NCEP-ATPIII Criteria Research Articles

Metabolic syndrome among diabetics and pre-diabetics of Jenu Kuruba tribe in Mysore district (JKDHS-2)—An evidence of metabolic abnormalities leading to increase in CVD's among Jenu Kuruba tribal population

BackgroundMetabolic syndrome is a cluster of clinical and metabolic abnormalities. In diabetics, other components of metabolic syndrome are an added risk factor for cardiovascular disease and all these cause mortality. Epidemiological transition is happening all over the world and tribes are not spared either. Identifying the extent of metabolic syndrome and its components in diabetics is vital for the prevention of cardiovascular diseases and other morbidities. ObjectiveTo estimate the prevalence of Metabolic Syndrome among diabetics and pre-diabetics of Jenu Kuruba tribe and compare the mean values of various components of metabolic syndrome among diabetics and pre-diabetics. MethodsA community based cross sectional study was carried out among 7500 Jenu Kuruba tribal population in two phases. In phase I, total of 7500 subjects were screened for diabetes and hypertension and in phase II, a total of 249 diabetics and 310 pre-diabetics were identified and evaluated for metabolic syndrome. ResultsPrevalence of metabolic syndrome was estimated using NCEP ATP-III criteria. Metabolic syndrome was found in 84 (33.7%) of diabetics and 113 (36.4%) of pre-diabetic study subjects. Metabolic syndrome was highest in the 41–50 year age group. Lipid parameters such as total cholesterol, triglycerides and VLDL were significantly higher and HDL levels were significantly lower among subjects with metabolic syndrome as compared to subjects without metabolic syndrome. ConclusionsOne third of diabetics and pre-diabetics had definable metabolic syndrome. Dyslipidemia is a significant component of metabolic syndrome. Epidemiological transitions are happening among Jenu Kuruba tribes and non-communicable diseases are on the raise among them.

PREVALENCE OF METABOLIC SYNDROME AMONG ADOLESCENTS IN A CITY IN THE MEDITERRANEAN AREA: COMPARISON OF TWO DEFINITIONS.

there are few studies on the prevalence of metabolic syndrome (MetS) in European adolescent populations, and some have reported a higher prevalence in the Mediterranean basin area. Our objective was to examine the prevalence of MetS in adolescents in a Mediterranean city of Spain, comparing two different definitions of MetS and the associated risk factors. a cross-sectional population-based study was conducted among 379 adolescents aged 12-16.9 years, selected using a random sampling method. Anthropometric measurements and fasting blood samples were obtained. The definitions of MetS used were that of the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATPIII) and that of the International Diabetes Federation (IDF). Kappa coefficient was used to measure the agreement between definitions and a multivariate logistic regression model to determine the associated risk factors. the prevalence of MetS was 5.7% (95%CI 3.33-8.07) according to the NCEP-ATPIII definition and 3.8% (95%CI 1.85-5.75) according to the IDF definition. No differences between the sexes or by age groups were found. The agreement between the two definitions was very good (kappa 0.815), especially in the obese subsample, but was lower in normal weight adolescents (kappa 0.497). Insulin resistance and obesity were associated with both definitions. the prevalence of MetS in our adolescent population is higher than the European media. Although the overall agreement between both definitions was very good, the prevalence was higher using the NCEP-ATPIII criteria. Independently of the definition used, obesity and insulin resistance were risk factors for MetS.

The association between serum uric acid levels, metabolic syndrome and cardiovascular disease in middle aged and elderly Chinese: results from the DYSlipidemia International Study.

BackgroundTo explore the association between serum uric acid (SUA) levels, metabolic syndrome (MetS) and cardiovascular disease (CVD) in patients treated with lipid-lowering agents from multiple centers in China.MethodWe investigated 15,478 participants who had been documented with recorded SUA in the DYSlipidemia International Study which included 25,697 patients, aged 45 years old or older, who were treated with lipid-lowering agents from 122 centers between April 2012 and October 2012. Logistic regression analysis was performed to examine the association between SUA levels, MetS and CVD.ResultAfter adjusting for multi-variables, hyperuricemia (the highest category of SUA level) showed a significantly higher risk of MetS compared to the lowest category[according to NCEP-ATPIII criteria, odds ratio (OR) 1.51, 95 % confidence interval (CI) (1.30,1.74) in men, OR 2.35 95 % CI (2.00,2.75) in women; and according to IDF criteria, OR 1.40 95 % CI (1.20,1.63) in men, OR 1.65 95 % CI (1.41,1.94) in women]. In addition, elevated SUA concentration was shown to be associated with coronary heart disease (CHD) (OR 1.26 95 % CI (1.09, 1.45) in men, and OR 1.27, 95 % CI (1.07, 1.50) in women) and heart failure (HF) (OR 1.61 95 % CI (1.15, 2.24) in men, and OR 1.91, 95 % CI (1.29, 2.82) in women).ConclusionOur research suggested a positive association between SUA levels and MetS in Chinese patients receiving lipid-lowering therapy. Elevated SU levels were positively associated independently of measured confounders to CHD and HF.

