International Diabetes Federation Metabolic Syndrome Research Articles

Handgrip Strength Cutoff Value Among Korean Adolescents with Metabolic Syndrome Components: Korean National Health and Nutrition Examination Survey Data 2014-2017.

Abstract Objectives: To propose the cutoff value of handgrip strength (HGS) for each metabolic syndrome component in Korean adolescents. Methods: Total of 2303 adolescents (1226 boys and 1077 girls; age 10-18 years) who participated in the Korea National Health and Nutrition Examination Survey from 2014 to 2017. We used the International Diabetes Federation metabolic syndrome guideline for children to define metabolic syndrome. The highest HGS for both hands were recorded. The optimal HGS cutoff for predicting metabolic syndrome components was determined by receiver operating characteristic curve analysis. Results: Adolescents with metabolic syndrome components defined by each criterion had higher HGS, systolic blood pressure, waist circumference, body mass index, fasting glucose, cholesterol, triglyceride (TG), alanine aminotransferase, and aspartate aminotransferase compared with average participants' data. The cutoff value of HGS defining waist circumference, TG level, high-density lipoprotein, and blood pressure was 24, 21.5, 30.9, and 30.2, respectively. The cutoff value of HGS defining metabolic syndrome was 28.9. For HGS to body weight ratio, the cutoff value defining metabolic syndrome was 0.38. Conclusions: This study showed that cutoff values of HGS have relation with metabolic syndrome in adolescents. Although cutoff has been suggested, it may not be sufficient for clinical use. Additional data are need to be accumulated in actual clinical trials for more accurate cutoff HGS value.

Comparison of Inflammatory Markers in the Diagnosis of Metabolic Syndrome in Hemodialysis Patients: A Multicenter Observational Study

ObjectiveThe purpose of this study is to observe the correlation between high sensitivity C-reactive protein (hs-CRP) and metabolic syndrome (MetS) in hemodialysis patients, determine its optimal cut-off point value, and compare the diagnostic ability of different inflammatory markers for MetS.MethodsThis cross-sectional study finally included 860 long-term hemodialysis patients (male 524, average age 61.5 years) from seven dialysis centers in Shanghai, China. The International Diabetes Federation metabolic syndrome guidelines were used to define MetS, including high waist circumference, elevated blood pressure, elevated fasting blood glucose, elevated triglycerides, and reduced HDL cholesterol. Serum hs-CRP was determined by the immunonephelometric assay. The association with MetS was observed according to the quartile of inflammatory markers, and then the optimal cut-off point value of the hs-CRP was determined by ROC analysis.ResultsThe overall prevalence of MetS was 55.1% (46.6% in males and 68.5% in females). In the final logistic regression model, there was a significant, graded positive association between hs-CRP and MetS (p for trend = 0.010). The traditional inflammatory markers leukocytes, neutrophils, lymphocytes, monocytes and neutrophil-to-lymphocyte ratio (NLR) were not associated with MetS. The results of the ROC analysis showed that the optimal cut point value of hs-CRP for the diagnosis of MetS was 1.58 mg/L. In the components of MetS and hs-CRP was significantly positively associated with high waist circumference, elevated TG and low HDL (p < 0.05).ConclusionThe increase in hs-CRP concentration is significantly associated with the risk of MetS, and the diagnostic ability of hs-CRP for MetS is better than traditional inflammatory markers.

Acrochordon as a marker of metabolic syndrome – A cross-sectional study from South India

Objectives: To determine the association of acrochordons with metabolic syndrome and its components. Materials and Methods: A cross-sectional study was conducted in 100 patients with acrochordon and 100 age- and gender-matched controls who attended the dermatology outpatient department of a tertiary care center in South India from January 2017 to December 2017. A detailed dermatological examination was carried out in cases with respect to distribution, number, color, and morphology of acrochordons. Blood pressure (BP), pulse rate, waist circumference, height, weight, and body mass index were recorded in all cases and controls. Fasting lipid profile, fasting blood sugar, liver function test, and renal function test were done in all study participants. A diagnosis of metabolic syndrome was made based on the International Diabetes Federation metabolic syndrome worldwide definition specified for the Asian population. Statistical analysis was done using Pearson’s Chi-square test. Results: There were 52 females and 48 males in each group. About 80% of patients belonged to the age group of 20–50 years. A significantly higher number of cases had metabolic syndrome (P &lt; 0.001). Acrochordons showed a significant association with the components of metabolic syndrome such as high BP (P &lt; 0.001), high fasting plasma glucose levels (P &lt; 0.001), and low levels of high-density lipoprotein cholesterol (P = 0.04). Comparison of cases showed that patients with acrochordons limited to axilla were less likely to have metabolic syndrome in comparison to those who had acrochordons on other body sites with or without involvement of axilla (P = 0.008). Patients who manifested only sessile lesions were less likely to have metabolic syndrome when compared to those who manifested pedunculated/filiform/pedunculated and filiform lesions (P &lt; 0.001). Limitations: A cross-sectional study design and study carried out in a tertiary referral center were the limitations. Conclusion: A significant association was noted between acrochordons and metabolic syndrome.

