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Liu Z, Huang Q, Deng B, Wei M, Feng X, Yu F, Feng J, Du Y, Xia J. Elevated Chinese visceral adiposity index increases the risk of stroke in Chinese patients with metabolic syndrome. Front Endocrinol (Lausanne) 2023; 14:1218905. [PMID: 37455909 PMCID: PMC10339806 DOI: 10.3389/fendo.2023.1218905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Patients with Metabolic Syndrome (MetS) are considered at high-risk for incident stroke. An indicator of visceral adiposity dysfunction, the Chinese Visceral Adiposity Index (CVAI) is used to evaluate the dysfunction of visceral fat. Given the impact of visceral adiposity dysfunction on elevating cardiovascular hazards, this study aimed to examine the association between CVAI and stroke risk in MetS patients. Method Between November 2017 and December 2018, a total of 18,974 individuals aged ≥40 underwent standardized in-person clinical interviews in Hunan Province, with 6,732 meeting the criteria for MetS. After the baseline survey was completed, subsequent surveys were conducted biennially. The study was split into two stages performed at baseline and after two years. During the former, receiver-operating characteristic curves were used to assess the accuracy of using baseline CVAI in diagnosing MetS. After two years, we examined the association between CVAI and incident stroke in MetS patients using logistic regression, subgroup analysis, and restricted cubic spline (RCS) analysis. Result As evidenced by a higher AUC (AUC:0.741), CVAI demonstrated superior diagnostic performance relative to body mass index (AUC:0.631) and waist circumference (AUC:0.627) in diagnosing MetS. After a 2-year follow-up, 72 MetS patients had a stroke event. There was a robust positive correlation between incident stroke and CVAI in patients with MetS. Each 1 SD increase in CVAI was associated with a 1.52-fold higher risk of stroke after adjustment for confounding factors (aOR=1.52, 95%CI: 1.18-1.95). The RCS demonstrated a reduced risk of stroke for MetS patients when the CVAI was below 110.91. However, no significant correlation was detected between CVAI and stroke in non-MetS patients. Conclusion Our findings recommend CVAI as a superior screening tool for detecting MetS and suggest that reducing CVAI can mitigate the risk of stroke in patients with MetS.
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Affiliation(s)
- Zeyu Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qin Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bi Deng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Minping Wei
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xianjing Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fang Yu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yang Du
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jian Xia
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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He F, Blackberry I, Yao L, Xie H, Rasekaba T, Mnatzaganian G. Pooled incidence and case-fatality of acute stroke in Mainland China, Hong Kong, and Macao: A systematic review and meta-analysis. PLoS One 2022; 17:e0270554. [PMID: 35759497 PMCID: PMC9236238 DOI: 10.1371/journal.pone.0270554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 06/13/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Stroke incidence and case-fatality in Mainland China, Hong Kong, and Macao vary by geographic region and rates often differ across and within regions. This systematic review and meta-analysis (SR) estimated the pooled incidence and short-term case-fatality of acute first ever stroke in mainland China, Hong Kong, and Macao.
Methods
Longitudinal studies published in English or Chinese after 1990 were searched in PubMed/Medline, EMBASE, CINAHL, Web of Science, SinoMed and CQVIP. The incidence was expressed as Poisson means estimated as the number of events divided by time at risk. Random effect models calculated the pooled incidence and pooled case-fatality. Chi-squared trend tests evaluated change in the estimates over time. When possible, age standardised rates were calculated. Percent of variation across studies that was due to heterogeneity rather than chance was tested using the I2 statistic.The effect of covariates on heterogeneity was investigated using meta-regressions. Publication bias was tested using funnel plots and Egger’s tests.
Results
Overall, 72 studies were included. The pooled incidences of total stroke (TS), ischaemic stroke (IS) and haemorrhagic stroke (HS) were 468.9 (95% confidence interval (CI): 163.33–1346.11), 366.79 (95% CI: 129.66–1037.64) and 106.67 (95% CI: 55.96–203.33) per 100,000 person-years, respectively, varied according to the four economic regions (East Coast, Central China, Northeast and Western China) with the lowest rates detected in the East Coast. Increased trends over time in the incidence of TS and IS were observed (p<0.001 in both). One-month and three-to-twelve-month case-fatalities were 0.11 (95% CI: 0.04–0.18) and 0.15 (95% CI: 0.12–0.17), respectively for IS; and 0.36 (95% CI: 0.26–0.45) and 0.25 (95% CI: 0.18–0.32), respectively for HS. One-month case-fatality of IS and HS decreased over time for both (p<0.001). Three-to-twelve-month fatalities following IS increased over time (p<0.001). Publication bias was not found.
Conclusions
Regional differences in stroke incidence were observed with the highest rates detected in less developed regions. Although 1-month fatality following IS is decreasing, the increased trends in 3-12-month fatality may suggest an inappropriate long-term management following index hospital discharge.
Registration
Registration-URL: https://www.crd.york.ac.uk/prospero/; Reference code: CRD42020170724
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Affiliation(s)
- Fan He
- John Richards Centre for Rural Ageing Research, La Trobe Rural Health School, La Trobe University, Albury-Wodonga, Victoria, Australia
- * E-mail:
| | - Irene Blackberry
- John Richards Centre for Rural Ageing Research, La Trobe Rural Health School, La Trobe University, Albury-Wodonga, Victoria, Australia
| | - Liqing Yao
- Department of Rehabilitation, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Haiyan Xie
- Department of Healthcare, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tshepo Rasekaba
- John Richards Centre for Rural Ageing Research, La Trobe Rural Health School, La Trobe University, Albury-Wodonga, Victoria, Australia
| | - George Mnatzaganian
- Rural Department of Community Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
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Xu R, Hu X, Wang T, Yang Y, Jiang N, Luo J, Zhang X, Patel AB, Dmytriw AA, Jiao L. Visceral Adiposity and Risk of Stroke: A Mendelian Randomization Study. Front Neurol 2022; 13:804851. [PMID: 35481268 PMCID: PMC9035635 DOI: 10.3389/fneur.2022.804851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/15/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose In recent years, metabolic syndrome has risen in prevalence and brought a heavy disease burden to modern society. As the representative aspect of metabolic syndrome, obesity has been shown to be related to an increased risk of stroke. Given that visceral adipose tissue (VAT) forms the fundamental basis of central obesity, we sought to explore a causal relationship between VAT and stroke by using mendelian randomization (MR) methods. Methods Based on two large genome-wide association studies (GWAS) including 325,153 and 35,762 cases of VAT and stroke, respectively, we conducted a MR study which has the inherent advantage of reducing the noise of confounding and reverse causation. Results VAT had a significant causal association with ischemic stroke (OR, per 1kg increase in VAT mass, 1.30; 95% CI, 1.18 ~ 1.45; P = 5.87E-07) as opposed to intracranial hemorrhage (ICH) (OR, 1.15; 95% CI, 0.70 ~ 1.88, P = 5.81E-01) as evaluated with inverse-variance weighting (IVW). Regarding subtypes of ischemic stroke, there was a significant causal effect for cardioembolic stroke (OR, 1.34; 95% CI, 1.13 ~ 1.58, P = 8.07E-04), and potential causal effect for small-vessel stroke (OR, 1.32; 95% CI, 1.06 ~ 1.65, P = 1.39E-02) and large-artery atherosclerotic stroke (OR, 1.33; 95% CI, 1.03 ~ 1.70, P = 2.59E-02). Conclusions This study provides potential evidence for a causal role of VAT in ischemic stroke and could suggest novel genetical therapeutic strategies for distinct subtypes of ischemic stroke.
