Odds Ratio Of MetS Research Articles

Oral health behaviors and metabolic syndrome: the 2008–2010 Korean National Health and Nutrition Examination Survey

This study examined whether oral health behaviors are associated with metabolic syndrome (MetS) in Korean adults involved in the 2008-2010 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 18,742 subjects (8,034 men and 10,708 women) were included. MetS was defined according to the criteria of the American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement for Asians. Oral health behavior was assessed using a questionnaire included in the KNHANES. Subjects with MetS brushed their teeth less frequently and used fewer secondary oral products than subjects without MetS (p < 0.01). As frequency of toothbrushing and number of secondary oral products increased, body mass index, waist circumference, diastolic blood pressure, fasting plasma glucose, triglyceride, and white blood cell count decreased, but high-density lipoprotein-cholesterol increased (all p for trend <0.01). In the multivariable logistic regression models, as frequency of toothbrushing increased, the odds ratios (ORs) for MetS, abdominal obesity, and hyperglycemia are more than one after adjusting for age, gender, education, income, alcohol and tobacco use, physical activity, and the components of MetS. The ORs for MetS, abdominal obesity, and high blood pressure were more than one in subjects who do not use dental floss after adjusting for all covariates. MetS is associated with infrequent daily toothbrushing and disuse of dental floss in South Korean. Dentists may recommend evaluation for MetS in the patients with infrequent daily toothbrushing and disuse of dental floss.

Different distribution of phenotypes and glucose tolerance categories associated with two alternative proposed cutoffs of insulin resistance

We investigated whether two alternative HOMA-IR thresholds recently proposed identify similar phenotype and have the same impact on gluco-metabolic risk. The two IR cutoffs, IR1 and IR2 (IR1: HOMA-IR >5.9 and IR2: HOMA-IR between 2.8 and 5.9 with HDL-C <51 mg/dl), were applied to a database of 2,360 outpatients, and their association with phenotypes, glucose tolerance, lipids and metabolic syndrome (MetS) was examined. IR1 group showed 5.5% of overweight versus 27.8% of IR2 subjects, and obesity was present in 92.3 versus 68.4%, respectively. We observed the major prevalence of pathological waist in IR1 compared to IR2 subjects: 96.0 versus 80.5% (p < 0.001). After OGTT, IR1 patients presented higher prevalence of impaired glucose tolerance (IGT: 25.8 vs. 20.2%, p < 0.001) and DM2 was diagnosed in 39.7% of IR1 versus 11.3% of IR2 patients (p < 0.001) with odds ratio (OR) 8.3 (95% CI 6.1-11.6) versus 0.8 (0.6-1.2), respectively. IR1 versus IR2 cutpoint showed higher significant (mean ± SEM) total cholesterol (224.8 ± 2.6 vs. 213.1 ± 1.7 mg/dl, p < 0.001) and triglyceride (208.1 ± 12.3 vs. 177.4 ± 4.8 mg/dl, p < 0.001) levels. MetS prevalence was significantly higher in IR1 than IR2 (89.0 vs. 78.3%, p < 0.001). The IR1 cutpoint was associated with a higher OR of MetS 7.3 (5.3-10.2) versus 5.2 (2.8-9.5) of IR2. In summary, the two alternative HOMA-IR cutoffs identify subjects with different distribution of phenotypes and gluco-metabolic risk. The IR1 patients are characterized by higher prevalence of obesity, pathological waist, MetS, dyslipidemia and IGT/DM2.

Physical Activity and Metabolic Syndrome among Ethiopian Adults

BACKGROUND The global prevalence of chronic noncommunicable diseases (NCDs) is on the rise, with the majority of the growth occurring among populations in developing countries. Few studies have quantified the health benefits for physical activity among sub-Saharan African adults. We examined associations of physical activity with the prevalence of metabolic syndrome (MetS) and its components in Ethiopian men and women. METHODS This cross-sectional study of 1,843 individuals (1,117 men and 726 women) was conducted among working adults (public schools and bank employees) in Addis Ababa, Ethiopia. The study was conducted in accordance with the STEPwise approach of the World Health Organization. Physical activity was assessed using a previously validated Global Physical Activity Questionnaire. MetS was defined according to the International Diabetes Federation criteria. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI). RESULTS The odds of MetS was inversely associated with physical activity in men (P trend = 0.02) but not women (P trend = 0.85). Among men, the OR of MetS comparing those with high vs. low levels of physical activity was 0.56 (95% CI = 0.33-0.97). For women, the corresponding OR was 1.07 (95% CI = 0.57-2.01). Physical activity was significantly and inversely associated with high waist circumference and hypertriglyceridemia among men, but no such associations were observed among women. CONCLUSIONS Higher levels of physical activity were inversely associated with MetS and several individual components among men. No similar trends were observed among women in this cohort, in part because of the small sample size.

