International Diabetes Federation Definition Research Articles

High levels of very long-chain saturated fatty acid in erythrocytes correlates with atherogenic lipoprotein profiles in subjects with metabolic syndrome

AimVery long chain saturated fatty acid (VLCFA) levels in erythrocytes are associated with metabolic syndrome (MS). However, the relationship between levels of the VLCFA ligonoceric acid (C24:0) in erythrocytes and the atherogenic lipoprotein profiles and inflammatory state in MS remain unclear. MethodsBased on the International Diabetes Federation (IDF) definition of MS, 195 apparently healthy males were assigned to either an MS group (n=38) or a non-MS group (n=157). Fatty acid composition of erythrocytes was determined by gas liquid chromatography. ResultsErythrocytes from the MS group had a significantly higher level of C24:0 than cells from the non-MS group (4.06±0.48% versus 3.88±0.34%; p=0.03). C24:0 levels were significantly correlated with several components of MS. The C24:0 levels showed a significant negative correlation with LDL and HDL particle size. Multivariate linear regression analysis showed that C24:0 levels were independently correlated with LDL particle size after adjusting for age and each MS criterion. C24:0 levels were also positively correlated with log-transformed high-sensitivity CRP levels (p=0.04). ConclusionC24:0 levels in erythrocytes are associated with specific atherogenic lipoprotein profiles and inflammation status in subjects with MS.

Prevalence and risk factors for metabolic syndrome in Medellin and surrounding municipalities, Colombia, 2008–2010

ObjectiveWe assessed the prevalence of and risk factors for metabolic syndrome (MetS) among adults 25–64years of age from Medellin and surrounding municipalities, Colombia. MethodWe used 2008–2010 data from the Antioquia STEPwise approach to Surveillance (STEPS), a multi-stage complex cross-sectional survey designed according to World Health Organization guidelines. The revised 2005 International Diabetes Federation definition of MetS was used. ResultsThere were a total of 3000 participants. Of these, 21.4% had high blood pressure (HBP) and 64% had abdominal obesity (AO). In the subsample with serum data (n=943), 19.8% had high fasting serum glucose, 43.9% had high triglycerides (HTG), and 56.6% had low HDL cholesterol (L-HDL). Among those with data to define MetS (n=901), 41% had MetS. Older age was associated with MetS and all components except L-HDL. Female sex [odds ratio (OR)=2.85, 95% confidence interval (CI): 2.20–3.70], being married (OR=1.40, CI: 1.09–1.82), and high physical activity (OR=0.59, CI: 0.39–0.91) were associated with AO, smoking with HTG (OR=1.76, CI: 1.16–2.67) and L-HDL (OR=1.67, CI: 1.10–2.51) and rural residence with HBP (OR=3.42, CI: 1.83–6.37) and L-HDL (OR=1.18, CI: 1.10–2.51). ConclusionThe prevalence of MetS and AO was high in this Colombian region. Targeted strategies for promoting healthy behaviors are needed.

Comparación de dos metodologías utilizadas para la determinación de síndrome metabólico en población adulta

Metabolic syndrome is characterized by the simultaneous or sequential appearance of various metabolic and inflammatory changes at molecular, cellular or hemodynamic level associated with the presence of insulin resistance and dominant visceral adiposity. Different expert groups, including the International Diabetes Federation and the National Cholesterol Education Program, have tried to develop criteria for its diagnosis. To establish diagnostic criteria concordance levels for metabolic syndrome. A total of 357 people were part of the study. We performed a descriptive analysis of qualitative variables, and laboratory and anthropometric measurement results to determine the prevalence of metabolic syndrome according to the International Diabetes Federation and National Cholesterol Education Program - ATP III definitions. We used kappa concordance and logistic regression for the comparison of methodologies. The prevalence of metabolic syndrome was 19.9% according to the International Diabetes Federation, and 10.4% using the National Cholesterol Education Program - ATP III. The estimate of agreement between the two diagnostic criteria of the International Diabetes Federation and the National Cholesterol Education Program - ATP III was fair (low) (κ=0.3997, CI 95% 0.28-0.52). In the working population who participated in this study, the obtained prevalence of metabolic syndrome occurred at a higher rate using the International Diabetes Federation definition, being higher in men than in women. The use of diagnostic criteria for metabolic syndrome must take into account the study population as well as sex and age.

