Metabolic Syndrome Risk Score Research Articles

Dietary acid load berhubungan dengan sindrom metabolik dan kesehatan mental pada mahasiswi obesitas

The dietary acid load was associated with metabolic syndrome and mental health among obese college studentsBackground: The prevalence of metabolic syndrome has been increasing every year in the young population. The western diet is one of the causes that makes excess acid in the body called a dietary acid load. On the other hand, the high dietary acid load was associated with decreased mental health status.Objective: To examine the association between dietary acid load and the risk of metabolic syndrome and mental health.Methods: This was a cross-sectional study conducted with 115 female students in Semarang aged 18-22 years. The dietary acid load was evaluated through a potential renal acid load (PRAL), the risk score for metabolic syndrome was calculated by Metabolic syndrome risk score. Mental health status was assessed through levels of self-esteem and levels of anxiety. The level of self-esteem was measured by the Rosenberg Self-Esteem Scale questionnaire, while the level of anxiety was measured by the State Anxiety Inventory questionnaire. Multiple linear regression models with adjustment for a potential cofounding variable were used to evaluate the association between dietary acid load with metabolic syndrome scores, self-esteem scores, and anxiety scores.Results: The mean PRAL score was 6.11 ± 9.72 mEq/day indicated the intake of the subjects was the dietary acid load. 13% of subjects had metabolic syndrome, and 87% had a pre-metabolic syndrome. 36.5% of the subjects have low self-esteem scores. The anxiety level score calculation shows that 59.1% of the subjects are at high risk of anxiety. Pearson test showed that PRAL scores were correlated with anxiety scores (r=0,669; p<0,001). The linear regression test showed that PRAL scores were correlated with metabolic syndrome scores (β=0.899; p<0.001) and self-esteem scores (β =-0.069; p=0.047).Conclusions: High dietary acid load may be a risk factor related to the development of metabolic disorders and decreased mental health status in females with obesity.

Sedentary Time and Metabolic Risk in Extremely Active Older Adults.

OBJECTIVEIncreasing evidence suggests that time spent sedentary predicts increasing cardiometabolic risk independent of other physical activity. We objectively measured activity levels in active older adults and examined the association between sedentary behavior and the continuous metabolic syndrome risk score (cMSy).RESEARCH DESIGN AND METHODSOlder adults (age ≥65 years) were recruited from the Whistler Masters ski team, a group of active older adults who undergo organized group training. Daily activity levels were recorded with accelerometers (SenseWear) worn for 7 days. A compositional approach was used to determine proportion of the time spent sedentary as compared with all other nonsedentary behaviors (isometric log-ratio transformation for time spent sedentary [ILR1]). Waist circumference, triglycerides, HDL, systolic blood pressure, and fasting glucose were measured, and cMSy was calculated using principal component analysis (sum of eigenvalues ≥1.0).RESULTSFifty-four subjects (30 women and 24 men, mean ± SE age 71.4 ± 0.6 years) were recruited. Subjects demonstrated high levels of physical activity (2.6 ± 0.2 h light activity and 3.9 ± 0.2 h moderate/vigorous activity). In our final parsimonious model, ILR1 showed a significant positive association with increasing cMSy (standardized β = 0.368 ± 0.110, R2 = 0.40, P = 0.002), independent of age and biological sex.CONCLUSIONSDespite high levels of activity, ILR1 demonstrated a strong association with cMSy. This suggests that even in active older adults, sedentary behavior is associated with increasing cardiometabolic risk.

A comparison between body mass index and waist circumference for identifying continuous metabolic syndrome risk score components in Iranian school-aged children using a structural equation modeling approach: the CASPIAN-V study.

