International Diabetes Federation Criteria Research Articles

Prevalence of Metabolic Syndrome in Primary Health Care, Riyadh, Saudi Arabia

Background: Metabolic Syndrome (MS) is identified as a cluster of risk factors that significantly increase the risk of diabetes, cardiovascular disease, and stroke. It is characterized by obesity, hyperglycemia, dyslipidemia, and hypertension. Multiple definitions and criteria of MS exist. The most widely used set of criteria are the US National Cholesterol Education Program (NCEP) ATP III and the International Diabetes Federation (IDF), both of which are used in this study. Due to different defining criteria and population demographics, the prevalence of MS varies widely across countries, regions, and continents.Objective: This study investigates the prevalence and risk factors of metabolic syndrome among primary healthcare attendees in Riyadh, Saudi Arabia.Methods: A cross-sectional study was conducted over 12 months at the Prince Sultan Military Medical City (PSMMC) Wazzarat Center in Riyadh, Saudi Arabia, involving 262 participants. The study aimed to determine the prevalence and predictors of MS among primary healthcare attendees using ATP III and IDF criteria. Participants were assessed for sociodemographic features, comorbidities, vital signs, and laboratory data related to MS. Statistical analysis utilized R v 4.3 for descriptive statistics, Pearson correlation, Chi-square tests for categorical variables, and the Mann-Whitney test for continuous variables.Results: Among the study participants, 20.2% met the criteria for MS according to ATP III, and 19.9% according to IDF criteria, with a strong concordance between the two (Kappa statistic = 0.92, P < 0.001). The median age of individuals with MS was significantly higher (45 years) than those without (35 years, P < 0.001). Significant predictors included age, with BMI and fasting blood glucose showing a strong positive correlation (r > 0.5, P < 0.001). Notably, 60.7% of the cohort were medically free from conditions contributing to MS.Conclusion: The prevalence of MS among primary healthcare attendees in Riyadh, as defined by ATP III and IDF criteria, underscores the importance of age and lifestyle factors as predictors. The findings advocate for targeted preventive strategies focusing on lifestyle modifications to mitigate the risk of MS. Further research is suggested to explore the long-term impact of these interventions.

Association of Three Novel Inflammatory Markers: Lymphocyte to HDL-C Ratio, High-Sensitivity C-Reactive Protein to HDL-C Ratio and High-Sensitivity C-Reactive Protein to Lymphocyte Ratio With Metabolic Syndrome.

We aimed to compare the association of three novel inflammatory indicators with metabolic syndrome (MetS) among Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort participants. According to the International Diabetes Federation (IDF) criteria, the cohort participants were divided into the MetS(+) and MetS(-) groups. The lymphocyte to high-density lipoprotein cholesterol (HDL-C) ratio (LHR), high-sensitivity C-reactive protein (hs-CRP) to HDL-C ratio (HCHR) and hs-CRP to lymphocyte ratio (HCLR) were calculated and were compared between the groups. Binary logistic regression (LR) analysis was performed to find the association of the indices with the presence of MetS among men and women. Receiver-operating characteristic (ROC) curve analysis was used to establish cut-off values in predicting MetS for men and women. p-Values <0.05 were considered as statistically significant. Among a total of 8890 participants (5500 MetS(-) and 3390 MetS(+)), LHR, HCHR and HCLR were significantly higher in the MetS(+) group than in MetS(-) group (p < 0.001). In LR analysis, after adjusting for multiple cofounders, LHR remained an independent factor for the presence of MetS among men (OR: 1.254; 95% CI: 1.202-1.308; p < 0.001) and women (OR: 1.393; 95% CI: 1.340-1.448; p < 0.001). HCHR also remained an independent factor for the presence of MetS only in women (OR: 1.058; 95% CI: 1.043-1.073; p < 0.001). ROC curve analysis showed that LHR had the higher AUC for predicting MetS in both men (AUC: 0.627; 95% CI: 0.611-0.643; p < 0.001) and women (AUC: 0.683; 95% CI: 0.670, 0.696; p < 0.001). This suggests that among both genders, the LHR as an inexpensive and easy-to-access marker has a better diagnostic performance and could be a promising alternative to the traditional expensive inflammatory markers such as hs-CRP for the evaluation of inflammation in patients with MetS.

Evaluation of prediabetes patients in terms of metabolic syndrome.

