International Diabetes Federation Definition Research Articles

High arousal threshold is associated with metabolic syndrome in patients with obstructive sleep apnea

ObjectiveObstructive sleep apnea (OSA) is associated with metabolic syndrome (MetS). OSA patients with high arousal threshold (ArTH) are less easy to arouse, which leads to more severe hypoxic events. We explored the relationship between high ArTH and MetS in patients with OSA. MethodsWe conducted a cross-sectional study of 112 patients with OSA (mean age 43.50 ± 11.64 years, 89.29 % male). High ArTH was based on an overnight polysomnography, and defined as none or one of the following conditions: apnea-hypopnea index (AHI) < 30 events/hour, minimum oxygen saturation > 82.5 %, or frequency of hypopnea events > 58.3 %. Metabolic syndrome and its components were defined according to the new International Diabetes Federation definition. ResultsAmong the 112 OSA patients, 51 (45.54 %) had MetS and 68 (60.71 %) had high ArTH. Logistic regression, after adjusting for confounders, showed that patients with high ArTH had higher odds for MetS (OR = 4.31, 95 % CI = 1.63–11.42, p = 0.003), central obesity (OR = 5.78, 95 % CI = 1.95–17.16, p = 0.002) and hypertriglyceridemia (OR = 2.84, 95 % CI = 1.11–7.28, p = 0.030) compared to patients with low ArTH. Furthermore, higher ArTH levels were associated with higher values for waist circumference (p-for-trend < 0.001), triglycerides (p-for-trend = 0.042), and systolic blood pressure (p-for-trend = 0.037). Moreover, patients with high ArTH had more apnea events and less hypopnea events. ConclusionsHigh ArTH is associated with MetS in OSA patients. High ArTH is a marker of the severity of cardiometabolic comorbidity in OSA.

Metabolic syndrome increases the length of stay and medical complications after hip and knee arthroplasty: results from a prospective cohort study of 2,901 patients.

Metabolic syndrome (MetS) affects more than 60% of the patients having a hip or knee arthroplasty due to osteoarthritis. As it is debated whether metabolic syndrome increases the risk of complications, we aimed to investigate the length of stay (LOS) and risk of readmission at 30 and 90 days after surgery, including causes of readmission. We conducted a prospective cohort study of 2,901 patients undergoing hip and knee arthroplasty from May 2017 to November 2019. Physical examination, blood samples, and medical history from national registries determined the diagnosis of metabolic syndrome from the International Diabetes Federation definition. We used multivariate linear regression to investigate differences in LOS according to MetS, and binary regression to investigate the risk and causes of readmission within 30 and 90 days, including 95% confidence intervals (CI) and P values. Patients with MetS showed a slightly longer LOS (0.20 days, CI 0.10-0.29) and had an increased risk of readmission within 90 days (adjusted relative risk [RR] 1.2, CI 1.0-1.4; P = 0.02), but not within 30 days (adjusted RR 1.1, CI 0.9-1.4; P = 0.3) after surgery. Cardiovascular disease was the dominant cause of readmission. Although patients with MetS do not experience a clinically relevant longer LOS after hip and knee arthroplasty, they have an increased risk of 90-day readmission mainly due to cardiovascular complications, which should be considered when planning surgical care in this group of patients.

The association of metabolic syndrome with telomere length as a marker of cellular aging: a systematic review and meta-analysis.

It has been suggested that metabolic syndrome (MetS) accelerates the aging process, potentially contributing to the development of age-related complications. Available studies examining the relation of MetS to telomere length (TL), a putative biological marker of aging, have yielded inconclusive findings. This meta-analysis was performed to investigate the association between MetS and TL. A comprehensive systematic search was conducted in PubMed and Scopus databases to identify relevant literature published up to February 2024. Standard mean difference (SMD) and standardized beta coefficient (β) with their 95% confidence intervals (CI) were used as effect sizes to measure the associations using the random effects model. A total of nine studies, comprising a total sample size of 8,606 participants, were eligible for the meta-analysis. No significant difference in mean TL was found between patients with and without MetS (SMD = -0.03, 95%CI = -0.17 to 0.10), with a significant heterogeneity across the studies (I 2 = 89.7.0%, p ≤ 0.001). In contrast, it was revealed that MetS is negatively related to TL (β = -0.08, 95%CI = -0.15 to -0.004). In the subgroup analysis, this finding was supported by the International Diabetes Federation (IDF) definition of MetS. This meta-analysis highlighted that MetS may be linked to a shorter TL. Additional studies are required to confirm this finding.