Impact of excluding hyperglycemia from international diabetes federation metabolic syndrome diagnostic criteria on prevalence of the syndrome and its association with microvascular complications, in adult patients with type 1 diabetes.

We aimed to determine, in patients with type 1 diabetes (T1DM), the impact of excluding hyperglycemia as a criterion from the International Diabetes Federation (IDF) definition of the metabolic syndrome (MetS), both on its prevalence and on its association with micro and macrovascular complications and markers of subclinical inflammation. A cross-sectional design, including 280 patients with T1DM. We defined MetS by three different models: (i) the standard IDF criteria, (ii) a modification consisting of excluding of hyperglycemia as a criterion (modified IDF criteria) and (iii) a modification consisting in changing the hyperglycemia by insulin resistance (MetS + IR model) defined by the estimated glucose disposal rate. Microvascular complications and cardioautonomic neuropathy were assessed. We measured an inflammatory panel including high sensitivity C reactive protein, erythrocyte sedimentation rate, homocysteine, and fibrinogen concentrations. After excluding hyperglycemia, the prevalence of MetS was 6.4% (95%CI: 4.1 to 9.9) compared with 20.7% (95%CI: 16.3 to 25.8) using standard IDF criteria. After adjusting for duration of diabetes, all three MetS definitions increased the odds for having microvascular complications [OR: 6.012 (2.208-16.307) for modified definition; OR: 5.176 (2.555-10.486) for standard definition and [OR: 3.374 (1.649-8.456) for MetS+IR model]. However, the both modified IDF models for MetS showed better predictive performance than standard criteria for suffering from neuropathy, nephropathy, cardiovascular disease and were associated with markers of subclinical inflammation. The prevalence of MetS significantly varies as a function whether or not hyperglycemia is included as a diagnostic criterion. The subset of patients fulfilling the modified MetS definitions may reflect better the concept of metabolic syndrome in T1DM. These modified definitions were accompanied by a poorer metabolic control and lipid profile, showing the worse inflammatory biomarker profiles and higher odds for micro- and macrovascular complications. In patients with T1DM, the inclusion of insulin resistance instead of hyperglycemia as a criterion of MetS may be of interest in routine clinical practice.

Association between Sleep Duration and Mild Cognitive Impairment at Different Levels of Metabolic Disease in Community-Dwelling Older Chinese Adults.

The purpose of this study was to investigate the relationship between metabolic syndrome (MetS), sleep duration and mild cognitive impairment (MCI) in community-dwelling older Chinese adults. The study comprised of 1367 community-dwelling Chinese participants (563 men; mean age: 71.0 years) recruited from Tianjin and Shanghai, China who were invited to participate in a comprehensive geriatric assessment. The International Diabetes Federation metabolic syndrome guidelines were used to define MetS. The Mini-Mental State Examination (MMSE) and the Instrumental Activities of Daily Living (IADL) scale were used for the initial classification of patients with MCI. We divided sleep duration into five groups (≤6 h, 6-8 h which was used as the reference, 8-9 h, 9-10 h, and >10 h). Nutritional status was assessed by Mini Nutrition Assessment Short Form. The overall incidence of metabolic syndrome was 46.7%, the overall incidence of mild cognitive impairment was 17.4%. In logistic regression analysis model, after adjusting for multiple confounding factors such as nutritional status and physical activity level, there was a significant positive association between long sleep duration (> 10h) and mild cognitive impairment in general population and metabolic syndrome population (p<0.05), but the association was not significant in non-metabolic syndrome group. In addition, in the long sleep duration group, the components of metabolic syndrome, elevated blood glucose were significantly associated with mild cognitive impairment (p<0.05). Long sleep duration was significantly associated with increased risk of MCI in older adults with MetS, but not in those without MetS. The prevention of MCI may be more effective in the population of MetS with long sleep duration.