The purpose of this study was to investigate the association of anthropometric indices with continuous metabolic syndrome (cMetS) risk score components in a large population-based sample of children and adolescents. This multi-centric study was performed on 3843 students aged 7-18years who were selected by multistage, stratified cluster sampling method from 30 provinces of Iran. Demographic, anthropometric and biochemical factors were obtained and standardized residuals (z-scores) were calculated for MetS components. A structural equation modeling approach was applied to evaluate the relationships among the study variables and to implement the subsequent structural modeling. The mean age of the participants (52.3% boys) was 12.4 ± 3.05years. Standardized scores of body mass index (ZBMI) and waist circumference (ZWC) had a direct effect on standardized scores of mean arterial pressure (ZMAP) (0.23 and 0.24 in boys and 0.22 and 0.23 in girls, respectively) and triglyceride (ZTG) (0.07 and 0.04 in boys and 0.02 and 0.06 in girls, respectively), but the effect of ZWC was stronger than ZBMI on these variables. Age, socioeconomic status and sedentary behaviors showed a positive direct effect on ZWC (0.01, 0.05 and 0.07 in boys and 0.05, 0.08 and 0.002 in girls, respectively). These variables induced indirect effects on cMets risk score components through ZWC. The magnitude of association between WC and continuous metabolic syndrome risk score components was higher compared to BMI in school-aged children, emphasizing on paying more attention to central obesity in childhood. Level V, cross-sectional descriptive study.

Body Mass Index From Early to Late Childhood and Cardiometabolic Measurements at 11 to 12 Years.

To examine how overweight and obesity at specific ages and overall BMI growth patterns throughout childhood predict cardiometabolic phenotypes at 11 to 12 years. In a population-based sample of 5107 infants, BMI was measured every 2 years between ages 2 to 3 and 10 to 11 years. We identified 5 BMI trajectories using growth curve models. At ages 11 to 12 years, 1811 children completed assessments for metabolic syndrome risk scores, carotid-femoral pulse wave velocity, and carotid intima-media thickness. Multivariable regression models were used to estimate associations, adjusted for potential confounders (eg, age, sex, smoking exposure, and small for gestational age). Overweight and obesity from early childhood onward were strongly associated with higher cardiometabolic risk at 11 to 12 years of age. At age 6 to 7 years, compared with those with a healthy weight, children with overweight had higher metabolic syndrome risk scores by 0.23 SD units (95% confidence interval 0.05 to 0.41) and with obesity by 0.76 SD units (0.51-1.01), with associations almost doubling by age 10 to 11 years. Obese (but not overweight) children had higher outcome pulse wave velocity (0.64-0.73 SD units) from ages 6 to 7 years and slightly higher outcome carotid intima-media thickness (0.20-0.30 SD units) at all ages. Cumulative exposure to high BMI from 2 to 3 years of age carried the greatest cardiometabolic risk, with a gradient of risk across trajectories. High early-childhood BMI is already silently associated with the development of cardiometabolic risk by 11 to 12 years, highlighting the urgent need for effective action to reduce overweight and obesity in early childhood.

702-P: Daily Sedentary Time and Continuous Metabolic Risk Score in Very Active Older Adults

Background: Increasing evidence suggests that time spent sedentary (ST) predicts increasing cardiometabolic risk independent of other activity. We objectively measured activity levels in active older adults, and examined the association between ST and the continuous Metabolic Syndrome Risk Score (cMSy). Methods: Older adults (age >= 65) were recruited from a Master’s Ski Team, a group of active older adults that undergo organized group training. Daily activity levels (sedentary, ST; light, LT; moderate/vigorous activity, MT) were recorded with accelerometers (SenseWear) worn for 7 days continuously. Waist circumference, triglycerides, high-density lipoprotein, systolic blood pressure and fasting glucose were measured and cMSy was calculated using principal component analysis (sum of eigenvalues ≥ 1.0). Results: 54 subjects (age=71.4±0.6 years, 30 women and 24 men) were recruited. Subjects demonstrated high levels of physical activity (LT= 2.6±0.2 and MT=3.9±0.2 hours per day). In our final parsimonious model, ST showed a significant positive association with increasing cMSy (Standardized β=0.312±0.115, R2 = 0.36, p<0.001), independent of age, biological sex and other measures of physical activity (LT and MT). Conclusions: Despite high levels of activity, ST demonstrated a strong association with cMSy. This suggests that even in active older adults, ST is associated with increasing cardiometabolic risk. Disclosure K.M. Madden: None. J.M. Chase: None. Funding Allan M. McGavin Foundation

