NCEP ATPIII Research Articles

Associations between body fat anthropometric indices and mortality among individuals with metabolic syndrome

BackgroundThe distribution of body fat and metabolic health may contribute to the onset of metabolic syndrome (MetS), but the associations between body fat anthropometric indices (AIs) and mortality in individuals with MetS remain unclear.MethodsParticipants aged 18 years or older with MetS were recruited from the NHANES 1999–2018. The body fat anthropometric indices included the a body shape index (ABSI), body roundness index (BRI), cardiometabolic index (CMI), visceral adiposity index (VAI), waist triglyceride index (WTI), lipid accumulation product (LAP), atherogenic index of plasma (AIP), and triglyceride‒glucose (TyG) index. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) criteria. Mortality data were obtained from the National Death Index through December 31, 2019.ResultsData were collected from 8,379 individuals with MetS, with a median follow-up of 8.5 years, of whom 1,698 died from all causes and 568 from the CCD. The random survival forest (RSF) analysis indicated that the ABSI had the strongest predictive power for both all-cause mortality and CCD mortality among the eight body fat AIs. After adjusting for multiple variables, the ABSI was found to be linearly and positively associated with all-cause and CCD mortality in individuals with MetS. Participants in the highest quartile of ABSI had an increased risk of all-cause (HR = 1.773 [1.419–2.215]) and CCD (HR = 1.735 [1.267–2.375]) mortality compared with those in the lowest quartile. Furthermore, the ABSI predicted areas under the curve (AUCs) of 0.735, 0.723, 0.718, and 0.725 for all-cause mortality at 3, 5, 10, and 15 years, respectively, and 0.774, 0.758, 0.725, and 0.715 for CCD mortality, respectively.ConclusionAmong eight body fat AIs, the ABSI exhibited the strongest predictive power for mortality in individuals with MetS. Higher ABSI values significantly increased all-cause mortality and CCD mortality in participants with MetS.

Metabolic Syndrome and Its Component Factors Among Corporate Company Employees in Kampala Uganda.

Metabolic syndrome (MetS), a cluster of metabolic dysregulations indicative of increased cardiometabolic risk is on the rise in Sub-Saharan Africa. The study aimed to determine the prevalence of MetS and its components, among corporate employees in Kampala, Uganda. A cross-sectional survey was undertaken among 408 adults who were employees from seven corporate companies in Kampala, using the WHO STEPwise NCD screening approach. Metabolic syndrome was measured using the National Cholesterol Education Program Adult Treatment Panel (ATPIII) and the International Diabetes Federation (IDF) criteria with the waist circumference (WC) cut-off points adapted for Sub-Saharan African populations. The mean population age (standard deviation [SD]) of the respondents was 34years (± 8.87) years and 52% of them were females. The prevalence of MetS was 22.8% (NCEP ATPIII) and 28.4% (IDF). Of the respondents who did not have MetS, 75% had at least one metabolic dysregulation. Of those respondents with MetS, only 31% perceived that they were at risk of this cluster of metabolic dysregulations. In this analysis, we observed that the systolic blood pressure (BP) and the body mass index (BMI) correlated strongly (r = 0.81 and r = 0.71) with the diastolic BP and waist circumference (WC), respectively. Age on the other hand correlated fairly with the WC and BMI (both r values = 0.46). Principal component analysis showed that the greatest loadings in principle factors one, two and three were from central obesity, with low HDL-C explaining 60.8% variance in the population. Age, BMI, family history of having cardiometabolic disorders, and perceived cardiometabolic disease risk (CMR) were associated with an increased risk of MetS by 5, 8.86, 1.55, and 2.73 (all P values were < 0.05) respectively in this group of respondents. These risks remained for age, BMI and perceived CMR after removing the confounding effects of education status, marital status and family history of cardiometabolic disease. Being single on the other hand, was associated with a reduced risk of MetS (0.23, p < 0.009). While the primary contributors to the high prevalence of MetS among corporate employees in Kampala, Uganda were the high BP, high WC and high fasting blood sugar (FBS); age, BMI and perceived CMR were the key determinants of MetS. Future MetS interventions should aim to control and monitor obesity indicators in this population. Additionally, the findings inform targeted screening parameters for cardiometabolic risk assessment and suggest the need for further research into a weighted algorithm for MetS in this population.