Muscle mass rather than muscle strength or physical performance is associated with metabolic syndrome in community-dwelling older Chinese adults

ObjectiveThe purpose of this study was to examine whether muscle mass, muscle strength, and physical performance were associated with metabolic syndrome (MetS) in community-dwelling older Chinese adults.MethodsThe study comprised of 1413 community-dwelling Chinese participants (577 men; mean ± standard deviation age: 71.3 ± 5.9) recruited from Tianjin and Shanghai, China who were invited to participate in a comprehensive geriatric assessment. The International Diabetes Federation metabolic syndrome guidelines were used to define MetS, including high waist circumference, elevated blood pressure, elevated fasting blood glucose, elevated triglycerides, and reduced HDL cholesterol. Muscle mass was measured by appendicular skeletal muscle mass/weight (ASM/weight), and ASM was measured by BIA. Muscle strength was measured using grip strength. Physical performance was represented by walking speed and the time up and go test (TUGT).ResultsThe overall prevalence of MetS was 46.8% (34.1% in males and 55.5% in females). In the final logistic regression model, there was a significant, graded inverse association between muscle mass and MetS (p for trend = 0.014). Muscle strength and physical performance, including walking speed and TUGT, were not associated with overall MetS. In the components of MetS, muscle mass and grip strength were significantly inversely associated with high waist circumference and elevated blood pressure (p < 0.05), while physical performance was not associated with components of MetS.ConclusionsCompared with muscle strength and muscle function, muscle mass was inversely associated with MetS in a community-dwelling elderly Chinese population. Among muscle mass、muscle strength and physical performance, muscle mass appears to have the strongest association with MetS in the elderly.

Clinical relevance of different handgrip strength indexes and metabolic syndrome in Chinese community-dwelling elderly individuals

PurposeCurrently there is no consensus on the correlation between metabolic syndrome (MetS) and muscle strength. The objective of this study was to examine the associations between MetS and its components and different handgrip strength (HS) indexes among Chinese community-dwelling elderly individuals. In addition, we hoped to find an optimal cutoff point for the index most relevant to MetS. MethodsData were obtained from 909 participants aged ≥ 60 years (385 men, average age, 68.0 ± 5.9 y). We used the International Diabetes Federation metabolic syndrome guidelines to define MetS. General data of all participants were collected through questionnaires and anthropometric data were measured. At the same time, blood samples were collected. ResultsThe prevalence of MetS was 26.8 % in men and 46.9 % in women. In all HS indexes, HS/body fat mass was most strongly correlated with MetS, and the areas under the receiver-operating characteristic curve were 0.723 (95 % confidence interval [CI] = 0.669-0.776) in men and 0.619 (95 % CI = 0.571-0.667) in women, and the optimal cutoffs were 1.92 in men and 1.25 in women. The adjusted odds ratios (ORs) of MetS for low HS/body fat mass were 5.38 (95 % CI = 3.03–9.56, p < 0.001) in men and 2.39 (95 % CI = 1.56–3.64, p < 0.001) in women. ConclusionsHS/body fat mass appears to be the index best associated with MetS and its components, and in men it is more relevant than in women.

A Tale of Three Gorges in the Yangtze River: Comparing the Prevalence of Metabolic Syndrome According to ATPIII, WHO, and IDF Criteria and the Association with Vascular Health in Modernizing China.

Metabolic syndrome (MS) is associated with atherosclerotic diseases. The prevalence of MS according to the Adult Treatment Panel III (ATPIII), World Health Organization (WHO), and International Diabetes Federation (IDF) criteria are variable but increasing in western countries and modernizing China. This study aimed to evaluate the prevalence of MS according to these three criteria, in farmers or ex-farming residents in three-gorges territories undergoing rapid lifestyle changes. We compared 95 residents (ex-farmers) in Wu Shan (WS) (28.4% men, aged 49.7 ± 9 years) resettled uphill for 3-5 years, and 87 age- and gender-matched farmers in Da Chang (DC) (27.6% men, aged 48.8 ± 10 years) before migration. MS and other traditional risk factors were assessed and carotid intima-media thickness (IMT) measured. Ninety-nine percent of WS residents were retired or adopted nonfarming jobs. Compared with DC farmers, WS ex-farmers had higher waist circumference, low density lipoprotein-cholesterol, and triglycerides (P < 0.0001), but their blood pressures, HDL-cholesterol, and fasting glucose were similar. MS were identified in 43.2% (IDF), 36.8% (WHO), and 29.5% (ATPIII) respectively in WS ex-farmers, compared with 17.2%, 13.8%, and 11.5% respectively in DC farmers. Carotid IMT was significantly higher in WS ex-farmers (0.74 ± 0.16 mm) than in DC farmers (0.64 ± 0.11 mm) (P < 0.0001). On multivariate regression analysis, prevalence of MS was correlated with job nature (beta = 0.425, P < 0.0001). Carotid IMT was better correlated with IDF MS criteria (beta = 0.208, P = 0.021), independent of age and WS location (regression adjusted R2 = 0.444, F-value 12.0, P < 0.0001), but not with the ATPIII or WHO criteria. IDF MS criteria is more sensitive, better correlates with atherosclerosis surrogate, and accordingly is more readily applicable to modernizing China.

