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Aims: We aimed to assess whether female offspring birth weight (BW) is associated with anthropometric and metabolic outcomes in Chilean mothers at 10-years postpartum.Methods: We assessed data from 396 Chilean mother-daughter pairs participating in the longitudinal Chilean Growth and Obesity Cohort (GOCS) and Determinants of Breast Cancer Risk (DERCAM) studies. Multivariate linear and logistic regression models were performed to associate female offspring BW with maternal Body Mass Index (BMI), waist circumference, type 2 diabetes mellitus, metabolic syndrome and its components at 10-years postpartum.Results: At 10-years postpartum, 69% of mothers were overweight, 65% had central adiposity and 26% had metabolic syndrome. Adjusted linear regression models showed associations between female offspring BW and (1) maternal BMI (%Δ GM = 4.46; 95% CI 0.25-8.85); and (2) waist circumference (%Δ GM = 3.25; 95% CI 0-6.60). Adjusted logistic regression models showed associations between female offspring BW and (1) maternal metabolic syndrome (OR = 3.48; 95% CI 1.50-8.11); (2) central adiposity (OR = 2.37; 95% CI 1.08-5.22); and (3) hypertriglyceridemia (OR = 3.19; 95% CI 1.40-7.23).Conclusions: Female offspring BW was associated with maternal anthropometric and metabolic outcomes at 10-years postpartum. Our findings add to the emerging evidence that offspring BW might be a potential indicator for future maternal anthropometric and metabolic risks. [ABSTRACT FROM AUTHOR]

Aims: To assess the implications of low testosterone on cardiovascular risk factors, metabolic syndrome (MES) and clinical outcomes in Chinese men with Type 2 Diabetes (T2D).Methods: A prospective cohort study carried out in a university hospital involving a consecutive cohort of 1239 Chinese men with T2D and a median disease duration of 9years followed up for 4.8years. Clinical characteristics, frequency of MES, serum total testosterone and clinical events were analyzed. Multivariate logistic regression was performed to examine the independent association of low testosterone with MES after adjustment for confounding covariates. Cox proportional hazards regression analysis was used to derive hazard ratio for clinical outcomes.Results: More men with low testosterone had cardiovascular-renal disease and MES than those with normal testosterone. The adjusted odds ratio (OR) of low testosterone for MES was 2.63 (95% Confidence Interval [CI] 1.56-4.61). After a median follow-up of 4.8years, the hazard ratio (HR) of low testosterone was 2.22 (95% CI 1.23-4.01) for incident non-prostate cancer. In a multivariate Cox-regression model, the HRs were attenuated but remained significant with adjustment for MES and renal parameters.Conclusions: Chinese men with low testosterone had high prevalence of cardiovascular disease and MES with high incidence non-prostate cancer. [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]

Aims: To investigate the associations of 25-hydroxyvitamin D (25(OH)D) with insulin resistance (IR), beta-cell function and metabolic syndrome (MetS) in a First Nations population.Methods: We conducted a cross-sectional analysis using data from the Sandy Lake Health and Diabetes Project (2003-2005). A total of 390 participants (>12 y) were assessed for 25(OH)D, fasting glucose, insulin, lipids, blood pressure, inflammatory markers, anthropometric and lifestyle variables and a 75-g oral glucose tolerance test was administered. IR was calculated using the Matsuda insulin sensitivity index (ISOGTT) and the computational homeostasis model assessment of IR (HOMA2-IR). Beta-cell function was calculated using the insulinogenic index (IGI) divided by HOMA-IR (IGI/IR) and the insulin secretion sensitivity index-2 (ISSI-2). The 2009 harmonized criteria were used to define MetS.Results: Higher 25(OH)D was associated with a decreased prevalence of dysglycemia (OR = 0.71 95% CI, 0.51-0.97 per SD increase). In addition, there were significant associations of 25(OH)D with measures of insulin action (ISOGTT; beta=0.31; 95% CI, 0.12, 0.49; HOMA2-IR; beta = -29; 95% CI -0.46, -0.11 and beta-cell function (ISSI-2; beta = 0.15; 95% CI, 0.02, 0.28). The prevalence of MetS was 41%. There was a decreased risk (OR=0.73, 95% CI 0.56, 0.94) of MetS per SD increase in baseline 25(OH)D. Finally, there was a significant positive association of 25(OH)D with adiponectin (beta = 0.16; 95% CI = 0.01, 0.31).Conclusions: These results support a potential role for vitamin D metabolism in the natural history of T2DM among Aboriginal Canadians, although carefully designed randomized trials will be required to establish causality. [ABSTRACT FROM AUTHOR]