Prediabetes accompanied by metabolic syndrome accelerates the process leading to diabetes and causes an increase in complications. The current study aimed to investigate the clinical conditions accompanying prediabetes and the effect of the association of metabolic syndrome on clinical outcomes in prediabetics. This cross-sectional study was conducted with 88 prediabetic individuals between November 2022 and January 2023. Prediabetes was diagnosed using the American Diabetes Association (ADA) criteria, and metabolic syndrome was diagnosed using the International Diabetes Federation criteria. Clinical history, physical examination and laboratory tests of the participants were recorded. Metabolic syndrome (MetS) was present in 69 of 88 prediabetic patients included in the study (78.4%). Hypertension (p=0.019), abdominal obesity (p<0.001), low-density lipoprotein (LDL) elevation (p=0.006), and dyslipidemia (p=0.020) were detected more frequently in prediabetic individuals accompanied by MetS. Median values of waist circumference (p=0.020), systolic blood pressure (p=0.021), triglyceride (p<0.001), LDL (p=0.003) and postprandial blood sugar (p=0.049) in prediabetics accompanied by MetS were statistically significant. It was higher than those without MetS. The median Vit-D level of prediabetics without MetS was higher than those with MetS (p=0.049). The median creatinine value of prediabetics without MetS was higher than that of prediabetics with MetS (p=0.049). Hypertension, dyslipidemia, abdominal obesity, and metabolic obesity increased in the coexistence of prediabetes and MetS. At the same time, the coexistence of prediabetes and MetS was associated with higher systolic blood pressure, postprandial blood sugar, and LDL levels. Prediabetic individuals accompanied by MetS are at greater metabolic risk.

The prognostic significance of fibroblast growth factor-23 in predicting complications of type 2 diabetes mellitus, especially when associated with obesity

type 2 Diabetes Mellitus (T2DM) is considered a global health problem with an exceptionally high economic burden not only for families but also for countries overall. In 90-95% of T2DM cases, varying degrees of obesity are observed. One aspect contributing to complications in T2DM involves musculoskeletal system impairment, specifically alterations in bone mineral density (BMD), indicative of bone architecture disruption, leading to secondary osteoporotic conditions. Fibroblast growth factors (FGFs), known for their regulatory influence on metabolism, are identified as mechanisms activated in T2DM. Within this group, fibroblast growth factor 23 (FGF-23) is acknowledged. In individuals with T2DM and excess weight or obesity, conditions conducive to increased FGF-23 synthesis are established, contributing to disturbances in mineral metabolism. Therefore, our study aimed to investigate the content and role of FGF-23 in the development of secondary osteoporosis in T2DM patients with concurrent obesity. A total of 103 patients with type 2 diabetes were involved, with 83 cases featuring elevated body weight or obesity (main group). To assess the impact of obesity on FGF-23 changes, a comparison group of 20 T2DM patients with normal body weight (NBW) was formed. The average age of patients with comorbid conditions was 43±4.6 years, and for those with isolated T2DM, it was 44.1±2.1 years. The average duration of T2DM across groups ranged from 1 to 13 years (6.7±2.4 years on average). Control FGF-23 values were obtained from a group of 20 practically healthy individuals of similar age and gender. The diagnosis of T2DM was confirmed according to the Unified Medical Assistance Protocol "Diabetes Mellitus" (Order of the Ministry of Health of Ukraine dated December 21, 2012, No. 1118). Thus, all examined T2DM patients were in the subcompensation stage with a moderate degree of disease severity. The presence and severity of obesity were assessed according to the International Diabetes Federation (IDF, 2005) criteria based on the body mass index (BMI) calculation using the Ketle formula. In the examination of 83 T2DM patients with obesity, a probable increase in fibroblast growth factor 23 (FGF-23) in serum was determined, correlating with osteoporotic changes in dual-energy X-ray absorptiometry. Therefore, FGF-23 can be utilized as a marker for bone mineral density status and control of treatment measures.

Metabolic Health, Overweight or Obesity, and Depressive Symptoms among Older Australian Adults.

The relationship between overweight or obesity and depressive symptoms in individuals with or without cardio-metabolic abnormalities is unclear. In a cross-sectional study we examined the odds of experiencing depressive symptoms in overweight or obese older adults with or without metabolic abnormalities. The participants included 3318 older adults from the Hunter Community Study Cohort with a Body Mass Index (BMI) ≥ 18.5 kgm2, stratified by BMI and metabolic health risk. Obesity was defined as BMI ≥ 30 kgm2 and metabolically healthy as the absence of metabolic risk factors, according to International Diabetic Federation criteria for metabolic syndromes. Moderate to severe depressive symptoms were defined as a Centre for Epidemiological Studies Depression Scale (CES-D) score ≥ 16. Compared to the metabolically healthy normal weight (MHNW) group, the odds of experiencing moderate/severe depressive symptoms were higher in those classified as a metabolically unhealthy normal weight (MUNW) (odds ratio (OR) = 1.25, 95% Confidence Interval (CI): 0.76-2.06) or metabolically unhealthy obesity (MUO) (OR = 1.48, 95% CI: 1.00-2.19), but not in those classified as metabolically unhealthy overweight (MUOW) (OR = 0.96, 95% CI: 0.63-1.45), metabolically healthy overweight (MHOW) (OR = 0.80, 95% CI: 0.51-1.26), and metabolically healthy obesity (MHO) (OR = 1.03, 95% CI: 0.65-1.64). Compared with MHNW males, the odds of moderate/severe depressive symptoms were increased in all other BMI category-metabolic health groups for males and females. Our relatively small sample size and cross-sectional design did not allow us to robustly establish causality. The odds of experiencing moderate/severe depressive symptoms were increased in metabolically unhealthy older adults regardless of normal weight or obesity, with the odds of having moderate/severe depressive symptoms being higher in females than in males.