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Affiliation(s)
- Ran Xu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Xinzhi Hu
- Department of Human Anatomy, Histology and Embryology, Peking Union Medical College Hospital, Peking Union Medical College, Institute of Basic Medical Sciences, Chinese Academy of Medical Science, Beijing, China
| | - Tao Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Yutong Yang
- Faculty of Medicine, Imperial College London, National Heart and Lung Institute, London, United Kingdom
| | - Nan Jiang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Jichang Luo
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Xiao Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Aman B. Patel
- Neuroendovascular Program, Massachusetts General Hospital, Boston, MA, United States
| | - Adam A. Dmytriw
- Neuroendovascular Program, Massachusetts General Hospital, Boston, MA, United States
- Neuroradiology and Neurointervention Service, Brigham and Women's Hospital Harvard Medical School, Boston, MA, United States
- *Correspondence: Adam A. Dmytriw
| | - Liqun Jiao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
- Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Liqun Jiao
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Dixon A, Robertson K, Yung A, Que M, Randall H, Wellalagodage D, Cox T, Robertson D, Chi C, Sun J. Efficacy of Probiotics in Patients of Cardiovascular Disease Risk: a Systematic Review and Meta-analysis. Curr Hypertens Rep 2020; 22:74. [PMID: 32860083 DOI: 10.1007/s11906-020-01080-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This meta-analysis examined the effect of probiotics on outcomes associated with cardiovascular disease risk factors (high blood pressure, overweight BMI, high cholesterol and triglycerides, elevated HbA1c and serum glucose). All randomised controlled trials publish on PubMed, Scopus, Embase, Grey Literature and the Cochrane Central Register of Controlled Trials (CENTRAL) from 1990 to 2020 were systematically searched. The PEDro scale was used to assess the quality of studies. A total of 34 studies with 2177 adults were selected for inclusion in the analysis. The mean difference and effect size with a 95% confidence interval (CI) were analysed for the pooled results. Statistically significant pooled effects of probiotics were found in the reduction of systolic and diastolic blood pressure, total cholesterol, LDL-C, serum glucose, HbA1C and BMI; and elevation of HDL-C. No significant changes were observed in the outcome of triglycerides. Subgroup analysis revealed statistically significant effects of probiotics on the treatment of risk factors, with results favouring longer duration of treatment (> 1.5 months), use of alternate formulations (kefir and powder), higher dosage of probiotics (> 1.0 × 109 CFU), lower rate of study attrition (< 15%), double blinding of the study, diabetic patients and female populations. In summary, our meta-analysis showed a highly significant reduction in SBP, DBP associated with type 2 diabetes and in patients with diabetes mellitus, milk intake and more than 1.5 months duration intake. The effect on the reduction of total cholesterol LDL-C was associated with diabetes, hypertension, hypercholesterolemia, yoghurt intake and less than 1.5 months probiotic intake. The effect on the reduction of glucose and HbA1c was associated with diabetes, small dosage of probiotics, milk type and less than 1.5 months duration intake. Additionally, probiotic supplement had a beneficial effect in reducing BMI associated with obesity, higher dosage intake of probiotics and more than 1.5 months duration of intake.
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Affiliation(s)
- Asher Dixon
- School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, Queensland, Q4222, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.,St Paul's College Graduate House, Camperdown, Australia
| | - Kai Robertson
- School of Medical Science, Griffith University, Gold Coast, Australia
| | - Amanda Yung
- Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
| | - Michael Que
- Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
| | - Hayden Randall
- Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.,St Paul's College Graduate House, Camperdown, Australia
| | - Don Wellalagodage
- Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.,St Paul's College Graduate House, Camperdown, Australia
| | - Tynan Cox
- School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, Queensland, Q4222, Australia
| | - Dylan Robertson
- School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, Queensland, Q4222, Australia
| | - Cheng Chi
- School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, Queensland, Q4222, Australia
| | - Jing Sun
- School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, Queensland, Q4222, Australia.
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5
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Amir A, Hassan M, Alvi S, Mueed A, Idrees S, Ashraf J, Haleem F, Ali Khan M. Frequency and Characteristics of Metabolic Syndrome in Patients With Ischemic Stroke Admitted to a Tertiary Care Hospital in Karachi. Cureus 2020; 12:e9004. [PMID: 32775084 PMCID: PMC7402533 DOI: 10.7759/cureus.9004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction Metabolic syndrome (MetS) is defined as a syndrome of truncal obesity, insulin resistance, hypertension, hypertriglyceridemia, and dyslipidemia. It is well known that MetS increases the risk of cardiovascular disease and adverse events. Each of its components is associated with an increased risk of cardiovascular disease, but data on the association with ischemic stroke are scarce. At the international level, a significant body of research has been conducted on this issue, but the situation is very different in Pakistan. Very little data are present on the subject matter. This study is an endeavor in this direction, generating data, that can be used in early identification and developing treatment services for patients with ischemic stroke having MetS. Aims To determine the frequency of MetS in ischemic stroke patients admitted to a tertiary care hospital in Karachi, Pakistan. Methods This six-month observational and cross-sectional study was conducted at Medical Unit I, Jinnah Postgraduate Medical Centre from July 1, 2019, to December 31, 2019. Patients with a diagnosis of acute ischemic stroke were enrolled. Detailed history, physical examination, and biochemical measurements were noted. The presence of MetS was defined in accordance with the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III)/American Heart Association (AHA) guidelines. Results A total of 224 patients fulfilling the inclusion criteria were inducted into this study. The mean age of presentation was 61.04 ± 14.72 years, and more than two-thirds of the patients were ≥60 years of age. A total of 150 (66.96%) patients with ischemic stroke also had MetS. The male-to-female ratio in this group was 2:1. The most common variables constituting the MetS were truncal obesity, hypertension, and dyslipidemia. The median MetS score was 3. Conclusions MetS is highly prevalent in patients presenting with ischemic stroke irrespective of age or gender. The three most deranged and common components of MetS in these patients are truncal obesity, hypertension, and dyslipidemia.
