IDF Criteria Research Articles

Determinants of arterial hypertension control in the hypertensive population receiving medical therapy

Highlights. The leading factor of ineffective arterial hypertension (AH) control in the population taking medications was the number of metabolic risk factors (RF). In addition, in men, the odds of reaching the blood pressure targets were lower if there was a history of kidney disease and bronchitis, and higher, if statins and hypotensive drugs were taken together, respectively. In women, heart rate equal or higher than 75 beats/min and total carotid atherosclerotic plaque thickness were associated with lower and a visit to a physician in the past year - with higher odds of effective hypertension control, respectively.Aim. Analysis of factors associated with reaching blood pressure targets in hypertensive population taking medications.Methods. We examined men and women of 25-64 y.o., randomly drawn from general population, having hypertension and receiving medications. All participants underwent standardized cardiac screening, including a survey on a number of socio-demographic, psychosocial, behavioral variables, traditional and metabolic cardiovascular risk factors, life quality. We measured anthropometric and blood pressure variables, "intima-media" thickness, presence and total thickness of carotid atherosclerotic plaques. Analysis included data from 480 respondents. Parametric and nonparametric statistics were used. To analyze relationships, multivariable logistic regression was used. An error probability <5% was considered statistically significant.Results. After adjustment for age, wealth level, cardio-vascular deseases and the number of antihypertensive drugs, the following factors increased the chances of effective treatment for hypertension in men - statins, positive answer to the question “Do you feel pain or discomfort?” on the EQ5D scale. Lower odds for detecting target blood pressure levels were associated to the count of metabolic syndrome components according to IDF criteria except arterial hypertension (0-4), kidney disease, previous bronchitis, age. A direct association with the effectiveness of treatment for hypertension in women was shown by a visit to the doctor during the past year, and the opposite - the number of metabolic syndrome components, heart rate ≥75 per minute and the total thickness of carotid atherosclerotic plaques, respectively.Conclusion. Lack of hypertension control was associated to metabolic risk factors count, age, kidney disease, heart rate ≥75 per minute, previous bronchitis, lack of visit to a doctor over the past year, as well as total thickness of carotid atherosclerotic plaques. The situation can be improved by deliberately losing weight, taking statins by all people at very high and high risk, and seeing a doctor regularly. It is necessary to further study the factors that hinder achievement of blood pressure targets, as well as methods aimed at the prevention and effective correction of metabolic disorders.

Association of Inflammatory Markers with Metabolic Syndrome among Pre & Post-menopausal Women

Background: Metabolic Syndrome (MetS) comprises of an array of clinical, physiological, metabolic and biochemical disturbances; associated with a systemic inflammatory response. The debilitating condition entails high morbidity and mortality and thus it is important to identify and resolve it timely; a goal which may be achieved with the help of biomarkers. Fibrinogen and hsCRP; highly sensitive C-reactive protein, are found to be increased in acute inflammations. The raised quantity is indicative of underlying inflammatory states and thus may be relevant to MetS.
 Objectives: To determine the association of inflammatory markers with metabolic syndrome among pre & post-menopausal women.
 Materials and Methods: This cross-sectional analysis was carried out on a sample of 278 women (aged at or above 25 years) presenting to the Outpatient Department of General Medicine and the Obstetrics – Gynecology at Liaquat University Hospital (Hyderabad) from 01-02-2020 to 01-10-2020. Data was collected using a structured interview-based proforma which include information about biodata and sociodemographic details of research participants and biochemical analysis (CRP, DLC and fibrinogen and insulin measurement).
 Results: In this study a cumulative MetS prevalence was found out to be around 60% (63.7% as per IDF criteria and (57.6% as per ATP-III classifications). Women with MetS had higher levels of CRP and fibrinogen. Women with high fibrinogen levels and CRP suffered with more type of metabolic abnormalities.
 Conclusion: The findings of this studies showed that with total body fat and fat percentage, body mass-index, have a positive association with the studied inflammatory markers (CRP and fibrinogen).

Craniopharyngioma and Metabolic Syndrome: A 5-Year Follow-Up Single-Center Experience.