Daily rice intake strongly influences the incidence of metabolic syndrome in Japanese men aged 40-59 years.

Objectives: The first objective of this study was to classify men aged 40–74 yrs with metabolic syndrome (MetS) according to daily rice intake, and the second was to investigate physical measurements, physiological examinations, blood biochemical assays, intake of food other than rice and lifestyle and environmental factors in the study group.Methods: We analyzed data from 6095 men aged 40–74 yrs who had undergone full medical examinations. The men were classified into 3 age groups: (1) 40–49 yrs, (2) 50–59 yrs, and (3) 60–74 yrs. The men were classified further into 3 groups according to daily rice intake: group 1 (≤300 g), group 2 (300–450 g), and group 3 (≥450 g). The relationship between daily rice intake and the following factors was analyzed in the three age brackets: (1) physical measurements including waist circumference, (2) physiological measurements, (3) serum biochemical indices, (4) whether or not the person was taking medication for hypertension, diabetes mellitus or serum lipid abnormalities, (5) lifestyle, and (6) consumption of foods other than rice.Results: Daily rice intake was related strongly to the occurrence of MetS in all three age brackets. Multiple logistic regression analysis showed (1) a significant increase in the odds ratio for MetS (1.461 times) for group 3 compared with group 1 in men aged 40–49 yrs and (2) a significant increase in the odds ratio for MetS (1.501 times) for group 3 compared with group 1 in men aged 50–59 yrs. However, there was no significant difference in the odds ratio for MetS among rice intake groups in the 60–74 age bracket.Conclusion: In men aged 40–59 yrs, daily rice intake strongly influenced the incidence of MetS, whereas in men aged 60–74 yrs, there was no relationship between daily rice intake and MetS.

Circulating anti-Hsp70 levels in nascent metabolic syndrome: the Casale Monferrato Study

The metabolic syndrome (MetS) confers an increased risk of both type 2 diabetes and cardiovascular diseases (CVD). Heat shock protein 70 (Hsp70), an intracellular polypeptide, can be exposed on the plasma membrane and/or released into the circulation, eliciting both native and immune responses that may contribute to vascular damage. Our aim was to assess if serum anti-Hsp70 antibody levels were cross-sectionally associated with uncomplicated MetS. A cross-sectional case-control study from the nondiabetic cohort of the Casale Monferrato Study was performed. Subjects with established CVD and/or abnormal renal function were excluded. Case subjects (n = 180) were defined as those fulfilling the criteria for the diagnosis of MetS. Control subjects (n = 136) were completely free of any component of the MetS. Serum anti-Hsp70 levels were measured by immunoenzymatic assay. We found that anti-Hsp70 antibody levels were significantly higher in cases than in control subjects [122.6 (89.5-155.6) vs 107.1 (77.3-152.4) μg/ml, p = 0.04], even after age and sex adjustment. In logistic regression analysis, higher levels of log-anti-Hsp70 conferred greater odds ratio (OR) for MetS, independently of age and sex. There was a statistically significant trend of ORs across quartiles of anti-Hsp70 and values greater than 108.0 μg/ml conferred a 77% increased OR of MetS as compared with values in the lower quartiles. The strength of the association slightly decreased after further adjustment for apolipoprotein B, smoking, and albumin excretion rate. In conclusion, our results show that serum anti-Hsp70 antibody levels are independently associated with nascent MetS.