Association Between Metabolic Syndrome and Helicobacter pylori Infection Diagnosed by Histologic Status and Serological Status

We aimed to simultaneously evaluate the association between metabolic syndrome and Helicobacter pylori (HP) infection diagnosed histologically and serologically in a large number of healthy Korean adults. Serological positivity for HP does not necessarily indicate current infection. No study to date has compared the association between metabolic syndrome and HP infection diagnosed by histologic and serological status. HP status was ascertained histologically and serologically in healthy Korean adults who underwent comprehensive health screening in a private health screening center in Korea. Metabolic syndrome was defined according to the International Diabetes Federation definition. Multivariate logistic analyses were performed, after adjusting for potential confounders, including age, sex, smoking, alcohol consumption, and income level. A total of 5889 subjects were included in the analysis. The metabolic syndrome was more strongly associated with histologic positivity for HP [adjusted odds ratio (aOR)=1.26; 95% confidence interval (CI), 1.08-1.48] than serologic positivity (aOR=1.12, 95% CI, 0.95-1.32), after adjusting for age, sex, smoking status, alcohol consumption, and economic status. The stronger association between metabolic syndrome and histologic positivity than serological positivity suggests that the effects of HP infection on the pathogenesis of cardiometabolic outcomes may be reversible. Further prospective studies are needed.

Metabolic syndrome – a risky combination

Abstract The metabolic syndrome is characterized by a cluster of related clinical, anthropometric and biochemical features such as central obesity, dysglycaemia, dyslipidaemia and hypertension. It is highly prevalent in the general population (approximately 22%), with differences in relation to race, gender, and age. It carries an increased cardiovascular morbidity and mortality, which makes an early and correct assessment mandatory. The prevalence of the metabolic syndrome is very high in type 2 diabetes patients, in whom it influences the risk of chronic complications. The aim of the present report is to explore the characteristics and the combination types of the metabolic syndrome and to assess the cardiovascular risk in patients presenting this clinical entity. 329 patients consecutively diagnosed with metabolic syndrome were included in the study, both men and women, no limit regarding age. Patient selection was made during the periodic medical visits in the outpatient clinics of Diabetes, Cardiology and Internal Medicine. Metabolic syndrome (MetS) was diagnosed according to 2005 International Diabetes Federation (IDF) Criteria. Women were more frequent than men, mean age was 59.08±888 and they all had central obesity (it is the major criteria of 2005 IDF definition for MetS) .The diagnosis of the metabolic syndrome was fulfilled with only 3 criteria, most of the times. The complete metabolic syndrome was the rarest, less than 25% of the patients presenting all 5 definition criteria and it was more frequent among men (men 39.2% vs women 15.9%: p < 0.0001). Apart from central obesity, which is mandatory for diagnosing MetS and thus present in all patients, arterial hypertension is the most common finding in our study population, with impaired glycaemia and increased triglycerides occupying the second and third place, respectively. Central obesity, arterial hypertension and impaired glycaemia represent the most frequent combination, a real „hard core” of MetS. As expected, the cardiovascular risk was high in the study population. The cardiovascular „score” of our patients increased significantly with the number of components used for the diagnosis of MetS (MetS with 3 elements vs MetS with 4 elements vs MetS with 5 elements: SCORE - 5.36 ± 7.07 vs 7.66 ± 8.63 vs 8.52 ± 8.34, p < 0.01).