Predictor of Metabolic Syndrome: A community study from Urban Delhi, India

<p>The aim of the present study is to assess and compare the presence of metabolic syndrome using IDF and Modified NCEP ATPIII criteria among Sunni Muslim of Delhi and to determine the optimal cut off values of different parameters for the detection of metabolic syndrome. A total of, 406 individuals (125 men, 281women) aged 35-65 years were recruited. Anthropometric, blood pressure and laboratory investigations were performed following the standard protocols. Receiver operating characteristics (ROC) curves of waist circumference, serum triglycerides, High density lipoprotein cholesterol, systolic and diastolic blood pressure and fasting blood glucose were created for the determination of the metabolic syndrome and the area under curve (AUC) was evaluated to determine the predictive efficiency of each variable of metabolic syndrome. The cut off values of each parameter with corresponding sensitivity, specificity, Youden index and likelihood ratios were estimated. </p><p>The overall metabolic syndrome assessed through Modified NCEP ATP III was 75.12% while through IDF criterion it was 75.36%. Majority of the participants were equally identified by both definitions. The metabolic syndrome was higher in women as compare to men using both the criteria. The area under curve (AUC) shows that serum triglycerides have highest predictive ability for metabolic syndrome in modified NCEP ATP III and IDF. The population specific cut off values of different variable to detect metabolic syndrome was formed. Although these result may not apply to rest of Indian population due to multi ethnicity but similar studies with large sample size to find the cut off values of parameter for metabolic syndrome is needed for better detection and prevention. </p><p align="left"><strong> </strong></p>

Abstract 273: HDL Particle Concentration Inversely Associates with Incident Metabolic Syndrome in the Multiethnic Dallas Heart Study

Objective: Metabolic syndrome (MetS) increases atherosclerotic cardiovascular disease (ASCVD) risk. Low HDL cholesterol (HDL-C) is a diagnostic criterion of MetS and a major ASCVD risk factor. HDL particle concentration (HDL-P) associates with incident ASCVD independent of HDL-C, but its association with incident MetS has not been studied. We hypothesized that HDL-P would be inversely associated with incident metabolic syndrome independent of HDL-C and other recognized risk factors. Methods: HDL-P was measured by NMR and visceral fat by MRI in participants of the Dallas Heart Study, a probability-based population sample of adults age 30-65. Participants with prevalent MetS, DM, CVD, cirrhosis, cancer, HIV, or renal failure were excluded. Incident MetS as defined by NCEP ATPIII criteria was determined in all participants after median follow-up period of 9.4 years. Results: Among a cohort of 1120 participants without DM or MetS at baseline (57% women, 45% Black, mean age 43), 22.8% had incident MetS at follow-up. HDL-P and HDL-C were modestly correlated (r=0.54, p<0.0001). The lowest quartile of HDL-P was associated with younger age, men, Hispanic ethnicity, lower total, HDL, and LDL cholesterol levels and particle sizes, and less reported alcohol intake. Participants in the lowest sex and race stratified quartile of HDL-P had the highest incidence of MetS (Figure). In models adjusted for traditional risk factors, HDL-C, visceral fat, HOMA-IR, and hs-CRP, the lowest quartile of HDL-P was associated with 65% increased risk of incident MetS (Figure). Conclusion: HDL-P is independently associated with incident MetS after adjustment for HDL-C, adiposity, inflammation, and markers of insulin sensitivity. Further studies are warranted to validate these findings and elucidate the mechanisms underpinning this association.

