Independent Risk Factor For MetS Research Articles

Cross-sectional and longitudinal associations between serum uric acid and metabolic syndrome: Results from Fangchenggang Area Male Health and Examination Survey in China

BackgroundIt is controversial whether serum uric acid (SUA) is a risk factor for the prevalence of metabolic syndrome (MetS). The current study was designed to highlight the association of SUA and MetS and its components. MethodsData on 3675 healthy male subjects, aged 17–88years, were collected for the cross-sectional study. A representative sample of 2575 individuals who did not suffer from MetS at baseline was involved in the cohort study. A cox regression model was applied to evaluate causality for the 2- and 4-year large scale longitudinal study. ResultsIn the cross-sectional analysis, SUA showed a statistically significant negative correlation with high-density lipoprotein cholesterol (HDL-c) and a positive correlation with blood pressure (BP), triglycerides (TG), waist circumference (WC), and body mass index (BMI) (all P<0.001). In longitudinal analysis, examining the risk of developing MetS, SUA concentrations (hazard ratios comparing fourth quartile to the first quartile of 1.75; 95% CI, 1.26–2.41) were positively associated with incident MetS after adjusted for age, blood pressure, glucose, TG, HDL-c, smoking, alcohol drinking and education. ConclusionSUA is positively correlated with the prevalence of MetS. Increased SUA concentration may be an independent risk factor for MetS.

Using brachial-ankle pulse wave velocity to screen for metabolic syndrome in community populations.

The aim of this study is to investigate the viability of using brachial-ankle pulse wave velocity (baPWV) as a primary tool to screen metabolic syndrome (MetS), and to explore the risk factors of MetS in community populations. A total of 1914 subjects completed medical examination in Shanghai. BaPWV was significantly associated with the components of MetS. The area under curve (AUC) and its 95% confidence interval (CI) in total group were 62.50% and 60.00%–65.30% with the appropriate cut-off point being 1435 cm/sec. The AUC (95%CI) of three subgroups (40–50 yrs, 50–60 yrs and over 60 yrs group) were 75.30% (67.48%–83.35%), 63.35% (58.96%–67.60%), 55.37% (51.19%–60.01%), respectively. A clear pattern surfaced in the process of investigation: the younger were the subjects group, the better receiver operating characteristic (ROC) efficacy would emerge; and the higher sensitivity was, the better negative predictive value (NPV) would be. Male gender, high baPWV values, elevated uric acid (UA) and excess hypersensitive C reaction protein (hs-CRP) levels were stayed in the two regression models as the independent risk factors for MetS. We conclude that baPWV may serve as a potential screening tool for MetS at the cut-off point of 1435 cm/sec.

Association between serum vitamin D, parathyroid hormone and metabolic syndrome in middle-aged and older Korean adults.

This study explored the association between serum 25-hydroxyvitamin D (25(OH)D) or parathyroid hormone (PTH) concentrations and the risk of metabolic syndrome (MetS) in middle-aged and older Korean adults using the most recent, nationally representative survey data. The study sample consisted of 2624 Korean adults (⩾ 50 years old) who participated in the fifth Korean National Health and Nutrition Examination Surveys. Serum 25(OH)D was measured by radioimmunoassay and serum PTH was measured using chemiluminescence assay. MetS was defined according to the joint interim statement of the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. Serum 25(OH)D concentrations were significantly lower in subjects with MetS than in subjects without MetS, and the prevalence of MetS significantly decreased according to quartiles of serum 25(OH)D concentration. Serum 25(OH)D concentrations were negatively associated with the risk of elevated blood pressure (P for trend = 0.039), hypertriglyceridemia (P for trend = 0.0474) and reduced high-density lipoprotein cholesterol (P for trend= 0.0139), whereas serum PTH concentrations were positively associated with the risk of elevated blood pressure (P for trend = 0.0002) after adjusting for age, gender, residential district, education level, income, smoking status, body mass index, alcohol intake and physical activity. Furthermore, serum 25(OH)D concentrations were inversely associated with the risk of MetS after adjusting for confounding factors (P for trend = 0.0163). However, serum PTH concentrations were not associated with the risk of MetS. Serum 25(OH)D concentration may be an independent risk factor of MetS among middle-aged and older Korean adults.

