MetS Diagnostic Criteria Research Articles

Increased miscarriage rate is associated with at least four components of metabolic syndrome in women with polycystic ovary syndrome undergoing in vitro fertilization or intracytoplasmic sperm injection embryo transfer cycle.

This study aimed to investigate the association between the components of metabolic syndrome (MetS) and reproductive outcomes in women with polycystic ovary syndrome (PCOS) undergoing their first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) embryo transfer cycle. This is a retrospective study that included 720 women with PCOS from January 2018 to December 2021. Anthropometric, biochemical, and reproductive data of the study subjects were collected from electronic medical record. Women with PCOS met <3, 3, and >3 criteria of MetS were classified in group 1, 2, and 3, respectively. The miscarriage rate in women with MetS was significantly higher than that in non-MetS group (23.2% vs. 14.2%, p = 0.03). There was a significant increasing trend in miscarriage rate from group 1 to group 3 (p for trend <0.05). The miscarriage rate in group 3 was significantly higher than that in group 1 (29.3% vs. 14.2%, p < 0.05). Logistic regression analyses showed that women with at least four components of MetS (group 3) were independently associated with a high risk of miscarriage, with the odds ratios and 95% confidence intervals for group 2 and 3 versus group 1 were 1.38 (0.67-2.82) and 2.46 (1.06-5.74), respectively (p for trend = 0.04). PCOS women accompanied with at least four diagnostic criteria of MetS is independently associated with increased miscarriage rate when undergoing their first IVF or ICSI cycle.

C-reactive protein, fibrinogen, prothrombin time and international normalized ratio levels as indicators of chronic inflammation in patients with metabolic syndrome

Aims: Although it has been stated in studies conducted in patients with metabolic syndrome (MetS) that elevated serum fibrinogen and C-Reactive Protein (CRP) may be due to chronic inflammation, sufficient studies have not been conducted on International normalized ratio (INR) and prothrombin time (PT). The aim of this study is to examine the fibrinogen, INR and PT levels of patients with MetS and to investigate the relationship between these parameters and MetS components. Methods: A total of 56 patients, 19 males and 37 females were included in our study who applied to the Internal Medicine outpatient clinic of Ondokuz Mayıs University Faculty of Medicine and met the MetS diagnostic criteria. The control group consists of a total of 64 people, 35 men and 29 women, who have at least one of the MetS criteria and do not have a chronic disease. Fasting blood glucose, total cholesterol (Total-C), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), creatinine, thyroid stimulating hormone (TSH), PT, INR and fibrinogen levels were examined from the available samples. Data were compared between healthy and patient groups. Results: As a result of our study, it was determined that the CRP level was significantly higher in the patient group (p&lt;0.01). The average fibrinogen level was calculated as 3.56 g/l in the patient group and 2.95 g/l in the control group, and a significant difference was detected when the two groups were compared (p&lt;0.001). The average PT value was 13.1 in the patient group and 12.04 in the control group and a significant difference was detected between both groups (p&lt;0.001). The average INR level was 1.14 in the patient group and 1.04 in the control group and a significant difference was detected between both groups (p&lt;0.001). Conclusion: MetS is associated with high CRP. In patients with MetS, PT, INR and fibrinogen levels are also high. In the follow-up and treatment of patients with MetS, the presence of chronic inflammation and factors affecting the coagulation system should be taken into consideration.

Cardiorespiratory Fitness Decreases High-Sensitivity C-Reactive Protein and Improves Parameters of Metabolic Syndrome.

To evaluate the relationship between cardiorespiratory fitness (CRF), expressed as maximal oxygen uptake (ml.kg-1.min-1), metabolic syndrome (MetS), and high-sensitivity C-reactive protein (hs-CRP), a marker of systemic inflammation. The relationship between CRF, MetS, and hs-CRP was examined in a cohort of 173 men and women. CRF was evaluated using a Bruce protocol treadmill test and measured as estimated maximal oxygen uptake (VO2 max). Participants' physical activity status was self-reported. Plasma hs-CRP levels were measured using a standardized immunoassay, and the diagnostic criteria for MetS were based on guidelines established by the International Diabetes Federation (IDF). An inverse association was observed between hs-CRP levels and estimated VO2 max (p<0.01). Additionally, hs-CRP increased linearly with the number of MetS criteria present (p<0.01), while the estimated VO2 max decreased as the number of MetS criteria increased (p<0.01). Moreover, higher estimated VO2 max correlated with increased self-reported physical activity levels (p<0.01). Notably, participants engaging in two to three hours of exercise per week had hs-CRP levels ≤2.5 mg/L (p=0.018), considered a low-to-moderate risk range. Higher CRF, reflected by an estimated VO2 max, ≥45 ml/kg/min, is associated with lower hs-CRP levels and fewer MetS criteria. Additionally, regular physical activity, corresponding to higher VO2 max, appears to reduce systemic inflammation and ameliorate MetS risk factors. These findings support the mechanisms by which improved CRF and exercise may lower the risk of cardiovascular diseases (CVD) and type 2 diabetes (T2DM).