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Affiliation(s)
- Anum Amir
- Internal Medicine, Civil Hospital, Karachi, PAK
| | - Mujtaba Hassan
- Critical Care, National Institute of Cardiovascular Diseases, Karachi, PAK
| | - Souhaib Alvi
- Medicine, Abbassi Shaheed Hospital, Karachi, PAK
| | - Abdul Mueed
- Cardiac Electrocardiography, National Institute of Cardiovascular Diseases, Karachi, PAK
| | | | - Jibran Ashraf
- Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK
| | - Farhan Haleem
- Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - M Ali Khan
- Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, PAK
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Teoh RJJ, Huang CJ, Chan CP, Chien LY, Chung CP, Sung SH, Chen CH, Chiang CE, Cheng HM. Does statin increase the risk of intracerebral hemorrhage in stroke survivors? A meta-analysis and trial sequential analysis. Ther Adv Neurol Disord 2019; 12:1756286419864830. [PMID: 31384308 PMCID: PMC6657129 DOI: 10.1177/1756286419864830] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 06/30/2019] [Indexed: 12/15/2022] Open
Abstract
Background: It remains debatable whether statin increases the risk of intracerebral
hemorrhage (ICH) in poststroke patients. Methods: We systematically searched PubMed, EMBASE, and CENTRAL for randomized
controlled trials. Trial sequential analysis (TSA) was conducted to assess
the reliability and conclusiveness of the available evidence in the
meta-analysis. To evaluate the overall effectiveness, the net composite
endpoints were derived by totaling ischemic stroke, hemorrhagic stroke,
transient ischemic attack (TIA), myocardial infarction, and cardiovascular
mortality. Results: A total of 17 trials with 11,576 subjects with previous ischemic stroke, TIA,
or ICH were included, in which statin therapy increased the risk of
hemorrhagic stroke (risk ratio [RR], 1.42; 95% confidence interval [CI],
1.07–1.87), but reduced the risk of ischemic stroke (RR, 0.85; 95% CI,
0.75–0.95). For the net composite endpoints, statin therapy was associated
with a 17% risk reduction (95% CI, 12–21%; number needed to treat = 6). With
a control event rate 2% and RR increase 40%, the TSA suggested a conclusive
signal of an increased risk of hemorrhagic stroke in stroke survivors taking
statin. However, with the sensitivity analysis by changing assumptions, the
conclusions about hemorrhagic stroke risk were less robust. Conclusions: Statin therapy in poststroke patients increased the risk of hemorrhagic
stroke but effectively reduced ischemic stroke risk. Weighing the benefits
and potential harms, statin has an overall beneficial effect in patients
with previous stroke or TIA. However, more studies are required to
investigate the conclusiveness of the increased hemorrhagic stroke risk
revealed in our study.
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Affiliation(s)
| | - Chi-Jung Huang
- Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei
| | - Chi Peng Chan
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Li-Yin Chien
- International Health Program, National Yang-Ming University, Taipei
| | - Chih-Ping Chung
- Department of Neurology, National Yang-Ming University, Taipei
| | - Shih-Hsien Sung
- Department of Medicine, National Yang-Ming University, Taipei
| | - Chen-Huan Chen
- Department of Internal Medicine, Taipei Veterans General Hospital, Taipei
| | - Chern-En Chiang
- Department of Medicine, National Yang-Ming University, Taipei
| | - Hao-Min Cheng
- Center for Evidence-based Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Beitou District, Taipei 11217
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A Data-Driven Assessment of the Metabolic Syndrome Criteria for Adult Health Management in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010092. [PMID: 30602658 PMCID: PMC6339104 DOI: 10.3390/ijerph16010092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/21/2018] [Accepted: 12/24/2018] [Indexed: 12/14/2022]
Abstract
According to the modified Adult Treatment Panel III, five indices are used to define metabolic syndrome (MetS): waist circumference (WC), high blood pressure, fasting glucose, triglycerides (TG), and high-density lipoprotein cholesterol. Our work evaluates the importance of these indices. In addition, we attempted to identify whether trends and patterns existed among young, middle-aged, and older people. Following the analysis, a decision tree algorithm was used to analyze the importance of the five criteria for MetS because the algorithm in question selects the attribute with the highest information gain as the split node. The most important indices are located on the top of the tree, indicating that these indices can effectively distinguish data in a binary tree and the importance of this criterion. That is, the decision tree algorithm specifies the priority of the influence factors. The decision tree algorithm examined four of the five indices because one was excluded. Moreover, the tree structures differed among the three age groups. For example, the first key index for middle-aged and older people was TG whereas for younger people it was WC. Furthermore, the order of the second to fourth indices differed among the groups. Because the key index was identified for each age group, researchers and practitioners could provide different health care strategies for individuals based on age. High-risk middle-aged and healthy older people maintained low values of TG, which might be the most crucial index. When a person can avoid the first and second indices provided by the decision tree, they are at lower risk of MetS. Therefore, this paper provides a data-driven guideline for MetS prevention.
