Joint Interim Statement Research Articles

Gender Difference in the Association of Metabolic Syndrome and Its Components with Age-Related Cataract: The Korea National Health and Nutrition Examination Survey 2008-2010

PurposeTo explore the relationship of the metabolic syndrome (MetS) and its components with age-related cataract in a representative Korean population.MethodsWe analyzed the data from the Korea National Health and Nutrition Examination Surveys (2008–2010). A total of 11,076 adults (4,811 men and 6,265 women) aged 40 and over who completed ophthalmologic examination were evaluated. Cataract was defined as the presence of cortical, nuclear, anterior (sub)capsular or posterior subcapsular cataract, from slit-lamp examination or previous cataract surgery. MetS was defined according to the Joint Interim Statement proposed in 2009 from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute.ResultsThe prevalence of cataract and MetS in this population was 39.4% (37.1% for men and 41.6% for women) and 38.5% (37.6% for men and 39.4% for women), respectively. Cataract prevalence tended to increase with the number of MetS components in both genders (both P< 0.001). After being controlled for confounders, however, MetS was significantly associated with cataract only in women (adjusted odds ratio (aOR), 1.24; 95% confidence interval (CI), 1.02–1.50]. Reduced HDL cholesterol, elevated fasting glucose, and elevated triglycerides were also significantly associated with cataract in women (aOR, 95% CI; 1.27 (1.07–1.50), 1.23 (1.01–1.50), and 1.26 (1.04–1.52), respectively). In the subgroup analysis for cataract subtype, MetS and reduced HDL cholesterol were significantly associated with nuclear cataract in women (aOR, 95% CI; 1.25 (1.07–1.55) and 1.25 (1.03–1.52), respectively). However, such associations were not found in men.ConclusionsOur results suggest that MetS and its components appear to be associated with age-related cataract only among Korean women, especially in nuclear cataract.

Prevalence of metabolic syndrome in elderly and agreement among four diagnostic criteria.

BackgroundMetabolic syndrome (MS) is an aggregation of risk factors that increase the incidence of cardiovascular events and diabetes mellitus (DM). Population aging is accompanied by higher prevalence of MS, which varies depending on the population studied and the diagnostic criteria used. ObjectiveTo determine prevalence of MS in the elderly using four diagnostic criteria and agreement between them. MethodsCross-sectional study on 243 patients older than 60 years (180 women) in Niterói, RJ. They were evaluated by clinical examination, fasting glucose, fasting insulin, lipid profile and anthropometric measurements - weight, height, waist circumference and waist/hip ratio. Prevalence of MS was estimated by World Health Organization (WHO) modified, National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF) and Joint Interim Statement (JIS) criteria. ResultsPrevalence was high with the four criteria WHO (51.9%), NCEP-ATPIII (45.2%), IDF (64.1%) and JIS (69.1%), and agreement between criteria by kappa was moderate in almost all comparisons WHO vs. IDF (k = 0.47;95% confidence interval (CI), 0.35 to 0.58); WHO vs. NCEP-ATPIII (k = 0.51; 95% CI, 0.40 to 0.61); WHO vs. JIS (k = 0.45; 95% CI, 0.33 to 0.56); IDF vs. NCEP-ATPIII (k = 0.55; 95% CI, 0.45 to 0.65) and NCEP-ATPIII vs. JIS (k = 0.53; 95% CI, 0.43-0.64), except between IDF vs. JIS (K = 0.89;95% CI, 0.83 to 0.95), which was considered good. ConclusionPrevalence of MS was high with the four diagnostic criteria, mainly by JIS. There was good agreement between JIS and IDF criteria and moderate among the others.

The Incidence and Alliance of Metabolic Syndrome with Cardiovascular Risk Markers among Kodavas

Background: Metabolic syndrome is the major cause for life threatening disorders such as cardiovascular diseases and type 2 diabetes. These disorders are associated with hyperuricemia and the number is growing among the urban population. Methods: A cross sectional study was done among Kodava population by conducting health camps in Mysore district. Metabolic syndrome was defined according to Joint Interim Statement criteria. Anthropometry was done and blood pressure readings were noted. Clinical markers like fasting glucose, triglyceride, high density lipoprotein, CVD markers and uric acid levels were analyzed. Results: The prevalence of metabolic syndrome was 60.77% and the utmost occurrence was in 41 - 60 age groups. Women were more affected than men (31.58%) and MetS became pronounced with advance of age. Biochemical levels of C-reactive protein, ApolipoproteinB/ApolipoproteinA1 ratio and uric acid wereraised (P