Metabolic Syndrome and Its Associated Factors Among Patients With Schizophrenia Treated With Second-Generation Antipsychotics at Amanuel Mental Specialized Hospital, Ethiopia.

Background Metabolic syndrome (MetS) encompasses a group of risk factors that increase the likelihood of developing cardiovascular diseases, thereby increasing the mortality rate. Second-generation antipsychotics (SGAs) are known for these side effects. This study aimed to determine the prevalence of MetS and its associated factors at Amanuel Mental Specialized Hospital. Methods A cross-sectional study was conducted from October 3, 2022, to August 31, 2023. Fasting blood sugar and lipid analysis were performed using the Dimension® EXL™ 200 Integrated Chemistry System (Siemens Healthineers, Malvern, PA, USA). A diagnosis of MetS was established using the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) criteria. IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, NY, USA) was used for analysis. A binary logistic regression model was employed, and a p-value less than 0.05 was considered significant. Results A total of 271 participants were enrolled in the study. Most subjects were male (90%) and had a mean age of 34.2 years, with an SD of 10.5. Most participants (70.8%) had abnormal waist circumference, followed by lower high-density lipoprotein cholesterol (HDL-C) at 42.8%. The prevalence of MetS was 35.8%. Gender (being female) (adjusted odds ratio or AOR 3, 95% CI: 1.2-7.4; p = 0.02) and olanzapine use (AOR 2.2, 95% CI: 1.3-3.7; p = 0.005) were predictors of MetS. Conclusions MetS is highly prevalent in patients treated with SGAs. Being female and olanzapine use were predictors of MetS. Clinicians managing these patients should screen and monitor the metabolic components used to diagnose MetS.

Trends and characteristics of the metabolically healthy obese phenotype in an Arab population.

The metabolically healthy obesity (MHO) phenotype represents a complex and distinctive trait, the trends and characteristics of which remain unknown in the Saudi Arabian adult population. The present study aims to fill that gap. A combined total of 10,220 Saudi adults from 2 independent cohorts [2008-2019, N = 7,896 (2,903 males and 4,993 females), and 2021-2023, N = 2,324 (830 males and 1,494 females)] aged 19-70 years old was screened, of whom 9,631 (3,428 males and 6,203 females) were included. Anthropometric data were measured, and fasting blood samples were collected to assess glucose, lipids, adipocytokines and inflammatory markers using routine methods and commercially available assays. Obesity was defined as a body mass index (BMI) ≥30 kg/m2. Screening for MHO was done using the empiric definition proposed by Zembic and colleagues and the by the National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATPIII). Of the 3,949 (41.0%) participants with obesity, 33.4% (95% confidence interval, CI, 32-35) were considered MHO using the empiric definition, and 32.8% (95% CI, 31-34) using NCEP-ATPIII. The overall age and gender adjusted prevalence of MHO in the Saudi adult population was 31.6% (95% CI, 30-33) and 30.1% (29-31) by the two definitions, respectively. Females had a higher age-adjusted prevalence of MHO than males (OR = 1.22, 95% CI 1.1-1.4, p = 0.009) as per the ATPIII criteria. MHO prevalence substantially increased over time from 2008 to 2023 (p < 0.001) for both definitions. Circulating leptin levels and insulin resistance were significantly higher in the MUO group than the MHO group independent of the definition used, suggesting the presence of a more severe form of leptin resistance in the MUO group which may explain the worse cardiometabolic profile as compared to the MHO group. In summary, the study highlights the first time the characteristics and trends of the MHO phenotype among Saudi Arabian adults. The pluripotent effects of leptin and its resistance may be central to MHO's progression, or lack thereof, to the MUO phenotype, and this needs further investigation.

The burden and care cascade in young and middle-aged patients with diabetes hypertension comorbidity with abdominal obesity in India: A nationally representative cross-sectional survey.

