International Diabetes Federation Diagnostic Criteria Research Articles

Superiority of the triglyceride glucose index over the homeostasis model in predicting metabolic syndrome based on NHANES data analysis

The triglyceride-glucose (TyG) index is a simple and inexpensive new marker of insulin resistance that is being increasingly used for the clinical prediction of metabolic syndrome (MetS). Nevertheless, there are only a few comparative studies on its predictive capacity for MetS versus those using the traditional homeostasis model assessment (HOMA). We conducted a cross-sectional study using a database from the National Health and Nutrition Examination Survey (1999 March to 2020 pre-pandemic period). Using statistical methods, we compared the predictive abilities of the TyG index and HOMA (including HOMA of insulin resistance [HOMA-IR] and HOMA of beta-cell function [HOMA-β]) for MetS. A total of 34,195 participants were enrolled and divided into the MetS group (23.1%) or no MetS group (76.9%) according to the International Diabetes Federation (IDF) diagnostic criteria. After applying weighted data, the baseline characteristics of the population were described. Following the exclusion of medication influences, the final count was 31,304 participants. Receiver operating characteristic curve analysis revealed that while distinguishing between MetS and no MetS, the TyG index had an area under the curve (AUC) of 0.827 (sensitivity = 71.9%, specificity = 80.5%), and the cutoff was 8.75, slightly outperforming HOMA-IR (AUC = 0.784) and HOMA-β (AUC = 0.614) with a significance of P < 0.01. The prevalence of MetS in the total population calculated using the TyG index cutoff value was 30.9%, which was higher than that reported in the IDF diagnostic criteria. Weighted data analysis using univariate and multivariate logistic regression displayed an independent association between elevated TyG and HOMA-IR with the risk of MetS. Subgroup analysis further revealed differences in the predictive ability of the TyG index among adult populations across various genders and ethnicities, whereas such differences were not observed for children and adolescents. The TyG index is slightly better than HOMA in predicting MetS and may identify more patients with MetS; thus, its applications in a clinical setting can be appropriately increased.

#474 Features of the functional state of the kidney in patients with chronic heart failure with metabolic syndrome

Abstract Background and Aims to study the features of the functional state of the kidneys in patients with chronic heart failure with intermediate ejection fraction, depending on the representation of components of metabolic syndrome Method To achieve the objectives, 197 male patients with chronic heart failure (CHF) of ischemic origin II - III functional class (FC) according to NYHA, aged 40-60 years with a history of myocardial infarction of 6 months, were examined. up to 5 years. Depending on the presence of MS components, 3 groups of patients were identified: group I (n = 70), patients without MS (CHF FC II -38, CHF FC III - 32 patients); Group II (n = 67) patients with various combinations of dyslipidemia (HDL-C &amp;lt;1.03 mmol/l; LDL-C &amp;gt;3.0 mmol/l) with AO, hypertension and HTG (CHF FC II -35, CHF FC III - 32 patients); Group III (n = 60) patients with various combinations of dyslipoproteinemia (DLP) and type 2 diabetes mellitus (DM2) with AO, hypertension and HTG (CHF FC II -26, CHF FC III - 34 patients). When diagnosing MS, the International Diabetes Federation diagnostic criteria for MS were used (IDF, 2009). The study of the functional state of the kidneys included determination of the level of serum creatinine, urinary albumin excretion (determination of microalbuminuria (MAU ≥300 mg/l), glomerular filtration rate (GFR), calculated using the GFR EPI formula. Results when studying the parameters of the functional state of the kidneys in patients with CHF HFmrEF group 1, MAU was identified in 10 patients (35.7%) out of 28. Serum creatinine clearance in this group was 89.0 ± 8.49 μmol /l, and the GFR level was 88.58 ± 8.36 ml/min. With the development of MS in group II patients, 16 out of 28 patients had MAU (53.6%). A decrease in GFR was also found by 11.3% ( P &amp;lt; 0.05) with an increase in serum creatinine levels by 12.7% (P &amp;lt; 0.01), in contrast to the data from group I of the study. Further analysis of the parameters of renal function in group III of CHF HFmrEF revealed a significant decrease in GFR (by 23.0%; P &amp;lt; 0.01) with a significant increase in blood creatinine levels (by 21.8%; P &amp;lt; 0.01) in relation to the data Group I. Also in group III of patients with CHF and MS (+DM2 ), microalbuminuria was detected in 24 patients (85.7%) out of 32 . When comparing indicators of renal function between study groups II and III, there was a significant difference in the level of blood creatinine clearance and glomerular filtration rate by 11.3% and 10.1% (P &amp;lt; 0.05), respectively. Conclusion MS in patients with CHF HFmrEF aggravates renal dysfunction, which developed as one of the main pathogenetic links of CHF. Evidence of the importance of MS in the nature of the clinical manifestations of CHF HFmrEF is the established dependence of the identified disorders on the severity of MS.

