NCEP-ATPIII Criteria Research Articles

Prevalence Of Metabolic Syndrome in Peri and Postmenopausal Women Aged 40- 65 Years in a Tertiary Care Centre

Metabolic syndrome (MetS) is a constellation of interrelated risk factors of metabolic origin— metabolic risk factors—that appear to directly promote the development of atherosclerotic cardio-vascular disease (ASCVD). Menopausal transition with its incidental hormonal changes is considered to contribute to the development of MetS. This was a hospital based cross sectional descriptive study conducted in the Obstetrics and Gynaecology department of Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, from the 1st of September 2023 till the 29th of February 2024 after clearance from the IRC (Ref. No: 56-080/081). Convenience sampling was used among women who fulfilled the inclusion criteria. The aim of the study was to determine the prevalence of MetS among the peri and postmenopausal women and to determine which component of the diagnostic criteria of MetS was more strongly associated with MetS in our population. Women were evaluated to have MetS using both the International Diabetes Federation (IDF) and the National Cholesterol Education Program- Adult Treatment Panel III (NCEP-ATPIII criteria). The prevalence of MetS by the IDF criteria was 54% among the perimenopausal women and 61% among the postmenopausal women. Similarly, the prevalence of MetS according to NCEP-ATPIII was 53.5% among the perimenopausal and 65% among the postmenopausal women. All the MetS diagnostic markers showed a strong correlation with MetS (p<0.001). The prevalence of MetS is high in our population by both the IDF and NCEP-ATP III criteria, being higher in the postmenopausal population, though not statistically significant.

The Association of Glycated Hemoglobin and Lipid Profile with Peripheral Artery Disease in Metabolic Syndrome Patients from Northwestern Algeria

تم إدماج الهيموجلوبين السكري (Hb1Ac) كمؤشر لخلل السكر في الدم بدلا من غلوكوز الدم الصائم (FGB)، لتصنيف المرضى بناء على حوادث الأوعية الدموية ،حيث يرتبطHb1Acارتباطا وثيقا بعوامل الأوعية الدموية مثل سرعة موجة النبض وسمك الوسائط الداخلية، نسبة الألبومين / الكرياتينين (ACR) ومع ذلك فإن العلاقة بينHb1Acونسبة الدهون في تطور أمراض الشرايين لاتزال غير مؤكدة. هدفنا الرئيسي من هذه الدراسة هو التحقيق في ارتباطHb1Acونسبة الدهون مع أمراض الأوعية الدموية الطرفية (PAD) في المرضى الذين يعانون من الاضطراب الأيضي (MetS) في شمال غرب الجزائر. أجريت دراستنا المقطعية لمدة ستة أشهر. تم حساب مؤثر كتلة الجسم كالتالي: (BMI (kg/m²)=weight(kg)/height²(m²، تم استخدام مؤشر الكاحل والعضد (ABI) أقل من 0.9 وتصوير الأوعية لتشخيص PADوحددنا MetS وفقا لمعاييرNECP-ATPIII. تم استعمال اختبار تحليل الارتباط (correlation test) والانحدار الخطي (linear regression) لدراسة الصلة بينHb1Ac، نسبة السكر في الدم، نسب الدهون وحدوث أمراض الشرايين الطرفية لدى الأفراد المصابين بالاضطراب الأيضي. من بين 300 مصاب الاضطراب الأيضي، 53 % تمثل الذكور. لوحظ وجود ارتباطات إيجابية بينHb1Ac،(r=0.753, p<0.001) FGB والتري غلسيريد ((TG (r=0.288, p<0.001) وارتباط سلبي مع البروتين الدهني عالي الكثافة (HDL) (r=-0.356, p<0.001). لم يظهرHb1Ac أي ارتباط مع الكوليسترول الكلي (TC) و البروتين الدهني منخفض الكثافة (LDL). أظهرت نسب الدهون(TG/HDL ,LDL/HDL , TC/HDL) ارتباطات ايجابية مع)Hb1Acr=0.332 r=0.232, r=0.43.(أكد اختبار الانحدار الخطي هذه النتائج. أظهر Hb1Ac ارتباطات ايجابية مع FGB و TG في حين أنه يرتبط سلبا بالبروتين الدهني عالي الكثافة(HDL) . و مستقل عن البروتين الدهني منخفض الكثافة (LDL) والكوليسترول الكلي (TC) و الجدير بالذكر أن نسب الدهون الثلاثة TG/HDL) LDL/HDL , TC/HDL (أظهرت ارتباطات ايجابية معHb1Ac .