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Hu H, Nakagawa T, Honda T, Yamamoto S, Nanri A, Konishi M, Okazaki H, Kuwahara K, Hori A, Nishiura C, Kashino I, Imai T, Nishihara A, Akter S, Miyamoto T, Sasaki N, Ogasawara T, Uehara A, Yamamoto M, Murakami T, Shimizu M, Eguchi M, Kochi T, Nagahama S, Tomita K, Kabe I, Mizoue T, Sone T, Dohi S. Metabolic Syndrome Over 4 Years Before the Onset of Cardiovascular Disease - Nested Case-Control Study. Circ J 2017; 82:430-436. [PMID: 28931789 DOI: 10.1253/circj.cj-17-0513] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND We investigated the risk of cardiovascular disease (CVD) with duration of metabolic syndrome (MetS) for the past 4 years before the CVD event.Methods and Results:We performed a nested case-control study within the Japan Epidemiology Collaboration on Occupational Health Study. A total of 139 registered cases of CVD and 561 self-reported cases of CVD were identified and matched individually on age, sex, and worksite with 695 and 2,803 controls, respectively. MetS was defined by the Joint Interim Statement definition. The odds ratio (95% confidence interval) for registered CVD was 4.7 (2.9, 7.5) for people with persistent MetS (positive for MetS for ≥3 assessments) and 1.9 (1.1, 3.3) for those with intermittent MetS (positive for MetS for 1-2 assessments), compared with people without MetS during the past 4 years before the event/index date (P for trend <0.001). The corresponding odds ratio for self-reported CVD was 2.7 (2.2, 3.5) and 1.8 (1.4, 2.3) (P for trend <0.001). The association with MetS duration was stronger for myocardial infarction than for other CVD subtypes. Similar results were obtained when using the Japanese MetS criteria. CONCLUSIONS The risk of CVD increases with increasing MetS duration. These findings contribute to risk stratification and encourage lifestyle modification for people with MetS to minimize their health risk.
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Affiliation(s)
- Huanhuan Hu
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine
| | | | | | | | - Akiko Nanri
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine
| | - Maki Konishi
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine
| | | | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine.,Teikyo University Graduate School of Public Health
| | - Ai Hori
- Department of Global Public Health, University of Tsukuba
| | | | - Ikuko Kashino
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine
| | | | | | - Shamima Akter
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine
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Li X, Li X, Lin H, Fu X, Lin W, Li M, Zeng X, Gao Q. Metabolic syndrome and stroke: A meta-analysis of prospective cohort studies. J Clin Neurosci 2017; 40:34-38. [DOI: 10.1016/j.jocn.2017.01.018] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/22/2017] [Indexed: 12/15/2022]
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10
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Seo YG, Choi HC, Cho B. The Relationship between Metabolically Obese Non-Obese Weight and Stroke: The Korea National Health and Nutrition Examination Survey. PLoS One 2016; 11:e0160846. [PMID: 27494241 PMCID: PMC4975497 DOI: 10.1371/journal.pone.0160846] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 07/26/2016] [Indexed: 11/18/2022] Open
Abstract
Objective Both metabolic syndrome (MetS) and obesity increase the risk of stroke. However, few studies have compared the risks of stroke associated with metabolically obese non-obese weight (MONW) and metabolically healthy obesity (MHO). This study aimed to compare the prevalence of stroke in MONW and MHO individuals. Methods A total of 25,744 subjects aged ≥40 years were selected from the 2007–2014 Korean National Health and Nutrition Examination Survey. MetS was defined using 2001 National Cholesterol Education Program/Adult Treatment Panel III and 2005 American Heart Association/National Heart, Lung, and Blood Institute criteria. Non-obese weight and obesity were defined as a body mass index (BMI) <25 kg/m2 and ≥25 kg/m2, respectively. MONW was defined as meeting the MetS criteria with a BMI <25 kg/m2 and MHO was defined as not meeting the MetS criteria with a BMI ≥25 kg/m2. Results Women with MONW had a higher prevalence of stroke than those with MHO (odds ratio [OR] = 2.27, 95% confidence interval [CI]: 1.45–3.57). The prevalence of stroke increased as the number of MetS components increased. The ORs for MONW with 3, 4, and 5 MetS components were 1.95 (95% CI: 1.19–3.21), 2.49 (95% CI: 1.46–4.24) and 2.74 (95% CI: 1.39–5.40), respectively. Conclusions Our study findings may better emphasize the risk of stroke among more lean but unhealthy individuals, who appear healthy but may be suffering from MetS. These findings also highlight the need for stroke risk factor assessment in non-obese weight individuals.
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Affiliation(s)
- Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Korea
| | - Ho-Chun Choi
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
- * E-mail:
| | - Belong Cho
- Department of Family Medicine, Center for Health Promotion and Optimal Aging, Health Promotion Center for Cancer survivor, Seoul National University Hospital, Seoul, Korea
- Advanced Institutes of Convergence Technology, Seoul National University, Suwon, Gyeonggi-do, Korea
- Institute on Aging, Seoul National University College of Medicine, Seoul, Korea
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Higher levels of serum lycopene are associated with reduced mortality in individuals with metabolic syndrome. Nutr Res 2016; 36:402-7. [PMID: 27101758 DOI: 10.1016/j.nutres.2016.01.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 01/07/2016] [Accepted: 01/08/2016] [Indexed: 11/20/2022]
Abstract
Metabolic syndrome increases the risk of mortality. Increased oxidative stress and inflammation may play an important role in the high mortality of individuals with metabolic syndrome. Previous studies have suggested that lycopene intake might be related to the reduced oxidative stress and decreased inflammation. Using data from the National Health and Nutrition Examination Survey, we examined the hypothesis that lycopene is associated with mortality among individuals with metabolic syndrome. A total of 2499 participants 20 years and older with metabolic syndrome were divided into 3 groups based on their serum concentration of lycopene using the tertile rank method. The National Health and Nutrition Examination Survey from years 2001 to 2006 was linked to the mortality file for mortality follow-up data through December 31, 2011, to determine the mortality rate and hazard ratios (HR) for the 3 serum lycopene concentration groups. The mean survival time was significantly higher in the group with the highest serum lycopene concentration (120.6 months; 95% confidence interval [CI], 118.8-122.3) and the medium group (116.3 months; 95% CI, 115.2-117.4), compared with the group with lowest serum lycopene concentration (107.4 months; 95% CI, 106.5-108.3). After adjusting for possible confounding factors, participants in the highest (HR, 0.61; P = .0113) and in the second highest (HR, 0.67; P = .0497) serum lycopene concentration groups showed significantly lower HRs of mortality when compared with participants in the lower serum lycopene concentration. The data suggest that higher serum lycopene concentration has a significant association with the reduced risk of mortality among individuals with metabolic syndrome.
