MetS In Adults Research Articles

Changes in insulin resistance mediate the associations between phthalate exposure and metabolic syndrome

BackgroundInformation on the relationships between phthalate exposure, insulin resistance, and metabolic syndrome (MetS) in younger adults is limited. It is still unclear whether changes in insulin resistance represent an intermediate biological mechanism linking phthalate exposure and MetS. ObjectiveTo investigate the associations between cumulative risk of phthalates (such as daily intake [DI] and hazard index [HI]), insulin resistance, and MetS in younger adults and to examine the mediating role of insulin resistance in the associations between phthalate exposure and MetS. MethodsUrinary phthalate metabolite levels, insulin resistance (by using the Homeostatic Model Assessment of estimated Insulin Resistance [HOMA-IR]), and MetS status were determined in 435 military personnel in Taiwan. We estimated the DI of five phthalates: dimethyl phthalate (DMP), diethyl phthalate, dibutyl phthalate, benzyl butyl phthalate (BBzP), and di (2-ethylhexyl) phthalate and the HI based on urinary phthalate metabolite levels. Cross-sectional associations between DI and HI, HOMA-IR, and the indicators of MetS were explored using logistic regression models. Mediation analysis was conducted to assess the role of insulin resistance in the associations between phthalate exposure and MetS. ResultsHigher DIDMP was associated with an increased odds of high HOMA-IR and MetS (odds ratio [OR], 1.686; 95% confidence interval [CI], 1.079–2.634 for high HOMA-IR; OR, 2.329; 95% CI, 1.263–4.295 for MetS). The mediation analysis indicated that 43% of the association between higher DIDMP and MetS was mediated by HOMA-IR. Higher DIBBzP and HI were associated with an increased odds of abdominal obesity (OR, 1.816; 95% CI, 1.180–2.797 for the high DIBBzP group; OR, 1.700, 95% CI, 1.105–2.614 for the high HI groups). ConclusionsExposure to environmental phthalates may be positively associated with insulin resistance and MetS. Insulin resistance may mediate these associations between exposure to certain phthalates and MetS.

OR31-2 Effects of Colchicine on Insulin Resistance, Pancreatic Beta-Cell Function, and Aspects of the Metabolic Syndrome (MetS) in Adults with Obesity, MetS, and Inflammation: A Pilot Randomized Controlled Trial

Introduction: Low-grade chronic inflammation, due in part to activation of the NLRP3 inflammasome, increases with increasing adiposity and plays a significant role in the development of type 2 diabetes and cardiovascular disease. However, to date, the efficacy of anti-inflammatory medications to improve aspects of the metabolic syndrome (MetS) is not well established. As colchicine has been shown to prevent assembly of the NLRP3 inflammasome and ameliorate other inflammatory conditions, we aimed to evaluate the efficacy and safety of colchicine for improving metabolic and inflammatory outcomes in adults with obesity and MetS. Materials and Methods: We conducted a randomized, double-blind, placebo-controlled pilot trial in which 40 non-diabetic adults with obesity, MetS, and elevated high-sensitivity C-reactive protein (hsCRP≥ 2.0 mg/L) were randomized to colchicine 0.6 mg or placebo twice daily for three months. Fasting labs, insulin-modified frequently sampled intravenous glucose tolerance test (FSIVGTT), and body composition by DXA were performed at baseline and 3-month follow up. The primary outcome was change in FSIVGTT insulin sensitivity (SI) as measured by Bergman’s minimal model. Secondary outcomes included changes in other metabolic parameters and inflammatory markers. ANCOVA was used to examine differences between treatment arms, with age, sex, baseline body fat%, and Δbody fat% as covariates. Data were analyzed according to intention-to-treat and reported as mean±SD. Results: Colchicine significantly reduced inflammatory indices, including hsCRP (-2.8±2.9 vs. 0.4±2.8 mg/L, p=.002), ESR (-5.5±6.4 vs. 0.6±6.3 mm/hr, p=.007), white blood cell count (-1.09±1.23 vs. 0.29±1.16 K/µL, p=.002), and absolute neutrophil count (-1.06±1.05 vs. 0.12±0.93 K/µL, p<.001). However, change in SI was not significantly different between colchicine and placebo arms (2.9x10-6 ± 3.1x10-5 vs 3.4x10-6 ± 2.9x10-5 min-1·mU-1·ml, p=.82). Changes in other metabolic parameters also did not reach significance, although changes in HOMA-IR (p=.097) and glucose effectiveness (SG; p=.067) trended towards improvement in the colchicine group. Adverse events were similar in both groups, and no patients withdrew due to side effects. Post-hoc analyses calculated that a sample size of 166 subjects would be necessary to achieve 80% power to detect a difference in measures of metabolic health (e.g. HOMA-IR, fasting insulin, fasting glucose, SG, and disposition index) between colchicine and placebo groups, for a two-tailed α <0.05. Conclusions: Colchicine significantly improved obesity-associated inflammatory variables and demonstrated a good safety profile among obese non-diabetic adults with MetS. Larger, adequately powered studies are needed to determine whether colchicine has beneficial effects on insulin resistance and other measures of metabolic health in at-risk individuals.

