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Prevalence of cardio-metabolic syndrome in Nigeria: a systematic review. Public Health 2015; 129:413-23. [DOI: 10.1016/j.puhe.2015.01.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 01/17/2015] [Accepted: 01/20/2015] [Indexed: 11/22/2022]
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Vidigal FDC, Ribeiro AQ, Babio N, Salas-Salvadó J, Bressan J. Prevalence of metabolic syndrome and pre-metabolic syndrome in health professionals: LATINMETS Brazil study. Diabetol Metab Syndr 2015; 7:6. [PMID: 25717347 PMCID: PMC4339435 DOI: 10.1186/s13098-015-0003-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 01/28/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The metabolic syndrome (MS) is characterized by several cardiovascular risk factors and is associated with an increased incidence of diabetes, cardiovascular events and mortality. The prevalence of MS is increasing in epidemic proportions worldwide. The present study aimed to investigate the prevalence of MS and its components in health professionals in the municipality of Viçosa, Brazil. METHODS Cross-sectional observational study in the frame of the LATIN America METabolic Syndrome (LATINMETS) multicenter study. The study sample consisted of 226 healthcare personnel (20-59 years). Weight, height, waist circumference and hip circumference were determined. The following anthropometric indices were calculated: body mass index (BMI), waist/hip ratio, waist/height ratio, body adiposity index (BAI) and conicity index. Body composition was assessed by tetrapolar bioelectrical impedance. The lipid profile, fasting glucose, insulin, uric acid, high-sensitive C-reactive protein (hs-CRP) and complement C3 were measured in fasting conditions. Insulin resistance was assessed by the Homeostasis Model Assessment Index of Insulin Resistance (HOMA-IR). RESULTS Of the 226 healthcare individuals included in the study, 74.3% were female, 77.0% graduated and 23.0% students of the last two years of courses in health area, with a median age of 27 years. The overall prevalence of MS was 4.5%, and increased with age (20 to 29 years: 1.3%; 30 to 39 years: 5.6%; ≥ 40 years: 26.3%) (P < 0.01). The presence of pre-MS and MS was associated with several measures of adiposity, total cholesterol/HDL-c and LDL-c/HDL-c ratios and serum complement C3 concentrations. CONCLUSIONS The LATINMETS Brazil study reported an association between MS prevalence and age, especially in those over 40 years. The presence of MS is associated with an increased prevalence of several cardiovascular risk factors.
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Affiliation(s)
- Fernanda de Carvalho Vidigal
- />Postgraduate Program in Nutrition Science, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Andréia Queiroz Ribeiro
- />Postgraduate Program in Nutrition Science, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Nancy Babio
- />Human Nutrition Unit, Department of Biochemistry and Biotechnology, University Hospital Sant Joan de Reus, IISPV, Faculty of Medicine and Health Sciences, Rovira i Virgili University, Tarragona, Spain
- />CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- />Human Nutrition Unit, Department of Biochemistry and Biotechnology, University Hospital Sant Joan de Reus, IISPV, Faculty of Medicine and Health Sciences, Rovira i Virgili University, Tarragona, Spain
- />CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Josefina Bressan
- />Postgraduate Program in Nutrition Science, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
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Pokharel DR, Khadka D, Sigdel M, Yadav NK, Acharya S, Kafle RC, Shukla PS. Prevalence of metabolic syndrome in Nepalese type 2 diabetic patients according to WHO, NCEP ATP III, IDF and Harmonized criteria. J Diabetes Metab Disord 2014; 13:104. [PMID: 25469328 PMCID: PMC4251856 DOI: 10.1186/s40200-014-0104-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 10/21/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) present in type 2 diabetic patients greatly increases the risk of strokes and cardiovascular diseases. Timely detection and mapping of MetS facilitates appropriate preventive and therapeutic approaches to minimize these risks. Our study aimed to determine the prevalence of MetS among Nepalese type 2 diabetic patients using WHO (1999), NCEP ATP III (2001), IDF (2005) and Harmonized (2009) definitions and identify the diagnostic concordance and disparity resulting from these four definitions. METHODS Clinical and biochemical data were collected for 1061 type 2 diabetic patients at Manipal Teaching Hospital, Pokhara, Nepal. The data was analyzed in order to identify prevalence of MetS in these patients. Statistical analysis included usage of Student's t- and Chi-square tests, kappa statistics and 95% confidence intervals. RESULTS The total age adjusted prevalence rates of MetS were 80.3%, 73.9%, 69.9% and 66.8% according to Harmonized, NCEP ATP III, WHO and IDF definitions, respectively. Prevalence increased with the age and was higher in females (p <0.001) according to WHO, NCEP ATP III and Harmonized definitions. Patients of Dalit community had the highest prevalence (p<0.05) according to NCEP ATP III and Harmonized definitions while Mongoloid and Newar patients had the highest prevalence (p <0.05) according to WHO and IDF definitions, respectively. Prevalence was also highest among patient engaged in agriculture occupation. Central obesity and hypertension were respectively the most and the least prevalent components of MetS. The highest overall agreement was between Harmonized and NCEP ATP III definitions (κ =0.62, substantial) and the lowest between WHO & IDF definitions (κ=0.26, slight). The Harmonized definition had the highest sensitivity (99.9%) and negative predictive value (98.9%) while NCEP ATP III definition had the highest specificity (98.9%) and positive predictive values (99.9%) in identifying the cases of MetS. CONCLUSIONS The prevalence of MetS among Nepalese type 2 diabetic patients was very high suggesting that these patients were at increased risk of strokes, cardiovascular diseases and premature death. The Harmonized definition was the most sensitive while NCEP ATP III and IDF definitions were the most specific in detecting the presence of MetS in Nepalese type 2 diabetic patients.
