International Diabetes Federation Guidelines Research Articles

Comparing ADA and IDF diagnostic criteria for intermediate hyperglycaemia and diabetes in the SHiDS study.

This study aimed to assess the prevalence of IH and diabetes, as well as insulin secretion, insulin sensitivity, and related curve patterns in subjects with different glucose tolerance categories according to the diagnostic criteria established by the American Diabetes Association (ADA) and the more recently published International Diabetes Federation (IDF) guidelines. We used data of 5,387 adult participants from the Shanghai High-risk Diabetic Screen (SHiDS) study. All participants underwent a five-point 75 g oral glucose tolerance test (OGTT). Glycemic states were then classified according to the ADA/IDF diagnostic criteria, while OGTT-derived indices were employed to evaluate insulin secretion and sensitivity. Overall, 3,729 subjects were diagnosed consistently under ADA/IDF criteria; while 941 and 717 subjects exhibited inconsistencies in the diagnostic classification for diabetes and IH, respectively. Notably, all of these individuals with discrepant diagnoses displayed β-cell dysfunction and/or insulin resistance compared to the NGT/NGT group. The ADA criteria can identify individuals with elevated haemoglobinA1c (HbA1c) levels when the 1-hour plasma glucose (1-h PG) stay within the normal range, while the IDF criteria can identify subjects with impaired insulin sensitivity and secretion when fasting plasma glucose (FPG), 2-hour plasma glucose (2-h PG) and HbA1c values are in the normal range.

Estimation of Undiagnosed Diabetes and Pre-diabetes in People 45–75 Years in Two Blocks of Himachal Pradesh, India: A Cross-sectional Study

Abstract Background: As per the International Diabetes Federation guidelines and American Diabetic Association guidelines, all people above 45 and <75 years should be regularly tested for undiagnosed diabetes. Objective: We aimed to estimate the prevalence of undiagnosed diabetes and pre-diabetes in the population aged 45–75 years using fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), and glycated hemoglobin (HbA1c). Materials and Methods: An observational cross-sectional study was conducted at district Hamirpur and district Una of Himachal Pradesh on 600 adults 45–75 years of age. A community-based screening was conducted using a questionnaire with symptoms suggestive of diabetes and other non-communicable diseases such as hypertensions and stroke. Already diagnosed diabetics were excluded from the second phase of the study where all patients positive on screening were invited for laboratory investigations to confirm the diabetic status. Diabetes and pre-diabetes prevalence was calculated using fasting blood glucose (FBS), OGTT, and HbA1c criteria of the World Health Organization individually. Results: Using FBS, 21.7% were found to be pre-diabetic and 15.5% were diabetic. Using OGTT on the same population, 19.7% were labeled as diabetic and 48.2% were impaired glucose-tolerant. Conclusion: The prevalence of only diabetes was highest on OGTT and lowest using FPG.

Factors Influencing Prevalence, C-reactive Protein Levels, and Lymphocyte Counts in Chronic Obstructive Pulmonary Disease Patients With Metabolic Syndrome.

Background This research examined the relationship between C-reactive protein (CRP) levels and lymphocyte counts in individuals with chronic obstructive pulmonary disease (COPD) comparing those with metabolic syndrome (MetS) to those without. Methodology This cross-sectional study involved 100 consecutive COPD patientsattending the outpatient wards at the Department of Medicine, Index Medical College, over 18 months. MetS was assessed using the International Diabetes Federation's guidelines. Pulmonary function tests such as spirometry were conducted following the European Respiratory Society's procedures, including measurements of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and the FEV1/FVC ratio. The Global Initiative for Obstructive Lung Disease criteria were employed to evaluate COPD severity using post-bronchodilator FEV1. Results Our results indicated no significant differences in demographics, anthropometrics, or pulmonary function tests between COPD patients with MetS and those without. Average age, height, weight, body mass index, and blood pressure readings were similar between the groups, with no significant variations (p > 0.05). However, the total white blood cell count was significantly higher in the MetS group (9,214 ± 3,161.8 cells/µL) compared to the non-MetS group (6,657.8 ± 4,218 cells/µL, p = 0.001). CRP levels were markedly elevated in 90.9% of MetS patients compared to 21.4% of non-MetS patients. Pulmonary function tests showed no significant differences in pre- and post-bronchodilator FEV1 or FEV1/FVC ratios (p > 0.05). Conclusions The study found that individuals with COPD and MetS have elevated levels of CRP, suggesting that this association exacerbates systemic inflammation and metabolic issues. Furthermore, the risk of MetS in COPD patients did not significantly differ between smokers and non-smokers, indicating that MetS can affect all COPD patients regardless of smoking status. Additionally, more than half of the COPD patients had hypertension, a common comorbidity that reflects the oxidative stress and inflammatory processes shared by both conditions.