Metabolic syndrome and cardiovascular disease in cancer survivors.

The risk of subsequent cardiovascular disease (CVD) is high in cancer survivors. Although metabolic syndrome is an established risk factor for CVD, its association with cancer survivors has not yet been established. This study aimed to clarify whether metabolic syndrome is associated with subsequent CVD risk in patients with cancer using a nationwide epidemiological dataset. We retrospectively analysed 53510 patients with a history of breast, colorectal, or stomach cancer, which is reportedly a major site for developing cancer in Japan. Study participants were categorized into two groups based on the presence of metabolic syndrome, defined using the Japanese criteria (high waist circumference and ≥2 metabolic parameters including elevated blood pressure, elevated triglycerides, reduced high-density lipoprotein cholesterol, or elevated fasting plasma glucose). The clinical outcomes were collected between 2005 and 2021. The primary endpoint was defined as the composite CVD outcome, including myocardial infarction, angina pectoris, stroke, and heart failure. The median patient age was 54years, and 37.5% of the patients were men. Metabolic syndrome was observed in 5558 (10.4%) patients. Over a mean follow-up period of 973±791days, 3085 composite CVD outcomes were recorded. Multivariable Cox regression analyses showed that metabolic syndrome was associated with a greater risk of developing CVD events (HR=1.29, 95% CI=1.15-1.45). Metabolic syndrome was also associated with an increased risk of CVD in patients with a follow-up period ≥1year (HR=1.33, 95% CI=1.15-1.53). This relationship was also observed when metabolic syndrome was defined according to the International Diabetes Federation criteria (HR=1.34, 95% CI=1.21-1.49) and the National Cholesterol Education Program Adult Treatment Panel III criteria (HR=1.32, 95% CI=1.19-1.46). Subgroup analyses showed that the relationship between metabolic syndrome and incident CVD was more pronounced in the non-obese participants than in the obese participants. Metabolic syndrome is associated with a greater risk of developing CVD, even among cancer survivors.

Abstract P216: Physical Fitness and Incidence of Metabolic Syndrome Before Midlife in Military Young Adults: A Cohort Study

Background: Cardiorespiratory fitness (CRF) could reduce the risk of metabolic syndrome (MetS), while the association of muscular endurance capacity (MEC) with incident MetS before midlife was rarely investigated. Methods: A total of 2,890 military men and women, aged 18-39 years, free of baseline MetS were followed for new-onset MetS from baseline (2014) through the end of 2020 in Taiwan. All subjects received annual health examinations for an assessment of MetS. Physical fitness was evaluated by CRF (estimated VO 2 max (mL/kg/min), from a 3000-m run) and MEC (2-min push-up numbers), respectively. MetS was defined based on the International Diabetes Federation criteria. The CRF and MEC were divided by tertiles, respectively against the subjects free of MetS for the Kaplan-Meiner survival analysis. Multivariable Cox regression model with adjustments for baseline demographics, body mass index, and physical activity was used to determine the associations of CRF and MEC (continuous variables) with incident MetS. Subgroup analyses within major MetS components were performed. Results: During a median follow-up of 5.8 years, there were 673 (23.3%) incident MetS. The Kaplan-Meiner Curves are shown in Figure 1. Greater CRF and MEC were associated with a lower risk of MetS [HRs and 95% CI: 0.956 (0.926-0.988) and 0.992 (0.985-0.999), respectively]. In the subgroup analyses, there were no heterogeneities within groups, e.g., body mass index, except that the associations for incident MetS were significantly lower in subjects with serum triglycerides &lt;150 mg/dL [HRs: 0.943 (0.900-0.987) and 0.989 (0.981-0.997), respectively] than those with hypertriglyceridemia (both p for interaction =0.01). Conclusion: Both CRF and MEC were inversely associated with incident MetS in military young adults, which was obviously observed in those without hypertriglyceridemia. This cohort study suggests that obtaining greater physical fitness and lower serum triglycerides are important preventive measures to reduce the risk of MetS before midlife.

Association between intuitive eating and health outcomes in outpatients with type 2 diabetes: a cross-sectional study.

