Resting heart rate predicts metabolic syndrome in apparently healthy non-obese Japanese men

Autonomic nervous dysfunction is considered to be one of the mechanisms of metabolic syndrome (MetS). The aim of this study is to investigate whether resting heart rate, a marker of autonomic nervous dysfunction, is a predictor of MetS in apparently healthy non-obese [body mass index (BMI) <25 kg/m(2)] Japanese men. This is an observational study through 3 years in apparently healthy Japanese 1,265 men and 793 women without MetS and with no history of cardiovascular disease and no use of antihypertensive, antidiabetic, or antihyperlipidemic medication at baseline. Hazard ratios (HRs) of incident MetS were calculated for each 1 SD increase in heart rate stratified by gender and obesity. Incidence of MetS for each tertile of heart rate and HRs of MetS for the highest tertile (T3) compared with the lowest tertile (T1) were calculated stratified by gender and obesity. The HRs [95% confidence intervals (CIs)] of MetS for each 1 SD increase in heart rate were 1.319 (1.035-1.681) (p = 0.025) in non-obese men, 1.172 (0.825-1.665) (p = 0.377) in obese men, 1.115 (0.773-1.608) (p = 0.560) in non-obese women, and 1.401 (0.944-2.078) (p = 0.094) in obese women adjusted for BMI, age, smoking, alcohol drinking, and physical activity. The HRs (95% CIs) of MetS for T3 were 2.138 (1.071-4.269) (p = 0.031) in non-obese men and 1.341 (0.565-3.180) (p = 0.506) in obese men adjusted for pre-existing five components of MetS, age, smoking, alcohol drinking, and physical activity. In conclusion, an increase in resting heart rate was a significant predictor of MetS in non-obese Japanese men.

Metabolic syndrome in young people

PURPOSE OF REVIEW

The prevalence of obesity is on the increase, and consequently metabolic syndrome is also becoming a serious health problem in children and adolescents all over the world. This review attempts to summarize the recent literature on metabolic syndrome in children and adolescents.

RECENT FINDINGS

To date, a standard definition of metabolic syndrome for the pediatric population is not available. Recently, the International Diabetes Federation has proposed a new set of criteria to define metabolic syndrome in children and adolescents aged 6-16 years. The relationships between obesity, insulin resistance and metabolic syndrome may be explained by the pattern of lipid partitioning. Fatty liver plays a central role in the insulin-resistant state in obese adolescents. Although insulin resistance has been proposed as the central factor leading to the abnormalities observed in metabolic syndrome, most definitions of metabolic syndrome use impaired fasting glucose as a marker. Nutrition impairment during both prenatal and early postnatal life can cause metabolic disturbances leading to insulin-resistance, type 2 diabetes, hypertension and cardiovascular disease.

SUMMARY

Metabolic syndrome prevalence in children and adolescents is on the increase. Therefore, the emphasis in all studies and programs related to metabolic syndrome should be focused on prevention, early detection of metabolic risk factors and interventions that will have a significant impact on future adult health.

Abnormal metabolic phenotype in middle-aged GH-deficient adults despite long-term recombinant human GH replacement

BACKGROUND

Adult GH deficiency (GHD) is associated with increased cardiovascular mortality. Recombinant human GH (rhGH) replacement has beneficial short-term metabolic effects. Although these positive effects sustain during longer follow-up, the prevalence of the metabolic syndrome (MS) remains increased in comparison with population data not adjusted for the higher mean BMI in GHD adults.

OBJECTIVE

To explore whether middle-aged patients with proposed physiological rhGH replacement have been normalized with respect to MS and its individual components in comparison with the general population, adjusted for age, sex, and BMI.

METHODS

One hundred and sixty-one GHD patients (aged 40-70 years) were studied before the start and after 5 years of rhGH replacement, and were compared with 1671 subjects (aged 45-66 years) from the general population (NEO Study).

RESULTS

MS PROPORTION IN GHD PATIENTS WAS 41.0% BEFORE THE START OF RHGH SUPPLETION, INCREASING TO 53.4% AFTER 5 YEARS (P=0.007). DESPITE CHRONIC RHGH REPLACEMENT, GHD PATIENTS HAD A 1.3-TIMES HIGHER MS PROPORTION THAN THE GENERAL POPULATION, INDEPENDENTLY OF AGE, SEX, AND BMI (95% CI 1.11.5, P=0.008). THE GHD POPULATION SHOWED A DIFFERENT METABOLIC PROFILE THAN THE GENERAL POPULATION WITH SIMILAR BMI: an increased risk of hypertriglyceridemia (adjusted prevalence ratio (PR) 2.0, 95% CI 1.7-2.3) and low HDL-C (adjusted PR 1.8, 95% CI 1.5-2.2), but less hyperglycemia (adjusted PR 0.5, 95% CI 0.4-0.7).