Taurine reduces the risk for metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials

BackgroundMetabolic syndrome (MetS) is a cluster of interconnected risk factors that significantly increase the likelihood of cardiovascular disease and type 2 diabetes. Taurine has emerged as a potential therapeutic agent for MetS. This meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of taurine supplementation on MetS-related parameters.MethodsWe conducted electronic searches through databases like Embase, PubMed, Web of Science, Cochrane CENTRAL, and ClinicalTrials.gov, encompassing publications up to December 1, 2023. Our analysis focused on established MetS diagnostic criteria, including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C). Meta-regression explored potential dose-dependent relationships based on the total taurine dose administered during the treatment period. We also assessed secondary outcomes like body composition, lipid profile, and glycemic control.ResultsOur analysis included 1024 participants from 25 RCTs. The daily dosage of taurine in the studies ranged from 0.5 g/day to 6 g/day, with follow-up periods varying between 5 and 365 days. Compared to control groups, taurine supplementation demonstrated statistically significant reductions in SBP (weighted mean difference [WMD] = −3.999 mmHg, 95% confidence interval [CI] = −7.293 to −0.706, p = 0.017), DBP (WMD = −1.509 mmHg, 95% CI = −2.479 to −0.539, p = 0.002), FBG (WMD: −5.882 mg/dL, 95% CI: −10.747 to −1.018, p = 0.018), TG (WMD: −18.315 mg/dL, 95% CI: −25.628 to −11.002, p < 0.001), but not in HDL-C (WMD: 0.644 mg/dl, 95% CI: −0.244 to 1.532, p = 0.155). Meta-regression analysis revealed a dose-dependent reduction in DBP (coefficient = −0.0108 mmHg per g, p = 0.0297) and FBG (coefficient = −0.0445 mg/dL per g, p = 0.0273). No significant adverse effects were observed compared to the control group.ConclusionTaurine supplementation exhibits positive effects on multiple MetS-related factors, making it a potential dietary addition for individuals at risk of or already experiencing MetS. Future research may explore dose-optimization strategies and potential long-term benefits of taurine for MetS management.

Metabolic syndrome distribution based on diagnostic criteria and family history among adults in Al-Basra, Iraq.

Metabolic syndrome (MetS) is a collection of cardiovascular risk factors induced by insulin resistance and an inflammatory state that increases the likelihood of developing type 2 diabetes and a variety of cardiovascular disorders. The study aims to determine the distribution of MetS by diagnostic criteria and family history among adults in Al- Basra province, southern Iraq. A cross-sectional study was conducted at the Al- Fiaha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC) from October 2nd, 2022, to May 1st, 2023. Following ethical approval, data was obtained using a pre-tested questionnaire. All patient information was obtained from direct interviews as well as FDEMC's digital records, which controlled patient data via a Microsoft Access program and an internal network. This study included 476 people, aged 19 to 89. The sample had an equal number of males and females (238). MetS was identified in 247 people in the entire sample using the International Diabetes Federation criteria. The proportion of participants with a family history was as follows: obesity (30.0%), hypertension (44.1%), diabetes mellitus (46.6%), and cardiovascular disease (9.3%). The diagnostic criteria for MetS were as follows: high wc (94.3%), elevated glucose (69.6%), reduced highdensity lipoprotein (HDL) (80.2%), elevated TG (40.5%), and hypertension (71.7%). Controlled on glycemic status (21.1%), hypertension (61.9%), and lipids (44.1%). Large wc, reduced HDL, and family histories of obesity, hypertension, diabetes mellitus, or cardiovascular disease are the most important risk factors for MetS. Participants with MetS have difficulties controlling their blood sugar, but they regulate the other MetS components.

The relationship between metabolic syndrome criteria and pentraxin-3 levels in children.