Aims Apelin is one of adipokines that plays a pivotal role in energy metabolism, insulin sensitivity and vascular integrity. A definite genetic variant of apelin gene ( APLN ), rs3115757, was recently introduced to potentially influence apelin expression in adipocytes. The aim of our study was to explore the sights of a potential association of this functional variant with obesity traits, insulin resistance indices as well as type 2 diabetes mellitus (T2DM) prevalence. Methods Genotype screening for rs3115757 variant in 151 Egyptian female samples was conducted. Fasting levels of serum insulin and lipid profile, in addition to plasma glucose were measured. Cochran–Armitage trend test was used to decide the risk allele and evaluate the association between the candidate variant and obesity using a case-control design. Results The homozygous G risk allele carriers showed higher values of body mass index (BMI) and waist circumference ( P = 0.001,0.02, respectively) as compared to CC or CG genotypes. As for GG genotype carriers, the risk of developing morbid obesity in lean subjects, (BMI < 25), is twelve times the risk in subjects carrying other genotypes (OR = 12.09, 95% CI: 1.4, 104.8, P = 0.024). On the other hand, GG carriers are shown to be more resistant to insulin. Significantly after correction for BMI and age effects, GG genotype carriers showed 14% and 41% increment in insulin level and resistance (OR = 1.14, 95% CI: 1.06, 1.23, P = 0.001), (OR = 1.42, 95% CI: 1.19, 1.70, P < 0.001), respectively. Conclusion These results suggest a prospective role mediated by this variant in mounting obesity disorders and as significant as insulin resistance complications. [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 Recent data have suggested a relationship between the high-density lipoprotein (HDL) subclass ratio and metabolic syndrome (MetS). However, limited information is available regarding the relationships between the HDL subclass ratio and insulin resistance, associated adipocytokine levels, and MetS components. The associations of the high-density lipoprotein 2 cholesterol (HDL 2 -C) to high-density lipoprotein 3 cholesterol (HDL 3 -C) ratio with the homeostasis model assessment of insulin resistance (HOMA-IR) index, high-molecular-weight adiponectin (HMW-Ad) levels, and MetS components were examined. Methods The study included 1155 Japanese subjects who met our inclusion criteria and underwent an annual health examination that included an HDL subclass analysis. Results The HDL 2 -C/HDL 3 -C ratio and the HMW-Ad level gradually decreased as the number of MetS components increased. In contrast, HOMA-IR gradually increased as the number of MetS components increased. The HDL 2 -C/HDL 3 -C ratio correlated inversely with HOMA-IR and positively with the HMW-Ad level. A strong positive correlation was observed between the HDL 2 -C/HDL 3 -C ratio and the HDL-C level. The HDL 2 -C/HDL 3 -C ratio exhibited moderate negative correlations with the body mass index, waist circumference, and triglyceride level. Weak negative correlations were observed for the HDL 2 -C/HDL 3 -C ratio with the systolic and diastolic blood pressure and fasting plasma glucose levels. Conclusions Our data indicated that the HDL 2 -C/HDL 3 -C ratio was associated with insulin resistance, the HMW-Ad level, and MetS components, and it was useful for evaluating MetS in Japanese individuals. [ABSTRACT FROM AUTHOR]

Aims Fetuin-A, a protein exclusively secreted from the liver, is associated with insulin resistance and/or metabolic syndrome (MetS). However, few studies have examined this association in Japan. We investigated this issue in a Japanese general population. Methods We performed an epidemiological survey in a small community in Japan. The participants consisted of 659 subjects (253 males and 406 females). Fetuin-A levels were measured by a sandwich ELISA method and the modified NCEP-ATP III criteria were adopted to diagnose MetS. The homeostasis model assessment index (HOMA-IR) was calculated as a marker of insulin resistance. Results Statistically significant characteristics of the 659 subjects stratified by fetuin-A quartiles were male gender (inversely), age (inversely), insulin, HOMA-IR, uric acid (inversely), alcohol intake (inversely) and the prevalence of MetS. Mean fetuin-A levels were 249.7 ± 45.1 μg/ml in males and 262.7 ± 55.8 μg/ml in females. In males, the prevalence of MetS was 43.1%, and their mean HOMA-IR level was 1.1. In females, the prevalence of MetS was 17.7%, and their mean HOMA-IR level was 0.9. Multiple stepwise regression analyses showed that fetuin-A levels in males but not females were independently associated with MetS and LDL-c. Multiple logistic regression analysis of fetuin-A (quartile 1 vs. quartile 4) in males showed significant odds ratios of 1.009 (95% C.I.: 1.003–1.015) for MetS and 1.376 (95% C.I.: 1.027–1.844) for 1-SD increment increase in LDL-c. Conclusions High plasma fetuin-A levels were associated with MetS in community-dwelling Japanese males but not females. [ABSTRACT FROM AUTHOR]