Handgrip Strength Among Korean Adolescents With Metabolic Syndrome in 2014–2015

The prevalence of metabolic syndrome is increasing worldwide in adolescents. Metabolic syndrome is a systemic disease that is likely to be associated with other diseases. Studies have shown a relationship between muscle strength, muscle quality, and metabolic syndrome. Handgrip strength is known as a simple tool to measure muscle strength. Therefore, we aimed to investigate the relationship between handgrip strength and metabolic syndrome and each metabolic syndrome features in adolescents. Data were obtained from 1050 adolescents (574 boys, 476 girls; age 10–18 years) who participated in the Korea National Health and Nutrition Examination Survey. We used the International Diabetes Federation metabolic syndrome guideline and National Cholesterol Education Program Adult Treatment Panel III guideline for children to define metabolic syndrome. The highest handgrip strength for both hands was recorded. Handgrip strength was also divided by the participants’ own weight (handgrip-to-weight ratio). Adolescents with metabolic syndrome defined by each guideline have higher handgrip strength (p < 0.05). When handgrip strength was divided with participants’ own body weight (handgrip-to-weight ratio), values were decreased in participants with metabolic syndrome (p < 0.05). The male participants tend to have higher handgrip-to-weight ratio than female. However, the handgrip-to-weight ratio was found to be decreased regardless of gender when the metabolic syndrome feature was present. This study shows that handgrip strength is associated with metabolic syndrome in adolescents. This is the first study to compare handgrip strength and metabolic syndrome in Korean adolescents. Given that handgrip strength is associated with metabolic syndrome in adolescents, it can be a diagnostic modality to easily identify the patients’ current state in the clinic.

Normal serum alanine aminotransferase and non-alcoholic fatty liver disease among Korean adolescents: a cross-sectional study using data from KNHANES 2010\u20132015

BackgroundNon-alcoholic fatty liver disease (NAFLD) is complicated disease and increasing worldwide. Previously, many studies of NALFD prevalences have used alanine aminotransferase (ALT) of > 40 U/L to define NAFLD, although that is too high to be reliable among adolescents. This study aimed to define the upper normal limit of ALT among Korean adolescents, and use it to estimate the prevalence of NAFLD, based on data from the Korea National Health and Nutrition Examination Survey (KNHANES).MethodsData were obtained from 1785 healthy adolescents (916 boys and 869 girls, 10–18 years old) who participated in the KNHANES during 2010–2015. The International Diabetes Federation metabolic syndrome criteria for adolescents were used to exclude participants with metabolic syndrome components. Furthermore, participants who previously had diseases related to low HDL levels, high TG levels, diabetes, or very low/high body mass index and hepatitis B were excluded. The 95th percentiles level of ALT from healthy participants were evaluated. The definition of NAFLD was overweight status (≥85th percentile of body mass index) plus elevated ALT levels (95th percentile).ResultsThe upper normal ALT were 24.1 U/L for boys and 17.7 U/L for girls. Based on these values, the estimated prevalences of NAFLD in 2015 were 8.9% among adolescents.ConclusionDefining the upper normal limit of ALT can be adjusted for each sex and ethnics in the general population. ALT laboratory thresholds used for children should be re-examined. The physicians should be aware not to underdiagnose NAFLD patient even ALT level is < 40 U/L.

The prevalence of metabolic syndrome increases with serum high sensitivity C-reactive protein concentration in individuals without a history of cardiovascular disease: a report from a large Persian cohort.

Background Metabolic syndrome is defined by a clustering of cardiovascular risk factors and is associated with a heightened inflammatory state. A raised serum high-sensitivity C-reactive protein, a marker of inflammation, is also known to associate with cardiovascular risk. We have investigated the relationship between the presence of metabolic syndrome and serum high-sensitivity C-reactive protein concentration in a large representative Persian population cohort without a history of cardiovascular disease. Methods The MASHAD study population cohort comprised 9778 subjects, who were recruited from the city of Mashhad, Iran, between 2007 and 2008. Several cardiovascular risk factors were measured in this population without cardiovascular disease. Individuals were categorized into quartiles of serum high-sensitivity C-reactive protein concentration: first quartile - 0.72 (0.59-0.85) (median [range]) mg/L, second quartile - 1.30 (1.14-1.4) mg/L, third quartile - 2.29 (1.92-2.81) mg/L and fourth quartile - 6.63 (4.61-11.95) mg/L, respectively. The prevalence of metabolic syndrome in each quartile was determined using either International Diabetes Federation or Adult Treatment Panel III criteria. Results The prevalence of metabolic syndrome was highest in the fourth quartile for serum high-sensitivity C-reactive protein (1220 subjects [50.0%]), and significantly higher than that in the first quartile (reference group) (634 subjects [25.9%]) ( P < 0.001). A positive smoking habit (OR, 1.47 [1.26-1.70], P < 0.001) and the presence of either metabolic syndrome-International Diabetes Federation (OR, 1.35 [1.18-1.55], P < 0.001) or metabolic syndrome-ATPIII (OR, 1.40 [1.18-1.50], P < 0.001) were strong predictors of a fourth quartile for serum high-sensitivity C-reactive protein concentration. Conclusions There was a significant association between high concentrations of serum high-sensitivity C-reactive protein and the presence of metabolic syndrome among individuals without a history of cardiovascular disease in our Persian cohort.