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Chen LJ, Lai YJ, Sun WJ, Fox KR, Chu D, Ku PW. Associations of exercise, sedentary time and insomnia with metabolic syndrome in Taiwanese older adults: A 1-year follow-up study. Endocr Res 2015; 40:220-6. [PMID: 26167672 DOI: 10.3109/07435800.2015.1020547] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Understanding the risk factors of metabolic syndrome (MetS) is important to public health, since individuals with MetS have an increased risk of health problems. This study examined the associations of exercise, sedentary time and insomnia with incident MetS among older adults 1 year later. METHOD A total of 1,359 older adults receiving hospital health examinations in 2012 were studied, and 779 subjects had a follow-up after 1 year. The components of MetS (waist, blood pressure, high-density lipoprotein cholesterol, fasting glucose and triglyceride) were defined by the Program's Adult Treatment Panel III report. Exercise, sedentary time and insomnia data were obtained through self-report questionnaires. Physical fitness (body fatness, balance and hand grip strength) was measured. Two logistic regressions were computed to examine the associations of exercise/physical fitness, sedentary time and insomnia at baseline with incident MetS 1 year later. The first regression included age, sex, smoking and alcohol as covariates. The second regression was further adjusted with the components of MetS. RESULTS Sex, exercise/balance, sedentary time and insomnia were significant predictors of MetS. The risk of MetS incidence was 3.36 (95% CI 1.96-5.77) for women, 1.92 (95% CI 1.01-3.63) for those who did not exercise, 2.52 (95% CI 1.37-4.63) for those who sat more than 5 h/day, and 2.17 (95% CI 1.13-4.15) for those with insomnia. Poor balance was significantly associated with greater risk of MetS (AOR = 1.07, 95% CI 1.02-1.12). Sex, sedentary time, insomnia and balance remained significant after adjusting with the components of MetS. CONCLUSIONS Cultivating exercise habits, reducing sedentary time and improving sleep quality may be important strategies for MetS prevention among older adults.
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Affiliation(s)
- Li-Jung Chen
- a Department of Exercise Health Science , National Taiwan University of Sport , Taichung , Taiwan
| | - Yun-Ju Lai
- b Division of Endocrinology and Metabolism , Puli Branch of Taichung Veterans General Hospital , Puli , Taiwan
| | - Wen-Jung Sun
- c Family Medicine Department, Taipei City Hospital Zhongxing Branch , Taipei , Taiwan
| | - Kenneth R Fox
- d Centre for Exercise, Nutrition and Health Sciences, University of Bristol , Bristol , UK
| | - Dachen Chu
- e Department of Neurosurgery , Taipei City Hospital, and Institute of Public Health and Community Medicine Research Center, National Yang-Ming University , Tapei , Taiwan , and
| | - Po-Wen Ku
- f Graduate Institute of Sports and Health, National Changhua University of Education , Changhua , Taiwan
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Chen YC, Sun CA, Yang T, Chu CH, Bai CH, You SL, Hwang LC, Chen CH, Wei CY, Chou YC. Impact of metabolic syndrome components on incident stroke subtypes: a Chinese cohort study. J Hum Hypertens 2014; 28:689-93. [PMID: 24430706 DOI: 10.1038/jhh.2013.152] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 12/09/2013] [Accepted: 12/11/2013] [Indexed: 11/09/2022]
Abstract
Limited evidence is available on the risk differences in the development of stroke subtypes in relation to particular clustering patterns of the metabolic syndrome (MetS) components. A follow-up study of a Chinese cohort involving 10,292 individuals was performed to assess the roles of cluster patterns of the MetS components in the prediction of incident stroke subtypes. During follow-up, there were 161 incident cases of ischemic strokes and 41 incident cases of hemorrhagic strokes. Among MetS components, only the hypertensive trait was associated with significantly elevated risks of both ischemic and hemorrhagic strokes. Furthermore, MetS with hypertension as components was associated with increased risk of ischemic and hemorrhagic strokes (adjusted hazards ratio (95% confidence interval) was 2.96 (1.94-4.50) and 2.93 (1.25-6.90), respectively) as compared with those who had neither hypertension nor MetS. Notably, as the number of the MetS components increased, the risk of ischemic stroke significantly and dose-dependently increased. This implies a cumulative effect of MetS components in elevating the risk of ischemic stroke. These findings suggest that MetS comprises heterogenous clusters with respect to the risk of developing the subtype of stroke.
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Affiliation(s)
- Y-C Chen
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei City, Taiwan, Republic of China
| | - C-A Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan, Republic of China
| | - T Yang
- Department of Health Business Administration, Meiho University, Pingtung, Taiwan, Republic of China
| | - C-H Chu
- Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan, Republic of China
| | - C-H Bai
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei City, Taiwan, Republic of China
| | - S-L You
- 1] Genomics Research Center, Academia Sinica, Taipei City, Taiwan, Republic of China [2] School of Public Health, National Defense Medical Center, Taipei City, Taiwan, Republic of China
| | - L-C Hwang
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan, Republic of China
| | - C-H Chen
- Digestive Disease Center, Changhua Show-Chwan Memorial Hospital, Changhua County, Taiwan, Republic of China
| | - C-Y Wei
- Department of Neurology, Chang Bing Show-Chwan Memorial Hospital, Changhua County, Taiwan, Republic of China
| | - Y-C Chou
- 1] Graduate Institute of Life Sciences, National Defense Medical Center, Taipei City, Taiwan, Republic of China [2] School of Public Health, National Defense Medical Center, Taipei City, Taiwan, Republic of China
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Takahashi T, Harada M, Kikuno T, Ujihara M, Sadamitsu D, Manabe Y, Yasaka M, Takayama H, Kobori S, Araki E. Prevalence of metabolic syndrome in stroke patients: a prospective multicenter study in Japan. Acute Med Surg 2014; 1:17-22. [PMID: 29930817 PMCID: PMC5997207 DOI: 10.1002/ams2.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 08/29/2013] [Indexed: 11/12/2022] Open
Abstract
AIMS The fact that Metabolic Syndrome (MetS) increases the risk of atherosclerosis has been epidemiologically studied and proven; however, a prospective study on the prevalence of MetS in stroke patients has never been conducted because of the difficulty in diagnosis under critical illness in the acute phase. Therefore, we conducted a prospective multicenter study to investigate the prevalence of MetS in stroke patients with modified diagnostic criteria for MetS. METHODS Stroke patients admitted in the seven participating Emergency and Critical Care Centers within the two years from April 2007 were registered in this study as a prospective multicenter study. Inclusion criteria were 50 to 89 year-old stroke patients who presented within three days from the onset of symptoms. A total of 992 subjects were classified according to the stroke type and the prevalence of MetS and the associated risk factors were investigated. The participants in a medical checkup without any history of a stroke were enrolled as the control group, and compared between the two groups. RESULTS The prevalence of MetS as well as hyperglycemia and dyslipidemia in the infarction group was significantly higher than that in the non-stroke group. While the hemorrhage group showed no significant difference in the prevalence of MetS, only hypertension was significantly high. According to a subtype analysis, there is a significant correlation between waist circumference increment of the stroke patients and the prevalence of the risk factors of hypertension, hyperglycemia and dyslipidemia. CONCLUSIONS Different risk factors are significantly related to the type of stroke.
