Search

Aims: Metabolic syndrome (MetS) and chronic kidney disease (CKD) are significant risk factors for incident atrial fibrillation (AF). Few studies have reported the synergistic effect of MetS and CKD on development of AF. We investigated the individual and synergistic effects of MetS and CKD on the risk of incident AF.Methods: We studied a retrospective cohort comprising 22,886,663 Koreans whose data was obtained from the national health claims database established by the Korean National Health Insurance Service between 2008 and 2013. Patients were classified into a MetS and a CKD group and followed-up until 2016 for new-onset AF. A Cox proportional hazards model assessed the independent and synergistic effect of MetS and CKD on the risk of incident AF.Results: The prevalence of MetS and CKD in these patients was 27.4% and 5.4%, respectively. During a mean follow-up of 5.4 years, AF developed in 225,529 patients (1% of the total cohort). The adjusted hazard ratio (HR) for incident AF was 1.38 (95% confidence interval [CI] 1.36-1.39) for MetS, and 1.35 (95% CI 1.34-1.37) for CKD. Patients with MetS and CKD showed a higher risk of AF (HR 1.75, 95% CI 1.73-1.78) than that observed in those without MetS and CKD.Conclusions: The combination of MetS and CKD showed a high risk of development of AF in a large-scale nationwide cohort. Further studies are warranted to determine whether pharmacological and/or lifestyle interventions can control/manage these modifiable risk factors to reduce the risk of development of AF. [ABSTRACT FROM AUTHOR]

Objectives: To determine and compare the prevalence and risk factors of metabolic syndrome (MS) among Tarahumara Indians living in rural and urban communities.Methods: Conducted in 2010, this cross-sectional study included 204 Tarahumara (100 urban and 104 rural individuals 18-75 years old [yo]). Data obtained includes: Anthropometric, lifestyle, blood pressure (BP) and fasting blood tests. Analyses were stratified by gender and age.Results: The total prevalence of MS in rural and urban Tarahumara were 41% and 28% (p = 0.04), respectively. In urban cohorts, the prevalence of MS increased linearly with age. Women presented with a higher MS prevalence than men in urban (44.6% vs. 34.3%, p = 0.4) and rural (50% vs. 12.5%, p = 0.0001) cohorts. In men, urban residents presented with a higher MS prevalence vs. rural subjects; The same was not true for women. Age-related increment in waist circumference was linear and significantly higher in urban men compared to their rural counterpart (urban 6.5 [95% CI 4.24-8.79] vs. rural 2.7 [95% CI 1.19-4.24] centimeters/decade, p < 0.05). Multivariate analysis showed a significant relationship between urban residency and MS in men, but not in women.Conclusion: The overall prevalence of MS is higher in women than men, but the latter are more susceptible to the urbanization-associated worsening of cardiometabolic health. [ABSTRACT FROM AUTHOR]

Aims: Metabolic syndrome (MetS) is one of the most important issues in elderly people because of its association with ensuing cardiovascular disease (CVD). The components of MetS play a key role in the pathogenesis of arterial thickness and stiffness. Pulse pressure (PP), an easily accessible parameter in a basic health evaluation, has been documented as a marker of arterial stiffness and widespread atherosclerosis. The aim of our study was to assess the association between PP and MetS in Korean elderly people.Methods: A nationwide cross-sectional study was conducted to examine the relationship between PP and MetS among 6187 participants (2687 men and 3500 women) aged 60years older Korean people using the Korean National Health and Nutrition Examination Survey. The odds ratios (ORs) and 95% confidence intervals (CIs) for MetS were calculated across PP quartiles using multiple logistic regression analyses.Results: There was a positive relationship between PP and MetS in a dose-response manner. The prevalence of MetS significantly increased with increasing PP quartile in both men and women (p<0.001). Compared with the lowest PP quartile group, the ORs (95% CIs) for MetS of the highest PP quartile was 2.60 (1.91-3.52) for men and 1.97 (1.48-2.59) for women after adjusting for age, cigarette smoking, alcohol intake, regular exercise and mean arterial blood pressure. These associations remained valid after additionally adjusting for hypertension and diabetes medications.Conclusion: We found a positive relationship between PP and MetS among Korean elderly men and women. [ABSTRACT FROM AUTHOR]

Background: A growing number of people with type 1 diabetes (T1DM) are identified with features of metabolic syndrome (MS) known as "double diabetes", but epidemiologic data on the prevalence of MS in T1DM and its comorbidities are still lacking. Aim of this cross sectional study is to better estimate the prevalence of MS in T1DM, and to assess its association with comorbidities.Methods: Data of 31,119 persons with autoimmune diabetes mellitus were analysed for signs of MS and presence of late complications. Double diabetes was defined as T1DM coexisting with MS (obesity, hypertension, dyslipidemia). Multiple linear or logistic regression analyses were performed to identify associations between double diabetes and late complications.Results: 25.5% (n=7926) of persons with T1DM presented additionally the MS. Persons with double diabetes showed significantly more macrovascular comorbidities (coronary heart disease 8.0% versus 3.0% w/o MS, stroke 3.6% versus 1.6%, diabetic foot syndrome 5.5% versus 2.1%). Also microvascular diseases were increased in people with double diabetes (retinopathy 32.4% versus 21.7%, nephropathy 28.3% versus 17.8%). Both macrovascular and microvascular comorbidities were increased independent of glucose control, even if patients with good metabolic control (HbA1c <7.0%, 53mmol/mol) showed significantly less macrovascular (coronary heart disease 2.3% versus 1.8%, p<0.0001) and microvascular problems (retinopathy 8.7% versus 6.6%, p<0.0001).Conclusions: Double diabetes seems to be an independent and important risk factor for persons with T1DM in developing macrovascular and microvascular comorbidities. Therefore, patients should be identified and development of MS should be avoided. Longterm studies are needed to observe the effect of insulin resistance on patients with autoimmune diabetes. [ABSTRACT FROM AUTHOR]