We ascertained the burden, determinants, and care cascade in the young and middle-aged patients having co-existing hypertension (HTN), Diabetes Mellitus (DM), and abdominal obesity in India from a secondary data analysis of nationally representative data. The study examined cross-sectional data from the National Family Health Survey (NFHS-5) conducted in India from 2019 to 2021 in 788974 individuals aged 15-49 years including 695707 women and 93267 men. The weighted prevalence of DM-HTN comorbidity with high waist circumference in the sample was 0.75% (95% CI: 0.71 to 0.79) including 46.33% (95% CI: 44.06 to 48.62) newly diagnosed cases detected for HTN and high blood sugars. The weighted prevalence of Metabolic syndrome as per NCEP ATPIII criteria was found to be 1.13% (95% CI: 1.08 to 1.17). Only 46.16% existing cases were treated with both anti-diabetes and antihypertensive medication (full treatment), while 34.71% cases were untreated. On adjusted analysis, increasing age, females, higher wealth index, high fat diet, obesity and comorbidities were significantly associated with having DM-HTN comorbidity along with high-waist circumference. More than half of young and middle aged-population in India with DM-HTN-abdominal obesity triad are not initiated on treatment for DM and HTN comorbidities, while a majority of the previously diagnosed cases have uncontrolled blood pressure and poor glycemic control. The poor cascade of care for DM and HTN in these high-risk group of patients may substantially increase their risk for early progression and severity of microvascular and macrovascular complications especially cardiovascular disease.

Explainable artificial intelligence for LDL cholesterol prediction and classification

IntroductionMonitoring LDL-C levels is essential in clinical practice because there is a direct relation between low-density lipoprotein cholesterol (LDL-C) levels and atherosclerotic heart disease risk. Therefore, measurement or estimate of LDL-C is critical. The present study aims to evaluate Artificial Intelligence (AI) and Explainable AI (XAI) methodologies in predicting LDL-C levels while emphasizing the interpretability of these predictions. Materials and methodsWe retrospectively reviewed data from the Laboratory Information System (LIS) of Ankara Etlik City Hospital (AECH). We included 60.217 patients with standard lipid profiles (total cholesterol [TC], high-density lipoprotein cholesterol, and triglycerides) paired with same-day direct LDL-C results. AI methodologies, such as Gradient Boosting (GB), Random Forests (RF), Support Vector Machines (SVM), and Decision Trees (DT), were used to predict LDL-C and compared directly measured and calculated LDL-C with formulas. XAI techniques such as Shapley additive annotation (SHAP) and locally interpretable model-agnostic explanation (LIME) were used to interpret AI models and improve their explainability. ResultsPredicted LDL-C values using AI, especially RF or GB, showed a stronger correlation with direct measurement LDL-C values than calculated LDL-C values with formulas. TC was shown to be the most influential factor in LDL-C prediction using SHAP and LIME. The agreement between the treatment groups based on NCEP ATPIII guidelines according to measured LDL-C and the LDL-C groups obtained with AI was higher than that obtained with formulas. ConclusionsIt can be concluded that AI is not only a reliable method but also an explainable method for LDL-C estimation and classification.

Cardiometabolic profiles and proteomics associated with obesity phenotypes in a longitudinal cohort of young adults

To assess cardiometabolic profiles and proteomics to identify biomarkers associated with the metabolically healthy and unhealthy obesity. Young adults (N = 156) enrolled were classified as not having obesity, metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO) based on NCEP ATP-III criteria. Plasma proteomics at study entry were measured using Olink Cardiometabolic Explore panel. Linear regression was used to assess associations between proteomics and obesity groups as well as cardiometabolic traits of glucose, insulin, and lipid profiles at baseline and follow-up visits. Enriched biological pathways were further identified based on the significant proteomic features. Among the baseline 95 (61%) and 61 (39%) participants classified as not having obesity and having obesity (8 MHO and 53 MUHO), respectively. Eighty of the participants were followed-up with an average 4.6 years. Forty-one proteins were associated with obesity (FDR < 0.05), 29 of which had strong associations with insulin-related traits and lipid profiles (FDR < 0.05). Inflammation, immunomodulation, extracellular matrix remodeling and endoplasmic reticulum lumen functions were enriched by 40 proteins. In this study population, obesity and MHO were associated with insulin resistance and dysregulated lipid profiles. The underlying mechanism included elevated inflammation and deteriorated extracellular matrix remodeling function.