Prevalence of Metabolic Syndrome in Urban Colombian Adolescents Aged 10-16 Years Using Three Different Pediatric Definitions

The aim of this study was to evaluate the metabolic syndrome (MetS) prevalence in adolescents using three different definitions for this age group. The evaluated sample consisted of 718 male and 743 female adolescents. Definitions by Cook et al., de Ferranti et al. and International Diabetes Federation (IDF) for adolescents were used to estimate the prevalence of MetS. The prevalence of MetS was 8.5, 2.5 and 1.2% by de Ferranti et al., Cook et al. and IDF definitions, respectively. High fasting glucose component had the lower prevalence whereas high triglycerides levels component was the most prevalent. In obese adolescents, the prevalence of MetS was higher. MetS classification in adolescents strongly depends on the definition chosen. Further research is required for the evaluation of the current definitions (multicentric studies), and for addition or design of new and useful criteria.

Management of diabesity in primary care: individualisation of care

Management of diabesity in primary care: individualisation of care

Associations between metabolic syndrome and syndrome components and retinal microvascular signs in a rural Chinese population: the Handan Eye Study

Our purpose was to determine the relationship of metabolic syndrome (MetS) and its components with retinal microvascular abnormalities in a rural Chinese population. The Handan Eye Study, a population-based survey, recruited 6,830 (90.4% of eligible) rural Chinese ≥30years of age. A diagnosis of metabolic syndrome was based on the International Diabetes Federation definition. Retinal microvascular signs and arteriolar and venular diameters were assessed from fundus photographs by graders who were trained at the Retinal Vascular Imaging Centre, University of Melbourne. After adjusting for age, gender, and smoking status, 5,519 participants with MetS, or with the specific components of large waist circumference, elevated blood pressure (BP), or elevated fasting blood glucose (FG), were more likely to have retinopathy, arteriovenous nicking, focal arteriolar narrowing, enhanced arteriolar wall reflex, and generalized retinal arteriolar narrowing than those without MetS or the corresponding component. Individuals with elevated triglycerides were significantly more likely to have arteriovenous nicking and retinopathy. These results show that individual components of MetS are associated with different retinal microvascular signs and with changes in retinal arteriolar and venular diameters.

682 PREVALENCE OF METABOLIC SYNDROME AMONG MALAYSIAN ADULTS AGED ≥ 30 YEARS ACCORDING TO THE NCEP-ATP III, IDF AND JIS DEFINITIONS

Objective: The objective of this study is to compare the prevalence of Metabolic Syndrome (MetS) as defined by the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III)1, International Diabetes Federation (IDF) world-wide definition2 and the ‘harmonised’ definition by the Joint Interim Statement (JIS)3. Methods: A community based cross-sectional study involving 11,288 adults aged ≥ 30 years was conducted in urban and rural areas of Malaysia between 2007 and 2010. Demographic data, waist circumference (WC), blood pressure readings; and fasting venous blood for lipid and glucose assays were obtained. Data was analysed using STATA version 11. Results: Out of the11,288 subjects, 8836 had complete data on all the MetS components and were therefore included in the analysis. Mean age was 53.2 years (SD ± 10.6). The table shows the overall and age-adjusted prevalence of MetS according to the NCEP-ATP III, IDF and JIS definitions by location, gender, ethnicity and education attainment.Conclusions: The JIS definition gave the highest overall prevalence of MetS among Malaysian adults, as well as the age-adjusted prevalence by location, gender, ethnicity and education attainment. The NCEP-ATP III gave the lowest prevalence due to the higher WC cut points. Prevalence was significantly lower in Chinese and Indigenous groups regardless of the criteria used. There was no significant difference in the prevalence between urban and rural population using IDF and JIS definitions. References National Cholesterol Education Program (NCEP)Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106: 3143–421. Alberti KG, Zimmet P, Shaw J, International Diabetes Federation (IDF) Epidemiology Task Force Consensus Group. The metabolic syndrome: a new world- wide definition. Lancet 2005; 366: 1059–62. Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome. A Joint Interim Statement (JIS) of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120: 1640–5.