High-normal albuminuria predicts metabolic syndrome in middle-aged Korean men: A prospective cohort study

ObjectiveHigh-normal albuminuria has recently been associated with an elevated risk of cardiovascular disease. However, it is uncertain whether high-normal albuminuria is associated with metabolic syndrome (MetS). The objective of this prospective cohort study was to investigate whether a temporal relationship exists between a high-normal urine albumin-to-creatinine ratio (UACR) and the development of MetS. Study designA total of 4338 healthy Korean men who had their UACRs and MetS components assessed in 2005 were enrolled in the study. A MetS-free cohort of 1364 individuals, who did not have any conditions that would have excluded them from the study, was followed up until 2010. Main outcome measureMetS was defined according to the joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. ResultsCox proportional hazards models were used to estimate the hazard ratio (HR) associated with normal UACR values stratified into following tertiles: <3.12μg/mg, ≥3.12, <4.87μg/mg, and ≥4.87μg/mg. The UACR was categorised into the following tertiles. During 4470.6 person-years of follow-up, 247 incident cases of MetS developed between 2006 and 2010. The third UACR tertile was associated with the development of MetS after adjusting for multiple baseline covariates (HR 1.57; 95% confidence interval: 1.14–2.18). ConclusionsOn the basis of our 5-year follow-up study, a high-normal UACR predicts the development of MetS in Korean men.

Incidence of Metabolic Syndrome over 9 Years Follow-Up; the Importance of Sex Differences in the Role of Insulin Resistance and Other Risk Factors

To determine, the predictors of incident metabolic syndrome (MetS) in a community-based cohort of West Asians, during a mean follow-up of 9.3 years, a sample of 2858 non-MetS Iranian adults aged ≥ 20 years were examined at baseline and followed at three year intervals during three consecutive phases. The MetS was defined using the joint interim statement. Cox proportional hazard regression was used to determine the independent variables associated with incident MetS. Overall, 1117 new cases MetS were identified resulting in an incidence rate of 550.9/10000 person years (95% CI: 519.5-584.2). The corresponding incidence rates among women and men were 433.5/10000 person years (95% CI: 398.8-471.2) and 749.2/10000 person years (95% CI: 689.9-813.5), respectively. Baseline-adjusted predictors of developing MetS included all of the MetS components, being overweight or obese in both gender, and family history of diabetes and age only in women. There were significant effect modifications of gender on age (P<0.001), high blood pressure (0.026), high waist circumference (P<0001) and obesity categories (all P ≤ 0.01) in multivariate analysis. After considering HOMA–IR in the model, among women, all of the MetS predictors as well as those with HOMA-IR ≥ 2.23 showed a significant risk for incident MetS [HR: 1.63 (1.16-2.28)]; however, among men all the MetS components (WC was marginally significant) as well as the fourth quartile of HOMA-IR [HR: 1.50 (1.03-2.17)] and being overweight showed a significant risk. Finally, in the pooled analysis, we showed that female gender had lower risk for incident MetS than male [HR: 0.58 (0.47-0.70)]. In the Iranian population, high incidence of MetS, especially among men, was shown. Our findings confirmed that sex- specific risk predictors should be considered in primary prevention for incident MetS.

Significant but weak spousal concordance of metabolic syndrome components in Japanese couples

This study was initiated to investigate if spousal concordance in metabolic syndrome (MS) components exist in Japan. In all, 756 couples (mean age: 48.9 and 47.3years for husbands and wives, respectively) were identified. Each subject was classified as an MS, MS reserves (MSRES) or no risk of MS (NonMS) case after Japanese Ministry of Health, Labour and Welfare (JMHLW) criteria. Criteria of the National Cholesterol Education Program and of the Joint Interim Statement were also applied. With Japanese Ministry of Health, Labor and Welfare (JMHLW) criteria, MS, MSRES and NonMS cases accounted for 11.9, 14.7 and 73.4% in husbands and 1.6, 3.7 and 94.7% in wives. Waist circumference (WC), body mass index (BMI), systolic blood pressure (SBP) and hemoglobin A1c (HbA1c) showed significant correlation (p<0.01). Correlation was also significant (p<0.05) for mean blood pressure (MBP) and fasting plasma glucose (FPG). When adjusted for age, correlations were significant only for WC, BMI and HbA1c. Furthermore, none of the correlation coefficients were greater than 0.2. Logistic regression analyses did not suggest significant mutual influence in MS status between the couples. Spousal concordance in MS components was detected for WC, BMI, SBP, MBP, FPG and HbA1c, but the correlation was generally weak and modest in Japanese couples.