To evaluate the association between intuitive eating and health outcomes in patients with type 2 diabetes in a cross-sectional study. Consecutively, outpatients attending at university hospital underwent clinical, laboratory, lifestyle, and eating behavior evaluations. Intuitive eating was assessed using the Intuitive Eating Scale-2 (IES-2), and the Three Factor Eating Questionnaire-21 was adopted as a confirmatory tool for disordered eating behavior. Optimized health outcomes were considered according to the American Diabetes Association criteria for BMI, HbA1c, lipid profile, and blood pressure values, and the International Diabetes Federation criteria for waist circumference. Considering the answers of the IES-2 items, patients were grouped by latent class analysis, and their characteristics were compared by appropriate tests. In total, 267 patients were evaluated: 62.2% women, with 60 (53-65) years, BMI 31.9 ± 5.4kg/m², diabetes duration of 16 ± 9 years, HbA1c 8.5 ± 1.5%, and an IES-2 total score of 58 (50-67)%. Three intuitive eating groups were identified: higher intuitive eating, nonemotional-oriented coping, and lower intuitive eating. Patients with higher intuitive eating have higher chances of having optimized BMI and serum triglycerides values compared to patients with lower intuitive eating. Also, the 10-point increase on IES-2 was associated with a 0.62kg/m² reduction on BMI values (95%CI -1.18;-0.06), 1.90cm on waist circumference (95%CI -3.26;-0.54), and 23mg/dL in serum triglycerides values (95%CI -38.27;-7.40) after adjustment for age, sex, psychotropic drug use, medication effect score, smoking, and BMI. Intuitive eating seems to be associated with optimized health outcomes and may contribute to better personalized interventions in nutritional treatment that promote adaptive behaviors in diabetes management, but should be tested.

Association of priori-defined DASH dietary pattern with metabolic health status among Iranian adolescents with overweight and obesity

There was no evidence on the relationship of Dietary Approaches to Stop Hypertension (DASH) with metabolic health condition in adolescents with overweight and obesity. The purpose of this research was to investigate the association of priori-defined DASH dietary pattern with metabolic health status among adolescents with overweight and obesity in Iran. A cross-sectional survey performed on a representative sample of adolescents with overweight and obesity (n = 203). Dietary intakes were collected via a validated food frequency questionnaire and DASH score was characterized according to eight components. Data of anthropometric measures, blood pressure, circulating insulin, fasting blood sugar, and lipid profile were collected. Metabolic health status was defined based on criteria of International Diabetes Federation (IDF) and insulin resistance (IR). Based on IDF and IDF/IR criteria, 38.9% and 33.0% of adolescents suffered from metabolically unhealthy overweight/obesity (MUO). After controlling all confounders, subjects in the highest vs. lowest tertile of DASH diet had respectively 92% and 91% lower odds of MUO based on IDF definition (OR = 0.08; 95%CI 0.03–0.22) and IDF/IR criteria (OR = 0.09; 95%CI 0.03–0.29). Subgroup analysis by sex and body mass index determined that this relationship was more powerful in girls and overweight individuals. Also, in fully adjusted model, highest vs. lowest adherence to DASH diet was linked to decreased odds of hyperglycemia (OR = 0.07; 95% CI 0.03–0.21), hypertriglyceridemia (OR = 0.26; 95% CI 0.09–0.73), low HDL cholesterolemia (OR = 0.30; 95% CI 0.12–0.73) and insulin resistance (OR = 0.07; 95% CI 0.02–0.28), as metabolic health components. Greater compliance to DASH dietary pattern was linked to a remarkable lower odd of metabolic unhealthy condition among Iranian adolescents, especially in overweight subjects and girls. More prospective surveys are required to assert these results.

Metabolic Syndrome Prevalence in Women with Gestational Diabetes Mellitus in the Second Trimester of Gravidity.

Background: Women with gestational diabetes (GDM) have an increased risk of metabolic syndrome (MS) after delivery. MS could precede gravidity. The aims of this study were (i) to detect the prevalence of MS in women at the time of GDM diagnosis, (ii) to detect the prevalence of MS in the subgroup of GDM patients with any form of impaired glucose tolerance after delivery (PGI), and (iii) to determine whether GDM women with MS have a higher risk of peripartal adverse outcomes. Methods: A cross-sectional observational study comprised n = 455 women with GDM. International Diabetes Federation (IDF) criteria for MS definition were modified to the pregnancy situation. Results: MS was detected in 22.6% of GDM patients in those with PGI 40%. The presence of MS in GDM patients was associated with two peripartal outcomes: higher incidence of pathologic Apgar score and macrosomia (p = 0.01 resp. p = 0.0004, chi-square). Conclusions: The presence of MS in GDM patients is a statistically significant risk factor (p = 0.04 chi-square) for PGI. A strong clinical implication of our findings might be to include MS diagnostics within GDM screening using modified MS criteria in the second trimester of pregnancy.