We examined the prevalence of metabolic syndrome (MetS), glucose tolerance categories and risk factors of cardiovascular-disease (CVD) in the general Spanish population. We studied 3844 randomly sampled subjects (46% males) aged 35-74 years. Glucose tolerance categories were defined according to the 2003 ADA and MetS according to the Harmonized Consensus Criteria with waist circumference (WC) cut-off-points previously reported in Spanish population (≥94.5/≥89.5cm for males/females). The prevalences of normoglycemia (NG), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG and IGT considered together (IFG/IGT), and diabetes mellitus (DM) were 67.6/16.6/5.0/3.3, and 7.5%, respectively. The overall prevalence of MetS was 31.2%. In subjects with NG, IFG, IGT, IFG/IGT, and DM the MetS prevalence's were 16.3/57.1/31.5/66.1, and 74.4% (p<0.001), respectively. MetS was more common in males, older subjects, smokers, and/or individuals with obesity, IFG, IFG/IGT, DM, or insulin resistance (HOMA-IR ≥3.8). MetS was less prevalent in individuals with low alcohol intake and/or high education level. Regarding the risk level of CVD estimated by Framingham and SCORE risk charts, IGT had higher estimated CVD-risk than IFG and IFG/IGT. The presence of MetS increases the risk 4.85 times by Framingham and 2.43 times by SCORE. Prevalence of prediabetes (IFG/IGT) and MetS were 25% and 31.2% respectively. Prevalence of MetS has not changed in the past decade in Spanish females, but has slightly increased in males. We found that subjects with IGT showed a higher risk of CVD than IFG and IFG/IGT according to the Framingham and SCORE. MetS increased the CVD-risk previously estimated by Framingham and SCORE. [ABSTRACT FROM AUTHOR]

Metabolic syndrome is becoming a worldwide medical and public health challenge as it has been seen increasing in prevalence over the years. Age-related eye diseases, the leading cause of blindness globally and visual impairment in developed countries, are also on the rise due to aging of the population. Many of the individual components of the metabolic syndrome have been shown to be associated with these eye diseases. However, the association of metabolic syndrome with eye diseases is not clear. In this review, we reviewed the evidence for associations between metabolic syndrome and certain ocular diseases in populations. We also reviewed the association of individual metabolic syndrome components with ocular diseases due to a paucity of research in this area. Besides, we also summarised the current understanding of etiological mechanisms of how metabolic syndrome or the individual components lead to these ocular diseases. With increasing evidence of such associations, it may be important to identify patients who are at risk of developing metabolic syndrome as prompt treatment and intervention may potentially decrease the risk of developing certain ocular diseases. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the association between hydrogenated- (HVOs) and non-hydrogenated vegetable oils (non-HVOs) and butter and the metabolic syndrome (MetS) after 3-years of follow-up in adults.Methods: This study was conducted between 2006-2008 and 2009-2011 within the framework of the Tehran Lipid and Glucose Study, on 1582 adults, aged 19-84 years. Intakes of HVOs, non-HVOs and butter were assessed by a validated semi-quantitative food frequency questionnaire. Based on the consumption of food rich in fat including HVOs, non-HVOs and butter, participants were categorized to consumers and non-consumers.Results: Of 1582 participants during a 3-year follow-up, 15.2% developed MetS. Non-consumption of butter was associated with lower MetS risk compared with its consumption. Among consumers of food rich in fat, intake of HVOs and butter were associated with an increased risk of MetS; ORs in the final multivariate model were 2.70 (95% CI: 1.52-4.78) for HVOs and 2.03 (95% CI: 1.20-3.41) for butter, in the highest, compared to the lowest category of dietary intakes. Intake of non-HVOs was not associated with risk of MetS.Conclusions: Consumption of HVOs and butter were positively associated with an increase risk of MetS. [ABSTRACT FROM AUTHOR]

Aims: This study was aimed at finding out the efficacy of Indian Diabetes Risk Score (IDRS) in identifying the individuals with increased risk of developing metabolic syndrome (MS) phenotype.Methods: A total of 1007 (645 males and 362 females) rural participants aged ≥ 20 years took part in the study. Anthropometric measures and blood pressure were collected using standard techniques. Metabolic profiles and insulin were also estimated and HOMA-IR was calculated accordingly.Results: There existed significant differences by IDRS categories for waist circumference, waist-hip ratio, waist-height ratio, body mass index, percentage body fat, sum of four skinfolds, total cholesterol, triglycerides, high, low and very low density lipoprotein cholesterol, fasting blood glucose, insulin, insulin resistance, systolic and diastolic blood pressure and mean arterial pressure. Significant (p<0.001) age group differences were also evident for IDRS categories. Remarkably higher prevalence of MS was observed with increasing IDRS.Conclusion: IDRS could be used to identify the individuals with increased risk of developing MS phenotype in this population. [ABSTRACT FROM AUTHOR]

