Education Program Adult Treatment Panel-III Research Articles

Insulin resistance and periodontitis: Mediation by blood pressure.

This study investigated the association between the triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, and moderate/severe periodontitis and the role of blood pressure as a mediator in this association. A second aim was to assess the role of cardiometabolic conditions such as obesity, hypertension, and dyslipidemia as potential effect modifiers. Data from 5733 US adults aged 30-64 years and with complete periodontal examination were analyzed (NHANES 2011-2014). Participants were classified as having moderate/severe periodontitis or mild/no periodontitis according to the CDC/AAP criteria as the outcome. The exposure was the TyG index, while both systolic (SBP), and diastolic (DBP) blood pressure were tested as mediators using parametric g-formula. Analyses were adjusted for relevant confounders, namely, age, sex, ethnicity, poverty-income ratio, and smoking, using inverse probability treatment weighting. Obesity status (based on a body mass index ≥30 kg/m2), self-report of hypertension and dyslipidemia (calculated based on the thresholds provided by National Cholesterol Education Program-Adult Treatment Panel-III) were tested as effect modifiers. The findings showed the TyG index to be associated with increased odds of moderate/severe periodontitis [odds ratio (OR), 95% confidence interval (CI) = 1.17 (1.11-1.23)], with 50% of the total effect mediated by SBP. Stratified analysis showed a stronger association in individuals with obesity, hypertension, and dyslipidemia compared to those without these conditions. However, in those taking anti-hypertensive medications, the association was partially mitigated. Sensitivity analysis using imputed data showed consistent results. The TyG index was associated with increased odds of moderate/severe periodontitis, especially in individuals with obesity, hypertension, and dyslipidemia. SBP levels partially mediated this association.

Comparison of three definition of the metabolic syndrome in Korean patients with acute ischemic stroke

Background: The metabolic syndrome (MetS) is a cluster of risk factors for atherosclerotic arterial disease including acute ischemic stroke but little is known about prognostic impact in acute ischemic stroke patients. Several diagnostic criteria have been proposed by number of organizations. So we aimed to investigate the prevalence of MetS according to different diagnostic criteria.Methods: Patients with acute ischemic stroke were performed to estimate the prevalence of MetS using the 3 definitions of MetS: the National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III), the International Diabetes Federation (IDF) and Joint Interim Societies (JIS) MetS definition. One year mortality and morbidity of all cause and vascular cause was evaluated according to individual definition.Results: Among total 914 patients, the MetS prevalence was 32.5%, 37.2% and 56.6% with the NCEP, IDF and JIS definitions. Central obesity was more frequently observed in patients diagnosed with MetS by IDF and JIS definition than patients with MetS by NCEP ATP-III definition. One year mortality of all cause was 6.9% in the whole study population and 5.4%, 4.4% and 5.8% according to the NCEP ATP-III, IDF and JIS definitions. Age and C-reactive protein was positively in contrast, the IDF and the JIS definitions were negatively predicted 1-year mortality.Conclusions: The prevalence of MetS was higher with JIS definitions in comparison with other 2 definitions. But JIS and IDF definitions were negatively predicted 1 year mortality. These findings suggest needs for further study for prognostic impact of individual MetS definition in patients with acute ischemic stroke.

Association Between Metabolic Syndrome and the Risk of Lung Cancer: A Meta-Analysis.

Previous studies showed conflicting results regarding the association between metabolic syndrome (MetS) and risk of lung cancer. We performed a systemic review and meta-analysis to determine the relationship between MetS and lung cancer incidence and mortality in adults. Longitudinal follow-up studies were identified by search of Medline, Embase, Cochrane Library, and Web of Science. By incorporating potential heterogeneity into the model, a randomized-effects model was selected to pool the results. Fourteen observational studies were included. Pooled results showed that MetS was associated with a higher risk of lung cancer incidence [risk ratio (RR): 1.15, 95% confidence interval (CI): 1.05 to 1.26, p=0.002; I2=89%). Subgroup analysis suggested that the association was not significantly affected by study country, design, sex of the participants, adjustment of smoking, or different study quality scores (p for subgroup difference all>0.05). The association was predominantly contributed by studies with MetS defined by the National Cholesterol Education Program Adult Treatment Panel-III rather than those with MetS defined by the International Diabetes Foundation criteria, and the association seemed to be stronger in studies with follow-up within 6 years than those over 6 years (p for subgroup difference=0.03 and 0.04, respectively). In addition, pooled results also showed that MetS was associated with a higher risk of lung cancer mortality (RR: 1.46, 95% CI: 1.19 to 1.79, p <0.001; I2=0%). In conclusion, in adult population, MetS may be a risk factor of lung cancer incidence and mortality.