Comparison of three definition of the metabolic syndrome in Korean patients with acute ischemic stroke

Background: The metabolic syndrome (MetS) is a cluster of risk factors for atherosclerotic arterial disease including acute ischemic stroke but little is known about prognostic impact in acute ischemic stroke patients. Several diagnostic criteria have been proposed by number of organizations. So we aimed to investigate the prevalence of MetS according to different diagnostic criteria.Methods: Patients with acute ischemic stroke were performed to estimate the prevalence of MetS using the 3 definitions of MetS: the National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III), the International Diabetes Federation (IDF) and Joint Interim Societies (JIS) MetS definition. One year mortality and morbidity of all cause and vascular cause was evaluated according to individual definition.Results: Among total 914 patients, the MetS prevalence was 32.5%, 37.2% and 56.6% with the NCEP, IDF and JIS definitions. Central obesity was more frequently observed in patients diagnosed with MetS by IDF and JIS definition than patients with MetS by NCEP ATP-III definition. One year mortality of all cause was 6.9% in the whole study population and 5.4%, 4.4% and 5.8% according to the NCEP ATP-III, IDF and JIS definitions. Age and C-reactive protein was positively in contrast, the IDF and the JIS definitions were negatively predicted 1-year mortality.Conclusions: The prevalence of MetS was higher with JIS definitions in comparison with other 2 definitions. But JIS and IDF definitions were negatively predicted 1 year mortality. These findings suggest needs for further study for prognostic impact of individual MetS definition in patients with acute ischemic stroke.

Benign prostatic hyperplasia and metabolic syndrome; prevalence and association: a cross-sectional study in Syria

BackgroundBenign Prostatic Hyperplasia (BPH) is considered the most common cause of lower urinary tract symptoms in men aged 40 years and older. BPH is related to sex steroids, but there are increasing studies investigating the relationship between the urinary symptoms and the metabolic syndrome. They still have inconsistent results; some reported a significant positive association, while others found no significant association. In this study, we aim to assess the prevalence rate of metabolic syndrome in BPH patients and whether there is an association between symptoms linked to BPH and metabolic syndrome in the Syrian community.MethodsThe participants of this observational cross-sectional study were benign prostatic hyperplasia patients aged 40-year-old and older from Homs, Syria. An interview questionnaire was performed to collect data from all patients who visited the urology clinic of Homs Military Hospital in the period of January 10 to March 10, 2023. We used the International Prostate Symptom Score (IPSS) to assess the urinary symptoms, and we used the US National Cholesterol Education Program Adult Treatment Panel (NCEP ATPIII) criteria to define the metabolic syndrome.ResultsThe final sample size was 426 patients. The overall prevalence of metabolic syndrome was 46.2%. Patients with metabolic syndrome had higher International Prostate Symptom Score compared to patients without metabolic syndrome (21 vs. 18, P < 0.001), and 59.3% of patients with metabolic syndrome suffered from severe symptoms compared to 36.2% of patients without metabolic syndrome who suffered from severe lower urinary tract symptoms (P < 0.001). There was a positive association between (waist circumference, diabetes, triglycerides) (P < 0.001), HDL (P = 0.014) and higher International Prostate Symptom Score. However, there was no statistically significant association between blood pressure and International Prostate Symptom Score (P = 0.879).ConclusionOur results showed that patients with metabolic syndrome had a higher International Prostate Symptom Score. This idea should be used to design a new benign prostatic hyperplasia/lower urinary tract symptoms treatment.

Effect of adipose tissue quantity and dysfunction on the risk of cancer in individuals with and without type 2 diabetes.