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.

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.

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.

Relationship between genetic ancestry and metabolic syndrome in community-dwelling old adults

Genetic ancestry may contribute to ethnic differences in the risk of metabolic disorders. Aging leads to a worse ability for homeostasis maintenance, favoring the establishment of metabolic disorders. PurposeThis study aimed to evaluate the relationship between the degree of genetic ancestry (European, African, and Amerindian) with the Metabolic Syndrome (MetS) diagnosis and its diagnostic components separately, in community-dwelling old adults. One hundred and sixty-one community-dwelling old adults volunteered in this study. Sociodemographic data and health history were recorded. Venous blood samples were withdrawal for biochemical analysis and DNA extraction aiming to obtain genetic ancestry estimates (Amerindian [AME], European [EUR], and African [AFR]), which was done from 12 loci. MetS diagnosis followed the NCEP-ATPIII criteria. Additionally, the sample was stratified according to the presence or absence of each criterion used for MetS diagnosis (i.e., Type 2 diabetes mellitus (T2DM), hypertension, hypertriglyceridemia, dyslipidemia [low HDL], and central obesity (elevated waist circumference)). Comparisons of genetic ancestry estimates were performed using the Mann-Whitney test, with the significance level set at p < 0.05. The prevalence of MetS was 40.4%. The degree AME, EUR and AFR genetic ancestry was not different between volunteers with or without MetS (p > 0.05). However, AME ancestry was significantly higher among diabetic volunteers (non-diabetics: 13.7% (6.3–35.8) x Diabetics: 26.1% (10.6–48.5); p < 0.05). Community-dwelling old adults with a higher percentage of Amerindian ancestry seem to be prone to T2DM diagnosis.

The risk of metabolic syndrome is associated with vitamin D and inflammatory status in premenopausal and postmenopausal Algerian women.

This first cross-sectional study examined whether vitamin D status and proinflammatory cytokines may be associated with metabolic syndrome (MetS) in Algerian women regarding their menopausal status. Fasting plasma glucose (FPG), lipids, insulin, 25(OH)D, PTH, adiponectin, resistin, TNFα, and IL-6 levels were assessed in 277 participants aged 18-74years. MetS was diagnosed according to NCEP-ATPIII criteria. The association of vitamin D deficiency, IL-6, and TNFα with components of MetS was analyzed by the logistic regression. Among a cohort of 277 participants, the prevalence of MetS in 115 premenopausal vs. 162 postmenopausal women was 54.02 vs. 68.1%. Cut-offs for vitamin D deficiency were 15.7 vs. 13ng/mL, 51.07 vs. 41pg/mL for IL-6 and 8.28 vs. 9.33 pg/mL for TNFα, respectively. 25(OH)D levels were positively correlated with adiponectin levels, while negatively with HOMA-IR in postmenopausal-MS + women. Adjustment for age and BMI reveals a significant association between vitamin deficiency and high FPG (OR: 2.92 vs. 2.90), TG (OR:2.79 vs. 3.51), BP (OR:2.20 vs. 1.92), and low HDL-c (OR:2.26 vs. 3.42), respectively. A significant association was also detected in postmenopausal women between IL-6 and high FPG (OR5.11, p = 0.03), BP (OR:3.13, p = 0.04), and low HDL-c (OR5.01, p = 0.02), while TNFα was associated with high BP in postmenopausal women (OR: 3.70, p = 0.01), and inversely with TG in premenopausal women (OR: 0.16, p = 0.04). This study highlighted that severe vitamin D deficiency increases MetS score and was closely associated with four components of MetS, more potently in postmenopausal women, probably related with estrogens. Abdominal obesity, as influential component of MetS, may be involved in enhancing vitamin D deficiency, and dysregulating some metabolic hormones such as adiponectin, resistin and insulin, that contributes in onset an inflammatory state, through the increase in IL-6 and TNFα levels. These findings need to be improved by expanding investigation to a large cohort of participants.