Prevalence of undiagnosed metabolic syndrome using three different definitions and identifying associated risk factors among apparently healthy adults in Karachi, Pakistan: a cross-sectional survey in the year 2022

ObjectiveTo determine the prevalence and associated risk factors of undiagnosed metabolic syndrome (MetS) using three different definitions among apparently healthy adults of Karachi, Pakistan.MethodsThis community-based cross-sectional survey was conducted in Karachi, Pakistan, from January 2022 to August 2022. A total of 1065 healthy individuals aged 25–80 years of any gender were consecutively included. MetS was assessed using the National Cholesterol Education Program for Adult Treatment Panel (NCEP-ATP) III guidelines, International Diabetes Federation (IDF), and modified NCEP-ATP III.ResultsThe prevalence of MetS was highest with the modified NCEP-ATP III definition at 33.9% (95% CI: 31–36), followed by the IDF definition at 32.2% (95% CI: 29–35). In contrast, the prevalence was lower at 22.4% (95% CI: 19–25) when using the NCEP ATP III definition. The risk of MetS significantly increases with higher BMI, as defined by the IDF criteria (adjusted OR [ORadj] 1.13, 95% CI 1.09–2.43), NCEP-ATP III criteria (ORadj 1.15, 95% CI 1.11–1.19), and modified NCEP-ATP III criteria (ORadj 1.16, 95% CI 1.12–1.20). Current smokers had significantly higher odds of MetS according to the IDF (ORadj 2.72, 95% CI 1.84–4.03), NCEP-ATP III (ORadj 3.93, 95% CI 2.55–6.06), and modified NCEP-ATP III (ORadj 0.62, 95% CI 0.43–0.88). Areca nut use was associated with higher odds of MetS according to both IDF (ORadj 1.71, 95% CI 1.19–2.47) and modified NCEP-ATP III criteria (ORadj 1.58, 95% CI 1.10–2.72). Furthermore, low physical activity had significantly higher odds of MetS according to the NCEP-ATP III (ORadj 1.36, 95% CI 1.01–1.84) and modified NCEP-ATP III criteria (ORadj 1.56, 95% CI 1.08–2.26).ConclusionOne-third of the healthy individuals were diagnosed with MetS based on IDF, NCEP-ATP III, and modified NCEP-ATP III criteria. A higher BMI, current smoking, areca nut use, and low physical activity were significant factors.

Exploring the Prevalence and Components of Metabolic Syndrome in Sub-Saharan African Type 2 Diabetes Mellitus Patients: A Systematic Review and Meta-Analysis.

Type 2 diabetes mellitus and metabolic syndrome represent two closely intertwined public health challenges that have reached alarming epidemic proportions in low- and middle-income countries, particularly in sub-Saharan Africa. Therefore, the current study aimed to determine the weighted pooled prevalence of metabolic syndrome and its components among individuals with type 2 diabetes mellitus in sub-Saharan Africa as defined by the 2004 National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III 2004) and/or the International Diabetes Federation (IDF) criteria. A systematic search was conducted to retrieve studies published in the English language on the prevalence of metabolic syndrome among type 2 diabetic individuals in sub-Saharan Africa. Searches were carried out in PubMed, Embase, Scopus, Google Scholar, African Index Medicus, and African Journal Online from their inception until July 31, 2023. A random-effects model was employed to estimate the weighted pooled prevalence of metabolic syndrome in sub-Saharan Africa. Evidence of between-study variance attributed to heterogeneity was assessed using Cochran's Q statistic and the I2 statistic. The Joanna Briggs Institute quality appraisal criteria were used to evaluate the methodological quality of the included studies. The summary estimates were presented with forest plots and tables. Publication bias was checked with the funnel plot and Egger's regression test. Overall, 1421 articles were identified and evaluated using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, and 30 studies that met the inclusion criteria were included in the final analysis. The weighted pooled prevalence of metabolic syndrome among individuals with type 2 diabetes mellitus in sub-Saharan Africa was 63.1% (95% CI: 57.9-68.1) when using the NCEP-ATP III 2004 criteria and 60.8% (95% CI: 50.7-70.0) when using the IDF criteria. Subgroup analysis, using NCEP-ATP III 2004 and IDF criteria, revealed higher weighted pooled prevalence among females: 73.5% (95% CI: 67.4-79.5), 71.6% (95% CI: 60.2-82.9), compared to males: 50.5% (95% CI: 43.8-57.2), 44.5% (95% CI: 34.2-54.8), respectively. Central obesity was the most prevalent component of metabolic syndrome, with a pooled prevalence of 55.9% and 61.6% using NCEP-ATP III 2004 and IDF criteria, respectively. There was no statistical evidence of publication bias in both the NCEP-ATP III 2004 and IDF pooled estimates. The findings underscore the alarming prevalence of metabolic syndrome among individuals with type 2 diabetes mellitus in sub-Saharan Africa. Therefore, it is essential to promote lifestyle modifications, such as regular exercise and balanced diets, prioritize routine obesity screenings, and implement early interventions and robust public health measures to mitigate the risks associated with central obesity.

Incidence and predictors of metabolic syndrome onset in individuals with bipolar disorders: A longitudinal study from the FACE-BD cohort.