To determine the role of waist circumference and metabolic dysfunction in the risk of cancer in individuals with type 2 diabetes (T2D) and to compare this to individuals without T2D. Individuals with (n=1925) and without T2D (n=10,204) were included from the UCC-SMART cohort. Incident cancer diagnoses were obtained by linkage with the Netherlands Cancer Registry. Metabolic dysfunction was defined as ≥3 adapted NCEP ATP-III metabolic syndrome criteria. The effects of waist circumference and metabolic dysfunction on cancer were assessed using Cox proportional hazards models, adjusted for confounders. During a median follow-up of 8.3 years (IQR 4.2-13.1), 1740 individuals were diagnosed with cancer. Incidence rates of total cancer were 19.3 and 15.5/1000 person-years for individuals with and without T2D, respectively. In individuals without T2D, a higher waist circumference was associated with an increased risk of colorectal (per standard deviation: HR 1.23; 95%CI 1.03-1.46), urinary tract (HR 1.28; 95%CI 1.05-1.56) and total cancer (HR 1.06; 95%CI 1.02-1.13). Metabolic dysfunction was related to an increased risk of colorectal (HR 1.35; 95%CI 1.01-1.82), lung (HR 1.37; 95%CI 1.07-1.75) and total cancer (HR 1.13; 95%CI 1.01-1.25) in individuals without T2D. In individuals with T2D, no significant associations were found. Incidence rates of cancer are higher among individuals with T2D. However, higher waist circumference and metabolic dysfunction are only associated with an increased cancer risk in patients without T2D. These findings provide novel insights into the role of metabolic dysfunction in the occurrence of cancer.

Associations of starchy and non-starchy vegetables with risk of metabolic syndrome: evidence from the NHANES 1999–2018

BackgroundHigher dietary quality, including increased vegetable consumption, was associated with a reduced risk of metabolic syndrome (MetS). However, specific vegetable consumption in the development of MetS remains obscure. Our study aimed to investigate the correlation between starchy and non-starchy vegetables and MetS.MethodsSecondary data analysis from the National Health and Nutrition Examination Survey (NHANES 1999–2018). MetS was defined by National Cholesterol Education Program-Adult treatment Panel III (NCEP ATPIII) and dietary consumption was assessed by trained staff using two 24-h diet recall methods. Weighted logistic regression analysis was carried out to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses and restricted cubic spline (RCS) regression were performed to further investigate specific vegetable subtypes and MetS.ResultsThis research enrolled 24,646 individuals (11,725 females and 12,921 males), with an average age of 45.84 ± 0.23 years. Approximately 15,828(64.22%) participants were defined to be with non-MetS and 8818(35.78%) were with MetS. Both total starchy vegetables and potatoes were associated with increased MetS risk, with the corresponding OR per standard deviation (SD) (95%CI, p-trend) being 1.06(1.02–1.11, p-trend = 0.028) and 1.08(1.04–1.13, p-trend = 0.011), respectively. However, an inverse correlation was found between dark-green vegetables and MetS, and the OR per SD (95%CI, p-trend) was 0.93(0.90–0.97, p-trend = 0.010). Subgroup analyses showed that the positive associations of starchy vegetables and potatoes on MetS risk were stronger in non-Hispanic White participants (p for interaction < 0.050).ConclusionTotal starchy vegetables and white potatoes were both associated with an increased risk of MetS, while consumption of dark-green vegetables was negatively associated with MetS risk. These findings might provide a promising and healthy dietary strategy for preventing MetS.

Metabolically Healthy Overweight and Obesity, Transition to Metabolically Unhealthy Status and Cognitive Function: Results from the Framingham Offspring Study.

To evaluate the association between metabolically healthy overweight/obesity (MHO) status and longitudinal cognitive function while also considering the stability of the condition. In total, 2892 participants (mean age 60.7 (9.4) years) from Framingham Offspring Study completed health assessments every four years since 1971. Neuropsychological testing was repeated every four years starting from 1999 (Exam 7) to 2014 (Exam 9) (mean follow-up: 12.9 (3.5) years). Standardized neuropsychological tests were constructed into three factor scores (general cognitive performance, memory, processing speed/executive function). Healthy metabolic status was defined as the absence of all NCEP ATP III (2005) criteria (excluding waist circumference). MHO participants who scored positively for one or more of NCEP ATPIII parameters in the follow-up period were defined as unresilient MHO. No significant difference on the change in cognitive function over time was observed between MHO and metabolically healthy normal weight (MHN) individuals (all p > 0.05). However, a lower processing speed/executive functioning scale score was observed in unresilient MHO participants compared to resilient MHO participants (β = -0.76; 95% CI = -1.44, -0.08; p = 0.030). Retaining a healthy metabolic status over time represents a more important discriminant in shaping cognitive function compared to body weight alone.