Colorectal Cancer and its Association with the Metabolic Syndrome: a Malaysian Multi-Centric Case-Control Study

Colorectal cancer (CRC) and the metabolic syndrome (MetS) are both on the rise in Malaysia. A multi-centric case-control study was conducted from December 2009 to January 2011 to determine any relationship between the two. Patients with confirmed CRC based on colonoscopy findings and cancer free controls from five local hospitals were assessed for MetS according to the International Diabetes Federation (IDF) definition. Each index case was matched for age, gender and ethnicity with two controls (140: 280). MetS among cases was highly prevalent (70.7%), especially among women (68.7%). MetS as an entity increased CRC risk by almost three fold independently (OR=2.61, 95%CI=1.53-4.47). In men MetS increased the risk of CRC by two fold (OR=2.01, 95%CI, 1.43-4.56), demonstrating an increasing trend in risk with the number of Mets components observed. This study provides evidence for a positive association between the metabolic syndrome and colorectal cancer. A prospective study on the Malaysian population is a high priority to confirm these findings.

Prevalence of the metabolic syndrome using two proposed definitions in a Japanese-Brazilians community

Metabolic Syndrome (MetS) is associated with increased risk of morbi-mortality, thus the characterization of the population magnitude of this syndrome is critical for allocating health care. However, prevalence estimates of MetS in the same population could differ depending on the definition used. Therefore, we compared the prevalence of the MetS using definitions proposed by: National Cholesterol Education Panel Revised (NCEP) and International Diabetes Federation (IDF) 2009 in a Japanese-Brazilians community (131 individuals, age 57 ± 16 years, 1st and 2nd generation). All individuals went through a clinical and laboratorial evaluation for assessment of weigh, height, waist circumference, blood pressure, triglycerides, HDL-cholesterol and fasting plasma glucose. The prevalence of MetS was 26.7% (n = 35) and 37.4% (n = 49) under the NCEP and IDF definitions, respectively. Despite higher blood pressure measurements, waist circumference and serum triglyceride levels and lower HDL cholesterol levels (p < 0.01), individuals identified with MetS did not show increased blood glucose levels. IDF definition classified 14 individuals (10.7%) with MetS that were not classified under the NCEP and 35 individuals were identified with MetS by both criteria. We observed, in this group, more severe lipid disorders, compared to individuals identified only under the IDF definition, and the BMI and waist circumference (p = 0.01; p = 0.006, respectively) were lower. In conclusion, the IDF revised criteria, probably because of the ethnic specific values of waist circumference, was able to identify a larger number of individuals with MetS. However, our data suggesting that additional studies are necessary to define best MetS diagnostic criteria in this population.

All-cause and cardiovascular mortality risk estimation using different definitions of metabolic syndrome in Lithuanian urban population

ObjectiveThe objective of the study was to assess mortality risk in the subjects with diagnosed metabolic syndrome (MS) using National Cholesterol Educational Program (NCEP-ATPIII), American Heart Association and National Heart Lung and Blood Institute (AHA/NHLBI) International Diabetes Federation (IDF) and Joint Interim Societies (JIS) definitions. MethodsTwo random samples aged 35–64years were examined in 1992–2002 in the framework within the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study (N=2455). The follow-up was carried out in terms of the end points reached from the baseline health examinations until December 31, 2009. ResultsCox regressions demonstrated that MS defined by IDF and JIS definitions remained the only significant determinants for all-cause mortality (RR=1.48 and RR=1.41; p<0.05) and cardiovascular disease (CVD) mortality in men (RR=1.81 and RR=1.66; p<0.05). In men (without previous CVD) the NCEP-ATPIII definition had increased mortality risk from CVD (RR=1.98; p=0.012), than in men with identified MS by the IDF and the new JIS definition. In women the MS was not associated with risk of mortality from CVD. ConclusionThe MS definitions according to the IDF and JIS criteria appear to be a slightly better predictor of all-cause mortality and mortality from CVD; MS according to the NCEP-ATPIII criteria appears to be a better predictor of mortality from CVD in men.