Aims Cumulative evidence suggests that coffee consumption may have beneficial effects on metabolic diseases; however, few previous studies have considered the types of coffee consumed and the additives used. We investigated the relationship between coffee consumption and metabolic syndrome (MetSyn) and its components. Methods We analyzed 17,953 Korean adults, aged 19–65 years, using cross-sectional data from the Korean National Health and Nutrition Examination Survey (KNHANES, 2007–2011). Coffee consumption level, types of coffee consumed, and the additives used were assessed based on a food frequency questionnaire and 24-h recall. Demographic and lifestyle factors were assessed using self-administered questionnaires. Data on metabolic biomarkers were obtained from a health examination. Multivariable logistic regression was used to determine the odds ratios of prevalent metabolic syndrome and its components according to frequency and type of coffee consumption. Results We found that 76% of the subjects were habitual coffee drinkers, most of whom consumed instant coffee mix containing sugar and powder creamer. After multivariable adjustment, the odds ratios (95% CI) comparing those who consumed coffee ≥3 times/day with those who consumed coffee <1 time/week were 1.37 (1.15–1.63) for obesity, 1.33 (1.11–1.59) for abdominal obesity, 1.28 (1.09–1.51) for hypo-HDL cholesterolemia, and 1.37 (1.10–1.72) for metabolic syndrome. Instant-coffee drinkers were observed to have elevated risks of these metabolic conditions. Conclusions Consumption of coffee, particularly instant coffee mix, may have harmful effects on MetSyn, perhaps partly deriving from excessive intake of sugar and powder creamer. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To investigate the influence of sex and age on the relationship between sleep duration and metabolic syndrome in a nationally representative population. Methods: We used data from the Korea National Health and Nutrition Examination Survey (2001–2010) and enrolled 24,511 participants aged 20–79 years. Sleep duration was categorized into five groups: ≤5, 6, 7 (referent), 8, and ≥9h/day. Age was categorized into three groups: younger (20–39y), middle-aged (40–59y), and older (60–79y). The association between sleep duration and metabolic syndrome was assessed in the total, separately in men and women, then in six groups based on sex and age. Results: The prevalence of metabolic syndrome by sleep category demonstrated a U-shaped pattern in the total population. However, after adjusting for age, education, occupation, exercise, smoking, alcohol, and body mass index, the prevalence of metabolic syndrome increased in long sleepers (OR 1.31; 95% CI 1.14–1.51) but not in short sleepers (OR 1.00; 95% CI 0.89–1.11). The relationship between sleep duration and metabolic syndrome varied by sex and age–long sleep (≥9h/day) was positively associated with metabolic syndrome only in younger (OR 2.13; 95% CI 1.38–3.28) and middle-aged (OR 1.63; 95% CI 1.21–2.21) women. Short sleep (≤5h/day) was not associated with metabolic syndrome in any sex and age groups. However, extremely short sleep (≤4h/day) was associated with metabolic syndrome in middle-aged men (OR 1.76, 95% CI 1.05–2.96). Conclusion: These data suggest that sex and age significantly modify the relationship between sleep duration and metabolic syndrome. [Copyright &y& Elsevier]