교대근무 근로자의 대사증후군 유병률 및 관련요인 분석

Purpose: This study looks at the prevalence rate of such metabolic syndrome among shift workers and aims to figure out related risk factors. Method: Data from night duty workers who had special medical examinations in 2014, in a university hospital situated in Incheon, were used. Data of 343 people taking medicine for high blood pressure, diabetes and hyperlipidemia were discarded. Of the remaining 3,305 people, data on their blood pressure, diabetes, waist measurement, neutral fat level and HDL cholesterol level were used. Results: In this study, the prevalence of metabolic syndrome in shift workers was found to be 12.7% by applying NCEP's ATPⅢ diagnostic criteria. By analyzing the effects of subjects’ general characteristics, lifestyle and job-related characteristics on prevalence of metabolic syndrome using logistic regression analysis, we found out that prevalence rate was higher for those who are older, are men, smoke and do not exercise have worked in shift for over 10 years, work for over 52 hours a week on average, have worked for more than 4 consecutive days on night duty, have less than 11 hours of rest after work, are not allowed to sleep during working hours. Conclusion: It can be concluded from the result that it is important to help shift workers protect their health through setting reasonable working hours, improving working condition, promoting healthy lifestyle and providing customized management plans that take individual characteristics into consideration.

Serum Ferritin in Metabolic Syndrome-Mechanisms and Clinical Applications.

Metabolic syndrome (MS) is a cluster of conditions including central obesity, hypertriglyceridemia, low HDL cholesterol, hyperglycaemia, and hypertension with a prevalence rate of 20–25% of the world’s adult population. Metabolic syndrome is often characterized by insulin resistance, which some have suggested is a major supportive connection between physical inactivity and MS. Various studies suggest that moderately elevated iron and ferritin levels are associated with an increased prevalence of metabolic syndrome and are markers of insulin resistance. Increased body iron stores are associated with the development of glucose intolerance, type 2 diabetes mellitus, and insulin resistance syndrome (IRS). This is a hospital-based cross-sectional observational study, which was conducted in the department of internal medicine of a tertiary care hospital in northern India. The study was conducted from 1 January 2019 to 30 June 2020 and included 100 patients and 100 controls. All subjects in the age group of 35–65 years were enrolled and investigated as per the study design. Metabolic syndrome patients were diagnosed according to the modified National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III) with BMI > 23 kg/m2. All baseline investigations were undertaken, including serum ferritin levels. Insulin resistance (IR) was calculated using the homeostasis model assessment IR (HOMA-IR) formula. We found a positive association between an increase in serum ferritin with the prevalence of metabolic syndrome and its clinical parameter. The serum ferritin level was positively correlated with the level of insulin resistance and inversely correlated with the insulin level of the patients.

THE EARLY DETECTION OF METABOLIC SYNDROME USED NCEP ATP-III METHOD IN WAAI VILLAGE COMMUNITY CENTRAL MALUKU REGENCY

Metabolic syndrome is a metabolic disorder that complexly includes carbohydrate, lipid and protein metabolism disorders which are known to be the main cause of diabetes mellitus, hypertension and coronary heart disease. Waai Village, Central Maluku Regency is one of the villages affected by the earthquake for a long time so that social assistance in the form of fast food is consumed in the long term which is thought to be one of the causes of metabolic syndrome. The purpose of this research is to detect the presence of metabolic syndrome with the NCEP ATP-III criteria consists of measuring blood pressure, fasting blood glucose levels and serum triglyceride levels using the photometric method. This type of research is descriptive research with a cross sectional approach. The sampling technique used is purposive sampling, in accordance with the predetermined sample criteria. The results showed that 29 of 50 subjects (58%) had metabolic syndrome with an average blood pressure of 148/94 mmHg, an average fasting blood glucose level of 158 mg/dL, and an average triglyceride level of 198 mg/dL.

The Association between Human Epididymis Secretory Protein 4 and Metabolic Syndrome.