Elevated depressive symptoms in metabolic syndrome in a general population of Japanese men: a cross-sectional study

BackgroundUncertainty still surrounds the association between metabolic syndrome (MetS) and depression. We aimed to evaluate the association between MetS and elevated depressive symptoms in a general Japanese population.MethodsThis is a cross-sectional survey of 3,113 community-dwelling individuals aged 40 years or over. MetS was defined according to the joint interim statement. MetS was diagnosed when a subject had three or more of the following components: 1) central obesity (waist circumference ≥90 cm for men, ≥80 cm in for women); 2) elevated blood pressure (≥130/85 mmHg or current use of antihypertensive medication); 3) hypertriglyceridemia (≥1.7 mmol/L); 4) low HDL cholesterol (< 1.0 mmol/L for men, < 1.3 mmol/L for women); and 5) elevated fasting plasma glucose (≥5.55 mmol/L or current use of antidiabetic medication). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). The age- and multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI) were estimated using a logistic regression model.ResultsElevated depressive symptoms were observed in 4.3% of male and 6.3% of female participants. In men, the age-adjusted prevalence of elevated depressive symptoms was significantly higher in subjects with MetS than in those without (7.1% versus 3.6%, p = 0.04). The prevalence of elevated depressive symptoms rose progressively as the number of MetS components increased (3.5%, 3.6%, 5.8%, and 9.2% in male subjects with 0–1, 2, 3, and ≥4 components, respectively; p = 0.02 for trend). This association remained significant even after adjustment for age, marital status, history of cardiovascular disease, smoking habit, alcohol intake, and regular exercise. In women, on the other hand, there was no clear association between MetS and depressive symptoms.ConclusionsMetS was associated with elevated depressive symptoms in a general population of Japanese men.

Sleep Apnea and Cardiometabolic Risk in South Asians

Sleep Apnea and Cardiometabolic Risk in South Asians

The Metabolic Syndrome among Postmenopausal Women in Rural Canton: Prevalence, Associated Factors, and the Optimal Obesity and Atherogenic Indices

ObjectivesThis research aimed to (i) determine the prevalence of metabolic syndrome (MetS) and its components; (ii) assess factors associated with MetS, and (iii) define optimal ethnic-specific cutoffs of obesity- and atherogenic-based markers to predict MetS among postmenopausal women in rural Canton.Methodology/Principal FindingsThe Rural Canton Diabetes and Metabolic Disorders Study, a population based cross-sectional study, was conducted during 2011–2012 in Canton. In person interviews, blood glucose and lipid measurements were completed for 4,706 postmenopausal women who did not receive hormone replacement therapy. MetS was diagnosed using criteria of the Joint-Interim-Statement (JIS), the International-Diabetes-Federation (IDF) and the Modified-Third-Adult-Treatment-Panel (M-ATPIII). Age-standardized prevalence of MetS was 38.4%, 28.8%, and 37.1% according to JIS, IDF, and M-ATPIII criteria, respectively. Excellent agreement was observed between three definitions (κ≥0.79), in particular between JIS and ATPIII (κ = 0.98, 95%CI: 0.97–0.98). Factors positively associated with MetS were living in Southern Canton, personal income, current smoking, higher BMI, and family history of cardiovascular disease. However, regular leisure-time physical activity can have protective effects. The optimal cutoff values for waist-circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio(WHtR), BMI, HDL-cholesterol to total cholesterol ratio (HDL/TC), HDL-cholesterol to LDL-cholesterol ratio (HDL/LDL), and triglyceride to HDL-cholesterol ratio (TG/HDL) that predicted the presence of MetS were 79.5 cm, 0.86, 0.53, 22.47 kg/m2, 0.33, 0.68, and 0.88, respectively.ConclusionsThis study highlights the importance of MetS among postmenopausal women in rural Canton. Our findings contribute to help selecting Cantonese-specific markers to predict MetS and support the need to establish educational program for promoting healthy-lifestyles among this population.