Aims: To compare diabetes-related mortality rates and factors associated with this disease in the Canary Islands compared with other 10 Spanish regions.Methods: In a cross-sectional study of 28,887 participants aged 35-74 years in Spain, data were obtained for diabetes, hypertension, dyslipidemia, obesity, insulin resistance (IR), and metabolic syndrome. Healthcare was measured as awareness, treatment and control of diabetes, dyslipidemia, and hypertension. Standardized mortality rate ratios (SRR) were calculated for the years 1981 to 2011 in the same regions.Results: Diabetes, obesity, and hypertension were more prevalent in people under the age of 64 in the Canary Islands than in Spain. For all ages, metabolic syndrome and insulin resistance (IR) were also more prevalent in those from the Canary Islands. Healthcare parameters were similar in those from the Canary Islands and the rest of Spain. Diabetes-related mortality in the Canary Islands was the highest in Spain since 1981; the maximum SRR was reached in 2011 in men (6.3 versus the region of Madrid; p<0.001) and women (9.5 versus Madrid; p<0.001). Excess mortality was prevalent from the age of 45 years and above.Conclusions: Diabetes-related mortality is higher in the Canary Islands population than in any other Spanish region. The high mortality and prevalence of IR warrants investigation of the genetic background associated with a higher incidence and poor prognosis for diabetes in this population. The rise in SRR calls for a rapid public health policy response. [ABSTRACT FROM AUTHOR]

Objective: To investigate the predictive role of adolescent metabolic phenotypes in development of early adult metabolic syndrome (MetS).Study Design: A group of 1446 adolescents (44.8% boys), participants of the Tehran Lipid and Glucose Study, with a mean (SD) of age 14.6 (2.2) years, followed for 10.4 years. Logistic regression models were developed to evaluate the predictive power of different metabolic phenotypes for adult MetS. Moreover, areas under the receiver operating characteristic (ROC) curve were estimated to compare the prediction power of metabolic phenotypes for adult MetS.Results: The prevalence of MetS was 14.6% (29.7% and 2.4% for adult males and females, respectively) at the end of follow up. The most frequent metabolic phenotype in adolescent was high TGs/low HDL-C (23.7%), while the prevalence of high TGs/high WC was 10.4% and the other phenotypes were less than 10%. After adjustment for baseline BMI Z-Score and BMI change, high TGs/low HDL-C (OR: 1.70, 95%CI: 1.23-2.37), high WC/high BP (OR: 1.75., 95%CI: 1.08-2.84), high BP/low HDL-C (OR:1.68, 95%CI: 1.05-2.60) and high WC/low HDL-C (OR: 2.41, 95% CI: 1.37-4.23) phenotypes were associated with adult MetS. However, their AUCs were significantly lower than overweight or obesity.Conclusion: Some combinations of metabolic abnormalities in adolescence predict early adult MetS, independent of baseline BMI Z-Score and BMI change. However, the discriminative power of these phenotypes was weak, in comparison to adolescent overweight or obesity. [ABSTRACT FROM AUTHOR]

Aims Previously rare among Alaska Native (AN) people, type 2 diabetes (DM2) prevalence as indicated by registry data has increased by as much as 300% in some western Alaska regions. We sought to determine prevalence and incidence of DM2 and analyze associated cardiometabolic risk factors in western AN people. Methods DM2 and prediabetes prevalence and incidence were determined by the Western Alaska Tribal Collaborative for Health using consolidated data from cohort studies conducted during 2000–2010. Crude and age-adjusted incidence for DM2 and prediabetes were calculated using 2010 American Diabetes Association criteria. Effects of covariates on DM2 and prediabetes were determined using univariate and multivariate Cox proportional hazards analyses, adjusted for age and sex. Results Excluding baseline diabetes ( n = 124, 4.5%), 53 cases of new DM2 were identified among 2630 participants. Age- and sex-adjusted DM2 incidence was 4.3/1000 (95% CI 2.9, 5.0) person-years over an average 5.9-year follow up. After excluding baseline prediabetes, 387 new cases of prediabetes were identified among 1841 participants; adjusted prediabetes incidence was 44.5/1000 (95% CI 39.5, 49.5) person years. Independent predictors for DM2 included age, impaired fasting glucose, and metabolic syndrome; family history of diabetes and obesity were additional independent predictors for prediabetes. Conclusions DM2 incidence in western AN people is substantially lower than that for U.S. whites; however, incidence of prediabetes is more than 10-fold higher than western AN DM2 incidence and more closely aligned with U.S. rates. Interventions aimed at achieving healthy lifestyles are needed to minimize risk factors and maximize protective factors for DM2 in this population. [ABSTRACT FROM AUTHOR]