Substance use and incidence of metabolic syndrome before midlife among military adults: the CHIEF cohort study.

Habitual substance use, i. e., alcohol, tobacco and betel nut, has been found with an increased risk of metabolic syndrome (MetS) in the general population, whereas the association remains unclear in physically fit military personnel. This study aimed to investigate the combination of these substances use and their associations with new-onset MetS in the military. A total of 2,890 military men and women, aged 18-39 years, without MetS were obtained from the cardiorespiratory fitness and health in eastern armed forces study (CHIEF) in Taiwan and followed for incident MetS from baseline (2014) through the end of 2020. Incident MetS event was defined by the International Diabetes Federation guideline and confirmed in the annual health examinations. A self-report was used to assess the alcohol, tobacco and betel nut use status (active vs. former/never). Multivariable Cox regression model was performed to determine the association with adjustments for sex, age, body mass index and physical activity at baseline. At baseline, there were 279 active betel nut chewers (9.7%), 991 active smokers (34.3%) and 1,159 active alcohol consumers (40.1%). During a mean follow-up of 6.0 years, 673 incident MetS (23.3%) were observed. As compared to no substance users, only one substance, and two and three substances users had a greater risk of incident MetS [hazard ratios (HRs) and 95% confidence intervals: 1.27 (1.06-1.54), 1.38 (1.12-1.69) and 1.78 (1.37-2.32), respectively]. In subgroup analyses, the risk of incident MetS in two and three substances users was significantly greater in those free of baseline low high-density lipoprotein [HRs: 1.54 (1.21-1.95) and 2.57 (1.92-3.46), respectively], as compared to their counterparts (both p for interactions <0.05). A dose-response association of more substances use for new-onset MetS was noted in military personnel. This finding suggests that the combined alcohol, tobacco and betel nut use may play a role in the development of MetS. Further study is required to establish causation and to investigate the potential benefits of substance use cessation in reducing the risk of MetS.

Racial Discrimination and Metabolic Syndrome in Young Black Adults

Metabolic syndrome (MetS) is a common health condition that predisposes individuals to cardiovascular disease (CVD) and disproportionately affects Black and other racially and ethnically minoritized people. Concurrently, Black individuals also report more exposure to racial discrimination compared with White individuals; however, the role of discrimination in the development of MetS over time and associated mediators in these pathways remain underexplored. To evaluate the association between racial discrimination and MetS in rural Black individuals transitioning from late adolescence into early adulthood and to identify potential mediating pathways. This longitudinal cohort study included Black adolescents enrolled in the Strong African American Families Healthy Adults (SHAPE) Project between June 2009 and May 2021. Families resided in rural counties of Georgia, where poverty rates are among the highest in the nation. Analyses included 322 of the 500 participants who originally enrolled in SHAPE and who were eligible to participate. Guardians provided information about socioeconomic disadvantage. Analyses were conducted in April 2023. Youths reported exposure to racial discrimination annually from ages 19 to 21 years. MetS was the main health outcome and was measured at ages 25 and 31 years. MetS was diagnosed according to the International Diabetes Federation guidelines, which requires central adiposity (ie, waist circumference ≥94 cm for males and ≥80 cm for females) and at least 2 of the 4 additional components: signs of early hypertension (ie, systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥85 mm Hg); elevated triglyceride levels (ie, >150 mg/dL); elevated fasting glucose level (ie, ≥100 mg/dL); or lowered high-density lipoprotein levels (ie, <40 mg/dL in men and <50 mg/dL in women). At age 25 years, markers of inflammatory activity (ie, soluble urokinase plasminogen activator receptor [suPAR]) and sleep problems were collected to consider as potential mediators. In 322 participants (210 [65.2%] female) ages 19 to 21 years, more frequent exposure to racial discrimination was associated with higher suPAR levels (b = 0.006; 95% CI, 0.001-0.011; P = .01) and more sleep problems at age 25 years (b = 0.062; 95% CI, 0.028-0.097; P < .001) as well as a 9.5% higher risk of MetS diagnosis at age 31 years (odds ratio [OR], 1.10; 95% CI, 1.01-1.20; P = .03). Both suPAR (b = 0.015; 95% CI, 0.002-0.037) and sleep problems (b = 0.020; 95% CI, 0.002-0.047) at age 25 years were significant indirect pathways. No significant interactions between sex and discrimination emerged. This study suggests that racial discrimination in late adolescence is associated with MetS among Black young adults through biobehavioral pathways. Thus, health interventions for MetS in Black adults will need to contend with sleep behaviors and inflammatory intermediaries as well as address and reduce exposure to racial discrimination to narrow disparities and promote health equity.