Metabolic syndrome (MetS) is a cluster of components including abdominal obesity, hyperglycemia, hypertension, and dyslipidemia. MetS is highly prevalent in individuals with bipolar disorders (BD) with an estimated global rate of 32.6%. Longitudinal data on incident MetS in BD are scarce and based on small sample size. The objectives of this study were to estimate the incidence of MetS in a large longitudinal cohort of 1521 individuals with BD and to identify clinical and biological predictors of incident MetS. Participants were recruited from the FondaMental Advanced Center of Expertise for Bipolar Disorder (FACE-BD) cohort and followed-up for 3 years. MetS was defined according to the International Diabetes Federation criteria. Individuals without MetS at baseline but with MetS during follow-up were considered as having incident MetS. A logistic regression model was performed to estimate the adjusted odds ratio and its corresponding 95% confidence interval (CI) for an association between each factor and incident MetS during follow-up. We applied inverse probability-of-censoring weighting method to minimize selection bias due to loss during follow-up. Among individuals without MetS at baseline (n = 1521), 19.3% developed MetS during follow-up. Multivariable analyses showed that incident MetS during follow-up was significantly associated with male sex (OR = 2.2, 95% CI = 1.7-3.0, p < 0.0001), older age (OR = 2.14, 95% CI = 1.40-3.25, p = 0.0004), presence of a mood recurrence during follow-up (OR = 1.91, 95% CI = 1.22-3.00, p = 0.0049), prolonged exposure to second-generation antipsychotics (OR = 1.56, 95% CI = 0.99, 2.45, p = 0.0534), smoking status at baseline (OR = 1.30, 95% CI = 1.00-1.68), lifetime alcohol use disorders (OR = 1.33, 95% CI = 0.98-1.79), and baseline sleep disturbances (OR = 1.04, 95% CI = 1.00-1.08), independently of the associations observed for baseline MetS components. We observed a high incidence of MetS during a 3 years follow-up (19.3%) in individuals with BD. Identification of predictive factors should help the development of early interventions to prevent or treat early MetS.

Association of Metabolic Syndrome with Macular Thickness and Volume in Older Adults: A Population-Based Optical Coherence Tomography Study.

Background: To explore the associations of the metabolic syndrome (MetS) and individual components with macular thickness and volume among rural-dwelling Chinese older adults. Methods: This population-based cross-sectional study included 705 participants (age ≥60 years) derived from the MIND-China study. In 2018-2019, we collected data through face-to-face interview, clinical examination, optical coherence tomography (OCT) examination, and blood test. We measured macular thickness and volume using spectral-domain OCT. MetS was defined following the International Diabetes Federation (IDF) criteria, the IDF/American Heart Association (AHA) criteria, the National Cholesterol Education Program-Adult Treatment Panel III criteria, and the Chinese Diabetes Society (CDS) criteria. Data were analyzed with multivariable general linear models. Results: MetS was significantly associated with thinner macula in central (multivariable-adjusted β = -5.29; 95% confidence interval: -9.31 to -1.26), parafoveal (-2.85; -5.73 to 0.04) and perifoveal regions (-4.37; -6.79 to -1.95) when using the IDF criteria, in the perifoveal regions (-3.82; -6.18 to -1.47) when using the IDF/AHA criteria, and in the central region (-5.63; -10.25 to -1.02) when using the CDS criteria, and with reduced macular volume when using the IDF (-0.16; -0.26 to -0.07) and IDF/AHA (-0.13; -0.22 to -0.04) criteria. In the parafoveal region, the IDF-defined MetS was significantly associated with thinner retina in men (β = -6.25; -10.94 to -1.56) but not in women. Abdominal obesity (-2.83; -5.41 to -0.25) and elevated fasting blood glucose (-2.65; -5.08 to -0.21) were associated with thinner macular thickness in the perifoveal region. Conclusion: MetS is associated with macular thinning and reduced macular volume among rural-dwelling older adults, and the associations vary by the defining criteria of MetS.

Prevalence and Risk Factors of Metabolic Syndrome Among Patients With Hypertension

Background: Metabolic syndrome (MetS) is a serious public health and clinical concern since its prevalence has been rising over the past few decades and is now approaching epidemic levels. Objective: To estimate the prevalence and risk factors of MetS in Jordanian adults with confirmed diagnoses of hypertension. Method: This is a hospital-based cross-sectional study conducted among Jordanian patients with hypertension who were followed at outpatient clinics at King Hussien Medical Center. Metabolic syndrome was diagnosed based on International Diabetes Federation (IDF) criteria. Data on socio-demographic, clinical, and anthropometric characteristics were collected from 336 hypertensive patients from June to October 2023. Descriptive analysis was utilized to assess the prevalence of MetS, and binary logistic regression analysis was used to determine independent risk factors for MetS. Result: The overall prevalence of MetS was 33.6% (33.6% in males and 66.4% in females). Advanced age (OR = 2.006, 95% CI: 1.280 - 2.913), increased waist circumference (OR = 2.864, 95% CI: 1.534 - 4.322), increased systolic blood pressure (OR = 1.073, 95% CI: 1.041 - 1.105), overweight (OR = 5.522, 95% CI: 1.371 - 7.422), and obesity (OR = 7.521, 95% CI: 4.520 - 9.016) were associated factors that increased the risk of Mets (P&lt;0.05). Meanwhile, high physical activity (OR = 0.321, 95% CI: 0.107–0.961) decreased the risk of MetS (P&lt;0.05). Conclusion: One-third of the hypertensive patients had MetS, thus highlighting the necessity of early screening and vigorous treatment of all hypertensive individuals to reduce the occurrence of cardiovascular events.