Peningkatan visceral adiposity index berhubungan dengan sindrom metabolik remaja obesitas

The increased visceral adiposity index associated with metabolic syndrome in obese adolescentsBackground: Metabolic syndrome is a complex risk factor of cardiovascular disease and diabetes mellitus type II. Metabolic syndrome scores are calculated to describe the severity of the risk of metabolic syndrome. Adipose tissue is an independent risk factor for metabolic changes related to metabolic syndrome. One indicator to calculate the distribution and fat function is through the calculation of the visceral adiposity index (VAI).Objective: Analyzing the correlation of VAI with metabolic syndrome score in adolescents in the City of Semarang.Methods: A cross-sectional study of 95 obese adolescents in Semarang City aged 12-17 years who were selected by consecutive sampling method. The inclusion criteria were students aged 12-17 years; subjects were obese based on BMI for age (BMI/U > 95th percentile CDC 2000 curves); not in chronic pain or the care of a doctor; and not on a certain diet. Data collected were waist circumference (WC), blood pressure, fasting blood sugar levels, triglyceride levels, and high-density lipoprotein (HDL) levels. Metabolic syndrome scores are calculated using metabolic syndrome risk score (cMets). VAI is calculated to measure fat distribution and dysfunction. Correlation of VAI with metabolic syndrome and the component was analyzed with the Spearman test.Results: VAI score has a range of 1.8-14.9 with a greater mean in female subjects. The metabolic syndrome score has a range of -5.9 to 6.3 with a greater mean in male subjects. The Spearman correlation test showed a significant relationship between VAI and HDL levels (r=-0.427), triglyceride levels (r=0.914), and metabolic syndrome scores (r=0.439) in male, and HDL levels (r=-0.427), triglyceride levels (r=0.955), WC (r=0.346), and metabolic syndrome scores (r=0.691) in female.Conclusions: VAI has a significant relationship with the metabolic syndrome score which indicates the body's metabolic profile which is getting worse, so the body's metabolic profile can be described from the magnitude of VAI.

Metabolic Syndrome and Framingham Risk Score in Coronary Artery Disease Cases

Metabolic syndrome is a group of simultaneous conditions that expanding your risk of heart disease, stroke, and type 2 diabetes. These conditions include increased blood pressure, high glucose level, and abundance muscle versus fat around the abdomen or triglyceride levels. The objective of the study is to demographic, biochemical, obesity indices and angiographic profile (severity of CAD) of patients with coronary artery disease (CAD). A prospective and observational study involving a number of 971 patients who had undergone coronary angiogram (CAG) for the 18-month CAD assessment. In present study about half of population had significant abnormality on coronary angiogram. Amongst abnormal coronary angiogram about 50% of patients had single vessel disease. The FRS had positive correlation with severity of coronary artery disease and waist circumference. FRS and metabolic syndrome had critical contribution as score and risk factors with presence of and severity of CAD. To conclude it was suggested to incorporate FRS and components of metabolic syndrome for better management and risk stratification of coronary artery disease at large.