While the positive correlation was shown in a few studies which investigated the relationship between obesity and pentraxin-3 (PTX-3) levels, different findings were obtained in other studies. We aimed to determine PTX-3 levels in obese and healthy children, and their relationship with Metabolic Syndrome (MetS) criteria. 105 children and adolescents were considered as the study population. Participants were divided into three groups; obese and MetS (OM+), obese and non-MetS (OM-) and the control group. Fasting glucose, blood lipids and PTX-3 levels were measured. Ultrasonography was performed to detect hepatic steatosis. MetS and hepatic steatosis were investigated by dividing the patients into two groups according to PTX-3 levels. The study population consisted of 37 patients with OM+; 35 patients with OM- and 33 healthy children. OM+ patients had higher fasting insulin (p<0.001), homeostatic model assessment for insulin resistance (p<0.001), triglyceride (p<0.001) and lower high-density lipoprotein (p=0.001). The PTX-3 level was higher in the OM+ group compared to both OM- group and the control group (p=0.002). When two groups were generated according to PTX-3 level, a higher frequency of MetS was detected in the high PTX 3 group than in all three major MetS diagnostic criteria groups. Moreover, there was more hepatic steatosis in the high PTX-3 group independent from obesity and MetS. Higher PTX-3 levels were present in children and adolescent obese patients with MetS.

Kidney stones are associated with metabolic syndrome in a health screening population: a cross-sectional study.

In parallel with the rise in obesity and metabolic syndrome (MetS), kidney stones are becoming more common. In this study, the relationship between MetS components and kidney stones in a health screening population was examined. Subjects who underwent health checkups in the Health Promotion Centre of Sir Run Run Shaw Hospital of Zhejiang University between January 2017 and December 2019 were recruited for this study. In this cross-sectional study, 74,326 participants were aged 18 or older. MetS diagnostic criteria were based on the joint statement of the International Diabetes Federation (IDF) and other associations on MetS in 2009. The association between MetS and its components with kidney stones was examined using multivariable logistic regression. A total of 74,326 participants took part in this cross-sectional study, including 41,703 men (56.1%) and 32,623 women (43.9%). There were 24,815 (33.4%) patients with MetS and 2,032 (2.7%) patients with kidney stones. The prevalence of kidney stones was 3.3% in subjects with MetS and 2.4% in subjects without MetS (P<0.001). The odds ratio and 95% confidence interval (CI) for kidney stones in MetS patients were 1.157 (95% CI: 1.051-1.273). Accordingly, the prevalence of kidney stones showed a statistically significant trend of gradual increase as the number of MetS components increased (P<0.001). Among the components of MetS, elevated waist circumference, reduced high-density lipoprotein cholesterol (HDL-C), and elevated fasting blood glucose (FBG) were independent influencing factors of kidney stones (P<0.001), with odds ratios of 1.205 (95% CI: 1.085-1.337), 1.222 (95% CI: 1.105-1.351) and 1.335 (95% CI: 1.202-1.482), respectively. MetS is an independent risk factor for kidney stones. Therefore, the control of MetS may help reduce the incidence of kidney stones.

Metabolic Syndrome and Its Components are Associated with In-Hospital Complications after Thoracic Endovascular Aortic Repair for Acute Type B Aortic Dissection

This study aimed to explore whether and to what extent metabolic syndrome (MetS) and its components are associated with in-hospital complications in patients with acute type B aortic dissection after thoracic endovascular aortic repair (TEVAR). We retrospectively enrolled 684 patients who had undergone TEVAR. Demographic and clinical data were collected and subgroup analysis, mixed-model regression analysis, scoring systems, and receiver operating characteristic (ROC) curve analyses were performed. Overall, 684 inpatients were assigned to the poor outcome (n=90) or no complications (n=594) group. Compared to the no complications group, the poor outcome group had a higher incidence of MetS (44 [48.9%] vs. 120 [20.2%], P<0.05). In the subgroup analysis, in-hospital complications were present in 3.1%, 6.6%, 11.9%, 20.7%, 40.0%, and 62.5% of patients in the 6 groups who met the 0, 1, 2, 3, 4, and 5 MetS diagnostic criteria, respectively. On multivariable logistic regression, hypertension (odds ratio [OR]: 2.680; 95% confidence interval [CI]: 1.571-4.570), type 2 diabetes (OR: 2.135; 95% CI: 1.192-3.824), quartiles of body mass index (OR: 1.801; 95% CI: 1.415-2.291), high-density lipoprotein cholesterol (OR: 0.763; 95% CI: 0.611-0.953), and systolic blood pressure (OR: 1.894; 95% CI: 1.486-2.413) were independent factors for in-hospital complications after adjustment for other risk factors. After adjusting for potential confounding factors, MetS was an independent risk factor for in-hospital complications. We established a scoring system for each component and the area under the ROC curve was 0.664 (95% CI: 0.618-0.710) in all patients, 0.672 (95% CI: 0.595-0.749) in patients with MetS, and 0.610 (95% CI: 0.552-0.667) in patients without MetS, as determined by ROC analysis. MetS, especially the blood pressure component, confers a greater risk of in-hospital complications in patients with acute type B aortic dissection after TEVAR.