The Prevalence Of Metabolic Syndrome And Its Components Among Male Workers In Indonesia

Introduction : Metabolic syndrome (MetS) has emerged as one of the world’s major public health issues and the prevalence of this syndrome varies among population. There is a little of information on the epidemiology of MetS in male workers in Indonesia. Therefore, this study aims to determine the prevalence, its component and risk factors of MetS in Indonesian’s male working population.&#x0D; Methods : This was a cross sectional study of 1298 workers (median age, IQR 41,37-48 years) who underwent a routine Medical Check Up (MCU). The metabolic syndrome is diagnosed using the criteria established by the revised National Cholesterol Education Program-Adult Treatment Panel-III definition (2005 ATP III).&#x0D; Results : Metabolic syndrome prevalence was 13.9% in male workers. The most common abnormalities among all participants were hypertriglyceridemia (94.5%) and abdominal obesity (80.6%) [p&lt;0.001]. Multivariable logistic regression analysis revealed that obesity (OR: 9.29; 95% CI: 5.56-15.54), overweight (OR: 2.15; 95% CI: 1.11-4.18), increasing age (OR: 2.39; 95% CI: 1.36-4.21), white blood cells/WBC or leukocyte (OR: 1.13; 95% CI: 1.04-1.24) and exercise (OR: 1.51; 95% CI: 1.06-2.15), were associated with a higher risk of developing MetS in the working population.&#x0D; Conclusion : The most common component of MetS in workers is hypertriglyceridemia followed by abdominal obesity. As a result, it is possible that these are the first detectable component of MetS in the working population. Early detection of MetS components, especially in obese workers, could be effective way to prevent the development of the syndrome.

Prevalence of the metabolic syndrome and associated factors among inpatients with severe mental illness in Botswana: a cross-sectional study

IntroductionThe metabolic syndrome, a cluster of inter-related risk factors for cardiovascular diseases is highly prevalent among individuals with obesity and sedentary lifestyle. Chronic psychiatric disorders such as severe mental illness are associated with increased risk for cardiovascular diseases. We aimed to assess the prevalence and correlates of metabolic syndrome among inpatients with severe mental illness in a resource limited setting with high HIV prevalence.MethodsThis was a cross-sectional study among adult inpatients at a referral psychiatric hospital in Botswana. We used convenience sampling to enrol participants available at the time of the study. The National Cholesterol Education Program Adult Treatment Panel-III (NCEP-ATP III) criteria was used to define the metabolic syndrome. Data were analysed using descriptive statistics as well as multiple logistic regression modelling.ResultsA total of 137 participants were enrolled. Of these, 119 (87%) had complete data for the main analysis. The overall prevalence of metabolic syndrome was 22.6% (95% CI 15.9, 30.6) and did not differ significantly by gender or HIV status. Age was significantly associated with the risk of having the metabolic syndrome while gender, body mass index, HIV status, and days of moderate physical activity were not.ConclusionThere was a moderately high prevalence of metabolic syndrome. Thus, the management of individuals with severe mental illness in resource limited settings should include assessment of cardiovascular risk and target modifiable risk factors in this population. Consideration for the patient’s age should be made when rationalizing the limited resources available for assessing metabolic syndrome among patients with severe mental illness.