Impulsivity is associated with blood pressure and waist circumference among adolescents with bipolar disorder

ObjectiveCardiovascular risk factors (CVRFs) and impulsivity are common in bipolar disorder (BD), and CVRFs are also linked with impulsivity through a number of mechanisms, both behavioral and biological. This study examines the association between CVRFs and impulsivity in adolescents with BD. MethodsSubjects were 34 adolescents with BD and 35 healthy control (HC) adolescents. CVRFs were based on International Diabetes Federation metabolic syndrome criteria (triglycerides, high-density lipoprotein cholesterol, waist circumference, blood pressure (BP) and glucose). Impulsivity was measured using the computerized Cambridge Gambling Task (CGT). Analyses controlled for age, IQ, lifetime attention deficit hyperactivity disorder, and current antipsychotic use. ResultsAdolescents with BD had higher diastolic BP (73.36 ± 9.57 mmHg vs. 67.91 ± 8.74 mmHg, U = 401.0, p = 0.03), higher triglycerides (1.13 ± 0.60 mmol/L vs. 0.78 ± 0.38 mmol/L, U = 373.5, p = 0.008), and were more likely to meet high-risk criteria for waist circumference (17.6% vs. 2.9%, p = 0.04) vs. HC. Within the BD group, CGT sub-scores were correlated with CVRFs. For example, overall proportion bet was positively correlated with systolic (r = 0.387, p = 0.026) and diastolic (ρ = 0.404, p = 0.020) BP. Quality of decision-making was negatively correlated with systolic BP (ρ = −0.401, p = 0.021) and waist circumference (ρ = −0.534, p = 0.003). Significant interactions were observed, such that BD diagnosis moderates the relationship between both waist circumference and BP with CGT sub-scores. ConclusionBP and waist circumference are associated with impulsivity in BD adolescents, but not in HC adolescents. Future studies are warranted to determine temporality and to evaluate whether optimizing CVRFs improves impulsivity among BD adolescents.

Are Obese Individuals with no Feature of Metabolic Syndrome but Increased Waist Circumference Really Healthy? A Cross Sectional Study.

Patients displaying the metabolically healthy but obese phenotype have an intermediate cardiometabolic prognosis compared to normal weight healthy and metabolically unhealthy obese subjects. We aimed to evaluate the proportion of patients with a definite metabolically healthy obese phenotype and better characterize them. Definite metabolically healthy obese phenotype was defined as having none of the International Diabetes Federation metabolic syndrome criteria, excluding waist circumference. We recruited 1 159 obese patients (body mass index 38.4±6.3 kg/m(2)) including 943 women, without known diabetes. Patients were characterized for cardiometabolic disorders. As the 202 (17.4%) metabolically healthy obese individuals were younger and had lower body mass indexes than the 957 metabolically unhealthy obese patients, they were matched for gender, age and body mass index with 404 metabolically unhealthy obese patients. In addition to the features of metabolic syndrome, when compared to unhealthy subjects, definite metabolically healthy obese patients were less frequently found with either homeostasis model assessment of insulin resistance index>3 (23.6 vs. 38.9%, p<0.001), or abnormal oral glucose tolerance test (13.9 vs. 33.9%, p<0.001), or HbA1c value≥5.7% (43.9 vs. 54.2%, p<0.05) or pulse pressure≥60 mmHg (11.7 vs. 64.9%, p<0.001). However, there were no significant differences in the prevalence of microalbuminuria (11.1 vs. 12.3%), cardiac autonomic dysfunction (45.5 vs. 35.3%) and fatty liver index ≥ 60 (5.6 vs. 10.2%). Our data do not support the characterization of metabolically healthy obesity, even definite, as really healthy, as many patients with this phenotype have abnormal cardiovascular markers and glucose or liver abnormalities. HbA1c measurement seems to be more sensitive than OGTT to detect dysglycemia in this population.

Influence Of Substance Use On The Development Of Metabolic Syndrome In The Semi-Urban Population Of Jimma Town, South West Ethiopia.