Aims The primary aim was to describe characteristics of men identified at high-risk for Type 2 diabetes mellitus (T2DM) using the Australian diabetes risk assessment (AUSDRISK) tool. Secondary aims were to determine the prevalence of pre-diabetes and metabolic syndrome in these men. Methods Men ( n = 209) completed the AUSDRISK tool, with 165 identified as high-risk for T2DM (score ≥ 12, maximum 38). Demographic, anthropometric, physiological and behavioural outcomes were assessed for 101 men. Comparisons (one-way ANOVA) among three AUSDRISK score groups (12–15, 16–19, ≥ 20) were performed (significance level, P < 0.05). Results Common risk factors (percentages) among high-risk men were waist circumference (> 90 cm; 93%), age (> 44 years; 79%), physical activity level (< 150 min wk −1 ; 59%), family history of diabetes (39%) and previously high blood glucose levels (32%). Men with AUSDRISK scores ≥ 20 had higher (mean ± SD) HbA 1C (6.0 ± 0.4% [42 ± 4.4 mmol.mol −1 ], P < 0.001), FPG (5.3 ± 0.6 mmol.L −1 , P = 0.001) and waist circumference (113.2 ± 9.8 cm, P = 0.026) than men with scores of 12–15. Mean FPG for the sample was 5.0 ± 0.6 mmol.L −1 , whereas mean HbA 1C was 5.8 ± 0.5% [40 ± 5.5 mmol.mol −1 ]. Pre-diabetes prevalence was 70% and metabolic syndrome prevalence was 62%. Conclusions The AUSDRISK tool identified men who were mostly older than 44, and had large waist circumferences and elevated HbA 1C . These findings provide evidence supporting the usefulness of the AUSDRISK screening tool for T2DM screening in clinical and research settings. [ABSTRACT FROM AUTHOR]

Abstract: Aims: We aimed to establish normal reference values of serum insulin and the homeostasis model assessment of insulin resistance (HOMA-IR). We also aimed to verify HOMA-IR “cut-off values” in predicting cardiometabolic risk among Korean children and adolescents. Methods: Data from 2716 Korean subjects (1421 male and 1295 female, aged 10–20 years) were evaluated. Insulin resistance was defined as HOMA-IR >95th percentile. The odds ratios of cardiometabolic risk were assessed based on the state of insulin resistance. Results: Reference values of insulin and HOMA-IR were determined according to sex and age, based on data obtained from normal-weight subjects with normal fasting glucose levels. HOMA-IR values appeared to peak at the age of 14–15 years in male subjects and at the age of 12–13 years in female subjects. The prevalence of insulin resistance in the subjects was 9.8% (male=10.9%, female=8.6%). The prevalence of insulin resistance in normal-weight, overweight, and obese subjects were 4.7%, 25.6%, and 47.1% respectively. Subjects with insulin resistance had a higher prevalence of metabolic syndrome (odds ratios=18.33; 95% confidence interval, 9.62–34.94) and its components, especially hyperglycemia and hypertriglyceridemia. Conclusion: We established reference values of serum insulin and HOMA-IR according to age and sex. Obesity is the most important risk factor for insulin resistance and metabolic syndrome. However, insulin resistance independently increases cardiometabolic risk. This information may be useful for Korean as well as other Asian in planning programs for the prevention of type 2 diabetes. [Copyright &y& Elsevier]

Abstract: This study investigates the prevalence and predictive value of metabolic syndrome in Abu Dhabi, using data from the population-based, programme, ‘Weqaya’. The Weqaya screen included family history of cardiovascular disease (CVD), CVD risk factors, random blood glucose (RBG) and HbA1c. Those not previously diabetic but at high risk of diabetes (RBG≥11.1mmol/l or HbA1c≥6.1%) and randomly selected normal subjects were followed-up with fasting glucose, oral glucose tolerance test (OGTT), HbA1c and fasting triglycerides. In 760 subjects, 325 (42.8%) were male with a mean age of 41.9 years (SD 13.8). Using World Health Organisation (WHO) criteria, 149 (20.2%) were newly diagnosed diabetics. Using International Diabetes Foundation (IDF) and Adult Treatment Panel III (ATPIII) criteria, metabolic syndrome was present in 29.0% vs. 31.5% of non-diabetics, 63.4% vs. 64.2% with impaired glucose handling and 78.6% vs. 79.8% with new-onset diabetes using OGTT (P <.001). IDF criteria better predicted pre-diabetes and diabetes (OR 3.4 P <.001; OR 6.4 P <.001, respectively); ATPIII criteria better predicted high CVD risk scores (OR 13.6 P <.001). Whilst IDF and APTIII definitions provide similar prevalence rates, they differentially predict prediabetes, diabetes and CVD. This ongoing study will enable the longitudinal investigation of the development of diabetes and cardiovascular events in this population. [Copyright &y& Elsevier]

Abstract: Aims: To investigate sex differences in the relationship between socioeconomic status (SES) and the prevalence of metabolic syndrome (MetS) in Korean adults. Methods: We 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. Results: We 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. Conclusions: We 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. [Copyright &y& Elsevier]

Abstract: Aims: Low serum 25-hydroxyvitamin D (25(OH)D) levels have been linked to metabolic syndrome. However, community-based data for healthy Korean individuals are lacking. We aimed to assess the vitamin D status and the association of 25(OH)D deficiency with metabolic syndrome in the South Korean population (latitude 33–38°N). Methods: In this population-based study, we assessed 5559 South Korean adults selected from the Korean National Health and Nutrition Examination Survey IV-2, 2008. We used multiple logistic regression analysis to assess the association between vitamin D deficiency and metabolic syndrome. Results: The prevalence of vitamin D deficiency (<20ng/mL) was 56.0%. Subjects with vitamin D deficiency were younger and had higher education, lower physical activity, and lower alcohol consumption than those with normal vitamin D levels. The overall risk of metabolic syndrome was not associated with 25(OH)D concentration. The adjusted OR of reduced high density lipoprotein cholesterol (HDL-C) decreased across the quintiles of 25(OH)D concentrations (OR=0.72; 95% confidence interval=0.54–0.95 for comparisons of lowest vs. highest quintile; P for trend=0.003). Conclusions: A high prevalence of vitamin D deficiency was noted in the general South Korean population. Serum 25(OH)D concentration was inversely associated with the risk of having reduced HDL-C. [Copyright &y& Elsevier]