Socioeconomic status and metabolic syndrome in the general population of China: a cross-sectional study

BackgroundIndividual socioeconomic status (SES) has been found to be associated with cardiovascular diseases in developed countries, but the association between individual SES and metabolic syndrome (MetS) is still unclear in China. The objective of this study was to investigate the association between individual SES and MetS in China.MethodsA cross-sectional study of 10054 community residents was performed from May to August 2007 using multistage stratified random sampling. SES was assessed in terms of education, personal monthly income, and household monthly income. The association between SES and MetS was determined by logistic regression models.ResultsAfter the adjustments regarding age, marital status, smoking, drinking, physical activity, body mass index (BMI), and community type, odds ratios (ORs) for MetS of individuals with education level of 7~12 years and >12 years were 0.87 (95% confidence interval [CI]: 0.75 to 0.99) and 0.83 (95% CI: 0.62 to 0.91) respectively compared with those with education level of <7 years in women. Following the adjustments as above, ORs for MetS of individuals with household monthly income level of middle and higher were 0.94 (95% CI: 0.86 to 0.97), and 0.72 (95% CI: 0.65 to 0.88) respectively compared with those with lower household monthly income level in women. The association between SES and MetS was not significant in men.ConclusionsGender had an influence on the association between individual SES and MetS. Lower education and household monthly income level were associated with higher risk of MetS among community residents in women, while such association was not significant in men.

Arsenic methylation, GSTO1 polymorphisms, and metabolic syndrome in an arseniasis endemic area of southwestern Taiwan

Previous studies have shown that hair arsenic (As) levels are associated with an increased prevalence of metabolic syndrome (MetS), which is a strong predictor for type 2 diabetes. The objective of this study was to evaluate whether urinary arsenic methylation is related to MetS in an arseniasis endemic area of southwestern Taiwan, taking genetic factors into account. Subjects were from a community-based cohort recruited in 1990 from three villages in Putai Township. In 2002–2003, we successfully followed 247 subjects and measured their urinary arsenic species including inorganic arsenic, monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA), as well as the coding region polymorphisms of three genes known to involve in arsenic methylation. Results showed that subjects of MetS had a history of consuming well water of higher arsenic concentration as compared to those without MetS. We also found a significant association between urinary arsenic species and risk for MetS, where the odds ratio of MetS was increased with decreasing proportion of MMA and low rate of primary methylation (defined as MMA/inorganic As). The increased risk associated with low primary methylation rate was further modified by the GSTO1 A140D polymorphism, with the D allele carriers showing a slightly higher risk for MetS. Our results suggest that a low MMA% is associated with increased risk for MetS among As-exposed subjects and the genetic polymorphism of GSTO1, an enzyme responsible for the reduction of pentavalent arsenic species, may also play a modest modification role.

Prevalence of metabolic syndrome in Iranian professional drivers: results from a population based study of 12,138 men.

BackgroundIt is evident that professional driving is associated with substantial changes in lifestyle habits. Professional drivers are prone to metabolic syndrome (MetS) and its complications because their working environment is characterized by numerous stress factors such as lack of physical activity due to working in a fixed position, disruption in diet, and irregular sleep habits. The aim of the present study was to estimate the prevalence of MetS among long distance drivers residing in West Azerbaijan province in Iran.MaterialsTo assess the prevalence of metabolic syndrome among professional long distance drivers, 12138 participants were enrolled in this cross sectional study. The MetS was defined using International Diabetes Federation criteria.ResultsAmong12138 participants, 3697 subjects found to be MetS. The crude and age-adjusted rates of MetS were 30.5% and 32.4% respectively. Based on Body mass index (BMI), 5027 subjects (41.4%) were overweight (BMI ≥25.01–30 kg/m2), and 2592 (21.3%) were obese (BMI ≥30.01 kg/m2). The presence of central obesity was more common than other components. The associations of MetS with BMI, pack-year smoking, age, weekly driving duration and driving experiences were significant in the logistic regression. By increasing BMI, pack-year smoking, age, weekly driving duration and driving experiences, odds ratio of MetS was increased.ConclusionThe study suggests that MetS has become a noteworthy health problem among Iranian long distance drivers. This might be due to the following facts: sitting in a fixed position for long hours while working, cigarette smoking, job stress, unhealthy diet and lack of physical activity. Educational programs should be established for promoting healthy lifestyle and also for early detection and appropriate interventions

Sex differences in the relationship between socioeconomic status and metabolic syndrome: The Korean National Health and Nutrition Examination Survey