Abstract P527: Body Mass Index (bmi, Kg/m 2 ) vs. Body Fat % (bf%): Battle of Obesity Classification Metrics to Inform Underlying Cardiometabolic Risk

Introduction: The WHO defines overweight and obesity as abnormal or excessive fat accumulation that may impair health. However, for population and clinical classification of overweight and obesity BMI is most commonly used as a proxy for adiposity. Despite the strength of the association between higher BMI and cardiometabolic disease risk across populations, and minimal direct comparison of BMI v. BF%, BMI draws significant criticism as a metric to classify obesity and screen for cardiometabolic risk. Hypothesis: BF% defined obesity classification categories have higher underlying cardiometabolic risk compared to equivalent BMI categories. Methods: We analyzed data from CARDIA study participants from the year 20 exam with concurrent measures of BMI, and BF% measured by Dual-energy X-ray absorptiometry (DXA), plus clinical measures. Sex specific BF% obesity classification categories were defined by evidence-based diagnostic and classification performance measures vs. standard BMI cut points. Underlying cardiometabolic risk was defined by a continuous metabolic syndrome risk score (MetS), consisting of the averaged standardized deviates of the 5 ATP III components. Higher MetS z-scores indicate higher overall risk. MetS z-scores between categories (e.g. obesity defined by BMI v. BF%) were compared by z-tests. Results: The figure reports the distribution of obesity classification categories by the different metrics and underlying cardiometabolic risk. The MetS risk score was significantly higher in BMI defined overweight and obesity compared to BF% defined categories; and BF% defined obesity categories classify a greater prevalence of the population as obese compared to BMI. Results for MetS risk did not differ by race/sex or when including prevalent cardiometabolic disease. Conclusions: Physiologically defined BF% obesity categories classify a greater prevalence of obesity in CARDIA at year 20, whereas there was higher underlying cardiometabolic risk in BMI defined obesity classification categories.

Clinical implication of 18F-NaF PET/computed tomography indexes of aortic calcification in coronary artery disease patients: correlations with cardiovascular risk factors.

Vascular calcification is known to be associated with cardiovascular risk factors. Recently, F-NaF PET has been reported to be effective for detecting early and active vascular calcification. In this study, correlations between F-NaF PET/computed tomography (CT) findings and cardiovascular risk factors were investigated in patients with suspected coronary artery disease. Forty patients with suspected coronary artery disease underwent F-NaF PET/CT. The maximum and overall burden of calcifying activity, and the overall burden of calcium deposition in the descending thoracic aorta (DTA) were measured on F-NaF PET/CT and they were compared with cardiovascular risk factors, particularly, with those related to metabolic syndrome. The maximum and overall burden of calcifying activity in DTA measured on F-NaF PET were significantly correlated with diabetes mellitus (P = 0.030 and 0.049, respectively) and serum HbA1c level (ρ = 0.433 and 0.344, respectively). In contrast, the overall burden of calcium deposition measured on CT was significantly correlated with hypertension (P < 0.001). The overall burden of calcium deposition was also significantly correlated with metabolic syndrome (P = 0.002) and 10-year cardiovascular disease risk score (P = 0.004) CONCLUSION: F-NaF uptake is closely related to diabetes mellitus, whereas aortic calcification on CT is closely related to hypertension. Although F-NaF uptake in DTA can be a potential prognostic factor, aortic calcification on CT is a more significant prognostic factor for overall cardiovascular risk than F-NaF uptake.

Comparison between metabolic syndrome and framingham risk score as predictor of cardiovascular disease among Kazakhs population

Objective To compare metabolic syndrome(MS)with Framingham risk score as predictors of cardiovascular disease(CVD)among Kazakhs population. Methods The participants were the residents who had been followed up for more than 5 years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting development of CVD using Cox regression and receiver operating characteristic curve. Results The incidence of CVD was 13.87%. The incidence of CVD was higher in the MS group than it in the non-MS group(21.59% vs 11.10%, P<0.001). The area under the receiver operating characteristic(ROC)curve of MS risk score was significantly larger than that of MS classification(0.727 vs 0.585, P<0.001); the area under the curve of MS risk score was close to that of Framingham risk score(0.732 vs 0.727, P=0.673). The association between CVD and each quintile of MS risk score was more significant than that between Framingham risk score and CVD under the same exposed condition(4.61, 9.33, 14.15, 22.29 vs 3.69, 6.36, 8.47, 16.99). Conclusion MS risk score that included age may be a better predictor of CVD among Kazakhs population. Key words: Metabolic syndrome; Framingham risk score; Kazakhs; Cardiovascular disease