Mortality in older adults with severe mental illness: the role of metabolic syndrome and its components

IntroductionStudies in adult psychiatric patients consistently call attention to premature mortality and its association with metabolic syndrome. However, the utility of the metabolic syndrome construct is controversial in older adults in the general population, since literature shows that some components, such as obesity, can be protective against mortality. In older adults with mental illness, only one study explored the relation between metabolic syndrome and mortality and found no association.ObjectivesTo examine whether metabolic syndrome or any of its components predicted mortality in a cohort of older adults with psychiatric disorders, and to determine if this association differs across diagnostic groups.MethodsWe used a multicentric prospective design to follow, over 5 years, a cohort that included 634 in– and outpatients with schizophrenia, bipolar or major depressive disorder (MDD). Metabolic syndrome was assessed at baseline following NCEP-ATPIII criteria. Cause of death was categorized as cardiovascular disorder (CVD) mortality, non-CVD disease-related mortality, suicide and accident.ResultsWe found no significant association between metabolic syndrome or any of its components with all-cause, CVD and non-CVD mortality. However, an association with increased all-cause and disease-related mortality was found in the subpopulation of older adults with MDD, even after adjustment for age, sex and smoking status (p=0.032 and p=0.036, respectively). A significant interaction was found between metabolic syndrome and psychiatric diagnoses indicating that in participants with MDD, metabolic syndrome had a significantly greater effect on all-cause mortality (p=0.025) and on disease-related mortality (p=0.008) than in participants with either bipolar disorder or schizophrenia.ConclusionsIn older adults with psychiatric illness, our findings do not support an association between metabolic syndrome and increased mortality, in contrast with the literature findings on their younger counterparts. We discuss several possible explanations, including a survival bias, a lack of sensitivity of the used cut-offs and a ceiling effect of metabolic syndrome on mortality in this very high-risk population. The lack of a ceiling effect in the depressive subgroup, because of a less marked premature mortality, could explain the positive association, in contrast with bipolar disorder or schizophrenia subgroups.Disclosure of InterestNone Declared

Metabolic syndrome in antiphospholipid syndrome versus rheumatoid arthritis and diabetes mellitus: Association with arterial thrombosis, cardiovascular risk biomarkers, physical activity, and coronary atherosclerotic plaques.

Cardiovascular disease (CVD) is the foremost cause of morbidity and deaths in antiphospholipid syndrome (APS), driven by thrombo-inflammation and atherothrombosis mechanisms. Metabolic syndrome (MetS) is a proinflammatory and prothrombotic state characterized by increased CVD risk. We aimed to evaluate the prevalence of MetS in APS patients compared to rheumatoid arthritis (RA) and diabetes mellitus (DM) and its associations with clinical and laboratory patient characteristics and vascular ultrasound (US) markers of subclinical atherosclerosis. We included 414 patients in our study: 138 patients with APS (median age: 44.9 years, females 70%) and matched 1:1 for age and sex RA and DM subjects. Three sets of criteria were used for MetS diagnosis: Joint Interim Statement (JIS), International Diabetes Federation (IDF) and modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). The demographic, clinical and laboratory characteristics of all participants were recorded and carotid and femoral US was performed in patients with APS. Multivariate regression models were applied. Prevalence of MetS was 23.9%, 23.2%, 20.3% (based on JIS, IDF, modified NCEP-ATPIII criteria, respectively) in APS versus 17.4%, 17.4%, 13% in RA (p=0.181, p=0.231, p=0.106, respectively), and 44.2%, 44.2%, 40.6% in DM patients. In multivariate analysis, patients with systemic lupus erythematosus- related APS had an approximately 2.5-fold higher risk of MetS versus RA patients. MetS in APS was independently associated with arterial thrombosis (Odds ratio 3.5, p=0.030). Odds ratio for MetS was 1.16 for each one unit increase in C-reactive protein levels according to JIS and IDF criteria, and 1.49 and 1.47 for each one unit increase in uric acid levels using the IDF and modified NCEP-ATPIII models, respectively. APS patients with atherosclerotic carotid plaques had 4 to 6.5-fold increased risk of MetS. Odds for MetS were decreased by 26% with an increase in physical activity by one hour per week. MetS is present in approximately one-fourth of APS patients at a comparable prevalence to that observed in patients with RA. MetS in APS is associated with arterial thrombosis, cardiovascular risk biomarkers, physical activity, and subclinical atherosclerosis, supporting its role in cardiovascular risk stratification and management in APS.

