National Cholesterol Education Panel Research Articles

Metabolic syndrome: a population-based study of prevalence and risk factors

The association between personal habits and metabolic syndrome (MetS) remains controversial. This study aimed to assess the prevalence of MetS among youths and its association with cigarette, tobacco, opium, and alcohol consumption in the Rafsanjan Youth Cohort Study (RYCS). The current cross-sectional study was based on data from RYCS, as part of the Rafsanjan Cohort Study (RCS). RCS is a branch of the prospective epidemiological research studies in Iran (PERSIAN). In the present study, 2843 youths aged 15–35 were included. MetS was diagnosed using the international diabetes federation (International IDF), National Cholesterol Education Panel- Adult Treatment Panel III (NCEP-ATPIII), and Iranian criteria (IDF Iranian). Binary logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs). The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS according to international IDF and Iranian IDF in the alcohol-drinking group in the last 12 months (OR: 1.51, 95%CI 1.02–2.21, OR: 1.66, 95%CI 1.11–2.48 respectively) were greater compared with the non-drinking group. The odds of having high TG in the alcohol-drinking group in the last 12 months was 1.53 times higher than the control group (OR = 1.53, 95% CI: 1.20–1.94). Furthermore, the odds of having high waist circumference (WC) according to IDF International was significantly higher in the tobacco-smoking group in the last 12 months and in the tobacco-smoking group in the last 12 months daily (OR: 1.23, 95%CI 1.01–1.49 and OR: 1.41, 95%CI 1.01–1.98 respectively) compared to the control groups. The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS and high TG were greater in the alcohol-drinking group in the last 12 months compared with the non-drinking group. The odds of high WC in the last 12 months, were greater in the tobacco-smoking group compared with the non-smoking group. However, more longitudinal studies are needed to verify the associations observed in the current study.

Potential Antihyperlipidemic Effect of Edaravone against Triton X-100 and High Fat Diet (HFD) Induced Experimental Model of Hyperlipidemia in Rats

Background: Hyperlipidemia is a condition in which blood lipid levels are greater than the normal range, and it is a major risk factor for the development of cardiac heart diseases. It affects 25-30% of the urban and 15-20% of the rural population. The current hyperlipidemia classification schemes and treatment levels are based on the Adult Treatment Program-3 guidelines issued by the National Cholesterol Education Panel, but there is no permanent treatment. So, the present study was aimed to investigate the antihyperlipidemic effect of Edaravone in Triton-X 100 and High Fat Diet-induced hyperlipidemic rat models.

Effect of atorvastatin on lipogenic, inflammatory and thrombogenic markers in women with the metabolic syndrome

Background and aimSpecific drug therapy to target the underlying proinflammatory and prothrombotic state in patients with metabolic syndrome (MS) is lacking. We sought to study the effect of high-intensity atorvastatin on markers of lipogenesis, inflammation and thrombogenesis, in women with MS in the absence of cardiovascular disease or diabetes. Methods and resultsThis randomized double-blinded controlled trial included 88 women with MS (according to National Cholesterol Education Panel Adult Treatment Panel III criteria) and low atherosclerotic cardiovascular risk. Participants were randomized to receive atorvastatin 80 mg or matching placebo. Thrombogenic, lipogenic and inflammatory markers were collected at the time of enrollment, after a 6-week dietary run-in phase (time of randomization), and at 6- and 12-weeks after randomization. At 6 weeks post-randomization, there was significant reduction in total cholesterol, low density lipoprotein cholesterol, triglycerides, apolipoprotein-B (Apo-B) and Apo-B/Apo-A1 ratio in the atorvastatin arm compared to placebo. This difference persisted at 12-weeks post randomization. There was no significant difference in fasting blood glucose, high-density lipoprotein cholesterol, high sensitivity C-reactive protein, serum leptin, Apo-A1, intercellular adhesion molecule 1 and platelet activity. A significant increase in vascular adhesion molecule 1 at 6 and 12 weeks was seen within the atorvastatin arm. No difference was observed in blood pressure and waist circumference. ConclusionsIn conclusion, high-intensity atorvastatin has an early and significant impact on lipoproteins and apolipoproteins but did not lower inflammatory, thrombogenic or biomarkers of platelet activity and aggregation in women with MS. The use of statins for primary prevention in these patients should be further explored.