Clinical features and predictors of metabolic syndrome among obstructive sleep apnea patients

BackgroundObstructive sleep apnea (OSA) and metabolic syndrome (MetS) are two diseases associated with an increased risk of cardio-metabolic complications and both share the same risk factors such as obesity and smoking.ObjectivesTo study the clinical features and predictors of MetS in OSA patients.MethodologyA cross-sectional study was conducted in the sleep lab of the Pulmonology Department at Kasr Al-Ainy Hospital, Cairo University, during the period from September 2022 to March 2023. Eighty OSA patients were included, and each patient was subjected to history taking, body measurements, blood pressure measurements, Epworth sleepiness scale, STOP-BANG score, polysomnography, and laboratory investigations including lipid profile and (HBA1C), MetS was defined based on the International Diabetes Federation (IDF) guidelines. Then patients were classified into two groups; OSA with MetS and OSA without MetS, we compared both groups using a one-way (ANOVA) test.ResultsMetS was diagnosed in 66.3% of the study group. OSA with MetS had higher BMI (44.76 ± 9.55) with significant p values (< 0.001), lower average O2 saturation % (90.23 ± 5.5, p value = 0.013), and longer SPO2 time < 90% (37.39 ± 34.14, p value = 0.034) than the other group. BMI, waist, hip, and neck circumferences and SPO2 < 90% were predictors of MetS among OSA patients with significant p values. Females had significantly higher BMI (46.64 ± 9.58), p value = 0.015. Males had significantly higher AHI than females (32.99 ± 24.02 versus 19.83 ± 14.74 respectively), p value = 0.031.ConclusionMetS was diagnosed in 66.3% of OSA. BMI, neck, hip, waist circumferences, and SPO2 < 90% were predictors of MetS among OSA.Trial registrationRetrospectively registered, date of registration is 18/09/2023, and number of registration is NCT06051097. The link to the study on clinicaltrials.gov.

Correlation of HbA1c with red cell width distribution and other red cell indices in Type II diabetic females.

Objective: To assess the correlation of HbA1c with hemoglobin concentration, RWD, and other red cell indices in Type II diabetes mellitus female patients. Study Design: Cross-sectional study. Setting: Department of Physiology, Al Nafees Medical College, and Pakistan Institute of Medical Sciences, Islamabad. Period: January 2019 to December 2020. Material &amp; Methods: The study included 70 adult female diabetic patients, adhering to International Diabetes Federation guidelines. Exclusion criteria encompassed uncontrolled diabetes, pregnancy, renal issues, cardiac failure, and hemoglobinopathies. Laboratory tests, such as Complete Blood Count and HbA1c measurements, were conducted. SPSS version 23 was used for statistical analysis, employing mean, standard deviation, and Pearson's correlation to assess relationships among HbA1c, hemoglobin, Red Cell Distribution Width (RDW), and other red cell parameters. Results: A total of 70 female patients with diagnosed Type II diabetes mellitus were included in our study with a mean age of 40.45±12.70 years. The Mean±SD of study variables like HbA1c, hemoglobin, MCV, MCHC, RDW, and FBS of the patients was 5.91±0.89%, 11.23±1.59 gm/dl, 76.32±9.50fl, 31.02±3.39mg/dl, 12.78±1.51 and 100.53±15.52mg/dl respectively. A significant correlation between HbA1c and RDW was found and showed that both variables were positively correlated with each other. (r= 320, p=0.001). Conclusion: RDW correlates with HbA1C in female Type II diabetes patients, suggesting CBC, including RDW, as a cost-effective diagnostic marker alongside HbA1c for glycemic status assessment.

