Difference In Prevalence Of MetS Research Articles

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.

Changing prevalence of overweight, obesity and metabolic syndrome criteria among college students

Overweight and obesity prevalence is high among young adults in the U.S. The purpose of the study was to determine if the prevalence of overweight/obesity, as well as metabolic syndrome (MetS) criteria, has changed since 2005–2007. Initiated in the fall of 2005, the College Health and Nutrition Assessment Survey (CHANAS) at the University of New Hampshire is an on‐going cross‐sectional survey of the health of young (18–24 yrs) adults; participants represent all majors at the university. Participants from 2005–07 (n=1,599; 71.5% female) and 2010–12 (n=1,384; 73.2% female) were included in the analyses. The prevalence of overweight/obesity was 32.9%/7.4% in 2005–07 and 25.1%/4.5% in 2010–12 (both p<0.01). Although no difference in MetS prevalence was observed (2.9 vs. 4.1%, p=0.1), reductions in hypertension (32.6 vs. 26.1%, p<0.01), abdominal obesity (4.3 vs. 2.8%, p<0.05), and elevated glucose (6.6 vs. 4.1%, p<0.01) were observed. Conversely, prevalence of low HDL‐C increased (24.6 vs. 31.1%, p<0.01). These observations suggest the improving rates of overweight and obesity among young, college adults may be associated with modest improvements in many MetS criteria. Supported by NHAES grant NH00541.Grant Funding Source: New Hampshire Agricultural Experiment Station

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).

The Association between Apolipoprotein A-II and Metabolic Syndrome in Korean Adults: A Comparison Study of Apolipoprotein A-I and Apolipoprotein B

BackgroundApolipoprotein A-II (apoA-II) is the second-most abundant apolipoprotein in human high-density lipoprotein and its role in cardio metabolic risk is not entirely clear. It has been suggested to have poor anti-atherogenic or even pro-atherogenic properties, but there are few studies on the possible role of apoA-II in Asian populations. The aim of this study is to evaluate the role of apoA-II in metabolic syndrome (MetS) compared with apolipoprotein A-I (apoA-I) and apolipoprotein B (apoB) in Korean adults.MethodsWe analyzed data from 244 adults who visited the Center for Health Promotion in Pusan National University Yangsan Hospital for routine health examinations.ResultsThe mean apoB level was significantly higher, and the mean apoA-I level was significantly lower, in MetS; however, there was no significant difference in apoA-II levels (30.5±4.6 mg/dL vs. 31.2±4.6 mg/dL, P=0.261). ApoA-II levels were more positively correlated with apoA-I levels than apoB levels. ApoA-II levels were less negatively correlated with homocysteine and high sensitivity C-reactive protein levels than apoA-I levels. The differences in MetS prevalence from the lowest to highest quartile of apoA-II were not significant (9.0%, 5.7%, 4.9%, and 6.6%, P=0.279). The relative risk of the highest quartile of apoA-II compared with the lowest quartile also was not significantly different (odds ratio, 0.96; 95% confidence interval, 0.95 to 1.04; P=0.956).ConclusionCompared with apoA-I (negative association with MetS) and apoB (positive association with MetS) levels, apoA-II levels did not show any association with MetS in this study involving Korean adults. However, apoA-II may have both anti-atherogenic and pro-atherogenic properties.

Prevalence of Metabolic Syndrome Defined by the International Diabetes Federation and National Cholesterol Education Program Criteria Among Thai Adults

This study determines the prevalence of metabolic syndrome (MetS) according to the International Diabetes Federation (IDF) and National Cholesterol Education Program III (NCEP) criteria in Thai adults. Data from a national representative sample, InterASIA study, including a total of 5305 Thai adults 35 years and older were analyzed. Overall, the age-standardized prevalence of MetS by IDF and NCEP criteria were 24.0% (men 16.4%, women 31.6%) and 32.6% (men 28.7%, women 36.4%), respectively. The difference in prevalence of MetS between genders was much greater for the IDF compared with the NCEP definition. The age-standardized prevalence rates distributed by geographic region were relatively uniform with a lowest prevalence in the northeast. Among all possible sets of components for MetS, the most common combinations were a set of low high-density lipoprotein cholesterol, high triglyceride, and hyperglycemia in men (3.9%) and a set of abdominal obesity, low high-density lipoprotein cholesterol, and high triglycerides in women (6.7%). MetS is common in Thai adults and NCEP definition captures more cases of MetS compared with the IDF definition. Implementation of programs to prevent obesity and metabolic factors along with future periodic survey to monitor the problem is crucial.

Comparison of prevalence of metabolic syndrome in hospital and community-based Japanese patients with schizophrenia

BackgroundLifestyle factors, such as an unbalanced diet and lack of physical activity, may affect the prevalence of metabolic syndrome (MetS) in schizophrenic patients. The aim of this study was to compare the MetS prevalence between inpatients and outpatients among schizophrenic population in Japan.MethodsWe recruited inpatients (n = 759) and outpatients (n = 427) with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) diagnosis of schizophrenia or schizoaffective disorder from 7 psychiatric hospitals using a cross-sectional design. MetS prevalence was assessed using three different definitions, including the adapted National Cholesterol Education Program Adult Treatment Panel (ATP III-A).ResultsThe overall MetS prevalences based on the ATP III-A definition were 15.8% in inpatients and 48.1% in outpatients. In a logistic regression model with age and body mass index as covariates, being a schizophrenic outpatient, compared to being a schizophrenic inpatient, was a significant independent factor (odds ratio = 3.66 for males, 2.48 for females) in the development of MetS under the ATP III-A definition. The difference in MetS prevalence between inpatients and outpatients was observed for all age groups in males and for females over 40 years of age.ConclusionsOutpatients with schizophrenia or schizoaffective disorder in Japan had a high prevalence of MetS compared to inpatients. MetS in schizophrenic outpatients should be carefully monitored to minimize the risks. A change of lifestyle might improve MetS in schizophrenic patients.