The Association between Fish Consumption and Risk of Metabolic Syndrome in Adults: Tehran Lipid and Glucose Study.

Objective: Although fish consumption may play a role in prevention of the risk of metabolic syndrome (MetS), results of studies available on this topic are controversial. In this study, we have examined the association of fish consumption and 3.6-year incidence of MetS in Tehranian adults. We conducted a population based cohort study of 3382 adult subjects, aged 19-55years, from the Tehran Lipid and Glucose Study (TLGS). Fish consumption data were collected using a valid and reliable food-frequency questionnaire. The consumption of fish, in the form of canned and non-canned fish was designated for all subjects, and was classified into three categories (< 30, 30-45, and >45g/week). Odds ratio (OR) for the occurrence of MetS according to categories of fish consumption was assessed by multivariable logistic regression. The mean age of participants (35% male) at baseline was 35years. Mean fish consumption was 11.3g/d and incidence of MetS was 13.1%. In the fully adjusted model, subjects, who consumed>45g/week of fish had lower incidence of MetS, compared to those who consumed<30g/week (OR=0.73; CI: 0.56-0.95). However, there were no associations between consumption of non-canned fish (OR=0.86; 95% CI: 0.67-1.10) and canned fish (OR=0.91; 95% CI: 0.64-1.29) and the incidence of MetS. Our findings suggest that high consumption of fish can reduce the incidence of MetS among adults.

The relationship between serum-free insulin- like growth factor-1 and metabolic syndrome in school adolescents of northeast China.

PurposeFree insulin-like growth factor-1 (IGF-1) ratio (the ratio of IGF-1/insulin-like growth factor binding protein-3 [IGFBP-3]) was shown to be negatively correlated with metabolic syndrome (MetS) in adults, but it was unknown in Chinese adolescents.Patients and methodsThe cross-sectional study enrolled 701 healthy school students (aged 12–16 years, 46.1% females) and 93 of them (18–22 years old, 46.2% females) were followed after 5 years.ResultsIn the cross-sectional study, the IGF-1/IGFBP-3 ratios were found correlated with low-density lipoprotein cholesterol (LDL-C; r= −0.071, P<0.05) and diastolic blood pressure (r= −0.077, P=0.034). A lower IGF-1/IGFBP-3 ratio was an independent risk factor for MetS (OR =2.348, 95% CI: 1.040–5.303), hypertension (OR=1.729, 95% CI: 1.040–5.303), and increased LDL-C (OR=1.841, 95% CI: 1.230–2.755). In the follow-up study, all the participants were >18 years old. We found a lower baseline ratio of IGF-1/IGFBP-3 in adolescence was an independent risk factor for MetS in adulthood (OR=10.724, 95% CI: 1.032–11.403) and also indicated a higher body mass index (β=−1.361, 95% CI: −2.513 to −0.208) after 5 years.ConclusionThe lower IGF-1/IGFBP-3 ratio was an independent risk factor for MetS, hypertension, and high LDL-C in adolescents of northeast China and was also a predictive marker for MetS and increased body mass index in the adulthood.