Background: Metabolic syndrome is a cluster of metabolically related cardiovascular disease (CVD) risk factors that increases the risk of CVDs by 2-fold and the risk of developing type 2 diabetes mellitus by 3-fold. Previous studies revealed that the development of metabolic syndrome and its components can be influenced by various life style factors. Metabolic syndrome can be determined in an individual by different criteria - proposed by international Diabetes Federation (IDF), National cholesterol Education programme-Adult Treatment panel (NCEP -ATP- III) and y WHO. Objective: The main objective of this study was to assess the influence of substance use on the development of metabolic syndrome among adults in Jimma town, South West Ethiopia as determined by IDF and NCEP ATP -III criteria. Methods: A community based cross-sectional study was conducted to assess the risk factors of Metabolic syndrome (Met S) by using IDF ( Met S IDF) and NCEP ATP III criteria (Met S ATP-III) .The study was conducted in accordance with the Stepwise approach of the World Health Organization. Interviewer administered questionnaires was used for basic data collection; anthropometric measurements such as height , weight ,waist circumference , BMI and blood pressure measurements(systolic /diastolic) were done; blood sample were collected; lipid profile such as total cholesterol, triglyceride ,HDL-C, LDL -C and plasma glucose analyses were done. The prevalence of metabolic syndrome was determined based on the IDF and ATP III definitions from the anthropometric measurements and biochemical estimations. The association between Met S and substance use such as smoking, alcohol, khat chewing and coffee drinking were verified by chi-square and regression analysis using SPSS version 19. Results and discussion: The population of Jimma town comprises of different ethnic, religious, economic, educational and occupational categories with variations in their life style habits. Cigarette smoking was directly associated with the development of Met S. Alcohol consumption was not significantly associated with Met S; moderate alcohol consumers are at a reduced risk of Met S compared to abstainers; consumption of wine was found to be inversely correlated with development of Met S (Met S IDF =0 % and Met S ATP III= 0 %); beer and local arrack (teje) consumption was directly associated with the development of Met S; heavy alcohol consumption was significantly associated with greater risk of developing Met S. Moderate khat chewers had shown a lesser prevalence of Met S compared to abstainers (Met S IDF: chewer =11%, non chewer=18.3% and Met S ATP III: chewer= 7.3, non chewer=11.4%); but heavy chewers had shown a significantly higher prevalence of Met S. Generally, coffee consumers had shown a less prevalence rate compared to abstainers (Met S IDF: coffee consumers =15.9%, non consumers=22.2% and % and Met S ATP III: coffee consumers =9.9%, non consumers=14.2%); moderate coffee consumption (4-6 cups/day) was associated with a reduced risk of Met S (Met S IDF =5.5% and Met S ATP III=3.7%). Logistic regression analysis revealed that cigarette smoking, not drinking coffee, are directly associated with the development of Metabolic syndrome IDF. Drinking alcohol every day (AOR=0.798), drinking beer (AOR=0.870), drinking local arrack (tejje) (AOR=0.578), taking any forms of alcohol for long duration (AOR=1.614) were also directly associated. Cigarette smoking habit is directly associated with the development of Metabolic syndrome ATP-III; drinking beer (AOR=0.752) and local arrack (tejje) (AOR=0.678) are also directly associated. Conclusions: Cigarette smoking was found to be a serious risk factor. Even though heavy alcoholism and heavy khat usage are risk factors, moderate alcoholism, occasional Khat chewing and moderate coffee drinking were all found to reduce the risk of being affected with Met S compared to abstainers.

Diabetes and Cardiovascular Disease Outcomes in the Metabolically Healthy Obese Phenotype

OBJECTIVETo determine the correlates of the “metabolically healthy obese” (MHO) phenotype and the longitudinal risks of diabetes and cardiovascular disease (CVD)/stroke associated with this phenotype.RESEARCH DESIGN AND METHODSThe North West Adelaide Health Study is a prospective cohort study of 4,056 randomly selected adults aged ≥18 years. Participants free of CVD/stroke and not underweight (n = 3,743) were stratified by BMI categories and metabolic risk, defined as having two or more International Diabetes Federation metabolic syndrome criteria, excluding waist circumference.RESULTSCorrelates of the MHO (n = 454 [12.1%]) included smoking, socioeconomic disadvantage, and physical inactivity. Compared with metabolically healthy normal-weight subjects (n = 1,172 [31.3%]), the MHO were more likely to develop metabolic risk (15.5 vs. 33.1%, P < 0.001) and incident diabetes (odds ratio 2.09 [95% CI 0.87–5.03]) but not CVD/stroke (1.16 [0.58–2.29]) during 5.5–10.3 years of follow-up. These risks were not seen in MHO subjects maintaining metabolic health (n = 188 [67%]). Sustained metabolic health in obese participants was associated with age ≤40 years and lower waist circumference. Compared with the metabolically at-risk obese, MHO women demonstrated a significantly higher (mean [SE]) percentage of leg fat (49.9 [0.5] vs. 53.2 [0.7]) and lower waist circumference (104 [0.6] vs. 101 cm [0.8]), despite no significant differences in overall adiposity.CONCLUSIONS“Healthy” obesity was a transient state for one-third of subjects. Persistence of a MHO phenotype, which was associated with favorable outcomes, was related to younger age and a more peripheral fat distribution. The MHO phenotype may be sustained by promoting lower waist circumferences.