PSUN55 Abnormal Body Fat Distribution in Lean Individuals with Metabolic Abnormalities

Abstract Background Truncal obesity has long been considered an essential driver of metabolic abnormalities, but it is common for lean individuals with body mass index (BMI) &amp;lt;25 kg/m2 to have one or more metabolic abnormalities. We hypothesized that metabolically unhealthy lean (MUL) individuals have a different distribution of fat compared to their metabolically healthy lean (MHL) counterparts. Methods We performed a retrospective analysis of body composition data obtained from a repository of dual-energy X-ray absorptiometry scans performed during routine clinical practice at a University Bone Clinic. Metabolic data were retrieved from electronic medical records within one calendar year of the index scan. Those with at least 2 components of the metabolic syndrome: blood pressure &amp;gt;130/85 mmHg, triglyceride &amp;gt;150 mg/dL, HDL &amp;lt;50 mg/dL for women and &amp;lt;40 mg/dL for men, fasting plasma glucose &amp;gt;100 mg/dL (or HbA1c &amp;gt;5.7) were considered MUL, while those with 1 component or less were considered MHL. Waist circumference was not considered in this study. Adults with a BMI less than 25 kg/m2 were included in the analysis. Unadjusted and adjusted binary logistic regression were used to analyze the association between metabolic abnormalities and various anthropometric indexes. Results The study population consisted of 119 lean adults with a mean age of 62±14 years and a mean BMI of 22±1.9 kg/m2. Majority of participants were white (88%, n=105) and included postmenopausal women (85%, n=101). A large proportion were of Hispanic ethnicity (41%, n=70). There were 69 (58%) MHL and 50 (42%) MUL individuals. MUL and MHL groups had comparable percentage of total body fat (34±6.6 versus 34±5.6, p=0.360), fat mass index (8.2±1.6 versus 8.1±1.5, p=0.360) and appendicular lean mass (kg/m2) (5.9±0.8 versus 5.8±0.7, p=0.420). However, compared to MHL, MUL subjects had significantly higher visceral adipose tissue (cm2) (87±40 versus 9±29, p=0.004), trunk-to-leg fat ratio (0.89±0.18 versus 0.77±0.13, p&amp;lt;0.001), trunk-to-limb fat ratio (1.00±0.29 versus 0.82±0.18, p&amp;lt;0.001) and android-to-gynoid fat ratio (0.90±0.16 versus 0.81±0.15, p=0.010). After adjusting for age and sex, the odds of being MUL compared to MHL (odds ratio [OR (95% confidence interval (CI))]) increased for every standard deviation increase in visceral adipose tissue (OR=1.75 [1.13-2.73]), trunk-to-leg fat ratio (OR=2.28 [1.30-4.00]), trunk-to-limb fat ratio (OR=2.43 [1.37-4.32]) and android-to-gynoid fat ratio (OR=1.80 [1.07-3.03]). Conclusion Metabolically unhealthy subjects with normal BMI had markedly increased visceral adipose tissue and truncal redistribution of body fat without an increase in total body fat. These findings highlight the importance of using body morphometry measures, rather than total body fat, to assess CVD risk in lean individuals. Our findings suggest that the phenotype of lean individuals with metabolic derangements is not very different from that of obese individuals who have metabolic syndrome as per the National Cholesterol Education Program Adult Treatment Panel-III definition. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Serum Ferritin in Metabolic Syndrome-Mechanisms and Clinical Applications.

Metabolic syndrome (MS) is a cluster of conditions including central obesity, hypertriglyceridemia, low HDL cholesterol, hyperglycaemia, and hypertension with a prevalence rate of 20–25% of the world’s adult population. Metabolic syndrome is often characterized by insulin resistance, which some have suggested is a major supportive connection between physical inactivity and MS. Various studies suggest that moderately elevated iron and ferritin levels are associated with an increased prevalence of metabolic syndrome and are markers of insulin resistance. Increased body iron stores are associated with the development of glucose intolerance, type 2 diabetes mellitus, and insulin resistance syndrome (IRS). This is a hospital-based cross-sectional observational study, which was conducted in the department of internal medicine of a tertiary care hospital in northern India. The study was conducted from 1 January 2019 to 30 June 2020 and included 100 patients and 100 controls. All subjects in the age group of 35–65 years were enrolled and investigated as per the study design. Metabolic syndrome patients were diagnosed according to the modified National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III) with BMI > 23 kg/m2. All baseline investigations were undertaken, including serum ferritin levels. Insulin resistance (IR) was calculated using the homeostasis model assessment IR (HOMA-IR) formula. We found a positive association between an increase in serum ferritin with the prevalence of metabolic syndrome and its clinical parameter. The serum ferritin level was positively correlated with the level of insulin resistance and inversely correlated with the insulin level of the patients.