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Affiliation(s)
- Takeshi Takahashi
- Emergency and Critical Care Center of Kumamoto Medical CenterNational Hospital OrganizationKumamotoJapan
| | - Masahiro Harada
- Emergency and Critical Care Center of Kumamoto Medical CenterNational Hospital OrganizationKumamotoJapan
| | - Takaaki Kikuno
- Emergency and Critical Care Center of Tokyo Medical CenterNational Hospital OrganizationTokyoJapan
| | - Makoto Ujihara
- Metabolic Medicine of Yokohama Medical CenterNational Hospital OrganizationKanagawaJapan
| | - Daikai Sadamitsu
- Emergency and Critical Care Center of Osaka Medical CenterNational Hospital OrganizationOsakaJapan
| | - Yasuhiro Manabe
- Neurology of Okayama Medical CenterNational Hospital OrganizationOkayamaJapan
| | - Masahiro Yasaka
- Neurology of Kyusyu Medical CenterNational Hospital OrganizationFukuokaJapan
| | - Hayato Takayama
- Emergency and Critical Care Center of Nagasaki Medical CenterNational Hospital OrganizationNagasakiJapan
| | - Shozo Kobori
- Metabolic Medicine of Miyazaki HospitalNational Hospital OrganizationMiyazakiJapan
| | - Eiichi Araki
- Department of Metabolic Medicine, Faculty of Life SciencesKumamoto UniversityKumamotoJapan
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The relationship between metabolic syndrome (MetS) and spontaneous intracerebral hemorrhage (ICH). Neurol Sci 2012; 34:1523-8. [DOI: 10.1007/s10072-012-1272-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 12/08/2012] [Indexed: 10/27/2022]
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Jia Z, Wu S, Zhou Y, Wang W, Liu X, Wang L, Wang Y, Wang Y, Liang W, Zhao X, Zhang Y. Metabolic syndrome and its components as predictors of stroke in middle-aged and elderly Chinese people. Neurol Res 2012; 33:453-9. [PMID: 21669112 DOI: 10.1179/016164111x13007856083882] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND AND PURPOSE Little information is available on the role of metabolic syndrome (MetS) to predict first-ever stroke in the Chinese mainland. In this study, we investigated whether the metabolic syndrome and its single components, defined by original National Cholesterol Education Program (NCEP), International Diabetes Federation (IDF) and updated NCEP, could predict stroke in the middle-aged and elderly (40-85 years) Chinese population. METHODS In this prospective study, three metabolic syndrome definitions were applied to 19,369 subjects aged 40-85 years who were free of stroke and/or myocardial infarction at baseline and were followed up to 3 years. Multivariable Cox regression analysis was used to calculate the adjusted hazard ratios (HRs) and 95% confidence interval of metabolic syndrome and its single components with the first-ever stroke. RESULTS The metabolic syndrome defined by the original NCEP, IDF and updated NCEP were all significantly associated with stroke even after adjustment for confounding variables (HRs: 1.51 to 2.14). For the single components of metabolic syndrome, the following components predicted stroke incidence in both genders: insulin resistance or previous diagnosis with diabetes (HRs: 1.48-1.54 for men and 1.66-1.92 for women); blood pressure ≥ 130/85 mmHg or using medication (HRs: 2.54 for men and 2.31 for women). For men, central obesity defined by the IDF or updated NCEP criteria (waist circumference ≥ 90 cm) had association with stroke (HR: 1.47). However, none of criteria of central obesity was associated with stroke in female. CONCLUSIONS The metabolic syndrome is associated with first-ever stroke in this middle-aged and elderly Chinese population. Furthermore, blood pressure alone plays a more important role than metabolic syndrome in stroke risk in middle-aged and elderly Chinese population.
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Affiliation(s)
- Zhaoxia Jia
- Department of Epidemiology and Health Statistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China
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Reynolds K. Epidemiology of Obesity and Metabolic Syndrome in China. CURRENT CARDIOVASCULAR RISK REPORTS 2012. [DOI: 10.1007/s12170-012-0226-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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18
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Thompson AM, Zhang Y, Tong W, Xu T, Chen J, Zhao L, Kelly TN, Chen CS, Bazzano LA, He J. Association of inflammation and endothelial dysfunction with metabolic syndrome, prediabetes and diabetes in adults from Inner Mongolia, China. BMC Endocr Disord 2011; 11:16. [PMID: 21989115 PMCID: PMC3204247 DOI: 10.1186/1472-6823-11-16] [Citation(s) in RCA: 19] [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: 09/14/2010] [Accepted: 10/11/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We examined the association of biomarkers of inflammation and endothelial dysfunction with diabetes and metabolic syndrome (MetS) in persons from Inner Mongolia. METHODS A cross-sectional study was conducted among 2,536 people aged 20 years and older from Inner Mongolia, China. Overnight fasting blood samples were obtained to measure plasma concentrations of high sensitivity C-reactive protein (hsCRP), soluble inter-cellular adhesion molecule-1 (sICAM-1), sE-selectin, angiotensin II, high density lipoprotein cholesterol, triglycerides, and blood glucose. Waist circumference and blood pressure were measured by trained staff. MetS was defined according to the modified ATP III definition for Asians. Elevated level of the biomarker was defined as values in the upper tertile of the distribution. Participants were categorized into one of four groups based on the presence or absence of metabolic and glycemic abnormalities: 1) free of prediabetes, diabetes and MetS (reference group), 2) prediabetes or diabetes only, 3) MetS without prediabetes or diabetes, and 4) MetS plus prediabetes or diabetes. The multivariable models are adjusted for age, gender, smoking, drinking, family history of hypertension, and body mass index. RESULTS Among study participants, 18.5% had prediabetes, 3.6% had diabetes, and 27.4% of the entire study population had 3 or more components of the MetS. Elevated hsCRP was associated with an increased odds of prediabetes or diabetes only, MetS without prediabetes or diabetes, and MetS plus prediabetes or diabetes with multivariable adjusted odds ratios (95% confidence intervals) of 2.3 (1.7-3.1), 3.0 (2.4-3.8), and 5.8 (4.5-7.5), respectively. Elevated sICAM-1 was associated with increased odds (95% CI) of prediabetes or diabetes only (2.1, 1.6-2.9) and MetS plus prediabetes or diabetes (4.2, 3.2-5.3) but was not associated with MetS alone. Elevated sE-selectin was associated with a modestly increased risk of MetS (OR 1.7, 95% CI 1.4-2.2). Elevated levels of Angiotensin II were not associated with the MetS plus prediabetes or diabetes in this study. CONCLUSIONS Diabetes and the MetS are common in the Inner Mongolia population. The biomarkers of inflammation and endothelial dysfunction are associated with increased risk for diabetes and MetS in this population. These results are consistent with results from other populations.