Abstract: Aims: We investigated the association of insulin resistance with metabolic syndrome (MetS) and its components among Korean adolescents. Methods: We analyzed the Korea National Health and Nutrition Examination Survey (2008–2010). Adolescents aged 10–18 years without diabetes (1584 boys and 1388 girls) were evaluated. Insulin resistance was assessed by homeostasis model assessment-insulin resistance (HOMA-IR), and MetS was diagnosed according to the 2007 International Diabetes Federation criteria for adolescents. Results: The prevalence of MetS was 1.4% among boys and 1.7% among girls. Girls in the highest quartile of HOMA-IR were significantly more likely to have MetS compared to girls in the lower quartiles independent of survey year, age, body mass index, white blood cell count, and alanine aminotransferase [odds ratio (OR), 5.33; 95% confidence interval (CI), 1.57–18.11]. Moreover, compared to girls in the lowest quartile of HOMA-IR, girls in the highest quartile significantly exhibited large waist circumference (OR, 3.22; 95% CI, 1.01–10.35), high triglycerides (OR, 6.43; 95% CI, 2.83–14.58), and low high-density lipoprotein-cholesterol (HDL-C) (OR, 2.49; 95% CI, 1.50–4.11). However, such associations were not found among boys. Conclusions: Our results suggest that insulin resistance may be independently associated with MetS, large waist circumference, high triglycerides, and low HDL-C only among girls. [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: 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 investigate the familial concordance of metabolic syndrome and its components in a nationally representative survey in Korean. Methods: We used data from the Korean National Health and Nutrition Examination Survey (KNHANES), a nationwide survey examining the general health and nutritional status of the Korean people. We enrolled 1641 married couples and 1527 parents–1342 offspring. Results: Prevalence of the metabolic syndrome was 17.1% for husbands, 11.7% for wives, 14.3% for parents, and 7.2% for offspring. After adjustment for age, there were strong positive correlations between family members for the metabolic variables. Compared with husbands whose wives did not have metabolic syndrome, adjusted odds ratio in husbands whose wives had metabolic syndrome was 1.43 (95% CI: 1.10–1.87) for the risk of having metabolic syndrome. Similarly, wives whose husbands had metabolic syndrome had 1.41 (95% CI: 1.08–1.84) times higher risk of having metabolic syndrome. Compared with children whose parents did not have metabolic syndrome, adjusted odds ratio in children with at least one parent with the metabolic syndrome was 2.56 (95% CI: 1.09–5.98) for the metabolic syndrome. Conclusions: Our study revealed that there is significant familial concordance for metabolic syndrome and its components in Korean families. [Copyright &y& Elsevier]

Aims: Sarcopenia measured as appendicular skeletal muscle mass (ASM), and central obesity measured as visceral fat area (VFA) may act synergistically to influence metabolic syndrome and atherosclerosis. However, several previous studies reported that metabolic risk is higher in non-sarcopenic obesity groups than in sarcopenic obesity groups because of the close relationship between muscle mass and body fat. We investigated the association of the ASM to VFA ratio, which we have termed the muscle-to-fat ratio (MFR), with metabolic syndrome and arterial stiffness.Methods: This study was performed in 526 apparently healthy adults enrolled in the Korean Sarcopenic Obesity Study, an ongoing prospective observational cohort study. ASM was evaluated with dual energy X-ray absorptiometry and VFA with computed tomography. Arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV).Results: MFR was significantly associated with waist circumference, blood pressure, lipid profiles, glucose and baPWV. By multiple logistic regression analysis, the odds ratio for metabolic syndrome was 5.43 (lowest versus highest tertile of MFR, 95% confidence interval, 2.56-13.34). Multiple stepwise regression analysis showed that MFR was an independent determinant of baPWV (R²=0.57).Conclusions: MFR, a new index of sarcopenic obesity, showed an independent negative association with metabolic syndrome and arterial stiffness. [ABSTRACT FROM AUTHOR]

Aims: The recent definitions of the metabolic syndrome (MS) recognize the need for ethnic and region-specific waist circumference (WC) cut-offs that identify people with abdominal obesity. We tested WC as a diagnostic tool to identify people with visceral adiposity in Hispanics from the Latin America region.Methods: We used the area of visceral adipose tissue (VAT) ≥ 100 cm² at the level between the 4th and 5th lumbar vertebrae in abdominal CT scans as a marker of visceral adiposity and established the optimal WC threshold for men and women by means of receiver operating characteristic (ROC) curves.Results: 179 men and 278 women from Mexico, El Salvador, Venezuela, Colombia and Paraguay were included. The ROC curves were highly discriminative of excess VAT for men and women (area under the curve 0.9 and 0.8 respectively) and the WC threshold was identified at 94 cm for men and between 90 and 92 cm for women.Conclusion: In men the WC cutoff was equal to that proposed for europids and suggested for US adults who may have strong genetic contribution to insulin resistance such as Hispanics. In women the threshold was significantly higher than previously proposed for South and Central Americans. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To assess the association of alcohol consumption with metabolic syndrome (Mets) in a Chinese population. Methods: A community-based cross-sectional study was performed in 19,215 participants aged 40 years or over in Shanghai of China during June 2008–April 2009. Information about the alcohol consumption including quantity and type of alcoholic beverage was obtained using a standard questionnaire. Physical examination was performed and fasting blood samples were obtained for the measurements of biochemical indicators. Results: In male wine-only consumers, after adjusted for age, sex, BMI, education levels, exercise and smoking habit, severe alcohol consumption (≥50.0g/d), compared with non-alcohol consumption, conferred 53% increased risk of having MetS. In women, alcohol consumption did not have relation to the prevalence of Mets. In the beer-only, liquor-only and mixed type consumers, no significant associations between MetS or its components and the quantity of alcohol consumption were detected. Conclusions: Our findings suggest that excessive wine consumption (alcohol ≥50.0g/d) is associated with higher prevalence of MetS in Chinese men. [Copyright &y& Elsevier]