Prevalence and correlates of metabolic syndrome among adults in Freetown, Sierra Leone: A comparative analysis of NCEP ATP III, IDF and harmonized ATP III criteria

BackgroundMetabolic syndrome (MetS) is a global health concern, especially for low and middle-income countries with limited resources and information. The study's objective was to assess the prevalence of MetS in Freetown, Sierra Leone, using the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), International Diabetes Federation (IDF) and Harmonize ATP III. Additionally, we aimed to establish the concordance between these three different criteria used. MethodsThis community-based health screening survey was conducted from October 2019 to October 2022. A multistage stratified random design was used to select adults aged 20 years and above. Mean, interquartile range (IQR), and logistic regression were used for statistical analysis. The kappa coefficient statistics resolved the agreement between these defined criteria. ResultsThe prevalence for NCEP ATP III, Harmonize ATP III and IDF criteria was 11.8 % (95 % CI: 9.0–15.15), 14.3 % (95 % CI: 11.3–18.0), and 8.5 % (95 % CI: 6.2–11.2), respectively for the 2394 selected adults. The kappa coefficient (κ) agreement between the MetS is: Harmonized ATP III and IDF criteria = [(208 (60.8 %); (κ = 0.62)]; Harmonized ATP III and NCEP ATP III = [(201 (58.7 %); (κ = 0.71)]; while IDF and NCEP ATP III was [(132 (38.6 %); (κ = 0.52)]. In the multivariable regression analysis, waist circumference correlated with all three MetS criteria: ATP III [AOR = 0.85; C.I 95 %: (0.40–1.78), p = 0.032], Harmonized ATP III [AOR = 1.14; C.I 95 %: (0.62–2.11), p = 0.024], IDF [AOR = 1.06; C.I 95 % (0.52–2.16), p = 0.018] ConclusionWe reported a high prevalence of MetS in Freetown, Sierra Leone and identified waist circumference as a major risk factor for MetS. This underscores the crucial role of health education and effective management of MetS in Sierra Leone.

Association between alternative healthy eating index (AHEI) with metabolic health status in adolescents with overweight and obesity.

There has been lack of evidence on the association between healthy dietary patterns and metabolic health status of adolescents. The present study aimed to evaluate the association between alternative healthy eating index (AHEI) and metabolic health status among a relatively representative sample of Iranian adolescents with overweight/obesity. Adolescents with extra body weight (n = 203, aged 12-18 y), were selected for this cross-sectional study by a multistage cluster random-sampling method. Habitual dietary intakes and diet quality of individuals were assessed using validated food frequency questionnaire and AHEI-2010, respectively. Data on other covariates were also gathered by pre-tested questionnaires. To determine fasting glucose, insulin and lipid profiles, fasting blood samples were collected. Participants were categorized as having metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO) phenotypes, based on two approaches (International Diabetes Federation (IDF) and combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR)). The overall prevalence of MUO was 38.9% (based on IDF criteria) and 33.0% (based on IDF/HOMA-IR criteria). After considering all potential confounders, participants in highest tertiles of AHEI-2010 had lower odds of MUO profile according to both IDF (OR = 0.05; 95% CI: 0.01-0.15) and IDF/HOMA-IR (OR = 0.05; 95% CI: 0.02-0.19) definitions. This association was stronger in adolescents with overweight compared with obese ones and also among girls than boys. Moreover, each unit increase in AHEI-2010 score was associated with lower risk of MUO based on both criteria. Higher adherence to AHEI-2010 was inversely associated with odds of MUO in Iranian adolescents with overweight/obesity.

Prevalence of Metabolic Syndrome amongst Undergraduate Medical Students: A Cross-sectional Study