CONCLUSIONS

Despite 5 years of rhGH replacement, GHD patients still have a different metabolic profile and more frequently MS than the general population. These differences were independent of BMI, and resemble the unfavorable metabolic profile of untreated GHD patients, pointing to question the long-term benefits of rhGH replacement.

Lean people with dysglycemia have a worse metabolic profile than centrally obese people without dysglycemia

AIM

This study compared metabolic profiles of Asian Indians with normal waist circumference (WC) and dysglycemia versus those with high WC without dysglycemia.

SUBJECTS AND METHODS

In 2,350 subjects ≥20 years of age from the Chennai Urban Rural Epidemiology Study with full anthropometric and biochemical characterization, high WC was defined as ≥90 cm in males and ≥80 cm in females. Dysglycemia was defined as prediabetes (fasting plasma glucose ≥100 mg/dL and/or 2-h plasma glucose ≥140 mg/dL) or diabetes (fasting plasma glucose ≥126 mg/dL, 2-h plasma glucose ≥200 mg/dL, or treatment for diagnosed diabetes). Coronary artery disease (CAD) was defined as known myocardial infarction or Q waves on electrocardiography. Multivariable logistic regression models were used to explore factors associated with CAD.

RESULTS

Of the subjects, 260 (11.1%) had dysglycemia with normal WC, and 679 (28.9%), had high WC without dysglycemia. Compared with subjects with high WC without dysglycemia, those with dysglycemia/normal WC, adjusted for age, were more likely to be males (P<0.001) and have higher systolic blood pressure (P<0.05), higher serum triglycerides (P<0.001), higher tumor necrosis factor-α (P<0.001), lower high-density lipoprotein cholesterol (P<0.05), and higher prevalence of CAD (6.3% vs. 2.0%; odds ratio 3.25 [95% confidence interval 1.52-6.94]; P=0.002).

CONCLUSIONS

Dysglycemia is associated with a worse cardiometabolic profile than central obesity alone.

Is thyroid-stimulating hormone within the normal reference range a risk factor for atherosclerosis in women?

The relationship between overt hypothyroidism and cardiovascular risk has been well documented and some data also suggest an association between cardiovascular risk and subclinical hypothyroidism. The aim of our study was to investigate, in a large cohort of euthyroid women, the association of thyroid stimulating hormone (TSH) within the normal reference range with cardiovascular risk factors. The study was carried out on 744 women with normal thyroid function (TSH 0.3-4.9 μU/mL). Women with TSH above the median (≥2.1 μU/mL) were more obese, had greater waist girth, were more hypertensive and had higher levels of total cholesterol (TC), serum triglycerides (TG), blood sugar (BG) and lower levels of HDL-cholesterol (HDL-C) than women with TSH below the median. TSH was significantly correlated with body mass index (BMI), waist circumference, BG, TG, TC, HDL-C and hypertension. Multiple backward stepwise regression analysis with age, waist circumference and TSH as independent variables confirmed the strong association of TSH with BG, TG, HDL-C and hypertension. A total of 205 patients (28%) fulfilled the definition criteria of the metabolic syndrome and the prevalence of metabolic syndrome was significantly greater in patients with TSH above than in patients with TSH below the median. Results of logistic analysis, including age and TSH as predictor variables, confirmed the association of TSH with metabolic syndrome.The results of this study suggest that TSH in the upper limits of the reference range (above 2.1 μU/ml) is associated with a less favourable cardiometabolic profile and consequently with a higher risk of developing cardiovascular diseases.

Lower serum endogenous secretory receptor for advanced glycation end product level as a risk factor of metabolic syndrome among Japanese adult men: a 2-year longitudinal study

CONTEXT

Receptor for advanced glycation end products (RAGE) activation by its ligands is implicated in obesity-related metabolic disease and accelerated atherothrombosis. Circulating soluble (sRAGE) and/or endogenous secretory RAGE (esRAGE) may counteract the detrimental effects of RAGE.

OBJECTIVE

This study aimed at determining the relationship between circulating RAGE and metabolic syndrome (MetS) incidence among Japanese adult men.