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Affiliation(s)
- Daya Ram Pokharel
- Department of Biochemistry, Manipal College of Medical Sciences and Teaching Hospital, Pokhara, Nepal
| | - Dipendra Khadka
- Department of Laboratory Medicine, Gandaki Medical College Teaching Hospital and Research Center, Prithvi Chowk, Pokhara Nepal
| | - Manoj Sigdel
- Department of Biochemistry, Manipal College of Medical Sciences and Teaching Hospital, Pokhara, Nepal
| | - Naval Kishor Yadav
- Department of Biochemistry, Manipal College of Medical Sciences and Teaching Hospital, Pokhara, Nepal
| | - Shreedhar Acharya
- Department of Planning and Research, Cambrian College of Arts and Technology, 1400 Barrydowne Road, Sudbury, ON P3A 3 V8 Canada
| | - Ram Chandra Kafle
- Department of Internal Medicine, Manipal College of Medical Sciences and Teaching Hospital, Pokhara, Nepal
| | - Pramod Shankar Shukla
- Department of Biochemistry, Manipal College of Medical Sciences and Teaching Hospital, Pokhara, Nepal
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Mogre V, Salifu ZS, Abedandi R. Prevalence, components and associated demographic and lifestyle factors of the metabolic syndrome in type 2 diabetes mellitus. J Diabetes Metab Disord 2014; 13:80. [PMID: 25054102 PMCID: PMC4106220 DOI: 10.1186/2251-6581-13-80] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 07/07/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Adults with the metabolic syndrome (MetS) are twice as likely to die from and three times as likely to have a heart attack or stroke compared with people without the syndrome. About 70-80% of type 2 diabetes mellitus (type 2 DM) patients are diagnosed with the MetS. Investigating the occurrence of the MetS in type 2 DM patients is critical for cardiovascular disease prevention. We evaluated the prevalence and components of the MetS and its associated clinical and demographic factors in a Ghanaian adult population with DM 2. METHODS This cross-sectional study was conducted among 200 previously diagnosed type 2 DM patients receiving care from an outpatient clinic of the Tamale Teaching Hospital, Ghana. Anthropometric measurements of waist circumference (cm), weight (Kg) and height (m) were measured appropriately. Clinical data were obtained from the personal health record files of the participants. MetS was defined according to the International Diabetes Federation criteria. RESULTS The prevalence of MetS was 24.0% (n=48). The prevalence was higher in women (27.3%, n= 42) compared to men (13.0%, n=6). The commonest occurring components of the MetS included abdominal obesity (77.0%) and elevated FPG (77.0%) denoting uncontrolled diabetes. The prevalence of elevated BP was found to be 44.0%(n=88) and was higher in men (56.5%) than in women (40.3%). Factors that were found to be associated to the MetS were being overweight/obese (Crude OR = 2.9, 95% CI = 1.43 - 5.90, p=0.004), ever tried to lose weight (Crude OR = 2.5, 95% CI = 1.24 - 4.94, p=0.015) and having diabetes for over 5 years (Crude OR = 11.3, 95% CI = 5.26 - 24.08, p<0.001). Other factors that were associated to the MetS were current smokers (Crude OR = 6.8, 95% CI = 1.21- 38.49, p=0.030) and alcohol drinkers (Crude OR = 3.1, 95% CI = 1.23 - 7.65, p=0.018). CONCLUSION A comparatively low prevalence of the MetS was found. More females than males had the MetS. Uncontrolled diabetes and abdominal obesity were prevalent. The factors identified by our univariate logistic regression model were not significant predictors of the MetS in our multivariate model.
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Affiliation(s)
- Victor Mogre
- Department of Human Biology, School of Medicine and Health Sciences, University for Development Studies, P. O. Box TL 1883, Tamale, Ghana
| | - Zenabankara S Salifu
- Department of Allied Health Sciences, School of Medicine and Health Sciences, University for Development Studies, P. O. Box TL 1883, Tamale, Ghana
| | - Robert Abedandi
- Department of Allied Health Sciences, School of Medicine and Health Sciences, University for Development Studies, P. O. Box TL 1883, Tamale, Ghana
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Abstract
BACKGROUND The aim of this study is to describe the metabolic syndrome (MS) and to evaluate five diagnostic criteria of the MS with respect to their sensitivity and specificity in patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS It is a cross-sectional case control study of T2DM patients and their first degree relatives (FDRs) recruited using convenience sampling and data collected through questionnaire administered technique. Variables of interest included anthropometric indices, blood pressure, serum lipid profile, fasting blood sugar (FBS), proteinuria, and microalbuminuria. The Chi-square test was used for comparison of proportions. A P value of less than 0.05 was taken as statistically significant. Kappa statistic was used to test the degree of agreement between the diagnostic criteria. RESULTS The World Health Organization (WHO), International Diabetes Federation (IDF), revised National Cholesterol Education Program (NCEP-R), NCEP Adult Treatment Panel (ATP)-III, and American Association of Clinical Endocrinologists (AACE) criteria reported a prevalence of 87.1, 64.5, 61.3, 55.6, and 22.6%, respectively in persons with T2DM. Using the WHO criteria as a reference or gold standard, the sensitivity of the IDF, NCEP-R, NCEP ATP-III, and AACE criteria among persons with T2DM were 71.3, 67.6, 61.1, and 25.9% respectively. Using the WHO criteria as a reference or gold standard, the specificity of the IDF, NCEP-R, NCEP ATP-III, and AACE criteria among persons with T2DM were 81.3, 81.3, 81.3, and 100%, respectively. Using the WHO criteria as a reference or gold standard, the level of agreement of the IDF, NCEP-R, NCEP ATP-III, and AACE criteria with the WHO criteria among persons with T2DM (as estimated by the kappa statistics) were 0.30, 0.26, 0.21, and 0.08 respectively. CONCLUSION THE LEVEL OF AGREEMENT APPEARS TO BE GENERALLY POOR, THOUGH THE IDF CRITERIA SHOWED A FAIR LEVEL OF AGREEMENT WITH THE WHO CRITERIA: Therefore the IDF criteria is recommended for screening of the MS in persons with T2DM because of its ease of application and its level of agreement with the WHO criteria being the best compared to the other three criteria.
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Affiliation(s)
- S Ogedengbe Onesi
- Departments of Medicine, University of Benin Teaching Hospital, Benin City and Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - U Ezeani Ignatius
- Departments of Medicine, University of Benin Teaching Hospital, Benin City and Federal Medical Centre, Umuahia, Abia State, Nigeria
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Ezenwaka CE, Okoye O, Esonwune C, Onuoha P, Dioka C, Osuji C, Oguejiofor C, Meludu S. High Prevalence of Abdominal Obesity Increases the Risk of the Metabolic Syndrome in Nigerian Type 2 Diabetes Patients: Using the International Diabetes Federation Worldwide Definition. Metab Syndr Relat Disord 2014; 12:277-82. [DOI: 10.1089/met.2013.0139] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Chidum E. Ezenwaka
- Department of Para-Clinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Osita Okoye
- College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nigeria
| | - Chibuike Esonwune
- College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nigeria
| | - Philip Onuoha
- Department of Para-Clinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Chudi Dioka
- College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nigeria
| | - Charles Osuji
- College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nigeria
| | | | - Samuel Meludu
- College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nigeria
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Ogedengbe SO, Ezeani IU. Profile of metabolic abnormalities seen in patients with type 2 diabetes mellitus and their first degree relatives with metabolic syndrome seen in Benin City, Edo state Nigeria. J Diabetes Metab Disord 2014; 13:61. [PMID: 24932458 PMCID: PMC4057575 DOI: 10.1186/2251-6581-13-61] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 05/02/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND To determine the profile of metabolic abnormalities in T2DM persons with metabolic syndrome and their non-diabetic first-degree relatives who also had metabolic syndrome in Benin City. METHODOLOGY This was a cross sectional case controlled study in which convenience sampling technique was used to recruit 106 persons with T2DM, 96 people who are first degree relatives of type 2 diabetic persons and 96 controls using a interviewer administered questionnaire technique. The following were assessed: anthropometric indices, blood pressure, serum lipid profile, fasting blood sugar, proteinuria, and microalbuminuria. The data obtained were analyzed using the statistical software-Statistical package for social sciences [SPSS] version 16. A p-value of less than 0.05 was taken as statistically significant. RESULTS THE MEAN AGE (SD) OF THE STUDY GROUPS WERE: persons living with T2DM: 58.6 ± 11.2 years, control: 57.69 ± 60.8 years and FDR: 57.4 ± 10.6 years. No significant age and sex differences were observed in these groups. There were more females (59.7%) than males (40.3%) with T2DM. The prevalence of MS was 13.5%, 16.7%, and 87.1% in the control, FDR and T2DM patients respectively. For the T2DM group of subjects, impaired fasting glycaemia was the commonest metabolic abnormality followed by microalbuminuria, low HDL cholesterol, high LDL cholesterol, hypercholesterolaemia and hypertriglyceridaemia in decreasing frequency. For the FDR group, low HDL cholesterol was the commonest metabolic abnormality followed by hypertriglyceridaemia, impaired fasting glucose, high LDL cholesterol, hypertriglyceridaemia and microalbuminuria in decreasing frequency. Hypercholesterolemia and low HDL cholesterol were the commonest metabolic abnormalities in the control group. CONCLUSION The prevalence of the MS in persons with T2DM in Nigeria appears to be high. Secondly, there is a high prevalence of lipid abnormalities in all the study groups.