AB58. Insight into male’s health from FAMHES cohort study in South China

Fangchenggang Area Male Health Examination Survey (FAMHES) was designed to investigate the effects of environmental and genetic factors and their interaction with the development of age-related chronic diseases. It was a population-based study conducted among non-institutionalized Chinese men aging from 17 to 88 years old in Guangxi, China. A comprehensive demographic and health survey was conducted among a consecutive series of 4,303 men participating in the routine physical examination at the Medical Centre in Fangchenggang First People’s Hospital from September 2009 to December 2009. Using of the FAMHES cohort, we have performed a series of genome-wide association studies (GWAS) for more than 30 quantitative trait loci (QTL) including phenotypes which is related to the men’s health, such as PSA, male sex hormone. We found above 100 gene loci associated with the QTL phenotypes that reach GWAS significant levels and have published 14 papers including PLoS Genetics, Human Molecular Genetics and others.Additionally, we also did the some cross section epidemiology studies in these subjects to understand the effects of some life-style, such as smoking, drinking alcohol, on the men’s health.Firstly, we examined the association between cigarette smoking and testosterone. We found out the smoking has a positive and independent effect on testosterone levels. In another study of association between cigarette smoking and erectile dysfunction (ED), we found the heavy smokers are more likely to have ED. We also studied the association between ED and testosterone. Moreover, we examined the association between ED and metabolic syndrome (MetS). We found out that abnormal fasting blood glucose was the most significantly independent factor of MetS for ED. When we examined the association between MetS and testosterone, we found out that testosterone was the independent risk factor for MetS. Collectively, the studies mentioned above were oriented with ED. As we can see, the lifestyle smoking and the co-exist disease status MetS is the potential marker for ED.In the studies oriented with lower urinary tract symptom (LUTS), we found out the metabolic disorder is associated with some symptoms of LUTS, and the inflammatory marker hsCRP is another indicator for LUTS. In studies oriented with Chronic Prostatitis (CP), we find out the CPSI questionnaire is not associated with the severity of CP. The main symptom of CP is pain, which is associated with metabolic factors. The prevalence of type IV CP is also reported in our cohort. In another oriented disease Non-Alcoholic Fatty Liver Disease (NAFLD), we found one of the sex hormones oestradiol may be its protective factor. Another important hormone osteocalcin is associated with NAFLD as well. Collectively, the studies mentioned above were mainly oriented with sex hormone, especially the testosterone. These studies have not only provided the baseline characteristics for the subjects so that we can set up a cohort to follow up but also paved the way to study the interaction between the various men’s diseases and metabolic diseases, such as diabetes, hypertension, metabolic syndromes. In this field, we have published 25 papers including Journal of andrology, Prostate, Urology, Journal of Clinical Endocrinology & Metabolism, Clinical endocrinology and others.

Correlation of serum adiponectin and adiponectin gene polymorphism with metabolic syndrome in Chinese adolescents.

To investigate the association of adiponectin and its gene polymorphisms with metabolic syndrome (MetS) and cardiovascular disease (CVD) risk factors in Chinese adolescents. This cross-sectional study enrolled 919 healthy middle school students (aged 11-16 years; 46.7% females). All participants underwent anthropometric and biochemical examinations, and MetS was diagnosed using 2007 International Diabetes Federation criteria. The presence of adiponectin and its genotypes of single nucleotide polymorphisms (SNPs) rs266729 (-11377C/G), rs2241766 (+45T/G) and rs1501299 (+276G/T) was detected. (1) Serum adiponectin levels were negatively correlated with numerous CVD risk factors (all P<0.05), and following adjustments for confounding factors, a lower adiponectin level was an independent risk factor for MetS (odds ratio=5.59; 95% confidence interval: 1.90, 16.41). Central obesity and low levels of high-density lipoprotein cholesterol were positively associated with MetS and reduced serum adiponectin levels. (2) The genotype and frequencies of SNP-11377 and SNP+276 in a MetS group and non-MetS group were not significantly different. Subjects with genotype SNP+45 GG were at higher risk for MetS compared with subjects with genotypes SNP+45 TT (P=0.033) or TT+TG (P=0.021). Subjects with genotype SNP+276 TT or TT+TG had higher levels of serum adiponectin compared with subjects with SNP+276 GG (P=0.012 and 0.014, respectively). Adiponectin may be used as a predictive biomarker of MetS, and shows a significant association with CVD risk factors in Chinese adolescents. Adiponectin gene polymorphisms are associated with serum adiponectin concentrations and the presence of MetS.