Patients with craniopharyngioma often have comorbidities, such as obesity and hypopituitarism. These two conditions affect each other and worsen the quality of life of patients, which lead to a higher risk of morbidity and mortality. In addition, abdominal obesity, measured as waist circumference (WC), is together with other parameters [arterial hypertension, hyperglycemia, hypertriglyceridemia, and reduced levels of high-density lipoprotein (HDL) cholesterol], one of the components of metabolic syndrome (MS). Each one of these morbidities occurs in patients with craniopharyngioma more frequently than in the remaining population. On these bases, we evaluated metabolic parameters in patients with craniopharyngioma at the time of diagnosis and after a 5-year follow-up, which compares these data with those of age-, gender-, WC-, and body mass index (BMI)-matched controls. In addition, we evaluated the prevalence of MS according to IDF criteria (MS-IDF) and the prevalence of MS according to ATP III (MS-ATPIII) criteria in patients and controls at baseline and after 5 years. We recruited 20 patients with craniopharyngioma (age 38.5 ± 15 years, 10 M) and 20 age-, gender-, WC- and BMI-matched controls (age 34.16 ± 13.19 years, 10 M). In all patients and controls, we evaluated the following: anthropometric features [height, weight, BMI, WC, hip circumference (HC) and waist-to-hip ratio (WHR)], systolic blood pressure (SBP) and diastolic blood pressure (DBP), lipid profile [total cholesterol (TC), HDL, low-density lipoprotein (LDL) cholesterol, triglycerides (TG)], and blood glucose at baseline and after 5 years. The prevalence of MS, according to IDF and ATPIII criteria, was calculated in the two groups at baseline and after 5 years. According to our results, at baseline, patients with craniopharyngioma had a worse metabolic profile than controls and a higher prevalence of MS. Besides, at a 5-year follow-up, patients still had impaired metabolic characteristics and more frequent MS (according to IDF and ATPIII criteria) when compared to controls. These data confirm that MS in patients with craniopharyngioma is unresponsive to life-changing interventions and to a common pharmacological approach. Other factors may be involved in the evolution of these conditions; so, further studies are needed to establish the correct management of these patients.

Metabolic syndrome and its components among HIV/AIDS patients on Antiretroviral Therapy and ART-Naïve Patients at the University of Calabar Teaching Hospital, Calabar, Nigeria.

Although an increasing access to ART in sub-Saharan Africa has made it possible for HIV/AIDS patients to live longer, clinicians managing such patients are faced with the challenge of drug-related metabolic complications. A cross -sectional study was carried out at the University of Calabar Teaching Hospital, Nigeria, on three groups of participants; namely HIV patients on ART, ART-naïve patients and HIV negative subjects (n =75). Demographic and anthropometric data were collected using a well-structured questionnaire while biochemical parameters were measured using colorimetric methods. The highest prevalence of MS was associated with the HIV/AIDS patients on ART (i.e. 32.0 %, and 50.3% for NCEP-ATP III and IDF criteria respectively). Patients on ART had significant increases (p< 0.05) in waist to hip ratio, FPG, serum TG and LDL-c; and a significantly higher (p< 0.05) prevalence of hypertension, diabetes, low HDL-c and hypertriglyceridaemia compared to the ART-naïve patients. Low serum HDL-c was the most prevalent form of dyslipidaemia in all three groups and the most prevalent component of MS in HIV patients. ART increases the risk of MS and CVD. HIV/AIDS patients on ART should be advised on lifestyle modifications and undertake regular assessment of their cardiovascular risk factors.

Prevalence of metabolic syndrome in Brazilian adults in the last 10\xa0years: a systematic review and meta-analysis

BackgroundA cluster of interconnected cardiometabolic risk factors characterizes metabolic Syndrome (MS). The prevalence of MS is increasing worldwide, but there is not a meta-analysis of this prevalence in the Brazilian population. We aimed to determine the prevalence of metabolic syndrome among adult general population in Brazil through a meta‑analysis study.MethodsOriginal research studies were searched at PubMed, Scopus, Web of Science, and SciELO databases, from 2011 to 2021. We used the Joanna Briggs Institute tool to assess the quality of included studies. The random effect model was used to estimate the pooled prevalence of MS. Subgroup and meta-regression analysis were conducted for explored heterogeneity and used the Funnel Plot and Egger’s test to assess publication bias. The study was performed based on the criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).ResultsThe search in electronic databases identified 1598 records. From this total, 26 studies were eligible to be included in the final analysis. The overall pooled prevalence among the general population of Brazil was 33% with high heterogeneity observed. By gender, the prevalences were 26% in males and 38% in females. By criteria that was used to define MS, the prevalence were 31% in NCEP ATP III, 25% in JIS, 37% in IDF/NHLBI/AHA/WHF/IAS/IASO and 33% in IDF criteria. The prevalence in different habitat was 34% in urban, 15% in rural, 28% in quilombola and 37% in indigenous. In different regions was 37% in the South, 30% in Southeast, 38% in North, 31% in Northeast and 39% in Midwest. The pooled prevalence of MS with age was < 45 years: 43% and ≥ 45 years: 42% and the prevalence based on year of study implementation was 31% in 2015–2019, 35% in 2010–2014 and 28% in 2005–2009. There were no statistically significant differences between subgroups. Most of the studies showed high quality assessment criteria’s except adequate sample size criteria and many studies participants were not sampled in an appropriate way.ConclusionsOur review indicates a high prevalence of MS in the healthy Brazilian adult population, when compared to others countries and with a world estimate.