#472 Cardiorenal relations in patients with chronic heart failure

Abstract Background and Aims To study the functional state of the kidneys and cardiorenal relationships in patients with chronic heart failure, depending on the representation of components of metabolic syndrome Method To achieve the objectives, 227 male patients with chronic heart failure (CHF) of ischemic origin of functional class II-III according to NYHA, aged 40-60 years with a history of myocardial infarction of 6 months, were examined up to 5 years. Depending on the presence of MS components, 3 groups of patients were identified: group I (n=80), patients without MS (CHF FC II—42, CHF FC III—38 patients); Group II (n=77) patients with various combinations of dyslipidemia (HDL-C &amp;lt;1.03 mmol/l; LDL-C &amp;gt;3.0 mmol/l) with abdominal obesity (AO), hypertension and hypertriglyceridemia (HTG) (CHF FC II—40, CHF FC III—37 patients); Group III (n=75) patients with various combinations of dyslipoproteinemia (DLP) and type 2 diabetes mellitus (DM2) with AO, hypertension and hypertriglyceridemia (CHF) (CHF FC II—36, CHF FC III—39 patients). When diagnosing MS, the International Diabetes Federation diagnostic criteria for MS were used (IDF, 2009). The study of the functional state of the kidneys included determination of the level of serum creatinine, urinary albumin excretion (determination of microalbuminuria (MAU ≥300 mg/l) in a single morning urine using indicator strips (Biosensor AN, Russia), glomerular filtration rate (GFR), calculated by the formula GFR EPI, which takes into account race, sex, age, serum creatinine. To calculate GFR using the CKD-EPI formula, you can use special applications for mobile devices (QxMDCalculator). Results When studying the parameters of the functional state of the kidneys in patients with group 1 CHF, 20 patients (25%) out of 80 were diagnosed with MAU. Serum creatinine clearance in this group was 89.0 ± 8.49 μmol/L, and the GFR level was 88.58 ± 8.36 ml/min. With the development of MS in group II patients, 41 out of 77 patients had MAU (53.2%). A decrease in GFR by 19.3% (P&amp;lt;0.01) was also found with an increase in serum creatinine levels by 22.7% (P&amp;lt;0.01), in contrast to the data from group I of the study. Further analysis of the parameters of renal function in CHF group III revealed a significant decrease in GFR (by 29.8%; P&amp;lt;0.001) with a significant increase in blood creatinine levels (by 31.8%; P&amp;lt;0.001) in relation to the data of group I. Also in group III of patients with CHF and MS (+DM2), microalbuminuria was detected in 47 patients (74.6%) out of 75. When comparing indicators of renal function between study groups II and III, there was a significant difference in the level of blood creatinine clearance and glomerular filtration rate by 21.3% and 20.1% (P&amp;lt;0.005), respectively. According to the classification of CKD, in group I of patients with CHF, stage I CKD was detected in 39.3%, in group II in 28.6% and in group III in 19.4%. CKD stage II was detected in group I in 46.4%, in group II in 50% of patients. 46.9% had CKD stage II of the disease in group III of the study. Also, in group II, 21.4% and group III, 43.7% were diagnosed with stage III CKD. V In group I, 35% had a high risk, 53.6% had a moderate and 14.3% had a low combined risk of developing cardiovascular complications in cardiorenal syndrome. Conclusion Thus, MS in patients with CHF aggravates renal dysfunction, which developed as one of the main pathogenetic links of CHF. It has been established that as MS progresses (addition of type 2 diabetes to other components of MS), the phenomena of functional renal failure increase. Violation of the functional state of the kidneys, the severity and nature of this dysfunction depends on the presence and nature of the representation of MS components.

