International Diabetes Federation Definition Research Articles

Metabolic Syndrome in Children: Comparison of the International Diabetes Federation 2007 Consensus with an Adapted National Cholesterol Education Program Definition in 300 Overweight and Obese French Children

Background/Aims: Former definitions of metabolic syndrome (MS) in children have been adapted from adult MS definitions using age-related thresholds for each biochemical component, whereas the International Diabetes Federation (IDF) definition is based on absolute values. We compared the IDF childhood MS definition (IDF-MS) to the adapted National Cholesterol Education Program (adapted-NCEP) definition in overweight children. Methods: 300 overweight and obese children were included with a median age of 11 years and BMI SDS of +4.7. Results: Below 10 years of age, the frequency of MS according to the adapted-NCEP-MS definition was 18.6%, and 86.1% had abdominal obesity. In children aged 10 to <16 years (n = 214), the frequency of IDF-MS was 8.9% compared to 14.5% by adapted-NCEP. IDF-MS children had a larger waist circumference, and higher triglycerides, fasting insulin and tended to be older than the intermediate severity group of children with MS only according to adapted-NCEP. Children with MS only according to adapted-NCEP (IDF-MS negative), differed from non-MS children in systolic blood pressure, triglycerides and high-density lipoprotein cholesterol. Conclusions: The recent IDF-MS criterion in children represents a more severe definition and appears to identify a group of children with higher fasting insulin than the adapted-MS definition which uses age-related thresholds (90th percentile).

Variations in prevalent cardiovascular disease and future risk by metabolic syndrome classification in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study

The International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) III define metabolic syndrome (MetSyn) differently, with unclear implications for cardiovascular disease (CVD) risk. We examined 22,719 participants in the REGARDS study. We classified participants as: no MetSyn, MetSyn by ATP-III and IDF criteria, MetSyn by ATP-only, or MetSyn by IDF-only. To assess current CVD, we determined the odds of self-reported CVD by MetSyn category using multivariable logistic regression, controlling for socio-demographic and behavioral factors. To estimate future coronary heart disease risk, we calculated Framingham risk scores (FRS). Overall, 10,785 individuals (47%) had MetSyn. Of these, 79% had MetSyn by both definitions, 6% by ATP-only, and 14% by IDF-only. Compared to those without MetSyn, ATP-only individuals had the highest odds of current CVD and of having a FRS >20%. Also compared to those without MetSyn, IDF-only individuals had 43% higher odds of current CVD and 2-fold increased odds of having a FRS >20%. Consistent with previous reports, ATP-III MetSyn criteria identified individuals with increased odds of CVD and elevated future coronary heart disease risk. However, the IDF definition identified a clinically important number of additional individuals at excess CVD risk.

Metabolic syndrome as a risk factor for high-ocular tension

To investigate the relationship between the metabolic syndrome and intraocular pressure (IOP). An observational study was conducted in a medical health checkup program at a general hospital. This study involved 14 003 apparently healthy Japanese men and women, 18-83 years of age, with a mean IOP of 14.8 (3.0) mm Hg. IOP was examined by noncontact tonometer. High-ocular tension was defined as IOP >21 mm Hg without optic-disc abnormalities or history of receiving any anti-glaucoma therapy. Modified criteria of the revised National Cholesterol Education Program Adult Treatment Panel III (rATPIII), the new International Diabetes Federation definition, and the Japan Society for The Study of Obesity definition were used to characterize the metabolic syndrome. Air temperature was assessed from the Gifu Meteorological Observatory, Gifu, Japan. In the male and female subjects, mean IOP and the prevalence of high-ocular tension became high in direct correlation with the increased number of metabolic syndrome components. To analyze by logistic regression, the metabolic syndrome defined by rATPIII was positively and maximum temperature was negatively correlated with high-ocular tension in males (adjusted odds ratio: 2.0 [95% confidence interval, CI, 1.43-2.78] and 0.63 [95% CI, 0.54-0.73], respectively) and in females (adjusted odds ratio: 7.09 [95% CI, 3.74-13.43] and 0.67 [95% CI, 0.53-0.87], respectively). Three of five metabolic syndrome components (fasting plasma glucose, blood pressure, and triglycerides) were related to high-ocular tension. The metabolic syndrome is a risk factor for high-ocular tension.