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Affiliation(s)
- Stephen O Ogedengbe
- Departments of Medicine, University of Benin Teaching Hospital, Benin City and Federal Medical Center, P.M.B 7001, Umuahia, Abia state, Nigeria
| | - Ignatius U Ezeani
- Departments of Medicine, University of Benin Teaching Hospital, Benin City and Federal Medical Center, P.M.B 7001, Umuahia, Abia state, Nigeria
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Via-Sosa MA, Toro C, Travé P, March MA. Screening premorbid metabolic syndrome in community pharmacies: a cross-sectional descriptive study. BMC Public Health 2014; 14:487. [PMID: 24885099 PMCID: PMC4042002 DOI: 10.1186/1471-2458-14-487] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 05/06/2014] [Indexed: 11/10/2022] Open
Abstract
Background Premorbid metabolic syndrome (pre-MetS) is a cluster of cardiometabolic risk factors characterised by central obesity, elevated fasting glucose, atherogenic dyslipidaemia and hypertension without established cardiovascular disease or diabetes. Community pharmacies are in an excellent position to develop screening programmes because of their direct contact with the population. The main aim of the study was to determine the prevalence of pre-MetS in people who visited community pharmacies for measurement of any of its five risk factors to detect the presence of other risk factors. The secondary aims were to study the presence of other cardiovascular risk factors and determine patients’ cardiovascular risk. Methods Cross-sectional, descriptive, multicentre study. Patients meeting selection criteria aged between 18 and 65 years who visited participating community pharmacies to check any of five pre-MetS diagnostic factors were included.The study involved 23 community pharmacies in Catalonia (Spain). Detection criteria for pre-MetS were based on the WHO proposal following IDF and AHA/NHBI consensus. Cardiovascular risk (CVR) was calculated by Regicor and Score methods. Other variables studied were smoking habit, physical activity, body mass index (BMI), and pharmacological treatment of dyslipidemia and hypertension. The data were collected and analysed with the SPSS programme. Comparisons of variables were carried out using the Student’s T-test, Chi-Squared test or ANOVA test. Level of significance was 5% (0.05). Results The overall prevalence of pre-MetS was 21.9% [95% CI 18.7-25.2]. It was more prevalent in men, 25.5% [95% CI 22.1-28.9], than in women, 18.6% [95% CI 15.5-21.7], and distribution increased with age. The most common risk factors were high blood pressure and abdominal obesity. About 70% of people with pre-MetS were sedentary and over 85% had a BMI ≥25 Kg/m2. Some 22.4% had two metabolic criteria and 27.2% of patients with pre-MetS had no previous diagnosis. Conclusions The prevalence of pre-MetS in our study (21.9%) was similar to that found in other studies carried out in Primary Care in Spain. The results of this study confirm emergent cardiometabolic risk factors such as hypertension, obesity and physical inactivity. Our study highlights the strategic role of the community pharmacy in the detection of pre-MetS in the apparently healthy population.
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Affiliation(s)
- Maria Angeles Via-Sosa
- Unit of Practice Pharmacy, Unidad de Prácticas Tuteladas, Faculty of Pharmacy, University of Barcelone, Catalonia, Spain.
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Hernández-Vázquez E, Aguayo-Ortiz R, Ramírez-Espinosa JJ, Estrada-Soto S, Hernández-Luis F. Synthesis, hypoglycemic activity and molecular modeling studies of pyrazole-3-carbohydrazides designed by a CoMFA model. Eur J Med Chem 2013; 69:10-21. [DOI: 10.1016/j.ejmech.2013.07.054] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/28/2013] [Accepted: 07/30/2013] [Indexed: 01/22/2023]
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Oguz A, Mesci B, Sagun G, Kilic DC, Yetkin DO, Akalin A. Secondary metabolic syndrome: the frequency of factors which may underlie the parameters of metabolic syndrome. Ann Saudi Med 2013; 33:566-71. [PMID: 24413860 PMCID: PMC6074899 DOI: 10.5144/0256-4947.2013.566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Each of the metabolic syndrome (MetS) components (central obesity, hypertriglyceridemia, hypertension, low high-density lipoprotein cholesterol, and insulin resistance) may arise from an underlying disease or factors such as hormonal or pharmacological factors. These components arising secondary to a reason other than life style disturbances cause secondary MetS. The present study aimed to present, for the first time, the factors affecting secondary MetS. DESIGN AND SETTINGS An observational study at Medeniyet University Goztepe Training and Research Hospital, Istanbul, from June 2010 to February 2011. PATIENTS AND METHODS The underlying causes in 902 MetS patients with a mean age of 53.5 (12.9) years, of whom 79% were female, were investigated. A detailed evaluation was made, which comprised a history for drugs, diseases and habits that may manifest MetS parameters, physical examination, and laboratory analysis. RESULTS In 10.6% of the patients, hypothyroidism was determined as the main factor affecting secondary MetS, and in 4.1% the use of corticosteroid was determined as the main factor. Other factors underlie affecting secondary MetS are as follows: the use of thiazide diuretics (22.8%), beta-blockers (12.5%), antiphysichotics (2.1%), insulins (12.8%), insulin secretagog oral hypoglycemics (13.8%), thiazolidinediones (4.9%), oral contraceptives (0.8%), and alcohol intake (2.2%). CONCLUSION Hypothyroidism and corticosteroid treatment are the leading causes of secondary MetS. While evaluating the patients, it is a prerequisite to determine the high frequency of other factors that may affect the presence and the degree of MetS parameters.
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Affiliation(s)
| | - Banu Mesci
- Dr. Banu Mesci, Internal Medicine,, Istanbul Medeniyet University,, Oncu sk. Seher apt 5/10,, Suadiye Kadikoy,, Istanbul 34740, Turkey, T: +905322923159, F: +902165655526,
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Bolognani CV, de Sousa Moreira Reis LB, de Souza SS, Dias A, Rudge MVC, de Mattos Paranhos Calderon I. Waist circumference in predicting gestational diabetes mellitus. J Matern Fetal Neonatal Med 2013; 27:943-8. [PMID: 24053462 DOI: 10.3109/14767058.2013.847081] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND To evaluate waist circumference (WC) measured at 20-24 weeks of gestation as a predictor of gestational diabetes mellitus (GDM). METHODS This cross-sectional study included 240 women at 20-24 weeks of gestation. At enrollment, WC was measured, and both prepregnancy and gestational body mass index (BMI) were estimated. According to the results of 75-g oral glucose tolerance test (OGTT) performed at 24-28 weeks, subjects were allocated into two groups, non-GDM and GDM. WC sensitivity and specificity, and odds ratios (OR) and 95% confidence intervals for BMI and WC were estimated, and a receiver operating characteristics curve was generated. RESULTS Of the 240 pregnant women enrolled, 31 (13%) had GDM. Prepregnancy BMI (OR = 4.21), gestational BMI (OR = 3.17) and WC at 20-24 weeks (OR = 4.02) correlated with GDM risk. At 20-24 weeks, a WC of 85.5-88.5 cm was the optimal cutoff point for predicting GDM (Sens/Spec balance between 87.1/41.1% and 77.4/56.9%). CONCLUSION At 20-24 weeks of gestation, WC values in the range of 86-88 cm showed to be a good performance in predicting GDM.