METHODS

This 2-year longitudinal study included 426 Japanese men aged 30-83 years who had no MetS at baseline. Serum esRAGE and sRAGE were assayed by ELISA at baseline. Incident metabolic syndrome, defined according to the Asian cutoff based on the 2009 criteria of the American Heart Association Scientific Statements, was evaluated after the 2-year follow-up.

RESULTS

During the follow-up period, 55 participants (12.9%) had newly diagnosed MetS. In the multiple logistic models comparing MetS risk in the lowest with that in the highest tertile of baseline esRAGE, a high serum esRAGE level was found to be significantly associated with a low risk of MetS [odds ratios (95% confidence interval), 0.37 (0.14-0.95); P for trend = 0.038] after adjusting for lifestyle and sociodemographic factors, serum high-sensitivity C-reactive protein level, estimated glomerular filtration rate, and MetS components at baseline. Although sRAGE and esRAGE were strongly correlated (r(s) = 0.88), the sRAGE level was not associated with MetS incidence.

CONCLUSIONS

A high circulating esRAGE level, but not sRAGE level, was associated with a low MetS incidence among Japanese adult men.

Metabolic syndrome risk after gestational diabetes: a systematic review and meta-analysis

BACKGROUND

A number of studies have been conducted to investigate the risk of metabolic syndrome (MS) after gestational diabetes mellitus (GDM), but the results are contradictory. Accordingly, we performed a systematic review and meta-analysis to assess the association between these two conditions. The aim was to better understand the risks of MS with prior gestational diabetes.

METHODS

Pubmed, ISI Web of Science, and Cochrane databases from September 1, 1979 to July 11, 2013 were searched to identify relevant studies. 17 studies containing 5832 women and 1149 MS events were included. We calculated the odds ratio (OR) with 95% confidence interval (CI) in analysis for each study using a random-effect or fixed-effect model. We also determined heterogeneity among these 17 articles and their publication bias.

RESULTS

Women with a history of gestational diabetes had a significantly higher risk of MS than those who had a normal pregnancy (OR, 3.96; 95% CI, 2.99 to 5.26), but had significant heterogeneity (I (2) = 52.6%). The effect remained robust (OR, 4.54; 95% CI, 3.78-5.46) in the subgroup of Caucasians, but no association (OR, 1.28; 95% CI, 0.64-2.56) was found in Asians. Heterogeneity was reduced (body mass index (BMI) matched group I (2) = 14.2%, BMI higher in the GDM group I (2) = 13.2%) in the subgroup of BMI. In addition, mothers with higher BMI in the GDM group had higher risk of MS than those in the BMI matched group (BMI higher in GDM group OR, 5.39; 95% CI, 4.47-6.50, BMI matched group OR, 2.53; 95% CI, 1.88-3.41).

CONCLUSIONS

This meta-analysis demonstrated increased risk of MS after gestational diabetes. Therefore, attention should be given to preventing or delaying the onset of MS in GDM mothers, particularly in Caucasian and obese mothers.

Obesity and the metabolic syndrome in developing countries: focus on South Asians

With improvement in the economic situation, an increasing prevalence of obesity and the metabolic syndrome is seen in developing countries in South Asia. Particularly vulnerable population groups include women and children, and intra-country and inter-country migrants. The main causes are increasing urbanization, nutrition transition, reduced physical activity, and genetic predisposition. Some evidence suggests that widely prevalent perinatal undernutrition and childhood 'catch-up' obesity may play a role in adult-onset metabolic syndrome and type 2 diabetes. Data show that atherogenic dyslipidemia, glucose intolerance, thrombotic tendency, subclinical inflammation, and endothelial dysfunction are higher in South Asians than white Caucasians. Many of these manifestations are more severe even at an early age in South Asians than white Caucasians. Metabolic and cardiovascular risks in South Asians are also heightened by their higher body fat, truncal subcutaneous fat, intra-abdominal fat, and ectopic fat deposition (liver fat, muscle fat, etc.). Further, cardiovascular risk cluster manifests at a lower level of adiposity and abdominal obesity. The cutoffs of body mass index and waist circumference for defining obesity and abdominal obesity, respectively, have been lowered for Asians, and same has been endorsed for South Asians in the UK. The economic cost of obesity and related diseases in developing countries, having meager health budget, is enormous. Increasing awareness of these noncommunicable diseases and how to prevent them should be focus of population-wide prevention strategies in South Asian developing countries. Community intervention programs focusing on increased physical activity and healthier food options for schoolchildren are urgently required. Data from such a major intervention program conducted by us on adolescent urban schoolchildren in north India (project MARG) have shown encouraging results and could serve as a model for initiating such programs in other South Asian developing countries.