Association between metabolic syndrome components and cardiac autonomic modulation in southern Indian adults with pre-metabolic syndrome: hyperglycemia is the major contributing factor.

Metabolic syndrome (MetS) involves multi-factorial conditions linked to an elevated risk of type 2 diabetes mellitus and cardiovascular disease. Pre-metabolic syndrome (pre-MetS) possesses two MetS components but does not meet the MetS diagnostic criteria. Although cardiac autonomic derangements are evident in MetS, there is little information on their status in pre-MetS subjects. In this study, we sought to examine cardiac autonomic functions in pre-MetS and to determine which MetS component is more responsible for impaired cardiac autonomic functions. A total of 182 subjects were recruited and divided into healthy controls (n=89) and pre-MetS subjects (n=93) based on inclusion and exclusion criteria. We performed biochemical profiles on fasting blood samples to detect pre-MetS. Using standardized protocols, we evaluated anthropometric data, body composition, baroreflex sensitivity (BRS), heart rate variability (HRV), and autonomic function tests (AFTs). We further examined these parameters in pre-MetS subjects for each MetS component. Compared to healthy controls, we observed a significant cardiac autonomic dysfunction (CAD) through reduced BRS, lower overall HRV, and altered AFT parameters in pre-MetS subjects, accompanied by markedly varied anthropometric, clinical and biochemical parameters. Furthermore, all examined BRS, HRV, and AFT parameters exhibited an abnormal trend and significant correlation toward hyperglycemia. This study demonstrates CAD in pre-MetS subjects with reduced BRS, lower overall HRV, and altered AFT parameters. Hyperglycemia was considered an independent determinant of alterations in all the examined BRS, HRV, and AFT parameters. Thus, hyperglycemia may contribute to CAD in pre-MetS subjects before progressing to MetS.

Periodontitis severity relationship with metabolic syndrome: Asystematic review with meta-analysis.

The objective of this study was to investigate the association between periodontitis severity and metabolic syndrome (MetS) through systematic review, registered in PROSPERO: CRD42021232120. Selected articles were independently chosen by three reviewers from six databases, including using article reference lists, up until March 2022. Eligible studies were observational, without language limitation, and in subjects aged at least 18 years. The methodological quality of selected studies was assessed using the Newcastle-Ottawa Scale. Random effects models calculated summary measurements (odds ratio-OR, 95% confidence interval, 95%CI). The I2 test evaluated the statistical heterogeneity of the data. Sensitivity, subgroup, and meta-regression analyses were performed. For the reliability of evidence, the Grading of Recommendations, Assessment, Development, and Evaluations tool was used. A total of 2133 records were identified, and 14 studies were included comprising 24,567 participants. The summary odds ratio showed a positive association between individuals with moderate (ORadjusted =1.26; 95%CI=2.10-5.37; I2 = 45.85%), and severe periodontitis (ORadjusted =1.50; 95%CI:1.28-1.71; I2 = 56.46%), and MetS. Subgroup and meta-regression analyses showed that study effect size was influenced by year of publication, study design, and MetS diagnostic criteria, contributing to inter-study variability. The findings showed that moderate and severe levels of periodontitis are associated with MetS, suggesting a possible dose-response effect.

Waist-to-height ratio is a simple and practical alternative to waist circumference to diagnose metabolic syndrome in type 2 diabetes.