Empirical dietary inflammatory pattern and risk of metabolic syndrome and its components: Tehran Lipid and Glucose Study

BackgroundThe rising incidence of metabolic syndrome (MetS) is a major public health problem. The inflammatory potential of diet contributes to the development of MetS. The aim of this study was to investigate the relationship between empirical dietary inflammatory pattern (EDIP) and risk of MetS among the Tehranian population. Our hypothesis was that high EDIP would increase the risk of MetS and its components.MethodsIn this prospective study, 2216 adults were selected from among the Tehran Lipid and Glucose Study participants. The usual dietary intakes were estimated using a valid and reliable food frequency questionnaire. Biochemical and anthropometric measurements were assessed at baseline and over 6.2 years of follow up. MetS components were defined according to the modified national Cholesterol Education Program Adult Treatment Panel III. The inflammatory potential of diet was calculated using EDIP score; more positive scores means higher pro-inflammatory diet. Adjusted logistic regression models were used to estimate the occurrence of MetS and its components across quartiles of EDIP score.ResultsMean ± SD for EDIP score was 0.61 ± 0.40 (range − 2.3 to 6.9). Participants with the highest EDIP scores, had a higher risk of MetS incidence compared to those with the lowest score (OR: 1.75, 95% CI 1.21–2.54, Ptrend = 0.003). Among the MetS components, hyperglycemia, abdominal obesity, and low HDL-C had a significant positive association with EDIP score; (OR: 1.46, 95% CI 1.03–2.08, Ptrend = 0.026), (OR: 1.43, 95% CI 1.03–1.97, Ptrend = 0.046), and (OR: 1.57, 95% CI 1.34–2.19, Ptrend = 0.015), respectively. No significant association was found between EDIP score, hypertension and hypertriglyceridemia.ConclusionOur finding indicated that higher intake of the pro-inflammatory diet may be an independent risk factor for the development of MetS, hyperglycemia, low HDL-C and abdominal obesity in Tehranian adults.

Association of sedentary behavior and metabolic syndrome.

To examine the association of sedentary behavior (SB) with metabolic syndrome (MetS) in adults, as well as to identify the impact of physical inactivity and economic condition on such association. This is a cross-sectional study. This study was conducted in the city of Bauru, São Paulo State, Brazil (n=970). Television (TV) viewing and physical activity (PA) were assessed by questionnaire. MetS was assessed via medical records. Descriptive statistics and binary logistic regression were used in data analyses. Participants with moderate TV viewing were associated with MetS when compared with low TV viewing group, even after adjustments for age, sex, economic status, smoking, and PA (odds ratio [OR]=1.49 [95% confidence interval {CI}: 1.01-2.20]). The fully adjusted model showed an association between high exposure to TV viewing with MetS (OR=1.77 [95%CI: 1.11-2.82]). The combination of physical inactivity and high TV viewing boosted the likelihood of having MetS (OR=1.89 [95%CI: 1.08-3.29]). The results of the present study suggest that moderate and high TV viewing time is associated with the presence of MetS, mainly in insufficiently active adults and those living in lower economic condition.

Light smoking is associated with metabolic syndrome risk factors in Chilean young adults.

Metabolic syndrome (MetS) is a cluster of risk factors for cardiometabolic diseases. While cigarette smoking is associated with MetS in adults, young adulthood is an under-studied, susceptible period for developing long-term morbidity from MetS. We examined associations between cigarette smoking and MetS risk factors. We studied 430 participants in Santiago, Chile who have been followed in a longitudinal cohort since infancy and assessed in adolescence for MetS. Participants were evaluated at 22years from May 2015 to July 2017. Adiposity, blood pressure, and blood samples were measured. MetS was defined using International Diabetes Federation criteria. A continuous MetS score was calculated using z-scores. Participants self-reported cigarette and alcohol consumption using standardized questionnaires. We used multivariate regressions to examine associations between smoking and MetS risk factors, adjusting for sex, MetS in adolescence, alcohol consumption, and socioeconomic status. Thirteen percent of participants had MetS and 50% were current smokers. Among smokers, mean age of initiation was 14.9years and consumption was 29 cigarettes weekly. Smokers had larger waist circumferences, higher BMIs, and lower high-density lipoprotein (HDL) cholesterol compared to non-smokers. Being a current smoker was significantly associated with higher waist circumference (β = 2.82; 95% CI 0.63, 5.02), lower HDL (β = - 3.62; 95% CI - 6.19, - 1.04), higher BMI (β = 1.22; 95% CI 0.16, 2.28), and higher MetS score (β = 0.13, 95% CI 0.02, 0.24). Cigarette smoking at light levels (mean < 30 cigarettes weekly) was associated with MetS risk factors in a sample of Chilean young adults.

Associations between caries experience, dietary habits, and metabolic syndrome in Japanese adults.