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Gender differences in fat distribution and inflammatory markers among Arabs. Mediators Inflamm 2013; 2013:497324. [PMID: 24227909 PMCID: PMC3818915 DOI: 10.1155/2013/497324] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 09/13/2013] [Accepted: 09/13/2013] [Indexed: 11/22/2022] Open
Abstract
Recent studies from the Gulf region suggest that compared to men, women have a greater risk of developing metabolic syndrome (MeS). Objective. To investigate gender differences in body composition, adipokines, inflammatory markers, and aerobic fitness in a cohort of healthy Qatari adults. Participants. Healthy Qatari (n = 58) were matched for age, gender, and body mass index. Methods. Body composition and regional fat distribution were determined by dual-energy X-ray absorptiometry and computerized tomography. Laboratory assessments included serum levels of fasting glucose, insulin, lipid profile analysis, adipokines, and inflammatory markers. Subjects were also evaluated for aerobic fitness. Results. Women had more adipose tissue in the total abdominal (P = 0.04) and abdominal subcutaneous (P = 0.07) regions compared to men. Waist circumference and indices of insulin sensitivity were similar; however, women had a more favourable lipid profile than men. Serum adiponectin and leptin levels were significantly higher in women, whereas inflammatory profiles were not different between men and women. Aerobic fitness was lower in women and was associated with abdominal fat accumulation. Conclusion. In premenopausal women, higher levels of adiponectin may support maintenance of insulin sensitivity and normolipidemia despite greater adiposity. However, poor aerobic fitness combined with abdominal fat accumulation may explain their greater future risk of MeS compared with men.
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Laws RA, Fanaian M, Jayasinghe UW, McKenzie S, Passey M, Davies GP, Lyle D, Harris MF. Factors influencing participation in a vascular disease prevention lifestyle program among participants in a cluster randomized trial. BMC Health Serv Res 2013; 13:201. [PMID: 23725521 PMCID: PMC3702446 DOI: 10.1186/1472-6963-13-201] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 05/20/2013] [Indexed: 11/30/2022] Open
Abstract
Background Previous research suggests that lifestyle intervention for the prevention of diabetes and cardiovascular disease (CVD) are effective, however little is known about factors affecting participation in such programs. This study aims to explore factors influencing levels of participation in a lifestyle modification program conducted as part of a cluster randomized controlled trial of CVD prevention in primary care. Methods This concurrent mixed methods study used data from the intervention arm of a cluster RCT which recruited 30 practices through two rural and three urban primary care organizations. Practices were randomly allocated to intervention (n = 16) and control (n = 14) groups. In each practice up to 160 eligible patients aged between 40 and 64 years old, were invited to participate. Intervention practice staff were trained in lifestyle assessment and counseling and referred high risk patients to a lifestyle modification program (LMP) consisting of two individual and six group sessions over a nine month period. Data included a patient survey, clinical audit, practice survey on capacity for preventive care, referral and attendance records at the LMP and qualitative interviews with Intervention Officers facilitating the LMP. Multi-level logistic regression modelling was used to examine independent predictors of attendance at the LMP, supplemented with qualitative data from interviews with Intervention Officers facilitating the program. Results A total of 197 individuals were referred to the LMP (63% of those eligible). Over a third of patients (36.5%) referred to the LMP did not attend any sessions, with 59.4% attending at least half of the planned sessions. The only independent predictors of attendance at the program were employment status - not working (OR: 2.39 95% CI 1.15-4.94) and having high psychological distress (OR: 2.17 95% CI: 1.10-4.30). Qualitative data revealed that physical access to the program was a barrier, while GP/practice endorsement of the program and flexibility in program delivery facilitated attendance. Conclusion Barriers to attendance at a LMP for CVD prevention related mainly to external factors including work commitments and poor physical access to the programs rather than an individuals’ health risk profile or readiness to change. Improving physical access and offering flexibility in program delivery may enhance future attendance. Finally, associations between psychological distress and attendance rates warrant further investigation. Trial registration ACTRN12607000423415
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Affiliation(s)
- Rachel A Laws
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW 2006, Australia.
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Kengne AP, Echouffo-Tcheugui JB, Sobngwi E, Mbanya JC. New insights on diabetes mellitus and obesity in Africa-part 1: prevalence, pathogenesis and comorbidities. Heart 2013; 99:979-83. [PMID: 23680891 DOI: 10.1136/heartjnl-2012-303316] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Evidence continues to accumulate on the rising burden of diabetes mellitus at a higher pace in Africa. In a series of two papers, we sought to summarise recent evidence on diabetes and obesity in Africa based on a systematic review of studies published between January 2002 and October 2012. This first paper on the prevalence, pathogenesis and comorbidities shows that the increase in diabetes prevalence has paralleled that of obesity in Africa. Recent surveys on diabetes and obesity have been largely suboptimal. Hence, the need for more representative and robust continent-wide prevalence figures, which may be somehow achieved through pooling of existing data. Prospective studies linking environmental risk factors to disease occurrence and outcomes remain scarce, and genetic factors for diabetes or obesity have not been extensively assessed. The health consequences of diabetes are manifold, and include a complex interaction with other conditions like HIV infection and sickle cell disease/trait.
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Kengne AP, Sobngwi E, Echouffo-Tcheugui JB, Mbanya JC. New insights on diabetes mellitus and obesity in Africa-Part 2: prevention, screening and economic burden. Heart 2013; 99:1072-7. [PMID: 23680890 DOI: 10.1136/heartjnl-2013-303773] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Evidence has been accumulating on the importance of the rising burden of diabetes mellitus on the African continent at an increasingly higher pace. In the first paper of this series of two companion papers, recent evidence on the prevalence, pathogenesis and comorbidities of obesity and diabetes mellitus in Africa were summarised. In this second paper, we focus on recent developments pertaining to the prevention, screening and the economic burden of diabetes and obesity on the continent. There are indications that awareness on diabetes and chronic diseases at large has increased in Africa in recent times. However, the care for diabetes largely remains suboptimal in most countries, which are not adequately prepared to face the prevention and control of diabetes, as the costs of caring for the condition pose a tremendous challenge to most local economies. Moreover, translation strategies to prevent and control diabetes and obesity, on the continent, are still to be evaluated.
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Affiliation(s)
- Andre Pascal Kengne
- Department of Medicine, University of Cape Town and South African Medical Research Council, Cape Town, South Africa.