Presence of Metabolic Syndrome is not an Independent Predictor of In-hospital Adverse Events in Patients with ST Elevation Myocardial Infarction that Underwent Primary Percutaneous Coronary Intervention

Background: Presence of Metabolic Syndrome (MetS) has been shown to predict higher risk for cardiovascular diseases. However, in patients with ST Segment Elevation Myocardial Infarction (STEMI), prognostic importance of MetS has not been widely studied. Methods: We prospectively recruited 611 STEMI patients (521 male, 90 female) who were treated by primary angioplasty. Metabolic syndrome was diagnosed according to the International Diabetes Federation metabolic syndrome worldwide definition. Coronary angiographic data and in-hospital events of individuals were recorded. Major Adverse Cardiac Events (MACE) included cardiac death, recurrent myocardial infarction and target lesion revascularization. Results: Metabolic syndrome group included 276 (45.1% of the study cohort; mean age 56.8 ± 12.2; 210 male) and control group included 335 subjects (54.9% of the study cohort; mean age 55.6 ± 12.9; 311 male). The frequency of female gender, hypertension, Diabetes Mellitus (DM), hyperlipidemia and positive history for coronary artery disease were higher in MetS group, whereas, the ratio of smokers was higher in the control group. The incidence of in-hospital death and MACE was not statistically different in MetS and control groups. Presence of MetS was not correlated with in-hospital death and MACE in univariate analysis. In multivariate analysis using model adjusted for age, gender, DM/ fasting glucose >100 mg/dL, left ventricular ejection fraction, post-PCI TIMI flow grade <3 and high creatinine and peak CK-MB levels age, peak CK-MB and creatinine levels remained the independent predictors of in-hospital mortality. Peak CK-MB and creatinine levels were also independent predictors of in-hospital MACE. Conclusion: Presence of MetS was not a predictor of in-hospital adverse events in patients with STEMI treated with primary percutaneous intervention. Peak CK-MB and creatinine levels may indicate higher risk for in-hospital adverse events.

Fitness and metabolic syndrome in obese fatty liver children

Background: Metabolic Syndrome (MS) is highly prevalent among obese children with fatty liver. However, it is well-known that there is a lower prevalence of MS in individuals with higher cardiorespiratory fitness (CRF).Aim: To analyse the association between CRF with features of the MS in obese children that present fat liver indicators, namely abnormal alanine aminotransferase (ALT) values.Methods: A total of 79 obese students (40 girls), 10–11 year-olds ( ± 0.60), with abnormal serum ALT from Porto public schools comprised the sample. Measurements included CRF (20-metre Shuttle Run Test), Metabolic Risk Factors (MRF), according to MS International Diabetes Federation criteria, ALT values (Cholestech LDX® analyser) and maturational stage (Tanner criteria). Logistic regression analysis was used to determine the influence of CRF on MRF adjusted for sex, maturation, and BMI.Results: The logistic regression showed that, despite being classified as being obese and presenting abnormal levels of ALT, those classified as fit were less likely to have MS than their unfit counterparts (OR = 0.52; p ≤ 0.05).Conclusion: Obese-fit children with abnormal ALT values have a significant reduction in the likelihood to be classified as having MS, even after adjustments for gender, maturation and BMI, Thus, CRF might be an important factor for tackling fatty liver among obese.