Decreased muscle mass is not an independent risk factor for metabolic syndrome in Korean population aged 70 or older.

The association of low muscle mass with cardiometabolic risks is still controversial. The aim of this study was to investigate the relationship between low muscle mass and metabolic syndrome (MetS) according to the various muscle mass indices and to evaluate the influence of muscle mass on MetS independent of fat mass. Cross-sectional study About 841 men and 1106 women aged 70 or older from Korea National Health and Nutrition Examination Survey 2008-2010 MEASUREMENTS: We used various muscle mass indices: appendicular skeletal muscle mass (ASM) divided by height squared (ASM/Ht(2) ), ASM divided by body weight (ASM/Wt) and ASM adjusted for height and fat mass (residual). Low muscle mass is defined as ASM/Ht(2) and ASM/Wt below 2 SD of the sex-specific mean for healthy young adults. The sex-specific lowest quintile of the distribution of the residual was regarded as low muscle mass. The prevalence of MetS was higher in the population with low muscle mass defined by ASM/Wt, but lower in those defined by ASM/Ht(2) . However, after stratification according to the central obesity, low muscle mass was barely related with MetS. Meanwhile, when both ASM and fat mass were included in a logistic regression model, the odds ratios of 1 SD change of ASM for MetS were 1·07 (0·85-1·34) for men and 1·24 (1·04-1·47) for women, respectively. The relationship between low muscle mass and MetS was different according to the various muscle mass indices. After controlling the influence of fat mass, decreased muscle mass was not an independent risk factor for MetS.

Metabolic syndrome in patients taking clozapine: prevalence and influence of catechol-O-methyltransferase genotype

Metabolic syndrome (MetS) has consistently been identified as an adverse effect of long-term treatment with atypical antipsychotics (AAPs) such as clozapine. Elevated serum homocysteine concentration has been found to act as an independent risk factor for MetS, and catechol-O-methyltransferase (COMT) catalyzes the homocysteine metabolism. We accordingly hypothesized that COMT dysregulation may confer the susceptibility to MetS induced by AAPs, potentially in a gender-specific manner, because the interaction effects of COMT and gender have been consistently reported. This study aimed at determining the prevalence and influence of COMT on MetS among a population undergoing long-term clozapine treatment. A total of 468 schizophrenia patients taking clozapine were divided into two groups, those experiencing MetS and non-MetS. We genotyped three functional variants (rs4633, rs4680, and rs4818) in COMT and measured the serum levels of fasting homocysteine, glucose, triglyceride (TG), and high-density lipoprotein cholesterol. MetS was found in 202/468 (43.2%) of all the patients, with 40.2% prevalence (138/343) in males and 51.2% (64/125) in females. Patients with MetS had notably higher metabolic parameters than those without MetS. The mean levels of homocysteine in patients with MetS were significantly higher than those without MetS. We found a positive association between the rs4680 polymorphism and the serum triglyceride levels (corrected P = 0.024). Further analysis revealed that the rs4680 Met allele was significantly associated with increased triglyceride levels among female patients (P = 0.009), but not among males (P = 0.07). Our findings suggest a potential association between rs4680 in COMT and elevated TG levels, particularly among female patients.