Dental caries could be a risk factor for metabolic syndrome (MetS); however, there is limited evidence of such a relationship in the literature. This cross-sectional study investigated the relationships among dental caries experience, dietary habits, and MetS in Japanese adults. A total of 937 participants aged 40-74 years underwent a health check, including dental examination. Decayed, missing, and filled teeth (DMFT) were used as an index of caries experience. The mean DMFT score was 14, and 12% of the participants had MetS in this study. Multivariate logistic regression analyses showed that the prevalence of MetS was significantly related to DMFT (first vs. fourth quartile, odds ratio [OR] = 1.80; P < 0.05). In addition, the OR of DMFT for MetS was found to be greater in each successively higher DMFT quartile. The prevalence of MetS was significantly related to daily coffee consumption (OR = 0.51, P < 0.01), and the relationship between DMFT and MetS was noted after adjusting for daily coffee consumption. There appears to be a positive association between caries experience and MetS in Japanese adults. This relationship increased with the increase in DMFT regardless of dietary habits.

Metabolic Syndrome: Findings from 20 Years of the Tehran Lipid and Glucose Study.

ContextIn recent decades, investigations have been focused on the definition, incidence and predictors of metabolic syndrome (MetS) in Iranians. This study aimed to review systematically investigations on MetS, conducted among the Tehran lipid and glucose study (TLGS) participants.Evidence AcquisitionLiterature on MetS documented by TLGS studies published from 2000 to 2017 were searched using Pubmed and Scopus database in English language with a combination of following keywords: Metabolic syndrome, TLGS.ResultsThe harmonized definition of MetS was confirmed, based on the estimated cut point of waist circumference (WC) ≥ 95 cm for both genders in Iran. The incidence rate was 550.9/10000 person/years, lower among women (433.5/10000) than men (749.2/10000). The prevalence of abdominal obesity, high triglycerides (TG), low high density lipoprotein cholesterol (HDL-C), high blood pressure (BP), and high fasting blood glucose (FBG) was 30, 46, 69, 34, and 12%, respectively. The prevalence of MetS in adolescents was 10.1% with no significant difference between boys and girls (10.3% in boys and 9.9% in girls). A strong association of WC (OR: 2.32, CI: 2.06 - 2.59) and TGs (OR: 1.95, CI: 1.65 - 2.11) with development of MetS was found. In adolescent boys, WC had the highest OR for MetS risk. WHO-defined MetS was a significant predictor of total and cardiovascular mortality both in men (HR: 1.66, CI: 1.23 - 2.24; HR:1.93, CI: 1.26 - 2.94) and women (HR: 2.01, CI: 1.39 - 2.88; HR:2.71, CI: 1.44 - 5.09).ConclusionsOur results indicate high incidence of MetS in Tehranian adults and adolescents; high WC also appears to be a strong predictor of MetS. All definitions of MetS predicted cardiovascular disease.

Objectively Measured Physical Activity, Sedentary Behavior, and Metabolic Syndrome in Adults: Systematic Review of Observational Evidence.

Objective measurement of physical activity (PA) and sedentary behavior (SB) associated with metabolic syndrome (MetS) has gained more attention among researchers in recent years. Although almost similar trends of results have been reported worldwide, they were not always statistically significant. This systematic review summarizes the evidence of observational studies reporting the associations between objectively measured PA, SB, and MetS in adults. Registration in PROSPERO was made (CRD42017078929). Literature search was conducted in the PubMed database for observational studies associating objectively measured PA and SB with MetS among adults. Secondary manual search was also conducted to find more related studies. A total of 44 studies were included in this systematic review. The quality score of studies obtained using National Institutes of Health Quality Assessment Tool ranged between 4 and 11. For total PA, most studies showed negative association with MetS. Similar association with MetS was reported in most studies assessing moderate-to-vigorous PA (MVPA) (total, bouts, sporadic), vigorous-intensity PA (VPA) (total, bouts), moderate-intensity PA (MPA) (total, bouts), and light-intensity PA (LIPA) bouts. However, more studies assessing LIPA total and LIPA sporadic found no significant association with MetS, with only a few studies reporting negative association. Meanwhile, all studies assessing step counts reported negative association with MetS. In contrast, MetS was positively associated in all studies investigating physical inactivity. MetS was also positively associated in most studies reporting sedentary (SED) time and bouts, while SED breaks showed no significant association with MetS. Further studies are required to ascertain the interaction and independent contribution of objectively measured PA and SB to the overall risk of MetS.