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Sossa C, Delisle H, Agueh V, Sodjinou R, Ntandou G, Makoutodé M. Lifestyle and dietary factors associated with the evolution of cardiometabolic risk over four years in West-African adults: the Benin study. J Obes 2013; 2013:298024. [PMID: 23555051 PMCID: PMC3608277 DOI: 10.1155/2013/298024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Accepted: 02/06/2013] [Indexed: 11/18/2022] Open
Abstract
AIM To assess in adults from Benin changes in cardiometabolic risk (CMR) using both the Framingham risk score (FRS) and metabolic syndrome (MetS) and to examine the effects of diet, and lifestyles, controlling for location and socioeconomic status. METHODS Apparently healthy subjects (n = 541) aged 25-60 years and randomly selected in the largest city, a small town, and rural areas were included in the four-year longitudinal study. Along with CMR factors, socioeconomic, diet and lifestyle data were collected in individual interviews. A food score based on consumption frequency of four "sentinel" food groups (meat and poultry, dairy, eggs, and vegetables) was developed. Lifestyle included physical activity, alcohol and tobacco use. Education and income (proxy) were the socioeconomic variables. RESULTS Among the subjects with four-year follow-up data (n = 416), 13.5% were at risk at baseline, showing MetS or FRS ≥ 10%. The incidence of MetS and FRS ≥ 10% during follow-up was 8.2% and 5%, respectively. CMR deteriorated in 21% of subjects. Diet and lifestyle mediated location and income effects on CMR evolution. Low food scores and inactivity increased the likelihood of CMR deterioration. CONCLUSION Combining MetS and FRS might be appropriate for surveillance purposes in order to better capture CMR and inform preventive measures.
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Affiliation(s)
- Charles Sossa
- TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, University of Montreal, CP 6128, Succursale Centre-Ville, Montréal, QC, Canada H3C 3J7.
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Raha O, Sarkar B, Lakkakula BVKS, Pasumarthy V, Godi S, Chowdhury S, Raychaudhuri P, Vadlamudi RR. HLA class II SNP interactions and the association with type 1 diabetes mellitus in Bengali speaking patients of Eastern India. J Biomed Sci 2013; 20:12. [PMID: 23441825 PMCID: PMC3599455 DOI: 10.1186/1423-0127-20-12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 02/25/2013] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Several studies have demonstrated a fundamental role for the HLA in the susceptibility of, or protection to, type 1 diabetes mellitus (T1DM). However, this has not been adequately studied in Asian Indian populations. To assess the frequency of HLA class II (DPA1, DPB1, DQA1, DQB1 and DRB1) associated to susceptibility or protection toT1DM in a Bengali population of India with diabetes. RESULTS Single nucleotide polymorphism study. The HLA genotyping was performed by a polymerase chain reaction followed by their HLA-DP, DQ, and DRB1 genotypes and haplotypes by sequencing method. The results are studied by Plink software. The χ2 tests were used for the inferential statistics. To our knowledge, this study is the first of a kind which has attempted to check the HLA association with T1DM by SNPs analysis. The study recruited 151 patients with T1DM and same number of ethno-linguistic, sex matched non-diabetic controls. The present study found a significant SNP rs7990 of HLA-DQA1 (p = 0.009) negative correlation, again indicating that risk from HLA is considerably more with T1DM. CONCLUSIONS This study demonstrates that the HLA class-II alleles play a major role in genetic basis of T1DM.
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Affiliation(s)
- Oindrila Raha
- Anthropological Survey of India, Kolkata, West Bengal 700016, India
| | - Biswanath Sarkar
- Anthropological Survey of India, Kolkata, West Bengal 700016, India
| | - Bhaskar VKS Lakkakula
- Department of Biomedical Sciences, Sri Ramachandra University, Chennai 600 116, India
| | - Veerraju Pasumarthy
- Department of Human Genetics, Andhra University, Visakhapatnam 530003, India
| | - Sudhakar Godi
- Department of Human Genetics, Andhra University, Visakhapatnam 530003, India
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Garcia TS, Silva DC, Gertrudes JC, Maltarollo VG, Honorio KM. Molecular features related to the binding mode of PPARδ agonists from QSAR and docking analyses. SAR AND QSAR IN ENVIRONMENTAL RESEARCH 2013; 24:157-173. [PMID: 23282254 DOI: 10.1080/1062936x.2012.751453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Diabetes affects approximately 4% of world's population and metabolic syndrome has been directly related to obesity. There is a class of nuclear receptors, peroxisome proliferator-activated receptors (PPARs), which controls the metabolism of carbohydrates and lipids. It has been considered an attractive target to treat diabetes and metabolic syndrome. Accordingly, the primary objective of this study was to employ molecular modelling techniques to understand the factors involved in PPARδ activation. The QSAR models obtained showed good internal and external consistency and presented good validation coefficients (QSAR: q(2) = 0.83, r(2) = 0.87; HQSAR: q(2) = 0.73, r(2) = 0.90; CoMFA: q(2) = 0.88, r(2) = 0.94). The selected properties and the contour maps described the possible interactions between the PPARδ receptor and its agonists. From these findings, it is possible to propose molecular modifications to design new compounds with improved biological properties.
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Affiliation(s)
- T S Garcia
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
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Birarda G, Holman EA, Fu S, Weikel K, Hu P, Blankenberg FG, Holman HY, Taylor A. Synchrotron infrared imaging of advanced glycation endproducts (AGEs) in cardiac tissue from mice fed high glycemic diets. BIOMEDICAL SPECTROSCOPY AND IMAGING 2013; 2:301-315. [PMID: 26500847 PMCID: PMC4617198 DOI: 10.3233/bsi-130057] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Recent research findings correlate an increased risk for dieases such as diabetes, macular degeneration and cardiovascular disease (CVD) with diets that rapidly raise the blood sugar levels; these diets are known as high glycemic index (GI) diets which include white breads, sodas and sweet deserts. Lower glycemia diets are usually rich in fruits, non-starchy vegetables and whole grain products. The goal of our study was to compare and contrast the effects of a low vs. high glycemic diet using the biochemical composition and microstructure of the heart. The improved spatial resolution and signal-to-noise for SR-FTIR obtained through the coupling of the bright synchrotron infrared photon source to an infrared spectral microscope enabled the molecular-level observation of diet-related changes within unfixed fresh frozen histologic sections of mouse cardiac tissue. High and low glycemic index (GI) diets were started at the age of five-months and continued for one year, with the diets only differing in their starch distribution (high GI diet = 100% amylopectin versus low GI diet = 30% amylopectin/70% amylose). Serial cryosections of cardiac tissue for SR-FTIR imaging alternated with adjacent hematoxylin and eosin (H&E) stained sections allowed not only fine-scale chemical analyses of glycogen and glycolipid accumulation along a vein as well as protein glycation hotspots co-localizing with collagen cold spots but also the tracking of morphological differences occurring in tandem with these chemical changes. As a result of the bright synchrotron infrared photon source coupling, we were able to provide significant molecular evidence for a positive correlation between protein glycation and collagen degradation in our mouse model. Our results bring a new insight not only to the effects of long-term GI dietary practices of the public but also to the molecular and chemical foundation behind the cardiovascular disease pathogenesis commonly seen in diabetic patients.