Tipe tubuh (somatotype) dengan sindrom metabolik pada wanita dewasa non-obesitas usia 25 – 40 tahun

Body type (somatotype) with metabolic syndrome among non-obese woman aged 25-40 years oldBackground: The prevalence of central obesity was found high in women, not only in obese individuals but also occur in non-obese individuals or metabolically obese normal weight (MONW). Endomorph marked by higher fat mass, which will lead to metabolic disorders.Objective: This study aimed to describe the correlation of somatotype with metabolic syndrome in a non-obese woman.Methods: Cross-sectional observational study, subjects were selected using purposive sampling involving 46 women 25-40 years old with BMI 18.5-24.9 kg/m2 in several offices in the City of Semarang, consist of Balai Besar Teknologi Pencegahan dan Pencemaran Industri, Dinas Pekerjaan Umum, and Dinas Perindustrian dan Perdagangan Central Java. Somatotype data is measured in three components, namely endomorph, mesomorph, and ectomorph. The resulting value of each component is calculated using the Heath-Carter formula. Triglycerides, HDL, and fasting blood glucose measured by enzymatic colorimetric methods. Blood pressure measured by aneroid sphygmomanometer. Syndrome metabolic was defined as metabolic syndrome risk score (cMetS). Data were analyzed by Rank Spearman and Pearson.Results: The subject's body type is endomorph as much as 91.3% and ectomorph-endomorph (8.7%). Central obesity (50%), low HDL levels (28%), hypertriglyceridemia (2%), normal GDP levels (100%), hypertension (15%), metabolic syndrome (13%), and metabolic pre-syndromes (47, 8%) found in the subject of this study. There were correlation between endomorph (p=0.005; r=0.4) and ectomorph (p=0.000; r=-0.53) with waist circumference. There was a significant correlation between endomorph with metabolic syndrome risk score (p=0.05; r=0.129).Conclusions: Endomorph was associated with a metabolic syndrome risk score. Higher endomorph tends to have higher metabolic syndrome risk scores.

Development of an At-Risk Score for Metabolic Syndrome

To develop and validate a metabolic syndrome (MetS) risk score, young adults completed an in-person assessment and online health history questionnaire. Risk scoring was based on weighted multivariate risk score functions. The area under the curve was 0.86 (95% CI, 0.32 to 0.81), indicating a significant relationship between higher scores and increased odds of MetS diagnosis (OR = 1.7; 95% CI, 1.38 to 2.25). The new score was associated with the MetS Severity Score (r [correlation coefficient] = 0.42; 95% CI, 0.31 to 0.51; P &lt; .0001) and the American Heart Association score (r = −0.49; 95% CI, −0.57 to −0.39; P &lt; .0001). This score can help improve primary prevention intervention strategies for young adults at risk of MetS.

Assessment of Long Term Metabolic Effects of Atypical Antipsychotics in Schizophrenia Patients

Abstract Background and aims. Patients with schizophrenia have a shorter life expectancy than normal population partially due to the metabolic side effects of antipsychotic treatment. The aim of this study is to evaluate the long-term evolution of the metabolic syndrome in chronic schizophrenia patients on fixed second generation antipsychotics (SGA). Material and method. The components of metabolic syndrome were evaluated repeatedly in a minimum 6 months and maximum 2 years follow-up period. The presence of metabolic syndrome (MetS) and metabolic risk scores (cMetS) according to National Cholesterol Education Program Adult Treatment Panel III were calculated and compared in time. In the prevalence, incidence and normalization logistic regression studies included all the known risk factors together with the follow-up period. Finally, all these rates were compared depending on the type of SGA. Results. Only cMetS, waist circumference and diastolic blood pressure presented significant increase in the follow-up period which was in average 385.5 days. The prevalence of MetS at base-line was 39.4%, which increased to 48.5% after the follow-up period. The calculated incidence of 30% was associated with a 23.1% rate of normalization. Logistic regression studies revealed as independent risk factors the age and base-line cMetS/weight for incidence and for normalization. In the aripiprazole group the normalization rate exceeded the incidence rate (33.3% vs 20%). Conclusions. The results emphasize the highly dynamic character of the metabolic syndrome even in chronic schizophrenia patients with fixed SGA regimen. The normalization of MetS is a possibility that should not ignored. The age and weight continue to remain independent risk factors, thus close monitoring in elderly and strict weight control plan are necessary. Aripiprazole showed better safety profile, but more extensive studies are required for definitive conclusions.