Screening for the metabolic syndrome using simple anthropometric measurements in south Asian and white Europeans: A population-based screening study. The Leicester Ethnic Atherosclerosis and Diabetes Risk (LEADER) Study

Aims To estimate the prevalence of metabolic syndrome in a general population sample of south Asians and white Europeans and compare predictors of metabolic syndrome, using ethnic specific definitions of obesity. Methods 3099 participants (71.4% white European, 28.6% south Asian) aged 40–75 years were screened using a 75 g oral glucose tolerance test. Metabolic syndrome was defined using National Cholesterol Education Programme and International Diabetes Federation definitions. We compared sensitivity, specificity and area under the curve of waist circumference, body mass index and waist–hip ratio. Results The prevalence of metabolic syndrome using the definitions above was 29.9% (29.2% south Asian, 30.2% white European), and 34.4% (34.2% south Asian, 34.5% white European), respectively. Using the National Cholesterol Education Programme definition, waist circumference was significantly more predictive of metabolic syndrome than body mass index or waist–hip ratio. The area under the curve for waist circumference was 0.75 (95% CI: 0.69–0.80) and 0.76 (0.72–0.81) for south Asian men and women; 0.83 (0.80–0.85) and 0.80 (0.77–0.82) for white European men and women. Conclusions The prevalence of metabolic syndrome is high in both south Asian and white European populations. Waist circumference is a simple and effective measure for predicting metabolic syndrome in different populations.

Epidemiological Investigation of Metabolic Syndrome and Analysis of Relevant Factors in North-Eastern China

This epidemiological study was conducted to investigate the prevalence of metabolic syndrome and associated risk factors in Chinese subjects from Dehui in north-eastern China. Using a random sampling method, a questionnaire was completed by 3785 permanent residents aged 18 - 72 years and relevant clinical data were collected from each subject. Binary multivariate logistic regression analysis was used to identify factors that were significantly associated with metabolic syndrome. Based on the International Diabetes Federation definition, the prevalence of metabolic syndrome was 22.4%, which is higher than that of the general Chinese population. Metabolic syndrome occurred more frequently in females and the prevalence gradually increased with age. Living in an urban setting and being female, > 50 years old, overweight, having total cholesterol > or = 5.18 mmol/l, low-density lipoprotein cholesterol > or = 3.1 mmol/l, and a fatty liver were significant risk factors associated with metabolic syndrome.

Arterial Structure and Function After Recovery From the Metabolic Syndrome

The reversibility of ultrasonographic vascular changes associated with the metabolic syndrome (MetS) recovery is unknown. We examined whether spontaneous recovery from MetS (according to the International Diabetes Federation definition) has a favorable effect on vascular properties and evaluated the associations between lifestyle factors and MetS recovery. We measured carotid artery intima-media thickness, distensibility, and brachial flow-mediated dilatation by ultrasound in 1673 subjects of the Young Finns Study cohort (age, 31.5+/-5.0 years in 2001) who participated in follow-up studies in 2001 and 2007. At baseline, no differences in intima-media thickness, carotid artery distensibility, or flow-mediated dilatation were observed between the recovery group (baseline-only MetS) and those with incident (only at follow-up) or persistent (both at baseline and follow-up) MetS. After 6 years, the recovery group had smaller intima-media thickness (mean+/-SEM, 0.62+/-0.01 versus 0.68+/-0.01 mm; P=0.0009) and higher carotid artery distensibility (1.98+/-0.07%/mm Hg versus 1.56+/-0.04%/mm Hg; P=0.001) compared with the persistent group and higher flow-mediated dilatation compared with the control group (9.91+/-0.51% versus 8.57+/-0.12%; P=0.03). The recovery group had reduced intima-media thickness progression compared with the persistent group (0.036+/-0.005 versus 0.079+/-0.010 mm; P=0.001) and reduced carotid artery distensibility change compared with the incident group (-0.12+/-0.05%/mm Hg versus -0.38+/-0.10%/mm Hg; P=0.03) over the 6-year follow-up. Differences in carotid artery distensibility levels were attenuated (P=0.11) after the inclusion of weight change in the models. MetS recovery was paralleled with significant reductions in waist circumference that independently correlated with increased physical activity and increased attention paid to health habits during the follow-up. Recovery from the MetS was associated with positive effects on vascular properties during a 6-year follow-up period of young adults.