Ceramide Risk Score in the Evaluation of Metabolic Syndrome: An Additional or Substitutive Biochemical Marker in the Clinical Practice?

Ceramide risk score (CERT1, ceramide test 1), based on specific ceramides (Cers) and their corresponding ratios in the plasma, has been reported as a promising biochemical marker for primary and secondary prediction of cardiovascular disease (CVD) risk in different populations of patients. Thus far, limited attention has been paid to metabolic syndrome, a condition considered at high CVD risk. The aim of the present study was to evaluate CERT1 in a group of obese subjects without (OB-MetS-) and with (OB-MetS+) metabolic syndrome (according to the International Diabetes Federation (IDF) diagnostic criteria), compared to an age- and sex-matched normal-weight (NW) group. In all participants, plasma levels of Cer 16:0, Cer 18:0, Cer 24:1, and Cer 24:0 were measured, and the corresponding ratios Cer 16:0/24:0, Cer 18:0/24:0, and Cer 24:1/24:0 were calculated together with CERT1. Subjects with obesity showed higher CERT1 values than the NW group (p < 0.05), with no difference between OB-MetS- and OB-MetS+ groups. Waist circumference (WC), homeostatic model assessment of insulin-resistance (HOMA-IR) (surrogates of IDF diagnostic criteria for metabolic syndrome), and C reactive protein (CRP) (a marker of inflammation) were predictors of CERT1 (p < 0.05), with the contribution of the other IDF criteria such as arterial hypertension and dyslipidemia being negligible. Adjustment for WC resulted in a loss of the difference in CERT1 between OB-MetS- and NW subjects, with the combination of WC and HOMA-IR or CRP as covariates being necessary to yield the same effect for the difference in CERT1 between OB-MetS+ and NW subjects. Importantly, an association was found between CERT1 and vascular age (VA) (p < 0.05). Proportions of NW, OB-MetS- and OB-MetS+ subjects appeared to be distributed according to the CERT1-based risk groups (i.e., low, moderate, increased, and high risk; p < 0.05), with some OB-MetS- subjects included in the increased/high-risk group and some OB-MetS+ in the low/moderate-risk one. In conclusion, the clinical diagnosis of metabolic syndrome seems to be inaccurate to assess CVD risk in the obese population; however, further studies are needed before considering CERT1 as an additional or substitutive biochemical marker in clinical practice.

Identification of a Specific Plasma Sphingolipid Profile in a Group of Normal-Weight and Obese Subjects: A Novel Approach for a "Biochemical" Diagnosis of Metabolic Syndrome?