Metabolic syndrome may be more frequent in treatment-naive sarcoidosis patients.

Sarcoidosis is achronic granulomatous multisystem inflammatory disease. An association between sarcoidosis and subclinical atherosclerosis has recently been demonstrated. However, there are limited publications on metabolic syndrome (MetS) and its metabolic changes in sarcoidosis. In this study, we evaluated our hypothesis that the frequency of MetS may also be increased in treatment-naive, newly diagnosed sarcoidosis patients. We included 133 newly diagnosed sarcoidosis patients, 133age- and sex-matched controls, and 51untreated rheumatoid arthritis (RA) patients as diseased controls. We then compared the frequency of MetS and MetS-related items in the three groups. The criteria defined for metabolic syndrome in the National Cholesterol Education Program (NCEP) Adult Treatment PanelIII report (ATPIII) were used to diagnose MetS. MetS was more common in sarcoidosis than controls (odds ratio, OR: 5.3; 95% confidence interval, CI 95%: 2.4-11.5; p < 0.001) and was similar to RA. In addition, triglyceride and glucose levels, diastolic blood pressure measurements, and waist circumference of female sarcoidosis patients were significantly higher than in controls. We show that MetS is afrequent feature of sarcoidosis even before treatment is started. Therefore, clinicians should be aware of MetS both during treatment and during the course of the disease to reduce the risk of cardiovascular events.

Metabolic Syndrome Associated with Polycystic Ovary Syndrome in Some Nigerian Women

Background: Polycystic Ovary Syndrome (PCOS) is a group of symptoms associated with endocrine disorders in women of reproductive age. Women with this syndrome is at increased risk of metabolic syndrome. This study described the metabolic syndrome and its associated components among women with PCOS in Nigerian populace. Methods: A total of 90 participants (50 PCOS and 40 controls) were recruited for the study. The diagnosis of PCOS was established using the criteria defined by International PCOS guidelines 2018. Demographic, anthropometric, and clinico-pathological data, including blood pressure, were obtained for each participant. Metabolic syndrome was diagnosed using the 2005 revised National Cholesterol Education Program Adult Treatment Panel-III (revised NCEP ATP_III) guidelines. Fasting blood glucose, insulin, total cholesterol, HDL, LDL, and triglycerides were evaluated with conventional spectrophotometric methods. Results: The prevalence of metabolic syndrome in PCOS women was 24%, with an odds ratio of 5.211, while the prevalence of 5.7% was observed in the control group. The prevalence of central obesity (waist circumference &gt;88cm), FBS ≥100 mg/dl, HDL &lt;50 mg/dl, triglycerides ≥150 mg/dl, and blood pressure ≥130/85 mmHg in PCOS women was 60%, 22%, 54%, 12%, and 20%, respectively. The most frequently observed individual components of metabolic syndrome were increased waist circumference and decreased HDL cholesterol. Conclusion: Metabolic syndrome and its components, especially obesity, are a major risk factor of PCOS in our population. Routine screening and modulating individual contributors of metabolic syndrome may support PCOS management.

Prevalence and Associated Factors of Dyslipidemia Among Psychiatric Patients on Antipsychotic Treatment at Hawassa University Comprehensive Specialized Hospital.