Prevalence of the metabolic syndrome diagnosed using three different definitions and risk of ischemic heart disease among Kaunas adult population

The aim of this study was to compare the prevalence of the metabolic syndrome diagnosed using three different definitions and to evaluate its associations with ischemic heart disease in Kaunas adult population. MATERIAL AND METHODS. Data of preventive screening carried out in Kaunas in 2001-2002 according to the MONICA study protocol were used for analysis; a total of 1336 persons aged 35-64 years (603 men and 733 women) were recruited. The metabolic syndrome was defined by the World Health Organization, Adult Treatment Panel III, and International Diabetes Federation definitions. Ischemic heart disease was diagnosed based on the following criteria: a documented history of myocardial infarction, angina pectoris, or ischemic changes on electrocardiogram. RESULTS. The metabolic syndrome was identified for 11.3% of men and for 9.4% of women using the World Health Organization definition, for 19.4% of men and for 26.3% of women using the Adult Treatment Panel III definition, and for 30.0% of men and for 37.7% of women using the International Diabetes Federation definition. In male and female groups, the prevalence of the metabolic syndrome (irrespective of definition) significantly increased with age (P<0.05). After adjusting for age, men diagnosed with the metabolic syndrome using the International Diabetes Federation definition (OR=2.30; P=0.001) and Adult Treatment Panel III definition (OR=1.97; P=0.01) and women diagnosed with metabolic syndrome using the International Diabetes Federation definition (OR=1.50; P=0.039) had a significantly higher risk of having ischemic heart disease as compared with those without the metabolic syndrome by the same definitions. The metabolic syndrome diagnosed using the World Health Organization definition was not associated with a significant risk of ischemic heart disease in men and women. CONCLUSION. In Kaunas population aged 35-64 years, the highest prevalence of the metabolic syndrome was determined according to the International Diabetes Federation definition. Usage of the International Diabetes Federation and the Adult Treatment Panel III definitions in establishing diagnosis of the metabolic syndrome provides more opportunities to identify subjects with ischemic heart disease.

Síndrome metabólica em ambulatório cardiológico

In Brazil, the prevalence of the metabolic syndrome (MS) is little known in several regions. To analyze the prevalence of MS, its components and the agreement between two diagnostic definitions in a population aged > 13 years. Cross-sectional study conducted from June to October 2007 in 719 patients of outpatient cardiology clinics in the city of São Luis, State of Maranhão, Brazil. Blood pressure (BP), weight, height, waist circumference and lipid profile were measured. Risk factors for MS were evaluated according to the International Diabetes Federation (IDF) definition. Prevalence ratios and 95% confidence intervals were estimated using Poisson regression. The prevalence of MS was higher in both genders when using IDF definition (62.3% in men and 64.6% in women) than when using that of the National Cholesterol Education Program - Adult Treatment Prevention (NCEP ATPIII) (48.9% in men and 59% in women). The most prevalent MS components were: hypertension (87.2% and 86%); hypertriglyceridemia (84.4% and 82.5%); increased waist circumference (77.8% and 100%); low HDL-c (58.1% and 49.9%); and high blood glucose (59.9% and 51.9%), using NCEP ATPIII and IDF definitions, respectively. In the adjusted analysis, age > 60 years and body mass index (BMI) > 30 were associated with a higher risk of MS (p<0.001). The prevalence of MS was much higher than in the overall population, and hypertension was the most prevalent component. There was good agreement between the two definitions, very good in the female gender and moderate in the male gender.