Abstract: 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

Abstract: Aims: This study evaluates the effectiveness of three metabolic syndrome (MS) criteria in identifying cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) in the Chinese population. Methods: 3598 subjects were recruited from a cohort study on Prevention of Multiple Metabolic disorders and MS in Jiangsu of China (PMMJS), followed at 6.3 years. MS was diagnosed using criteria of the National Cholesterol Education Program''s Adult Treatment Panel III (ATPIII), the International Diabetes Federation (IDF) and Chinese Diabetes Society (CDS). Cox regression model was used to analysis the association between MS and onset of CVD and T2DM. Receiver operating characteristic (ROC) curve, sensitivity and specificity were also used to test the ability of three MS criteria to identify CVD or T2DM. Results: Among three criteria, CDS has the highest specificity but lowest sensitivity. Using the CDS criterion, over 50 percent of patients would be misdiagnosed. ATPIII criterion has the shortest distance in ROC curve, lowest false positive rate and false negative rate for identifying CVD and T2DM. ATPIII+/IDF+ has lower ability to predict CVD than ATPIII+/IDF−. ATPIII+/IDF+ and ATPIII+/IDF− has similar ability to predict T2DM. Conclusions: The ATPIII-MS criterion has the highest ability to predict CVD and T2DM. ATPIII is the best MS criterion for the Chinese population. [Copyright &y& Elsevier]

Abstract: Attempts to explain the associations among metabolic syndrome (MetS) features using factor analysis to identify unobserved potential causes have resulted in inconsistent findings. We examined whether an unobserved categorical factor explains the associations among MetS features using latent class analysis. A cross-sectional analysis of 499 non-diabetic Japanese-Americans who underwent measurements of fasting blood, waist circumference (WC) and CT-measured intra-abdominal fat (IAF) area was conducted. MetS components were defined by IDF criteria. IAF and fasting serum insulin (FI) were dichotomized at the 75th percentile. Latent two- and three-class models were fit that included hypertension, dyslipidemia, hyperglycemia, and either WC, IAF, or FI for a total of six models. A three-class latent model fit the data well, while a two-class model did not. In the three-class model, one latent class was strongly associated with all MetS components, while another was associated with hyperglycemia and hypertension only. IAF was associated with only one latent class. Latent class analysis supports the presence of an unobserved factor linked to the co-occurrence of MetS features. One class of this factor was associated with hypertension and hyperglycemia but not central adiposity or FI, suggesting another pathway for observed MetS features. [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: 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: Aims: We conducted this study to compare the relationships between subclinical atherosclerosis and metabolic syndrome (MS) defined by four definitions in Chinese subjects. Methods: In 2006–2007, we enrolled 140 Chinese subjects without reported diabetes in this study. Anthropometric, biochemical profile, and carotid intima-media thickness (IMT) were measured. MS was defined by International Diabetes Federation (IDF), American Heart Association and the National Heart, Lung, and Blood Institute (AHA/NHLBI), National Cholesterol Education Program Adult Treatment Panal III (NCEP-ATP III), and World Health Organization (WHO) criteria. Results: Subjects with MS defined by IDF and AHA/NHLBI criteria had significantly higher carotid IMT, controlling for age, gender, smoking, and serum LDL-C (MS by IDF, partial r =0.225, p =0.008; AHA/NHLBI, partial r =0.176, p =0.04). The association between carotid IMT and MS defined by NCEP-ATP III or WHO criteria was not significant. Subjects with more components of MS defined by IDF, AHA/NHLBI, or NCEP-ATP III criteria correlated to higher carotid IMT in adjusted models (p-values for trend, MS by IDF, 0.011; AHA/NHLBI, 0.011; NCEP-ATPIII, 0.01; WHO, 0.113). Conclusion: MS definitions by IDF and AHA/NHLBI criteria are the best among four definitions in detecting subclinical atherosclerosis in non-diabetic Chinese subjects; whereas MS defined by WHO criteria is the worst. [Copyright &y& Elsevier]