Mediterranean Diet and Metabolic Syndrome in Adult Moroccan Women

The objective was to assess the relationship between adherence to Mediterranean dietary pattern (MDP) and the prevalence of metabolic syndrome (MS) in urban Moroccan adult women, living in an agricultural Mediterranean province; El Jadida. A random sample (n=182) of Moroccan women (18-55 years old) was interviewed; anthropometrical measures and fasting blood sample were collected. The prevalence of MS was determined using the NCEP-ATPIII criteria. A general questionnaire on socio-economic status and lifestyle factors was used. Dietary habits were assessed using three 24hours recalls and a semi-quantitative food frequency questionnaire. Adherence to the Mediterranean diet (MD) was defined according to a score constructed considering the consumption of major MD components. The overall prevalence of MS was 20.9 %; MS was prevalent in 20 % among the overweight and 37.8% among the obese women. Eight point eight of women had no risk factors while 41.2% had one risk factor and 29.1% had two risk factors. Low-HDL cholesterol was found among 82.4 %, Hypertension in 36.8 and abdominal obesity among 25.8 % women with MS. The mean adherence to Mediterranean Diet (MD) was 62.84 % (± 12.7). Once adjusted for age, socioeconomic and lifestyle variables, MD adherence was not related to metabolic syndrome but some MD components, such as Cereals and monounsaturated to saturated fatty acids ratio, showed a protective effect on triglyceridemia and glycemia criteria, respectively. The study data show that MS is prevalent among the population sample, especially among obese women. Some components of the MD have a protective effect on MS and on its components. However, no association was found between MS and adherence to MD. High education level and availability of family environment were also related to a better adherence to MD pattern.

Association of Lipoprotein(a) and hsCRP Levels with Metabolic Syndrome and its Components

Cardiovascular diseases (CVDs) deserve more clinical attention being the primary clinical outcome of metabolic syndrome (MetS). Indians are highly predisposed to MetS, insulin resistance and CVDs. The traditional and unconventional risk factors in circulation could prove to be of immense value in further CVD risk stratification. Lipoprotein(a) [Lp(a)] and high sensitivity CRP (hs-CRP) are among the emerging risk factors in the development of CVDs. But there is a dearth of such studies in Gujarat. Therefore the current study attempts to evaluate the levels of Lp(a) and hs-CRP in MetS and its components in population of Jamnagar district, Gujarat. This cross-sectional study comprised 222 subjects of both genders attending OPD and IPD of Guru Gobind Singh Government Hospital, Jamnagar. The modified NCEP ATPIII criteria were used to diagnose participants with MetS. Various anthropometric measurements were recorded as per standard protocol. 5 ml overnight fasting blood samples were collected for the analyses of various biochemical parameters. A significantly higher BMI, W/H ratio, systolic & diastolic BP (SBP & DBP) and lipid profile were observed in MetS. The association between the presence of MetS and Lp(a) was found to be significant (χ2 = 26.60; p < 0.0001). Elevated fasting blood glucose presented with the highest risk of causing an elevation in Lp(a) levels (OR = 2.369; CI = 1.087, 5.163; p = 0.03) in this study on multivariate regression analysis. Multivariate analysis also showed hs-CRP as a strong risk factor (OR = 3.18; CI = 1.236, 8.217; p = 0.016) for developing MetS. Thus Lp(a) and hs-CRP investigations are recommended in MetS subjects for defining preventive strategies against future coronary events.

Association of Metabolic Syndrome with the Cardioankle Vascular Index in Asymptomatic Korean Population.

Aim. Metabolic syndrome is characterized by a cluster of atherosclerotic cardiovascular risk factors. The cardioankle vascular index (CAVI) reflects arterial stiffness and may be used as an indicator of atherosclerotic cardiovascular disease. In this study, we investigated the association of CAVI with metabolic syndrome. Methods. A total of 1,144 adults were included in this study. We measured CAVIs and examined blood samples to identify metabolic syndrome according to WHO Asia Pacific criteria and NCEP-ATPIII criteria. AST, ALT, r-GTP, BUN, creatinine, high sensitivity C-reactive protein, and uric acid were also measured. Results. CAVI values were significantly higher in subjects with metabolic syndrome than those without metabolic syndrome and increased according to the number of metabolic syndrome components present. Subjects with high fasting blood sugar levels or high blood pressure showed high CAVI values. Multiple regression analysis showed that age, sex, diastolic blood pressure, and uric acid were independent predictors of CAVI. Conclusion. Subjects with metabolic syndrome had high CAVIs, which indicated arterial stiffness, and were closely associated with an increase in the number of metabolic risk factors. The individual risk factors for metabolic syndrome have the synergistic effect of elevating arterial stiffness in asymptomatic Korean population.