Sex-specific prevalence of metabolic syndrome in older adults: results from the Neyshabur longitudinal study on aging, Iran.

The prevalence of metabolic syndrome (MetS) and associated diseases grows as the population ages. This study aimed to investigate sex differences in the prevalence of MetS and its components among people aged 50years and older in Iran. Data were drawn from the Neyshabur Longitudinal Study on Ageing (NeLSA), which is an ageing component of the Prospective Epidemiological Research Studies in IraAn (PERSIAN). TheNCEP ATP III and IDF criteria were used to identify the prevalence of MetS among 3383 men and 3873 women aged 50years and older. Sociodemographic information, lifestyle and clinical factors were collected via an interview-based questionnaire. Weight and height, waist circumferences and blood pressure were measured. Laboratory measures such as fasting blood sugar, triglycerides and high-density cholesterol were also assessed. The overall prevalence of the MetS according to the NCEP ATP III and IDF definitions were 45% and 47%, respectively. The prevalence of the MetS in men and women was 37% and 63% according to the NCEP ATP III definition, 33% and 67% by the IDF definition, respectively. The prevalence of MetS components was significantly higher in women than in men. In the current study, the prevalence of MetS and its components was significantly higher among women than men. We also observed good concordance between IDF and NCEP ATP III criteria.

Gender differences in Anxious-depressive symptomatology, Metabolic Syndrome and Colorectal Adenomas among outpatients undergoing colonoscopy: a cross-sectional study according to a PNEI perspective.

Background and aim of the work:To explore gender differences in patients suffering from anxious-depressive symptoms, Metabolic Syndrome (MetS) and Colorectal Adenomas (CRAs) in a sample of outpatients undergoing colonoscopy for screening purposes.Methods:Cross-sectional study. 126 consecutive outpatients of both sexes undergoing colonoscopy for non-specific abdominal symptoms between January 2015 and June 2021 at the Modena Policlinico General Hospital (Modena, Northern Italy) were enrolled. MetS was diagnosed according to ATPIII and IDF criteria. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS), while the Temperament and Character Inventory (TCI) was used to study personality. The SF-36 was also included as a measure of quality of life perception.Results:Among 126 outpatients (51.60% male) undergoing colonoscopy, 51 (44%) had CRAs, 54 (47%) MetS, 41 (41.40%) anxiety symptoms, 22 (22.20%) depressive symptoms and 13 (13.10%) combined anxious-depressive symptoms. HADS-Anxiety (t=2.68, p=0.01) and TCI Reward Dependence (TCI-RD) (t=3.01, p=0.00) mean scores were significantly higher in women; conversely, SF-36 Mental Component Summary scores were higher in men. CRAs were significantly prevalent in men (χ2=9.32, p=0.00) and were statistically significantly associated with male sex at the univariate logistic regression analysis (OR=3.27; p<0.01). At the multivariate logistic regression, diastolic hypertension (p<0.01) was positively associated with male sex, while TCI-RD (p=0.04) and HDL hypocholesterolemia (p=0.02) were inversely associated with male sex.Conclusions:Several significant gender differences in anxious-depressive symptoms, MetS and CRAs were found. These preliminary data suggest the need to consider gender specificities while implementing therapeutic, diagnostic, and preventive strategies. (www.actabiomedica.it)

Determination of the association of some polymorphisms with metabolic syndrome in residents of the city of Nur-Sultan

Aim: Metabolic syndrome develops as a result of a combined effect of environmental factors and genetics. Therefore, this study is an attempt to detect polymorphisms that influence the development of metabolic syndrome among people of reproductive age in the case of Nur-Sultan. Material and methods:128 polymorphisms were selected from those involved in metabolic disorders in other studied populations; further, their effect on developing metabolic syndrome in the focused group was studied. The study involved 717 respondents aged 18 to 49 with an average age of 40.2 years. Out of them, 243 participants were diagnosed with metabolic syndrome with IDF criteria. Results: Based on the study results, five polymorphisms that influence the development of metabolic syndrome were found: rs7903146, rs157582, rs 4506565, rs7578597, rs4072037. T allele in polymorphisms as rs 7903146 ​​- 1.56 (СI 1.14-2.14; p = 0.004), rs 157582 - 1.54 (СI 1.16-2.04; p = 0.001), rs 4506565 - 1.5 (СI 1.1-2.03; p = 0.007), rs 7578597 - 1.59 (СI 1.02-2.46; р = 0.016) increases the risk of metabolic syndrome development approximately by 1.5 times according to the additive model, whereas C allele by polymorphism rs 4072037 does the risk of MS development by 1.99 (СI 1,1-3,6; р = 0,016) times according to the recessive model. Conclusion: The identified five polymorphisms make it possible to assess the risks of MS and associated diseases. Keywords: metabolic syndrome, polymorphism, allele, genotype