Background:Dyslipidemia is one of the adverse metabolic outcomes associated with psychotropic medications and the nature of the mental illness itself. Therefore, this study aimed to assess magnitude of dyslipidemia and associated factors among patients with severe mental illness on antipsychotic treatments.Methods:A cross-sectional study was conducted among 245 patients with severe mental illness in Hawassa University Comprehensive Specialized Hospital, Sidama Regional state, Southern Ethiopia. Socio-demographic and other important data were collected using a structured questionnaire through a systematic random sampling technique. Individual dyslipidemia was characterized by the National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III) guideline.Results:Mean total cholesterol (TC) was significantly higher in males when compared to females (162.2 mg/dl vs 121 mg/dl, P = .023). While, mean LDL-cholesterol was significantly higher in females when compared to males (100.9 mg/dl vs 93.6 mg/dl, P = .028). Overall 58.4% (95% CI: 52.2-64.8) of participants had at least 1 dyslipidemia. The prevalence of TC ⩾200 mg/dl, HDL-cholesterol <40 mg/dl, triglyceride (TG) and LDL-cholesterol were 61 (24.9%), 75 (30.6%), 66 (26.9%), and 47 (19.2%), respectively. Female sex and smoking were significantly and positively associated with LDL-c dyslipidemia, the aOR (95% CI) were 2.1 (1.0-4.2) for female sex and 3.4 (1.1-10.5) for smoking. Also, Age >40 years was significantly associated with TC dyslipidemia, the aOR (95% CI) was 2.0 (1.1-3.7).Conclusion:More than half of psychiatric patients are at risk of developing cardiovascular and other related health problems. Therefore, periodic screening of lipid profiles during healthcare follow-up is mandatory to limit risks of cardiovascular-related comorbidities among patients with severe mental illness.

Abstract PO-190: Prevalence and predictors of obesity-related cancers amongst racial/ethnic groups with metabolic syndrome

Abstract Background: Obesity-related cancer (ORC) accounts for 40% of all cancer diagnoses in the United States and are associated with higher amounts of body fat (BMI ≥25), which could increase the risk of developing cardiovascular disease (CVD). CVD remains the leading cause of death in cancer survivors and its associated risk tends to cluster into interrelated groups of conditions commonly known as the metabolic syndrome (MetS). Therefore, further insight on groups at risk for developing CVD within the ORC and MetS population is warranted. Previous studies identified the prevalence of ORC to be higher in non-Hispanic Blacks and Hispanics compared to non-Hispanic Whites. However, prior studies did not control for sociodemographic and lifestyle factors that can differ across race/ethnicity. The purpose of this study was to compare the prevalence of ORCs by race/ethnicity among the adult (&amp;gt;18) cancer population with MetS represented in the 1999-2014 NHANES Survey and to identify predictors associated with having an ORC among adults with MetS. Methods: MetS was defined using the National Cholesterol Education Program (NCEP) Adult Treatment Panel-III (ATP-III) guidelines. Cancer type was self-reported and further classified as ORC or non-ORC. A chi-square test was performed to determine prevalent differences in ORC between Non-Hispanic White, Non-Hispanic Black, and Hispanic participants with comorbid cancer and MetS. A multivariate logistic regression was utilized to evaluate predictors (race, sex, income, insurance, education, marital status, and smoking status) of ORC among adults with comorbid cancer and MetS. Results. Of the 1,554 adults with MetS, the prevalence of ORC was 30.6% in non-Hispanic Whites, 51.3% in non-Hispanic Blacks, and 54.1% in Hispanics (p=&amp;lt;0.001). Three of the eight predictors were significantly associated with ORC. For every one-year unit increase in age, the odds of ORC increased by 3% [95% CI (1.00- 1.05), p=&amp;lt;0.01]. Females were 6.27 times more likely to have an ORC compared to males [(95% CI (4.95-14.11), p= &amp;lt;0.0001]. Lastly, when compared to non-Hispanic Whites, Non-Hispanic Blacks were 2.1 times more likely to have an ORC [(95% CI (1.40-3.38) p= &amp;lt;0.001]; and Hispanics were 2.5 times more likely [(95% CI (1.39-4.77), p=&amp;lt;0.01]. All other factors were insignificant. Conclusions. Among NHANES participants with MetS, the prevalence of ORCs was significantly higher in Blacks and Hispanics compared to Whites. In addition, ORC risk was reduced for males and younger adults with MetS. Future studies on the long-term impact of MetS on persons with ORC by race/ethnicity are warranted. Citation Format: Shanada Monestime. Prevalence and predictors of obesity-related cancers amongst racial/ethnic groups with metabolic syndrome [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-190.