Abstract 18402: Impact of Obesity on Outcomes After Percutaneous Coronary Intervention in Japanese Population: Obesity Paradox with High Waist Circumference but Not High BMI

Introduction: Although the counterintuitive association between obesity and mortality has been termed the obesity paradox, the evaluation of obesity was inconsistent, and evidence for an obesity paradox among past studies has been also less consistent. Hypothesis: This inconsistency may be due, in part, to a discrepancy between central obesity, estimated by waist circumference (WC), and body mass index (BMI) as patterns of adiposity. Methods: To elucidate the impact of obesity, 2817 subjects with both WC and BMI data were enrolled from the data of Kumamoto Intervention Conference Study (KICS), a multicenter registry, enrolling consecutive patients undergoing PCI in 15 centers from August 2008 to March 2011 in Japan. Subjects were stratified according to patterns of adiposity (WC or BMI), utilizing NCEP-ATPIII criteria and WHO classification. Results: Subjects’ mean age was 69.8 years, and 28% were female. There were 68 deaths during 12-month follow up. Although obesity defined by WC (ObWC) was associated with lower mortality compared with non-obesity (no-ObWC, p=0.013), no difference was shown between obesity, defined by BMI (ObBMI), and non-obesity (no-ObBMI) (p=0.201). When dividing into 4 categories based on high/low of WC and BMI, subjects with high WC and high BMI had the lowest mortality (1.6%) compared to other 3 categories (high WC low BMI; 1.7%, low WC high BMI; 2.4%, or low WC and low BMI; 3.1%). Kaplan-Meier analysis for all cause mortality showed a significant difference between ObWC and no-ObWC (Log Rank p=0.010), but comparable in BMI (ObOMI vs no-ObBMI, p=0.295). This discrepancy was also observed in the analysis for cardiac death (Figure). In multivariate analysis, in addition to age and CKD, ObWC was an independent predictor for the low mortality (OR; 0.582, 95% CI; 0.342-0.991, p=0.046). Conclusions: In Japanese patients with known CAD who undergo PCI, central obesity but not BMI is associated with the paradoxical protective effect of obesity.

Bone health and risk factors of cardiovascular disease--a cross-sectional study in healthy young adults.

ObjectiveBoth osteoporosis and cardiovascular disease (CVD) are diseases that comprise a growing medical and economic burden in ageing populations. They share many risk factors, including ageing, low phy-sical activity, and possibly overweight. We aimed to study associations between individual risk factors for CVD and bone mineral density (BMD) and turnover markers (BTMs) in apparently healthy cohort.DesignA cross-sectional assessment of 155 healthy 32-year-old adults (74 males) was performed for skeletal status, CVD risk factors and lifestyle factors.MethodsWe analysed serum osteocalcin, procollagen I aminoterminal propeptide (P1NP), collagen I carboxy-terminal telopeptide (ICTP) and urine collagen I aminoterminal telopeptide (U-NTX), as well as serum insulin, plasma glucose, triglyceride and HDL-cholesterol levels. BMD, fat and lean mass were asses-sed using DXA scanning. Associations were tested with partial correlations in crude and adjusted mo-dels. Bone status was compared between men with or without metabolic syndrome (defined according to the NCEP-ATPIII criteria) with multivariate analysis.ResultsOsteocalcin and P1NP correlated inversely with insulin (R = −0.243, P = 0.003 and R = −0.187, P = 0.021) and glucose (R = −0.213, P = 0.009 and R = −0.190, P = 0.019), but after controlling for fat mass and lifestyle factors, the associations attenuated with insulin (R = −0.162, P = 0.053 and R = −0.093, P = 0.266) and with glucose (R = −0.099, P = 0.240 and R = −0.133, P = 0.110), respectively. Whole body BMD associated in-versely only with triglycerides in fully adjusted model. In men with metabolic syndrome, whole body BMD, osteocalcin and P1NP were lower compared to healthy men, but these findings disappeared in fully adjusted model.ConclusionsIn young adults, inverse associations between BTM/BMD and risk factors of CVD appeared in crude models, but after adjusting for fat mass, no association continued to be present. In addition to fat mass, lifestyle factors, especially physical activity, modified the associations between CVD and bone charac-teristics. Prospective studies are needed to specify the role of mediators and lifestyle factors in the prevention of CVD and osteoporosis.