Prevalence, detection, and management of the metabolic syndrome in patients with acute myocardial infarction: role of an obesity-centric definition.

Background. We sought to determine and compare the prevalence of the Metabolic Syndrome (MS) in patients with acute myocardial infarction (AMI) utilizing the new International Diabetes Federation (IDF) definition with the older National Cholesterol Education Program (NCEP) definition. We also examined the clinical utility of MS in this context. Methods. A total of 107 consecutive patients with AMI were prospectively evaluated for MS. Fasting lipids obtained at admission and fasting glucose at discharge were used. A postdischarge folder audit verified rates of discharge coding and implementation of specific management strategies for MS. Results. Baseline patient characteristics included: mean age 59 ± 13 years; males 80%; diabetes 19%; mean BMI 29.7 ± 8.4 kg/m2. MS prevalence was 54% by the IDF definition and 49% by the NCEP definition, with good agreement between definitions: κ = 0.664, P < .001. Factors predictive of MS after multivariate analysis included: hypertension, fasting glucose, waist circumference, and serum HDL (all P < .05). Despite the high prevalence, MS was recognized at discharge in only 1 patient, and referral for exercise and/or weight-loss programs was undertaken in 5 patients. Conclusion. There is a high prevalence of MS utilizing contemporary definitions in patients with AMI: 54% by the IDF definition and 49% by NCEP criteria. Despite the high prevalence, MS was under-recognized and under-treated in this population.

Prevalence of the Metabolic Syndrome Among Overweight and Obese College Students in Korea

This study examined the prevalence of metabolic risk factors among overweight and obese college students aged 18 to 29 years in Korea. Baseline data from a healthy lifestyle intervention study for overweight and obese college students in Korea were used. We recruited the sample (N = 73) (84% male; mean [SD] age, 23.77 [2.45] years) from 2 universities in Seoul, Korea, and measured body mass index, waist-hip circumstance, blood pressure, and fasting blood chemistry. Descriptive statistics, Spearman rank order correlations, and analysis of variance were conducted using SPSS 16.0 (SPSS Inc, Chicago, Illinois) for windows. Three-fourths of the participants were identified as being viscerally obese based on the Asia Pacific criteria. Of the total sample, about 12% and 20% were defined as having metabolic syndrome according to the National Cholesterol Education Program--the Adult Treatment Panel III and International Diabetes Federation, respectively. Concordance between the National Cholesterol Education Program--the Adult Treatment Panel III and International Diabetes Federation definitions was very good in the current study (Cohen kappa coefficient = 0.74, P <.001). Body mass index was significantly correlated with greater triglyceride and systolic and diastolic blood pressure and waist circumference but with lower high-density lipoprotein cholesterol. Early screening and targeted interventions to prevent obesity and the metabolic syndrome are urgently needed to promote health for adolescents and young adults in South Korea.

Prevalence of metabolic syndrome in urban and suburban Rivers State, Nigeria: International Diabetes Federation and Adult Treatment Panel III definitions