Fat-to-Muscle Ratio: A New Anthropometric Indicator as a Screening Tool for Metabolic Syndrome in Young Colombian People.

Fat-to-muscle ratio has been proposed as an alternative approach for assessing body fat. The objective of this study was to explore fat-to-muscle ratio thresholds in metabolic syndrome (MetS) diagnosis; it was hypothesised that the fat-to-muscle ratio is a good predictive indicator of MetS in a large population of young Colombian adults. For this purpose, a cross-sectional study was conducted on 1416 subjects (66.6% female), aged from 18.1 to 25.1. As part of the study, measurements of the subjects’ anthropometric indicators, serum lipid indices, blood pressure, and fasting plasma glucose were taken. Body composition was measured through bioelectrical impedance analysis (BIA). A new variable (ratio of fat mass to muscle mass, in kg) was calculated. Following the International Diabetes Federation (IDF) definition, MetS includes three or more metabolic abnormalities. Receiver operating characteristic (ROC) curves and logistic regression determined the discriminatory ability of the fat-to-muscle ratio to predict MetS. According to the IDF, the best fat-to-muscle ratio cut-off point for detecting MetS in men was 0.225 kg, with an area under the curve (AUC) of 0.83, sensitivity of 80%, and specificity of 70%. For women, the fat-to-muscle ratio cut-off point was 0.495 kg, the AUC was 0.88, and the sensitivity and specificity were 82% and 80%, respectively. In conclusion, our results showed that the fat-to-muscle ratio cut-off points from ROC analyses demonstrate good discriminatory power for detecting MetS in young Colombian adults.

Identification of an obesity index for predicting metabolic syndrome by gender: the rural Chinese cohort study

BackgroundTo compare the accuracy of different obesity indexes, including waist circumference (WC), weight-to-height ratio (WHtR), body mass index (BMI), and lipid accumulation product (LAP), in predicting metabolic syndrome (MetS) and to estimate the optimal cutoffs of these indexes in a rural Chinese adult population.MethodsThis prospective cohort involved 8468 participants who were followed up for 6 years. MetS was defined by the International Diabetes Federation, American Heart Association, and National Heart, Lung, and Blood Institute criteria. The power of the 4 indexes for predicting MetS was estimated by receiver operating characteristic (ROC) curve analysis and optimal cutoffs were determined by the maximum of Youden’s index.ResultsAs compared with WHtR, BMI, and LAP, WC had the largest area under the ROC curve (AUC) for predicting MetS after adjusting for age, smoking, drinking, physical activity, and education level. The AUCs (95% CIs) for WC, WHtR, BMI, and LAP for men and women were 0.862 (0.851–0.873) and 0.806 (0.794–0.817), 0.832 (0.820–0.843) and 0.789 (0.777–0.801), 0.824 (0.812–0.835) and 0.790 (0.778–0.802), and 0.798 (0.785–0.810) and 0.771 (0.759–0.784), respectively. The optimal cutoffs of WC for men and women were 83.30 and 76.80 cm. Those of WHtR, BMI, and LAP were approximately 0.51 and 0.50, 23.90 and 23.00 kg/m2, and 19.23 and 20.48 cm.mmol/L, respectively.ConclusionsWC as a preferred index over WHtR, BMI, and LAP for predicting MetS in rural Chinese adults of both genders; the optimal cutoffs for men and women were 83.30 and 76.80 cm.

Association of dietary sodium:potassium ratio with the metabolic syndrome in Chinese adults.

Several epidemiological studies have investigated that Na or K intakes might be associated with the metabolic syndrome (MetS). However, little evidence has evaluated the association between Na:K ratio and the MetS. In this study, we assessed the association between the dietary Na:K ratio and the MetS. The cross-sectional study was conducted among adults aged 18 years and older in Nanjing, using a multi-stage random sampling method, which resulted in a sample size of 1993 participants. Dietary Na and K intakes were assessed by 3 consecutive days of dietary recollection combined with condiments weighing method. Health-related data were obtained by standardised questionnaires, as well as physical examinations and laboratory assessments. The prevalence rate of the MetS was 36·5 % (728/1993). After adjusting for various lifestyle and dietary factors of the MetS, participants in the highest quartile of dietary Na:K ratio were at a higher risk of developing MetS (OR=1·602; 95 % CI 1·090, 2·353) compared with those in the lowest quartile. Each 1-sd increase in dietary Na:K ratio was associated with a higher risk of prevalent MetS (OR=1·166; 95 % CI: 1·018, 1·336). Among the components of the MetS, dietary Na:K ratio was positively associated with high blood pressure (quartile 3 v. quartile 1: OR=1·656; 95 % CI 1·228, 2·256) and hypertriacylglycerolaemia (quartile 4 v. quartile1: OR=1·305; 95 % CI 1·029, 1·655) in multivariate analysis. These results revealed that higher dietary Na:K ratio significantly increased the risk of the MetS in Chinese adults. Further studies are needed to verify this association.