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Affiliation(s)
- Angela M Thompson
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Radiation Medicine and Public Health, Medical College of Soochow University, Suzhou, Jiangsu, PR China
| | - Weijun Tong
- Department of Epidemiology, School of Radiation Medicine and Public Health, Medical College of Soochow University, Suzhou, Jiangsu, PR China
| | - Tan Xu
- Department of Epidemiology, School of Radiation Medicine and Public Health, Medical College of Soochow University, Suzhou, Jiangsu, PR China
| | - Jing Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Li Zhao
- Tongliao Center for Disease Prevention and Control, Tongliao, Inner Mongolia, PR China
| | - Tanika N Kelly
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Chung-Shiuan Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
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Institoris A, Snipes JA, Katakam PV, Domoki F, Boda K, Bari F, Busija DW. Impaired vascular responses of insulin-resistant rats after mild subarachnoid hemorrhage. Am J Physiol Heart Circ Physiol 2011; 300:H2080-7. [PMID: 21421821 DOI: 10.1152/ajpheart.01169.2010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Insulin resistance (IR) impairs cerebrovascular responses to several stimuli in Zucker obese (ZO) rats. However, cerebral artery responses after subarachnoid hemorrhage (SAH) have not been described in IR. We hypothesized that IR worsens vascular reactions after a mild SAH. Hemolyzed blood (300 μl) or saline was infused (10 μl/min) into the cisterna magna of 11-13-wk-old ZO (n = 25) and Zucker lean (ZL) rats (n = 25). One day later, dilator responses of the basilar artery (BA) and its side branch (BA-Br) to acetylcholine (ACh, 10(-6) M), cromakalim (10(-7) M, 10(-6) M), and sodium nitroprusside (10(-7) M) were recorded with intravital videomicroscopy. The baseline diameter of the BA was increased both in the ZO and ZL rats 24 h after the hemolysate injection. Saline-injected ZO animals showed reduced dilation to ACh (BA = 9 ± 3 vs. 22 ± 4%; and BA-Br = 23 ± 5 vs. 37 ± 7%) compared with ZL rats. Hemolysate injection blunted the response to ACh in both the ZO (BA = 4 ± 2%; and BA-Br = 12 ± 3%) and ZL (BA = 7 ± 2%; and BA-Br = 11 ± 3%) rats. Cromakalim (10(-6) M)-induced dilation was significantly reduced in the hemolysate-injected ZO animals compared with the saline control (BA = 13 ± 3 vs. 26 ± 5%; and BA-Br = 28 ± 8 vs. 44 ± 9%) and in the hemolysate-injected ZL rats compared with their saline control (BA = 24 ± 4 vs. 32 ± 4%; but not BA-Br = 39 ± 6 vs. 59 ± 9%). No significant difference in sodium nitroprusside reactivity was observed. Western blot analysis of the BA showed a lower baseline level of neuronal nitric oxide synthase expression and an enhanced cyclooxygenase-2 level in the hemolysate-injected ZO animals. In summary, cerebrovascular reactivity to both endothelium-dependent and -independent stimuli is severely compromised by SAH in IR animals.
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Affiliation(s)
- Adam Institoris
- Dept. of Pharmacology, Tulane Univ., 1430 Tulane Ave., SL 83, New Orleans, LA, 70112-2632, USA
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Controlling energetic intake based on a novel logistic regression model for the metabolic syndrome in a Chinese population. Br J Nutr 2011; 105:256-62. [PMID: 20807463 DOI: 10.1017/s0007114510003235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The present study was designed to develop a novel method of energy calculation for controlling energetic intake in patients with the metabolic syndrome. Demographics and dietary data were recorded for 2582 obese subjects. Nutritional education was applied to all the patients. One year later, the data on age, sex, activity intensity coefficient, waistline, environmental temperature and BMI in subjects who lost ≥ 5% body weight were entered into a multivariate logistic regression analysis model. Energy requirement was calculated from the results of multivariate logistic regression. Four hundred and thirty-four metabolic syndrome patients were then randomly divided into the treated group (216) and the control group (218). The energetic intake in the experimental group was controlled based on the new energy requirement model. The traditional energy exchange method was used in the control group. The independent factors predicting metabolic syndrome prognosis, such as age, sex, activity intensity coefficient, waistline, environmental temperature and BMI, were identified by multivariate logistic regression analysis. The energy requirement model was then constructed by logistic regression analysis. After 6 months of energetic intake control based on the new model, the parameters of the experimental group were significantly different from those of the controls (all P < 0·05): waistline, 89·65 (SD 5·54) v. 91·97 (SD 4·78) cm; BMI, 24·67 (SD 3·54) v. 25·87 (SD 2·65) kg/m2; fasting blood glucose, 6·9 (SD 3·6) v. 8·7 (SD 4·6) mmol/l; 2 h PG, 8·7 (SD 5·7) v. 10·7 (SD 4·5) mmol/l; HbA1c, 7·7 (SD 1·6) v. 8·9 (SD 2·6) %; homoeostasis model insulin resistance index, 3·14 (SD 1·62) v. 4·32 (SD 2·25). The new energy requirement model can effectively improve the clinical outcomes of controlling energetic intake in metabolic syndrome patients.