As an indicator of abdominal obesity, waist circumference (WC) varied with race and gender in diagnosing metabolic syndrome (MetS). Therefore, it is clinically important to find an alternative indicator of abdominal obesity independent of these factors to diagnose MetS. Our aims were to evaluate the association between waist-to-height ratio (WHtR) and MetS and further determine whether WHtR could be used as a simple and practical alternative to WC to diagnose MetS in patients with type 2 diabetes mellitus (T2DM). This cross-sectional, real-world study recruited 8488 hospitalized T2DM patients including 3719 women (43.8%) aged from 18 to 94 years and 4769 men (56.2%) aged from 18 to 91 years. A WHtR cut-off of 0.52 was used to diagnose MetS in both men and women T2DM patients based on our previous study. The association of WHtR with MetS in T2DM patients was analyzed by binary logistic regression. The consistency of two diagnostic criteria for MetS according to WC and WHtR was determined by Kappa test. The prevalence of MetS according to WHtR was 79.4% in women and 68.6% in men T2DM patients, which was very close to the prevalence of MetS according to WC in both women (82.6%) and men (68.3%). The prevalence of MetS diagnosed by WC in both men and women with WHtR ≥ 0.52 was significantly higher than in those with WHtR < 0.52 after adjustment for age and duration of diabetes (89.2 vs. 38.7% for men; 92.8 vs. 57.4% for women; respectively, all p < 0.001). Binary logistic regression analysis displayed that after adjusting for confounding factors, WHtR was significantly associated with the presence of MetS in both men and women (men: OR = 4.821, 95% CI: 3.949-5.885; women: OR = 3.096, 95% CI: 2.484-3.860; respectively, all p < 0.001). Kappa test revealed that there was an excellent consistency between the diagnosis of MetS based on WC and on WHtR in T2DM patients (men: kappa value = 0.929, 95% CI: 0.918-0.940; women: kappa value = 0.874, 95% CI: 0.854-0.894; total: kappa value = 0.911, 95% CI: 0.901-0.921; respectively, all p < 0.001). WHtR is independently associated with the presence of MetS and can be used as a simple and practical alternative to WC to diagnose MetS regardless of gender in T2DM patients.

ODP544 Cumulative exposure of metabolic syndrome components and the risk of end-stage renal disease in the general population: a nationwide cohort study

Abstract Aims Status of metabolic syndrome (MetS) and its components can changes over time. However, few studies have investigated the cumulative burden of MetS and its components on clinical renal outcomes in the general population. Methods Using nationally representative data from the Korean National Health Insurance System, 2,664,270 subjects who underwent health examinations for four consecutive years and were free from end-stage renal disease (ESRD) from 2009 to 2013. We used exposure-weighted scores in two ways: (1) cumulative number of MetS diagnosis at each health examination (MetS exposure score, range: 0 to 4); (2) the composite of its five components (MetS component exposure score, 0 to a maximum of 20). Hazard ratio and 95% confidence interval (CI) values for ESRD were analysed using the Cox proportional-hazard model. Results Overall, 63.4%, 14. 0%, 8.2%, 6.2% and 8. 0% met the MetS diagnostic criteria 0 to 4, respectively. After a median follow up of 5.3 years, 2,303 incident ESRD cases were identified. In the multivariate adjusted model, the hazard ratio (HR) and 95% confidence interval (CI) for the development of ESRD showed a gradual increase with increasing exposure score of MetS and its components, which was independent of age, sex, and baseline estimated glomerular filtration rate (each p for trend &amp;lt; 0. 0001). The HR of ESRD was 6.48 (95% CI, 4.12 to 10.20) in subjects with a MetS component exposure score of 20 compared with those with a score of 0. Conclusions This provides evidence supporting the strategy of reducing MetS exposure to prevent the development of ESRD in the general population. Presentation: No date and time listed

Selection of Aggregation Function in Fuzzy Inference System for Metabolic Syndrome

Metabolic syndrome (MetS) has long-term, very detrimental effects, including chronic kidney disease, cardiovascular disease, stroke, and diabetes mellitus. Therefore, early detection of MetS is very important. Numerous global health organizations have made some Metabolic Syndrome (MetS) diagnosis criteria, but they are still mostly in a dichotomous form. On the other hand, a continuous MetS risk score has been proven to be more sensitive and with less risk of error. This study aims to build a Fuzzy Inference System (FIS) model. MetS diagnostic criteria issued by NCEP-APT III are used as a reference for generating rules. This model uses max, probor, and additive functions to obtain membership values as a result of rules aggregation in seven steps: 1) Identification of variables; 2) Determination of fuzzy sets and their membership functions; 3) Knowledge base generation; 4) Implementation of the implication functions; 5) Fuzzy rules aggregation; 6) Defuzzification; 7) Performance testing of the model and selecting the best aggregation function. The findings show the max function as the most suitable function for the aggregation process with an accuracy, sensitivity, specificity, and precision value of 100% according to the measurement results with NCEP-ATP III. A continuous risk score between 0% and 99.99% is considered a non-high risk, whereas a score of 100% indicates a high risk. This function also has an ideal risk value distribution according to the neighborhood level of the NCEP-ATP III diagnostic criteria.

