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Sharma K, Poudyal S, Subba HK, Khatiwada S. Metabolic syndrome and life style factors among diabetes patients attending in a teaching hospital, Chitwan. PLoS One 2023; 18:e0286139. [PMID: 37228052 DOI: 10.1371/journal.pone.0286139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/10/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is associated with an increased incidence of chronic complications and mortality of diabetes patients. Prevention and treatment of MetS is important means of lowering the risk of cardiovascular diseases and mortality. OBJECTIVE This study aimed to find out metabolic syndrome and life style factors among diabetes patients. METHODS A cross-sectional survey was carried out among 296 patients with type 2 diabetes mellitus attending Chitwan Medical College Teaching Hospital. Consecutive sampling technique was used to select sample. Data were collected from 15th December 2021 to 15th March, 2022 using Interview Schedule, bio-physiological measurement and record review. Obtained data were analysed in SPSS version 20 for window using descriptive and inferential statistics. Chi-square test was applied to measure the association between the variables. Logistic regression analysis was performed to identify the factors associated with metabolic syndrome. RESULT Findings revealed that the prevalence of MetS was 66.2% and 58.4% in patients according to International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria respectively. The most common MetS parameters were raised fasting plasma glucose (94.6%) and abnormal waist circumference (78.4% in IDF criteria) while the least prevalent parameter was reduced HDL level (43.2%). Majorities of the patients were non-vegetarian (85.5%), had poor dietary compliance (poor-46.3%, very poor-32.1%), overweight/obese (65.5%), and suffered from moderate stress (90.1%). Bivariate analysis showed that MetS as per NCEP ATP criteria was significantly associated with gender (p = 0.006), occupation (p = 0.007), presence of other co-morbid condition (<0.001) and sleep problem (p = <0.001). However, MetS as per IDF criteria was significantly associated with age (p = <0.028), duration of diabetes (p = <0.001), follow-up visit (p = <0.030), blood sugar monitoring (p = <0.009) and physical activity of diabetes patients (p = <0.001). Further logistic regression analysis revealed that sleep problem (AOR = 21.812;95%CI = 8.512,55.894) and presence of other comorbidities (AOR = 4.024;95%CI = 2.220,7.295) were the significant factors of metabolic syndrome. CONCLUSION AND RECOMMENDATION Metabolic syndrome is high in patients with type 2 diabetes mellitus. Therefore, treating physicians and other health workers need to monitor MetS parameters regularly to reduce the risk of cardiovascular diseases, stroke and premature death.
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Affiliation(s)
- Kalpana Sharma
- School of Nursing, Chitwan Medical College, Bharatpur, Nepal
| | - Sunita Poudyal
- School of Nursing, Chitwan Medical College, Bharatpur, Nepal
| | - Hem K Subba
- School of Nursing, Chitwan Medical College, Bharatpur, Nepal
| | - Saurav Khatiwada
- Departments of Endocrine Medicine, Chitwan Medical College, Bharatpur, Nepal
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Gahlan D, Rajput R, Singh V. Metabolic syndrome in north Indian type 2 diabetes mellitus patients: A comparison of four different diagnostic criteria of metabolic syndrome. Diabetes Metab Syndr 2019; 13:356-362. [PMID: 30641725 DOI: 10.1016/j.dsx.2018.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/09/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Deepak Gahlan
- Department of Medicine, Maharaja Agrasen Medical College & Hospital, Agroha, 125047, Hisar, Haryana, India.
| | - Rajesh Rajput
- Department of Endocrinology and Medicine, Pt. B.D. Sharma PGIMS, Rohtak, 124001, Haryana, India.
| | - Vandana Singh
- Haryana School of Business, Guru Jambheswar University of Science & Technology, Hisar, 125001, Haryana, India.