A 3-SNP gene risk score and a metabolic risk score both predict hypertriglyceridemia and cardiovascular disease risk

Evidence on the causal link between plasma triglyceride (TG) levels and risk for cardiovascular disease (CVD) has recently emerged. Individuals with the metabolic syndrome have an increased risk for acquiring elevated TG levels later in life. Moreover, common DNA sequence variations in genes affecting TG levels identify individuals at risk for elevated plasma TG levels. We evaluated whether a 3-single nucleotide polymorphism (SNP) TG gene risk score (GRS) and a metabolic risk score (MetRS) both improved CVD risk prediction. A 3-SNP GRS and MetRS were generated in the EPIC-Norfolk cohort (n=20,074) based on 3 SNPs in LPL and APOA5 or the number of Metabolic Syndrome criteria present (maximum 5), respectively. The associations between the 3-SNP GRS, MetRS, TG levels, and CVD risk were evaluated. The 3-SNP GRS and MetRS were both linearly associated with plasma TG levels, that is,+0.25mmol/L [95% CI 0.22-0.27] per allele change (P<.001) and+0.72mmol/L [95% CI 0.70-0.73] per increase of number of metabolic syndrome risk score points (P<.001), respectively. We observed a positive association between the 3-SNP GRS and the risk of CVD with an adjusted hazard ratio (HR) of 1.35 [95% CI 1.04-1.74] for the highest versus the lowest GRS, which was independent of the MetRS. For the MetRS, the adjusted HR was 2.03 [95% CI 1.73-2.40] for the highest versus the lowest MetRS. Both the 3-SNP GRS and the MetRS are associated with increased plasma TG levels and increased risk for CVD.

Randomized Controlled Trial of A 12-Week Yoga-Based (Including Diet) Lifestyle vs. Dietary Intervention on Cardio-Metabolic Risk Factors and Continuous Risk Score in Indian Adults with Metabolic Syndrome

Metabolic syndrome, a prediabetic and precardiovascular pathologic condition that begins early in life, tracks into adulthood and magnifies with age. Randomized controlled trials evaluating efficacy of yoga-based lifestyle vs. dietary intervention on metabolic syndrome are lacking. Here, the efficacy of a 12-week yoga-based lifestyle intervention vs. dietary intervention on cardio-metabolic risk factors and metabolic syndrome risk scores have been assessed in Indian adults with metabolic syndrome. In this two-arm, open label, parallel group, randomized controlled trial, 260 adults (20–45 years) diagnosed with metabolic syndrome as per joint interim statement, 2009 were randomized to yoga-based (including diet) lifestyle or dietary intervention alone (n = 130, each) for 12 weeks. Primary endpoints were the 12-week changes in cardio-metabolic risk factors and metabolic risk scores. The secondary endpoints were the 12-week changes in the proportion of subjects recovered from metabolic syndrome, dietary intake, and physical activity. Intent-to-treat analysis was performed including all the subjects with baseline data with imputed missing data. Treatment × time interaction showed yoga-based lifestyle intervention had a greater treatment effect over dietary intervention by significantly reducing waist circumference, continuous metabolic syndrome z-score, and dietary intake/day while significantly increasing physical activity. High-density lipoprotein cholesterol showed a significantly greater reduction following dietary intervention than yoga-based lifestyle intervention. A significantly greater proportion of subjects recovered from metabolic syndrome in yoga-based lifestyle (45.4%) vs. dietary intervention group (32.3%). A 12-week yoga-based lifestyle intervention is more efficacious than usual dietary intervention in improving cardio-metabolic risk factor and metabolic risk score in Indian adults with metabolic syndrome.