The accuracy of triglyceride-glucose (TyG) index for the screening of metabolic syndrome in adults: A systematic review and meta-analysis

AimsTo investigate the relationship between the triglyceride-glucose (TyG) index, a novel surrogate index of insulin resistance (IR), and metabolic syndrome (MetS) in a systematic review and meta-analysis. Data synthesisStudies that report the TyG index in adult subjects with and without MetS were included. Thirteen observational articles were included in this study, with a total of 49,325 participants. Two different categories of meta-analyses were performed. First, the means of the TyG index were compared in participants with and without MetS. The pooled mean difference (MD) of the TyG index between groups was 0.83 units (CI 95: 0.74–0.92, I2 = 98, P-value < 0.001), and the subgroup analyses showed MD significantly differed based on the MetS diagnostic criteria. The pooled MD were 0.80 units (CI 95: 0.70–0.91, I2 = %88, P-value < 0.001) and 0.82 units (CI 95: 0.79–0.86, I2 = %0, P-value > 0.767) for studies reported data for males and females individual, respectively. Second bivariate diagnostic test accuracy (DTA) meta-analysis was performed and determined that the TyG index's pooled sensitivity and specificity for screening of MetS were 80% (CI95: 75%–84%, I2 = 87%, P-value < 0.001) and 81% (CI95: 77%–84%, I2 = 90.45%, P-value < 0.001), respectively. Summary receiver-operating characteristics (sROC) curves were also plotted with the area under the sROC curve of 0.87 (CI 95: 0.84–0.90). ConclusionsThe TyG index is a sensitive and specific index for MetS and may be valuable for MetS screening. ProsperoCRD42022316209.

Metabolic syndrome and its components are associated with hypoxemia after surgery for acute type A aortic dissection: an observational study

BackgroundThe aim of this study was to explore whether or to what extent metabolic syndrome (METs) and its components were associated with hypoxemia in acute type A aortic dissection (ATAAD) patients after surgery.MethodsThis study involved 271 inpatients who underwent surgery. Demographic and clinical data were collected. Subgroup analysis, mixed model regression analysis, and receiver operating characteristic (ROC) curve analysis were performed, and a scoring system was evaluated.ResultsThe 271 inpatients were assigned to the hypoxemia group (n = 48) or no hypoxemia group (n = 223) regardless of METs status. Compared to the no hypoxemia group, the hypoxemia group had a higher incidence of METs. Hypoxemia was present in 0%, 3.7%, 19.8%, 51.5%, 90.0% and 100% in the groups of individuals who met the diagnostic criteria of MetS 0, 1, 2, 3, 4 and 5 times, respectively. In the multivariable logistic regression analysis, BMI quartile was still a risk factor for hypoxemia after adjustment for other risk factors. After adjustment for potential confounding factors, METs was an independent risk factor for hypoxemia in several models. After assigning a score for each METs component present, the AUCs were 0.852 (95% CI 0.789–0.914) in all patients, 0.728 (95% CI 0.573–0.882) in patients with METs and 0.744 (95% CI 0.636–0.853) in patients without METs according to receiver operating characteristic analysis.ConclusionsMETs, especially body mass index, confers a greater risk of hypoxemia in ATAAD after surgery.

Antioxidant and Anti-Inflammatory Effect of the Consumption of Powdered Concentrate of Sechium edule var. nigrum spinosum in Mexican Older Adults with Metabolic Syndrome.

Metabolic syndrome (MetS) has a high prevalence in older adults and is a risk factor for cardiovascular diseases and complications of old age. It has also been related to oxidative stress (OxS) and chronic inflammation (CI) and their consequent alterations. Therefore, it is important to propose therapeutic alternatives such as the consumption of Sechium edule (Chayote), since hypoglycemic, hypotensive, and lipogenesis inhibitor properties are attributed to it. We carried out a study in 81 older adults (OA) with MetS to determine the effect of consumption of chayote powder concentrate (500 mg, three times a day) for six months, with a baseline measurement, at three and six months in an experimental group (EG) (n = 41) and a placebo group (PG) (n = 40), all with a diagnosis of MetS according to the criteria of National Adult Treatment Panel of the National Cholesterol Program III (NCEP/ATP III). Anthropometric, biochemical, OxS markers, and inflammation measurements were performed on all participants, basal, three, and six months after. A statistically significant decrease was found in the concentration of lipoperoxides (TBARS), 8-isoprostanes, 8-OHdG, oxidative stress score (OSS), HbA1c, blood pressure, and in the number of MetS diagnostic criteria, as well as an increase in total antioxidant status (TAS), antioxidant gap (GAP), superoxide dismutase (SOD), interleukin 10 (IL-10), and HDL-cholesterol in EG. The results suggest that the consumption of Sechium edule powder has a hypotensive, hypoglycemic, antioxidant, and anti-inflammatory effect in OA with MetS and reduced the percentage of patients with MetS.