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Skalnaya MG, Skalny AV, Serebryansky EP, Yurasov VV, Skalnaya AA, Tinkov AA. ICP-DRC-MS analysis of serum essential and toxic element levels in postmenopausal prediabetic women in relation to glycemic control markers. J Trace Elem Med Biol 2018; 50:430-434. [PMID: 28941826 DOI: 10.1016/j.jtemb.2017.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/11/2017] [Accepted: 09/11/2017] [Indexed: 12/22/2022]
Abstract
PURPOSE Assessment of the influence of prediabetes on serum trace element and electrolyte levels in postmenopausal women. METHODS A total of 80 prediabetic and 80 healthy postmenopausal women took part in the present study. Serum was analyzed for glucose, insulin, insulin resistance index (HOMA-IR), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT). Glycated haemoglobin (HbA1c) levels were also assessed. Serum levels of 28 elements were estimated using inductively-coupled plasma mass spectrometry with dynamic reaction cell technology (ICP-DRC-MS). RESULTS Prediabetic women were characterized by significantly higher HbA1c, glucose, insulin, HOMA-IR, ALT, and GGT values. Of trace elements, only serum zinc (Zn) levels were significantly lower in prediabetics by 10% (p=0.001) when compared to the controls. Serum Zn levels were characterized by a significant inverse correlation with HbA1c (r=- 0.205; p=0.009), insulin (r=- 0.246; p=0.002), and HOMA-IR (r=- 0.227; p=0.004). Multiple regression analysis demonstrated a significant inverse association between serum Zn (β=-0.169; p=0.031) and Sr (β=-0.192; p=0.012) and HOMA-IR values after adjustment for anthropometric and biochemical parameters (p for a model <0.001). Although serum Zn was significantly associated with HbA1c both in crude and adjusted models, no significant relationship was detected after adjustment for age and anthropometric parameters. CONCLUSIONS Prediabetic postmenopausal women are characterized by significantly lower levels of serum Zn concentration, whereas serum Zn and Sr levels were inversely associated with insulin resistance.
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Affiliation(s)
- Margarita G Skalnaya
- Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklaya St., 6, Moscow, 105064, Russia
| | - Anatoly V Skalny
- Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklaya St., 6, Moscow, 105064, Russia; Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia; Orenburg State University, Pobedy Ave., 13, Orenburg, 460352, Russia; Trace Element Institute for UNESCO, Lyon, France
| | - Eugeny P Serebryansky
- Russian Society for Trace Elements in Medicine, ANO "Centre for Biotic Medicine", Zemlyanoi Val St., 46, Moscow, 105064, Russia
| | - Vasily V Yurasov
- Russian Society for Trace Elements in Medicine, ANO "Centre for Biotic Medicine", Zemlyanoi Val St., 46, Moscow, 105064, Russia
| | | | - Alexey A Tinkov
- Peoples' Friendship University of Russia (RUDN University), Miklukho-Maklaya St., 6, Moscow, 105064, Russia; Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia; Orenburg State University, Pobedy Ave., 13, Orenburg, 460352, Russia.
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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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Tao LX, Wang W, Zhu HP, Huo D, Zhou T, Pan L, Gao Q, Luo YX, Wu LJ, Li X, Tang Z, Guo XH. Risk profiles for metabolic syndrome and its transition patterns for the elderly in Beijing, 1992-2009. Endocrine 2014; 47:161-8. [PMID: 24452870 DOI: 10.1007/s12020-013-0143-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 11/29/2013] [Indexed: 10/25/2022]
Abstract
There have been few reports on the development of metabolic disorders, especially when they are considered as a cluster. The purpose of this study was to describe risk profiles for metabolic syndrome (MetS) in elderly dwellers in Beijing, and to find their transition patterns over time. Data were derived from Beijing longitudinal study of aging, a community-based cohort study hosted by Xuanwu hospital. There were 3,257 elderly people aged 55 years or over recruited in 1992. MetS was assessed for the years 1992, 2000, and 2009. Finally, 363 subjects with complete information for components of MetS in the three years were included in the study. The criteria of MetS recommended by the joint interim statement criteria were adopted. Latent transition analysis was used to calculate the transition probabilities between adjacent visits. A risk typology consisting of four time-invariant groups was detected based on the components of MetS for all subjects. Low MetS risk group, BP risk group, BP-HDL risk group, and BP-FPG-TG risk group were found. The probability of staying at the same status was higher at the two intervals across 18 years. Four latent groups were extracted based on three assessments for the components of MetS, together with their transition patterns. Findings suggested various trajectories for MetS components. Different combinations of intervention strategy might be needed for MetS risk groups.