The clinical availability of non alcoholic fatty liver disease as an early predictor of the metabolic syndrome in Korean men: 5-Year's prospective cohort study

ObjectivesThere were many studies for the clinical association between non alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS). However, while most of studies have focused on the unilateral effects of MetS on NAFLD, studies for reverse association were comparatively rare. Therefore, we carried out a prospective cohort study to evaluate the longitudinal effects of NAFLD on the development of MetS according to the degree of NAFLD. Patients and methodsA total of 46,874 men, who had participated in a medical health check-up program in 2005, were enrolled in this study. Out of them, a Mets-free cohort of 11,926 without excluding conditions was followed up until 2010. All participants were classified into 3 groups by their NAFLD status (normal, mild, moderate to severe). The baseline values of metabolic components and the development rates of MetS were compared according to the degree of NAFLD. Cox proportional hazards model was used to measure the hazard ratios (HRs) for MetS according to the degree of NAFLD. ResultsDuring 41,912.1 person-years of follow-up, 1861 incident cases of MetS developed between 2006 and 2010. Even after adjusting for multiple covariates, the HRs (95% CI) for MetS were higher in the mild group (1.49; 1.30–1.70) and moderate to severe group (2.00; 1.46–2.73) compared to normal group, respectively (P for trend <0.001). These associations were apparent in the clinically relevant subgroup analyses. ConclusionsNAFLD was independent risk factor for MetS during the 5-yr follow-up period.

Association of the apolipoprotein B/apolipoprotein A-I ratio and low-density lipoprotein cholesterol with insulin resistance in a Chinese population with abdominal obesity

The aim of this study is to assess the relationships among the apolipoprotein B/apolipoprotein A-I ratio (apoB/apoA-I ratio), low-density lipoprotein cholesterol (LDL-C) and insulin resistance (IR) in a Chinese population with abdominal obesity. This is a population-based, cross-sectional study of 3,945 men and 2,141 women with abdominal obesity. Individuals were referred to a primary health service and recruited for analysis. IR was measured using a homeostasis model assessment of insulin resistance (HOMA2-IR) with a HOMA2 calculator. Metabolic syndrome (MetS) was diagnosed using International Diabetes Federation (IDF) criteria. Comparing the apoB/apoA-I ratio and lipid indices using the HOMA2-IR showed that the ratio, LDL-C, total cholesterol level (TC) and triglyceride level (TG) were higher; and the high-density lipoprotein cholesterol level (HDL-C) was lower in the fourth than in the first quartile in both sexes (p ≤ 0.001). After adjustment for age, HOMA2-IR was positively correlated with the apoB/apoA-I ratio, LDL-C, TC and TG; and negatively correlated with HDL-C in men (all p < 0.0001). HOMA2-IR was also positively correlated with the apoB/apoA-I ratio, LDL-C, TC and TG; and negatively correlated with HDL-C in women (all p < 0.01). After adjustment for age and LDL-C, HOMA2-IR was found to be correlated with the apoB/apoA-I ratio in both men and women (r = 0.066 and 0.116, p < 0.0001). After adjustment for age and the apoB/apoA-I ratio, HOMA2-IR was correlated with LDL-C in men and women (r = 0.063 and 0.044, p < 0.0001 and p = 0.0431, respectively). Gender, age, LDL-C, BMI, HOMA2-IR and apoB/apoA-I were the covariates independently associated with presence of the MetS (Odds ratio, OR: 2.183, 1.034, 1.013, 1.157, 1.726 and 1.570, respectively; all p < 0.05). In conclusion, the study showed that the apoB/apoA-I ratio and LDL-C were positively correlated with IR. Excluding reciprocal interactions, the apoB/apoA-I ratio and LDL-C were still significantly correlated with IR, but the apoB/apoA-I ratio showed a greater correlation with IR than LDL-C in women with abdominal obesity, compared with men with abdominal obesity. Both LDL-C and apoB/apoA-I were independent risk factors of MetS, and the apoB/apoA-I ratio was stronger in this regard than LDL-C for this obese population.

A longitudinal cohort based association study between uric acid level and metabolic syndrome in Chinese Han urban male population