Abstract: Aims: The aim of the present study was to examine the cross-sectional relationship between vital capacity and diabetes, metabolic syndrome (MS), and high-sensitivity C-reactive protein (hs-CRP) among Japanese men. Methods: Medical check-up data of 1353 men were examined. Spearman''s correlation coefficients between respiratory function and MS-related risk factors were calculated excluding subjects with hypoglycemic medication. The prevalence of diabetes and MS were compared between subjects with the lowest and the highest quartiles of % vital capacity (%VC). Area under receiver operating characteristic curve (AUC) were calculated for risk factors excluding fasting glucose. Logistic regression using diabetes as a dependent variable and %VC and MS-related risk factors excluding fasting glucose as independent variables was performed. Results: %VC was significantly correlated with some components of MS and hs-CRP. The prevalence of diabetes, MS, and MS components other than blood pressure were significantly lower in the highest quartile than in the lowest quartile of %VC. AUC of -%VC was highest among MS-related risk factors excluding fasting glucose though statistically not significant. %VC was an independent marker of diabetes in the multivariable logistic regression analysis. Conclusions: Vital capacity was an independent marker of diabetes and associated with MS and hs-CRP in Japanese men. [Copyright &y& Elsevier]

Abstract: Aims: To determine the appropriate cutoff value of waist circumference associated with cardiometabolic risk factors in Koreans. Methods: Clinical and laboratory data on 31,076 Korean adults (age 20–89 years, 40% women) were recorded at regular health check-ups. Receiver operating characteristic curves were used to determine the cutoff values of waist circumference with respect to myocardial ischemia, hypertension, diabetes, and multiple risk factors for metabolic syndrome. Results: Age-adjusted odds ratios for myocardial ischemia, diabetes, hypertension, and multiple components of metabolic syndrome for one standard-deviation increase in waist circumference were 1.45, 1.37, 1.55, and 1.89 for men, and 1.28, 2.03, 1.64, and 2.08 for women, respectively. The cutoff value showing the maximum sensitivity plus specificity for detecting myocardial ischemia was 87cm for men and 74cm for women. The cutoff values for discrimination of hypertension, diabetes, and multiple risk factors for metabolic syndrome, were 84, 85, and 83cm, respectively, for men, and 77, 77, and 76cm, respectively, for women. Conclusions: The waist-circumference cutoff values for cardiometabolic disease and its risk factors are lower than those recommended for Asians by the WHO. Waist-circumference cutoff for defining metabolic syndrome should be lowered in the Korean population. [Copyright &y& Elsevier]

Abstract: Waist circumference (WC) was measured in 200 Japanese patients with type 2 diabetes mellitus (T2DM: male 106, female 94, mean age 61 years old) who had been admitted in our hospital, and relationship with various risk factors to predict future cardiovascular disease (CVD) was analyzed. There was a positive and statistically significant trend in WC levels with an increasing number of CVD risk factors in male patients, whereas no significant trend of WC was observed in female patients. The receiver operator characteristic (ROC) curve for WC to predict the presence of two or more risk factors of CVD depicted greater area under the curve in male patients (0.732) than that in female patients (0.571). Apart from positive correlation with fasting serum C-peptide (S-CPR) and log-transformed high-sensitivity C-reactive protein (log HS-CRP) in both genders, WC was positively correlated with log-transformed triglyceride (log TG), systolic and diastolic blood pressure (SBP and DBP) and negatively with HDL-cholesterol (HDL-C) in male patients, whereas it was negatively correlated with HbA1c and fasting plasma glucose (FPG) in female patients. The change of WC after administration (ΔWC) was correlated with ΔS-CPR, ΔLDL-C, ΔSBP and ΔDBP in male patients, while no relationship was observed in female patients. In conclusion, WC is a reliable marker to predict future CVD events at least in Japanese male, but not female patients with T2DM. [Copyright &y& Elsevier]