Prevalence and Clinical Correlates of Metabolic Syndrome in Nigerians Living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

Sub-Saharan Africa bears an inordinate burden of human immunodeficiency virus (HIV) infection/acquired immune deficiency syndrome (AIDS). Reports have shown increased prevalence of clustering of cardiovascular risk factors referred to as metabolic syndrome in treatment-naïve patients and patients on highly active antiretroviral therapy (HAART). In view of the fact that metabolic syndrome is a heterogeneous disorder with substantial variability in the prevalence and component traits within and across populations and the dearth of publications on the prevalence and clinical correlates of metabolic syndrome in people living with HIV/AIDS (PLWHA) in Nigeria, this study was carried out to determine the prevalence and clinical correlates of metabolic syndrome among an HIV-infected outpatient population using the National Cholesterol Education Adult Treatment Panel III (NCEP ATP III), the International Diabetes Federation (IDF), and the Joint Interim Statement (JIS) definitions. We also sought to determine if HAART use and CD4 count level were associated with metabolic syndrome. This cross-sectional study involved 291 (95 men, 196 women) consecutive PLWHA. Anthropometry, blood pressure, fasting plasma glucose, and lipid profile values were determined. The prevalence rates of metabolic syndrome according to the ATP III, IDF, and JIS criteria were 12.7%, 17.2%, and 21.0%, respectively. Metabolic syndrome was significantly associated with female gender (all definitions), body mass index (all definitions), increasing age, and CD4 count (IDF definition). There was no significant association between metabolic syndrome and HAART. The concordance [kappa coefficient (κ)] between the definitions of metabolic syndrome varied between 0.583 and 0.878. The prevalence of metabolic syndrome varied with the criteria used and metabolic syndrome correlates with traditional cardiovascular risk factors rather than HAART-related factors.

Risk of Metabolic Syndrome for Stroke Is Not Greater than the Sum of its Components: Thai Epidemiologic Stroke (TES) Study

Limited information is available on the association between the metabolic syndrome (MetS) and stroke. Whether or not MetS confers a risk greater than the sum of its components is controversial. This study aimed to assess the association of MetS with stroke, and to evaluate whether the risk of MetS is greater than the sum of its components. The Thai Epidemiologic Stroke (TES) study is a community-based cohort study with 19,997 participants, aged 45-80 years, recruited from the general population from 5 regions of Thailand. Baseline survey data were analyzed in cross-sectional analyses. MetS was defined according to criteria from the National Cholesterol Education Program (NCEP) Adult Treatment Panel III, the American Heart Association/National Heart, Lung, and Blood Institute (revised NCEP), and International Diabetes Federation (IDF). Logistic regression analysis was used to estimate association of MetS and its components with stroke. Using c statistics and the likelihood ratio test we compared the capability of discriminating participants with and without stroke of a logistic model containing all components of MetS and potential confounders and a model also including the MetS variable. We found that among the MetS components, high blood pressure and hypertriglyceridemia were independently and significantly related to stroke. MetS defined by the NCEP (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.32-2.04), revised NCEP (OR, 2.27; 95% CI, 1.80-2.87), and IDF definitions (OR, 1.70; 95% CI, 1.37-2.13) was significantly associated with stroke after adjustment for age, sex, geographical area, education level, occupation, smoking status, alcohol consumption, and low-density lipoprotein cholesterol. After additional adjustment for all MetS components, these associations were not significant. There were no statistically significant difference (P=.723-.901) in c statistics between the model containing all MetS components and potential confounders and the model also including the MetS variable. The likelihood ratio test also showed no statistically significant (P=.166-.718) difference between these 2 models. Our findings suggest that MetS is associated with stroke, but not to a greater degree than the sum of its components. Thus, the focus should be on identification and appropriate control of its individual components, particularly high blood pressure and hypertriglyceridemia, rather than of MetS itself.