Relationship between serum resistin concentrations with metabolic syndrome and its components in an Iranian population

BackgroundThe aim of the study is to determine the association of resistin with each MetS component. MethodsThis study had a case-control design, and its data was retrieved from the Isfahan Healthy Heart Program (IHHP), Serum samples from 44 subjects with MetS (diagnosed according to the NCEP-ATPIII criteria) and 46 healthy controls were analyzed for resistin using enzyme-linked immunosorbent assay. Association between serum resistin and levels of total (TC), low- (LDL-C) and high-density (HDL-C) lipoprotein cholesterol, triglycerides (TG), fasting blood sugar (FBS), waist circumference, body mass index, and systolic and diastolic blood pressures was determined. ResultsSerum resistin levels were significantly higher in the MetS compared with control group (3.64±1.63, P=0.040). Serum levels of resistin were found to be significantly correlated with levels of TC (r=−0.347; P=0.027) and LDL-C (r=−0.311; P=0.050), but not other components of MetS including systolic and diastolic blood pressure, TG, HDL-C and FBS (P>0.05) in the MetS group, after adjustment for age, gender and BMI. No significant correlation between resistin and MetS components was observed in the control group (P>0.05). ConclusionSerum resistin levels are elevated in subjects with MetS and may be associated with the severity of this syndrome.

Metformin treatment improves weight and dyslipidemia in children with metabolic syndrome.

To determine the effects of metformin therapy in children with metabolic syndrome (MS). A retrospective electronic chart review in children aged 8-18 years, from 2000 to 2012 with a diagnosis code for MS (ICD 277.7) that met the modified NCEP ATPIII criteria for MS. There were a total of 217 subjects, 150 in the non-metformin [untreated group (UTG)] and 67 in the metformin treated group (MTG). At baseline, the MTG had a body mass index (BMI) similar to UTG, but had higher total cholesterol, low-density lipoprotein cholesterol (LDL-C), and non-high density lipoprotein cholesterol (non-HDL-C). At the end of 1 year, the MTG (n=28) had reduced weight percentile (99.4±0.7 vs. 98.9±1.7, p=0.03), BMI percentile (99.2±0.5 vs. 98.8±1.1, p=0.012), total cholesterol (194.9±45.8 vs. 177.9±32.5 mg/dL, p=0.04), LDL-C (128.3±44.7 vs. 113.8±36.0 mg/dL, p=0.04), and non-HDL-C (154.6±45.5 vs. 136.4±35.2 mg/dL, p=0.03) compared to their baseline. The UTG (n=56) did not have any significant change in those parameters. Metformin treatment results in significant improvement in BMI, total cholesterol, LDL-C, and non-HDL-C in children with MS.

Lipid-modifying effects of adjunctive therapy with curcuminoids–piperine combination in patients with metabolic syndrome: Results of a randomized controlled trial

Dyslipidemia is an established feature of metabolic syndrome (MS) that is associated with an increased risk of atherosclerotic cardiovascular disease. Curcuminoids are natural products with anti-atherosclerotic and lipid-modifying effects but their efficacy in patients with MS has not yet been tested. To investigate the effects of bioavailability-enhanced curcuminoids, as adjunctive to standard of care, on serum lipid concentrations in patients with MS. Patients diagnosed with MS according to the NCEP-ATPIII criteria who were receiving standard of care were assigned to either curcuminoids (C3 complex(®); 1000 mg/day; n=50) or placebo (n=50; matched with drug capsules in shape and color) for 8 weeks. In order to improve the oral bioavailability, curcuminoids were co-administered with piperine (bioperine(®)) in a ratio of 100:1. Serum concentrations of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, small dense LDL (sdLDL), lipoprotein(a) [Lp(a)], and non-HDL-C were determined at baseline and at the end of 8-week treatment period. Curcuminoids were more effective than placebo in reducing serum LDL-C, non-HDL-C, total cholesterol, triglycerides and Lp(a), and elevating HDL-C concentrations. However, changes in serum sdLDL levels were found to be comparable between the study groups. The effects of curcuminoids on triglycerides, non-HDL-C, total cholesterol and Lp(a) remained significant after adjustment for baseline values of lipids and body mass index. Curcuminoids-piperine combination is an efficacious adjunctive therapy in patients with MS and can modify serum lipid concentrations beyond what is achieved with standard of care.