Metabolic syndrome is nosographically defined by using clinical diagnostic criteria such as those of the International Diabetes Federation (IDF) ones, including visceral adiposity, blood hypertension, insulin resistance and dyslipidemia. Due to the pathophysiological implications of the cardiometabolic risk of the obese subject, sphingolipids, measured in the plasma, might be used to biochemically support the diagnosis of metabolic syndrome. A total of 84 participants, including normal-weight (NW) and obese subjects without (OB-SIMET-) and with (OB-SIMET+) metabolic syndrome, were included in the study, and sphingolipidomics, including ceramides (Cer), dihydroceramides (DHCer), hexosyl-ceramides (HexCer), lactosyl-ceramides (LacCer), sphingomyelins (SM) and GM3 ganglosides families, and sphingosine-1-phosphate (S1P) and its congeners, was performed in plasma. Only total DHCers and S1P were significantly higher in OB-SIMET+ than NW subjects (p < 0.05), while total Cers decreased in both obese groups, though statistical significance was reached only in OB-SIMET- (vs. NW) subjects (p < 0.05). When considering the comparisons of the single sphingolipid species in the obese groups (OB-SIMET- or OB-SIMET+) vs. NW subjects, Cer 24:0 was significantly decreased (p < 0.05), while Cer 24:1, DHCer 16:0, 18:0, 18:1 and 24:1, and SM 18:0, 18:1 and 24:1 were significantly increased (p < 0.05). Furthermore, taking into account the same groups for comparison, HexCer 22:0 and 24:0, and GM3 22:0 and 24:0 were significantly decreased (p < 0.05), while HexCer 24:1 and S1P were significantly increased (p < 0.05). After having analyzed all data via a PLS-DA-based approach, the subsequent determination of the VIP scores evidenced the existence of a specific cluster of 15 sphingolipids endowed with a high discriminating performance (i.e., VIP score > 1.0) among the three groups, including DHCer 18:0, DHCer 24:1, Cer 18:0, HexCer 22:0, GM3 24:0, Cer C24:1, SM 18:1, SM 18:0, DHCer 18:1, HexCer 24:0, SM 24:1, S1P, SM 16:0, HexCer 24:1 and LacCer 22:0. After having run a series of multiple linear regressions, modeled by inserting each sphingolipid having a VIP score > 1.0 as a dependent variable, and waist circumference (WC), systolic/diastolic blood pressures (SBP/DBP), homeostasis model assessment-estimated insulin resistance (HOMA-IR), high-density lipoprotein (HDL), triglycerides (TG) (surrogates of IDF criteria) and C-reactive protein (CRP) (a marker of inflammation) as independent variables, WC was significantly associated with DHCer 18:0, DHCer 24:1, Cer 18:0, HexCer 22:0, Cer 24:1, SM 18:1, and LacCer 22:0 (p < 0.05); SBP with Cer 18:0, Cer 24:1, and SM 18:0 (p < 0.05); HOMA-IR with DHCer 18:0, DHCer 24:1, Cer 18:0, Cer 24:1, SM 18:1, and SM 18:0 (p < 0.05); HDL with HexCer 22:0, and HexCer 24:0 (p < 0.05); TG with DHCer 18:1, DHCer 24:1, SM 18:1, and SM 16:0 (p < 0.05); CRP with DHCer 18:1, and SP1 (p < 0.05). In conclusion, a cluster of 15 sphingolipid species is able to discriminate, with high performance, NW, OB-SIMET- and OB-SIMET+ groups. Although (surrogates of) the IDF diagnostic criteria seem to predict only partially, but congruently, the observed sphingolipid signature, sphingolipidomics might represent a promising "biochemical" support for the clinical diagnosis of metabolic syndrome.

Sociodemographic and lifestyle factors and the risk of metabolic syndrome in taxi drivers: A focus on street food.

In South Africa, similar to other populous countries, the taxi industry is an important form of transportation that contributes to the country's development. As a result, minibus taxi driving is an occupation characterized by strenuous activities such as long hours of driving, limited rest, and challenges related to securing passengers, among several others. Consequently, to combat stress, some commercial drivers resort to smoking, overeating unhealthy food sold at transportation interchange areas (i.e., taxi ranks), and participating in sedentary behaviors. Most of these activities are risk factors for metabolic syndrome (MetS). Therefore, this study aimed to investigate the sociodemographic and lifestyle factors that predispose South African taxi drivers who work in the Cape Town Metropole area to the risk of developing MetS. This cross-sectional study used a convenient sampling method that included 185 male minibus taxi drivers aged 20 years or above. The participants were interviewed using a validated questionnaire to gather information regarding their sociodemographic characteristics and lifestyle practices. They also underwent physical and metabolic assessments, and the International Diabetes Federation (IDF) criteria were used to diagnose people with MetS. Overall, the mean age and driving experience of the taxi drivers were 40.0 years (SD: 10.7) and 9.1 years (SD: 7.4), respectively, with those with MetS being significantly older and having more driving experience than those without. Older participants were 3 and 2.9 times more likely to be diagnosed with MetS than the younger participants. Most taxi drivers (70%) met the IDF diagnostic criteria for MetS. Smokers, those who spent more than 100 ZAR (USD 5.9) and those who spent less than 1.4 MET-minutes per week on physical activity were 1.96, 2.0, and 13.6 times more likely to suffer from MetS that those who were nonsmokers, those who spent less than 100 ZAR and those who spent <1.4 MET-minutes per week on physical activity. Consumption of alcohol and sugar-sweetened beverages (SSBs), as well as takeaway and fried foods, snacks, and sold by the SF vendors, increased the likelihood of developing MetS, abnormal HDL-C, TG, and hypertension, while avoiding takeaway and fried foods decreased this likelihood. Taxi drivers who also avoided consuming fresh fruits had abnormal HDL-C. These findings have significant public health implications, highlighting the need for South African policymakers to adopt a system-level approach to promote lifestyle changes among taxi drivers within the taxi industry. This can help reduce the health risks faced by these drivers and improve their overall health profile.