Relationship of High-Sensitivity C- Reactive Protein (Hs-Crp) with the Components of Metabolic Syndrome

Background: Metabolic syndrome is associated with both the development of Hypertension, Diabetes Mellitus and an increased risk of adverse cardiovascular outcome. It is considered aspro inflamatory state linked with low grade systemic inflammation. C- reactive protein is a powerful biomarker of chronic systemic inflammation. Aim of this study is to evaluate the relationship of Highsensitivity C-reactive Protein (hs-CRP) with the components of Metabolic Syndrome (MetS) among hospitalized patients.
 Materials and methods: 50 patients of 18 years and above with metabolic syndrome, attending outdoor or admitted to Medicine Department of Chittagong Medical College Hospital from January 2016 to December 2016 were enrolled for this cross sectional study. The National Cholesterol Education Panel (NCEP) ATP – III, 2001 criteria was used for the diagnosis of MetS. Results: hsCRP level was found increased in almost every components of MetSin univariate analysis but the differences were not statistically significant. Patients with MetS had higher value of hs-CRP than without MetS (5.18±1.98 Vs 3.51± 1.63mg/l) with a p value 0.023. 
 Conclusions: Patients with metabolic syndrome had higher levels of hs-CRP than those without metabolic syndrome and hs-CRP levels increased directly with increasing number of its components.
 JCMCTA 2020 ; 31 (1) : 71-75

A Structural Model of Social Determinants of the Metabolic Syndrome.

The metabolic syndrome (MetS) refers to a cluster of interrelated physiological characteristics that are associated with an increased risk of cardiovascular disease and diabetes. While the clinical usefulness of the MetS has been the subject of controversy for years, increasingly sophisticated methods are being used to measure the concept. Study of community health center patients who were not diabetic; study group was evenly divided between Black and White adults. Latent MetS score and MetS status based on the five-point scale developed by the National Cholesterol Education Panel (NCEP). Structural equation modeling of MetS incorporating the effects of race/ethnicity, racial discrimination, socioeconomic position (SEP), and selected mediating variables. The largest influences on latent MetS scores were SEP (negative relationship) and male gender (higher scores for men). Two mediating variables, physical activity and stress-related eating, had smaller impacts. Self-reported racial discrimination was associated with cynical hostility but did not influence the MetS level among nondiabetics. Despite higher NCEP scores and MetS prevalence rates for Blacks compared with Whites, race did not have direct effect on MetS levels when adjusted for the other characteristics in our model. Neither race nor self-reported racial discrimination had direct effects on MetS level in our structural model. The large effects of socioeconomic position and male gender were not mediated by the other variables in the model.

Prevalence of metabolic syndrome using international diabetes federation, National Cholesterol Education Panel- Adult Treatment Panel III and Iranian criteria: results of Tabari cohort study.