Prevalence of metabolic syndrome in Amol and Zahedan, Iran: a population based study.

So far, a variety of prevalence rates have been reported for the metabolic syndrome (MetS) according to several definitions. The aim of this study was to assess the prevalence of MetS in Iran according to two definitions and compare the characteristics of the subjects who met the MetS criteria according to the different definitions. Participants were recruited from family registries of public health centers. After obtaining demographic and clinical data, the subjects underwent anthropometric measurements and laboratory evaluations. MetS was defined according to the NCEP-ATPIII and IDF criteria. The subjects were then categorized into 3 groups: 1) Healthy non-MetS subjects based on either definition, 2) Individuals with MetS according to only one of the definitions, and 3) Individuals who met both NCEP-ATPIII and IDF criteria for MetS. Totally, 5826 subjects in Amol and 2243 subjects in Zahedan were enrolled in the study. The weighted prevalence of MetS according to the NCEP-ATPIII and IDF criteria was 27.8% and 26.9% in Amol and 12% and 11.8% in Zahedan, respectively. Overall, 18.9% of the subjects fulfilled both criteria for MetS. However, a considerable proportion (8.5%) met the MetS criteria according to only one definition but not both. MetS is increasingly prevalent in Iran as well as other parts of the world. Due to non-uniform definitions of MetS, some of the subjects who meet MetS according to one set of criteria might be considered healthy according to another definition and consequently would not receive the preventive health services.

0175 Preliminary baseline characteristics of a prospective night shift worker cohort in Shenzhen, China

ObjectivesThe incidence of metabolic syndrome (MS) increases rapidly in China. Growing evidence suggests that alterations in circadian systems and sleep disorders have participated in the etiology of metabolic disorders. This...

Meta-analysis on night shift work and risk of metabolic syndrome.

This study aims to quantitatively summarize the association between night shift work and the risk of metabolic syndrome (MetS), with special reference to the dose-response relationship with years of night shift work. We systematically searched all observational studies published in English on PubMed and Embase from 1971 to 2013. We extracted effect measures (relative risk, RR; or odd ratio, OR) with 95% confidence interval (CI) from individual studies to generate pooled results using meta-analysis approach. Pooled RR was calculated using random- or fixed-effect model. Downs and Black scale was applied to assess the methodological quality of included studies. A total of 13 studies were included. The pooled RR for the association between 'ever exposed to night shift work' and MetS risk was 1.57 (95% CI = 1.24-1.98, pheterogeneity = 0.001), while a higher risk was indicated in workers with longer exposure to night shifts (RR = 1.77, 95% CI = 1.32-2.36, pheterogeneity = 0.936). Further stratification analysis demonstrated a higher pooled effect of 1.84 (95% CI = 1.45-2.34) for studies using the NCEP-ATPIII criteria, among female workers (RR = 1.61, 95% CI = 1.10-2.34) and the countries other than Asia (RR = 1.65, 95% CI = 1.39-1.95). Sensitivity analysis confirmed the robustness of the results. No evidence of publication bias was detected. The present meta-analysis suggested that night shift work is significantly associated with the risk of MetS, and a positive dose-response relationship with duration of exposure was indicated.

Metabolic Syndrome in Overweight and Obese Adolescents: A Comparison of Two Different Diagnostic Criteria

Background: Due to the lack of consensus on its definition, the metabolic syndrome (MS) in children and adolescents is not formally recognized. However, several researchers have changed the adult criteria for pediatric standards in order to assess the prevalence. Objective: The aim of this study was to evaluate the frequency of MS and its components according to two of the currently used definitions in overweight and obese adolescents. Methods: A cross-sectional study with 232 adolescents with excess weight from a public school of the city of Rio de Janeiro. Anthropometric, blood pressure, and biochemical variables were assessed. MS was defined using two different diagnostic criteria: the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) and International Diabetes Federation (IDF). Results: MS was diagnosed in 40.4 and 24.6% of obese adolescents and 9.4 and 1.9% of overweight adolescents according to the NCEP-ATPIII and IDF criteria, respectively. The degree of agreement, assessed by the κ index, from the definitions adopted in this study was 0.48. Conclusion: The results show a significant difference between the two diagnostic criteria. A higher frequency was found when the NCEP-ATPIII was used, which is of concern given the association of MS with diabetes and cardiovascular disease.