Enhanced prediction of renal function decline by replacing waist circumference with \u201cA Body Shape Index (ABSI)\u201d in diagnosing metabolic syndrome: a retrospective cohort study in Japan

BackgroundAbdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is conventionally evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity.ObjectiveTo examine whether replacing WC with “A Body Shape Index (ABSI)”, an abdominal obesity index calculated by dividing WC by an allometric regression of weight and height, in MetS diagnosis is useful for predicting renal function decline.Subjects/MethodsIn total, 5438 Japanese urban residents (median age 48 years) who participated in a public health screening program for 4 consecutive years were enrolled. Systemic arterial stiffness was assessed by cardio-ankle vascular index (CAVI). The predictability of the new-onset renal function decline (eGFR < 60 mL/min/1.73 m2) by replacing high WC with high ABSI (ABSI ≥ 0.080) was examined using three sets of MetS diagnostic criteria: Japanese, IDF and NCEP-ATPIII.ResultsIn Japanese and NCEP-ATPIII criteria, MetS diagnosed using ABSI (ABSI-MetS) was associated with significantly higher age-adjusted CAVI compared to non-MetS, whereas MetS diagnosed using WC (WC-MetS) showed no association. Kaplan–Meier analysis of the rate of new-onset renal function decline over 4 years (total 8.7%) showed remarkable higher rate in subjects with ABSI-MetS than in those without (log-rank test p < 0.001), but almost no difference between subjects with and without WC-MetS (p = 0.014–0.617). In gender-specific Cox-proportional hazards analyses including age, proteinuria, and treatments of metabolic disorders as confounders, ABSI-MetS (Japanese criteria for both sexes, IDF criteria for men) contributed independently to the new-onset renal function decline. Of these, the contribution of IDF ABSI-MetS disappeared after adjustment by high CAVI in the subsequent analysis.ConclusionIn this study, replacing WC with ABSI in MetS diagnostic criteria more efficiently predicted subjects at risk of renal function decline and arterial stiffening.

Abdominal obesity negatively influences key metrics of reverse cholesterol transport

Cardiometabolic risk factors increase the risk of atherosclerotic cardiovascular disease (ASCVD), but whether these metabolic anomalies affect the anti-atherogenic function of reverse cholesterol transport (RCT) is not yet clearly known. The present study aimed to delineate if the function and maturation of high density lipoprotein (HDL) particles cross-sectionally associate with surrogate markers of ASCVD in a population comprising of different degree of cardiometabolic risk.We enrolled 131 subjects and characterized cardiometabolic risk based on the IDF criteria's for metabolic syndrome (MS). In this population, cholesterol efflux capacity (CEC), Lecithin–cholesterol acyltransferase (LCAT) and ApoA-1 glycation was associated with waist circumference, abdominal visceral fat (VFA) and abdominal subcutaneous fat. In multivariate analyses, VFA was identified as a critical contributor for low CEC and LCAT. When stratified into groups based on the presence of cardiometabolic risk factors, we found a prominent reduction in CEC and LCAT as a function of the progressive increase of cardiometabolic risk from 0–2, 0–3 to 0–4/5, whereas an increase in Pre-β-HDL and ApoA-1 glycation was observed between the lowest and highest risk groups.These findings confirm the connection between MS and its predisposing conditions to an impairment of atheroprotective efflux-promoting function of HDLs. Furthermore, we have identified the bona fide pathogenically contribution of abdominal obesity to profound alterations of key metrics of RCT.