Investigation of the Relationship Between Noise-Induced Hearing Loss and Metabolic Syndrome in One of the Oil Industries in the South of Iran.

Investigating the non-auditory effects of noise on humans has been of interest from different aspects. In this study, the relationship between noise-induced hearing loss (NIHL) and metabolic syndrome. This cross-sectional study was performed on 1380 male workers of one of the oil and gas companies in the south of Iran. The data was obtained via clinical examination and hearing status assessment to evaluate the metabolic syndrome and its components, intravenous blood samples were taken and tested according to NCEPATPIII criteria. For statistical analysis, the data were analyzed using SPSS software version 25 at a significant level of 0.05. The results showed that the body mass index variable increased the chance of developing metabolic syndrome by 11.4%. NIHL increases the chance of developing metabolic syndrome (OR = 1.291). Also, the same results were observed in hypertriglyceridemia OR = 1.255, waist circumference (OR = 1.163), fasting blood sugar (OR = 1.159), blood pressure (OR = 1.068) and HDL (OR = 1.051). Considering the effect of NIHL on metabolic syndrome, it is possible to help reducing the incidence of metabolic syndrome and any of its components by controlling noise exposure and accordingly reducing non-auditory injuries to individuals.

The CUN-BAE, Deurenberg Fat Mass, and visceral adiposity index as confident anthropometric indices for early detection of metabolic syndrome components in adults

There is no definition for the metabolic syndrome; visceral obesity, elevated lipids and glucose, and hypertension coexist. The aim of the study is to determine which anthropometric indicators best determine it. Cross-sectional study in 418,343 Spanish workers. Metabolic syndrome was determined using the NCEP-ATPIII, IDF and JIS criteria. The anthropometric variables studied were: body mass index, waist circumference, waist-to-height ratio, CUNBAE, Deuremberg formula, body fat index, body surface index, normalized weight adjusted index, body roundness index, body shape index, visceral adiposity index (VAI), dysfunctional adiposity index, conicity index, metabolic score for visceral fat (METS-VF), waist triglyceride index. In men, the anthropometric indices with the largest areas under the ROC curve are VAI with ATPIII criteria and JIS. If we use the IDF criteria: waist circumference and METS-VF, with the same result. In women, the largest areas under the curve were observed with the Deuremberg formula in both ATPIII and JIS while with the IDF criteria it is METS-VF. The most useful anthropometric indices for identifying metabolic syndrome are CUN-BAE and Deuremberg, followed by the VAI. A single definition of metabolic syndrome should be agreed to determine the best anthropometric index with predictive capacity for its diagnosis.

Socioeconomic differences in metabolic syndrome development among males and females, and the mediating role of health literacy and self-management skills

BackgroundOur aim was to investigate sex differences in the associations between socioeconomic position (SEP) and metabolic syndrome (MetS) development, and to what extent these associations are mediated by health literacy and self-management skills. MethodsA subsample (n = 88,384, 59.5% female) of the adult Lifelines Cohort Study was used. MetS development according to NCEP-ATPIII criteria was assessed on average 3.8 years after baseline. SEP-MetS associations were assessed for moderation by sex, and sex-stratified accordingly. Associations between SEP measures (education, income and occupational prestige), health literacy and self-management skills, and MetS development were investigated using logistic regression analyses. The mediating effects of health literacy and self-management skills on the SEP-MetS associations were investigated using the Karlson-Holm-Breen method. ResultsAmong males and females, respectively 9.4% and 7.1% developed MetS. For males, education was inversely associated with MetS development; health literacy (7.1%) and self-management skills (1.9%) mediated a proportion of these educational differences. For females, education, income and occupational prestige were inversely associated with MetS development; health literacy (respectively 5.9% and 6.4%) and self-management skills (respectively 4.1% and 3.7%) mediated a proportion of the educational and occupational differences in MetS development. Neither health literacy nor self-management skills mediated female income differences in MetS development. ConclusionsSocioeconomic differences in MetS development differ between males and females. Both for males and females, health literacy and self-management skills mediated a small proportion of socioeconomic differences in MetS development.