Prevalence of metabolic syndrome among adults in sub-district hospital Akhnoor: a cross sectional study

Background: Metabolic syndrome (MetS) is an aggregation of conditions that together increase the risk of cardiovascular disease in individuals, which would not otherwise be recognized. World-wide, its prevalence has been documented as 11-41%. It has become a major public health challenge globally due to rapid urbanization, sedentary lifestyle, and surplus energy intake.Methods: The present hospital-based-study was aimed at finding the prevalence of MetS in people attending OPD of medicine in sub-district hospital Akhnoor, Jammu: from November 2019 to April 2020. Study subjects included both males and females between the age group of 20-60 years attending the medicine OPD. Among the 400 participants, 185 were females and 215 were males. Patients were diagnosed as MetS according to national cholesterol education program adult treatment panel-III (ATP) criteria.Results: About 41.25% of the participants were below 40 years and 58.75% of the participants were above 40 years of age. A very high prevalence of 68.75% MetS was reported among patients, hinting at the changing lifestyle of the people. People of older age and with general obesity are under increased MetS risk. Prevalence among males (67.44%) and females (70.27%) differed only slightly. But our present study tends to suggest an increased risk among females, which is quite significant. Conclusions: Various researchers have associated MetS with depression and chronic diseases, which shows that the population is under graver risk with increased prevalence among masses. The prevalence in &gt;40 years age group is showing rapid and alarming increase. Lifestyle modifications are crucial to the management of MetS.

Prevalence and sex-specific patterns of metabolic syndrome in rural Uganda

Background and aimsIn sub-Saharan Africa, infectious diseases are still the leading causes of mortality; however, this may soon be surpassed by non-communicable illnesses, namely hypertension, diabetes and cardiovascular disease. This...

Association of dietary energy density with cardiometabolic risk factors and metabolic syndrome in Tehranian older adults.

Introduction: The objective of this study was to evaluate the association between the consumption of an energy-dense diet and cardiometabolic risk factors in Iranian older adults. Methods: This cross-sectional study was conducted on 226 older adults who were living in Tehran, Iran. Dietary energy density (DED) was calculated as energy per weight of food, kcal/g. The usual intake of participants was measured using a validated semi-quantitative food frequency questionnaire. Anthropometric measurements, fasting blood sugar, serum lipid profile and blood pressure and were assessed. The metabolic syndrome was defined according to National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP III). Results: Those who were in the third tertile of DED compared to the first tertile had 19% lower odds of having the cardiometabolic risk factors and metabolic syndrome (MetS) 0.81 (0.39,1.68) but the association was no significant (P =0.58). There was a significant inverse association between DED and systolic blood pressure (SBP) (β=-0.14, P =0.03) and diastolic blood pressure (DBP) (β=-0.17, P =0.01). We did not find any significant association between intake of energy-dense foods and serum levels of triglyceride (TG) (P =0.62), fasting blood sugar (FBS) (P =0.06), high-density lipoprotein (HDL) (P =0.72) and waist circumference (WC) (P=0.28). Conclusion: DED is negatively associated with SBP and DBP in Iranian older adults. Prospective studies are needed to establish a causal link between DED and MetS and risk factors of cardiovascular disease (CVD).

The incidence of Metabolic Syndrome in Subclinical Hypothyroid patients

Objevtive: The aim of this study was to evaluate the incidence of metabolic syndrome, a risk factor for chronic diseases such as cardiovascular diseases, diabetes mellitus and stroke, in patients with subclinical hypothyroidism. Methods: A total of 108 patients with subclinical hypothyroidism followed in the outpatient clinic of Ordu University Faculty of Medicine Training and Research Hospital between 2015-2018 were included in the study. Height, waist circumference, weight, blood pressure, High Density lipoprotein (HDL) cholesterol and triglyceride levels and fasting blood glucose levels were recorded from the archive records of the patients. Body Mass Index (BMI) was calculated. Metabolic Syndrome (MetS) diagnoses were made according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines. Results: Of the 108 patients included in the study, 74 (68.5%) were female and 34 (31.5%) were male. The mean age of the female patients was 38.3±12.5 years and the mean age of the male patients was 40.5±11.7 years. In this study, the prevalence of MetS was 42.6% (47.3% in females and 30.8% in males) in patients with subclinical hypothyroidism. MetS incidence was 1.5 times higher in female patients than in male patients. Among all patients, the most common MetS component was low HDL cholesterol (54.6%) and abdominal obesity (52.8%). Conclusion: The incidence of MetS was higher in female patients with subclinical hypothyroidism than in male patients. In addition, close follow-up of patients with subclinical hypothyroidism in terms of Metabolic Syndrome, which is a risk factor for many chronic diseases such as diabetes mellitus, cardiovascular diseases and stroke, will benefit in reducing the mortality of patients.