AimsTo investigate sex differences in the relationship between socioeconomic status (SES) and the prevalence of metabolic syndrome (MetS) in Korean adults. MethodsWe examined the relationship between SES, as measured by household income or education level, and the prevalence of MetS in Korean adults who participated in the 2007–2008 Korean National Health Examination and Nutrition Survey (KNHANES). The adjusted odds ratios (ORs) for MetS were calculated using multivariate logistic regression analysis across household income and education level quartiles. ResultsWe found significant differences between men and women in the association between SES and MetS, with a positive association for men and an inverse association for women. The adjusted OR and 95% confidence interval (95% CI) for MetS for the highest vs. lowest quartile of household income was 1.59 (1.15–2.20) in men. The adjusted ORs for MetS for the highest vs. lowest quartile of household income and education level were 0.54 (0.41–0.72) and 0.26 (0.17–0.38) in women, respectively. ConclusionsWe found sex differences in the relationship between SES and the prevalence of MetS in Korea. These findings suggest that sex-specific public health interventions that consider SES are needed for the prevention and treatment of MetS.

Predictors of Metabolic Syndrome among Employees: A Study from Jordan

Background: Metabolic syndrome (MetS) is a major health problem around the world including Jordan and it has received notable consideration from epidemiologists in the latest years. The objective of this study was to estimate MetS prevalence among employees and its associated factors including socio-demographic, lifestyle, and dietary. Methods: A total of 491 employees (344 men and 147 women aged 20 - 65 years) participated in this study. Data concerning fasting plasma glucose level, lipid profile, blood pressure, anthropometric measurements and 24-dietary recalls were obtained. Results: MetS prevalence was 36.3% (38.7% among men and 30.6% among women). Multiple logistic regression analysis results showed that the odds ratio of MetS was increased in older ages (OR: 3.0; 95% CI: 1.43 - 6.47; p < 0.01) and smokers (OR: 2.6; 95% CI: 2.58 - 4.22; p < 0.01). With elevation 1 unit in the body mass index (BMI), risk of MetS increased by 30% (95% CI: 22.9% - 38.4%; p < 0.01) and an increase1 mg/day in dietary iron intake, the risk of MetS increased 2.4% (95% CI: 0.07% - 4.3%; p < 0.01). Conclusions: MetS prevalence is considered to be high among Jordanian employees which highlights the urgent need to develop comprehensive national strategies for prevention and treatment of MetS.

The ACE insertion/deletion polymorphism and its association with metabolic syndrome

The angiotensin-1–converting enzyme (ACE) gene has been suggested to be involved in the development of metabolic syndrome (MetS). However, results have been inconsistent. In this study, a meta-analysis was performed to investigate the association between ACE insertion/deletion (I/D) polymorphism and MetS. Published literature from PubMed, EMBASE, and ISI Web of Science databases was searched for eligible publications. All studies assessing the association between ACE I/D polymorphism and MetS were included. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated using a fixed- or random-effects model. Ten studies (1939 cases/2845 controls) for ACE I/D polymorphism were included in this meta-analysis. Most of the studies were performed in whites. The ACE I/D polymorphism was associated with an increased OR of MetS under a dominant model (DD + ID vs II: OR = 1.39; 95% CI, 1.22-1.60; P < .001). Using this model, similar results were found among studies using different ethnic populations, studies using different MetS definitions, and studies with more than 100 cases. This meta-analysis indicated that the D allele of the ACE gene, known to be related to higher levels of angiotensinogen, is associated with an increased OR of MetS. However, given the limited sample size, this association warrants further investigation.

Different associations of apolipoprotein E polymorphism with metabolic syndrome by sex in an elderly Chinese population

The metabolic syndrome (MetS) is characterized by a cluster of metabolic disorders including abnormal lipid and lipoprotein metabolism. Apolipoprotein E (ApoE) is involved in the regulation of the metabolism of cholesterol, lipoproteins, and triglycerides. The common ApoE polymorphism has been found to be associated with cardiovascular disease and diabetes. This study evaluated the ApoE genetic polymorphism and its relation to MetS defined by the modified National Cholesterol Education Program and International Diabetes Federation criteria in a population-based cross-sectional survey of an elderly Chinese population in Beijing, China. Genotypes of 937 men and 1385 women were included in the study. All participants were measured for blood pressure, anthropometric measurements, and fasting concentrations of glucose, triglycerides, cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. We applied a logistic regression model to derive adjusted odds ratios (ORs) and their 95% confidence intervals. In this Chinese population, the ɛ2, ɛ3, and ɛ4 allele frequencies were 8.3%, 83.4%, and 8.3% for men and 8.7%, 82.9%, and 8.4% for women, respectively. In men, concentrations of fasting triglycerides were higher among the APOE2 and E4 subjects; and a lower level of high-density lipoprotein cholesterol was observed in the APOE4 group. There were approximately linear associations of low-density lipoprotein cholesterol levels with APOE genotype groups in both men and women. We observed that the ɛ4 allele was associated with a significantly increased OR of MetS defined by the modified National Cholesterol Education Program criteria in men (OR, 1.75; 95% confidence interval, 1.17-2.63). In summary, our data show that common polymorphism of ApoE gene is associated with the presence of MetS in an elderly Chinese population.