Metabolic syndrome is defined by co-incidence of multiple metabolic disorders such as central obesity, high triglycerides, low HDL, hyperglycemia and high blood pressure, which increases the risk of cardiovascular disease and diabetes. The aim of this study was to estimate the prevalence of metabolic syndrome using Adult Treatment Panel III (ATP-III), International Diabetes Federation (IDF) and Iranian criteria in large-scaled population based cohort study and to determine the concordance between these criteria. In the present study all information collected in Tabari cohort study(TCS) were utilized. These information were collected using a structural questionnaire and taking blood samples from all the participants. Blood pressure and anthropometric indices were measured for all participants by trained practitioners. Categorical variables were compared using chi-square test. In addition, the quantitative variables were compared between the two the groups using independent t-test. Kappa coefficient was estimated to show the agreement between the results of the three criteria. The prevalences of Metabolic syndrome were 41.10%(CI 95%:40.10-42.02), 44.60%(CI 95%:43.61-45.54), and 30.80% (CI 95%:29.89-31.69) based on ATPIII, international IDF and IDF Iranian criteria respectively. The Kappa agreement coefficients between Iranian IDF with ATPIII definition and international IDF were estimated as 61.80% and 71.20% in the total population respectively. Kappa coefficient showed that the Iranian IDF had a good agreement with International IDF and an intermediate agreement with the ATP-III. Considering more emphasis of international and Iranian IDF on waist circumference (WC), a better agreement between these two criteria is plausible. Regarding the high prevalence of abdominal obesity among Iranian population, applying these criteria to identify high risk persons might be helpful.

Copper Is Associated with Metabolic Syndrome and Fasting Blood Glucose in Non-Hispanic Black—Results from National Health and Nutrition Examination Survey

Background: The metabolic syndrome is a cluster of risk factors which predicts future cardiovascular disease and type 2 diabetes. Evidences have showed that a disorder in serum Copper (Cu) level could have effects on human health. However, little data are available regarding how serum Cu affects metabolic syndrome in adults. Method: Data from 3,375 subjects were examined from a nationally representative sample of the U.S. adults in the National Health and Nutrition Examination Survey 2011-2014. The metabolic syndrome was defined as satisfying three or more of the five criteria from the National Cholesterol Education Panel definition. Multivariate logistic and linear regression were applied to investigate the associations of serum Cu levels with metabolic syndrome prevalence and its component. Results: In the logistic models, non-Hispanic black with the highest serum Cu levels demonstrated a greater increase in risk of metabolic syndrome (OR: 2.69, 95% CI: 1.08-6.70, P for trend= 0.001) when compared to those with the lowest serum Cu levels. Moreover, we identified a remarkable association between serum Cu levels and high fasting blood glucose condition in non-Hispanic black (OR: 2.44, 95% CI: 1.04-5.76, P for trend= 0.031). No significant associations between serum Cu level and other components of metabolic syndrome were observed, regardless of race. In the linear regressions, a strong positive association between serum Cu levels and fasting blood glucose was also observed (coefficient= 0.231, 95% CI: 0.053-0.409, P< 0.001) in non-Hispanic black. Conclusion: Our results provide the first epidemiological evidence that serum Cu concentrations may be positively associated with the prevalence of metabolic syndrome and with fasting blood glucose in non-Hispanic black. Further clinical and animal studies are urgently needed to clarify the putative causal relationships. Disclosure X. He: None. Y. Yu: None. Q. Lou: None. W. Tang: None.

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.

Persistence of metabolic syndrome in children and adolescents are overweight according to two diagnostic criteria: a longitudinal study

Objective: To investigate the persistence of the metabolic syndrome (MS) in children and adolescents are overweight according to the diagnostic criteria of the World Health Organization (WHO) and National Cholesterol Education Panel Adult Treatment Program- III (NCEP / ATP III). Methods: A longitudinal study was conducted at the Center for Childhood Obesity between April/2009 and April/2012, involving 133 children and adolescents are overweight. The evaluation was made at first and after 24 months of follow up, anthropometry being performed, then the nutritional classification and diagnosis of MS which was subsequently divided into three groups: negative, intermittent and and persistent MS. Descriptive and agreement between the two criteria and also between groups analysis was performed using the Kappa index, using SPSS version 17.0 (95% CI). Results: Among those evaluated, the majority were female (60.9%), and adolescent with severe obesity. Among the components of metabolic syndrome, fasting glucose, blood pressure levels and insulin resistance were reduced in the period. There was no significant correlation between the diagnostic criteria, although it has seen significant coincidence in the group with persistent metabolic syndrome (p = 0.002). Conclusion: A significant similarity between the criteria of WHO and NCEP/ATPIII only in the group with persistent SM, demonstrating sensitivity of the tests, but the use of more specific markers for this age group it is necessary to identify the early SM.