Metabolic syndrome and socioeconomic status in France: The French Nutrition and Health Survey (ENNS, 2006–2007)

The main objective was to estimate, in France, the prevalence of metabolic syndrome (MetS) and to investigate the association between socioeconomic position and MetS. The French National Nutrition and Health Survey (ENNS) cross-sectional national multistage sampling was carried out in 2006-2007. Data collection included waist circumference and blood pressure measurements, blood sample and sociodemographic and medication information. The prevalence of MetS was assessed using several definitions, including Joint Interim Statement (JIS). Association with sociodemographic covariates was assessed using logistic regression models. Among the 1,856 participants 18-74 years of age, MetS prevalence was found to vary from 14.6 % (National Cholesterol Education Program definition) to 21.1 % (JIS), with no difference between genders. After adjustment, risk of MetS increased with age in both men and women. In women, MetS risk was inversely associated with education level. Risk of MetS was higher in men born outside France than in French-born males. MetS prevalence appeared to be lower in France than in most industrialised countries. The promoting of public health measures to reduce MetS, for example, lifestyle changes, is of utmost importance, particularly among less favourable socioeconomic categories and among migrants.

Metabolic syndrome and incidence of asthma in adults: the HUNT study

Obesity is a risk factor for incident asthma in adults, and obesity is a major component of metabolic syndrome. This study aimed to explore the associations of metabolic syndrome and its components with the cumulative incidence of asthma in adults. We conducted a prospective cohort study of participants who were asthma-free at baseline (n = 23 191) in the Nord-Trøndelag Health Study from 1995 to 2008. Baseline metabolic syndrome was categorised using the definition of the Joint Interim Statement from several international organisations. Incident asthma was self-reported at follow-up, which averaged 11 years. Metabolic syndrome was a risk factor for incident asthma (adjusted OR 1.57, 95% CI 1.31-1.87). This association was consistent in sensitivity analyses using a stricter asthma definition (adjusted OR 1.42, 95% CI 1.13-1.79). Among the components of metabolic syndrome, two remained associated with incident asthma after mutual adjustment for the other metabolic components: high waist circumference (adjusted OR 1.62, 95% CI 1.36-1.94) and elevated glucose or diabetes (adjusted OR 1.43, 95% CI 1.01-2.04). Metabolic syndrome and two of its components (high waist circumference and elevated glucose or diabetes) were associated with an increased risk of incident asthma in adults.

The lack of association between idiopathic hirsutism and metabolic disturbances: Iranian PCOS Prevalence Study

Background: Idiopathic hirsutism (IH) is a condition diagnosed after other hirsutism related is ruled out. Its definition diagnosis had a dynamic process along with improving the understanding of the various androgen excess disorders. There is uncertainty regarding its health impact and its long-term metabolic consequences. We aimed to compare metabolic syndrome (Mets) and insulin resistance (IR) of Iranian women with IH and a group of healthy controls in a large community-based study.Methods: Anthropometric measurements, biochemical parameters, Mets (using Joint Interim Statement criteria) and IR (estimated by the homeostasis model assessment), were compared between 101 women with IH and 423 healthy controls recruited from among 1126 reproductive aged women.Results: There was a statistically significant difference between the BMI of women with IH in comparison to normal control (27.7 versus 26.7 kg/m2, p = 0.02); however, the prevalence of android adiposity was similar (26.7% and 24.3%, respectively). The age and BMI adjusted prevalence of Mets and IR are similar in women with IH and controls (30% versus 23.9 and 25.7 % versus 22.5%, respectively).Conclusion: There will be no need for additional cardiometabolic evaluations for women with IH, later in life.

Lunch energy density and the metabolic syndrome in patients with type 2 diabetes mellitus