Role of anthropometric indices as a screening tool for predicting metabolic syndrome among apparently healthy individuals of Karachi, Pakistan.

Anthropometric indices are affordable and non-invasive methods for screening metabolic syndrome (MetS). However, determining the most effective index for screening can be challenging. To investigate the accuracy of anthropometric indices as a screening tool for predicting MetS among apparently healthy individuals in Karachi, Pakistan. A community-based cross-sectional survey was conducted in Karachi, Pakistan, from February 2022 to August 2022. A total of 1,065 apparently healthy individuals aged 25 years and above were included. MetS was diagnosed using International Diabetes Federation guidelines. Anthropometric indices were defined based on body mass index (BMI), neck circumference (NC), mid-upper arm circumference (MUAC), waist circumference (WC), waist to height ratio (WHtR), conicity index, reciprocal ponderal index (RPI), body shape index (BSI), and visceral adiposity index (VAI). The analysis involved the utilization of Pearson's correlation test and independent t-test to examine inferential statistics. The receiver operating characteristic (ROC) analysis was also applied to evaluate the predictive capacities of various anthropometric indices regarding metabolic risk factors. Moreover, the area under the curve (AUC) was computed, and the chosen anthropometric indices' optimal cutoff values were determined. All anthropometric indices, except for RPI in males and BSI in females, were significantly higher in MetS than those without MetS. VAI [AUC 0.820 (95% CI 0.78-0.86)], WC [AUC 0.751 (95% CI 0.72-0.79)], WHtR [AUC 0.732 (95% CI 0.69-0.77)], and BMI [AUC 0.708 (95% CI 0.66-0.75)] had significantly higher AUC for predicting MetS in males, whereas VAI [AUC 0.693 (95% CI 0.64-0.75)], WHtR [AUC 0.649 (95% CI 0.59-0.70)], WC [AUC 0.646 (95% CI 0.59-0.61)], BMI [AUC 0.641 (95% CI 0.59-0.69)], and MUAC [AUC 0.626 (95% CI 0.57-0.68)] had significantly higher AUC for predicting MetS in females. The AUC of NC for males was 0.656 (95% CI 0.61-0.70), while that for females was 0.580 (95% CI 0.52-0.64). The optimal cutoff points for all anthropometric indices exhibited a high degree of sensitivity and specificity in predicting the onset of MetS. BMI, WC, WHtR, and VAI were the most important anthropometric predictors for MetS in apparently healthy individuals of Pakistan, while BSI was found to be the weakest indicator.

Prevalence of Metabolic Syndrome among Apparently Healthy Adult Population in Pakistan: A Systematic Review and Meta-Analysis.

Metabolic syndrome (MetS) is considerably higher worldwide. It varies greatly in different populations geographically and based on criteria used to diagnose the disease. This review was conducted to determine the prevalence of MetS among apparently healthy adults of Pakistan. A systematic review was performed on Medline/PubMed, SCOPUS, ScienceDirect, Google Scholar, and Web of Science databases until July 2022. Articles published on Pakistani healthy adult population reporting MetS were included. Pooled prevalence was reported with 95% confidence interval (CI). Of 440 articles, 20 articles met the eligibility. The pooled prevalence of MetS was 28.8% (95% CI: 17.8-39.7). The maximum prevalence was from a sub-urban village of Punjab (68%, 95% CI: 66.6-69.3) and Sindh province (63.7%, 95% CI: 61.1-66.3). International Diabetes Federation guidelines had shown 33.2% (95% CI: 18.5-48.0) whereas National Cholesterol Education Program guidelines showed 23.9% (95% CI: 8.0-39.8) prevalence of MetS. Furthermore, individuals with low high-density lipoprotein (HDL) 48.2% (95% CI: 30.8-65.6), central obesity 37.1% (95% CI: 23.7-50.5), and high triglyceride 35.8% (95% CI: 24.3-47.3) showed higher prevalence. A considerably higher prevalence of MetS was observed among apparently healthy individuals in Pakistan. High triglyceride, low HDL, and central obesity were found as significant risk factors. (Registration # CRD42022335528).

