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Aims: To examine the long-term influence of metabolic syndrome (MetS) on death and vascular complications.Methods: Altogether, 1419 individuals with different levels of glycemia and MetS were recruited for this study. The participants were followed up for 30 years to assess outcomes.Results: Compared with the non_MetS, individuals with impaired glucose tolerance (IGT) plus MetS had a higher incidence (per 1000 person-years) of all-cause death (20.98 vs 11.70, hazard ratio [HR] = 1.84), macrovascular events (29.25 vs 15.94, HR = 1.36), and microvascular complications (10.66 vs 3.57, HR = 1.96). The incidence of these outcomes was even higher in participants with type 2 diabetes mellitus (T2DM) plus MetS. The T2DM without MetS shared a comparable risk profile of the outcomes with the T2DM plus MetS group (HRs were 3.45 vs 3.15, 2.21 vs 2.65, and 6.91 vs 7.41, respectively).Conclusions: The degree of hyperglycemia in MetS is associated with the severity of death and both micro- and macrovascular complications. T2DM was associated with a comparable risk for all outcomes as T2DM plus MetS. The findings highlight the need of early prevention of diabetes in individuals with IGT plus MetS, while the justification to redefine a subgroup of patients with T2DM as having MetS remains to be clarified. [ABSTRACT FROM AUTHOR]

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: Aims: The magnitude of the association between metabolic syndrome (MetS) and incident diabetes is still not widely evaluated in China. This study explored the association of MetS and its components with the development of diabetes among professionals living in Beijing. Methods: Population-based 6-year prospective study. The cohort consisted of 7922 eligible persons aged ≥20. Either fasting glucose (FPG) level ≥7.0mmol/l at the follow-up survey or diagnoses of diabetes during the 6-year period were considered incident diabetes cases. MetS was identified by both the definitions proposed by the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF). Results: The accumulated incidence of diabetes was 3.6% for men and 2.5% for women. MetS associated a 4.7- and 5.7-fold increase of the diabetic risk in men and women, respectively. Hyperglycemia exhibited the highest association with diabetes. FPG of 5.6–5.79mmol/l already presented a risk of diabetes. However, without hyperglycemia in the clustering of any 1, 2, 3 to 4 metabolic components, the tendency of increased diabetic risk was still observed. Conclusions: MetS has a strong association with incident diabetes. Of the individual components, hyperglycemia is the strongest predictor of diabetes. Additional numbers of metabolic components increase the risk of developing diabetes. [Copyright &y& Elsevier]

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: 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: 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: The aim of this study was to compare the strength of association between metabolic syndrome (MetS) and adiponectin, leptin and leptin to adiponectin ratio (L/A) in older Chinese. This study included 950 males (220 with MetS) and 1096 females (452 with MetS), aged 60–96 years from 18 major cities of the 2002 China National Nutrition and Health Survey. The associations of adiponectin, leptin and L/A with components of MetS and MetS were examined using logistic regression and the receiver operating characteristic (ROC) curves. The correlation coefficients of MetS components except fasting glucose with leptin were similar to those with L/A and higher than those with adiponectin. After adjusting for age and BMI, the odds ratio for MetS corresponding to 1 SD change in L/A was higher than those for leptin and adiponectin. L/A had highest area under the curve (AUC) for MetS. However, there was no statistically significant difference in AUC between leptin and L/A, and both indices produced a significantly higher AUC than adiponectin. In conclusion, L/A and leptin may be better diagnostic markers for MetS than adiponectin. After adjusting for BMI, L/A has better ability for correctly classifying subjects with and without MetS than adiponectin or leptin alone. [Copyright &y& Elsevier]

Abstract: The World Health Organisation (WHO), European Group for the Study of Insulin Resistance (EGIR) and National Cholesterol Education Program (NCEP) Expert Panels had introduced definitions for the metabolic syndrome (MES). We aimed to estimate the prevalence of MES in a working population in Hong Kong using the three definitions for MES and compare their relative significance. The data are obtained from a prevalence survey for glucose intolerance and lipid abnormality in a Hong Kong Chinese working population. The distribution of occupational groups in these subjects was similar to that recorded in the Hong Kong Census (1991) and representative of the Hong Kong working population. Definition of obesity was modified using the Asian criterion of body mass index (BMI)≥25kg/m2, waist circumference>80cm in women and >90cm in men. Of the 1513 subjects, 910 (60.1%) were men and 603 (39.9%) were women. The mean age was 37.5±9.2 (median 37.0 years, range 18–66 years). Using the Asian definition for obesity, the prevalence of MES using the WHO criterion was the highest (WHO versus EGIR versus NCEP—overall: 13.4% versus 8.9% versus 9.6%, p &#60;0.001; under age of 40 years: 7.9% versus 4.9% versus 5.4%, p =0.017; age of 40 years or above: 21.9% versus 14.9% versus 16.0%, p =0.003). The prevalence of different components of the MES ranged from 6 to 38%. In subjects aged less than 50 years, there was a male preponderance for MES (male versus female—WHO: 9.5% versus 6.2%, p =0.007; EGIR: 7.9% versus 6.2%, p =0.235; NCEP: 9.5% versus 6.2%, p =0.030) but this trend was reversed after the age of 50 years (WHO: 29.3% versus 31.9%, p =0.721; EGIR: 13.1% versus 34.8%, p =0.001; NCEP: 19.2% versus 23.2%, p =0.533). The prevalence of MES in Hong Kong Chinese of working age ranges from 6.1 to 13.4% depending on various diagnostic criteria. There was a male preponderance before the age of 50 years and a female-preponderance after the age of 50 years. The inclusion of albuminuria and insulin resistance by the WHO has made it the most discriminative criterion in identifying at risk individuals in all age groups. [Copyright &y& Elsevier]