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Affiliation(s)
- Li-Xin Tao
- School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmenwai, Fengtai, Beijing, 100069, China
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Tan MC, Ng OC, Wong TW, Joseph A, Chan YM, Hejar AR. Prevalence of metabolic syndrome in type 2 diabetic patients: A comparative study using WHO, NCEP ATP III, IDF and Harmonized definitions. Health (London) 2013. [DOI: 10.4236/health.2013.510227] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ertek S, Cicero AF, Cesur M, Akcil M, Altuner Kayhan T, Avcioglu U, Korkmaz ME. The severity of coronary atherosclerosis in diabetic and non-diabetic metabolic syndrome patients diagnosed according to different criteria and undergoing elective angiography. Acta Diabetol 2011; 48:21-7. [PMID: 20680373 DOI: 10.1007/s00592-010-0211-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 07/21/2010] [Indexed: 01/06/2023]
Abstract
Our aim in this study was to evaluate the relationship between metabolic syndrome (MS) as defined by different criteria and the severity of coronary lesions in a sample of diabetic and non-diabetic patients undergoing elective coronary angiography. All patients had blood and urine tests, physical examinations were performed before angiography, and finally they were classified based on three criteria (World Health Organisation-WHO, Adult Treatment Panel-ATP III and International Diabetes Federation-IDF). Eighty-eight patients were diabetic, and 96 patients were non-diabetic. Among all patients, diabetics had significantly higher Gensini scores (P < 0.001). According to WHO criteria (P = 0.005) and IDF criteria (P = 0.015) metabolic syndrome patients had higher Gensini scores, but for ATP III criteria difference was not significant. When we evaluated diabetics and non-diabetics separately, non-diabetic patients with MS had significantly higher scores with WHO definition (P = 0.015) and mildly higher but not significant values with other MS criteria (P = 0.057 for both IDF and ATP III). Neither any one of MS components nor gender revealed significant relationship with coronary disease severity. In our study with a cohort of Turkish patients undergoing elective coronary angiography; we concluded that MS should be taken into consideration, especially in non-diabetic patients.
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Affiliation(s)
- S Ertek
- Department of Endocrinology and Metabolic Diseases, Ufuk University, Dr. Ridvan Ege Hospital, Mevlana Bulvari, Ankara, Turkey.
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Yun JE, Kim SY, Kang HC, Lee SJ, Kimm H, Jee SH. Alanine aminotransferase is associated with metabolic syndrome independently of insulin resistance. Circ J 2011; 75:964-9. [PMID: 21304212 DOI: 10.1253/circj.cj-10-0465] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few studies have examined the effect of insulin resistance on the association between alanine aminotransferase (ALT) and metabolic syndrome. The association between ALT levels and metabolic syndrome were determined, independently of insulin resistance in Korean populations. METHODS AND RESULTS The association between ALT and metabolic syndrome were examined in 28,456 subjects who visited 7 Health Promotion Centers at University Hospitals in Korea from 2006 to 2008. HOMA-IR index was used to represent insulin resistance index. ALT levels were found to be positively associated with metabolic syndrome after adjusting for age, alcohol intake, and smoking status. Furthermore, when additional adjustment was made for insulin resistance, this association between ALT and metabolic syndrome, although slightly attenuated, remained strongly significant. Subjects in the highest ALT quartile were found to have a higher risk of having metabolic syndrome than those in the lowest quartile (odds ratio (OR)=4.45, 95% confidence interval (CI)=3.96-4.99 for men and OR=3.51, 95%CI=2.73-4.52 for women). In addition, the association between ALT level and the risk of metabolic syndrome was significantly higher in the relatively low risk group. CONCLUSIONS ALT levels were found to be significantly associated with metabolic syndrome independently of insulin resistance and with an interaction by age. Further cohort studies are needed to determine the usefulness of ALT levels for predicting the risk of metabolic syndrome.