N- terminal pro brain natriuratic peptide (nt-probnp) in apparently healthy subjects compared to metabolic syndrome subjects

Background and objectives: B –type natriuretic peptide is synthesized in myocardial cells to respond to increased wall stress in association with heart failure or acute myocardial ischemia. High B –type natriuretic peptide and high Nt-pro B –type natriuretic peptide levels are candidates for cardiovascular risk markers and hypertension, left ventricular hypertrophy, and albuminuria. The level and relation of Nt-pro B –type natriuretic peptide with metabolic syndrome was examined in this study. Methods: In this case-control investigation, level of Nt-pro B –type natriuretic peptide of 80 metabolic syndrome patients diagnosed based on the International Diabetes Federation guidelines was compared to its level in 40 healthy controls. The subjects who accompanied the diabetic patients at Duhok Diabetes Center were screened for inclusion and exclusion criteria between the first March and May 2019. Results: The concentrations of triglyceride (215.09 vs. 104.02 mg/dL), total cholesterol (179.68 vs. 162.75mg/dL), and fasting blood glucose (188.71 vs. 88.08 mg/dL) were significantly higher in metabolic syndrome patients compared to the healthy controls, respectively. Nt-pro B –type natriuretic peptide was significantly lower in patients in contrast with healthy individuals (35.00 vs. 46.00 pg/mL), respectively. However, the proBNP level was not significantly different in metabolic syndrome patients with normal and abnormal biochemical parameters. Conclusions: This study showed a significantly lower concentration of Nt-proBNP in metabolic syndrome compared to healthy controls. However, the study did not find a significant correlation with content of metabolic syndrome.

Associations Between Sleep Quality and Metabolic Syndrome in a Brazilian Population: A Primary and Cross-Sectional Study

Poor sleep quality can affect cardiovascular health and is considered a significant risk factor for the development of risk factors for Metabolic syndrome (MetS). This study aimed to investigate possible associations between sleep quality measured by the Pittsburgh Sleep Quality Index and the MetS. This was a cross-sectional that comprised data from 208 patients. Biochemical and anthropometric parameters were assessed. The identification of MetS was performed according to the International Diabetes Federation guidelines. The quantitative variables were described with the support of the BioEstat 5.3 software. To assess the association of the studied variables with the diagnosis of MetS, the Mann-Whitney and Chi-square (n x n) statistical tests were used. The level of significance considered was 5%. According to the International Diabetes Federation criteria, 111 (53,36%) men and women presented MetS. There were no statically significant differences between the groups with or without sleep disorders and the values of waist circumference (p=0.6996), high-density lipoprotein cholesterol levels (p=0.7940), triglycerides levels (p=0.8703), blood pressure values (p= 0.9851, and p=0.9795 for systolic and diastolic blood pressure, respectively), and glycemia (p=0.5351). Eighty-eight volunteers (42%) presented sleep quality dysfunction, with the highest proportion observed among individuals affected by MetS (p=0.0019). Our results indicate an association between sleep quality and the prevalence of MetS . Therefore, sleep quality could be evaluated in patients with MetS so that the therapeutic strategy would not be limited to the intervention in biochemical and anthropometric factors.

Dietary patterns and metabolic syndrome among urbanized Tibetans: A cross-sectional study

The prevalence of metabolic syndrome (MetS) and the major dietary patterns among urbanized Tibetans are unclear. The present study aimed to investigate the prevalence of MetS among Jiarong Tibetans in Aba Plateau, identify the major dietary patterns, and evaluate their association with the risk of MetS. In this cross-sectional study on 476 subjects, 18–80-years-old, dietary intakes were evaluated using a simplified food frequency questionnaire (SFFQ). MetS was defined according to the International Diabetes Federation (IDF) guidelines. Principal component analysis was performed to assess the major dietary patterns. Multivariate logistic regression analysis examined the associations between dietary patterns and the risk of MetS. The prevalence of Mets in the population was 37.6%. Herein, three major dietary patterns were extracted: traditional Tibetan, urbanized, and healthy dietary patterns. After adjusting for potential confounders (Model 1: adjusted for sex and age; Model 2: adjusted for sex, age, smoking status, drinking situation, physical activity level and total energy intake), subjects in the highest tertile of the healthy dietary had a lower risk of MetS compared to those from the lowest tertile. Also, no significant statistical association was established between the risk of MetS and the traditional Tibetan and urbanized diet.