Utility of waist-to-height ratio, waist circumference and body mass index in predicting clustered cardiometabolic risk factors and subclinical vascular phenotypes in children and adolescents: A pooled analysis of individual data from 14 countries

AimsThe clinical utility of waist-to-height ratio (WHtR) in predicting cardiometabolic risk factors (CMRFs) and subclinical markers of cardiovascular disease remains controversial. We aimed to compare the utility of WHtR with waist circumference (WC) and body mass index (BMI) in identifying children and adolescents (youths) at risk for cardiometabolic outcomes, including clustered CMRFs, high carotid intima-media thickness (cIMT), and arterial stiffness (assessed as high pulse wave velocity, PWV). MethodsWe analyzed data from 34,224 youths (51.0 % boys, aged 6–18 years) with CMRFs, 5004 (49.5 % boys, aged 6–18 years) with cIMT measurement, and 3100 (56.4 % boys, aged 6–17 years) with PWV measurement from 20 pediatric samples across 14 countries. ResultsWHtR, WC, and BMI z-scores had similar performance in discriminating youths with ≥3 CMRFs, with the area under the curve (AUC) (95 % confidence interval, CI)) ranging from 0.77 (0.75–0.78) to 0.78 (0.76–0.80) using the modified National Cholesterol Education Program (NCEP) definition, and from 0.77 (0.74–0.79) to 0.77 (0.74–0.80) using the International Diabetes Federation (IDF) definition. Similarly, all three measures showed similar performance in discriminating youths with subclinical vascular outcomes, with AUC (95 % CI) ranging from 0.67 (0.64–0.71) to 0.70 (0.66–0.73) for high cIMT (≥P95 values) and from 0.60 (0.58–0.66) to 0.62 (0.58–0.66) for high PWV (≥P95 values). ConclusionsOur findings suggest that WHtR, WC, and BMI are equally effective in identifying at-risk youths across diverse pediatric populations worldwide. Given its simplicity and ease of use, WHtR could be a preferable option for quickly screening youths with increased cardiometabolic risk in clinical settings.

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.

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.

Comparison of metabolic syndrome prevalence and characteristics using five different definitions in China: a population-based retrospective study.

Metabolic syndrome (MetS) is on the rise in developing countries and is characterized by a series of indications of metabolic disturbance. However, the prevalence of MetS varies under different definitions. The study aimed to compare five definitions of MetS in the China adult population, to explore their prevalence, characteristics and agreement. The data for the retrospective study came from the China Health and Retirement Longitudinal Study (CHARLS), consisting of 9,588 participants (≥45). MetS definitions from International Diabetes Federation (IDF) (2006), National Cholesterol Education Program Adult Treatment Panel III (ATPIII) (2005), National Cholesterol Education Program Adult Treatment Panel III (ATPIII) (2001), Chinese Diabetes society (CDS) (2004) and the World Health Organization (WHO) (1999). We used binary and multivariable logistic analysis to explore factors connected with MetS. The five definitions of MetS led to different prevalence of MetS:34.52% by IDF (2006), 38.63% by ATP (2005), 25.94% by ATP (2001), 26.31% by CDS (2004), 21.57% by WHO (1999). According to the definition of IDF (2006) (22.32% vs. 45.06%), ATPIII (2005) definition (27.99% vs. 47.82%), ATPIII (2001) definition (15.37% vs. 35.07%), CDS (2004) definition (19.96% vs. 31.80%), and WHO (1999) definition (17.44% vs. 25.14%), the prevalence of MetS in men was low but in women was high. The agreement between the five definitions for men was good except for the IDF (2006) definition and ATPIII (2001) definition (kappa = 0.51), with kappa values from 0.64 to 0.85. For women, the agreement between the five definitions was good ranging from 0.67 to 0.95, however, except for the definition of CDS (2004) and the definition of IDF (2006) (kappa = 0.44), the definition of WHO (1999) and the definition of IDF (2006) (kappa = 0.55), and the definition of WHO (1999) and the definition of ATPIII (2005) (kappa = 0.54). Binary logistic analysis indicated that although the impact and relevance varied by sex and definition, age, education, marital status, current residence, current smoking, alcohol using, taking activities and number of chronic diseases were factors connected to MetS. the prevalence and characteristics of the five definitions of MetS are different in the Chinese population. Therefore, it is vital to use the same definition for a country to diagnose MetS. On the other side, a lower prevalence in men than in women and the consistency of five MetS definitions are good in men but relatively poor in women.