The aim of the present study was to investigate the possible associations between dietary energy density (ED) and the metabolic syndrome (MetS) in patients with type 2 diabetes. In the present case-control study, the dietary ED of 125 patients with type 2 diabetes (seventy-eight with (cases) the MetS and forty-seven without (controls) the MetS; mean age 62·0 (SD 9·4) years, mean diabetes duration 12·5 (SD 8·4) years and mean glycated Hb 7·2 (SD 1·3) %) was assessed by weighed diet records. The MetS was defined according to the 2009 Joint Interim Statement and ED by the amount of energy (kJ) in a given weight of food. Data are expressed as means (standard deviations) or medians (interquartile ranges). Patients with the MetS reported lower intakes of total energy and fibre, and a higher total food amount than the controls; the total ED did not differ, but the cases had a higher ED at lunch (mean 6·3 (SD 1·3) v. 5·9 (SD 0·8) kJ/g; P= 0·017). In this meal, patients with the MetS had lower intakes of beans (median 0·7 (interquartile range 0·4-1·1) v. 1·1 (interquartile range 0·6-1·6) g/kg; P= 0·020), vegetables (median 1·2 (interquartile range 0·6-1·7) v. 1·4 (interquartile range 1·0-2·0) g/kg; P= 0·046) and total meat (median 1·3 (interquartile range 1·0-1·6) v. 1·4 (interquartile range 1·2-1·8) g/kg; P= 0·034) than patients without the MetS. The associations between lunch ED (kJ/g) and food groups (g/kg) were confirmed for vegetables (r - 0·584; P< 0·001), fruits (r - 0·233; P= 0·070), beans (r - 0·189; P= 0·037) and oils (r 0·323; P< 0·001). In a multivariate logistic regression model, a high lunch ED was associated with the MetS (OR 6·89, 95 % CI 1·35, 35·15; P =0·020) after adjusting for confounders. In conclusion, a high ED at lunch increased the odds of the presence of the MetS in patients with type 2 diabetes. Beans and vegetables may be the major contributors to this association and their consumption might be considered to decrease ED.

Dairy food consumption is inversely associated with the risk of the metabolic syndrome in Korean adults

The present study explored the association between dairy food consumption and the risk of the metabolic syndrome in Korean adults using the most recent nationally representative data. The study sample comprised 4862 Korean adults (≥19years) who participated in the fifth Korean National Health and Nutrition Examination Surveys. Dairy food consumption was assessed using a food frequency questionnaire. The metabolic syndrome was defined according to the joint interim statement of the International Diabetes Federation and the American Heart Association/National Heart, Lung and Blood Institute. We found that the prevalence of the metabolic syndrome was significantly lower in subjects with higher milk or yogurt consumption (P<0.0001). Adjusted odds ratios (ORs) for abdominal obesity and high fasting glucose were significantly lower among subjects in the highest (≥ once per day) than in the lowest (none or rarely) category of milk consumption after adjusting for potential risk factors [OR=0.68, 95% confidence interval (CI)=0.50-0.93, P for trend=0.0314; OR=0.82, 95% CI=0.65-1.03, P for trend=0.0233]. The adjusted ORs for lower high-density lipoprotein cholesterol was 28% lower among subjects in the highest compared to subjects in the lowest category of yogurt consumption (OR=0.72, 95% CI=0.52-1.00, P for trend=0.0197). Furthermore, higher consumption of milk or yogurt was found to be significantly associated with a lower risk of the metabolic syndrome (OR=0.71, 95% CI=0.55-0.93, P for trend=0.0066; OR=0.71, 95% CI=0.48-1.05, P for trend=0.0067). High intakes of dairy foods may be associated with a lower risk of the metabolic syndrome.

Metabolic Syndrome and Fatal Outcomes in the Post-Stroke Event: A 5-Year Cohort Study in Cameroon

Background and PurposeDeterminants of post-acute stroke outcomes in Africa have been less investigated. We assessed the association of metabolic syndrome (MetS) and insulin resistance with post-stroke mortality in patients with first-ever-in-lifetime stroke in the capital city of Cameroon (sub-Saharan Africa).MethodsPatients with an acute first-stroke event (n = 57) were recruited between May and October 2006, and followed for 5 years for mortality outcome. MetS definition was based on the Joint Interim Statement 2009, insulin sensitivity/resistance assessed via glucose-to-insulin ratio, quantitative insulin sensitivity check index and homeostatic model assessment.ResultsOverall, 24 (42%) patients deceased during follow-up. The prevalence of MetS was higher in patients who died after 28 days, 1 year and 5 years from any cause or cardiovascular-related causes (all p≤0.040). MetS was associated with an increased overall mortality both after 1 year (39% vs. 9%) and 5 years of follow-up (55% vs. 26%, p = 0.022). Similarly, fatal events due to cardiovascular-related conditions were more frequent in the presence of MetS both 1 year (37% vs. 9%) and 5 years after the first-ever-in-lifetime stroke (43% vs. 13%, p = 0.017). Unlike biochemical measures of insulin sensitivity and resistance (non-significant), in age- and sex-adjusted Cox models, MetS was associated with hazard ratio (95% CI) of 2.63 (1.03–6.73) and 3.54 (1.00–12.56) respectively for all-cause and cardiovascular mortality 5 years after stroke onset.ConclusionThe Joint Interim Statement 2009 definition of MetS may aid the identification of a subgroup of black African stroke patients who may benefit from intensification of risk factor management.