Serum Trimethylamine N-Oxide Levels Correlate with Metabolic Syndrome in Coronary Artery Disease Patients.

Trimethylamine N-oxide (TMAO) is a gut microbial metabolite that affects atherogenesis and glucose dysregulation. The purpose of this study was to look at the link between blood TMAO levels and metabolic syndrome (MetS) in individuals with coronary artery disease (CAD). Blood samples were obtained in fasting status, and serum TMAO level was quantified by high-performance liquid chromatography–mass spectrometry. MetS and its components were defined according to the International Diabetes Federation diagnostic criteria. Of 92 enrolled patients, 51 (55.4%) had MetS. Patients with MetS had a greater proportion of hypertension and diabetes mellitus, higher body weight, waist circumference, body mass index, systolic blood pressure, fasting glucose, triglycerides, blood urea nitrogen, creatinine, C-reactive protein (CRP), insulin level, homeostasis model assessment of insulin resistance, and TMAO level. Multivariable logistic regression models revealed that TMAO level (odds ratio: 1.036, 95% confidence interval: 1.005–1.067, p = 0.023) could be an effective predictor of MetS among the CAD population. In these patients, the log-TMAO level was positively associated with log-CRP (β = 0.274, p = 0.001) and negatively associated with eGFR (β = −0.235, p = 0.022). In conclusion, our study revealed a positive association between serum TMAO level and MetS among patients with CAD.

The association between vitamin D deficiency and metabolic syndrome in Ukrainian adolescents with overweight and obesity.

PurposeThis work aims to determine the association between vitamin D deficiency and metabolic syndrome in overweight and obese adolescents from Ukraine.MethodsAnthropometric measurements were taken and general and biochemical examinations were performed on 136 obese and overweight adolescents and 60 adolescents with normal body weight. The vitamin D status was determined using 25-hydroxyvitamin D (25(OH)D) (calcidiol) levels in blood serum. To establish the factors influencing vitamin D status, the subjects were asked to answer a questionnaire and 2007 International Diabetes Federation diagnostic criteria were used to determine the incidence of metabolic syndrome. All research results were processed statistically.ResultsA calcidiol sufficiency level was found in 3.9% of obese adolescents and 6.7% of overweight adolescents. Metabolic syndrome was found in 64.4% of obese adolescents with vitamin D deficiency, and in 26.2% of overweight adolescents. Factors associated with an increased risk of developing vitamin D deficiency in adolescents with metabolic syndrome included male sex (P=0.042), low income per family member (P=0.040), daily milk consumption of up to 1 cup per day (P=0.001), physical activity (P=0.001), duration of outdoor stays (P=0.001), and passive rest in front of a computer or television (P=0.001). Adolescents with metabolic syndrome were found predominance of body mass index (P<0.001), waist circumference (P<0.001), fasting blood glucose level (P<0.001), and decreased calcidiol level (P=0.022). Among metabolic syndrome components, vitamin D deficiency was strongly associated with waist circumference and increased fasting blood glucose (P<0.05).ConclusionsVitamin D deficiency is prevalent in overweight and obese adolescents from Ukraine. Vitamin D deficiency is associated with metabolic syndrome criteria in overweight and obese adolescents.