Metabolic disturbances are risk factors for readmission to psychiatric hospitals in non-smokers but not in smokers: results from a Swiss psychiatric cohort and in first-episode psychosis patients.

Psychiatric patients are at high risk of readmission, and a high body mass index has previously been shown as a risk factor. We sought to replicate this finding and 1) to prospectively assess the association of metabolic syndrome and its five components with readmission in psychiatric hospitals and 2) to identify other clinical and sociodemographic predictors of readmission. Between 2007 and 2019, data on 16727 admissions of 7786 adult and elderly patients admitted to the Department of Psychiatry of the Lausanne University Hospital, were collected. Metabolic syndrome was defined according to the International Diabetes Federation definition. Cox frailty models were used to investigate the associations between readmission and metabolic disturbances. A total of 2697 (35%) patients were readmitted to our psychiatric hospital. Novel risk factors for readmission in non-smokers were identified, including being overweight (HR=1.26; 95%CI=[1.05; 1.51]) or obese (HR=1.33; 95%CI=[1.08; 1.62]), displaying hypertriglyceridemia (HR=1.21; 95%CI=[1.04; 1.40]) and metabolic syndrome (HR=1.26; 95%CI=[1.02; 1.55]). Central obesity and hyperglycemia increased the risk of readmission when considering the Health of the Nation Outcome Scales variable. In first-episode psychosis patients, obesity (HR=2.23; 95%CI=[1.14; 4.30]) and high-density lipoprotein hypocholesterolemia (HR=1.90; 95%CI=[1.14; 3.20]) doubled the risk of readmission. The observed interaction between smoking and metabolic variables are compatible with a ceiling effect; metabolic variables increase the risk of readmission in non-smokers but not in smokers who are already at higher risk. Future studies should determine whether better metabolic monitoring and treatment can reduce readmission risk.

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

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

Trajectory of metabolic syndrome and its association with knee pain in middle-aged adults

ObjectiveMetabolic syndrome (MetS) is characterised by the clustering of central obesity with metabolic abnormalities. We aimed to describe the association of MetS and trajectories of MetS over 10–13 years with knee symptoms in general population-based middle-aged adults. MethodsFasting blood biochemistry, waist circumference and blood pressure measures were collected during Childhood Determinants of Adult Health (CDAH)-1 study (year:2004–6; n = 2447; mean age:31.48 ± 2.60) and after 10–13 year at CDAH-3 (year:2014–2019; n = 1549; mean age:44 ± 2.90). Participants were defined as having MetS as per International Diabetes Federation (IDF) definition. Knee symptoms were assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale at CDAH-3 (mid-adulthood). ResultsThe prevalence of MetS increased from 8 % at young adulthood (female:52.06 %) to 13 % in mid-adulthood (female:53.78 %) over 10–13 years. Presence of MetS at mid-adulthood was associated with knee symptoms at mid-adulthood [ratio of means (RoM): 1.33; 95%CI:1.27,1.39]. Four MetS trajectories were identified—‘No MetS’ (85.01 %); ‘Improved MetS’ (2.14 %), ‘Incident MetS’ (8.81 %), and ‘Persistent MetS, (4.04 %). Compared to ‘No MetS‘, ‘Persistent MetS’ [RoM:1.15; 95%CI:1.06,1.25], ‘Incident MetS’ [RoM:1.56; 95%CI:1.48,1.65], and ‘Improved MetS’ [RoM:1.22; 95%CI:1.05,1.41] was associated with higher knee symptoms. Notably, ‘Incident MetS’ was strongly associated with knee symptoms [RoM: 1.56; 95%CI:1.48,1.65] and pain [RoM:1.52; 95%CI:1.37,1.70] at mid-adulthood. ConclusionIn this sample of middle-aged adults, there was a significant positive association between MetS and knee symptoms. Relative to those without MetS at either life stage, the elevation in mean knee pain scores was more pronounced for those who developed MetS after young adulthood than for those who had MetS in young adulthood.