Increasing the proportion of beans to white rice is associated with lower cardio‐metabolic risk factors in Costa Rican adults

High intake of white rice has been associated with metabolic syndrome (MetS) and type 2 diabetes (T2D). Costa Ricans follow a staple dietary pattern that includes white rice and beans, yet the combined effect of these foods on cardio-metabolic risk factors has not been studied. We aimed to determine the association between intake of white rice and beans and MetS and its components in Costa Rican adults (n=1879) without T2D. Multivariate adjusted means were calculated for components of MetS by daily servings of white rice and beans (<1, 1, >1), and by the proportion of beans to white rice. Odds ratio for MetS was calculated by substituting one serving of beans for one of white rice. Results showed that increasing daily servings of white rice were associated positively with systolic blood pressure (BP), triglycerides (TG) and fasting glucose, and inversely with HDL-C (all P for trend <0.01). Increasing servings of beans were inversely associated with diastolic BP (P=0.049). Significant trends for higher HDL-C and lower BP and TG were observed for 1:3, 1:2, 1:1, and 2:1 proportions of beans to white rice. Substituting one serving of beans for white rice was associated with 36% (95% CI=13%–53%) lower odds of MetS. In conclusion, increasing the proportion of beans to white rice, or limiting the intake of white rice by substituting beans, may lower cardio-metabolic risk factors. Grant Funding Source: NIH grants HL 60692 and HL 49086

Association between metabolic syndrome and estimated glomerular filtration rate in older Koreans based on data from the third Korean National Health and Nutrition Examination Survey

To examine the association between metabolic syndrome (MetS) and renal function in older Koreans. A total of 1270 people aged 60 years and older who participated in the third Korean National Health and Nutrition Examination Survey were included in this study. After adjusting for confounding factors, central obesity, high-density lipoprotein cholesterol and fasting glucose were significantly associated with decreased renal function in men. In women, however, each component of MetS with the exception of fasting glucose was not associated with renal function. The odds ratios for MetS were 2.548 in men and 1.454 in women after adjustment for confounding variables; both were statistically significant. The odds ratio of decreased renal function increased as the number of components of MetS increased. The results of this study suggest that MetS may be an independent risk factor for decreased renal function in older population as well.

Association of the cell death-inducing DNA fragmentation factor alpha-like effector A (CIDEA) gene V115F (G/T) polymorphism with phenotypes of metabolic syndrome in a Chinese population

Aims The CIDEA gene is involved in energy metabolism and a non-synonymous single nucleotide polymorphism (SNP), V115F (G/T), is a risk factor for obesity in Swedish subjects and metabolic syndrome (MetS) in Japanese subjects. However, the risk allele was a G in Swedish subjects and a T in Japanese subjects. The present study investigated the association between this SNP and MetS in a Chinese population. Methods Three hundred and fifty-one subjects evaluated at the Cardiac Clinic in Xuanwu Hospital for MetS risks were recruited. Anthropometric measurements, blood pressure, fasting blood glucose, and blood lipid levels were determined in addition to the polymorphism. Results The proportion of subjects with MetS was significantly higher based on genotype, in the order: GG < GT < TT ( p = 0.003). In multiple logistic regression analysis, the odds ratios for MetS in the GT and TT genotypes, compared to the referent GG genotype, were 2.26 ( p = 0.003) and 2.89 ( p = 0.002), respectively. Similar trends were observed for the related phenotypes of central obesity (GT: OR = 2.20, p = 0.004; TT: OR = 3.31, p = 0.002) and dyslipidemia (GT: OR = 1.73, p = 0.047; TT: OR = 2.10, p = 0.03). Conclusions The T allele of the CIDEA V115F SNP is a risk factor for MetS and its related phenotypes in a Chinese population.