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Affiliation(s)
- Ji Eun Yun
- Institute for Health Promotion, Yonsei University, Seoul, Korea
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Guize L, Pannier B, Thomas F, Bean K, Jégo B, Benetos A. Recent advances in metabolic syndrome and cardiovascular disease. Arch Cardiovasc Dis 2008; 101:577-83. [PMID: 19041842 DOI: 10.1016/j.acvd.2008.06.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Revised: 05/30/2008] [Accepted: 06/17/2008] [Indexed: 12/15/2022]
Abstract
Metabolic syndrome is defined as an association of central obesity and several other cardiometabolic risk factors. Dysfunctional visceral adipose tissue and inflammatory status appear to be involved in its genesis. New definitions have decreased the threshold for glycaemia and one has lowered the threshold for waist circumference, leading to an increase in the prevalence of metabolic syndrome. However, the impact on mortality with these new definitions is lower than with the National Cholesterol Education Program-Adult Treatment Panel III 2001 definition. An increase in waist circumference, along with increased glycaemia, triglycerides and/or blood pressure is more highly associated with an increased risk of mortality than are other associations, while a decrease in high density lipoprotein cholesterol increases risk of coronary heart disease. The risk of sudden death and stroke is particularly notable with metabolic syndrome. Metabolic syndrome is associated with an increase in heart rate, pulse pressure, arterial stiffness and left ventricular hypertrophy, impairment of diastolic function, enlargement of the left atrium and atrial fibrillation. In the 2007 European recommendations for the management of high blood pressure, metabolic syndrome is now taken into consideration for both risk stratification and in selecting the optimal therapeutic strategy for arterial hypertension.
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Affiliation(s)
- Louis Guize
- Centre IPC, 6/14, rue La Pérouse, 75116 Paris, France
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Bove M, Cicero AFG, Manca M, Georgoulis I, Motta R, Incorvaia L, Giovannini M, Poggiopollini G, V Gaddi A. Sources of variability of plasma HDL-cholesterol levels. ACTA ACUST UNITED AC 2007. [DOI: 10.2217/17460875.2.5.557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Guize L, Thomas F, Pannier B, Bean K, Jego B, Benetos A. All-cause mortality associated with specific combinations of the metabolic syndrome according to recent definitions. Diabetes Care 2007; 30:2381-7. [PMID: 17563336 DOI: 10.2337/dc07-0186] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim was to evaluate the impact of specific component combinations of the metabolic syndrome on all-cause mortality risk in a large French cohort. RESEARCH DESIGN AND METHODS The population was composed of 39,998 men (aged 52.6 +/- 8.3 years) and 20,756 women (aged 54.7 +/- 9.2 years) who were examined at the Investigations Préventives et Cliniques Center from 1999 to 2002. Mean follow-up was 3.57 +/- 1.12 years. Metabolic syndrome was defined according to three definitions: the National Cholesterol Educational Program (NCEP 2001), the revised NCEP (NCEP-R; American Heart Association/National Heart, Lung, and Blood Institute 2005), and the International Diabetes Federation (IDF 2005). Subjects with metabolic syndrome were compared with subjects without metabolic syndrome and with subjects with no metabolic syndrome components using Cox regression models. RESULTS The prevalence of metabolic syndrome increased from 10.3% (NCEP) to 17.7% (NCEP-R) and 23.4% (IDF). After adjustment for age, sex, classical risk factors, and socioprofessional categories, and compared with subjects without metabolic syndrome, the risk of all-cause mortality was 1.79 (95% CI 1.35-2.38), 1.46 (1.14-1.88), and 1.32 (1.04-1.67) with the NCEP, NCEP-R, and IDF definitions, respectively. Among the combinations significantly associated with all-cause mortality, the following three-component combinations and the four-component combination were more highly significant than other combinations (P < 0.05): elevated waist circumference plus elevated glucose, plus either elevated blood pressure or elevated triglycerides, and the combination of all four of these. CONCLUSIONS In a large middle-aged French population, four specific components of metabolic syndrome are associated with a much higher mortality risk. These results may have a significant impact on detecting high-risk subjects suffering from metabolic disorders and underline the fact that metabolic syndrome is a nonhomogeneous syndrome.
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Affiliation(s)
- Louis Guize
- Centre Investigations Préventives et Cliniques, Paris, France.
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