Metabolic syndrome, adiposity, diet, and emotional eating are associated with oxidative stress in adolescents.

Metabolic syndrome (MS), a condition related to adiposity and oxidative stress, can develop in adolescence, a critical stage in life that impacts health in adulthood. However, there is scarce scientific research about the relationship between lifestyle factors, emotion management, and oxidative stress in this phase of life. To analyze whether nutritional parameters, lifestyle factors, emotion management, and MS in adolescents are associated with oxidative stress measured by the biomarker 8-isoprostane. A cross-sectional study was carried out in 132 adolescents (48.5% girls, aged 12 ± 0.48 years) and data were collected on nutritional parameters (anthropometric measurements, biochemical analyzes, and blood pressure), lifestyle factors (physical activity, sleep, and diet), and emotion management (self-esteem, emotional eating, and mood). 8-isoprostane was analyzed in spot urine samples. The study population was categorized in three groups (healthy, at-risk, and with MS) using the International Diabetes Federation definition of MS in adolescents. To capture more complex interactions, a multiple linear regression was used to analyze the association between 8-isoprostane and the aforementioned variables. Urinary 8-isoprostane levels were significantly higher in the MS group compared to the healthy group (1,280 ± 543 pg./mg vs. 950 ± 416 pg./mg respectively). In addition, univariable analysis revealed positive significant associations between 8-isoprostane and body mass index, waist circumference, waist-to-height ratio, body fat percentage, blood lipid profile and glucose, emotional eating, and refined cereal intake. Conversely, a negative significant association was found between 8-isoprostane and sleep duration and fish intake. The multiple linear regression analysis revealed associations between 8-isoprostane and LDL-c (β = 0.173 value of p = 0.049), emotional eating (low β = 0.443, value of p = 0.036; high β = 0.152, value of p = 0.470), refined cereal intake (β =0.191, value of p = 0.024), and fish intake (β = -0.187, value of p = 0.050). The MS group, LDL-c, emotional eating, and high refined cereals and low fish intakes were associated with higher levels of oxidative stress in an adolescent population.

Metabolic Health and Carotid Intima-Media Thickness: Association of Different Definitions in Women

The concept of metabolic health and the metabolic syndrome is to identify subjects at a higher cardiovascular risk. However, many definitions are currently in use, and it is uncertain which is the best in identifying at-risk subjects. We performed a cross-sectional study whereby women were invited to participate and were assessed for several anthropometric and biochemical parameters. Carotid intima-media thickness (CIMT) was measured in both common carotid arteries in each participant. The study cohort consisted of 203 white premenopausal women with a mean age of 38.3 ± 5.4years. The prevalence of the metabolically unhealthy varied from 7.3% to 61.6%, according to the definition used. The prevalence of the metabolic syndrome, as defined by the International Diabetes Federation, was 20.7%. Women with a metabolically unhealthy phenotype had a higher referent CIMT for all definitions of metabolic health. Defining metabolically unhealthy phenotype as having <2 abnormalities using the National Cholesterol Education Program Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (NCEP-ATPIII) cutoffs had the highest odds ratio for an abnormal CIMT. In conclusion, we found that in a contemporary cohort of middle-aged women, the NCEP-ATPIII definition of the metabolic syndrome was more strongly associated with atherosclerosis as determined by the CIMT than the International Diabetes Federation definition or other definitions of metabolic health; it was also more strongly associated than body mass index or waist circumference. Our results need to be validated by other investigators in other populations.

Screening tools for metabolic syndrome based on anthropometric cut-off values among Thai working adults: a community-based study.