Prevalence rates of metabolic health and body size phenotypes by different criteria and association with insulin resistance in a Maltese Caucasian population

IntroductionHyperinsulinemia and insulin resistance are known to be associated with increased cardiovascular morbidity and mortality. A metabolically unhealthy phenotype is frequently used as a surrogate marker for insulin resistance. The aims of the current study were to compare the prevalence of the body size phenotypes using different definitions of metabolic health and to investigate which one of them is most strongly associated with insulin resistance in men and women.MethodsWe conducted a cross-sectional study in a middle-aged cohort of Maltese Caucasian non-institutionalized population. Metabolic health was defined using the various currently used definitions.ResultsThere were significant differences in the prevalence of body size phenotypes according to the different definitions. We also found significant sex differences in the predictive value of the various definitions of the metabolically unhealthy phenotype to predict insulin resistance. The strongest association was for the definition of having >2 NCEP-ATPIII criteria to characterize the metabolic unhealthy phenotype in women (odds ratio of 19.7). On the other hand, the Aguilar-Salinas et al. definition had the strongest association in men (odds ratio of 18.7).ConclusionsWe found large differences in the prevalence of the various body size phenotypes when using different definitions, highlighting the need for having standard criteria. Our data also suggest the need for sex-specific definitions of metabolic health.

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.

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.

Differences in cardiovascular risk levels between cleaning staff and hotel housekeepers.

Background and objectiveCardiovascular diseases are the leading cause of morbidity and mortality worldwide, with a greater incidence in the most disadvantaged social classes. In this study, we aimed to evaluate the level of cardiovascular risk in cleaning workers.MethodsThis was a descriptive, cross‐sectional study in 46.632 cleaning workers (40.169 women and 6.463 men). Thirty‐one different scales related to cardiovascular risk were studied (14 assessing overweight and obesity, 5 determining the risk of nonalcoholic fatty liver disease, 5 scales of cardiovascular risk, 4 atherogenic indices, and 3 scales of metabolic syndrome, among others). The results obtained were divided between personnel who perform their cleaning tasks in the hotel and catering industry and those in other sectors.ResultsThe prevalence of obesity and arterial hypertension in cleaning workers was over 20% in both sexes. A similar amount was observed in moderate or high values on the REGICOR (Registre GIroní del COR) scale. More than 15% presented metabolic syndrome according to the NCEP ATPIII (National Cholesterol Education Program‐Adult Treatment Program III) criteria, while over 10% of women and 20% of men had a high risk of nonalcoholic fatty liver disease assessed with the fatty liver index.ConclusionCardiovascular risk is higher, in both sexes, in the group of cleaning workers who work in companies other than hotels.

Metabolic syndrome and the risk of adverse cardiovascular events in patients with myocardial infarction with non-obstructive coronary arteries

Background and aimsMetabolic syndrome (MeS) is recognized as a significant predictor of poor outcomes in coronary artery disease. However, its prognostic implications in myocardial infarction with non-obstructive coronary arteries (MINOCA) have not been examined. We aimed at investigating the role of MeS on the clinical outcomes in MINOCA patients. Methods and resultsPatients diagnosed with MINOCA between 2015 and 2019 were included. MeS was defined according to modified NCEP-ATPIII criteria. The primary endpoint was major adverse cardiovascular events (MACE). Cox regression analysis was used to evaluate the correlation between MeS and the hazard of MACE. The integrated discrimination improvement (IDI) and net reclassification index (NRI) were performed to assess MeS incremental predictive value. Of 281 MINOCA patients, 83 (29.5%) patients satisfied the MeS criteria. During a median follow-up duration of 28 months, MINOCA patients with MeS had a notably higher rate of MACE than those without MeS (30.1% vs. 17.6%, respectively P = 0.020). Cox regression analysis revealed that MeS was associated with an increased hazard of MACE (adjusted HR 2.126; 95% CI: 1.193–3.787, P = 0.010). When each component of MeS was analyzed as a categorized variable separately, only high fasting blood glucose and BMI ≥25 kg/m2 were associated with an increased hazard of MACE. Moreover, MeS had an incremental predictive ability for MACE when added to a model with clinical risk factors. ConclusionMeS is relatively common in patients with MINOCA. The presence of MeS significantly increased the hazard of MACE among the MINOCA population.