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Bankoski A, Harris TB, McClain JJ, Brychta RJ, Caserotti P, Chen KY, Berrigan D, Troiano RP, Koster A. Sedentary activity associated with metabolic syndrome independent of physical activity. Diabetes Care 2011; 34:497-503. [PMID: 21270206 PMCID: PMC3024375 DOI: 10.2337/dc10-0987] [Citation(s) in RCA: 306] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study examined the association between objectively measured sedentary activity and metabolic syndrome among older adults. RESEARCH DESIGN AND METHODS Data were from 1,367 men and women, aged ≥ 60 years who participated in the 2003-2006 National Health and Nutrition Examination Survey (NHANES). Sedentary time during waking hours was measured by an accelerometer (<100 counts per minute). A sedentary bout was defined as a period of time >5 min. A sedentary break was defined as an interruption in sedentary time (≥ 100 counts per minute). Metabolic syndrome was defined according to the Adult Treatment Panel (ATP) III criteria. RESULTS On average, people spent 9.5 h (65% of wear time) as sedentary. Compared with people without metabolic syndrome, people with metabolic syndrome spent a greater percentage of time as sedentary (67.3 vs. 62.2%), had longer average sedentary bouts (17.7 vs. 16.7 min), had lower intensity during sedentary time (14.8 vs. 15.8 average counts per minute), and had fewer sedentary breaks (82.3 vs. 86.7), adjusted for age and sex (all P < 0.01). A higher percentage of time sedentary and fewer sedentary breaks were associated with a significantly greater likelihood of metabolic syndrome after adjustment for age, sex, ethnicity, education, alcohol consumption, smoking, BMI, diabetes, heart disease, and physical activity. The association between intensity during sedentary time and metabolic syndrome was borderline significant. CONCLUSIONS The proportion of sedentary time was strongly related to metabolic risk, independent of physical activity. Current results suggest older people may benefit from reducing total sedentary time and avoiding prolonged periods of sedentary time by increasing the number of breaks during sedentary time.
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Affiliation(s)
- Andrea Bankoski
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, USA
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López M, Dávalos A. Advances in cerebrovascular disease research in the last year. J Neurol 2010; 258:168-72. [PMID: 21113722 DOI: 10.1007/s00415-010-5837-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Accepted: 11/10/2010] [Indexed: 10/18/2022]
Abstract
The following review summarizes the progress in cerebrovascular disease research published in the Journal of Neurology in the last year.
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Affiliation(s)
- Mirta López
- Department of Neurosciences and Neurology service, Health Sciences Research Institute and Hospitals Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
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Xu WH, Ruan XN, Fu XJ, Zhu QL, Zhang H, Bai Y, Wu HY, Zhou Y, Qiu H, Sun Q, Jiang QW, Yang LM, Gu JJ, Zhao GM. Prevalence of the metabolic syndrome in Pudong New Area of Shanghai using three proposed definitions among Chinese adults. BMC Public Health 2010; 10:246. [PMID: 20459855 PMCID: PMC2889866 DOI: 10.1186/1471-2458-10-246] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 05/12/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of metabolic syndrome (MS) has been increasing in China in recent years. The aim of this study is to estimate and compare the prevalence of MS among Chinese adults in Shanghai, one of the most economic developed areas in China, using definitions proposed by World Health Organization (WHO), National Cholesterol Education Program Adult Treatment Panel (modified ATP III) and International Diabetes Federation (IDF). METHODS This cross-sectional study included 5,584 adults at age 20-79 randomly selected from Pudong New Area of Shanghai, China, through a three-stage sampling. All participants were interviewed in-person between April and July of 2008 to collect information on demographic and lifestyle characteristics. At the interview, anthropometry and blood pressure were measured and bio-specimens were collected. RESULTS The prevalence estimates for the MS increased with age for each definition in men and women, but the estimates varied greatly between the definitions and by sex. The prevalence of the MS was higher in men (20.2%) than in women (18.7%) using WHO definition but this sex difference was reversed when using the modified ATP III (28.4% for men vs. 35.1% for women) and the IDF (15.9% for men vs. 26.7% for women) criteria. The most common metabolic disorder in this population was dyslipidaemia, regardless of the definition used. Substantial agreement, estimated using the kappa statistic, was found between the modified ATP III and IDF definition, whereas the lowest agreement was observed between the WHO and ATP III criteria. CONCLUSIONS The MS is highly prevalent among Chinese adults in Pudong New Area of Shanghai and the most prevalent component was dyslipidemia. These findings underscore the importance of prevention and control efforts for the MS in this area and the need for a unified predictive definition for the syndrome for use by clinical practitioners and public health agencies.
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Affiliation(s)
- Wang-hong Xu
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education (Fudan University), 138 Yi Xue Yuan Road, Shanghai 200032, China
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Jia WP, Wang C, Jiang S, Pan JM. Characteristics of obesity and its related disorders in China. BIOMEDICAL AND ENVIRONMENTAL SCIENCES : BES 2010; 23:4-11. [PMID: 20486430 DOI: 10.1016/s0895-3988(10)60025-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Obesity is a medical condition with excess body fat accumulation to the extent which leads to serious health consequences. Abdominal obesity, also known as central obesity, refers to the presence of excess fat in the abdominal area. Obesity, especially abdominal obesity, contributes to many metabolic disorders including metabolic syndrome (MetS), type 2 diabetes (T2DM) and cardiovascular diseases (CVD). The incidence of obesity has increased dramatically in recent years worldwide. In China, more than one-third of adults are overweight or obese and 10%-20% of all adults are affected by MetS. The pathogenesis underlying the abdominal obesity remains unclear. The ultimate health outcome of obesity and its related metabolic disorders haveprompted physicians to take aggressive treatments (lifestyle changes, pharmacological interventions and surgical therapies) before a serious consequence becomes clinically apparent. In this review, we discuss the prevalence, pathogenesis and clinic features of obesity in China.
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Affiliation(s)
- Wei-Ping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai 200233, China.
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