The metabolic syndrome (MetS) is a universal disease of increasing prevalence, but the prevalence varies depending on ethnicity. There is a crucial need to assess the validity of anthropometric indicators and determine appropriate cut-off values for MetS screening. Determine cut-off anthropometric indicators values for screening of MetS. Cross-sectional SETTING: Rural and urban areas of provinces with a high prevalence of MetS in the central region of Thailand. The subjects were recruited based on the International Diabetes Federation definition of MetS, which includes four anthropometric indicators. Receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity for different cut-off values of all novel indicators. The cut-off values for screening of MetS, which included neck circumference (NC), body roundness index (BRI), conicity index (C-index), and body shape index (BSI). 2520 participants RESULTS: The BRI and NC were the indices with higher areas under the curve, followed by the C-index and BSI. The optimal cut-off values for BRI and NC were 4.1 and 36.5 cm for males and 4.0 and 34.5 cm for females. This study defined the specific cut-off values for Thai working adults. The participants might not be representative of all Thai adults and we may have overestimated MetS for Thai working adults because our research focus was on the highest prevalence of MetS in the central region of Thailand.

The correlation between metabolic syndrome and calcium urolithiasis

Background: Urolithiasis affects about 12% of the global population. This study helps us to find the correlation between metabolic syndrome, its components and the risk of calcium stone urolithiasis. Methods: A cross-sectional study was conducted on 140 patients who underwent surgery for urolithiasis and whose stones were calcium-containing. A group of subjects who never had a history of urolithiasis was taken as control. Various anthropometric and biochemical parameters were studied to estimate and compare the prevalence of metabolic syndrome in both the groups. Results: The study showed that the central obesity of the study population was higher. However, even though prevalence of hypertension was more in the stone group compared to the control population, this difference was not statistically significant. On analysis of biochemical parameters like fasting blood sugar, triglycerides and HDL, abnormal triglycerides and HDL were significantly higher in the stone group when compared to the control. On consideration of all parameters as per international diabetes federation (IDF) definition, prevalence of metabolic syndrome in stone group was 40% which was higher than the control group with 25% and the difference was statistically significant. While summing up the number of parameters of metabolic syndrome an individual has in each group it is evident that the proportion of patients in the stone group had a greater number of parameters compared to the control group. Conclusions: This study could conclude that there is a significant correlation between calcium urolithiasis and metabolic syndrome.

Associations of Fruit and Vegetable Intake with Metabolic Health Status in Overweight and Obese Youth

Introduction: The objective of this study was to assess the relationship between fruit and vegetable intake with metabolic health status among overweight and obese Iranian youth. Methods: In total, 203 obese and overweight youth including 101 boys and 102 girls, 12–18 years, were randomly recruited through a multistage cluster sampling approach in this study. A validated Persian format of food frequency questionnaire was used to estimate participants’ usual food intake. Adolescents were categorized in accordance with the International Diabetes Federation (IDF) criteria as well as IDF plus insulin resistance (HOMA-IR) definition into metabolically healthy obese and metabolically unhealthy obese (MUO). Results: Based on IDF criteria, youth in the third tertile of vegetable and the combination of fruit and vegetable intake had 66% (odds ratio = 0.34, 95% CI: 0.12–0.95) and 73% (odds ratio = 0.27, 95% CI: 0.09–0.81) lower odds of MUO compared to those in the first tertile, in the fully-adjusted model. According to IDF plus HOMA-IR definition, inverse associations were also found between vegetable (odds ratio = 0.36, 95% CI: 0.12–1.02) and the combination of fruit and vegetable (odds ratio = 0.25, 95% CI: 0.08–0.79) intake with MUO phenotype. Stratified analysis indicated inverse associations between intake of vegetables and the combination of fruits and vegetables with MUO phenotype (based on IDF definition) in overweight, but not obese subjects. Conclusion: The current study demonstrated that greater consumption of vegetables as well as the combination of fruits and vegetables was related to a lower risk of MUO phenotype, particularly in overweight youth.

Association of time-restricted feeding, arterial age, and arterial stiffness in adults with metabolic syndrome.