It was not clear for a while, which of the definitions of metabolic syndrome best predicted those at risk of cardiovascular disease and diabetes but recent studies have confirmed the predictive ability of various definitions of metabolic syndrome and have reported that the International Diabetes Federation definition, although more sensitive is associated with a higher false positive predictive rate. To determine the prevalence of metabolic syndrome, using the International Diabetes Federation and Adult Treatment Panel III definitions among adult Nigerians attending Family Medicine Clinics at two hospitals in Rivers State Nigeria. Adult subjects attending family medicine clinics at an urban and a sub-urban hospital in Rivers State, Nigeria were bled after an overnight fast, and venous blood obtained for lipid studies and fasting plasma glucose estimations. Measurements were made to determine height, weight, waist circumference and blood pressure. The data obtained was analysed using SPSS for Windows software version 12 and Epi info version 6.04D RESULTS: The prevalence of metabolic syndrome was 19.81% (ATP III) and 23.19% (IDF) at one centre and 34.17% (ATP III) and 35.42% (IDF) at the other centre. The prevalence of metabolic syndrome by the two definitions was significantly higher at the second centre. The difference in the prevalence rates by the two definitions was also much smaller in the second centre perhaps because the second centre had more women and the mean age of the subjects was significantly higher.

Metabolic Syndrome and Its Individual Components among Jordanian Children and Adolescents.

This study aimed to determine the prevalence of metabolic syndrome (MeS) and its individual components in Jordanian children and adolescents aged 7–18 years and determine the factors that are associated with clustering of metabolic abnormalities. MeS was defined using the International Diabetes Federation (IDF) definition. The prevalence of MeS was estimated from 512 subjects who had complete information on all MeS components. The prevalence of MeS according to IDF criteria was 1.4% in subjects aged between 10 and 15.9 years and 3.6% in subjects aged between 16 and 18 years. When categorized according to body mass index (BMI), the prevalence of the MeS was 15.1% in obese subjects, compared to 0.3% in subjects with normal BMI, and 3.0% in overweight subjects. In conclusion, our results indicate that although the prevalence of MeS is low in Jordanian children and adolescents, a large proportion of them had one or two metabolic abnormalities.

Metabolic syndrome: an occupational perspective.

Objective:To study the prevalence of Metabolic Syndrome (MS) in an Indian industrial setup and to study disparity in occurrence of MS in a working population based on occupational status.Materials and Methods:Cross-sectional study of 651 employees who underwent periodic medical examination. The International Diabetes Federation (IDF) definition of MS and International Standard Classification of Occupations (ISCO)-88 classification of occupations were used.Results:The overall crude prevalence of MS was found to be 18.5%. Nineteen percent of the non-manual workers and 18.3% of the manual workers suffered from MS. The single largest occupational category with MS was ISCO-88 group 1, which included the managers and senior officials. However, no difference was found among the manual and non-manual workers in prevalence of MS.

Index of Central Obesity Is Better Than Waist Circumference in Defining Metabolic Syndrome

The International Diabetes Federation (IDF) global definition of metabolic syndrome suggests using race- and gender-specific waist circumference (WC) cutoffs. Previously, we have hypothesized that need for gender- and race-specific cutoffs could be obviated by supplanting WC with index of central obesity (ICO). The aim of this study was to test the utility of ICO in defining metabolic syndrome. Data were collected from National Health and Nutrition Examination Survey (NHANES) database for year 2005-2006. Subjects were analyzed for presence of metabolic syndrome using National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. The IDF definition was modified by replacing WC with ICO. Sensitivity and specificity of the IDF definition and modified definition were compared against the NCEP ATP III definition. Using a modified IDF definition, a common cutoff of 0.53 could be obtained for both males and females. The modified IDF definition improved sensitivity from 0.85 to 0.98 and 0.98 to 0.99 among males and females, respectively. This was at the cost of compromised specificity, which reduced from 1.0 to 0.89 and 0.98 for males and females, respectively. ICO appears better than WC in defining metabolic syndrome in terms of better sensitivity and potential to be used with single cutoff for both genders.