Racial/ethnic discrepancies in the metabolic syndrome begin in childhood and persist after adjustment for environmental factors

Background and AimsEvaluation of metabolic syndrome (MetS) characteristics across an age spectrum from childhood to adulthood has been limited by a lack of consistent MetS criteria for children and adults and by a lack of adjustment for environmental factors. We used the pediatric and adult International Diabetes Federation (IDF) criteria to determine whether gender-specific and race-specific differences in MetS and its components are present in adolescents as in adults after adjustment for socio-economic status (SES) and lifestyle factors. Methods and ResultsWaist circumference, blood pressure, triglycerides, HDL cholesterol, and fasting glucose measures were obtained from 3100 adolescent (12–19years) and 3419 adult (20–69years) non-Hispanic white, non-Hispanic black, and Mexican-American participants of the 1999–2006 National Health and Nutrition Examination Surveys. We compared odds of having MetS and its components across racial/ethnic groups by age group, while adjusting for income, education, physical activity and diet quality. After adjusting for possible confounding influences of SES and lifestyle, non-Hispanic-black adolescent males exhibited a lower odds of MetS and multiple components (abdominal obesity, hypertriglyceridemia, low HDL, hyperglycemia) compared to non-Hispanic-white and Mexican-American adolescents. Compared to non-Hispanic-white adolescent males, Mexican-American adolescent males had less hypertension. There were no differences in MetS prevalence among adolescent females, though non-Hispanic-black girls exhibited less hypertriglyceridemia. ConclusionRacial/ethnicity-specific differences in MetS and its components are present in both adolescence and adulthood, even after adjusting for environmental factors. These data help strengthen arguments for developing racial/ethnic-specific MetS criteria to better identify individuals at risk for future cardiovascular disease.

Effects of Individual Components, Time, and Sex on Prevalence of Metabolic Syndrome in Adolescents

To examine selected clinical characteristics for cohorts of similar adolescents over 4 survey periods from 1999-2006, to examine changes in rates of adolescents who exceed cutoff points for individual components of metabolic syndrome (MetS), to describe sex differences in individual components of MetS, to describe changes in MetS prevalence from 1999-2006 using 4 common MetS definitions, and to describe sex differences in MetS prevalence from 1999-2006. Cross-sectional, US representational National Health and Nutrition Examination Survey from 1999-2006. Mobile examination centers conducted by the Centers for Disease Control and Prevention. For 1999-2000, 613 adolescents (aged 12-19 years); for 2001-2002, 892 adolescents; for 2003-2004, 857 adolescents; and for 2005-2006, 814 adolescents. Exclusions were pregnancy, taking insulin or diabetic pills, and incomplete measurements. Fasting plasma glucose level, triglyceride level, high-density lipoprotein cholesterol level, waist circumference, and systolic and diastolic blood pressures. Increases in fasting plasma glucose and high-density lipoprotein cholesterol levels and decreases in diastolic blood pressure were observed. Rates of adolescents exceeding cutoff points for fasting plasma glucose levels have increased. Compared with girls, adolescent boys had higher rates exceeding cutoff points for fasting plasma glucose and high-density lipoprotein cholesterol levels. Adolescent girls had higher rates exceeding cutoff points for waist circumference. The prevalence of MetS among adolescents has not changed. No sex differences in MetS prevalence were observed. Some criteria for MetS have remained stable (triglyceride level and systolic blood pressure) and one has improved for boys (high-density lipoprotein cholesterol level), but waist circumference has increased in girls and the rate of an elevated fasting plasma glucose level has nearly doubled for both boys and girls. Adolescent MetS prevalence has remained stable from 1999-2006.

Prevalence of Metabolic Syndrome and Its Relation to Body Composition in a Chinese Rural Population

To investigate the prevalence of metabolic syndrome (MetS) with three different working definitions in a rural Chinese population and to examine its relation to body composition. A total of 18,630 adults 25 to 64 years old (mean age, 45.8 years; 51.2% men) from 5686 families were enrolled from Anhui province of China during 2004 to 2005. Anthropometric measurement, body composition, blood pressure, plasma lipids, and fasting glucose and insulin and a questionnaire-based interview were obtained from each participant. Three different working definitions for MetS, including the U.S. National Cholesterol Education Program's Adult Treatment Panel III, a modified Adult Treatment Panel III that adopts the World Health Organization's criterion for central obesity in Asian populations, and one recently proposed by the International Diabetes Federation, were used in the study. According to the three definitions, the age-adjusted prevalence of MetS for adults 25 to 64 years old was 3.2%, 4.9%, and 3.9% in men and 7.2%, 11.5%, and 10.9% in women, respectively. MetS prevalence increases significantly with age in women, but not in men. Body fat percentage and BMI and waist circumference were significantly associated with each component of MetS, especially with triglyceride level, insulin resistance index, and number of MetS components (r = 0.28 to 0.49). The age-adjusted prevalence of MetS in our study population is lower than that reported in other urban Chinese populations. Significant gender differences in MetS prevalence were observed. The waist circumference is a good surrogate for abdominal fat percentage.