218 INCREASING PREVALENCE OF METABOLIC SYNDROME IN OLDER ADULTS IN IRELAND

Abstract Background Metabolic syndrome (MetS) is a cluster of inter-related risk factors of metabolic origin, occurring together more often than by chance alone. MetS is a recognised risk factor for cardiovascular disease, several other chronic medical conditions and mortality. This study aimed to describe the prevalence of MetS in older adults in Ireland and to examine if this changed over a 4-year follow-up period. Methods This study used data collected as part of wave 1 and 3 of The Irish Longitudinal Study of Ageing (TILDA). Using objective measurements of triglycerides, high-density lipoprotein cholesterol, blood pressure, height, weight, waist circumference and glycated haemoglobin (HbA1c), in addition to medication usage, the prevalence of MetS using both the National Cholesterol Education Program Third Adult Treatment Panel criteria (ATPIII) and the International Diabetes Foundation criteria (IDF) were determined. Weights were used to allow the sample to be representative of the population. Weights for wave 3 included an adjustment for attrition between wave 1 and wave 3. Weighted logistic regression models were undertaken to examine the odds ratios for age, sex and educational attainment. Results 32.5% of the community-dwelling population aged ≥50 years at wave 1 had MetS according to the ATPIII criteria, with 39.3% according to the IDF criteria. Males were 36% (ATPIII) or 53% (IDF) more likely than females to have MetS at wave 1. MetS was increasingly prevalent with age, and lower educational attainment at both waves. Prevalence had increased by wave 3 with 35.1% and 41.3% meeting the ATPIII and IDF criteria respectively. Conclusion The prevalence of MetS, a modifiable disorder, is very high and increasing in older adults in Ireland, with nearly 400,000 of the community-dwelling population ≥ 54 years at wave 3 meeting either the ATPIII or IDF criteria. More public health interventions are warranted.

Abstract 13182: Dapagliflozin and Changes in Metabolic Syndrome in Patients With Type 2 Diabetes: A DECLARE TIMI 58 Sub-Analysis

Introduction: SGLT2 inhibitors reduce cardiovascular (CV) risk in a broad range of patients including those with and without type 2 diabetes mellitus (DM). In addition, non-glycemic effects modify parameters that define metabolic syndrome (MetS) such as weight, BP, and lipid profile. In this context, we investigated the effects of dapagliflozin on key components of MetS and the association with outcomes. Methods: 17,160 patients with DM were randomized to dapagliflozin or placebo in DECLARE-TIMI 58. Since all had DM, MetS was classified using a modification of IDF criteria requiring BMI ≥30 kg/m 2 and ≥1 of the following: triglycerides ≥150 mg/dL, HDL-C &lt;40 in men or &lt;50 mg/dL in women, SBP ≥130 or DBP ≥85 mmHg. Classification of MetS and its subcomponents were tracked at baseline and follow-up visits (6-48 months). An analysis adjusted for baseline characteristics and treatment was performed to assess the association of MetS with key outcomes. Results: At baseline, 53% had MetS. On adjusted analysis, MetS was predictive of CV death or hospitalization for heart failure (CVD/HHF) (HR 1.28, 95%CI 1.11-1.47, p&lt;0.001), HHF (HR 1.62, 95%CI 1.33-1.97, p&lt;0.001), and MI (HR 1.22, 95%CI 1.05-1.4, p=0.008). From 6 to 48 months, there was a lower prevalence of MetS in the dapagliflozin arm (47.9% vs. 52.5%, p&lt;0.001, Figure 1), as well as lower prevalence of BMI ≥30 kg/m 2 (54.9% vs. 58.0%), low HDL-C (38.7% vs. 42.6%), and elevated BP (58.2% vs. 65.7%) with p&lt;0.001 for each. In the dapagliflozin arm, there were lower odds of progression to MetS (10.5% vs. 13.5%; OR 0.76, 95%CI 0.64-0.89, p&lt;0.001) and, in those with MetS at baseline, higher odds of regression (24.6% vs. 18.3%; OR 1.45, 95%CI 1.29-1.64, p&lt;0.001) at 48 months. Conclusions: The presence of MetS is prognostically important in patients with DM. Dapagliflozin led to significant early and sustained changes in the likelihood of MetS.

The Frequency of Metabolic Syndrome in Aged Female Patients (Older Than 65 Years) With and Without Stress Urinary Incontinence: A Case-Control Study.

The aim of the study was to assess the incidence of metabolic syndrome (MetS) in aged patients (older than 65 years) with and without stress urinary incontinence (SUI). We evaluated the components of MetS in 460 SUI patients and 460 age-matched women without urinary incontinence from January 2009 to October 2019. Stress urinary incontinence was diagnosed by clinical complaint and the presence of involuntary urine leakage during physical activity. Definition of MetS was on the basis of the National Cholesterol Education Program Adult Treatment Panel III recommendations definition (NCEPATPIII) and the International Diabetes Federation criteria (IDF). Totally, 460 SUI patients with the median age of 70 years were eventually included in the study. Subsequently, 460 age-matched controls were selected. The prevalence of MetS was more frequent in SUI patients based on the NCEPATPIII (43.04% vs 19.78%, P < 0.0001) and IDF criteria (45.22% vs 20.22%, P < 0.0001). Moreover, logistic regression analysis revealed that MetS significantly increased the risk of SUI (odds ratio = 3.06, 95% confidence interval = 2.28-4.09) according to the NCEPATPIII definition and (odds ratio = 3.26, 95% confidence interval = 2.43-4.34) on the basis of IDF criteria compared with controls. Patients in the SUI group had a statistically higher body mass index (P < 0.0001), larger waist (P < 0.0001), higher level of fasting blood glucose (P = 0.0001), triglycerides (P = 0.00), and systolic blood pressure (P = 0.0001) than controls. Patients with SUI demonstrated a statistically worse symptom score in all aspects compared with controls (P < 0.0001). The prevalence of MetS was higher in older women with SUI than in an age- and sex-matched control group without clinical SUI. Further studies are warranted to determine the pathophysiology mechanism of SUI and MetS.