Risk Factors of Dyslipidaemia in a Cohort of Geriatric Nigerians with Essential Hypertension in a Rural Hospital in Eastern Nigeria

Background: Evidence has demonstrated the metabolic relationship between dyslipidaemia and hypertension which are independent cardio-metabolic risk factors. As socio-economic and environmental dynamics in rural Nigeria changes, geriatric Nigerians tend to adopt lifestyles that predispose to atherosclerotic cardiovascular diseases. Aim: This study was designed to determine the risk factors of dyslipidaemia in a cohort of geriatric Nigerians with essential hypertension in a rural hospital in Eastern Nigeria. Study Design: This was a cross sectional study conducted on a cohort of 122 geriatric Nigerians with essential hypertension. Place and Duration of Study: The study was conducted in a rural hospital in Eastern Nigeria Original Research Article Iloh and Amadi; BJMMR, 5(2): xxx-xxx, 2015; Article no. BJMMR.2015.021 between June 2008 and June 2011. Methodology: Risk factor variables were examined using a pretested, structured and intervieweradministered questionnaire. Hypertension and dyslipidaemia were defined using JNC VII and The Third Report of National Cholesterol Education Panel in adult (ATP III) criteria respectively. Results: The risk factors significantly associated with dyslipidaemia were advanced old age (p=.039), abdominal obesity (p=.022) and physical inactivity (p=.042). The abdominally obese patients were three times more likely to have dyslipidaemia compared to the non-abdominally obese patients. Conclusion: Risk factors of dyslipidaemia exist in geriatric Nigerians with essential hypertension. Dyslipidaemia was significantly associated with advanced old age, abdominal obesity and physical inactivity. These risk factors should be considered alongside the complex of other cardio-metabolic risk factors during clinical encounter with geriatric hypertensives.

Non-high-density lipoprotein cholesterol changes in middle-aged obese men with and without metabolic syndrome during weight loss.

Non-high-density lipoprotein (non-HDL-C) is the best predictor of coronary artery disease and stroke. Studies have shown that weight loss decreases non-HDL-C levels. However, whether diet-induced weight loss in individuals with and without metabolic syndrome causes a reduction in non-HDL-C levels remains unclear. We investigated the effects of weight loss on non-HDL-C levels in 34 middle-aged obese men with and without metabolic syndrome classified using National Cholesterol Education Panel Adult Treatment Panel III criteria (metabolic syndrome, n = 17; non-metabolic syndrome, n = 17). We conducted a 12-week dietary intervention using a low-carbohydrate, -fat, and -protein diet to reduce body weight. A significant decrease in body weight and body mass index in both groups was observed. However, the non-HDL-C level after weight loss was significantly decreased in the metabolic syndrome group (151.9 ± 6.8 to 131.4 ± 6.2 mg/dL, P < 0.01) but not in the non-metabolic syndrome group (152.1 ± 8.2 to 141.2 ± 8.1 mg/dL, P > 0.05). Levels of apolipoprotein AII and B, but not AI, were similarly decreased in both groups (P > 0.05). Pearson correlation analysis showed that the change in non-HDL-C levels in the metabolic syndrome group was strongly associated with levels of total cholesterol, fasting insulin, and alanine and aspartate transaminase, as well as homeostatic model assessment index, diastolic blood pressure, and maximal oxygen uptake (P < 0.05). These results demonstrated that diet-induced weight loss without physical activity decreases non-HDL-C levels, an important factor associated with changes in cardiorespiratory fitness and insulin sensitivity, in obese individuals with metabolic syndrome.