Individuals with metabolic syndrome (MetS) are known to have an increased risk of carcinogenesis. Human epididymis protein 4 (HE4) is a tumor marker and prognostic factor for epithelial ovarian carcinoma (EOC) patients. However, no studies have evaluated the association between MetS and HE4 levels. This study aimed to evaluate the relationship between HE4 levels and MetS in the National Health and Nutrition Examination Survey (NHANES 2001–2002). This cross-sectional analysis assessed all five components of MetS and HE4 levels in 2104 females (age ≥20 years) from the NHANES dataset. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) criteria. The analysis indicated MetS in 593 individuals, and the β coefficient of their HE4 levels was 0.097 (95% CIs, 0.028–0.166, p = 0.006). Specifically, the β coefficients of the HE4 levels of participants with 1, 2, 3, and ≥4 features of MetS were 0.072 (95% confidence interval (CI): −0.015–0.159), 0.125 (95% CI: 0.030–0.220), 0.161 (95% CI: 0.053–0.270), and 0.242 (95% CI: 0.117–0.368), respectively, and all p values were <0.001. The p-value for the trend was <0.001. There was a significant association between the presence of MetS and HE4 levels. There were positive relationships between HE4 levels and an increased number of MetS components (with 1, 2, 3, and ≥4 features of MetS, all p values <0.001). Among the MetS components, low high-density lipoprotein levels and high triglyceride levels were independently associated with HE4 levels.

Gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study

BackgroundBeyond the degree of adiposity, the pattern of fat distribution has a profound influence on cardiometabolic risk. It is unclear if sex differences in body fat distribution can potentially explain any sex differences in the prevalence of the metabolic syndrome (MetS) and in individual cardiometabolic risk factors among obese men and women.MethodsIn this cross-sectional analysis, 432 persons from the ongoing Obesity Weight Reduction Study (n = 356 obese, ØBMI 41 ± 8 kg/m2, and 76 non-obese, ØBMI 25 ± 3 kg/m2), were included. The relations of sex to MetS prevalence and selected cardiometabolic risk factors were assessed using univariate and multivariate adjusted regression models.ResultsIn crude analyses, %fat mass and the fat mass/lean mass ratio were significantly higher in women than in men, regardless of increasing obesity categories, from normal weight to grade-3-obesity. In contrast, markers of abdominal obesity, such as waist circumference and waist-to-hip ratio were higher in men than in women, despite similar BMI. The prevalence of the MetS was higher in obese men than in women (67.6 vs. 45.0%, p < 0.0001), particularly in younger individuals < 40 years (72.5 vs. 36.8%, p < 0.0001), but “metabolically healthy obesity” (BMI ≥ 30, no other NCEP ATPIII MetS component) was more common in women than in men (15.6 vs. 4.1%, p < 0.0001). After adjusting for age, %body fat and height, sex differences were observed for HDL-cholesterol (p < 0.001), triglycerides (p < 0.001), fasting glucose (p = 0.002), insulin and HOMA-IR levels (p < 0.001), ALAT (p < 0.001), adiponectin (p < 0.001), and sE-selectin (p = 0.005). In contrast, crude sex differences in other variables, such as leptin levels (68 ± 4 in obese women vs. 33 ± 2 µg/L in men, p < 0.0001), disappeared after accounting for differences in %body fat (least-squares means of leptin: 52 ± 4 vs. 55 ± 6 µg /L, p = 0.740). A logistic regression model adjusting for age and lifestyle factors revealed a lower risk of having MetS for women as compared to men (OR = 0.38[0.22–0.60]). That risk estimate did not materially alter after adding BMI to the model. In contrast, no statistically significant association between sex and MetS prevalence was observed after adding waist circumference and adiponectin to the model (OR = 1.41[0.59–3.36]).ConclusionsDifferent body fat distribution patterns, particularly abdominal adiposity, adiponectin, and related biomarkers, may contribute to sex differences in cardiometabolic risk factors and to the prevalence of the MetS.