Metabolic syndrome components for different assessment criteria among women of a middle-urbanized city of Western Siberia

The prevalence of metabolic syndrome components at the population level was determined mainly in age-limited contingents, by criteria for assessing metabolic syndrome, or on selective samples of the population, while conducting correct epidemiological studies in open female populations to study the prevalence of metabolic syndrome components according to various assessment criteria seems to be extremely relevant. Aim of the study was to establish the prevalence of metabolic syndrome components in an open female population according to different assessment criteria (on the model of Tyumen). Material and methods. A cross-sectional epidemiological study was carried out among females in one of the administrative districts of Tyumen. A representative sample was formed from electoral lists among women 25-64 years old by the method of «random numbers» – 1000 subjects (250 persons in four decades of life). The response to the study was 70.3 %. The NCEP ATP III (2004) and IDF (2005) criteria for assessing the metabolic syndrome were used for the analysis. Results. In an open population of a moderately urbanized city of Western Siberia among women 25-64 years old, a high prevalence of abdominal obesity was revealed according to various criteria for assessing agestandardized indicator (33.5 and 49.8 %), a positive relationship with age was determined. The prevalence of arterial hypertension, hyperglycemia and hypertriglyceridemia HTG occupies the middle position with a significant increase in indicators in older age categories. In women of the urban population, a high prevalence of high density lipoprotein hypocholesterolemia was revealed in young and middle age (from 18.5 to 31.3 %). Conclusion. The obtained data on the prevalence of metabolic syndrome components in women in an open population help to identify risk groups for the development of cardiovascular diseases and to outline measures for primary prevention among the population of a medium-urbanized city of Western Siberia.

Cardiometabolic syndrome and associated factors among Ethiopian public servants, Addis Ababa, Ethiopia

Non-communicable diseases (NCDs) are increasingly becoming the global cause of premature death encompassing cardiovascular diseases (CVDs), cancer, respiratory diseases and diabetes mellitus. However, cardiometabolic risk factors in the general population, especially among the high-risk groups have rarely been assessed in Ethiopia. The study aimed to assess the prevalence of metabolic syndrome, its components and associated factors among staff in the Ethiopian Public Health Institute (EPHI). An institutional-based cross-section study was conducted from March to June 2018 among EPHI staff members. A total of 450 study participants were involved in the study, and the World Health Organization NCD STEPS survey instrument version 3.1 was used for the assessment. The biochemical parameters were analyzed by using COBAS 6000 analyzer. Statistical package for the social science (SPSS) version 20 was used for data analysis. Both bivariate and multivariate logistic regression analyses were used to identify associated risk factors. p value < 0.05 was considered for statistical significance. The overall prevalence of metabolic syndrome was 27.6% and 16.7% according to IDF and NCEP criteria respectively, with males having greater prevalence than females (35.8% vs 19.4%). Central obesity, low high-density lipoprotein (HDL) and hypertension had a prevalence of 80.2%, 41.3%, and 23.6%, respectively. In multivariate analysis increasing age and having a higher body mass index (25–29.9) were significantly associated with metabolic syndromes. The magnitude of metabolic syndrome was relatively high among public employees. Preventive intervention measures should be designed on the modification of lifestyle, nutrition and physical activities, and early screening for early identification of cardiometabolic risks factors should be practised to reduce the risk of developing cardiovascular diseases.

Cardiovascular risk and associated risk factors in Spanish professional drivers

IntroductionCardiovascular diseases are the leading cause of mortality worldwide and are related to harmful lifestyles and certain professions such as being a professional driver. The aim of this study was to determine cardiovascular risk in professional drivers and the factors that influence it, with the intention of recommending improvements in their lifestyle habits. Material and methodsA retrospective, cross-sectional study was carried out on 24784 professional drivers (cab drivers and bus drivers) of both sexes (23,560 men and 1227 women) in different Spanish regions. Several variables and scales related to cardiovascular risk were assessed. In order to see if this type of profession produces an increase in cardiovascular risk. Results27.8% of drivers were obese, 34.7% were hypertensive, and 48.7% had a high waist to height ratio. 46.5% were considered non-metabolically healthy, in that 24.9% had metabolic syndrome with the NCEP-ATPIII criteria, 19.2% with the IDF criteria, and 37.3% with JIS criteria. 26.9% had moderate or high values on the REGICOR scale and 29.5% on the SCORE scale. 32.7% had a high risk of hepatic steatosis. ConclusionsThe cardiovascular risk of our drivers was high in men and moderate in women. Significant differences were found between men and women with regard to the habits of regular physical exercise and healthy eating, which could justify the lower cardiovascular risk in women.