Aging, female sex, migration, elevated HDL-C, and inflammation are associated with prevalence of metabolic syndrome among African bank employees

BackgroundThe objective of this study was to compare four different criteria for diagnosing metabolic syndrome (MS) and to correlate sociodemographic data, liver enzymes, lipids, inflammation, and insulin resistance with MS definitions.MethodsThis cross-sectional study included a random number of 126 African bank employees from Brazzaville, Congo.ResultsThe prevalence of MS varied according to the different definitions used: 4.8% under World Health Organization (WHO) criteria, 8.7% under the National Cholesterol Education Program Adult Treatment Panel III (NECP-ATPIII) criteria, 14.3% under the International Diabetes Federation (IDF) for Europe, and 15.9% by the IDF for Central Africa. According to the IDF, specific cutoff points for the erythrocyte sedimentation rate, ≥13 mm at first hour and ≥30 mm at second hour, defined MS for Central Africa. The best agreement was observed between the IDF for Europe and the IDF for Central Africa (Kappa = 0.938; P < 0.0001) criteria. The worst agreements were between the WHO and IDF for Central Africa (Kappa = 0.419; P < 0.0001) criteria and between the WHO and IDF for Europe (Kappa = 0.462; P < 0.0001) criteria. The NECP-ATPIII criteria did not agree with either the IDF for Europe or the IDF for Central Africa criteria. There was a significant relationship between female sex, aging, elevated liver enzymes, elevated phospholipids, high homeostasis model assessment of insulin resistance, and MS defined by the IDF for Central Africa.ConclusionThe IDF definition of the MS modified for Central Africa provides higher prevalence estimates of MS than the estimates based on the NECP-ATPIII and IDF for Europe criteria. Liver enzymes, phospholipids, and homeostasis model assessment of insulin resistance should be included in clinical practice to stratify cardiovascular disease risk among Africans.

Prevalence of Metabolic Syndrome in Overweight and Obese Filipino Adolescents Based on the IDF Definition

Objective. This study determined the prevalence of metabolic syndrome (MetS) in overweight and obese Filipino adolescents. Methodology. A total of 350 overweight and obese Filipino adolescents (aged 10 to 18 years, 206 males and 144 females) referred to pediatric endocrine clinics in Metro Manila were included. Weight, height, waist and blood pressure were measured and fasting lipid profiles, blood glucose and insulin were determined. MetS is defined as presence of three out of five clinical features: central obesity, hyperglycemia, hypertriglyceridemia, low HDL-C level and hypertension. The prevalence of MetS was determined based on the International Diabetes Federation (IDF) definition. Results. The overall prevalence of MetS in overweight and obese adolescents was 19%. Among participants, 98% had abdominal adiposity, 25% hypertension, 24% hypertriglyceridemia, 17% low HDL and 12% hyperglycemia; 67% had hyperinsulinemia (>15 uU/ml) and 70% had insulin resistance based on HOMA-IR (≥3). Among those with MetS, 14% had 3 components and 5% had 4 components; the prevalence of hyperinsulinemia and insulin resistance rose to 79% and 90%, respectively, with high mean levels of serum insulin (31.3 μU/ml) and HOMA-IR (7.7). Conclusion. Overweight and obese adolescents are at risk to develop MetS. The prevalence of hyperinsulinemia and insulin resistance is high.

Metabolic syndrome in type 2 diabetes: comparative prevalence according to two sets of diagnostic criteria in sub-Saharan Africans.