Abstract MP65: Transgender Adolescents Have High Prevalence Of Atherosclerotic Cardiovascular Disease Risk Factors Before And After Taking Hormone Therapy For 1 Year

Introduction: The United States has a growing population of transgender adolescents aged 12-21y presenting for medical transition via gender affirming hormone therapy (HT). Transgender people do not identify with their sex assigned at birth while cisgender people do. HT involves estrogen for trans females, those who identify as female, and testosterone for trans males, those who identify as male. Initiation of HT is beginning in adolescence and is a lifelong commitment for many transgender individuals. Little is known about how HT affects ASCVD risk factors in transgender adolescents. Studies of cisgender adults show cardioprotective effects of estrogen, and an estimated 37% of normal-weight cis gender adolescents have at least 1 ASCVD risk factor; but little investigation exists for transgender people, especially adolescents. Although some studies involving the transgender population have reproducible results, few include adolescents and comparison to acceptable ASCVD risk factor profiles. Guidelines for transgender health recommend laboratory assessment before starting HT and annually. This study expands on current knowledge and informs clinical practice by comparing ASCVD risk biomarkers of transgender adolescents taking HT to acceptable clinical values for adolescents. Hypothesis: Estrogen therapy for trans females will ameliorate ASCVD risk factors while testosterone therapy for trans males will worsen ASCVD risk factors. Methods: Retrospective chart review identified 300 transgender patients receiving HT at an academic adolescent medicine gender clinic. Of those 300, 50 trans female and 50 trans male were randomly selected for evaluation of ASCVD risk parameters at baseline and 1 year after initiating HT. ASCVD risk factors were compared to the International Diabetes Federation guidelines for metabolic syndrome. Parameters included lipids, glucose, and blood pressure. BMI ≥30 was used as proxy for obesity. Results: At baseline, at least one abnormal value was found for 50% (n=25, of these 5 had obesity) of trans females and 66% (n=33, of these 13 had obesity) of trans males. At 1 year, at least one abnormal value was found for 30% (n=15) of trans females and 70% (n=35) of trans males. At baseline, 50% (n=25) of trans females and 82% (n=41) of trans males, and at 1 year 20% (n=10) of trans females and 48% (24) of trans males had all parameters measured. Paired t-tests (α=.05) showed no significant change in ASCVD risk factors for trans females, and significant decrease in HDL and significant increase in BMI for trans males after 1 year of HT. Conclusions: The prevalence of having at least 1 ASCVD risk factor is greater among transgender adolescents than normal weight cisgender adolescents. HT may worsen HDL and BMI for trans males. We recommend baseline parameters for all and follow up and lab surveillance for patients with abnormal baseline parameters.

A Descriptive Study to Assess Relationship between Body Fat Percentage and Obesity at a Tertiary Level Health Facility

Introduction: The prevalence of obesity is increasing in Indian adults at alarming rate and causing high burden of chronic diseases due to relatively high Body Fat Percentage (BFP) compared to other ethnic groups. There is a dearth of studies on assessment of obesity by using BFP measurement. This study was undertaken to strengththe reliability of BFP in assessment of obesity. Objectives: To find out the relationship between body fat percentage and obesity among adults aged 18-59 years. Method: A total of 228 subjects were included in the study from the in-patients admitted to tertiary care hospitalby systematic random sampling method. In the interview, socio-personal characteristics were collected using pre-tested, semi-structured questionnaire. Anthropometric measurements were conducted to calculate BMI based on Asia-Pacific classification and waist circumference based on International Diabetes Federation guidelines along with body fat percentage was measured using standard guidelines. The t- test, ANOVA and correlation was used to determine the relationship between obesity and BFP. Results: A significant association between Body Fat Percentage (BFP) and obesity measured by Body Mass Index (BMI) and Waist Circumference (WC) was observed across the categories and sex. Positive correlation was observed between BMI and waist circumference (p&lt;0.001), BMI and body fat percentage (P&lt;0.001) and waist circumference and body fat percentage (P&lt;0.001). Conclusions: The study shown significant association and positive correlation between body fat percentage and obesity measured by BMI and waist circumference at lower cut-off among Indian adults indicating BFP is a reliable measure for assessment of obesity.