Time-restricted feeding (TRF) is a kind of intermittent fasting defined as eating and drinking only during a certain number of hours in a day. It has been suggested that intermittent fasting may improve cardiovascular risk factors. This study evaluated the association of TRF and arterial stiffness, using pulse wave velocity (PWV), pulse wave analysis, and arterial age in metabolic syndrome participants. A cohort study was carried out among metabolic syndrome adults who were followed over the Ramadan fasting period (used as a model of TRF since food was only allowed for about 8 h/day). The subjects were divided into Ramadan fasting and Ramadan nonfasting groups. The aortic PWV and central aortic pressure waveform were measured. Central systolic pressure, central pulse pressure, and indices of arterial compliance, such as augmentation pressure and augmentation index (AIx), were determined from waveform analysis. Ninety-five adults (31.57% female, age: 45.46 ± 9.10 years) with metabolic syndrome (based on the International Diabetes Federation definition) participated in this study. Ramadan fasting and Ramadan nonfasting groups were including 80 and 15 individuals respectively. A significant reduction was seen in PWV (0.29 m/s), central systolic pressure (4.03 mmHg), central pulse pressure (2.43 mmHg), central augmentation pressure (1.88 mmHg), and central AIx (2.47) in the Ramadan fasting group (p = 0.014, p < 0.001, p = 0.001, p = 0.003, and p = 0.036 respectively). There were no significant changes in these indices among the Ramadan nonfasting group. This study suggested that TRF reduces arterial age and improves arterial stiffness among people with metabolic syndrome. This might be considered a beneficial nutrition strategy for extending healthspan (and perhaps longevity).

Serum Levels of Proinflammatory Biomarkers in Military Recruits with and without Metabolic Syndrome.

Inflammatory mediators are associated with many chronic diseases; however, their role in metabolic syndrome (Met-S) is not well documented. We therefore aimed to compare the serum markers of inflammation including C-reactive protein (CRP), myeloperoxidase (MPO), interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-α), and TNF-β in young military recruits with and without Met-S. We hypothesized that any significant change in inflammatory markers between the two groups would indicate the role of inflammation in Met-S that would help in future directions for screening and treatment of Met-S. Design and Methods. A total of 2010 adult men, aged 18-30 years, were divided into two groups: with Met-S (N = 488) and without Met-S (N = 1522), according to the International Diabetes Federation definition. We compared the serum levels of inflammatory biomarkers between the two groups. We also studied the correlations between the inflammatory markers and the components of Met-S to explore the biomarker potential of inflammatory markers for screening of Met-S. Logistic regression analysis was performed to test the association between inflammatory markers and Met-S. A large number of subjects in the Met-S group were suffering from obesity. Out of the 2010 total subjects, only 731 (36.4%) had normal fasting blood sugar (FBS), while the prevalence of prediabetes and diabetes was significantly higher in subjects with Met-S. We observed significant increases in serum levels of CRP, MPO, IL-6, and TNF-β but not TNF-α in subjects with Met-S as compared to subjects without Met-S. All the markers of inflammation showed significant correlations with Met-S, triglycerides (TG), blood pressure, body mass index (BMI), and age; however, none of these markers were correlated with HDL. Logistic regression analysis showed a significant association between Met-S and inflammatory markers. Serum levels of CRP, MPO, IL-6, and TNF-β are significantly increased in young adults with Met-S. This is probably the first study reporting TNF-β levels in Met-S. Since a proinflammatory cascade precedes many years before the onset of cardiovascular disease, these inflammatory biomarkers could help in the monitoring of high-risk individuals with Met-S who will be requiring therapeutic intervention.

Temporal Trends of the Prevalence of Abdominal Obesity and Metabolic Syndrome in Korean Children and Adolescents between 2007 and 2020.