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Affiliation(s)
- Giovanni Birarda
- Berkeley Synchrotron Infrared Structural Biology Program, Lawrence Berkeley National Laboratory, University of California, Berkeley, CA, USA
| | - Elizabeth A. Holman
- Department of Radiology and Pediatrics/Molecular Imaging Program at Stanford, Stanford, CA, USA
| | - Shang Fu
- Laboratory for Nutrition and Vision Research, Jean Mayer USDA HNRCA at Tufts University, Tufts University, Boston, MA, USA
| | - Karen Weikel
- Laboratory for Nutrition and Vision Research, Jean Mayer USDA HNRCA at Tufts University, Tufts University, Boston, MA, USA
- Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Ping Hu
- Berkeley Synchrotron Infrared Structural Biology Program, Lawrence Berkeley National Laboratory, University of California, Berkeley, CA, USA
| | - Francis G. Blankenberg
- Department of Radiology and Pediatrics/Molecular Imaging Program at Stanford, Stanford, CA, USA
| | - Hoi-Ying Holman
- Berkeley Synchrotron Infrared Structural Biology Program, Lawrence Berkeley National Laboratory, University of California, Berkeley, CA, USA
| | - Allen Taylor
- Laboratory for Nutrition and Vision Research, Jean Mayer USDA HNRCA at Tufts University, Tufts University, Boston, MA, USA
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Panayiotou AG, Griffin M, Kouis P, Tyllis T, Georgiou N, Bond D, Nicolaides AN. Association between presence of the metabolic syndrome and its components with carotid intima-media thickness and carotid and femoral plaque area: a population study. Diabetol Metab Syndr 2013; 5:44. [PMID: 23962225 PMCID: PMC3765162 DOI: 10.1186/1758-5996-5-44] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 08/08/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We aimed to explore the association between presence and number of components of the Metabolic Syndrome (MetS) and subclinical atherosclerosis outcomes (common carotid intima media thickness, plaque presence and sum of plaque area) in both the carotid and femoral bifurcations. METHODS Cross-sectional analysis of 771 volunteers from the ongoing epidemiological Cyprus Study (46% male; mean age = 60.1 ± 9.8). (a) Carotid intima-media thickness (IMTcc), (b) sum of plaque area in the carotid bifurcations (sum of the largest plaques in each carotid bifurcation-SPAcar), (c) sum of plaque area in the femoral bifurcations (sum of the largest plaques in each femoral bifurcation-SPAfem) and (d) sum of plaque area in both carotid and femoral bifurcations (sum of the areas of the largest plaques present in each of the four bifurcations-SPA) were measured at baseline using ultrasound. Presence and number of components of the MetS was ascertained using the National Cholesterol Education Program ATPIII definition and their association tested using multivariable regression models. RESULTS MetS was present in 259 (33.6%) individuals and was associated with a 0.02 mm increase in IMTcc (95% CI: 0.00 to 0.04, p = 0.047) after adjustment for age, sex, family history of CVD, alcohol consumption (BU/week) and smoking (pack-years). Each additional component of the MetS was associated with a 16% higher SPA (95% CI: 6.8% to 25.2%, pfor trend = 0.001), a 10% higher SPAcar (95% CI: 5% to 24%, pfor trend = 0.003) and a 14% higher SPAfem in the adjusted model. CONCLUSIONS We confirm an association between the MetS and IMTcc as well as report for the first time an association between the MetS and its components and femoral plaque area, in a general population over 40 years of age. Having any risk factors for the MetS increases the risk for subclinical atherosclerosis, with the risk increasing with each additional component. Using the dichotomous definition of the MetS may be overlooking the risk for subclinical atherosclerosis -and by inference future cardiovascular events- associated with having less than 3 risk factors.
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Affiliation(s)
- Andrie G Panayiotou
- Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, P.O. Box: 50329, Limassol, Cyprus
- The Cyprus Cardiovascular Disease Educational and Research Trust, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
| | - Maura Griffin
- Vascular Noninvasive Screening and Diagnostic Centre, 30 Weymouth street, W1G 7BS, London, UK
| | - Panayiotis Kouis
- Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, P.O. Box: 50329, Limassol, Cyprus
| | - Theodosis Tyllis
- Vascular Screening and Diagnostic Centre, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
| | - Niki Georgiou
- Vascular Screening and Diagnostic Centre, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
| | - Dawn Bond
- Vascular Noninvasive Screening and Diagnostic Centre, 30 Weymouth street, W1G 7BS, London, UK
| | - Andrew N Nicolaides
- The Cyprus Cardiovascular Disease Educational and Research Trust, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
- Vascular Noninvasive Screening and Diagnostic Centre, 30 Weymouth street, W1G 7BS, London, UK
- Vascular Screening and Diagnostic Centre, 2 Kyriacou Matsi, Nicosia 2368, Cyprus
- Department of Vascular Surgery, Imperial College, London SW72BX, UK
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Tančić-Gajić M, Vujović S, Vukčević M, Ivović M, Drezgić M, Marina L, Stojanović M, Arizanović Z, Nenezić A, Micić D. Effects of alternate fasting or very low calorie diet and low calorie diet on metabolic syndrome in severely obese patients. Hippokratia 2012; 16:335-341. [PMID: 23935313 PMCID: PMC3738608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND AND AIM Weight loss improves the metabolic syndrome (MetS) features and related clinical abnormalities in obese subjects. The aim of this study was to assess the effects of a non-surgical therapeutic program on the MetS in severely obese patients. PATIENTS AND METHODS Sixty-four extremely obese patients were involved in the therapeutic program, which consisted of two alternating phases: the three-week therapeutic fasting or semi-fasting in hospital conditions and the low calorie diet with dosed physical activity in outpatient conditions. At the baseline we measured: anthropometric parameters, blood pressure and lipid profile. Subjects underwent an oral glucose tolerance test and insulin resistance/sensitivity was evaluated by the homeostasis model assessment and the oral glucose insulin sensitivity. After weight reduction by at least 10%, all mentioned assessments were repeated. RESULTS None of the patients had significant adverse effects. Forty-one patients aged 43.0±11.5 years completed the study. The mean weight loss was 27 kg or 18% of the initial weight (p<0.01), which was followed by a significant decrease of the insulin resistance, the overall prevalence of MetS (32%) and all MetS parameters, without the significant change in high-density lipoprotein. This weight loss pogram substantially improves the MetS in extremely obese patients. CONCLUSION The tailored alternating either fasting or semi- fasting should be considered as an optional approach to manage extreme obesity and related metabolic abnormality.
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Affiliation(s)
- M Tančić-Gajić
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbia
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Kengne AP, Limen SN, Sobngwi E, Djouogo CFT, Nouedoui C. Metabolic syndrome in type 2 diabetes: comparative prevalence according to two sets of diagnostic criteria in sub-Saharan Africans. Diabetol Metab Syndr 2012; 4:22. [PMID: 22650602 PMCID: PMC3407752 DOI: 10.1186/1758-5996-4-22] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 05/31/2012] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Available definition criteria for metabolic syndrome (MS) have similarities and inconsistencies. The aim of this study was to determine the prevalence of MS in a group of Cameroonians with type 2 diabetes, according to the International Diabetes Federation (IDF) and the National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III) criteria, and to assess the concordance between both criteria, and the implications of combining them. METHODS We collected clinical and biochemical data for 308 patients with type 2 diabetes (men 157) at the National Obesity Center of the Yaounde Central Hospital, Cameroon. Concordance was assessed with the use of the Kappa statistic. RESULTS Mean age (standard deviation) was 55.8 (10.5) years and the median duration of diagnosed diabetes (25th-75th percentiles) was 3 years (0.5-5.0), similarly among men and women. The prevalence of MS was 71.7% according to the IDF criteria and 60.4% according to NCEP-ATP III criteria. The prevalence was significantly higher in women than in men independently of the criteria used (both p < 0.001). Overall concordance between both definitions was low to average 0.51 (95% confidence interval: 0.41-0.61). Combining the two sets of criteria marginally improved the yield beyond that provided by the IDF criteria alone in men, but not in the overall population and in women. CONCLUSIONS The IDF and NCEP-ATP III criteria do not always diagnose the same group of diabetic individuals with MS and combining them merely increases the yield beyond that provided by the IDF definition alone. This study highlights the importance of having a single unifying definition for MS in our setting.