Comparison of IDF criteria and NCEP ATP-III criteria for the diagnosis of metabolic syndrome in lean and non-lean NAFLD patients and its correlation with carotid intima media thickness

Background and Aims: The International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) define different criteria for the diagnosis of metabolic syndrome (MetS). This study compares the proportion of patients diagnosed with MetS by IDF and NCEP-ATP III definitions among Lean and non-Lean Non-alcoholic fatty liver disease(NAFLD) patients and assesses correlation with Carotid Intima Media thickness(CIMT) values in these subsets. Methods: Cross-sectional observational study of 120 patients with lean NAFLD (BMI< 23kg/m2) and 120 non-lean NAFLD patients (BMI‰¥ 23kg/m2). Prevalence of MetS was estimated using the IDF and NCEP-ATP III definitions. CIMT was measured using carotid doppler ultrasound. Results: Among lean NAFLD subjects, MetS was diagnosed in 44(36.67%) by IDF criteria and 67(55.83%) by NCEP-ATP III criteria (p=0.003). There was a trend towards higher values of CIMT in lean NAFLD with MetS diagnosed by NCEP-ATP III criteria (mean CIMT- 0.58±0.04) than by IDF criteria (mean CIMT-0.57±0.07) although the difference was not statistically significant(p=0.641). In the non-lean NAFLD group, 91(75.83%) and 97(80.83%) patients were diagnosed with MetS according to the IDF and NCEP-ATP III criteria (p=0.348) respectively. There was no difference in the mean CIMT (0.58±0.08) of patients of MetS diagnosed by either IDF or NCEP-ATP III criteria in the non-lean NAFLD group. Conclusions: A higher proportion of patients were diagnosed with MetS by NCEP-ATP III criteria than by IDF criteria in the lean NAFLD group. This is probably because waist circumference is an essential criterion in IDF. No significant difference was observed in the proportion of MetS diagnosed by either criterion in the non-lean NAFLD group. Mean CIMT remains the same irrespective of the criteria used for MetS definition.

Issue of Waist Circumference for the Diagnosis of Metabolic Syndrome Regarding Arterial Stiffness: Possible Utility of a Body Shape Index in Middle-Aged Nonobese Japanese Urban Residents Receiving Health Screening

Introduction: Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. This cross-sectional study aimed to clarify whether replacing WC with “A Body Shape Index (ABSI),” an abdominal obesity index, in MetS diagnosis detects individuals with arterial stiffening assessed by cardio-ankle vascular index (CAVI). Methods: A retrospective cross-sectional study was conducted in 46,872 Japanese urban residents (median age 40 years) who underwent health screening. Exclusion criteria were current treatments and a past history of cardiovascular disease (CVD). The Japanese, International Diabetes Federation, and NCEP-ATPIII criteria were used to diagnose MetS. High CAVI was defined as CAVI ≥9.0. Results: CAVI correlated positively with ABSI (β = 0.127), but negatively with WC (β = −0.186), independent of age, sex, systolic blood pressure, fasting plasma glucose, and high-density lipoprotein--cholesterol. Receiver operating characteristic (ROC) analysis showed that ABSI had a stronger contribution to high CAVI (area under the ROC curve [AUC] = 0.730) than WC (AUC = 0.595) and body mass index (AUC = 0.520). ABSI ≥0.080 was defined as abdominal obesity based on the results of ROC analysis for high CAVI and estimated glomerular filtration rate <60 mL/min/1.73 m2. Logistic regression analysis revealed that replacing high WC with ABSI ≥0.080 in MetS diagnosis enhanced the detection of subjects with high CAVI. Discussion/Conclusion: Use of ABSI can detect subjects with arterial stiffening, which may lead to efficient stratification of CVD risk. Further studies are needed to confirm whether MetS diagnosis using ABSI predicts CVD morbidity and mortality.

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

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