The prevalence of obesity in children and adolescents is increasing worldwide, which is of concern because obesity can lead to various complications such as metabolic syndrome (MS). Waist circumference (WC) and waist-height ratio (WHtR) are useful indicators of abdominal obesity and MS. In this study, we investigate trends in the prevalence of abdominal obesity and MS using two different references. Data from the Korea National Health and Nutrition Examination Survey (2007 to 2020) were used. In total, 21,652 participants aged 2 to 18 years and 9,592 participants aged 10 to 18 years were analyzed for abdominal obesity and MS, respectively. The prevalence of abdominal obesity and that of MS were compared using the Korean National Growth Chart in 2007 (REF2007) and the newly published WC and WHtR reference values in 2022 (REF2022). Both WC and WHtR showed an increasing trend. The prevalence of abdominal obesity was 14.71% based on REF2022, 5.85% points higher than that of 8.86% based on REF2007. MS based on REF2022 had a higher prevalence for both the National Cholesterol Education Program definition (3.90% by REF2007, 4.78% by REF2022) and the International Diabetes Federation definition (2.29% by REF2007, 3.10% by REF2022). The prevalence of both abdominal obesity and MS increased over time. The prevalence of abdominal obesity and MS increased in Korean children and adolescents from 2007 to 2020. When analyzed by REF2022, both abdominal obesity and MS showed higher prevalence rates than when using REF2007, indicating that previous reports were underestimated. Follow-up for abdominal obesity and MS using REF2022 is needed.

The prevalence of metabolic syndrome and its components among South Indian Chenchu tribal adults

ABSTRACT Background: Dietary patterns are paramount in the prevention and management of metabolic syndrome (MetS) yet the definition and criteria for MetS diagnosis varies. This analysis aims to estimate the prevalence of MetS among the adult Chenchu tribal population comparing International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) definitions of MetS and assess the relationship between dietary patterns and MetS. Materials and Methods: Demographics, medical history, nutrition, and physical activity were collected among 337 South Indian Chenchu tribal adults. The prevalence ratios and 95% confidence intervals of MetS using ATP and IDF definitions were estimated and associations between individual components of the MetS definitions, demographics, and dietary patterns were assessed. Pearson correlation coefficients (r) were calculated between the Modified Finnish Diabetic Risk Score (FINDRISC)-Bahasa Indonesia instrument and MetS definitions. Results: The prevalence of MetS was low by IDF (25, 7.4%) and ATP (22, 6.5%) definitions, while reporting vigorous physical activity (202, 59.9%) and a “vegetarian” dietary pattern (173, 51.3%) were high. Increasing age, high mutton consumption, and “empty-calorie” dietary pattern were associated with an increased prevalence of MetS, while vigorous physical activity and “vegetarian” dietary pattern were protective of MetS. The modified FINDRISC was not highly correlated with IDF MetS (r = 0.47; P &lt; 0.0001) or ATP MetS (r = 0.11; P = 0.0683). Conclusions: Healthy behaviors, such as vigorous physical activity and high vegetable consumption, may contribute to the low prevalence of MetS in Chenchu tribal adults. Future efforts should continue to monitor dietary patterns and the prevalence of MetS in the understudied South Indian Chenchu tribal population.

The association between egg consumption and metabolic health status in overweight and obese adolescents

Existing evidence examining the relation between egg consumption and metabolic health of overweight/obese adolescents is scarce. We examined the association between egg consumption and metabolic status in Iranian overweight/obese adolescents. Using multistage cluster random sampling approach, overweight/obese adolescents (n = 203) with ages from 12 to 18 years old were selected for the present cross-sectional study. A validated 147-item food frequency questionnaire was adopted to determine usual dietary intakes. Blood pressure and anthropometric data and were assessed, and levels of lipid profile, insulin, and glucose were measured by collecting fasting blood samples. Participants were classified into metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO) based on two methods of International Diabetes Federation (IDF) and the combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR). In total, 67 (33.0%) and 79 (38.9%) adolescents were classified as MUO based on IDF/HOMA and IDF definitions, respectively. Considering IDF criteria, the highest intake of egg was related to decreased chance of MUO, in crude (OR 0.22; 95% CI 0.10–0.48) and maximally-adjusted model (OR 0.25; 95% CI 0.10–0.59). Considering IDF/HOMA-IR criteria, similar results were obtained (crude model: OR 0.24; 95% CI 0.11–0.52; fully-adjusted model: OR 0.28; 95% CI 0.11–0.69). Stratified analyses found stronger relation among boys (vs. girls) and overweight (vs. obese) individuals. In conclusion, higher egg consumption was negatively related to decreased chance of being MUO in overweight/obese adolescents, especially in boys and overweight individuals, regardless of MUO definitions. Prospective studies are required to support our results.