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Affiliation(s)
- Andre P Kengne
- NCRP for Cardiovascular and metabolic diseases, South African Medical research Council & University of Cape Town, Cape Town, South Africa
| | - Serge N Limen
- Higher Institute of Health Sciences, Bangangte, Cameroon
| | - Eugene Sobngwi
- Yaounde Central Hospital and Faculty of medicine and biomedical sciences university of Yaounde 1-Cameroon, Yaounde, Cameroon
- Institute of Health and Society; The Medical School, University of Newcastle Upon Tyne, Newcastle, UK
| | | | - Christophe Nouedoui
- General Hospital Yaounde and Faculty of medicine and biomedical sciences university of Yaounde 1-Cameroon, Yaounde, Cameroon
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Abstract
BACKGROUND The objective of this study was to determine the prevalence of the metabolic syndrome and its components in people with thyroid disorders. MATERIALS AND METHODS 112 subjects with a history of thyroid disorders were consecutively enrolled for the study. Clinical data were obtained by interviewing the patients and referring to their case folders and prescriptions. The subjects were categorized into three: thyrotoxic, those with hypothyroidism and those with nontoxic goiters, based on clinical parameters and or thyroid function tests. The study subjects were weighed and their anthropometric indices were documented. The laboratory parameters that were analyzed included total cholesterol, high-density and low-density cholesterol and triglyceride. Statistical analysis was performed using Student's t test, one-way analysis of variance (ANOVA) test and chi-square test. RESULTS The study subjects were aged between 14 and 76 years, with a mean age of 44.5 years, and the female:male ratio was 97:15. The mean age and anthropometric indices were comparable in subjects with thyrotoxicosis, hypothyroidism and euthyroidism. The overall prevalence of the metabolic syndrome was 28% and the frequency of occurrence of the metabolic syndrome in subjects with thyrotoxicosis, hypothyroidism and nontoxic goiter was 24%, 40% and 42%, respectively. The commonest occurring metabolic syndrome defining criterion was dysglycemia, while hypertension and elevated triglyceride were the least documented of the criteria. CONCLUSION Metabolic syndrome occurs in 1 in every 4 persons with thyroid disorders, and as such, routine screening for this cardiovascular risk factor may be of benefit in this group of people, especially in those with hypothyroidism.
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Affiliation(s)
- Anthonia O. Ogbera
- Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
- Department of Medicine, General Hospital, Gbagada, Nigeria
| | - Sonny Kuku
- Department of Medicine, Eko Hospital, Ikeja, Lagos, Nigeria
| | - Olusola Dada
- Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
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Abstract
Metabolic syndrome is a clustering of several cardiovascular risk factors. Contrary to earlier thoughts, metabolic syndrome is no longer rare in Africa. The prevalence is increasing, and it tends to increase with age. This increase in the prevalence of metabolic syndrome in the continent is thought to be due to departure from traditional African to western lifestyles. In Africa, it is not limited to adults but is also becoming common among the young ones. Obesity and dyslipidemia seem to be the most common occurring components. While obesity appears more common in females, hypertension tends to be more predominant in males. Insulin resistance has remained the key underlying pathophysiology. Though pharmacologic agents are available to treat the different components of the syndrome, prevention is still possible by reverting back to the traditional African way of life.
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Affiliation(s)
- Christian I. Okafor
- Department of Physiology and Medicine, Faculty of Medical Sciences, University of Nigeria, Enugu Campus
- Department of Endocrine, Diabetes and Metabolism Unit, Department of Internal Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
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Botezelli JD, Cambri LT, Ghezzi AC, Dalia RA, M Scariot PP, Ribeiro C, Voltarelli FA, Mello MAR. Different exercise protocols improve metabolic syndrome markers, tissue triglycerides content and antioxidant status in rats. Diabetol Metab Syndr 2011; 3:35. [PMID: 22182600 PMCID: PMC3296599 DOI: 10.1186/1758-5996-3-35] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 12/19/2011] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND An increase in the prevalence of obesity entails great expenditure for governments. Physical exercise is a powerful tool in the combat against obesity and obesity-associated diseases. This study sought to determine the effect of three different exercise protocols on metabolic syndrome and lipid peroxidation markers and the activity of antioxidant enzymes in adult Wistar rats (120 days old). METHODS Animals were randomly divided into four groups: the control (C) group was kept sedentary throughout the study; the aerobic group (A) swam1 h per day, 5 days per week, at 80% lactate threshold intensity; the strength group (S) performed strength training with four series of 10 jumps, 5 days per week; and the Concurrent group (AS) was trained using the aerobic protocol three days per week and the strength protocol two days per week. RESULTS Groups A and S exhibited a reduction in body weight compared to group C. All exercised animals showed a reduction in triglyceride concentrations in fatty tissues and the liver. Exercised animals also exhibited a reduction in lipid peroxidation markers (TBARS) and an increase in serum superoxide dismutase activity. Animals in group A had increased levels of liver catalase and superoxide dismutase activities. CONCLUSIONS We concluded that all physical activity protocols improved the antioxidant systems of the animals and decreased the storage of triglycerides in the investigated tissues.
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Affiliation(s)
- José D Botezelli
- Physical Education Department, São Paulo State University - UNESP, 24-A Av. 1515, Rio Claro, Zip Code:13607-331, Brazil
| | - Lucieli T Cambri
- Physical Education Department, São Paulo State University - UNESP, 24-A Av. 1515, Rio Claro, Zip Code:13607-331, Brazil
| | - Ana C Ghezzi
- Physical Education Department, São Paulo State University - UNESP, 24-A Av. 1515, Rio Claro, Zip Code:13607-331, Brazil
| | - Rodrigo A Dalia
- Physical Education Department, São Paulo State University - UNESP, 24-A Av. 1515, Rio Claro, Zip Code:13607-331, Brazil
| | - Pedro P M Scariot
- Physical Education Department, São Paulo State University - UNESP, 24-A Av. 1515, Rio Claro, Zip Code:13607-331, Brazil
| | - Carla Ribeiro
- Physical Education Department, São Paulo State University - UNESP, 24-A Av. 1515, Rio Claro, Zip Code:13607-331, Brazil
| | - Fabrício A Voltarelli
- Physical Education Department, Mato Grosso Federal University-UFMT, Brasilia Av. 1200, Cuiabá, Zip Code: 78550-000, Brazil
| | - Maria AR Mello
- Physical Education Department, São Paulo State University - UNESP, 24-A Av. 1515, Rio Claro, Zip Code:13607-331, Brazil
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Mattoo SK, Chakraborty K, Basu D, Ghosh A, Vijaya KKG, Kulhara P. Prevalence & correlates of metabolic syndrome in alcohol & opioid dependent inpatients. Indian J Med Res 2011; 134:341-8. [PMID: 21985817 PMCID: PMC3193715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND & OBJECTIVES The research on the association of metabolic syndrome (MS) and substance abuse is scanty. The present research aimed to study the prevalence and correlates of MS among the inpatients at a Drug De-addiction Centre in north India. METHODS Consecutive male subjects (N=110) admitted to a drug de-addiction centre during July to December 2009 with a primary diagnosis of alcohol or opioid dependence were evaluated for the presence of MS as per the International Diabetes Federation (IDF) criteria. RESULTS The prevalence of MS was 24.6 and 29.3 per cent in alcohol and opioid dependent groups, respectively. MS showed a significant association with the age and body mass index (BMI) in the opioid dependent group. Co-morbid tobacco use was not associated with MS in either group. INTERPRETATION & CONCLUSIONS The prevalence of MS in our sample of alcohol and opioid dependent male inpatients was greater than the prevalence of MS in general population, however it was comparable to that reported in physical and other psychiatric disorder populations. Even though the absence of any comparative study limits the generalizability of our findings, results indicate towards a need for screening of the patients with substance dependence especially for those aged above 30 years and/or having a high BMI for MS.