MO949: Metabolic Syndrome and Longitudinal Risk of Renal and Cardiovascular Events in Renal Transplant Recipients: A Single Center Study in Japan

Abstract BACKGROUND AND AIMS Metabolic syndrome (MetS) is a condition that promotes arteriosclerosis due to various arteriosclerosis risk factors such as impaired glucose tolerance, impaired lipid metabolism and hypertension, caused by insulin resistance as a result of visceral fat obesity. There have been several epidemiological studies on MetS after renal transplantation conducted in the U.S. and Europe, indicating that MetS is an accumulation of non-immunological risks of renal transplantation, which affects the patient's prognosis as well as that of the kidney. However, the incidence of MetS in Japanese renal transplant recipients is 20 to 30% and lower compared with that of American and European recipients, and its effects on cardiovascular complications and kidney prognosis are not clear. We report on the results of our long-term longitudinal study on MetS in renal transplant recipients. METHOD A total of 104 renal transplant outpatients, over 6 months after their transplants and in stable condition, were diagnosed with MetS from January 2006 and June 2007 and followed up until December 2020. The effects of MetS on outcomes including renal and cardiovascular events were studied using four diagnostic criteria [NCEP-ATP III (Japanese, original, Asian) and IDF criteria]. We performed multivariate Cox proportional hazards regression analysis to examine the association between the presence or absence of MetS and combined vascular events in renal transplant recipients. This study protocol was conducted in accordance with the Principles of the Declaration of Helsinki and the Declaration of Istanbul, and was approved by the ethics committee of Osaka City University (No. 2020–197). All analyses were performed using R ver. 4.0.3 (https://www.r-project.org/foundation/) with the ‘rms’ and ‘RcmdrPlugin.EZR’ packages. RESULTS The incidence of MetS among our renal transplant recipients in our baseline investigation was 24.0% by the NCEP-ATP III (Japanese) criteria, and our longitudinal study showed that MetS was a significant risk factor even after adjustment of background factors using the propensity score (HR: 2.82; 95% CI: 1.26–6.34, P = 0.012). In addition, the effects of MetS diagnosed using the NCEP (original), NCEP (Asian) and IDF criteria on cardiac composite events were HR: 2.39; 95% CI: 1.07–5.38, P = 0.035, HR: 2.35; 95% CI: 1.00–5.55, P = 0.051, and HR: 1.90; 95% CI: 0.84–4.31, P = 0.12, respectively. CONCLUSION Although the incidence of MetS in Japanese renal transplant recipients was lower compared to that of American and European renal transplant recipients, our results indicated that MetS also affected cardiovascular complications and kidney prognosis in Japanese renal transplant recipients. Moreover, depending on the diagnostic criteria for MetS, the HR was shown to be around 2.0–3.0.

Vitiligo and Metabolic Syndrome: Systematic Review and Meta-Analysis.

Metabolic syndrome (MetS) has been associated with various skin conditions including vitiligo. However, the association between these 2 conditions has yet to be determined by quantitative meta-analysis. The aim of this paper was to determine the association between vitiligo and metabolic syndrome via systematic review and meta-analysis. A systematic literature search of Pubmed, Embase, Cochrane, and Web of Science was performed for all published literature prior to August 16, 2020. Case control and prospective cross-sectional studies analyzing the association between vitiligo and MetS were included in this review. The primary outcome measures include the type of vitiligo, diagnostic criteria for MetS, components of MetS (waist circumference, blood pressure, triglycerides, fasting glycemic index, and high-density lipoprotein cholesterol), low-density lipoprotein cholesterol levels, and BMI. A meta-analysis was performed to evaluate the prevalence and association of MetS in patients with vitiligo. A total of 6 studies (n=734 participants) meeting eligibility criteria were included for systematic review and meta-analysis. The pooled prevalence of MetS in patients with vitiligo was (0.296, 95% CI 0.206, 0.386; P<.001). Patients with vitiligo were no more likely to develop MetS compared to control patients (odds ratio 1.66, 95% CI 0.83, 3.33; P=.01). A leave-one-out sensitivity analysis showed a significant association between MetS and vitiligo (P<.001). Significant elevations in fasting glycemic index (mean difference 5.35, 95% CI 2.77, 7.93; P<.001) and diastolic blood pressure (mean difference 1.97, 95% CI 0.02, 3.92; P=.05) were observed in patients with vitiligo compared to control patients. The association between vitiligo and metabolic syndrome carries important clinical implications. Dermatologists and other multidisciplinary team members should remain vigilant when treating this patient population in order to prevent serious cardiovascular complications that may arise as a result of metabolic disease.