Serum uric acid predicts incident metabolic syndrome in the elderly in an analysis of the Brisighella Heart Study

Several epidemiological studies report a positive correlation between hyperuricemia and metabolic syndrome (MetS) in adults, which hyperuricemic subjects seem to more easily develop. We aimed to verify if serum uric acid (SUA) concentrations were positively associated with MetS prevalence and middle-term (4-year) incidence in older overall healthy subjects. We also purposed to identify which SUA cut-off values could be functional in MetS diagnosis in addition to the traditionally used parameters. For this reason, we selected from the historical cohort of the Brisighella Heart Study 923 older healthy subjects repeatedly visited during the 2008 and 2012 population surveys. In our sample, MetS was more frequent for higher SUA concentrations rather than the population’s mean in both men [OR = 2.12, 95%C.I.(1.55, 2.90)] and women [OR = 2.69,95%C.I.(1.91, 3.78)]. ROC analysis showed SUA was predictive of MetS in the whole population [AUC = 0.647, 95%C.I.(0.609, 0.686), P = 0.000001] and in both sex subgroups [men: AUC = 0.592, 95%C.I.(0.529, 654); P = 0.004; women: AUC = 0.758, 95%C.I.(0.711, 0.806), P < 0.000001], even there were sex-related differences in the best cut-off values (5.5 mg/dL for men; 4.2 mg/dL for women). Prospectively, SUA appeared predictive of middle-term (4-year) MetS incidence in the whole population (AUC = 0.604, 95%C.I.[0.518, 0.690], P = 0.029, best cut-off value = 4.7 mg/dL) and in the female group (AUC = 0,641, 95%C.I.[0.519, 0.762], P = 0.039, best cut-off value = 3.9 mg/dL) though not in the male one (P > 0.05). In conclusion, in our cohort, SUA is a frequent component of MetS, other than a middle-term predictor of newly diagnosed MetS in older women.

Association of High-Risk Drinking with Metabolic Syndrome and Its Components in Elderly Korean Men: The Korean National Health and Nutrition Examination Survey 2010-2012.

BackgroundPrevious studies have examined the association between alcohol consumption and metabolic syndrome (MetS) in adults, but studies in the elderly are lacking. We examined the relationship between high-risk alcohol consumption and MetS in elderly Korean men using the Alcohol Use Disorders Identification Test (AUDIT) questionnaire from the 2010–2012 Korean National Health and Nutrition Examination Survey.MethodsAmong 25,534 subjects, 2,807 were men >60 years of age; after exclusions, we included 2,088 men in the final analysis. We categorized the study participants into three groups according to AUDIT score: low risk (0–7), intermediate risk (8–14), and high risk (≥15 points).ResultsAmong the study population, 17.0% of the men were high-risk drinkers, who had the highest mean waist circumference, systolic and diastolic blood pressure (BP), fasting plasma glucose (FPG), and triglyceride (TG) levels. The overall prevalence of MetS was 41.9% in the elderly men, and it was significantly higher in the group with high (48.3%) versus low (31.9%) AUDIT scores. The prevalence of MetS components (elevated BP, high FPG, high TG, and low high-density lipoprotein cholesterol) was associated with a high AUDIT score. The odds ratios (95%confidence interval) of the high-risk group for MetS, elevated BP, and high TG were 1.40 (1.03–1.89), 1.82 (1.28– 2.60), and 1.77 (1.30–2.41) after adjustment for confounding variables. ConclusionAUDIT score was correlated with most MetS components in elderly Korean men.