Abstract: Aim: To report the national prevalence of metabolic syndrome (MetS) and its risk factors among adult Malaysians (>18years old) based on World Health Organization (WHO), the National Cholesterol Education Program Expert Panel III (ATP III), International Diabetes Federation (IDF) and the ‘Harmonized’ criteria. Methods: A multi-stage stratified sampling method was used to select 4341 subjects from Peninsular and East Malaysia. Subjects underwent physical and clinical examinations. Results: Based on the WHO, ATP III, IDF and Harmonized definitions, the overall crude prevalences of MetS were 32.1, 34.3, 37.1 and 42.5%, respectively. Regardless of the criteria used, MetS was higher in urban areas, in females, in the Indian population and increased significantly with age. Risk factors also increased with age; abdominal obesity was most prevalent (57.4%), was higher in females (64.2%) and was highest in Indians (68.8%). Hypertension was higher in males (56.5%) and highest among Malays (52.2%). In contrast, the Chinese had the highest prevalence of hypertriglyceridemia (47.4%). Conclusions: Malaysia has a much higher prevalence of MetS compared with other Asian countries and, unless there is immediate intervention to reduce risk factors, this may pose serious implications on the country''s healthcare costs and services. [Copyright &y& Elsevier]

Abstract: Aims: To investigate the prevalence of undiagnosed diabetes mellitus (DM) and cardiovascular risk factors among professional drivers in Hong Kong. Methods: Chinese professional drivers with no history of DM were invited to complete a questionnaire on their health status, followed by taking their body measurements, fasting blood glucose (FG) and lipids. 75g OGTT were performed when FG≥5.6 to <7.0mmol/L. Results: Of these 3376 drivers (male 92.6%, mean age 50.9±7.6 years), the prevalence of undiagnosed DM, prediabetes, and metabolic syndrome was 8.1% (272/3376, 95% CI 7.1–9.0%), 10.0% (337/3376, 95% CI 9.0–11.0%) and 26.8% (904/3376, 95% CI 25.3–28.3%) respectively, while the corresponding WHO Standard Population age-standardized prevalence was 7.8%, 9.0% and 24.7% respectively. Many of them were obese (51.2%), had hypertension (57.0%) and high cholesterol (58.7%), and a third had hypertriglyceridaemia (34.9%) and low HDL-cholesterol (29.3%). Their median working hours were 60.0 (IQR 14)h. Majority had exercise <1h/week (56.0%) and ate out ≥6times/week (54.9%). Conclusions: Hong Kong professional drivers have higher prevalence of undiagnosed DM, cardiovascular risk factors and metabolic syndrome than the general population. Therefore, health care measures targeting against them should be taken to prevent and detect DM and cardiovascular diseases. [Copyright &y& Elsevier]

Abstract: To explore the utility of the HbA1c criterion in the definition of metabolic syndrome (MS) in Koreans, we cross-sectionally analyzed clinical and laboratory data on 11,293 non-diabetic Korean adults (aged 20–89years, 34% women) collected during regular health checkups. Dysglycemia was defined as either fasting plasma glucose (FPG) ≥5.6mmol/l or HbA1c ≥5.7%. The prevalence of MS as judged by the HbA1c criterion alone (17.8%) was significantly less than that determined by FPG level alone (24.5%). Use of a combination of both criteria slightly increased the prevalence of MS (26.0%). Among the 2953 subjects categorized as having MS using the combined criteria, 929 (31%) were diagnosed by the FPG criterion alone, 177 (6%) by the HbA1c criterion alone, and 1847 (63%) using both criteria. The group diagnosed using FPG values alone had significantly higher BMI, waist circumference, blood pressure, fasting plasma insulin levels, and insulin resistance index compared with those in the group diagnosed using HbA1c levels alone. In men, the brachial-ankle pulse wave velocity was significantly higher and the HDL-cholesterol level was lower in the HbA1c-alone group. Therefore, employment of the HbA1c criterion may be useful to define MS in subjects at increased risk for atherosclerosis. [Copyright &y& Elsevier]

Abstract: Aims: To know which MS criteria best predict the presence of NAFLD and the prevalences of metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD) diagnosed ultrasonographically among pre-diabetic and diabetic subjects based on three different MS criteria (IDF, ATP III, WHO). Methods: Subjects were screened and those with a fasting serum glucose level ≥100mg/dL were further tested with a 75g oral glucose tolerance test. And those who were newly diagnosed as having pre-diabetes or diabetes were evaluated for MS and NAFLD. We compared the risk ratios of NAFLD among three MS criteria using multivariate and multiple logistic regression analyses. Results: A total of 1365 subjects (977 males, mean age 48.4±9.5 years) were analyzed. The WHO criteria produced the highest prevalence of MS in both the pre-diabetic (49.8%) and diabetic (58.9%) groups. The IDF criteria produced the highest odds ratio for NAFLD in both pre-diabetic (3.89 [95% CI 2.75–5.51]) and diabetic (5.53 [95% CI 3.21–9.52]) groups. Conclusions: The prevalence of MS depends on the set of diagnostic criteria used. IDF criteria best predicts the presence of NAFLD. The presence of NAFLD should be considered as a component of the diagnostic criteria for MS. [Copyright &y& Elsevier]