Dairy consumption is inversely associated with the risk of metabolic syndrome in Korean adults

This study explored the association between dairy food consumption and the risk of metabolic syndrome in Korean adults. The study sample comprised 4,862 Korean adults (≥ 19 years) who participated in the fifth Korean National Health and Nutrition Examination Surveys. Dairy food consumption was assessed using a food‐frequency questionnaire. Metabolic syndrome was defined according to the joint interim statement of the International Diabetes Federation/American Heart Association. We found that adjusted odds ratios (ORs) for abdominal obesity and high fasting glucose were significantly lower among subjects in the highest (≥ once/day) than in the lowest (none or rarely) category of milk consumption after adjusting for potential risk factors (OR=0.68, 95 % CI: 0.50–0.93, P for trend=0.0314; OR=0.82, 95% CI: 0.65–1.03, P for trend=0.0233). The adjusted ORs for lower HDL cholesterol was 28 % lower among subjects in the highest as compared with subjects in the lowest category of yogurt consumption (OR=0.72, 95 % CI: 0.52–1.00, P for trend=0.0197). Furthermore, higher consumption of milk or yogurt was found to be significantly associated with a lower risk of metabolic syndrome (OR=0.71, 95 % CI: 0.55–0.93, P for trend=0.0066; OR=0.71, 95 % CI: 0.48–1.05, P for trend=0.0067). High intakes of dairy foods may be associated with a lower risk of metabolic syndrome. Supported by Daegu University

Metabolic syndrome in Chinese patients with systemic lupus erythematosus: no association with plasma cortisol level

Our objective was to determine metabolic syndrome (MS) prevalence in Chinese patients with systemic lupus erythematosus (SLE) and to investigate the conditions that contribute to its development. 116 patients with SLE classified according to the American College of Rheumatology (ACR) classification criteria, and 115 controls were enrolled. MS was defined by the joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity (IDF/NHLBI/AHA/WHF/IAS/IASO). SLE features and treatment of SLE were assessed. Fasting insulin and cortisol levels of 30 newly diagnosed, untreated patients and 33 age and sex-matched controls were detected. MS prevalence was 34.2% in patients with SLE and 14.8% in controls (p=0.002). Lupus patients with MS had less frequency of hydroxychloroquine (HCQ) intake (16.0% vs 45.8%; p=0.012). Untreated patients with SLE had higher levels of fasting insulin (10.92 ± 13.53 vs 5.48 ± 5.43 uU/mL, p<0.001) and plasma cortisol at 16:00 (257.22 ± 177.98 vs 139.84 ± 63.46 nmol/L, p=0.001), but lower plasma cortisol at 08:00 (195.51 ± 149.84 vs 278.95 ± 136.27 nmol/L, p=0.024). Comparisons regarding steroid therapy, levels of insulin and cortisol were not statistically significant between patients with MS and without MS. The Chinese patients with SLE presented a higher MS prevalence and fasting insulin than controls. MS was not associated with the steroid therapy and plasma cortisol. HCQ use proved to be protective against MS. The circadian rhythm of cortisol may differ in patients with SLE.

Normal Weight Obesity Is Associated with Metabolic Syndrome and Insulin Resistance in Young Adults from a Middle-Income Country

ObjectiveThis population-based birth cohort study examined whether normal weight obesity is associated with metabolic disorders in young adults in a middle-income country undergoing rapid nutrition transition.Design and MethodsThe sample involved 1,222 males and females from the 1978/79 Ribeirão Preto birth cohort, Brazil, aged 23–25 years. NWO was defined as body mass index (BMI) within the normal range (18.5–24.9 kg/m2) and the sum of subscapular and triceps skinfolds above the sex-specific 90th percentiles of the study sample. It was also defined as normal BMI and % BF (body fat) >23% in men and >30% in women. Insulin resistance (IR), insulin sensitivity and secretion were based on the Homeostasis Model Assessment (HOMA) model.ResultsIn logistic models, after adjusting for age, sex and skin colour, NWO was significantly associated with Metabolic Syndrome (MS) according to the Joint Interim Statement (JIS) definition (Odds Ratio OR = 6.83; 95% Confidence Interval CI 2.84–16.47). NWO was also associated with HOMA2-IR (OR = 3.81; 95%CI 1.57–9.28), low insulin sensitivity (OR = 3.89; 95%CI 2.39–6.33), and high insulin secretion (OR = 2.17; 95%CI 1.24–3.80). Significant associations between NWO and some components of the MS were also detected: high waist circumference (OR = 8.46; 95%CI 5.09–14.04), low High Density Lipoprotein cholesterol (OR = 1.65; 95%CI 1.11–2.47) and high triglyceride levels (OR = 1.93; 95%CI 1.02–3.64). Most estimates changed little after further adjustment for early and adult life variables.ConclusionsNWO was associated with MS and IR, suggesting that clinical assessment of excess body fat in normal-BMI individuals should begin early in life even in middle-income countries.