The Need for a Systematic Approach to Statin Switching

In the advent of generic statins becoming increasingly available and with the recent addition of atorvastatin to the generic market, healthcare providers are often encouraged by payers to switch from a branded statin to an alternate, less costly agent. The aim of this study was to determine the impact of a therapeutic switch on cholesterol goal attainment among patients with existing cardiovascular disease (CVD) or risk factors for CVD. A cross-sectional, multisite retrospective review of patient records evaluating low-density lipoprotein cholesterol (LDL-C) control before and after switching statins was conducted. Participants were 18 to 89 years olds who were stable on statin therapy and had 1 or more risk factors for CVD. Patients meeting switch criteria (n = 833) were evaluated for changes in their statin therapy and LDL-C goal attainment. Drug/dose information, cholesterol values, and goal attainment in accordance with National Cholesterol Education Panel Third Adult Treatment Panel guidelines were determined before and after the switch. Dose potency was based on mean LDL-C reductions. Data were collected from 22 US sites. Risk factors for CVD were common, with 88.5% of patients identified as high risk. Overall, patients' mean LDL-C levels improved from 87.1 to 81.5 mg/dL, and goal attainment increased from 75.5% to 82.5% (P < .05). Switches to a comparable or higher statin/dose improved mean LDL-C and goal attainment (P < .05). However, in patients transitioned to a lower statin/dose equivalency (36.4%), mean LDL-C level increased from 79.8 to 85.6 mg/dL and goal attainment fell from 84.2% to 78.6% (P < .05). Logistic regression confirmed that LDL-C goal attainment was reduced by 53% in patients switched to a lower statin/dose (odds ratio, 0.47; 95% confidence interval, 0.30-0.76; P = .002) compared with patients switched to an equipotent dose. The use of adjunctive lipid-lowering therapies increased in patients switched to a lower statin/dose (P < .05). Cholesterol values and goal attainment can be negatively impacted when a systematic approach is not used and patients are switched to lower potency therapies.

Physical activity and metabolic syndrome in liver transplant recipients

There is a high prevalence of metabolic syndrome in liver transplant recipients, a population that tends to be physically inactive. The aim of this study was to characterize physical activity and evaluate the relationship between physical activity and metabolic syndrome after liver transplantation. A cross-sectional analysis was performed in patients more than 3 months after transplantation. Metabolic syndrome was classified according to National Cholesterol Education Panel Adult Treatment Panel III guidelines. Physical activity, including duration, frequency, and metabolic equivalents of task (METs), was assessed. The study population consisted of 204 subjects, with 156 more than 1 year after transplantation. The median time after transplantation was 53.5 months (range = 3-299 months). The mean duration of exercise was 90 ± 142 minutes, and the mean MET score was 3.6 ± 1.5. Metabolic syndrome was observed in 58.8% of all subjects and in 63.5% of the subjects more than 1 year after transplantation. In a multivariate analysis involving all subjects, metabolic syndrome was associated with a time after transplantation greater than 1 year [odds ratio (OR) = 2.909, 95% confidence interval (CI) = 1.389-6.092] and older age (OR = 1.036, 95% CI = 1.001-1.072). A second analysis was performed for only patients more than 1 year after transplantation. In a multivariate analysis, metabolic syndrome was associated with lower exercise intensity (OR = 0.690, 95% CI = 0.536-0.887), older age (OR = 1.056, 95% CI = 1.014-1.101), and pretransplant diabetes (OR = 4.246, 95% CI = 1.300-13.864). In conclusion, metabolic syndrome is common after liver transplantation, and the rate is significantly higher in patients more than 1 year after transplantation. The observation that exercise intensity is inversely related to metabolic syndrome after transplantation is novel and suggests that physical activity might provide a means for reducing metabolic syndrome complications in liver transplant recipients.