Abstract: Aim: To report the national prevalence of metabolic syndrome (MetS) and its risk factors among adult Malaysians (>18 years old) based on World Health Organization (WHO), the National Cholesterol Education Program Expert Panel III (ATP III), International Diabetes Federation (IDF) and the ‘Harmonized’ criteria. Methods: A multi-stage stratified sampling method was used to select 4341 subjects from Peninsular and East Malaysia. Subjects underwent physical and clinical examinations. Results: Based on the WHO, ATP III, IDF and Harmonized definitions, the overall crude prevalences of MetS were 32.1, 34.3, 37.1 and 42.5%, respectively. Regardless of the criteria used, MetS was higher in urban areas, in females, in the Indian population and increased significantly with age. Risk factors also increased with age; abdominal obesity was most prevalent (57.4%), was higher in females (64.2%) and was highest in Indians (68.8%). Hypertension was higher in males (56.5%) and highest among Malaysians (52.2%). In contrast, the Chinese had the highest prevalence of hypertriglyceridaemia (47.4%). Conclusions: Malaysia has a much higher prevalence of MetS compared with other Asian countries and, unless there is immediate intervention to reduce risk factors, this may pose serious implications on the country''s healthcare costs and services. [Copyright &y& Elsevier]

Abstract: Aim: To determine the prevalence of and risk factors for metabolic syndrome (MS) among urban Asian Indian adults. Methods: 2225 subjects aged ≥20 years were studied in a population based cross-sectional survey in Chandigarh, a city in north India. Anthropometric measurements, estimation of capillary plasma glucose, HDL cholesterol and triglycerides were done. Metabolic syndrome prevalence was estimated using National Cholesterol Education Program-Adult Treatment Panel III (NCEP ATP III), modified NCEP ATP III and International Diabetes Federation (IDF) criteria. Multiple logistic regression analysis was done to find out risk factors for metabolic syndrome. Results: The prevalence rates of metabolic syndrome were 35.8% (NCEP ATP III), 45.3% (modified NCEP ATP III) and 39.5% (IDF criteria). As per modified NCEP ATP III criteria, central obesity was the commonest abnormality among females and elevated blood pressure among males. Risk factors for MS were increasing age, female gender, sedentary lifestyle and diabetes in parents. Conclusions: Our study showed a high prevalence of metabolic syndrome and its individual components. Independent risk factors for metabolic syndrome included increasing age, female gender, sedentary lifestyle and diabetes mellitus in parents. [Copyright &y& Elsevier]

Abstract: Background: In the modified ATP III definition for metabolic syndrome (MS), the cut-off values for central obesity were set to ≥90cm for male and ≥80cm for women. Recently, a new Chinese definition for central obesity was set to ≥90cm for male and ≥85cm for women according to the corresponding BMI value of 25kg/m2. Objective: The purpose of this study was to explore the optimal WC cut-off points to reflect the cluster of multiple risk factors for adults in Beijing. Method: The data collected during the surveillance of risk factors for non-communicable diseases in Beijing 2005 were used, with a total of 16,711 adults studied. Subjects with two or more components from the modified ATP III definition other than central obesity were considered to have multiple risk factors. Results: The optimal WC cut-off points were 87cm in men and 80cm for women. When applied the WC advised definition for MS, the age-standardized prevalence was 38.0% for male and 32.3% for women, which is significantly higher than using the original one for men (34.7% vs 32.3%, P <0.001). Conclusion: The present study indicated that optimal waist circumference cut-off points were lower than that proposed in the modified ATP III definition, especially for men. [Copyright &y& Elsevier]

Abstract: Aim: To determine mutable risk factors for asymptomatic diastolic dysfunction in ethnic minority patients newly diagnosed with type 2 diabetes. Methods: We recruited consecutive adults with newly diagnosed diabetes who had no signs or symptoms or history of heart disease. All patients received standardized evaluation including interview, physical examination, laboratory tests and echocardiogram with tissue Doppler studies. We used logistic regression models to identify mutable risk factors for diastolic dysfunction. Results: Among 126 study subjects (52% women, age 45±10 years, BMI 33±7, 42% with hypertension, 100% ejection fraction ≥50%), evidence of diastolic dysfunction was present in 64 (51%). After controlling for age, heart rate and blood pressure, independent predictors of diastolic dysfunction included physical inactivity (OR: 2.3; 95% CI: 0.9–6.1; P =0.08) and glucose (OR: 4.9; 95% CI: 1.4–17.8; P =0.02). Physical inactivity was associated with early diastolic dysfunction (impaired relaxation), whereas epicardial fat thickness and glucose levels were associated with late diastolic dysfunction (impaired compliance). The hs-CRP and BNP levels were not associated with diastolic dysfunction. Conclusions: Asymptomatic diastolic dysfunction was prevalent among urban minority patients newly diagnosed with diabetes. Important differences exist among factors that affect early and late diastolic function that may have prognostic and therapeutic implications. [Copyright &y& Elsevier]