Absence of Association Between Vitamin D Deficiency and Incident Metabolic Syndrome: Tehran Lipid and Glucose Study

Links between vitamin D status and metabolic syndrome have been reported in cross-sectional studies; however, few prospective studies regarding this association exist. We performed this study to assess prospective association between vitamin D status and incident metabolic syndrome in a large population-based cohort. This was a nested case-control study within the Tehran Lipid and Glucose Study (TLGS) which followed representative Tehranian adults. A total of 324 matched pairs aged 20 or older were selected. Cases and controls were free of metabolic syndrome according to definition of Joint Interim Statement (JIS) at baseline and followed for a mean duration of 6.8 years. Each case was matched individually by sex, age, duration of follow-up, and month of entry to the study with a randomly selected control. Prespecified cut points were used to characterize varying degrees of 25-hydroxyvitamin D [25(OH)D] deficiency (<20, 20-29.9, and ≥30 ng/mL). Conditional logistic regression was used to investigate the association between 25(OH)D concentration and the incident metabolic syndrome. The mean age of participants was 40.8±11.7, and 50% were women. The median [interquartile range (IQR) 25-75] of serum 25(OH) D was 16 ng/mL (10-25 ng/mL) and there was no difference between cases (16 ng/mL; IQR 10-25 ng/mL) and controls (16 ng/mL; IQR 10-26 ng/mL). The odds ratio of serum 25(OH)D <20 ng/mL for developing metabolic syndrome was 0.97 [95% confidence interval (CI) 0.6-1.52] compared with serum 25(OH)D ≥30 ng/mL. Adjustment for potential confounders did not change the results. Our study does not provide evidence that there is association between different serum vitamin D levels and incidence of metabolic syndrome.

Prevalence of Metabolic Syndrome in Local Population of Patan.

Introduction: The metabolic syndrome (MS) is a cluster of complex interrelated risk factors for diabetes and cardiovascular disease which includes central obesity, glucose intolerance, hypertension, high triglyceride and low HDL-C. The prevalence of MS in Asian Indian is 49.2%. There is evidence of increasing prevalence of MS in the world. Therefore, we intended to find the prevalence of the metabolic syndrome in the local population of Patan, a major urban center in Nepal. Methods: It was a cross-sectional study which was carried out in one of the urban clusters (or wards) of the Lalitpur Sub- Metropolitan (or Patan) City. Measurements of waist circumference, height, weight; blood parameters like lipid profile, fasting blood sugar (FBS) were done. Measurement of blood pressure was done. The prevalence of MS was obtained by using three different criteria Joint Interim Statement 2009 criteria, International diabetes federation (IDF) 2005 criteria and National cholesterol education program adult treatment Panel (NCEP ATP) III 2001 criteria. Results: There were 205 participants among which 34.6% were male and 65.4% were female. The prevalence of MS as per the Joint Interim Statement 2009, IDF 2005 and NCEP ATP III 2001 criteria was 61.7%, 52.7% and 43.4% respectively. There was significantly high total cholesterol (TC), triglyceride (TAG), FBS, systolic blood pressure (SBP) and diastolic blood pressure (DBP) and significantly low HDL-C in the individuals with MS compared to the normal individuals. The logistic regression revealed the increasing prevalence of MS with increasing age, BMI and positive family history of diabetes. Conclusions: There is high prevalence of MS in the study population. Age, BMI and family history of diabetes are found to be the main predictors for metabolic syndrome. Medical Journal of Shree Birendra Hospital; Jan-June 2012/vol.11/Issue1/27-31 DOI: http://dx.doi.org/10.3126/mjsbh.v11i1.7764