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Affiliation(s)
- Surendra K. Mattoo
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India,Reprint requests: Dr Surendra Mattoo, Professor, Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012, India
| | - Kaustav Chakraborty
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Debasish Basu
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Abhishek Ghosh
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Kumar KG Vijaya
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Parmanand Kulhara
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Buitrago-Lopez A, Sanderson J, Johnson L, Warnakula S, Wood A, Di Angelantonio E, Franco OH. Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis. BMJ 2011; 343:d4488. [PMID: 21875885 PMCID: PMC3163382 DOI: 10.1136/bmj.d4488] [Citation(s) in RCA: 177] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2011] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate the association of chocolate consumption with the risk of developing cardiometabolic disorders. DESIGN Systematic review and meta-analysis of randomised controlled trials and observational studies. DATA SOURCES Medline, Embase, Cochrane Library, PubMed, CINAHL, IPA, Web of Science, Scopus, Pascal, reference lists of relevant studies to October 2010, and email contact with authors. STUDY SELECTION Randomised trials and cohort, case-control, and cross sectional studies carried out in human adults, in which the association between chocolate consumption and the risk of outcomes related to cardiometabolic disorders were reported. DATA EXTRACTION Data were extracted by two independent investigators, and a consensus was reached with the involvement of a third. The primary outcome was cardiometabolic disorders, including cardiovascular disease (coronary heart disease and stroke), diabetes, and metabolic syndrome. A meta-analysis assessed the risk of developing cardiometabolic disorders by comparing the highest and lowest level of chocolate consumption. RESULTS From 4576 references seven studies met the inclusion criteria (including 114,009 participants). None of the studies was a randomised trial, six were cohort studies, and one a cross sectional study. Large variation was observed between these seven studies for measurement of chocolate consumption, methods, and outcomes evaluated. Five of the seven studies reported a beneficial association between higher levels of chocolate consumption and the risk of cardiometabolic disorders. The highest levels of chocolate consumption were associated with a 37% reduction in cardiovascular disease (relative risk 0.63 (95% confidence interval 0.44 to 0.90)) and a 29% reduction in stroke compared with the lowest levels. CONCLUSIONS Based on observational evidence, levels of chocolate consumption seem to be associated with a substantial reduction in the risk of cardiometabolic disorders. Further experimental studies are required to confirm a potentially beneficial effect of chocolate consumption.
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Affiliation(s)
- Adriana Buitrago-Lopez
- Department of Public Health and Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
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Guinhouya BC, Hubert H. Insight into physical activity in combating the infantile metabolic syndrome. Environ Health Prev Med 2010; 16:144-7. [PMID: 21431795 DOI: 10.1007/s12199-010-0185-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Accepted: 09/29/2010] [Indexed: 02/06/2023] Open
Abstract
Metabolic syndrome (MetS) is increasingly reported in children, mainly in the presence of overweight/obesity. From the most recent report, up to 60% of overweight and obese children can be affected by this syndrome. MetS acquired during childhood has been shown to track into adulthood, including its clinical complications, such as type 2 diabetes and cardiovascular diseases. Among the practical preventive and therapeutic measures to be taken in children, physical activity (PA) appears to be at least as efficient as the most adequate pharmacology. The current literature suggests that exercise programs based either on aerobic-or resistance-type exercises, or a combination of these 2 types of structured activity, may promote insulin sensitivity and weaken or suppress MetS in children. Furthermore, daily-living activities such as brisk walking were found to substantially reduce the risk of MetS among children. Regardless of their weight status, PA needs to be promoted among children as early as possible.
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Affiliation(s)
- Benjamin C Guinhouya
- Laboratory of Public Health: EA 2694, Faculty of Engineering and Management in Health, UDSL/ILIS, Univ. Lille Northern France, 42, rue Ambroise Paré, 59120, Loos, France.
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Ogbera AO, Azenabor AO. Lipoprotein (a), C-reactive protein and some metabolic cardiovascular risk factors in type 2 DM. Diabetol Metab Syndr 2010; 2:51. [PMID: 20663222 PMCID: PMC2919447 DOI: 10.1186/1758-5996-2-51] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2010] [Accepted: 07/27/2010] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Lipoprotein (a) (LP (a) is an independent cardiovascular risk factor that is not widely studied in people of sub-Saharan African origin. The aim of this report is to determine the frequency of occurrence of elevated Lp (a) and possible relationship with total cholesterol (TCHOL), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), C reactive protein (CRP) and serum uric acid (SUA). METHODS This is a cross sectional study carried out in 200 Nigerian patients with type 2 DM and 100 sex and age matched healthy Controls aged between 32-86 years. We determined the frequency of occurrence of elevated Lp (a) levels in the study subjects and compared clinical and biochemical variables between type 2 diabetic patients and non-diabetic patients. Clinical and biochemical parameters were also compared between subjects with type 2 DM who had elevated LP (a) and normal LP (a) levels. Long term glycaemic control using glycosylated haemoglobin was determined and compared in the study subjects. Test statistics used include chi square, correlation coefficient analysis and Student's t test. RESULTS The mean Lp(a) concentration differed significantly between type 2 diabetic patients and the Control subjects (18.7 (5.8) mg/dl vs 23 (6.8) mg/dl, 0.00001). Similarly, the prevalence of high LP (a) levels in type 2 DM patients was significantly higher than that of the Control subjects (12.5% vs 4%, p-0.019). The mean levels of the lipid profile parameters (TCHOL, LDL-C, TG, LDL/HDL) and CRP were significantly higher in DM patients than in the Control subjects. The mean LP (a) levels were comparable in both sexes and in DM subjects with and without hypertension. TG was the only parameter that differed significantly between subjects with elevated Lp (a) levels and those with normal Lp (a) levels. There was a significant positive correlation (r) between Lp(a) levels and TG, LDL-C. TCHOL, LDL/HDL and uric acid. No association was found between Lp(a) and clinical parameters such as age and anthropometric indices. CONCLUSION We have showed that Lp (a), CRP and other CVS risk factors cluster more in patients with DM than non DM patients. Serum Lp (a) levels are not associated with anthropometric and glycaemic indices.
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Affiliation(s)
- Anthonia O Ogbera
- Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
- Department of Medicine, General Hospital Gbagada, Lagos, Nigeria
| | - Alfred O Azenabor
- Department of Surgery and Chemical Pathology, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria
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