Abstract: Aims: The aim of this study was to determine whether the metabolic syndrome (MS) preceded incidence of type-2 diabetes (T2DM) by 5 years and to investigate the interaction between impaired fasting glucose (IFG) and other components of MS. Methods: Subjects were recruited from the cohort study on the prevention of multiple metabolic disorders and MS in Jiangsu province, China; at the 5 years follow-up period (N =1844). The National Cholesterol Education Program Adult Treatment Panel III Asian criterion was used to define MS. In present study, we compared the T2DM risk among individuals with or without MS at baseline. Also the interaction between the IFG and other components of MS were evaluated. Results: Subjects with MS had a 2.3 (1.5–3.6) adjusted relative risk (aRR) of developing T2DM when compared with individuals without non-MS at baseline. Incidentally, the aRRs of MS components were 5.4 (2.6–10.8) for IFG, 2.6 (1.2–5.9) for greater waist circumference, 3.5 (1.6–7.4) for elevated triglyceride, 4.7 (2.3–9.9) for elevated blood pressure, and 2.4 (1.1–5.3) for low high density lipoprotein. After further adjustment of the components of MS, only IFG was found to be statistically significant. The T2DM risk of individuals combined with IFG increased by the number of other MS components. The result of interaction analysis was SI=1.41 but without significance. Conclusions: Subjects with MS were at a higher risk of developing T2DM than those who did not have the syndrome. Also IFG was found to be an excellent predictor of T2DM. However, there was not a significant interaction between IFG and the other MS components. [Copyright &y& Elsevier]

Abstract: A cross-sectional study was performed involving epidemiological and clinical features of the metabolic syndrome (MS) in Spanish migrants to Brazil and their descendants. This included 479 subjects: Group A (Spanish migrants): n =215; Group B (descendants born in Brazil of Spanish parents): n =126, Group C (mixed descendants born in Brazil with either father or mother born in Spain): n =138. MS was defined according to the original NCEP/ATP III criteria and by the revised NCEP/ATP definition (glucose≥100mg/dl). Overall prevalence of MS according to NCEP/ATP III criteria was 26.3%. Age/sex-adjusted prevalence was 27.4%. When the revised NCEP criteria were considered, overall prevalence was 30.1% (age/sex-adjusted 31.3%). The differences between the two criteria were 3.8% and 3.9% (CI −1.9–9.4%). When stratified by groups the MS was more prevalent in Group A (37.2%) and Group B (20.6%) than in Group C (10.9%). Environmental factors may have influenced the development of MS. Reason for the apparently protective role of genetic features due to admixture between populations in the mixed descendants needs to be explored. [Copyright &y& Elsevier]

Abstract: To assess the prevalence of the metabolic syndrome disease cluster in the Hong Kong Chinese population we applied the US National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) guidelines. This was present if ≥3 of the following conditions were present: Hypertension (≥130/85mmHg); fasting plasma glucose was ≥6.1mmol/L; fasting plasma triglycerides ≥1.69mmol/L; fasting HDL-cholesterol <1.04 or <1.29mmol in males and females, respectively; or subjects were receiving treatment for their condition; waist circumference >88 or 102cm (Asian WHO criteria ≥80 or 90cm) in females and males, respectively. A total of 16.7% (17.1 (95%CI 15.7–18.5)% age and gender-adjusted) of the 2893 subjects had the metabolic syndrome. The prevalence of having at least 2, 3, 4 or 5 components was 34.5, 16.7, 6.4 and 1.4%, respectively. The prevalence increased from 3.1% in those aged 25–29 years to 41.0% in those aged over 70 years. Using the 2001 Census, 880,499 Hong Kong residents would have the metabolic syndrome. If the WHO recommended waist circumference for Asians is used, the age and gender-adjusted prevalence is significantly higher at 21.2% (21.9 (95%CI 20.4–23.4)%). In summary, the high prevalence of the metabolic syndrome in adult Hong Kong Chinese, particularly in the elderly, forewarns a rapidly increasing problem in Mainland China, and other Asian populations, which may have overwhelming public health ramifications. [Copyright &y& Elsevier]

To determine whether the clustered features of the metabolic syndrome precede the 7 year incidence of cardiovascular disease (CVD) and type 2 diabetes, we examined 6182 Japanese male office workers aged 35–59 years without any history of CVD. The 5588 subjects without type 2 diabetes also constituted the nondiabetic cohort, and were re-examined over seven successive years. Components of the metabolic syndrome included glycemic disorder (type 2 diabetes for the risk of CVD and impaired fasting glucose for the risk of type 2 diabetes), systemic obesity, hypertension, dyslipidemia, proteinuria, and elevated white blood cell (WBC) count. After controlling for age, family history of diabetes, alcohol intake, and cigarette smoking, the multivariate-adjusted relative risk of incidence of CVD compared with absence of components was 3.18, 3.48, 12.55, and 14.15 (P for trend <0.001), for the presence of 1,2,3, and ≥4 components, respectively. The corresponding relative risks of incidence of type 2 diabetes were 1.92, 4.36, 6.44, and 15.08 (P for trend <0.001). In both non-smokers and current smokers, the multivariate-adjusted relative risks of incidence of CVD and type 2 diabetes increased as the number of components increased (P for trend <0.001 for all). Our findings indicate that clustered features of the metabolic syndrome are closely associated with development of CVD and type 2 diabetes in middle-aged Japanese. [Copyright &y& Elsevier]