Adiposity measurements in association with metabolic syndrome in older men have different clinical implications

Obesity is a major public health problem, and measuring adiposity accurately and predicting its future comorbidities are important issues. Therefore, we hypothesized that 4 adiposity measurements, body mass index (BMI), waist circumference (WC), waist-to-height ratio, and body fat percentage, have different physiological meanings and distinct associations with adverse health consequences. This study aimed to investigate the relationship of these 4 measurements with metabolic syndrome (MetS) components and identify the most associated factor for MetS occurrence in older, non-medicated men. Cross-sectional data from 3004 men, all 65 years of age and older, were analyzed. The correlation and association between adiposity measurements and MetS components were evaluated by Pearson correlation and multiple linear regression. Based on multivariate logistic regression, BMI and WC were significantly associated with MetS and were selected to build a combined model of receiver operating characteristic curves to increase the diagnosis accuracy for MetS. The results show that BMI is independently associated with systolic and diastolic blood pressure; WC and body fat percentage are associated with fasting plasma glucose and log transformation of triglyceride; BMI and WC are negatively associated with high-density lipoprotein cholesterol (HDL-C); and WC is a better discriminate for MetS than BMI, although the combined model (WC + BMI) is not significantly better than WC alone. Based on these results, we conclude that the 4 adiposity measurements have different clinical implications. Thus, in older men, BMI is an important determinant for blood pressure and HDL-C. Waist circumference is associated with the risk of fasting plasma glucose, HDL-C, triglyceride, and MetS occurrence. The combined model did not increase the diagnosis accuracy.

Therapeutic interventions for hypertension in metabolic syndrome: a comprehensive approach

Hypertension is a major component of the metabolic syndrome and a major cardiovascular risk factor. Both disorders are rapidly increasing in frequency, with hypertension affecting nearly 60 million Americans and over 1 billion people worldwide, and metabolic syndrome affecting 44% of the US population above the age of 60 years. Sedentary lifestyle, together with obesity and aging of the population, are the major contributing factors for this growing epidemic. Hypertension in metabolic syndrome possesses unique pathophysiological aspects that have considerable implications on therapy of this disease. In this article, we review the pathophysiology and provide a rationale for the current therapeutic options in light of the most recent clinical trials in the field.

Tree nuts are inversely associated with metabolic syndrome and obesity: the Adventist health study-2

OBJECTIVE

To examine the relationships of nut consumption, metabolic syndrome (MetS), and obesity in the Adventist Health Study-2, a relatively healthy population with a wide range of nut intake.

RESEARCH DESIGN AND METHODS

Cross-sectional analysis was conducted on clinical, dietary, anthropometric, and demographic data of 803 adults. MetS was defined according to the American Heart Association and the National Heart, Lung, and Blood Institute diagnostic criteria. We assessed intake of total nuts, tree nuts and peanuts, and also classified subjects into low tree nut/low peanut (LT/LP), low tree/high peanut (LT/HP), high tree nut/high peanut (HT/HP), and high tree/low peanut (HT/LP) consumers. Odds ratios were estimated using multivariable logistic regression.

RESULTS

32% of subjects had MetS. Compared to LT/LP consumers, obesity was lower in LT/HP (OR = 0.89; 95% CI = 0.53, 1.48), HT/HP (OR = 0.63; 95% CI = 0.40, 0.99) and HT/LP (OR = 0.54; 95% CI = 0.34, 0.88) consumers, p for trend = 0.006. For MetS, odds ratios (95% CI) were 0.77 (0.47, 1.28), 0.65 (0.42, 1.00) and 0.68 (0.43, 1.07), respectively (p for trend = 0.056). Frequency of nut intake (once/week) had significant inverse associations with MetS (3% less for tree nuts and 2% less for total nuts) and obesity (7% less for tree nuts and 3% less for total nuts).

CONCLUSIONS

Tree nuts appear to have strong inverse association with obesity, and favorable though weaker association with MetS independent of demographic, lifestyle and dietary factors.