A Cross - Sectional Analysis of The Association of Job Strain with Metabolic Syndrome and 10-Year Risk of Coronary Heart Disease

Objective: Beside the well-established biological and behavioral risk factors, psychosocial factors have been accepted as important risk factors for coronary heart diseases CHD . While there is abundant evidence for the association between job strain and CHD in developed countries, more research needed on this association in developing countries. This study aims to examine the association between job strain and the risk of CHD and metabolic syndrome among the 30–64-year-old employed individuals.Methods: This is a population-based cross-sectional study. The study sample was derived randomly from the employed individuals aged between 30 and 64 participated in baseline Balcova Heart Study. Karasek’s demand-control-support questionnaire was applied to measure job strain. Presence of metabolic syndrome and Framingham risk score were main dependent variables. 191 female and 216 male participants were included in the analyses. Pearson chi-square test, ANCOVA and logistic regression analyses were used.Results: Women were found to have higher education levels, have more white-collar jobs, and have better economic status perception than men. 20% of men and 18% of women have been working in high-strain jobs. There was significant association of job strain with neither the Framingham risk score nor metabolic syndrome. The adjustments for education, age, and occupation did not alter the results. The interaction between the social support and job strain was also not significant.Conclusion: Job strain did not have an impact on both the Framingham risk score and metabolic syndrome. Although psychosocial factors are known as important risk factors for CHD in developed countries, the evidence in developing countries is scarce

Physical activity energy expenditure and cardiometabolic health in three rural Kenyan populations.

ObjectivesPhysical activity is beneficial for metabolic health but the extent to which this may differ by ethnicity is still unclear. Here, the objective was to characterize the association between physical activity energy expenditure (PAEE) and cardiometabolic risk among the Luo, Kamba, and Maasai ethnic groups of rural Kenya.MethodsIn a cross‐sectional study of 1084 rural Kenyans, free‐living PAEE was objectively measured using individually‐calibrated heart rate and movement sensing. A clustered metabolic syndrome risk score (zMS) was developed by averaging the sex‐specific z‐scores of five risk components measuring central adiposity, blood pressure, lipid levels, glucose tolerance, and insulin resistance.Results zMS was 0.08 (−0.09; −0.06) SD lower for every 10 kJ/kg/day difference in PAEE after adjustment for age and sex; this association was modified by ethnicity (interaction with PAEE P < 0.05). When adjusted for adiposity, each 10 kJ/kg/day difference in PAEE was predicted to lower zMS by 0.04 (−0.05, −0.03) SD, without evidence of interaction by ethnicity. The Maasai were predicted to have higher cardiometabolic risk than the Kamba and Luo at every quintile of PAEE, with a strong dose‐dependent decreasing trend among all ethnicities.ConclusionFree‐living PAEE is strongly inversely associated with cardiometabolic risk in rural Kenyans. Differences between ethnic groups in this association were observed but were explained by differences in central adiposity. Therefore, targeted interventions to increase PAEE are more likely to be effective in subgroups with high central adiposity, such as Maasai with low levels of PAEE.