Changing predictors of statin initiation in US women over two decades.

To describe changing roles of predictors of statin initiation before and after incident coronary heart disease, and before and after publication of National Cholesterol Education Program Adult Treatment Panel-III (ATP-III) guidelines in a cohort of US women. We identified 34382 women enrolled into the Women's Health Study from 1993 to 1995 and followed up until 2012. Proportions of previous nonusers initiating statins were described over time. We used multivariable linear regression models to estimate adjusted initiation proportion differences (IPDs) for initiation overall, separately before and after incident coronary heart disease, and separately for ATP-II and ATP-III time periods. Key predictors of initiation overall were self-reported total cholesterol, and previous incident coronary heart disease, cerebrovascular disease, and diabetes. Adjusted IPDs (percentage) for total cholesterol>240 vs <200mg/dL were 7.5 (95% confidence interval [CI], 7.0-8.0) and 9.3 (95% CI, 8.7-9.9) during ATP-II and ATP-III time periods, respectively. Adjusted IPDs in women with diabetes were 7.0 (95% CI, 6.3-7.8) and 11.9 (95% CI, 6.7-17.0) for primary and secondary prevention, respectively, and 3.1 (95% CI, 2.1-4.0) and 9.2 (95% CI 8.2-10.2) for before and after ATP-III, respectively. Secular trends reflected evolution toward risk factor-based treatment indications for statin initiation with increased initiation among diabetics and women with normal and borderline cholesterol. The role of serum cholesterol changed over time, though the character was scale (multiplicative vs additive) dependent. In pharmacoepidemiologic studies of statins, strength of confounding by important variables sometimes unmeasured in claims data, such as cholesterol level, may be calendar time dependent.

노인 여성의 체력과 비만도 수준에 따른 대사증후군 발생위험률과의 관계

The purpose of this study was to investigate the relationships between total fitness, obesity levels and prevalence rate of metabolic syndrome in elderly female in Korea. A total of 128 subjects (66.89±5.46 years) participated in this cross-sectional study. Total fitness level was determined by sit-up and Grasping power. Metabolic syndrome risks were determined by the diagnostic criteria of the National Cholesterol Education Program Adult Treatment Panel-III (NCEP-APT III). After adjustment for age and BMI (body mass index), high fitness group had significantly decreased TG (triglyceride) and increased HDL-C (high density lipoprotein cholesterol) compared to low fitness group. Low BMI group had significantly decreased WC (waist circumference) and SBP (systolic blood pressure) compared to high BMI group after adjusting for age. When subjects were divided into four groups according to total fitness and obesity levels, s ubj ects w ith high f itness a nd low BMI group h ad 2 2.86 [ OR ( Odds R atio): 2 2.86, 9 5% C I (Confidence interval): 5.31-98.28] times higher prevalence rate of metabolic syndrome than those with low fitness and high BMI. Fitness and obesity levels are strongly associated with increased prevalence rate of metabolic syndrome in elderly female in Korea.

Prevalence and risk factors of metabolic syndrome in HIV-infected adults at three urban clinics in a post-conflict setting, eastern Democratic Republic of the Congo.