Gender difference in the association of metabolic syndrome and its components with age-related cataract: the Korea National Health and Nutrition Examination Survey 2008-2010

Purpose

To explore the relationship of the metabolic syndrome (MetS) and its components with age-related cataract in a representative Korean population.

Methods

We analyzed the data from the Korea National Health and Nutrition Examination Surveys (2008–2010). A total of 11,076 adults (4,811 men and 6,265 women) aged 40 and over who completed ophthalmologic examination were evaluated. Cataract was defined as the presence of cortical, nuclear, anterior (sub)capsular or posterior subcapsular cataract, from slit-lamp examination or previous cataract surgery. MetS was defined according to the Joint Interim Statement proposed in 2009 from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute.

Results

The prevalence of cataract and MetS in this population was 39.4% (37.1% for men and 41.6% for women) and 38.5% (37.6% for men and 39.4% for women), respectively. Cataract prevalence tended to increase with the number of MetS components in both genders (both P< 0.001). After being controlled for confounders, however, MetS was significantly associated with cataract only in women (adjusted odds ratio (aOR), 1.24; 95% confidence interval (CI), 1.02–1.50]. Reduced HDL cholesterol, elevated fasting glucose, and elevated triglycerides were also significantly associated with cataract in women (aOR, 95% CI; 1.27 (1.07–1.50), 1.23 (1.01–1.50), and 1.26 (1.04–1.52), respectively). In the subgroup analysis for cataract subtype, MetS and reduced HDL cholesterol were significantly associated with nuclear cataract in women (aOR, 95% CI; 1.25 (1.07–1.55) and 1.25 (1.03–1.52), respectively). However, such associations were not found in men.

Conclusions

Our results suggest that MetS and its components appear to be associated with age-related cataract only among Korean women, especially in nuclear cataract.

[Physical activity reference for health promotion 2013 and the prevalence of metabolic syndrome: A cross-sectional study]

OBJECTIVES

This study aimed to examine the association between meeting the reference value for physical activity (PA) defined in the "Physical activity reference for health promotion 2013" recommendations or incremental increases in PA (add 10-minute per day) and the prevalence of metabolic syndrome (MS).

METHODS

A total of 906 adults aged 23-64 years participated in this cross-sectional study. The amount of moderate to vigorous PA was measured with a tri-axial accelerometer. The participants were classified into 2 groups-those with a PA level greater than or equal to the reference value of 23 metabolic equivalents (METs)-hours/week versus those with a PA level less than the reference value. Pre-MS and MS were determined based on the diagnostic criteria used in Japan. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the prevalence of pre-MS and MS by adherence with the PA reference value were analyzed using a multivariable logistic regression model. Furthermore, adjusted ORs were calculated for each 3.5 METs-hours/week increase in PA, which is comparable to 10-minute increments of PA such as walking.

RESULTS

The prevalence rates of pre-MS and MS were 10.3% (n=93) and 4.4% (n=40), respectively. The adjusted OR (95% CI) for the prevalence of pre-MS/MS among the participants meeting the PA reference compared with those not meeting the reference was 0.49 (0.33-0.74). Each 3.5 METs-hours/week increase in PA was associated with a lower adjusted OR for the prevalence of pre-MS/MS (OR 0.92, 95% CI 0.87-0.98).

CONCLUSION

Our results suggest that meeting the reference value for PA (as defined in the "Physical activity reference for health promotion 2013" recommendations) and an increase in PA (add 10-minute) are both associated with a lower prevalence of pre-MS/MS.

[Psoriasis and comorbidity--literature review]

Nowadays we know that psoriasis is more than "skin deep": it is considered a systemic disease. An increasing number of studies on the pathogenesis of psoriasis have shown that this disease is associated with metabolic disorders such as obesity, diabetes and cardiovascular diseases. Psoriasis appears to be a risk factor for the development of these diseases. That is why the concept of "psoriatic march" was proposed to demonstate that severe psoriasis may cause cardiovascular diseases. Many epidemiological studies have shown frequent coexistence of metabolic syndrome (insulin resistance, atherogenic dyslipidemia, obesity, hypertension and diseases of the cardiovascular system) in patients with severe course of psoriasis. Additionally, we observe a frequent coexistence of autoimmune disorders and cancers in patients with psoriasis. Suffering from psoriasis causes impaired self-esteem and depressive disorders. It is a source of stress for the patients, making them more likely to use alcohol or cigarettes.