Simvastatin Impairs Exercise Training Adaptations

This study sought to determine if simvastatin impairs exercise training adaptations. Statins are commonly prescribed in combination with therapeutic lifestyle changes, including exercise, to reduce cardiovascular disease risk in patients with metabolic syndrome. Statin use has been linked to skeletal muscle myopathy and impaired mitochondrial function, but it is unclear whether statin use alters adaptations to exercise training. This study examined the effects of simvastatin on changes in cardiorespiratory fitness and skeletal muscle mitochondrial content in response to aerobic exercise training. Sedentary overweight or obese adults with at least 2 metabolic syndrome risk factors (defined according to National Cholesterol Education Panel Adult Treatment Panel III criteria) were randomized to 12 weeks of aerobic exercise training or to exercise in combination with simvastatin (40 mg/day). The primary outcomes were cardiorespiratory fitness and skeletal muscle (vastus lateralis) mitochondrial content (citrate synthase enzyme activity). Thirty-seven participants (exercise plus statins: n = 18; exercise only: n = 19) completed the study. Cardiorespiratory fitness increased by 10% (p < 0.05) in response to exercise training alone, but was blunted by the addition of simvastatin resulting in only a 1.5% increase (p < 0.005 for group by time interaction). Similarly, skeletal muscle citrate synthase activity increased by 13% in the exercise-only group (p < 0.05), but decreased by 4.5% in the simvastatin-plus-exercise group (p < 0.05 for group-by-time interaction). Simvastatin attenuates increases in cardiorespiratory fitness and skeletal muscle mitochondrial content when combined with exercise training in overweight or obese patients at risk of the metabolic syndrome. (Exercise, Statins, and the Metabolic Syndrome; NCT01700530).

Abdominal Obesity in Adult Nigerian Africans: Prevalence and Co-Occurrence with Cardio-Metabolic Risk Factors in a Resource Poor Setting of a Rural Hospital in Eastern Nigeria

Background: Abdominal obesity is socially and culturally not recognized as a health problem in Nigeria. However, the deleterious effects of abdominal obesity are on the cardio-metabolic disorders such as hypertension, dysglycaemia and dyslipidaemia. Of great concern in rural Nigeria is that most adult patients with abdominal obesity are not routinely diagnosed and therefore do not receive appropriate management Aim: This study was designed to determine the prevalence of abdominal obesity in adult Nigerian Africans and its co-occurrence with cardio-metabolic risk factors in a resource poor setting of a rural hospital in Eastern Nigeria Methods: This was a descriptive study carried out from June 2008 to June 2011. A total of 3012 adult patients aged 18-91 years were screened for abdominal obesity using the third report of National Cholesterol Education Panel(NCEP) in adult (ATP III) criterion and 350 patients who had WC ≥102cm and ≥88cm for men and women respectively were screened for cardio-metabolic risk factors. Hypertension, diabetes mellitus and dyslipidaemia were defined using JNC 7, American Diabetic Association and the third report of NCEP in adult (ATP III) criteria respectively. The data collected included basic demographic variables, blood pressure, waist circumference, and fasting lipid profile and plasma glucose. Results: .The prevalence of abdominal obesity was 11.6%. The most common co-occurring primary cardio-metabolic risk factor was hypertension (44.6%). Others included isolated dyslipidaemia(22.6%) and diabetes mellitus(7.1%). Conclusion: Abdominal obesity exists among the study population and co-occurred with cardio-metabolic risk factors with hypertension being the most frequent and diabetes the least. Abdominal obesity should be considered during clinical encounter with adult Nigerians in the study area alongside the complex of other primary cardio-metabolic risk factors.