Lipid Profiles and Associated Gene Polymorphisms in Young Asian Indian Patients With Acute Myocardial Infarction and the Metabolic Syndrome

The objective of this study was to examine the association between serum lipid levels and the metabolic syndrome, together with polymorphisms in lipid-associated genes, in young Asian Indians with acute myocardial infarction (AMI). The study population comprised 492 patients who were 45 years old or younger. We assessed lipid levels and the frequencies of the cholesteryl ester transfer protein (CETP) Taq-1 B, lipoprotein lipase (LPL)S447X, -93 T/G, apolipoprotein B (APO B) 96bp ins/del, lipoprotein(a) (LP[a]) pentanucleotide repeat, and apolipoprotein E (APO) E epsilon 2/3/4 polymorphisms in relation to the metabolic syndrome using both National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF) definitions. The metabolic syndrome as defined by the NCEP ATP III criteria was found in 301 (61%) patients and in 295 (60%) patients according to the IDF criteria. Hypercholesterolemia (64.5%), hypertriglyceridaemia (78.7%), low high-density lipoprotein cholesterol (HDL-C) (70.1%), and raised non-HDL-C (68.0%) occurred significantly more frequently in patients with the metabolic syndrome defined by the NCEP ATP III criteria. Similar results were observed for the IDF definition. A significant relationship with the LPL -93 T/G polymorphism was found, with the minor G allele occurring more frequently in patients defined by the NCEP ATP III criteria (odds ratio [OR] 2.72; 95% confidence interval [CI] 1.07-8.16; P = 0.023). The X allele of the LPL S447X polymorphism was observed less frequently in metabolic syndrome patients (OR 0.52; 95% CI 0.34-0.78; P = 0.0009). Several genotypes, including the LPL S447X, APO E3/E3, and the CETP Taq1 B2B2, were associated with favorable lipid profiles. Dyslipidemia occurred with similar frequency in young Asian Indian patients with AMI and the metabolic syndrome, irrespective of the definition used. Significant associations were observed between LPL gene polymorphisms and the metabolic syndrome. Several lipid-associated genotypes exerted a favorable effect on lipid profiles.

Harmonizing the Metabolic Syndrome

A cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which occur together more often than by chance alone, have become known as the metabolic syndrome. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and central obesity. Various diagnostic criteria have been proposed by different organizations over the past decade. Most recently, these have come from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. The main difference concerns the measure for central obesity, with this being an obligatory component in the International Diabetes Federation definition, lower than in the American Heart Association/National Heart, Lung, and Blood Institute criteria, and ethnic specific. The present article represents the outcome of a meeting between several major organizations in an attempt to unify criteria. It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool. Three abnormal findings out of 5 would qualify a person for the metabolic syndrome. A single set of cut points would be used for all components except waist circumference, for which further work is required. In the interim, national or regional cut points for waist circumference can be used.

Epidemiological investigation of metabolic syndrome and analysis of relevant factors in northeast China

This epidemiological study was conducted to investigate the prevalence of metabolic syndrome and associated risk factors in Chinese subjects from Dehui in northeastern China. Using a random sampling method, a questionnaire was completed by 3785 permanent residents aged 18 – 72 years and relevant clinical data were collected from each subject. Binary multivariate logistic regression analysis was used to identify factors that were significantly associated with metabolic syndrome. Based on the International Diabetes Federation definition, the prevalence of metabolic syndrome was 22.4%, which is higher than that of the general Chinese population. Metabolic syndrome occurred more frequently in females and the prevalence gradually increased with age. Living in an urban setting and being female, > 50 years old, overweight, having total cholesterol ≥ 5.18 mmol/l, low-density lipoprotein cholesterol ≥ 3.1 mmol/l, and a fatty liver were significant risk factors associated with metabolic syndrome.