Breastfeeding and Prevalence of Metabolic Syndrome among Perimenopausal Women.

Little is known about the long-term benefits of breastfeeding for mother’s metabolic health. This study aimed to investigate the links between breastfeeding duration and the prevalence of metabolic syndrome (MetS) and its components in perimenopausal women. The analysis included a group of 7621 women aged 55.4 ± 5.4 years. MetS and its components were defined according to the International Diabetes Federation guidelines. Women who breastfed for 13–18 months and beyond 18 months were at lower risk of MetS (odds ratio OR) = 0.76, 95% CI 0.60–0.95; p = 0.017 and OR = 0.79, 95% CI 0.64–0.98; p = 0.030, respectively) than those who never breastfed. Meanwhile, women who breastfed for 7–12 months showed increased glucose concentration (OR = 0.77, 95% CI 0.63–0.94; p = 0.012) compared with those who had never breastfed. The additional analysis involving parity showed that women who had given birth to two babies and breastfed them had lower odds of MetS than those who never breastfed (p < 0.05), although there was no significant difference among women who breastfed for >18 months. Women who had given birth to at least three children and breastfed for 1–6 and 13–18 months had lower odds of MetS and increased triglyceride concentration (p < 0.05). Moreover, participants having breastfed for 1–6 months were found to have a reduced risk of abdominal obesity compared with those who had not breastfed (p < 0.05). Breastfeeding is associated with lower prevalence of MetS in perimenopausal women and can be recommended as a way of reducing the risk of MetS and its components.

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.

Effect of Curcumin on Serum Cathepsin D in Patients with Metabolic Syndrome.

Inflammation has been shown to accompany Metabolic Syndrome (MetS) and its features. Cathepsin D is one of a proinflammatory mediator. In the current study, we aimed to investigate the effect of curcumin supplementation on serum cathepsin D levels in patients with MetS. The current study was conducted on 18-65 years old individuals with MetS diagnosed according to the International Diabetes Federation guidelines. A total of 80 participants were randomly divided into treatment and control groups. The first group (n=40) was given 2 capsules containing 500 mg of phosphatidylcholine complex of curcumin, and the other group (n=40) was given two 500 mg placebo capsules for 6 weeks. Before (week 0) and after (week 6) the intervention, anthropometric indices and blood pressure were measured and blood samples were taken. Serum cathepsin D was measured using an ELISA kit. There was no significant difference between treatment and control groups in terms of weight, body mass index, waist circumference and serum cathepsin D levels before and after the intervention. In addition, there was no significant difference between pre- and post-trial values of serum cathepsin D. The present results do not suggest any effect of curcumin on cathepsin D levels in patients with MetS.

The Association Between Serum Thyrotropin Within the Reference Range and Metabolic Syndrome in a Community-Based Chinese Population.

PurposeWe aimed to ascertain the association between thyrotropin (TSH) levels in euthyroid state and the prevalence of metabolic syndrome (MetS) in a community-based Chinese population.Participants and MethodsBased on a large and well-characterized community cohort in Beijing, China, 1831 men and 1742 women with serum TSH levels within the reference range (0.50–4.78 µIU/mL) were stratified by quartiles of TSH (Q1-4). MetS was identified according to the criteria of International Diabetes Federation guidelines. Poisson regression models were used to estimate the association between serum TSH and the prevalence of MetS and its components before and after adjustment for potential confounding factors. The reported association was measured using the prevalence ratio (PR) with its respective 95% confidence interval (95% CI).ResultsThe prevalence of MetS in euthyroid population across TSH quartiles (Q1-4) was 38.9%, 44.6%, 41.0%, and 47.7%, respectively, in men (P = 0.045), and 47.7%, 46.6%, 46.9%, and 54.6%, respectively, in women (P = 0.032). Compared with the reference group TSH-Q1, the prevalence of MetS was higher among TSH-Q4 group both in men (PR = 1.27; 95% CI: 1.09, 1.48, P = 0.002) and women (PR = 1.21; 95% CI: 1.07, 1.37, P = 0.003) even after adjustment for age, lifestyle factors, serum levels of free triiodothyronine (FT3), and free thyroxine (FT4). Most of the components of MetS were common in higher serum TSH levels within the normal range.ConclusionThe prevalence of MetS and most of its components increased in the higher TSH group in euthyroid Chinese population.