The Association Between Metabolic Syndrome and Frailty in Healthy Community-Dwelling Older Adults

This study examined the association between metabolic syndrome (MetS) and frailty status in relatively healthy community-dwelling older adults. Participants included 19,114 individuals from the “ASPirin in Reducing Events in the Elderly” (ASPREE) trial. The diagnostic criteria for MetS were according to the International Diabetes Federation Task Force on Epidemiology and Prevention and the American Heart Association/National Heart, Lung, and Blood Institute (2009); and comprised any three of five parameters: waist circumference, triglycerides, fasting blood glucose, high-density lipoprotein cholesterol or hypertension. Frailty and prefrailty were defined using a modified Fried phenotype (FP) comprising exhaustion, body mass index, grip strength, gait speed and physical activity and a deficit accumulation frailty index (FI) of 66 items. The association between MetS and frailty was examined using multinomial logistic regression. At baseline, 51.1% of participants met the criteria of MetS; of those, 41.8% and 2.5 % were prefrail and frail, respectively, according to Fried phenotype, while 49.6% and 11.8 % were prefrail and frail, respectively, according to FI. MetS at baseline was associated with an increased likelihood of prefrailty (RRR: 1.25; 95% CI: 1.17, 1.33) and frailty (RRR: 1.60; 95% CI: 1.28, 2.01) compared to no frailty after adjustment for potential confounders according to Fried phenotype, while the association was stronger for prefrailty (RRR: 2.74; 95% CI: 2.55, 2.94) and frailty (RRR: 5.30; 95% CI: 4.60, 6.11) according to FI. Overall, at baseline, more than half of the participants had MetS, and the presence of MetS was significantly associated with pre-frailty and frailty.

Enhanced prediction of renal function decline by replacing waist circumference with \u201cA Body Shape Index (ABSI)\u201d in diagnosing metabolic syndrome: a retrospective cohort study in Japan

BackgroundAbdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is conventionally evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity.ObjectiveTo examine whether replacing WC with “A Body Shape Index (ABSI)”, an abdominal obesity index calculated by dividing WC by an allometric regression of weight and height, in MetS diagnosis is useful for predicting renal function decline.Subjects/MethodsIn total, 5438 Japanese urban residents (median age 48 years) who participated in a public health screening program for 4 consecutive years were enrolled. Systemic arterial stiffness was assessed by cardio-ankle vascular index (CAVI). The predictability of the new-onset renal function decline (eGFR < 60 mL/min/1.73 m2) by replacing high WC with high ABSI (ABSI ≥ 0.080) was examined using three sets of MetS diagnostic criteria: Japanese, IDF and NCEP-ATPIII.ResultsIn Japanese and NCEP-ATPIII criteria, MetS diagnosed using ABSI (ABSI-MetS) was associated with significantly higher age-adjusted CAVI compared to non-MetS, whereas MetS diagnosed using WC (WC-MetS) showed no association. Kaplan–Meier analysis of the rate of new-onset renal function decline over 4 years (total 8.7%) showed remarkable higher rate in subjects with ABSI-MetS than in those without (log-rank test p < 0.001), but almost no difference between subjects with and without WC-MetS (p = 0.014–0.617). In gender-specific Cox-proportional hazards analyses including age, proteinuria, and treatments of metabolic disorders as confounders, ABSI-MetS (Japanese criteria for both sexes, IDF criteria for men) contributed independently to the new-onset renal function decline. Of these, the contribution of IDF ABSI-MetS disappeared after adjustment by high CAVI in the subsequent analysis.ConclusionIn this study, replacing WC with ABSI in MetS diagnostic criteria more efficiently predicted subjects at risk of renal function decline and arterial stiffening.