[Relationship between the attitudes towards improving eating habits and prevalence of metabolic syndrome. Data from the 2005 National Health and Nutrition Survey and the Comprehensive Survey of Living Conditions]

OBJECTIVES

The aim of the present study was to examine the constructive attitudes towards improving eating habits and their relationship with the prevalence of metabolic syndrome (MetS) using data from the National Health and Nutrition Survey (2005) and the Comprehensive Survey of Living Conditions (2005).

METHODS

Individuals aged >30 years (N=3084) were enrolled in this study. Exploratory factor analyses were performed to examine the constructive attitudes towards improving eating habits by using 14 parameters. In addition, confirmatory factor analysis was performed and the Cronbach α value was calculated. Furthermore, the relationship between attitudes towards improving eating habits and MetS prevalence was examined according to gender by using multinomial logistic regression analysis, after adjusting for age, number of members in a household, exercise habits, and rest by sleeping.

RESULTS

Two factors were extracted: balanced diet (BD) and control of food intake (CFI) (Cronbach α, 0.82 and 0.75, respectively). The goodness of fit model, based on the structural equation models, was adequate (goodness of fit, 0.96). No relationship was noted between BD and MetS prevalence. The MetS prevalence differed according to gender: "Strongly suspected MetS (sure MetS)", 16.3% (male, 24.4%; female, 10.7%), "Preliminary MetS (pre MetS)", 15.2% (male, 24.1%; female, 8.9%), "non-suspected MetS (non MetS)", 68.5% (male, 51.5%; female, 80.5%). The odds ratios (95% confidence interval) for pre MetS and sure MetS were 0.57 (0.42-0.78) and 0.52 (0.38-0.71) in males and 0.36 (0.25-0.53) and 0.39 (0.27-0.56) in females, respectively, when non MetS was used as a reference.

CONCLUSION

The results of this study indicated that the attitudes towards improving eating habits primarily focused on BD and CFI. Therefore, improving eating habits towards in terms of better CFI would be effective in preventing MetS in both genders.

Changing epidemiology of metabolic syndrome and type 2 diabetes in Chinese youth

China is gradually taking its place as one of the world's economic giants and concurrently learning to understand how to bear the burdens of diseases that are more common in the fully developed world, such as pediatric obesity, metabolic syndrome, and type 2 diabetes mellitus. The purpose of this review is to consolidate the available information regarding these and draw the focus toward their sequential progression and increasing prevalence in Chinese children. Studies were collected in both English and Chinese, and the data were reviewed on the basis of disease prevalence and risk factors that are known from scientific literature that has been published to date. The majority of studies with appropriate content for inclusion here have been conducted within the last 15 years and up to date information from recent local and international research has also been included. Several factors have been implicated for the rise in obesity, most notably, the progressing economic expansion and exposure of local Chinese populations to Western influences. With this, metabolic syndrome has become a growing concern, as it is a precursor to cardiovascular disease and type 2 diabetes, leading to the alarmingly rapid development of deleterious consequences in children. The International Diabetes Federation proposed a definition for metabolic syndrome in 2007 (MS-IDF2007) worldwide, but whether it is also suitable for the Chinese population remains uncertain, so we have created the Chinese definition of metabolic syndrome upon the IDF framework. This MS-CHN2012 definition is based on multicenter studies to simplify and standardize primary care screening methods and is the first of its kind in China. Juvenile type 2 diabetes is the most worrisome result of obesity and metabolic syndrome, and studies have shown that the prevalence has doubled within 5 years-surpassing the prevalence of juvenile type 1 diabetes. Because of the extremely low number of studies currently published on these topics in China, emphasis needs to be placed on the assessment of the health status of the population. Screening methods are imperative because lifestyle interventions can reduce and even reverse the pathologic consequences of this disease, if detected early.

Metabolic syndrome: comparison of prevalence in young adults at 3 land-grant universities

OBJECTIVE

The study examines metabolic syndrome (MetS) among college students at 3 geographically distinct US campuses.

PARTICIPANTS

Undergraduates (N = 360; 68% women), 18 to 24 years of age, were recruited at each public university in January and February 2011. MetS prevalence was evaluated in 83% (n = 299) participants.

METHODS

Anthropometric, biochemical, and clinical measures were collected in the fasted state.

RESULTS

Twelve percent of college men and 6% of college women met the clinical definition of MetS. Males were more likely to have ≥ 2 individual MetS criteria than females (33% vs 16%; p < .05). Prevalence and individual criteria of MetS differed between the 3 regions. Obese and overweight students met significantly more MetS criteria and had higher C-reactive protein levels than normal-weight students (both p < .05).