Gender Difference in Lipid Profile in Hypertensive Patients’ Hospital-Based Study

Background and objectives: Hypertension and dyslipidemia are the integral components of metabolic syndrome. It has emerged as cause of substantial mortality in both genders. The objective of the study was to find out the prevalence of dyslipidemia in both gender and difference in pattern of lipid profile in hypertensive patients. Methods: This was an observational study conducted in 2018 to 2019 at Sir Syed university Hospital Karachi Pakistan. Sample size of 250 diagnosed cases of hypertension (comprising equal number of males and females) were collected. The lipid values were interpreted in normal or high-risk category by applying NCEP ATPIII criterion. Fasting sample were collected for sugar and lipid profile. Anthropometric, demographic and biochemical data was tabulated. Categorical variables were displayed as mean ± standard deviation and percentage respectively, compared with chi-square test. Student 't' test was use to assess the difference for the lipid profile at 5% significance level. The prevalence of dyslipidemia was estimated for men and women, and pattern in lipid profile were compared. The factors associated with dyslipidemia in both genders were calculated by multiple logistic regression expressed as odd Ratio with 95% confidence interval (C.I). To evaluate the effect of age on dyslipidemia we made four age groups 25-65 years and lipid pattern was compared. Results: Dyslipidemia was found 63% of hypertensive group, 72% women were dyslipidemia than 54% men and pattern of lipid in males showed low LDL and high cholesterol and in females’ high triglycerides and low HDL. The Predictors of dyslipidemia in female were old age, BMI kg/m2 high blood pressure level, depression and lack of physical activity and in men smoking intake of fried, salty food, smoking and obesity with increasing age. Females have more triglycerides total cholesterol and low HDL compared to men. Conclusion: Dyslipidemia was more found in women with hypertension but as the age increasing more women have dyslipidemia. while treating hypertensive patient’s lipid lowering management gender heterogeneity should be considered.

Plasminogen activator inhibitor-1 mediate downregulation of adiponectin in type 2 diabetes patients with metabolic syndrome

IntroductionMetabolic syndrome (MetS) is a multifactorial disease characterized by metabolic abnormalities. Plasminogen activator inhibitor-1(PAI-1) is a key factor of the fibrinolysis its expression is elevated in insulin resistance, obesity, and MetS. In addition, an adiponectin produced by adipocytes is also key factor in MetS. This study aimed to investigate the relationship between PAI-1, adiponectin levels in MetS. Patients and MethodsA total of 379 subjects were analyse in this cross-sectional study. MetS was defined by NCEP ATP-III criteria. Anthropometric, fasting blood glucose, HbA1c, total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, PAI-1, and adiponectin were measured. ResultsPAI-1 levels were higher in MetS compared with non-MetS. In addition, adiponectin levels were significantly lower in MetS compared to non-MetS. Furthermore, increased level of PAI-1 corresponds with increase in prevalence of MetS. PAI-1 levels were significantly associated with MetS (OR = 2.51, CI = 1.23 – 5.14; p = 0.039). ConclusionPAI-1 increases the risk of MetS. PAI-1 and adiponectin regulation is useful in assesing the presence and severity of MetS. Further pharmacological targeting of PAI-1 studies are necessary for MetS management.

Relationship of Inflammatory Markers and Metabolic Syndrome in Postmenopausal Women.

The increased deposition of visceral fat in the postmenopause period increases the production of inflammatory cytokines and the release of tumor necrosis factor- α (TNF-α), interleukin-6 (IL-6), and decrease in IL-10. This study investigated the relationship between inflammatory biomarkers and metabolic syndrome (MS) in postmenopausal women considering different diagnostic criteria. We conducted a cross-sectional observational study based on STROBE. Data were collected regarding the diagnostic criteria for MS (International Diabetes Federation; NCEP (International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III), and Harmonized criteria), body composition, comorbidities, time without menstruation, values of IL-6, IL-10, and TNF-α. ANOVA, Kruskal–Wallis, Levene tests, ROC, and odds ratio were performed to analyze the data. The results showed no significant difference between the methods and no interaction between the method and the presence of MS. However, for the values of WC, body fat percentage, TNF-α, and IL-10/TNF-α ratio, a significant effect of MS was observed. In subjects with MS, lower values of body fat percentage and TNF-α and higher values of the IL-10/TNF-α ratio were also observed. The higher IL-10/TNF-α ratio in the MS group is related to the greater anti-inflationary action of IL-10. The IL-10/TNF-α ratio showed significant accuracy to discriminate patients with MS according to the NCEP-ATP III criteria.