BackgroundIt has been recently demonstrated that serum uric acid (UA) is associated with metabolic syndrome (MetS) or its related clinical indications based on cross-sectional or prospective cohort studies. Nonetheless, due to the fact that UA level constantly fluctuates from time to time even for the person, using a single measure of UA level at baseline of those studies may not be sufficient for estimating the UA-Mets association.MethodsTo further estimate this time-dependent association, we fitted a generalized estimating equation (GEE) regression model with data from a large-scale 6-year longitudinal study, which included 2222 participants aged > =25 years with an average of 3.5 repeated measures of UA per person in the Health Management Center of Shandong Provincial Hospital, Shandong, China.ResultsAfter adjusting for other potential confounding factors (i.e., total cholesterol, low-density lipoprotein), it was verified that time-dependent UA level was an independent risk factor for MetS (OR = 1.6920, p < 0.0001). It was found that UA level was positively associated with obesity, hypertension, and dyslipidemia, but was inversely associated with hyperglycemia.ConclusionsSerum UA level may serve as an important risk factor of MetS. Additionally, our study suggested that UA level be an independent risk factor to obesity, hypertension and dyslipidemia, but a protective factor to hyperglycemia. These findings are concordant with results from other studies on Asian populations, and jointly provide a basis to further develop a risk assessment model for predicting MetS using UA levels and other factors in China.

Increased prevalence of metabolic syndrome among hypertensive population: Ten years' trend of the Korean National Health and Nutrition Examination Survey

PurposeThe implication of metabolic syndrome (MetS) in the hypertensive population has not been known. The prevalence and the risk factors of MetS among the hypertensive population were investigated. MethodThe first to the fourth Korean National Health and Nutrition Examination Survey (KNHANES) held from 1998 to 2008, nationally representative cross-sectional survey, were analyzed. MetS was defined following NCEP-ATP III guideline. ResultsIn the general population, MetS prevalence was about 27%, however, it was doubled in the hypertensive population, reaching almost 60%. This trend was consistent through the first to the fourth KNHANES. Moreover, although the prevalence of hypertension as well as MetS among the general population has been slightly decreasing, MetS prevalence among the hypertensive population continues to rise which is more obvious among younger patients than the general population both in men and in women. In a multivariate analysis, high BMI, menopause, smoking and daily alcohol intake were suggested as independent risk factors of MetS in hypertensive population. Finally, the presence of MetS was associated with increased prevalence of target organ damage, such as stroke, coronary artery disease and chronic renal disease. ConclusionMetS prevalence among hypertensives was much higher than expected. Moreover, MetS increased target organ damage in hypertensives. Investigation of metabolic status when initiating hypertension control could help establish more effective overall risk control.

Reduced risk of metabolic syndrome due to regular intake of vegetables rich in antioxidants among African type 2 diabetics

Background Antioxidant nutrients found in vegetables are thought to prevent chronic diseases including type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS). Objective We evaluated the prevalence of MetS and the association of antioxidants and cardiovascular risk factors with risk of MetS among patients with T2DM from General hospital of Kinshasa, DRC. Methods This cross-sectional study using a validated semiquantitative food frequency questionnaire. MetS was defined using criteria of IDF/Europids, IDF modified for Africa and NCEP-ATP III. Risk factors of MetS (OR and 95% CI) was estimated using logistic regression, adjusting for confounding factors. Results Out of 244 T2 DM patients (56.6% of females) and 48 ± 16 years, 0%, 13%, 34.4%, 20.9%, and 11.9% were defined by never consuming fruits, never consuming vegetables, MetS/IDF Europids, MetS/IDF modified for Africa, and MetS/NCEP-ATP III. Females (OR = 5 95% CI 2–10; P < 0.01), High socioeconomic status (HSES, OR = 3.5, 95% CI 1.5–8.3; P = 0.005), and regular Cassava leaves intake (OR= 0.4, 95% CI 0.2–0.9; P = 0.027) were the independent determinants of MetS/IDF Europids. HSES (OR= 2.9, 95% CI 1.2–6.9; P = 0.015), physical inactivity (OR = 2.6, 95% CI 1.6–6; P = 0.03) and regular dry red beans intake (OR = 0.4, 95% CI 0.2–0.8; P = 0.016) were the independent determinants of MetS/IDF modified for Africa. Females (OR = 5, 95% CI 2–20; P < 0.001), HSES (OR = 3.5, 95% CI 1.5–8.3; P = 0.005) and regular Cassava leaves intake (OR = 0.4, 95% CI 0.2–0.9; P < 0.0001) were the independent determinants of MetS/NCEP-ATP III. Conclusion Cassava leaves and dried red beans intake, rich in antioxidants, are protective factors against MetS presence, while females, HSES, and physical inactivity are independent risk factors of MetS.