CONCLUSION

Findings suggest that MetS prevalence among college students differs by sex, weight status, and region. Further research is needed to identify effective, targeted interventions that are regionally appropriate for this population.

[Clinical evaluation of the influence of certain initial status parameters on the development of type 2 diabetes mellitus in patients with metabolic syndrome]

Type 2 diabetes mellitus (DM2) is one of the clinical outcomes of metabolic syndrome (MS). We observed 201 patients with MS during 10 years. At the study end-point 144 (71.9%) of them developed DM2. The study aimed at evaluating effect of initial parameter of MS on the rate of DM2 development. Results of correlation analysis show that the rate of DM2 development depends in the first place on the patients' age, severity of abdominal obesity, vicious habits and their combination with disturbed lipid metabolism, sympatho-adrenal disbalance , and arterial hypertension rather than on disordered carbohydrate metabolism at the onset of the disease.

[Hepatic steatosis and fatty pancreas--2 targets of metabolic syndrom in children]

OBJECTIVES

This study aimed to assess frequency of association between hepatic steatosis and pancreatic steatosis in obese children and find out common chains of pathogenesis.

METHODS

This study was conducted among 100 children aged 12-17 years, consisted 2 groups: 60 overweight children (BMI from 30,1 to 42,87-1st group) and 40 children with normal BMI (2nd group). Diagnosis of the hepatic steatosis and pancreatic steatosis was based on sonographic findings. Were investigated peculiarities of carbohydrates and lipid metabolism and pancreatic exocrine function.

RESULTS

Sonographic findings compatible with pancreatic steatosis in obese children were found with frequency- 70%, whereas sonographic findings compatible with hepatic steatosis were found with frequency- 46.6%. These findings were associated with BMI, parameters of metabolic syndrome: waist circumference, insulinresistancy, disturbances of the carbohydrates and lipid metabolism. Was found decreasing level of the elastase-1 in children with obesity.

CONCLUSION

In 70% obese children was found pancreatic steatosis. The presence of fatty pancreas represents a meaningful manifestation of metabolic syndrome together with obesity and hepatic steatosis.

Metabolic syndrome and C-reactive protein concentration as independent correlates of chronic kidney disease

Inflammation is a common phenotype for cardiometabolic disorders. In this study, we attempted to investigate inter-relationships between metabolic syndrome (MetS), C-reactive protein (an inflammatory biomarker) and chronic kidney disease (CKD). We performed a cross-sectional analysis of data from a representative sample of 4425 Chinese adults in Taiwan. The MetS was defined by a unified criteria set by several major organizations. A CKD event was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m(2). Additionly, a CRP cutpoint of 3 mg/L was used to differentiate high and low CRP levels. Overall, 1000 participants had MetS, resulting in a prevalence rate of 22.6%. High CRP level was noted in 782 (17.6%) subjects. In addition, a total of 508 (11.5%) persons qualified as having CKD. Subjects with the MetS had 1.55-fold [95% confidence interval (CI), 1.03-2.32] increased odds of CKD compared with their counterparts without the MetS after multiple adjustments. In addition, there was a significantly graded relationship between increasing levels of serum CRP and prevalent CKD (p for trend = 0.001). Participants in the highest category of serum CRP had a significantly elevated odds of CKD as compared with those in the lowest category [odds ratio (OR), 1.60; 95% CI, 1.21-2.12]. However, there was no interaction in excess of additive scale between the presence of MetS and high CRP level (p = 0.83). These findings suggest that MetS and high CRP were independently associated with increased prevalence of CKD in Chinese adults.

[Associations of the prevalence of cardiovascular diseases with a high level of depression in the open population of an average urbanized Siberian town]

AIM

To reveal an association of the prevalence of coronary heart disease (CHD) and metabolic syndrome (MS) with a high level of depression in the open population of 25-64-year-old men in an average urbanized Siberian town.

SUBJECTS AND METHODS

The survey was conducted on a representative sample formed from the voting list of 25-64-year-old men in one of the administrative districts of Tyumen. The standard WHO MONICA-psychosocial questionnaire was used to study associations of the prevalence of CHD and MS with a high level of depression within cardiologic screening.