Kadınlarda metabolik sendromun uyku ve yaşam kalitesi üzerine etkisi

Purpose: This study was conducted to determine the metabolic syndrome prevalence in women and evaluate its effect on the quality of life and sleep.&#x0D; Materials and Methods: This descriptive and cross-sectional study was completed with 372 women. Data were collected using a descriptive questionnaire, the Pittsburgh Sleep Quality Index, and the SF 36 Quality of Life Scale..&#x0D; Results: The metabolic syndrome prevalence in women was 41.9%, according to the International Diabetes Federation diagnostic criteria. The mean scores obtained from the sleep quality index by those with metabolic syndrome were significantly higher than those without metabolic syndrome. The median scores obtained from the physical function and role difficulty, pain, general health perception, and mental summary sub-dimensions of the SF-36 quality of life scale by the women who were found to have metabolic syndrome were lower than those without metabolic syndrome.&#x0D; Conclusion: Metabolic syndrome was found to be common in women and to affect the quality of life and sleep negatively in women in this study. We, therefore, recommend women to be evaluated in terms of metabolic syndrome at regular intervals and healthcare professionals to provide training and consultancy services to promote healthy living behaviors that could improve their quality of life and sleep.

Metabolic Syndrome in Women Who Have Polycystic Ovary Syndrome Related Infertility

Objective: The aim of the present study was to determine the prevalence of metabolic syndrome (MS) in infertile Mongolian women with polycystic ovary syndrome (PCOS) using the International Diabetes Federation (IDF) criteria. Methods: We used the case control retrospective study designs. Total 1340 infertile women enrolled in this study. Among the women, 114 were found with PCOS by Rotterdam’s criteria at the Infertility and reproductive department, National Center for Maternal and Child Health, between December 2018 and 2019. The IDF diagnostic criteria for metabolic syndrome (MS) was used. The PCOS patients were divided into the following groups: (1) cases (with MS, n = 42) and (2) controls (without MS, n = 72). Results: The average age, body mass index (BMI), and duration of infertility were 28.7 ± 4.1 years, 27.3 ± 5.2 kg/m² and 4.4 ± 3.1y, respectively. Among the patients 57.9% of them had oligomenorrhea, 22.8% had amenorrhea, 57.0% had primary infertility, 51.9% had hirsutism and 50.8% had acne. As a result of hormone assays, LH was 9.3±3.5mIU/ml, LH/FSH ratio was 1.6 ± 0.83 [0.1-3.6], and AMH was 6.1ng/ml ± 3.6 [2.9 - 21.0]. The prevalence of MS was 36.8%. The variables which include age (30.9 ± 4.9), body mass (75.9 ± 11.6kg), and also some metabolic parameters such as hypertension (133.6/88.4 ± 13.6 mm Hg), WC (94.1 ± 8.6 cm) and high triglyceride (1.8 ± 1.0 mmol/l) were observed in the MS group and compared to the without MS group. Conclusions: We found out that the prevalence of metabolic syndrome was 36.8% among infertile women with PCOS. Age, BMI, WC, amenorrhea, acne, and acanthosis nigricans were highly related to metabolic syndrome.

Association of Diet Quality and Food Insecurity with Metabolic Syndrome in Obese Adults.

Background:The link between diet quality, food insecurity (FI), and metabolic syndrome (MetS) remains unclear in obese adults. The aim of this study was to examine the association of diet quality and FI with MetS in obese Iranian adults.Methods:This cross-sectional study was conducted on 300 obese adults. Dietary intake was assessed using a validated 168-item food frequency questionnaire. Diet quality and FI were measured using the Diet Quality Index-International (DQI-I) and an adapted USDA2000 household food security status questionnaire, respectively. MetS was defined according to the International Diabetes Federation diagnostic criteria. Association was determined using logistic regression analysis adjusting for potential confounders.Results:MetS subjects had lower DQI-I score than subjects without MetS (67.5 ± 8.7 vs 71.5 ± 7.4, P = 0.05). The prevalence of food insecurity was 48.6% (95% confidence interval (CI): 41.2, 56.1) in MetS subjects and 39.4% (95% CI: 29.4, 49.9) in subjects without MetS. After adjustment, participants in the fourth quartile of DQI-I score had 70% lower odds of MetS (Adjusted odds ratio [AOR], 0.3; 95% CI: 0.1–0.7), 70% lower odds of hypertriglyceridemia (AOR, 0.3; 95% CI: 0.2–0.7) and 60% lower risk of reduced high-density lipoprotein [HDL] (AOR, 0.4; 95% CI: 0.2–0.9) compared with the first quartile. Obese food insecure adults had 60% higher odds of high blood pressure (AOR, 1.6; 95% CI: 1.0–2.6) and 70% higher odds of hypertriglyceridemia (AOR, 1.7; 95% CI: 1.0–2.8) compared with food-secure obese adults. There was no statistically significant interaction observed between DQI-I and food insecurity on MetS.Conclusions:Lower DQI-I score and food insecurity were associated with an increased risk of MetS and some features such as hypertriglyceridemia, reduced HDL, and high blood pressure in obese Iranian adults.