The 6th Annual World Congress on the Insulin Resistance Syndrome

This is the third of a series of articles based on presentations at the 6th Annual World Congress on the Insulin Resistance Syndrome held 25–27 September 2008 in Los Angeles, California. ### Insulin resistance epidemiology In an update on the metabolic syndrome, Earl Ford (Atlanta, GA) discussed epidemiological relationships between metabolic syndrome and incident diabetes and compared the syndrome with risk prediction models. Over the past 3 years, more than 3,000 articles have been written about the syndrome. The 1998 World Health Organization (WHO) definition focused on glucose intolerance or insulin resistance, the 1999 European Group for the Study of Insulin Resistance required either insulin resistance or fasting hyperinsulinemia, and the NCEP/ATP III (National Cholesterol Education Program/Adult Treatment Panel III) definition in 2001 did not focus on glycemia or insulin resistance, simply requiring three of five abnormalities (abdominal obesity, low HDL cholesterol, high triglyceride levels, hypertension, and hyperglycemia), in 2002 and 2005 changing the glycemic criteria. The 2005 International Diabetes Federation (IDF) definition focused on central adiposity, giving ethnic-specific limits. The American College of Endocrinology also proposed a definition, giving a large number of possible conditions associated with insulin resistance. Using the 1999–2004 National Health and Nutrition Examination Survey data, the age-adjusted prevalence of metabolic syndrome in adults is ∼35% with ATP III and 38% with IDF definitions. Based on the projected U.S. population of 218,000,000 adults in 2007, then, there are ∼80,000,000 individuals with metabolic syndrome. There is heterogeneity by ethnicity and sex, with prevalence lowest in African American men and higher in Hispanic women. With the IDF definition, prevalence of the syndrome is greater in men than women. A number of studies have analyzed the association of metabolic syndrome with cardiovascular disease (CVD) and diabetes, with meta-analysis showing a relative CVD risk of 1.5–1.8 and a threefold increase in likelihood of diabetes …

The prevalence of carotid artery calcifications detected on panoramic radiographs in patients with metabolic syndrome

The purpose of this study was to determine the prevalence of carotid artery calcifications (CAC) detected on panoramic radiographs in patients with metabolic syndrome (MetS). Eighty-five Thai subjects (29 men, 56 women) who had MetS according to the International Diabetes Federation definition were evaluated for CAC detected on panoramic radiographs. The confirmation of findings was done by ultrasonography. Carotid artery calcifications were detected in 19 subjects (22.4%) with a mean age of 64 years, range 48-74 years. These subjects included 12 men and 7 women. The CAC were significantly more common in men than in women (P = .002). There were 8 subjects (9.4%) with bilateral calcifications and 11 subjects (12.9%) with unilateral calcification. No significant difference between the right and left sides was found (P = .44). Thai people with MetS have high prevalence of radiographically detectable carotid artery calcifications.

Sex hormone-binding globulin levels and metabolic syndrome and its features in adolescents#

Low levels of sex hormone-binding globulin (SHBG) are associated with obesity, insulin resistance, and metabolic syndrome (MS) in men and women, and it has been suggested that SHBG could be a useful marker for MS risk. The aim of this study was to analyze the relationship of SHBG levels with MS and its components in Spanish adolescents. The sample population of this cross-sectional study was comprised of 386 male and 429 female adolescents, aged 12-16 yr. Anthropometric parameters and blood pressure (BP) were measured. Total cholesterol, high-density lipoprotein (HDL)-cholesterol, insulin, glucose, and SHBG levels were determined. The pediatric International Diabetes Federation (IDF) definition was used to classify adolescents for MS. SHBG levels were lower in adolescents with MS or with some MS features. More than 90% of the abdominally obese adolescents were in the lowest and medium SHBG tertiles. In girls, BP was significantly higher in the lowest SHBG tertile than in the two others, whereas in boys BP levels were significantly higher in the lowest and medium tertiles than in the highest one. Insulin levels and homeostasis model assessment (HOMA) index were also significantly higher in the lowest SHBG tertile than in the two others. The associations of SHBG with MS and its components, such as abdominal obesity, high BP or insulin levels, are already present in normal adolescents. This may suggest the possibility of using SHBG levels as a biomarker for MS risk in adolescents as well as adults.