Introduction: Metabolic Syndrome (MS) is a cluster of interconnected metabolic abnormalities involving glucose metabolism, lipid metabolism, elevated Blood Pressure (BP), and central obesity. It increases the risk of type-2 diabetes, cardiovascular disease, and mortality. Medical students during the Coronavirus Disease-2019 (COVID-19) pandemic were forced to remain indoors with minimal physical activity, improper sleep patterns, and long sessions of online classes. All these factors may cause various metabolic disturbances, posing them at risk for developing MS. Aim: To study the prevalence of MS among undergraduate (UG) medical students and assess the predictive risk factors for MS among them. Materials and Methods: The present cross-sectional study was conducted in the Department of Biochemistry, ESIC Medical College and Hospital, Hyderabad, Telangana, India, from June 2022 to August 2022. A total of 170 UG medical students, aged between 18-24 years of both genders, were included in the study. The International Diabetes Federation (IDF) criteria were used for diagnosing MS. Data for anthropometric measurements (height, weight, Waist Circumference (WC), Body Mass Index (BMI), and BP were collected. Blood samples were collected to analyse Fasting Blood Sugar (FBS), Triglyceride (TG), and High-Density Lipoproteins (HDL). Unpaired t-test was used to compare two groups. Pearson’s correlation coefficient was used to assess the association between different components of MS and anthropometric parameters. Results: Amongst the total sample of 170 undergraduate medical students, the prevalence of MS was 7.6% (n=13) of the sample population, almost equivocal among males 7 (9.7%) and females 6 (6.1%). Increased WC was seen in 75 (44.1%), raised Systolic BP was found in 24 (14.1%), raised Diastolic BP was found in 15 (20.8%), raised TG was found in 10 (5.9%), decreased HDL was found in 43 (25.3%), and increased FBS was found in 17 (10%) students. Regression analysis showed that high BMI, WC, and impaired FBS were the most critical predictive risk factors of MS. Conclusion: In the present study, the prevalence of MS in medical UG students was found to be 7.6%, and factors such as BMI, WC, and impaired FBS can be used to predict the risk of MS in them.

Cerebral hemodynamic disorders in patients with schizophrenia with concomitant metabolic syndrome

To identify the differences or comparability of parameters of cerebral hemodynamics between patients with schizophrenia with or without concomitant metabolic syndrome (MS). The study included 94 patients with schizophrenia (48 men and 46 women). A control group consisted of 40 mentally and somatically healthy individuals (17 men and 23 women) comparable in sex and age to the main group of patients. The diagnosis of metabolic syndrome was carried out according to the criteria of the International Diabetes Federation (IDF). Assessment of cerebral hemodynamics was carried out by 4 - channel rheoencephalography (REG) at rest with closed eyes. Data analysis was carried out using the Kraskel-Wallis ANOVA criterion with the procedure of automatic a posteriori pairwise comparison, the χ2 criterion and Spearman correlation analysis. According to the IDF criteria, 37 (39.4%) patients were diagnosed with MS. REG results revealed significantly (p<0.05) lower indicators of blood filling in the carotid basin, elasticity of the wall of the main arteries, the tone of small-caliber arteries and arterioles, as well as higher values of the tone of medium-caliber arteries in the carotid and vertebrobasilar basins, in both groups of patients with schizophrenia compared with the control group. In patients with schizophrenia with MS, compared with patients without MS, there were lower indicators of blood filling (p=0.044 and p=0.016) and elasticity of the wall of the main arteries (p=0.044 and p=0.028) in the carotid basin on the left and right sides. The presence of MS in patients with schizophrenia was accompanied by more pronounced disorders of cerebral blood flow in the form of a decrease in blood filling and elasticity of the wall of the main arteries in the carotid basin. The results indicate that patients with schizophrenia with MS should be considered as a group at increased risk of cerebrovascular diseases.

Association of Helicobacter Pylori Infection with Endothelial Dysfunction in Metabolic Syndrome

Background: Metabolic risk factors play a critical role in metabolic syndrome (MetS), and endothelial dysfunction is important in its development. On the other hand, Helicobacter pylori (H. pylori) infection has an essential role in MetS. The goal of present study was to evaluate the effect of H. pylori infection on endothelial dysfunction in MetS patients.&#x0D; Methods: Based on the International Diabetes Federation (IDF) criteria, 80 MetS patients (59 females and 21 males, mean age: 48.94 ± 10.00 years) were selected. Plasma samples were assayed for H. pylori IgG using the ELISA method. Endothelial function was also evaluated by measuring plasma concentrations of endothelin-1 (ET- 1), E-selectin, and intracellular adhesion molecule (ICAM-1) using ELISA method. Also, NO2 −− and NO3 −− concentrations were measured by Griess method.&#x0D; Results: Fifty patients (62.5%) had H. pylori infection. Plasma concentrations of ET-1, NO2−−, and NO3−− were significantly higher in MetS patients with positive H. pylori infection than in MetS patients with negative H. pylori infection (ET-1: 2.92 ± 2.33 vs 1.9 ± 1.4 pg/ml; P = 0.037; NO2 −−:19.46 ± 7/11 vs 15.46 ± 4.56 μM; P = 0.003; NO3 −−: 20.8 ± 10.53 vs 16.85 ± 6.03 μM, P = 0.036). However, plasma concentrations of ICAM-1 and E-selectin did not show any significant difference in the two groups.&#x0D; Conclusion: The results showed a relationship between H. pylori infection and endothelial dysfunction. Helicobacter pylori infection can lead to atherosclerosis by causing chronic inflammation and affecting the factors contributing to the MetS.