Prevalence of Metabolic Syndrome among Border Guard Bangladesh Personnel

Introduction: Metabolic syndrome (MetS) is a multifaceted syndrome comprises a cluster of metabolic abnormalities including hypertension, central obesity, insulin resistance, dyslipidemia, and is strongly associated with developing diabetes mellitus and cardiovascular diseases. Prevalence of MetS differs in different ethnic population by using different definition.&#x0D; Objectives: To determine the prevalence of the MetS and its component risk factors among Border Guard Bangladesh (BGB) personnel working in Chattagram Hill Tract (CHT).&#x0D; Materials &amp; Methods: This descriptive cross-sectional study was conducted from October 2016 to February 2018 among 1455 male BGB personnel aged between 40 to 59 years and working in CHT of Bangladesh. Study subjects were selected at BGB hospital, Guimara, Khagrachari. The new International Diabetes Federation (IDF) guidelines were used to identify MetS. Detail history, clinical examination, anthropometry and blood pressure (BP) were measured and fasting plasma glucose (FPG) and lipid profile were assessed.&#x0D; Results: Among the 1455 respondents’ BMI, waist circumference, systolic and diastolic BP were found more than normal in 34.1, 37.7, 16.4% and 12.3% respectively. Biochemical parameters including FPG, TC, TG, and LDL-C was raised in 28.7%, 49.8%, 52.2% and 37.7% of respondents respectively. HDL-C was found decreased in 26.9% respondents. Age wise prevalence of MetS for age group 40-44, 45-49, 50-54 and 55- 59 years were found 21.3%, 21.7%, 24.1% and 26.1% of the respondents respectively. The overall prevalence of MetS was found 22.4%.&#x0D; Conclusion: The prevalence of the MetS in BGB personnel was found 22.4%. Appropriate measure should be taken to lower the MetS cases.&#x0D; Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 97-100

Prevalence and Associated Factors of Metabolic Syndrome Among Patients with Severe Mental Illness at Hawassa, Southern-Ethiopia.

BackgroundPatients with severe mental disorders have a high risk of metabolic-related complications like metabolic syndrome (MetS), diabetes mellitus (DM), hypertension and lipid derangements, and these factors may predispose them to a high mortality rate. Data is very scarce regarding MetS among patients with severe mental illness in Ethiopia. Therefore, this study aimed to assess the prevalence of MetS and its associated factors among patients with severe mental illness.MethodsA cross-sectional study was conducted in Hawassa University Comprehensive Specialized Hospital from January to June 2019 among adult patients attending a psychiatric outpatient department, Southern Ethiopia. A systematic random sampling technique was used to select 245 study subjects. Socio-demographic and other data were collected using a structured questionnaire. Both the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) guidelines were used to define MetS.ResultsThe prevalence of MetS was 24.5% and 26.9% by NCEP-ATP and IDF criteria respectively. In both definitions, females had significantly higher MetS when compared to males (31.4% vs 19.6%; p=0.03 by NCEP), and (34.3% vs 21.7%; p =0.03 by IDF), respectively. Duration >5 years with mental illness indicated higher MetS when compared to duration ≤ 5 years (42.9% vs 19.9%, p=0.001; and 46.9% vs 21.9%, p<0.0001) in NCEP and IDF, respectively. In addition, marital status [AOR (95% CI): 2.4 (1.1–5.3)], and BMI [AOR (95% CI): 8.4(4.0–17.6)], duration > 5 years with mental illness [AOR (95% CI): 2.8(1.2–6.5)], and age >40 years [AOR (95% CI): 2.7(1.2–6.1)] were significantly associated factors of MetS by NCEP. While BMI, age >40 years and duration > 5 years with mental illness were associated with MetS by IDF.ConclusionLong-time experience with severe mental illness and antipsychotic therapy might predispose patients to metabolic complications with significant risks of cardiovascular events. Therefore, intensive screening of patients for MetS/components is required during follow-up based on national non-communicable diseases guideline. Besides, the proper intervention of patients concerning lifestyle changes and averting risk full behaviors is mandatory.