Prevalence and Family Biosocial Predictors of Abdominal Obesity among Adult Nigerian Africans in a Resource Constrained Setting of a Rural Hospital in Eastern Nigeria

Background: The variability of abdominal obesity within and across families is influenced by several factors. However, the relevance of family biosocial factors in the variability of abdominal obesity is an important health care challenge that is often neglected especially in this era of personalized medicine. Aim: This study was designed to determine the prevalence and family biosocial predictors of abdominal obesity among adult Nigerian Africans in a resource constrained setting of a rural hospital in Eastern Nigeria. Materials and Methods: A cross sectional analytic study carried out on 3012 adult patients aged 18-91 years who were screened for abdominal obesity using the Third Report of National Cholesterol Education Panel (NCEP) in adult (ATP III) criterion and 350 patients who had waist circumference (WC) ≥102cm and ≥88cm for men and women respectively and met the inclusion criteria were age and sex matched with 350 non-obese, non-hypertensive and non-diabetic control. Family bio-social variables were obtained using a pretested, structured and interviewer-administered questionnaire. Hypertension and diabetes mellitus were defined using Joint National Committee 7 Report on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and American Diabetic Association criteria respectively. Results: .The prevalence of abdominal obesity was 11.6%. The family biosocial variables significantly associated with abdominal obesity were family history of obesity (p=0.036) and family inadequate dietary fruits consumption (p=0.042). The most significant predictor of abdominal obesity was family history of obesity (OR=2.60, CI=0.95-13.01, p=0.022). The patient with family history of obesity was two and half times more likely to be obese than those without family history of obesity. Conclusion: Abdominal obesity is associated with family history of obesity and inadequate dietary fruits consumption. The interventional control programs for abdominal obesity should consider these risk factors alongside the complex of other cardiovascular risk factors.

Prevalence of the metabolic syndrome using two proposed definitions in a Japanese-Brazilians community

Metabolic Syndrome (MetS) is associated with increased risk of morbi-mortality, thus the characterization of the population magnitude of this syndrome is critical for allocating health care. However, prevalence estimates of MetS in the same population could differ depending on the definition used. Therefore, we compared the prevalence of the MetS using definitions proposed by: National Cholesterol Education Panel Revised (NCEP) and International Diabetes Federation (IDF) 2009 in a Japanese-Brazilians community (131 individuals, age 57 ± 16 years, 1st and 2nd generation). All individuals went through a clinical and laboratorial evaluation for assessment of weigh, height, waist circumference, blood pressure, triglycerides, HDL-cholesterol and fasting plasma glucose. The prevalence of MetS was 26.7% (n = 35) and 37.4% (n = 49) under the NCEP and IDF definitions, respectively. Despite higher blood pressure measurements, waist circumference and serum triglyceride levels and lower HDL cholesterol levels (p < 0.01), individuals identified with MetS did not show increased blood glucose levels. IDF definition classified 14 individuals (10.7%) with MetS that were not classified under the NCEP and 35 individuals were identified with MetS by both criteria. We observed, in this group, more severe lipid disorders, compared to individuals identified only under the IDF definition, and the BMI and waist circumference (p = 0.01; p = 0.006, respectively) were lower. In conclusion, the IDF revised criteria, probably because of the ethnic specific values of waist circumference, was able to identify a larger number of individuals with MetS. However, our data suggesting that additional studies are necessary to define best MetS diagnostic criteria in this population.

Prevalence of metabolic syndrome components among the elderly using three different definitions: A cohort study in Finland

Objective. Limited data are available on the metabolic syndrome (MetS) and its components in elderly people (aged 70 years and over) at population level in Northern Europe. A study was undertaken to investigate the prevalence of MetS and its components in an aging population by using different definitions. Design, setting, and subjects. A cross-sectional study of 539 inhabitants from Northern Finland (mean age 71.9 years) was conducted to investigate the prevalence of MetS, by using the definitions of MetS by the National Cholesterol Education Panel (NCEP), the modified NCEP (NCEPm), and the International Diabetes Federation (IDF). Main outcome measures. Prevalence of MetS by the NCEP, NCEP modified, and IDF criteria. Results. Overall, the prevalence of MetS was 24.7%, 35.2%, and 37.2% in men, by NCEP, modified NCEP, and IDF-definitions, respectively. In women the corresponding figures were 20.9%, 33.1%, and 47.8%. Hypertension was the most common component in both men (91.8%) and women (89.0%) by the IDF criteria. Glucose abnormalities were particularly prevalent in men (53.2% by NCEP and 78.4% by IDF criteria). Conclusions. The most common component was hypertension in both genders. Lower waist-circumference cut-off points of the IDF criteria led to a higher prevalence of MetS particularly in women. Prevalence of MetS varied significantly when measured by different definitions. Nearly half of older women met the IDF definition of MetS, which was more than twofold when compared with NCEP. Clinical practitioners should be aware of the limitations when using set criteria of MetS, in contrast to identifying the individual cardiovascular risk factors and the accumulation of these.