Effects of pistachios on body weight in Chinese subjects with metabolic syndrome

BackgroundStudies have shown that pistachios can improve blood lipid profiles in subjects with moderate hypercholesterolemia which could reduce the risk of cardiovascular disease. However, there is also a widely perceived view that eating nuts can lead to body weight gain due to their high fat content.PurposeTo investigate the impact of different dosages of pistachios on body weight, blood pressure, blood lipids, blood glucose and insulin in subjects with metabolic syndrome.MethodsNinety subjects with metabolic syndrome (consistent with 2005 International Diabetes Federation metabolic syndrome standard without diabetes) were enrolled in three endocrinology outpatient clinics in Beijing. All subjects received dietary counseling according to the guidelines of the American Heart Association Step I diet. After a 4 week run-in, subjects were randomized to consume either the recommended daily serving of 42 g pistachios (RSG), a higher daily serving of 70 g pistachio (HSG) or no pistachios (DCG) for 12 weeks.ResultsSubjects in all three groups were matched at baseline for BMI: DCG 28.03 ± 4.3; RSG 28.12 ± 3.22; and HSG 28.01 ± 4.51 kg/m2. There were no significant changes in body weight or BMI in any groups during the study nor any change from baseline at any time point in any group. During the entire study, there were no significant differences in waist-to-hip ratio among the groups or any change from baseline in any group (DCG -0.00 ± 0.03, RSG -0.01 ± 0.02 and HSG 0.01 ± 0.04). There were no significant differences detected among groups in triglycerides, fasting glucose and 2 hour postprandial glucose following a 75 gram glucose challenge. Exploratory analyses demonstrated that glucose values 2 h after a 75 gm glucose challenge were significantly lower at week 12 compared with baseline values in the HSG group (-1.13 ± 2.58 mmol/L, p = 0.02), and a similar trend was noted in the RSG group (-0.77 ± 2.07 mmol/L, p = 0.06), while no significant change was seen in the DCG group (-0.15 ± 2.27 mmol/L, p = 0.530). At the end of study, serum triglyceride levels were significantly lower compared with baseline in the RSG group (-0.38 ± 0.79 mmol/L, p = 0.018), but no significant changes were observed in the HSG or DCG groups.ConclusionDespite concerns that pistachio nut consumption may promote weight gain, the daily ingestion of either 42 g or 70 g of pistachios for 12 weeks did not lead to weight gain or an increase in waist-to-hip ratio in Chinese subjects with metabolic syndrome. In addition, pistachio consumption may improve the risk factor associated with the metabolic syndrome.

Prevalence of Metabolic Syndrome Among Human Immunodeficiency Virus–Infected Subjects Is Widely Influenced by the Diagnostic Criteria

The aim of this study was to compare the prevalence of metabolic syndrome in human immunodeficiency virus (HIV)-infected patients treated with highly active antiretroviral therapy (HAART), using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), European Group for the Study of Insulin Resistance (EGIR), and International Diabetes Federation (IDF) definitions. A cross-sectional study was carried out with 159 consecutive adult HIV-infected subjects (120 males and 39 females) under HAART. Anthropometric and laboratory parameters were measured by standard methods. Hyperinsulinemia was defined by a fasting concentration >75th percentile of values obtained in healthy individuals (107.5 pmol/L). The prevalence of ATP III-defined metabolic syndrome was 10.1%; it was 28.3% according to EGIR criteria and 15.1% using the IDF definition. The concordance between the definitions was low (kappa coefficient ranging between 0.134 and 0.296). All subjects with EGIR-defined metabolic syndrome had hyperinsulinemia, but only 50% of those with ATP III-defined metabolic syndrome and 62.5% in the IDF metabolic syndrome population had hyperinsulinemia. The inclusion of hyperinsulinemia as a criterion in the EGIR metabolic syndrome definition made it more discriminative than the ATP III definition, both in men and women, and than the IDF definition in men to identify metabolic syndrome in HIV-infected subjects under HAART.

Glucose intolerance in pregnancy and postpartum risk of metabolic syndrome in young women.

Gestational diabetes mellitus (GDM) and even mild glucose intolerance in pregnancy are both associated with increased risks of developing type 2 diabetes and cardiovascular disease in the future. Because the metabolic syndrome also identifies patients at risk of type 2 diabetes and cardiovascular disease, we hypothesized that gestational dysglycemia may be associated with an unrecognized latent metabolic syndrome. Thus, we sought to evaluate the relationship between gestational glucose tolerance status and postpartum risk of metabolic syndrome. In this prospective cohort study, 487 women underwent oral glucose tolerance testing in pregnancy and cardiometabolic characterization at 3 months postpartum. The antepartum testing defined three gestational glucose tolerance groups: GDM (n = 137); gestational impaired glucose tolerance (GIGT) (n = 91); and normal glucose tolerance (NGT) (n = 259). The primary outcome was the presence of the metabolic syndrome at 3 months postpartum, as defined by International Diabetes Federation (IDF) and American Heart Association/National Heart Lung and Blood Institute (AHA/NHLBI) criteria, respectively. The postpartum prevalence of IDF metabolic syndrome progressively increased from NGT (10.0%) to GIGT (17.6%) to GDM (20.0%) (overall P = 0.016). The same progression was observed for AHA/NHLBI metabolic syndrome (NGT, 8.9%; GIGT, 15.4%; and GDM, 16.8%; overall P = 0.046). On logistic regression analysis, both GDM (odds ratio, 2.05; 95% confidence interval, 1.07-3.94) and GIGT (odds ratio, 2.16; 95% confidence interval, 1.05-4.42) independently predicted postpartum metabolic syndrome. Both GDM and mild glucose intolerance in pregnancy predict an increased likelihood of metabolic syndrome at 3 months postpartum, supporting the concept that women with gestational dysglycemia may have an underlying latent metabolic syndrome.