BackgroundAvailable definition criteria for metabolic syndrome (MS) have similarities and inconsistencies. The aim of this study was to determine the prevalence of MS in a group of Cameroonians with type 2 diabetes, according to the International Diabetes Federation (IDF) and the National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III) criteria, and to assess the concordance between both criteria, and the implications of combining them.MethodsWe collected clinical and biochemical data for 308 patients with type 2 diabetes (men 157) at the National Obesity Center of the Yaounde Central Hospital, Cameroon. Concordance was assessed with the use of the Kappa statistic.ResultsMean age (standard deviation) was 55.8 (10.5) years and the median duration of diagnosed diabetes (25th–75th percentiles) was 3 years (0.5–5.0), similarly among men and women. The prevalence of MS was 71.7% according to the IDF criteria and 60.4% according to NCEP-ATP III criteria. The prevalence was significantly higher in women than in men independently of the criteria used (both p < 0.001). Overall concordance between both definitions was low to average 0.51 (95% confidence interval: 0.41–0.61). Combining the two sets of criteria marginally improved the yield beyond that provided by the IDF criteria alone in men, but not in the overall population and in women.ConclusionsThe IDF and NCEP-ATP III criteria do not always diagnose the same group of diabetic individuals with MS and combining them merely increases the yield beyond that provided by the IDF definition alone. This study highlights the importance of having a single unifying definition for MS in our setting.

PTU-194 Does metabolic syndrome impact tumour pathology in oesophageal adenocarcinoma?

IntroductionObesity is an established risk factor for both the increased incidence of oesophageal adenocarcinoma cancer (OAC), and adverse outcomes by increasing risk of recurrence and reducing survival in obese patients...

Fat distribution, insulin resistance and serum adiponectin of older women with and without metabolic syndrome

This study assessed associations among dietary intakes, body fat distribution and serum biomarkers in 41 women aged &gt; 50 yrs with and without metabolic syndrome (MetS). MetS by International Diabetes Federation definition (IDF) was waist circumference ≥88cm with two additional factors: elevated blood pressure, triglycerides, or glucose; or decreased HDL‐cholesterol. Three‐day diet records and 24‐hr duplicate plates were collected. Dual‐energy X‐ray absorptiometry (DEXA) scans was used to estimate body fat distribution. Total antioxidant capacity (TAC) in diet and serum were measured with the ferric reducing antioxidant power (FRAP) assay. The MetS group had significantly higher serum insulin and adiponectin as well as higher homoeostasis model assessment (HOMA)‐β, HOMA‐IR, and android:gynoid ratio. TAC in serum and 24‐hr duplicate plate diet samples were not significantly different between control and MetS groups; however, dietary fiber intakes were positively associated with dietary vitamin C (p&lt;0.03). Total body fat, android fat, android:gynoid ratio, and serum adiponectin were significantly (p&lt;0.05) associated with insulin resistance in these older women. (Supported by Oklahoma Agricultural Experiment Station, W2002).

The absence of insulin resistance in metabolic syndrome definition leads to underdiagnosing of metabolic risk in obese patients

This study explores in a group of obese children and adolescents aged 10 to 16 years, the prevalence of metabolic syndrome (MS) according to the criteria of International Diabetes Federation (IDF). In addition, the prevalence of insulin resistance (IR) was investigated to find correlations between MS and IR. IDF definition was compared to a modified WHO definition. A total of 159 obese patients (74 male and 85 female; median age 12.7 years) were included in the study. Anthropometric measurements, blood pressure, and serum fasting lipids were evaluated. An oral glucose tolerance test (OGTT) was performed, and serum glucose and insulin levels were measured at 0, 30, 60, 90, and 120 min. Homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), fasting glucose/insulin ratio (FGIR), Matsuda index, and total insulin levels during OGTT were calculated. For the IR diagnosis, we used cutoff values described in previous publications (HOMA-IR of >3.16, QUICKI of <0.357, FGIR of <7, and/or the sum of insulin levels during OGTT of >300 mIU/mL). MS prevalence, defined according to IDF criteria, was 34.6 %. Using the IDF definition, there was no statistically significant difference for the surrogate IR indices between patients with or without MS (QUICKI, 94.5 vs. 83.7 %), FGIR (81.1 vs. 78.8 %), HOMA-IR (70.9 vs. 63.5 %), and total insulin levels during OGTT (61.8 vs. 51.9 %). The Matsuda index values, the prevalence of fasting hyperinsulinemia, and impaired glucose tolerance were also similar in these two groups. In conclusion, IR was prominent in obese patients with and without MS. IDF definition of MS fails to discover individuals with IR, unless it is specifically investigated.