The role of visceral obesity and insulin resistance in right ventricular function in patients with metabolic syndrome

Abstract Background Evidence shows a strong relationship between visceral obesity, insulin resistance, metabolic syndrome (MetS) and cardiovascular disease risk. The role of right ventricular (RV) function is indisputably important in estimating of patient's prognosis. Multiple studies demonstrate that visceral fat represents a metabolically active organ, secreting a plethora of vasoactive substances that may have impact on cardiometabolic risk profile of the patient, especially under the circumstances of MetS. Purpose The objective of our study was to evaluate the role of visceral obesity and insulin resistance in RV function in patients with MetS. Methods The study included 100 subjects with MetS (mean age 53±8.9 years) and 100 controls without MetS (mean age 51±9.3 years, P=0.08). MetS was defined by ≥3 criteria of IDF, AHA/NHLBI. The participants of the study underwent complete 2D echocardiography and abdominal sonography with the assessment of diastolic function of RV: the ratio of early and late diastolic tricuspid flow velocities (Et/At), the ratio of early diastolic tricuspid flow velocity and early diastolic tricuspid annular velocity (Et/e't), Et deceleration time (DT); systolic RV function: TAPSE, ejection fraction of RV (EF); global RV function: Tei index of RV (by pulsed and pulsed tissue Doppler); visceral obesity sonographic parameters: epicardial fat thickness (EFT), intra-abdominal fat thickness (IFT), abdominal wall fat index (AWFI). The status of insulin resistance was determined by HOMA-IR≥2.5. Results All the parameters of RV diastolic function, as well as Tei index, were significantly changed in MetS group (P&amp;lt;0.05 for all parameters). Systolic function of RV showed no statically important differences among the groups (TAPSE 20,4±1,7 mm vs. 21.4±2.3 mm, P=0.087; EF RV 53±3% vs. 54±4%, P=0.092). In patients with MetS we found important correlations of diastolic parameters of RV (Et/At, Et/e'T, EtDT) with EFT (respectively: r=−0.524, P&amp;lt;0.001; r=0.291, P&amp;lt;0.001; r=0.692, P&amp;lt;0.001), IFT (respectively: r=−0.342, P&amp;lt;0.001; r=0.335, P&amp;lt;0.001; r=0.592, P&amp;lt;0.001), and AWFI (respectively: r=−0.426, P&amp;lt;0.001; r=0.212, P=0.002; r=0.538, P&amp;lt;0.001). In MetS group Tei index of RV (determined by pulsed and pulsed tissue Doppler) showed important correlations with EFT (r=0.623, P&amp;lt;0.001; r=0.618, P&amp;lt;0.001), IFT (r=0.498, P&amp;lt;0.001; r=0.530, P&amp;lt;0.001) and AWFI (r=0.313, P=0.001; r=0.307, P=0.001). In patients with HOMA-IR ≥2.5 risk for diastolic dysfunction of RV was 5 times higher. Systolic RV function did not show important correlations with selected parameters of visceral obesity. Multivariate regression analysis showed that EFT and HOMA-IR were independently associated with RV global and diastolic dysfunction in patients with MetS (P&amp;lt;0.05). Conclusions Our findings support that visceral obesity (especially determined by EFT) and insulin resistance are associated with diastolic and global dysfunction of RV in patients with MetS. Funding Acknowledgement Type of funding sources: None.

Cutoff point of TyG index for metabolic syndrome in Brazilian farmers.