The association between the ratio of visceral fat to thigh muscle area and metabolic syndrome: the Korean Sarcopenic Obesity Study (KSOS)

A relationship between visceral fat accumulation and metabolic syndrome (MetS) has been established. However, the effect of a relative increase in visceral fat and a decrease in muscle mass on metabolic disorders has not been investigated. The aim of the present study was to examine the association between the ratio of visceral fat to thigh muscle area (VMR) and MetS in Korean adults. STUDY SUBJECT/MEASUREMENTS: A total of 264 age-and gender-matched subjects recruited from the Korean Sarcopenic Obesity Study (KSOS), an ongoing prospective observational cohort study, were categorized into four groups based on their body mass index (BMI) and VMR. We measured visceral fat area and thigh muscle area using computed tomography. Subjects with MetS showed a significantly higher VMR than those without MetS. In both obese and nonobese groups, the subjects with a higher VMR had a higher prevalence of MetS than those in the lower VMR groups. VMR was significantly related to components of the metabolic syndrome, especially in women, and was positively correlated with a number of MetS components in both men and women. In multiple logistic regression analysis, the odds ratio for MetS was 6·72 (highest vs lowest quartile, 95% confidence interval, 1·60-28·14) after an adjustment of potential confounders, including BMI and waist-to-hip ratio. VMR is significantly increased in subjects with MetS and independently associated with MetS. These results suggest that the VMR may be a potential indicator for MetS risk in Korean adults.

Effect of changes in waist circumference on metabolic syndrome over a 6.6-year follow-up in Tehran

This cohort study was conducted to evaluate the effect of waist change on metabolic syndrome (MetS) status and its parameters in 5720 participants, aged >or=20 years, of the Tehran Lipid and Glucose Study who were followed up for a mean of 6.6 years. We measured waist circumference (WC) and MetS parameters at baseline (phase I: 1999) and at follow-up (phase III: 2008), and assessed this relationship across five groups: waist loss (<-2.0 cm); waist stable (-2.0 to 2.9 cm); mild (3.0-5.9 cm); moderate (6.0-8.9 cm) and large (>or=9.0 cm) waist gain. MetS was defined according to the International Diabetes Federation criteria. In phase I, the mean (s.d.) waist gain was 88.8 cm (11.7). Between phases I and III, the mean (s.d.) waist gain was 5 cm (7.9). There was 16% (95% confidence interval (95% CI): 13.6-18.4) age-adjusted incident MetS and for every centimeter of WC gained over 6.6 years, the risk of MetS increased by 10% (odds ratio (OR) 1.10; 95% CI: 1.09-1.12). Compared with a stable WC in both genders, ORs for MetS for different waist gain groups were as follows: mild (OR 2.3, 95% CI: 1.7-3.2); moderate (OR 3.5, 95% CI: 2.6-4.7) and large (OR 5.8, 95% CI: 4.5-7.6). Waist loss had a protective effect on MetS (OR 0.6, 95% CI: 0.4-0.9). Waist gain showed a detrimental effect on all parameters of MetS in both genders, except for high-density lipoprotein cholesterol and fasting blood sugar in women. Waist gain, even mild, was a risk factor of the development of MetS and its parameters. Intervention for reducing WC could be an effective strategy to decrease incident MetS.

Incidence of metabolic syndrome according to combinations of lifestyle factors among middle-aged Japanese male workers

ObjectiveTo examine a combination of healthy lifestyles on the risk of metabolic syndrome (MetS) to inform future interventions. MethodsA total of 1897 men aged 35–60years participated in an annual health check-up in 2002 and 2005. MetS was defined by AHA/NCEP criteria. Logistic regression analyses were used to estimate age- and BMI-adjusted odds ratios (ORs) of MetS incidence for each healthy lifestyle (regular physical activity, adherence to healthy eating behaviors, not current smoking, and maintaining a stable weight since one's mid-twenties), separately (Model 1) and simultaneously (Model 2). A points system was developed to derive 3-year risk of MetS incidence by assigning a specific point to each healthy lifestyle. ResultsMetS developed in 285 (15.0%) subjects after the follow-up. The ORs of MetS for each healthy lifestyle ranged from 0.42 to 0.64 (Model 2). Three-year risk of MetS incidence was predicted to differ from 1% to 60% according to the individual point total of the points system. The population-attributable fraction of MetS in subjects whose point total was not in the highest quartile was 71%. ConclusionAdherence to healthy lifestyles was associated with a lower risk of MetS among apparently healthy middle-aged Japanese male workers.