Abstract: Moderate alcohol consumption is known to be associated with a reduced risk of cardiovascular disease and mortality. However, few studies reported that long-term alcohol drinking may increase the prevalence of central obesity, and cardiovascular disease. We examined the association between metabolic syndrome, nutritional factors and alcohol intake amount in Korean male rural population. We performed a cross-sectional analysis on data from Korean Rural Genomic Cohort (KRGC) study. We used multiple logistic regression analysis to estimate the adjusted odds ratio of metabolic syndrome according to alcohol intake amount categories (never, 0–16g/day, 16–40g/day, and >40g/day). The age adjusted odds ratio for the prevalence of metabolic syndrome was significantly increased in the quartile with the highest alcohol consumption compared to the non-alcohol drinking group (1.33; C.I., 1.11–1.59). These results were similar in the high energy intake group, but not in the low energy intake group. Waist circumference, blood pressure, and serum triglyceride levels were significantly higher in the quartile with the highest alcohol consumption compared to the non-alcohol drinking group. These results suggest that large alcohol consumption is associated with metabolic syndrome and may be a modifiable risk factor of metabolic syndrome especially in subjects with high calorie intake. [Copyright &y& Elsevier]

Abstract: Juvenile metabolic syndrome (MetS) is a growing major medical problem in industrialised countries. We estimated its prevalence among two similar clinic-based sequentially recruited cohorts of extremely obese adolescents (age: 12–18 years) from Italy (N =665, males=271, females=394) and Germany (N =661, males=261, females=400) using the recent IDF paediatric criteria. The prevalence of the MetS was 23.3% among the Italians and 40.4% among the Germans. A multivariate logistic regression revealed an increased risk related to age (adjusted odd ratio (AOR): 2.24; 95% confidence interval (CI): 1.59–3.16; p <0.001), BMI SDS (AOR: 3.61; 95% CI: 2.33–5.60; p <0.001), male gender (AOR: 2.36; 95% CI: 1.80–3.10; p <0.001), and in German adolescents (AOR: 2.56; 95% CI: 1.98–3.31; p <0.001). Among Italian adolescents having the MetS, 83% had 3 abnormalities, 16% had 4 abnormalities while less than 1% had all the 5 abnormalities. In the German cohort, 67%, 28% and 5% of affected individuals had 3, 4 and 5 abnormalities, respectively. These results indicate that MetS is highly prevalent among extremely obese adolescents, and suggest that (besides age, obesity and gender) national sociocultural factors, as alimentary trends, could be important. Further tools should be developed to understand international epidemiological differences concerning obesity and its comorbidities in relation to lifestyles in the countries of European Union. [Copyright &y& Elsevier]

Abstract: We describe changes in markers and prevalence of glucose metabolism disorders following a 2-year community-wide intervention aimed at reducing insulin resistance (IR) prevalence in a high risk community. Surveys were undertaken before and 2 years after implementation of a community developed and led diabetes prevention program. Proportions and means were calculated and compared by sex and age groups: 25–49 years and 50+ years. A process evaluation contributed to interpretation of results. Response rates were around 50% and demographic characteristics similar in both surveys. Overall, IR prevalence decreased markedly from 35.5% to 25.4% (p =0.003). Most changes were observed amongst 25–49 years old women for whom there was a significant change in prevalences of IR and glucose metabolism disorders (p =0.015), largely due to reduced IR prevalence (38.2–25.6%). In 2006, 60.3% achieved minimum recommended exercise levels and 65.4% ate wholegrain bread compared with 45.1% (p =0.002) and 42.2% (p =0.044), respectively, in 2003. Participation in a community diabetes prevention intervention appeared to reduce IR prevalence after 2 years in those with the highest level of participation and most marked lifestyle changes. [Copyright &y& Elsevier]

Abstract: Objective: To determine the prevalence of microalbuminuria and associated risk factors in patients with type 2 diabetes in primary care. Methods: Clinical information of diabetic patients in 70 primary care units in Thailand was collected in a cross-sectional survey. Multinomial logistic regression model was used to examine several clinical risk factors with microalbuminuria and macroalbuminuria. Results: A total of 4162 patients were included. The prevalence of microalbuminuria was 39.12% and macroalbumninuria was 7.83%. The proportion of patients with HbA1c<7% was 37.9%. Independent risk factors for microalbuminuria and macroalbuminuria included HbA1c (adjusted OR 1.54, 95%CI 1.30–1.83 and 2.06, 95%CI 1.49–2.84 per unit increase in HbA1c, respectively), triglyceride ≥1.7mmol/L (1.31, 1.11–1.56 and 1.44, 1.06–1.98), hypertension (1.31, 1.10–1.54 and 1.64, 1.23–2.20), and duration of diabetes ≥5 years (1.31, 1.11–1.55 and 2.39, 1.74–3.28). Metabolic syndrome was associated with macroalbuminuria (OR 1.36, 95%CI 1.01–1.84). Conclusion: The high prevalence of microabuminuria and suboptimal glycemic control for the diabetic patients were found to highlight the need to improve in control of glycemia and metabolic risk factors. [Copyright &y& Elsevier]