RESULTS

The age-adjusted prevalence of depression was 4.6% (a high rate) and 19% (a moderate rate) in the 25-64-year-old men of the average urbanized town of West Siberia. With advancing age, the high level of depression increased, peaking in a 55-64-year-old group. In high depression and CHD in the 25-64-year-old men, the odds ratio (OR) was 21.07 for high depression and 39.84 for a definite CHD form. High depression was significantly more common in MS patients in the open population of 25-64-year-old people of the average urbanized Siberian town and in the 55-64 year old age group. An association was found between high depression and a combination of MS components: a concurrence of abdominal obesity, hypertriglyceridemia, and lower high-density lipoprotein cholesterol (OR 13.13).

CONCLUSION

The epidemiological criteria revealed by standardized survey methods for psychosocial factors, depression in particular, should be used during the preventive examinations of a male population and during the selection of able-bodied people with cardiovascular disease to undergo in-depth examination and follow-up.

[Peculiarities of the strategy for the treatment of elderly patients with duodenal ulcer and concomitant metabolic syndrome]

The study showed that ulcer disease in patients with metabolic syndrome is characterized by painless clinical course, bowel disorders in the form of constipation, enhanced appetite, unmotivated requirement for hypoglycemic therapy predisposition to complications along with activation of the inflammatory process in duodenal mucosa, high H. pylori count. The data obtained were used to develop the age-specific strategy for the treatment of elderly patients with duodenal ulcer and concomitant metabolic syndrome.

Relation between sleep duration, overweight, and metabolic syndrome in Korean adolescents

BACKGROUND AND AIMS

The increasing prevalence of obesity has been paralleled by a trend of reduced sleep duration. Sleep is considered a modulator of neuroendocrine function. The aim of this study was to determine the relation between sleep duration, overweight, and metabolic syndrome in Korean adolescents.

METHODS AND RESULTS

This study was based on data from the Korean National Health and Nutrition Examination Survey (KNHANES) IV. Data from 1187 adolescents aged 12-18 years were included in the analysis. Subjects were classified according to self-reported sleep duration: ≤ 5 h, 6-7 h, 8-9 h, and ≥ 10 h. We analysed the association between sleep duration, overweight, and metabolic syndrome after adjustment for potential confounding variables. Body mass index (BMI), waist circumference (WC), and diastolic blood pressure (DBP) were higher in subjects who slept ≤ 5 h, and triglyceride level was higher in subjects who slept ≥ 10 h. According to logistic regression analysis, subjects who slept ≤ 5 h had a higher risk of overweight (odds ratio (OR) 2.04, 95% confidence interval (CI) 1.17-3.57) and elevated blood pressure (BP) (OR 2.11, 95% CI 1.22-3.65). We did not find any association between sleep duration and metabolic syndrome. Subjects who slept ≥ 10 h had a higher risk of hypertriglyceridemia (OR 2.17, 95% CI 1.14-4.13).

CONCLUSION

Short sleep duration was associated with overweight in adolescents. Although there was no association between sleep duration and metabolic syndrome, short sleep duration was associated with elevated BP and long sleep duration was associated with hypertriglyceridemia.

Low skeletal muscle mass is associated with insulin resistance, diabetes, and metabolic syndrome in the Korean population: the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010

Sarcopenia is an emerging risk factor for metabolic disorders. No study of the association of sarcopenia with insulin resistance, diabetes, and metabolic syndrome (MS) according to age group and obesity status in the general population has been reported. We investigated these associations in the Korean population. Participants included 4558 males and 5874 females, who were ≥20 years of age or older from the fourth and fifth Korea National Health and Nutritional Examination Surveys of the Korean population (2009 and 2010). Age was categorized according to three groups (20-39, 40-59, and ≥ 60 years). Obesity was defined according to body mass index. Sarcopenia was defined as the appendicular skeletal muscle mass (ASM) divided by weight (Wt) (%) of > 2SD below the sex-specific mean for young adults. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. After adjustment for confounding variables, sarcopenia showed a significant association with HOMA-IR in the non-obese group (P<0.001). Sarcopenia was found to be a risk factor for diabetes in the non-obese group (OR, 2.140; 95% CI, 1.549-2.956; P<0.001). Sarcopenia also showed an association with MS in the non-obese group (OR, 2.209; 95% CI, 1.679-2.906; P<0.001), but not in the obese-group. However, these results were not relevant to young age group. In conclusion, sarcopenia showed an association with insulin resistance, diabetes, and MS, in the non-obese population. Sarcopenia may be an early predictor for diabetes and MS susceptibility in the non-obese population, particularly in elderly people.