Association of metabolic syndrome with smoking and alcohol intake in Japanese men

There have been conflicting findings on whether metabolic syndrome (MetS) is associated with smoking and alcohol intake. This study investigated the association of MetS with smoking and alcohol intake. MetS was defined according to the International Diabetes Federation criteria, and smoking and alcohol intake were evaluated for 1,215 Japanese male workers using a questionnaire. The association of MetS with smoking and alcohol intake was assessed using logistic regression after adjusting for potential confounders. Proportional analyses for the prevalence of MetS among smoking and alcohol intake were performed as well. Among the subjects, 148 (12%) were diagnosed with MetS, 485 (40%) were smokers, and 954 (79%) were regular alcohol users. The prevalence of MetS was the highest (19%) in smokers who did not drink, followed by smokers who also drank (13%), nonsmokers who drank (12%), and those who neither smoked nor drank (7%). Smoking itself was positively related to MetS (odds ratio [OR] = 1.4; 95% CI = 1.1-2.1) and MetS components, including larger waist circumference (OR = 1.5; 95% CI = 1.2-1.9), elevated triglyceride (OR = 1.9; 95% CI = 1.4-2.4), and reduced high-density lipoprotein cholesterol (OR = 1.7; 95% CI = 1.1-2.7). Alcohol intake was not significantly related to MetS; it was positively correlated only to higher fasting plasma glucose (OR = 1.7; 95% CI = 1.1-2.6). These results suggest that cigarette smoking is an independent risk factor for MetS, but the risk does not seem to be exaggerated by alcohol intake.

Use of methotrexate therapy is not associated with decreased prevalence of metabolic syndrome

With great interest, we read the article by Toms and colleagues [1] in the previous issue of Arthritis Research & Therapy, in which they assessed prevalences of metabolic syndrome (MetS) in rheumatoid arthritis (RA) patients. Moreover, they identified demographic and clinical factors that may be associated with MetS. Toms and colleagues found prevalences of up to 45% of MetS and demonstrated older age and health status (health assessment questionnaire) to be associated with MetS irrespectively of the definition used. Of most interest, an association between methotrexate (MTX) use and decreased presence of MetS was observed in patients more than 60 years of age. The investigators hypothesized that this may be attributed to a drug-specific effect (and not to an anti-inflammatory effect) either by changing levels of adenosine, which is known to interact with glucose and lipid metabolism, or by an indirect effect mediated through concomitant folic acid administration, thereby decreasing homocysteine levels. Recently, we also examined the prevalence of MetS in (a subgroup of) RA patients in the CARRE investigation, a prospective cohort study on prevalent and incident cardiovascular disease and its underlying cardiovascular risk factors [2]. The findings of Toms and colleagues stimulated us to perform additional analyses in our total study population (n = 353). The prevalences of MetS were 35% and 25% (Table ​(Table1)1) according to criteria of National Cholesterol Education Program (NCEP) 2004 and NCEP 2001, respectively. In multivariate backward regression analyses, we found significant associations between body mass index, pulse rate, creatinine levels, hypothyroidism and diabetes mellitus and the presence of MetS independently of the criteria used (Table ​(Table2).2). However, an independent association between single use of MTX or use of MTX in combination with other disease-modifying antirheumatic drugs, on the one hand, and a decreased prevalence of MetS, on the other hand, could not be demonstrated (even in the subgroup of patients over the age of 60). Table 1 Characteristics of the study population Table 2 Variables associated with metabolic syndrome Therefore, to get more support for a drug-specific effect, it is of interest to know whether or not in the study of Toms and colleagues the MTX effect was present only in the group of RA patients with single use of MTX or in the group of MTX-treated patients with other antirheumatic drugs. As patients with MetS were significantly older, it would give further information whether age was an independent risk factor for MetS in regression analyses. Moreover, as readers, we are not informed about comorbidities like diabetes and clinical hypothyroidism, which are notorious cardiometabolic risk factors. On the whole, we could not confirm a plausible protective role for the use of MTX and presence of MetS, and hence further investigation is required to explain the discrepancy between our findings and those of Toms and colleagues.