Association Between Metabolic Syndrome and Liver Histology Among Children With Nonalcoholic Fatty Liver Disease

Nonalcoholic steatohepatitis (NASH) is considered the hepatic manifestation of metabolic syndrome (MetS) among adults. Emerging data suggest that MetS may be associated with nonalcoholic fatty liver disease (NAFLD) in children as well. We sought to determine whether MetS or its component features are associated with specific histological features or severity of NAFLD. Children and adolescents aged 6-17 years enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) with clinical data obtained within 6 months of liver biopsy were included. MetS was defined as the presence of three or more of the following features as determined by application of age-adjusted normative values: central obesity, dyslipidemia, impaired fasting glucose, and elevated blood pressure. Liver biopsies were evaluated by the Pathology Committee of the NASH CRN. Two hundred fifty four children were included in the analysis, of whom 65 (26%) met specified criteria for MetS. Among children with MetS, there is a higher proportion of females who were on average older in age and pubertal. The risk of MetS was greatest among those with severe steatosis (odds ratio (OR)=2.58 for grade 3 vs. grade 1 steatosis, P=0.001). The presence of hepatocellular ballooning was also significantly associated with MetS (OR=2.10, P=0.03). Those with advanced fibrosis (stage 3/4) had an OR for MetS of 3.21 (P=0.04) vs. those without fibrosis (stage 0). Borderline zone 1 or definite NASH patterns compared with "not NASH" were strongly associated with MetS (OR=4.44, P=0.005 and OR=4.07, P=0.002, respectively). The mean NAFLD Activity Score (NAS) was greater among children with MetS vs. those without (4.8 +/- 1.4 vs. 4.3 +/- 1.4, P=0.01). Central obesity was significantly associated with steatosis, fibrosis, hepatocellular ballooning, and NAFLD pattern. Insulin resistance was significantly associated with steatosis, fibrosis, hepatocellular ballooning, NAS, and NAFLD pattern. MetS is common among children with NAFLD and is associated with severity of steatosis, hepatocellular ballooning, NAS, NAFLD pattern, and the presence of advanced fibrosis. Individual MetS features, particularly central obesity and insulin resistance, were also associated with severity of NAFLD. MetS features should be considered in children with NAFLD as individually and collectively they help identify children with more advanced disease.

Menopause impacts the relation of plasma adiponectin levels with the metabolic syndrome

Plasma adiponectin is negatively correlated with metabolic syndrome (MetS) components obesity and insulin sensitivity. Here, we set out to evaluate the effect of menopause on the association of plasma adiponectin with MetS. Data on plasma adiponectin and MetS were available from 2256 individuals participating in the Erasmus Rucphen Family study. Odds ratios for MetS were calculated by logistic regression analysis using plasma adiponectin quartiles. The discriminative accuracy of plasma adiponectin for MetS was determined by calculating the area under the curve (AUC) of receiver operator. Analyses were performed in women and men, pre- and postmenopausal women and younger and older men. Virtually all determinants of MetS differed significantly between groups. Low plasma adiponectin showed the highest risk for MetS in postmenopausal women (odds ratio = 18.6, 95% CI = 7.9-44.0). We observed a high discriminative accuracy of age and plasma adiponectin for MetS not only in postmenopausal women (AUC = 0.76) but also in other subgroups (AUC from 0.67 to 0.87). However, in all groups, the discriminative accuracy of age and body mass index (BMI) for MetS was similar to the discriminative accuracy of age and plasma adiponectin. Low plasma levels of adiponectin are associated with increased prevalence of MetS, especially in postmenopausal women. Age and BMI have similar discriminatory accuracies for presence of MetS when compared with age and plasma adiponectin. Thus, we conclude that the association of plasma adiponectin with MetS is significantly affected by menopause but challenge the additional value of adiponectin for the discriminatory accuracy for presence of MetS.