Risk of metabolic syndrome in patients with lichen planus: A systematic review and meta-analysis.

Studies have investigated whether patients with lichen planus are at a high risk of metabolic syndrome; however, currently, no conclusive data are available in this regard. This meta-analysis was performed to analyze the published literature investigating the association between metabolic syndrome and lichen planus. Two reviewers independently searched 4 databases (PubMed, Embase, the Cochrane Library and Web of Science) for observational studies assessing the prevalence of metabolic syndrome in patients with lichen planus. Review Manager 5.3 software was used to statistically analyze the data. 200 relevant articles were searched. After a further reading, 12 studies with 1422 participants (715 with LP and 707 controls) fulfilled the eligibility criteria. Overall, the pooled odds ratio based on random effects analysis was 2.81 (95% confidence interval: 1.79-4.41, P<0.00001). This meta-analysis shows that compared with the general population, patients with lichen planus are more likely to develop metabolic syndrome. Subgroup analysis of prevalence of metabolic syndrome showed higher odds ratio in studies using International Diabetes Federation diagnostic criteria (odds ratio 4.65) and the Harmonized criteria (odds ratio 26.62) than studies using National Cholesterol Education Program Adult Treatment Panel III criteria (odds ratio 1.75), and thus might be more appropriate for diagnosing metabolic syndrome. This meta-analysis shows that compared with the general population, patients with lichen planus are more likely to develop metabolic syndrome. Therefore, early diagnosis and prompt initiation of first-line therapy for metabolic disorders are important in patients with lichen planus.

A Comparative Assessment of Metabolic Syndrome and its Association with Vitamin D and Other Risk Factors in Type 2 Diabetes Mellitus Patients.

To determine the overall prevalence of metabolic syndrome using the World Health Organization (WHO); National Cholesterol Education Program (NCEP), and the International Diabetes Federation (IDF) guidelines and to study its association with vitamin D and other biochemical parameters in patients with type 2 Diabetes mellitus, as well as to identify the set of biochemical parameters that jointly influence the metabolic syndrome using different diagnostic criteria. A cross-sectional study was carried out at a private health care center in -a total of 291 diabetic patients. Socio-demographic, clinical, and laboratory data were obtained from the medical records of patients. Statistical analysis was carried out using the Statistical Package for the Social Sciences (SPSS, version 23). A total number of 291 patients with T2DM were included in this study. The overall prevalence of metabolic syndrome among the study subjects was 48.1%, 87.3%, 64.9% using the WHO, IDF, and NCEP-ATPIII criteria, respectively. The highest prevalence was reported following IDF diagnostic criteria. Sex, triglyceride, and fasting blood sugar were associated factors of metabolic syndrome by all the three diagnostic criteria of metabolic syndrome. The study revealed a high prevalence rate of metabolic syndrome among type 2 diabetic patients, which was highest at 87.3% according to IDF and lowest was observed according to the WHO criteria i.e, 48.1%. A significant variance in the prevalence of metabolic syndrome was reported between WHO, IDF, and NCEP criteria.