Association between socially disadvantaged groups and metabolics syndrome in European children. Results from the IDEFICS study

Introduction The metabolic syndrome (MetS) is an important cluster of cardiovascular disease risk factors. MetS is diagnosed if at least three of the four components, namely visceral obesity, dyslipidaemia, hyperglycaemia, and hypertension, exceed certain cut-off values, where the cut-offs vary depending on sex, age and the proposed definition. Social disadvantages in early life are hypothesized to have negative implications for health through potentially modifiable lifestyle (such as diet, physical activity and sedentary behaviours). Classical socioeconomic status (SES) indicators such as parental education or income have been found to be associated with MetS in adults. The extent to which the accumulation of these disadvantages and other social disadvantages can affect children's MetS risk is still unknown. Methods In the IDEFICS study, 16,228 children aged 2.0–9.9 years from eight European countries were examined at baseline and after 2-years of follow-up and 2401 of these children were eligible for this analysis. Sociodemographic variables, children's well-being score and lifestyle factors were reported by parents via questionnaires. Six socially disadvantaged groups were defined, including two low socioeconomic status groups (children whose parents had a low education and who had low-income) and four social vulnerable groups (children whose parents were migrants, children whose parents lack a social network, children from non-traditional families and children with unemployed parents). MetS risk was assessed through z-score standardization of the 4 components assessed using the following variables: waist circumference, blood pressure (mean of systolic and diastolic), blood lipids (mean of triglycerides and inverse HDL levels) and insulin resistance (homeostasis model assessment, HOMA-IR). Linear mixed effects models were used to study the association between: –social disadvantages and children's total MetS score at baseline and follow-up; –patterns of social disadvantages over time and children's total MetS score at follow-up; –accumulation of social disadvantages and children's total MetS score at baseline and follow-up. Models were adjusted for sex, age, and education and income for social vulnerable groups. In a second step, models were additionally adjusted for children's well-being score and lifestyle factors (fruit and vegetables consumption, physical activity, screen time) to assess whether social disadvantages have an effect independent of lifestyle factors on the metabolic risk. Results Children from low-income families at both time points (0.20 [0.03; 0.37]; β estimate and 99% confidence interval), children from non-traditional families at both time points (0.14 [0.02; 0.26]), children whose parents were unemployed at baseline and follow-up (0.31 [0.05; 0.57]) and children who accumulated more than 3 vulnerabilities (0.21 [0.04; 0.37]) showed a significantly higher MetS score compared to non-vulnerable groups. Conclusions Social disadvantages in children have been found to be related with a higher metabolic risk independently of diet, physical activity, sedentary behaviours and well-being. Interventions that focus on these socially disadvantaged groups should be developed to tackle health disparities.

Android fat as a determinant of metabolic syndrome: Sex differences.

Regional fat accumulation may play an important role in the pathogenesis of metabolic syndrome (MetS) and cardiovascular diseases, yet the results are controversial. The aim of this study was to determine the relationship between regional fat accumulation and MetS as well as the underlying mechanism in Chinese adults. We conducted a cross-sectional study of 428 Chinese adults (166 men and 262 women). Android and gynoid fat percentage (AFP and GFP) were measured by dual energy x-ray absorptiometry. Fasting lipid parameters were analyzed by chemistry analyzer COBAS. Forty-six (28%) men and 34 (13%) women had MetS according to the modified National Cholesterol Education Panel Adult Treatment Panel III definition for South Asia. AFP was strongly correlated with more metabolic risk factors than GFP in men. In women, AFP and GFP showed significant opposite effects on triacylglycerol, high-density lipoprotein cholesterol, and waist circumference. On multivariate regression, AFP was an independent determinant of MetS in men after adjustment for confounding factors. For women, both AFP and the homeostatic model assessment for insulin resistance were predictors for MetS. Increased android fat may play a direct role in the development of MetS in Chinese adults. However, the associations between android fat, insulin resistance, and MetS are sex-dependent. This is probably due to different effects of sex hormones on adipose tissue or by genetic factors between sexes. Knowing the sex differences in developing MetS may help design sex-specific preventive strategies that will benefit the overall population health.