To determine the prevalence of and risk factors for metabolic syndrome (MS) in HIV-infected adults at three urban clinics in Bukavu, Democratic Republic of the Congo. Cross-sectional study. From July to September 2016, baseline socio-demographics, risk factors and clinical characteristics were collected using a structured questionnaire or extracted from medical records. Fasting blood sugar and lipids were measured. MS was defined per the National Cholesterol Education Program (NCEP) Adult Treatment PanelIII (ATP III) and the International Diabetes Federation (IDF) criteria. Adjusted odds ratio (OR) was generated through multivariate logistic regression models. Of 495 participants, 356 (72%) were women and 474 (95.8%) were receiving antiretroviral therapy (ART). The median age (years) [interquartile range (IQR)] was 43 [36-51]. The overall prevalence of MS per NECP/ATP III and IDF criteria was 27% [95% CI: 20-35%] or 30% [95% CI: 23-38%], respectively. In a multivariate logistic regression, low physical activity (OR 2.47, 95% CI: 1.40-4.36); daily exposure to biomass fuel smoke (BMF) for more than 2h (OR 2.18, 95% CI: 1.01-4.68); protease inhibitor containing ART (OR: 2.96, 95% CI: 1.07-8.18); and stavudine-containing ART regimen (OR: 2.57, 95% CI: 1.11-5.93) were independently associated with MS. MS was highly prevalent in this hospital-based study population. Beside known traditional risk factors and contribution of specific ART regimens to MS, daily exposure to BMF is new and of specific concern, necessitating targeted urgent prevention and management interventions.

Metabolic syndrome in systemic lupus erythematosus patients

The study aims to evaluate the presence of metabolic syndrome (MetS) among Egyptian systemic lupus erythematosus (SLE) patients. Additionally, we intended to determine the association of MetS with disease activity, clinical and laboratory features. This cross-sectional study included adult SLE patients diagnosed and followed in rheumatology outpatient clinics. The demographic data, clinical and laboratory parameters were assessed for all patients. Disease activity was measured using SLE Disease Activity Index (SLEDAI-2k). Patients were diagnosed to have MetS according to The National Cholesterol Education Program Adult Treatment PanelIII (NCEP). The characteristics of SLE patients and their disease status were compared between those with and without MetS. Atotal of 74SLE patients were included; mean age was 32.1 ± 10.9years and 87.8% were females. Twenty-five (33.8%) SLE patients had neuropsychiatric lupus (NPSLE), with headache the most common manifestation. MetS was diagnosed in 45.9% of the SLE group. Patients with MetS had significantly older age, delayed age of diagnosis and higher SLEDAI-2k scores (p = 0.015, p = 0.014 and p = 0.019, respectively) compared to those without MetS. NPSLE was significantly correlated with MetS (r = 0.32, p = 0.006) and in particular with higher central obesity (r = 0.43, p < 0.001). In the multivariate analysis, NPSLE remained independently associated with MetS (OR = 4.9, p = 0.004, 95% CI = 1.7-14.4). Metabolic syndrome is present in asignificant proportion of Egyptian patients with adult SLE. Delayed disease diagnosis and higher disease activity are SLE-related factors that may contribute to increase the risk of MetS. Data suggest that neuropsychiatric lupus may underlie some of the increased risk for MetS and central obesity.

Comparison of the prevalence of metabolic syndrome in patients with schizophrenia and bipolar disorder: a cross-sectional study from Black Sea region

Objective: Previous research has suggested that metabolic syndrome is more prevalent among patients with schizophrenia and bipolar disorder. Given the scarcity of comparative research on these disorders, this study aims to compare the prevalence of metabolic syndrome in two diagnostic groups and to identify sociodemographic or clinical factors related to metabolic syndrome. Methods: A total of 235 patients diagnosed with schizophrenia (n=160) and bipolar disorder (n=75) and were being followed up by a metabolic monitoring program in a specialized outpatient clinic and using antipsychotic therapy for at least eight weeks have participated in this cross-sectional study. Patients were diagnosed with metabolic syndrome according to National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III) criteria. Sociodemographic and clinical data including metabolic records were collected retrospectively by reviewing the patients’ medical records. Results: The overall prevalence of meta-bolic syndrome was 32.3% and waist circumference was the most frequent individual component with a prevalence of 60%. There were no differences in the prevalence of metabolic syndrome between schizophrenia and bipolar patients. Age, body mass index (BMI), and use of certain types of atypical antipsychotics were found related to metabolic syndrome. Conclusion: The prevalence of metabolic syndrome and its components among patients with severe mental illness is alarming irrespective of their diagnoses. Thus, metabolic screening is crucial especially for high-risk groups.