Comparison Between Metabolic Syndrome and the Framingham Risk Score as Predictors of Cardiovascular Diseases Among Kazakhs in Xinjiang

Metabolic syndrome (MS) and Framingham risk score (FRS) can be used for predicting the risk of developing cardiovascular diseases (CVD). Previous studies that compared FRS and MS have focused on high-income urban areas. This study focused on the comparison between FRS and MS when used in nomadic minorities in mountain areas. Moreover, an applicable tool for predicting the risk of developing CVD was identified. 2,286 participants who were recruited from the far west of China were followed-up for a median of 5.49 years. MS and FRS were compared in terms of their ability in predicting development of CVD using Cox regression and receiver operating characteristic curve. After each component of MS was appraised, its area under the curve (AUC) was 0.647. When age was included, the AUC of MS risk score increased from 0.647 to 0.758 (P < 0.001). After adjusting for age, the AUC of FRS decreased from 0.732 to 0.582 (P < 0.001). The association between CVD and each quintile of MS risk score that included age was more significant than that between FRS and CVD under the same exposed condition. In conclusion, MS risk score that included age may be a better predictor of CVD among Kazakhs.

Incidence of cardiovascular risk factors in female patients with systemic lupus erythematosus: a 3-year follow-up cohort.

Objectives To evaluate the incidence and variability of traditional coronary artery disease (CAD) risk factors in a cohort of lupus patients and to investigate if prednisone use predicts an increase in the number of risk factors. Methods A total of 151 women, 37.8 ± 11.1 (mean ± SD) years old at baseline, were reevaluated after a median period of 39 (interquartile range 36.5-42.0) months. The cumulative incidence of traditional risk factors, the incidence rate (with 95% confidence interval) of hypertension, diabetes, dyslipidemia and hypertriglyceridemia, and the frequency of the risk factors' disappearance were calculated. Metabolic syndrome (MetS) and Framingham risk score (FRS) were computed. Logistic regression was used to investigate if maximum or cumulative prednisone dose used during follow-up predicted an increase in the cardiometabolic risk factors' number. Results The cumulative incidence of risk factors varied from 39.1% (abdominal obesity) to zero (smoking), and the incidence rate varied from 133.2 (87.8-178.6) per 1000 person-years (dyslipidemia) to 10.4 (1.3-19.5) per 1000 person-years (diabetes). The cumulative incidence for MetS was 18.8%, and 11.7% of 143 patients with low FRS at baseline (T1) were classified in the high-risk category at the end of the study (T2). Dyslipidemia was the most variable risk factor, with 43.5% disappearance at T2. The maximum prednisone dose used during follow-up was borderline ( p = 0.050) for prediction of an increase in the number of cardiometabolic risk factors in an adjusted model for antimalarial use, modified Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and age. Conclusion The authors described high incidence and variability of CAD risk factors in female lupus patients, with higher prednisone dose being borderline for an increase in the number of cardiometabolic risk factors.

Long-Term Evolution of Metabolic Status in Patients with Schizophrenia Stably Maintained on Second-Generation Antipsychotics.

Objective Second-generation antipsychotics (SGAs) increase the risk of metabolic syndrome (MetS). Despite the risk of MetS, SGAs may have to be continued with change in some patients. The aim of this study was to trace the evolution of MetS in these patients. Methods Patients with schizophrenia who had been maintained on a fixed SGA regimen for more than a year were followed-up without changing the regimen. Metabolic indicators were evaluated at baseline and at follow-up. Prevalence, incidence and spontaneous normalization rate of MetS were estimated. Risk factors that might have influenced the evolution were scrutinized. Results A total of 151 subjects were included. During the mean observation period of 389.9±162.4 days, the prevalence of MetS was increased from 35.1 to 45.0%. The incidence rate was 29.6%, while the normalization rate was 26.4%, risk factors affecting incidence were age (OR=1.09, 95% CI: 1.03–1.17), baseline continuous values of metabolic syndrome risk scores (cMetS, OR=1.77, 95% CI:1.29–2.55) and baseline body weight (OR=1.06, 95% CI: 1.01–1.13). Normalization was influenced by age (OR=0.74, 95% CI: 0.57–0.89) and baseline body weight (OR=0.85, 95% CI: 0.72–0.95). Conclusion The prevalence of MetS steadily increased with the continuous use of SGAs. However, individual difference was extensive and about a quarter of the patients were able to recover naturally without specific measurements.