The risk of metabolic syndrome as a result of lifestyle among Ellisras rural young adults

The study aimed to investigate the association between metabolic syndrome (MetS) and lifestyle risk factors among Ellisras adults. A cross-sectional study was conducted on 624 adults (306 males and 318 females). MetS was defined according to the criteria of the International Diabetes Federation. The prevalence of MetS was 23.1% (8.6% males and 36.8 % females). Females appeared to have higher mean values for waist circumference (WC), fasting blood glucose (FBG), total cholesterol (TCHOL) and low-density lipoprotein cholesterol (LDL-C), while males had high mean values for high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), systolic blood pressure (SBP) and diastolic blood pressure (DBP). No significant age and gender differences were observed for dietary intake. Significantly more females (51.9%) presented with increased WC than males (4.6%). Participants who had a high dietary energy intake were significantly less likely to present with larger WC (OR: 0.250 95% CI [0.161; 0.389]), low HDL-C (OR: 0.306 95% CI [0.220; 0.425]) and high LDL-C (OR: 0.583 95% CI [0.418; 0.812]) but more likely to present with elevated FBG (OR: 1.01 95% CI [0.735; 1.386]), high TCHOL (OR: 1.039 95% CI [0.575; 1.337]), high TG (OR: 1.186 95% CI [0.695; 2.023]) and hypertension (OR: 5.205 95% CI [3.156; 8.585]). After adjusting for age, gender, smoking, and alcohol status, high energy intake was more than two times likely to predict MetS in adults with a large WC (OR: 2.766 95% CI [0.863; 3.477] and elevated FBG (OR: 2.227 95% CI [1.051; 3.328]). Therefore, identifying groups that are at an increased risk and those that are in their early stages of MetS will help improve and prevent the increase of the MetS in the future.

Metabolic syndrome impact on cardiac autonomic modulation and exercise capacity in obese adults.

Cross-sectional study. Sixty-six subjects were classified as normal-weight (NW, n = 24) or obese (BMI ≥ 30 kg·m-2): metabolically healthy (MHO, n = 19) vs unhealthy (MUHO, n = 23: NCEP/ATPIII-MetS criteria). Body composition (bioimpedance), metabolic (glucose-insulin/lipid) and inflammatory profiles were determined. Linear and nonlinear heart rate variability (HRV) indices were computed at rest and during the submaximal six-minute step test (6MST). Blood pressure (BP) and metabolic and ventilatory variables were assessed (oxygen uptake, VO2; carbon dioxide production, VCO2; minute ventilation, VE) during the 6MST and the maximal cardiopulmonary exercise testing (CPX). All groups reached the same 6MST intensity (VO2 ~ 80% and HR ~ 87% of CPX peak values). Both obese groups, independently of MetS, presented higher BP and lower maximal VO2 than NW. However, HRV differed between groups according to MetS at rest and during exercise: MUHO had lower meanRRi and SD1 than NW and lower RMSSD and pNN50 than MHO at rest; during exercise, the lowest SDNN, TINN, SD1 and Shannon entropy were observed for MUHO. Significant correlations were found between MetS, insulin resistance and HRV indices; and between insulin resistance and aerobic capacity (VO2peak). Obesity per se impairs aerobic-hemodynamic responses to exercise. However, MetS in obese young adults negatively impacts overall HRV, parasympathetic activity and HRV complexity.

Relative handgrip strength as a marker of metabolic syndrome: the Korea National Health and Nutrition Examination Survey (KNHANES) VI (2014-2015).

PurposeMuscles play an important role in energy metabolism. Several studies have investigated the association between muscle mass and metabolic syndrome (MetS), reporting conflicting results. However, studies concerning the association between muscle strength and MetS are limited. We aimed to investigate the association between relative handgrip strength (HGS) and MetS in Korean adults.Participants and methodsWe analyzed data from 5,014 Korean adults aged ≥20 years (2,472 men and 2,542 women) who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) VI (2014–2015).ResultsThe increasing quartiles of relative HGS (defined as the sum of both hands’ HGS divided by body mass index) were inversely associated with the risk of MetS in both men and women (OR, 0.37; 95% CI, 0.30–0.45, vs OR, 0.19; 95% CI, 0.14–0.27, respectively) after multivariable adjustment for age, region of residence, smoking status, heavy alcohol consumption, regular exercise, family income, and education level. On multivariable logistic regression analyses, participants with the highest relative HGS had a significant decrease in relative risk of MetS, compared with those with the lowest relative HGS. The multivariable-adjusted ORs (with 95% CIs) for MetS in quartiles 1, 2, 3, and 4 were 1.00, 0.72 (0.55–0.94), 0.34 (0.26–0.46), and 0.22 (0.15–0.32) in men and 1.00, 0.50 (0.36–0.68), 0.26 (0.17–0.40), and 0.16 (0.09–0.27) in women, respectively.ConclusionRelative HGS showed a highly significant inverse association with the risk of MetS in Korean adults, and it can be a novel biomarker for assessing the risk of MetS.