Prevalence of the Metabolic Syndrome in the Yan-an Region of Northwest China

To evaluate the prevalence of the metabolic syndrome in a sample population from northwest China, and to determine the optimal cut-off point for waist circumference for diagnosing the metabolic syndrome in this population. A total of 1290 residents of the Yan-an region of China completed a cross-sectional survey, physical examination and laboratory tests. The International Diabetes Federation (IDF), Chinese Diabetes Society (CDS), and the National Cholesterol Education Program Adults Treatment Panel-III (NCEP-ATPIII) criteria were used to assess the prevalence of the metabolic syndrome and its relationship with age and gender. According to the NCEP-ATPIII, CDS and IDF diagnostic criteria, the prevalence of the metabolic syndrome was 15.8%, 20.4% and 26.4%, respectively. The optimal cut-off point for waist circumference was ≥ 86.5 cm for men and ≥ 80.5 cm for women. The prevalence of the metabolic syndrome in the Yan-an region was significantly higher than that in other regions of China, and participants with the metabolic syndrome were much younger than those in other Chinese regions.

National Cholesterol Educational Program and International Diabetes Federation diagnostic criteria for metabolic syndrome in an Italian cohort: Results from the FIBAR Study

The adoption of the International Diabetes Federation (IDF) criteria for metabolic syndrome (MS), in comparison with the National Cholesterol Educational Program (NCEP) criteria, produces different changes in estimates of prevalence in diverse populations. Few data are available in Caucasian non-diabetic subjects. The prevalence of NCEP- and IDF-defined MS was assessed in a sample of 2,945 individuals, aged 55.2+/-11.5 yr, enrolled in a screening program for diabetes. Association of different definitions of MS with glucose intolerance (120-min glucose 7.8 mmol/l after a 75 g-oral glucose load) and hyperuricemia (>0.38 mmol/l) was also assessed. The prevalence of MS was 16.6% and 29.7% with NCEP and IDF definitions, respectively. The prevalence of NCEP-defined MS was higher than IDF-MS through all age ranges; among those aged >60 yr, the prevalence of IDF-MS reached 52.8% (vs 33.1% for NCEP-MS). Both NCEP- and IDF-MS were associated with glucose intolerance and hyperuricemia. Individuals fulfilling IDF, but not NCEP criteria for MS, showed a prevalence of glucose intolerance (22.7%) significantly (p<0.05) lower than those fulfilling NCEP criteria only (31.6%) or both sets of criteria (31.8%). In Caucasian subjects without known diabetes, IDF criteria produce a relevant increase in estimates of prevalence of MS, particularly in older subjects, when compared with NCEP criteria. NCEP-MS seems to be more effective than IDF-MS in the identification of glucose intolerant subjects.

The Metabolic Syndrome Is a Risk Indicator of Microvascular and Macrovascular Complications in Diabetes

We aimed at assessing the degree of association and the predictive power of the metabolic syndrome with regard to clinically detectable complications in patients with diabetes. Metascreen is a cross-sectional survey of metabolic syndrome and clinically detected diabetes complications performed in 8,497 patients (7,859 with type 2 diabetes and 638 with type 1 diabetes) randomly chosen in 176 diabetes outpatient clinics throughout Italy. The metabolic syndrome was defined according to either the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) or the International Diabetes Federation (IDF) diagnostic criteria. Multivariate analyses of the association(s) between either AHA/NHLBI or IDF metabolic syndrome and clinical complications were performed. Receiver-operator characteristic (ROC) curves were constructed to compare the predictive power of the two sets of diagnostic criteria of the metabolic syndrome. Either definition of the metabolic syndrome was an independent statistical indicator of the presence of nephropathy and neuropathy (P < 0.02-0.01) in type 1 diabetes and of all complications (P < 0.0001), including cardiovascular disease and retinopathy, in type 2 diabetes. For each complication, the ROC curves based on either AHA/NHLBI or IDF metabolic syndrome were similar to each other and to the ROC curves constructed with all continuous traits compounding the metabolic syndrome. The metabolic syndrome, defined according to AHA/NHLBI or IDF diagnostic criteria, is an independent clinical indicator and may be involved in the pathogenesis of both macro- and microvascular complications of diabetes.