Thus, the aim of this study was to identify the cutoff point of the TyG index for the diagnosis of insulin resistance (IR), according to two different diagnostic criteria of metabolic syndrome in a rural Brazilian population. The study population consisted of 790 family farmers from 18 to 59 years old. The triglyceride-glucose index (TyG index) was calculated, and the Metabolic Syndrome was defined using the NCEP-ATPIII and IDF criteria. Mann-Whitney U test was used to analyze the association of quantitative and qualitative variables. When the qualitative variable had three or more categories, the comparison between the means was performed by the Kruskal-Wallis test (using the Mann-Whitney U Test two by two to identify the differences). For correlations, Spearman's correlation test was used. The cutoff values of TyG index for MetS were obtained using the Receiver Operating Characteristic (ROC) curve analysis with the area under the curve (AUC) and the Youden Index. The median TyG values increased according to the aggregation of the components of MetS. The AUCs and Youden's cutoff point for TyG index according to the NCEP and IDF diagnostic criteria were 0.873, Ln 4.52 (sensitivity: 84.30%; specificity: 75.75%), and 0.867, Ln 4.55 (sensitivity: 80.0%; specificity: 79.82%), respectively. A cutoff point of Ln 4.52 was defined, and it can be used both in clinical practice and epidemiological studies. It represents an important tool for promotion, protection and recovery health of rural populations.

Metabolic Syndrome, Homocysteine and uric acid in patients with obesity; experience from Obesity and Work Centre

BACKGROUND: Uric acid (UA) and homocysteine (HCys) are involved in cardiovascular diseases. Patients with obesity (PwO) are characterized by elevated cardiovascular risk. OBJECTIVE: To evaluate the relationship between HCys and UA concentrations in 1141 overweight patients and PwO with and without metabolic syndrome (MS). METHODS: MS was defined according to IDF criteria (2005). Anthropometric data were recorded and blood biochemical parameters were assessed with routine methods on fasting blood samples. Statistics: Spearman correlation and multiple regression analysis. RESULTS: Gender, obesity and MS influenced both UA and HCys levels, which were increased in males, MS patients, PwO with MS and positively correlated (p &lt; 0.001). Patients without MS had normal or slightly high levels. Hypertension, hyperuricemia and hyperhomocysteinemia were found in PwO with MS. UA concentration correlated with systolic blood pressure, triglycerides and HDL (all p &lt; 0.05). Multivariate analysis showed that HCys concentration was an independent determinant factor affecting UA levels (T value 3.5, p &lt; 0.001). CONCLUSIONS: HCys and UA levels positively and significantly correlated in PwO, especially in those with MS. The significant correlation between UA and hypertension, triglycerides, HDL suggests the clinical usefulness of monitoring UA together with HCys concentrations as cardiovascular risk marker in these patients.

К вопросу оценки сердечно-сосудистого риска у больных первичной хронической подагрой в сочетании с метаболическим синдромом

Цель исследования: изучить частоту метаболического синдрома (МС) и оценить суммарный сердечно­сосудистый риск у больных с первичной хронической подагрой в зависимости от наличия МС. Материалы и методы. Обследованы 82 больных с первичной хронической подагрой, диагностированной с учетом квалификационных критериев S.І. Wallаsе и соавт. В основную группу вошли больные подагрой с МС (n = 52), которые составили 63,4 % всех обследованных. МС диагностировали по критериям IDF. Группу сравнения составили больные МС, репрезентативные по полу и возрасту (n = 46). Проведено клиническое (антропометрические параметры, артериальное давление) и лабораторное обследование (уровень гликемии натощак, мочевой кислоты, липидограмма, пероральный тест толерантности к глюкозе), учтено наличие в анамнезе сердечно­сосудистых заболеваний и их осложнений, оценен сердечно­сосудистый риск по шкалам SCORE и PROCAM. Результаты. Частота ожирения в исследуемых группах составила 65,4 и 63,0 % соответственно. Частота дополнительных критериев МС была высокой в обеих исследуемых группах. Артериальная гипертензия и гипертриглицеридемия одинаково часто диагностировались у больных с МС независимо от наличия подагрического артрита (р &lt; 0,001). Как минимум один дополнительный критерий МС выявлялся у всех обследуемых. У 28,8 % больных основной группы и у 4,3 % пациентов группы сравнения диагностированы все пять дополнительных критериев МС (р &lt; 0,01). У больных основной группы чаще, чем в группе сравнения, выявляли более трех дополнительных критериев МС — 51,9 и 30,4% соответственно (р &lt; 0,01). Суммарный сердечно­сосудистый риск по шкалам SCORE и PROCAM у больных основной группы был значимо выше, чем в группе сравнения (р &lt; 0,05 и р &lt; 0,01 соответственно). Выводы. МС диагностировали у 63,4 % больных с первичной хронической подагрой. Больные с первичной хронической подагрой в сочетании с МС имеют более высокий суммарный сердечно­сосудистый риск по шкалам SCORE и PROCAM в сравнении с больными с МС. Оценка критериев МС наряду с оценкой сердечно­сосудистого риска может быть использована в рутинной клинической практике для стратификации больных с первичной хронической подагрой, нуждающихся в модификации образа жизни и/или дифференцированных подходах к медикаментозному лечению.