Abstract: Aim: To estimate prevalence of non-alcoholic fatty liver disease (NAFLD) and its association with glucose intolerance (type 2 diabetes (DM), prediabetes) and metabolic syndrome (MS) in urban south Indians. Methods: This study was carried out in 541 subjects (response rate 92%) of the original sample of 26,001 subjects in the Chennai Urban Rural Epidemiology Study maintaining the representativeness. Anthropometry and lipid estimations were done in all and oral glucose tolerance test in all, except self-reported diabetic subjects. NAFLD was diagnosed by ultrasonography and MS by modified Adult Treatment Panel III (ATP III) criteria. DM, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) were defined using WHO consulting group criteria. Results: Overall prevalence of NAFLD was 32% (173/541 subjects) (men: 35.1%, women: 29.1%, p =0.140). Prevalence of most cardio-metabolic risk factors was significantly higher in NAFLD subjects. Prevalence of NAFLD (54.5%) was higher in subjects with DM compared to those with prediabetes (IGT or IFG) (33%), isolated IGT (32.4%), isolated IFG (27.3%) and normal glucose tolerance (NGT) (22.5%) (DM vs. prediabetes: p <0.05, DM vs. NGT: p <0.001, prediabetes vs. NGT: p <0.05). Even after adjusting for age, gender and waist circumference, NAFLD was associated with diabetes (OR: 2.9, 95% C.I.: 1.9–4.6, p <0.001) and MS (OR: 2.0, 95% C.I.: 1.3–3.1, p <0.001). Conclusion: NAFLD is present in a third of urban Asian Indians and its prevalence increases with increasing severity of glucose intolerance and in MS. This is the first population-based prevalence of NAFLD from south Asia which faces the brunt of the diabetes epidemic. [Copyright &y& Elsevier]

Aims: To investigate the association between depressive symptomatology and health markers in type 1 diabetes.Methods: Four countries from the InterDiane Consortium had adopted the Finnish Diabetic Nephropathy Study protocol, including the Beck Depression Inventory (BDI). Associations between depression symptomatology, diabetes complications (diabetic nephropathy, proliferative retinopathy, major adverse cardiovascular events [MACE]) and vascular risk factors (metabolic syndrome, body mass index, glycaemic control) were investigated.Results: In a sample of 1046 participants (Croatia n = 99; Finland n = 314; Latvia n = 315; Lithuania n = 318), 13.4% displayed symptoms of depression (BDI score ≥ 16) with no statistically significant difference in the prevalence of depression among the cohorts. The highest rates of diabetic nephropathy (37.1%) and proliferative retinopathy (36.3%) were observed in Lithuania. The rates of MACE and metabolic syndrome were highest in Finland. In joint analyses, individuals exhibiting depression symptomatology had higher HbA1c (79 vs. 72 mmol/mol, p < 0.001) and higher triglyceride concentration (1.67 vs. 1.28 mmol/l, p < 0.001), than those without. In the multivariable model, BDI score was positively associated with the presence of diabetic nephropathy, proliferative retinopathy, MACE, and metabolic syndrome and its triglyceride component. Moreover, BDI score was positively associated with the number of metabolic syndrome components, triglyceride concentration, and HbA1c.Conclusions: Comorbid depression should be considered a relevant factor explaining metabolic problems and vascular outcomes. Causality cannot be inferred from this cross-sectional study. [ABSTRACT FROM AUTHOR]

Aims: To examine the association between dietary anti-inflammatory index (D-AII) and metabolic syndrome (MetS)prevalence, 10-year (2002-2012) diabetes, hypertension, hypercholesterolaemia incidence and 10-year transition from healthy (absence of all MetS traits, excluding waist circumference) to unhealthy metabolic status.Methods: In 2001-2002, n = 1514 men and n = 1528 women (>18 years old) in Athens, Greece, free of cardiovascular disease were recruited. MetS was defined according to the revised NCEP ATP III (2005) or the IDF criteria or the harmonized criteria. The validated D-AII was calculated using a standardized procedure (range 10-77).Results: Inverse associations were observed between D-AII and transition from healthy to unhealthy metabolic status (Odds Ratio (OR)3rd vs. 1st tertile = 0.88 95% Confidence Interval (95%CI)(0.73, 0.98)) and diabetes (OR3rd vs. 1st tertile = 0.55, 95%CI(0.29, 0.77)). In women, D-AII was inversely associated with transition from healthy to unhealthy metabolic status (OR3rd vs. 1st tertile = 0.55, 95%CI(0.26, 0.90), diabetes (OR3rd vs. 1st tertile = 0.41, 95%CI(0.18, 0.64) and hypertension (OR3rd vs. 1st tertile = 0.75, 95%CI(0.20, 0.95), yet only with diabetes incidence in men (OR3rd vs. 1st tertile = 0.62, 95%CI(0.38, 0.93).Conclusions: Diet with high anti-inflammatory load seems an effective preventive measure to retain a metabolically benign status, principally in terms of glycemic control. [ABSTRACT FROM AUTHOR]

Abstract: We performed a retrospective pooled analysis of 28 patients who had been diagnosed with insulin autoimmune syndrome and evaluated the prevalence of anti-insulin receptor antibodies. Dual positivity for anti-insulin and anti-insulin receptor antibodies was common (53.8%). However, these patients had a similar phenotype compared with insulin receptor antibody-negative patients. [Copyright &y& Elsevier]

Abstract: We assessed prevalence of metabolic syndrome (MS) in rural women of Bangladesh using 1485 women aged ≥15years. The prevalence rate of MS was 31.25% (NCEP ATP III modified). And 85.05% population had low HDL values. These findings are important in the development of future health prevention strategies in Bangladesh. [Copyright &y& Elsevier]

Abstract: We aimed to establish the prevalence and characteristics of latent autoimmune diabetes in adults (LADA) and compare it with type 2 diabetes in 1370 Korean patients. The prevalence of LADA was 5.1%. Low C-peptide level and absence of metabolic syndrome were variables independently associated with the diagnosis of LADA. [Copyright &y& Elsevier]