Subjects with metabolic syndrome (MetS) had lower FVC and FEV1 than non-MetS subjects and decreased gradually with the increasing number of MetS components. After adjusting for potential risk factors, the lowest quartile of FVC and FEV1 was associated with increased risk of MetS. [ABSTRACT FROM AUTHOR]

Abstract: We investigated if the metabolic syndrome (MetS) and its component risk factors predict cardiovascular disease (CVD) for Aboriginal people from central Australia. WHO (HR 2.83), NCEP (1.80) and IDF (2.47) definitions of the MetS all had positive associations with CVD, however offered little above individual MetS components for hyperglycaemia. [Copyright &y& Elsevier]

Abstract: Atherosclerosis is a systemic disease of blood vessels. We investigated clinical characteristics of Japanese type 2 diabetic patients with polyvascular lesions detected by systemic vascular ultrasonography. The results showed that the metabolic syndrome correlated with polyvascular lesions detected by systemic vascular ultrasonography in Japanese type 2 diabetics. [Copyright &y& Elsevier]

Abstract: We analysed the prevalence of metabolic syndrome (MS) of the new diagnostic criteria and the HbA1c to diagnose dysglycemia. We studied 2006 adults without cardiovascular disease or diabetes. The use of the new criteria and the HbA1c resulted in an increase in the population prevalence of MS. [Copyright &y& Elsevier]

Abstract: We evaluated the ratio of adiponectin level to homeostasis model assessment of insulin resistance (A/H ratio) as a risk marker for metabolic syndrome (MetS) and each of its components. The A/H ratio may prove to be a powerful index for evaluation of risk for MetS and each of its components. [Copyright &y& Elsevier]

Abstract: A total of 350 (184 males and 166 females) adults participated in the study. A sample of 138 individuals was selected randomly for genotyping. The synergistic effect of ACE (I/D) and ApoE (HhaI) on metabolic syndrome (MS) showed that individuals with e4/4+D/D combination had the highest occurrence of metabolic abnormalities. [Copyright &y& Elsevier]

Abstract: The presence of metabolic syndrome (MetS) and its individual components is related to an increased IMT. MetS and increasing numbers of individual MetS components predicted future progression of IMT. Improvement of MetS was related to smaller increases in IMT, especially in females. These findings may suggest a benefit of intervention for MetS, which needs to be confirmed by prospective studies. [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]

Abstract: Polycystic ovary syndrome (PCOS) is characterized by insulin resistance and consequent hyperinsulinemia. Insulin resistance also plays an important role in the metabolic syndrome (MS). We conducted a cross-sectional study to determine the prevalence of the MS in young Korean women with PCOS and whether it is associated insulin resistance. One hundred and seventeen young women with PCOS (age: 26±5, 16–39 years) were evaluated for the frequency of MS according to the modified Adult Treatment Panel III. Total testosterone (T), free T, androstenedione, dehydroepiandrosterone sulfate (DHEAS) and sex hormone binding globulin (SHBG) were measured, and insulin sensitivity was evaluated by euglycemic hyperinsulinemic clamp technique. The prevalence of MS in women with PCOS was 14.5%, nearly 3.5-fold higher than in age-matched women in Korean urban population (4.3%) [J.-Y. Oh, Y.-A. Sung, Y.S. Hong, E. Barrett-Conner, Prevalence and factor analysis of metabolic syndrome in an urban Korean population, Diabetes Care 27 (2004) 2027–2032]. The most frequently occurring component of MS was low HDL cholesterol (45%), and the least frequent was high fasting serum glucose level (0.9%). PCOS women with MS had significantly higher free T, and lower SHBG compared with those without MS. And women with MS showed significantly lower M-value and higher fasting/post-glucose load insulin levels. M-value was still significantly lower in women with MS even after the adjustment for BMI. MS is frequent in young Korean women with PCOS and it reflects more severe insulin resistance. These results suggest the importance of early and regular screening of metabolic disturbance in even young women with PCOS. [Copyright &y& Elsevier]