Status of antioxidant and lipid peroxidation in type 2 diabetic human subjects diagnosed with and without metabolic syndrome by using NCEP-ATPIII, IDF and WHO criteria

Antioxidants play a very crucial role in terms of disease incidence and its complications. Type 2 diabetes and metabolic syndrome (MetS) are now more prevalent than any other disorder. In this regard this study focuses on type 2 diabetic subjects with MetS having highest incidence of cardiovascular disease. Hence the aim of the study was to reveal the level of antioxidants and lipid peroxidation in MetS and non-MetS groups of type 2 diabetic subjects characterized by three different criteria. Present study was based on 70 type 2 diabetic subjects and 20 healthy controls. The metabolic syndrome criteria were defined by National Cholesterol Education Program (NCEP)-Adult Treatment Panel III (ATPIII), International Diabetes Federation (IDF), and World Health Organization (WHO). The selected subjects were of similar age group. The participants were selected from a diabetic camp being run in the University Campus. The antioxidant enzymes estimated were reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) while Thiobarbituric acid reactive substances (TBARS) measured as a marker of lipid peroxidation. The level of GSH, CAT, SOD decreases in non-MetS and MetS subjects as compared to normal. When comparison was made for GSH & SOD in the mentioned groups resulted a significant differences in non-MetS and MetS compared with normal subjects. TBARS levels was increased in non-MetS and MetS group of subjects. The results indicate reduction in antioxidant enzymes and elevation of lipid peroxidation in type 2 diabetic subjects with or without MetS defined by using any of the International criteria. The study revealed that absolute reduction of antioxidant and involvement of lipid peroxidation in MetS group may lead to progressive intensification of cardiovascular disease in type 2 diabetic subjects irrespective of using any criteria.

Metabolic syndrome in patients with prostate cancer undergoing androgen suppression

ObjectivesCardiovascular mortality is the leading cause of death in patients with prostate cancer (PC), metabolic syndrome (MS) being related to it. The main objective of this study was to determine the prevalence of MS in patients with CP undergoing androgen suppression (AS). Materials and methodsWe performed a retrospective study of cases and controls that included 159 patients. The study group was made up of 53 patients with PC undergoing SA for a period exceeding 12 months. The control group had 53 patients with PC at the time of diagnosis and 53 patients with negative prostate biopsy. All the patients were evaluated for presence of MS according to NCEP-ATPIII criteria. ResultsPrevalence of MS in patients without PC was 32.1% and in those with non-treated PC 35.8%, P=.324. In patients with PC undergoing AS, prevalence of MS was 50.9%, P<.001. When AS duration was less than 36 months, prevalence of MS was 44.0% and when greater than 36 months 57.1%, P<.001. Waist circumference and hyperglycemia were the two MS components that significantly increased. AS and its duration were independent predictors factors for the development of MS. ConclusionsContinuous AS therapy increases the prevalence of MS and especially waist circumference and hyperglycemia. Development of MS increases according to AS duration.

Arterial stiffness and influences of the metabolic syndrome: A cross-countries study

Specific clusters of metabolic syndrome (MetS) components impact differentially on arterial stiffness, indexed as pulse wave velocity (PWV). Of note, in several population-based studies participating in the MARE (Metabolic syndrome and Arteries REsearch) Consortium the occurrence of specific clusters of MetS differed markedly across Europe and the US. The aim of the present study was to investigate whether specific clusters of MetS are consistently associated with stiffer arteries in different populations.We studied 20,570 subjects from 9 cohorts representing 8 different European countries and the US participating in the MARE Consortium. MetS was defined in accordance with NCEP ATPIII criteria as the simultaneous alteration in ≥3 of the 5 components: abdominal obesity (W), high triglycerides (T), low HDL cholesterol (H), elevated blood pressure (B), and elevated fasting glucose (G). PWV measured in each cohort was “normalized” to account for different acquisition methods.MetS had an overall prevalence of 24.2% (4985 subjects). MetS accelerated the age-associated increase in PWV levels at any age, and similarly in men and women. MetS clusters TBW, GBW, and GTBW are consistently associated with significantly stiffer arteries to an extent similar or greater than observed in subjects with alteration in all the five MetS components – even after controlling for age, sex, smoking, cholesterol levels, and diabetes mellitus – in all the MARE cohorts.In conclusion, different component clusters of MetS showed varying associations with arterial stiffness (PWV).