: </b>MetS is prevalent in our young population in Sfax City. The results of this study will help in planning to control these problems in the future. So we suggest screening programs for secondary school adolescent to control obesity and MetS in Tunisia.

Concomitant psychiatric problems and hormonal treatment induced metabolic syndrome in gender dysphoria individuals: A 2 year follow-up study

ObjectiveSeveral studies indicate increased prevalence of metabolic syndrome (MetS) among patients with psychiatric disorders as well as among individuals with gender dysphoria (GD) treated by cross-sex hormonal treatment. However, the MetS prevalence among hormone treated GD individuals suffering from psychiatric problems has not been detected. MethodsFrom a sample of 146 GD patients we selected 122 metabolically healthy individuals in order to investigate the prevalence of MetS after the beginning of the cross-sex hormonal treatment in a 2year follow-up assessment. Furthermore, we assessed differences in MetS prevalence between hormone treated GD patients with and without concomitant psychiatric problems. ResultsWhen treated with hormone therapy, GD patients reported changes in several parameters which are clustered in MetS, with statistically significant differences compared to baseline. Glyco-insulinemic alterations were more pronounced in male to female patients (MtFs). However, weight gain, waist circumference increases, blood pressure increases, and lipid alterations were similar in MtFs and female to male patients (FtMs). 14.8% of the sample at year 1 and 17.2% at year 2 developed MetS. Among patients with concomitant psychiatric problems, 50% at year 1 and 55% at year 2 developed MetS against 8% at year 1 and 10% at year 2 of patients without concomitant psychiatric problems. ConclusionThis study indicates that sex hormones induce MetS in a relatively low proportion of healthy GD individuals and especially during the first year of hormonal treatment. Most importantly, concomitant psychiatric problems are associated with considerably greater MetS prevalence in hormone treated GD individuals.

Authors reply to Dr. Kawada’s comments

We thank Dr. Kawada for his insightful comments [1] on our study [2], which highlights the importance of the C-reactive protein (CRP) concentration as a significant risk marker for metabolic syndrome (MetS). Dr. Kawada argued that stratified analyses by gender for the association between CRP concentrations and MetS should be performed in our study, given that there were gender differences in the odds ratios of CRP concentrations for MetS. Our study demonstrates that a significant stepwise increase in the prevalence of MetS across quartiles of CRP was observed in both men and women. Therefore, the CRP concentration is a significant risk marker for MetS in Chinese adults. However, previous studies have suggested that chronic inflammation, as indicated by elevated CRP concentration, might have a greater effect on the development of MetS in women than in men [3, 4]. Ethnic differences in CRP levels and the prominent individual components of MetS may account for the inconsistent observations for gender-specific associations between CRP and MetS among various ethnic groups. Dr. Kawada noted a sizable difference in MetS prevalence between Mahajan et al. [5] study in India and our study in Taiwan. It has been noted that the prevalence of MetS has reached epidemic proportion in India [6]. Thus, our study might include relatively more sub-clinical MetS subjects. We agree with Dr. Kawada’s point that risk assessment should be conducted by understanding the baseline characteristics of the target population. Dr. Kawada emphasized the need for evaluating the subclinical association between CRP and MetS components. In particular, elevated CRP was significantly associated with the risk of impaired fasting glucose and/or impaired glucose tolerance [5]. Therefore, CRP might interplay with insulin resistance and have central role in the pathophysiology of MetS.