The magnitude of abdominal adiposity and atherogenic dyslipidemia among geriatric Nigerians with arterial hypertension in a rural hospital in South-eastern Nigeria

As the case detection rate of arterial hypertension increases daily in rural Nigeria, screening for its associated abdominal obesity and dyslipidemia is an important healthcare challenge. Of great concern in rural Nigeria is that most geriatric hypertensives with abdominal obesity and dyslipidemia are not routinely diagnosed and therefore do not receive appropriate management. This study was aimed at describing the magnitude (prevalence and pattern) of abdominal adiposity using waist circumference (WC) index and dyslipidemia among geriatric Nigerians with arterial hypertension in a rural hospital in South-eastern Nigeria. A descriptive hospital-based study was carried out from June 2008 to June 2011 on 122 consecutive geriatric patients with systemic hypertension who met the selection criteria at St. Vincent De Paul Hospital, Amurie-Omanze, a rural Mission General Hospital in Imo state. Abdominal obesity was defined as WC ≥102 cm and ≥88 cm for men and women, respectively. Dyslipidemia was defined using the third report of National Cholesterol Education Panel in adult (ATP III). The data collected included basic demographic variables, blood pressure, waist circumference, fasting lipid profile, and blood sugar. The prevalence of abdominal obesity was 50.8% and was the most common pattern of abdominal adiposity. Fifty-four (44.3%) out of 122 patients had at least one dyslipidemia with the most frequent being low high-density lipoprotein cholesterol (HDL-C, 38.5%). There was statistically significant difference between male and female gender based on abdominal adiposity (X 2 = 5.406, P value = 0.04) while their mean lipid differentials were not statistically significant. This study has shown that abdominal adiposity and dyslipidemia exist among geriatric hypertensives in the study area with abdominal obesity being the most common abdominal adiposity and low HDL-C being the most frequent lipid abnormality. This study therefore urges the necessity to consider abdominal obesity and dyslipidemia in geriatric hypertensives in rural Nigeria alongside the complex of other cardiovascular risk factors.

Lipoprotein profiles in Mexican American and non-Hispanic white women with polycystic ovary syndrome

To compare lipid profiles between Mexican American and non-Hispanic white women with polycystic ovary syndrome (PCOS). Cross-sectional analysis using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. University gynecology service. Self-identified Mexican Americans (n = 71) and non-Hispanic whites (n = 120) with PCOS defined by the 2003 European Society of Human Reproduction and Embryology and American Society of Reproductive Medicine consensus. Serum drawn from fasting state followed by oral glucose tolerance test. Age, body mass index (BMI), androgens, cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, fasting, and minimal model analyses of insulin sensitivity. Mexican American women were more insulin resistant than non-Hispanic whites, but cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and calculated non-HDL cholesterol levels were similar. BMI inversely correlated with HDL cholesterol and positively with triglycerides. Approximately half of both ethnic groups had at least one lipid level in the low (HDL) or high (cholesterol, triglycerides, and LDL cholesterol) range according to National Cholesterol Education Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults guidelines. Despite greater insulin resistance among Mexican Americans with PCOS, lipid levels were similar to those of age- and weight-matched non-Hispanic whites. Obesity adversely affected lipid levels-primarily HDL cholesterol and triglycerides-in both groups. The prevalence of dyslipidemia was approximately 50% in each ethnic group.