Identifying metabolic syndrome in a clinical cohort: Implications for prevention of chronic disease

Monitoring effects of heavy metal stress on biochemical and spectral parameters of cotton using hyperspectral reflectance

Monitoring heavy metal pollution in agricultural ecosystems is crucial to ensure environmental safety. Heavy metals interfere with plants' biochemical characteristics, such as chlorophyll content and photosynthesis, and also influence leaves' spectral properties. Spectral changes caused by heavy metal stress can easily be measured using proximal sensing or in-field spectroscopy. This research utilizes a combined approach of biochemical and spectral characteristics to evaluate cotton crops' performance under different heavy metal (Pb & Cd) stress after artificial contamination with the metal under study. A detailed study of spectroscopy and lab-based measurements for chlorophyll and heavy metal content during the crop's growth cycle revealed some significant findings. Results indicated that the chlorophyll pigments decreased significantly with increased heavy metal levels. Pb accumulation is high in cotton as compared to Cd. The most sensitive stage for the accumulation of Pb is the initial vegetative stage of cotton. The transfer factor from soil to plant was higher for Pb, indicating the feasibility of growing cotton in Pb-contaminated soil. The spectral measurement showed no characteristic changes in standard reflectance spectra due to heavy metal stress. Wavelet decomposition of reflectance spectra amplified the changes indicating Pb stress in cotton during the initial vegetative stage. The significant correlation of greater than - 0.70 between the reconstructed detail wavelet coefficients at the third level of the decomposition in the wavelength range of 651-742 nm suggested that Pb stress caused spectral changes in near-infrared and visible ranges in cotton plants. The effects of Cd stress on the cotton plant were negligible due to less absorption. Thus, detailed wavelet coefficients at the third level of decomposition in the range of 651-742 nm are a potential indicator of Pb stress. The results of this study can provide a basis for quantifying heavy metal stress in a particular region.

Development and Validation of a Simple Risk Model for Predicting Metabolic Syndrome (MetS) in Midlife: A Cohort Study

Purpose

To develop and validate a simple risk model for predicting metabolic syndrome in midlife using a prospective cohort data.

Design

Prospective cohort study.

Participants

A total of 7626 members of the 1958 British birth cohort (individuals born in the first week of March 1958) participated in the biomedical survey at age 45 and have completed information on metabolic syndrome.

Methods

Variables utilised were obtained prospectively at birth, 7, 16, 23 and 45 years. Multivariable logistic regression was used to develop a total of ten (10) MetS risk prediction models taking the life course approach. Measures of discrimination and calibration were used to evaluate the performance of the models. A pragmatic criteria developed was used to select one model with the most potential to be useful. The internal validity (overfitting) of the selected model was assessed using bootstrap technique of Stata.

Main Outcome Measure

Metabolic syndrome was defined based on the NCEP-ATP III clinical criteria.

Results

There is high prevalence of MetS among the cohort members (19.6%), with males having higher risk as compared to females (22.8% vs 16.4%, P < 0.001). Individuals with MetS are more likely to have higher levels of HbA1c and low HDL-cholesterol. Similarly, regarding the individual components of MetS, male cohort members are more likely to have higher levels of glycaemia (HbA1c), BP and serum triglycerides. In contrast, female cohort members have lower levels of HDL-cholesterol and higher levels of waist circumference. Furthermore, a total of ten (10) MetS risk prediction models were developed taking the life course approach. Of these, one model with the most potential to be applied in practical setting was selected. The model has good accuracy (AUROC 0.91 (0.90, 0.92)), is well calibrated (Hosmer-Lemeshow 6.47 (0.595)) and has good internal validity.

Conclusion

Early life factors could be included in a risk model to predict MetS in midlife. The developed model has been shown to be accurate and has good internal validity. Therefore, interventions targeting socioeconomic inequality could help in the wider prevention of MetS. However, the validity of the developed model needs to be further established in an external population.

A Retrospective Chart Review of Screening on the Prevalence of Metabolic Syndrome (MetS) in an Irish Community Mental Health Service

Individuals who are treated with antipsychotic medications are at risk of developing metabolic syndrome (MetS). The comorbidity of a severe mental illness (SMI) and a physical illness has a major impact on the quality of life of these individuals. We conducted a retrospective chart review (RCR) of 214 individuals with a diagnosis of schizophrenia who had been receiving antipsychotic medications for at least 6 months, in five clinical settings in an Irish community mental health service. The aim was to determine the presence of MetS to assist in improving screening practices and directing future practice. The National Cholesterol Education Program High Blood Cholesterol Adult Treatment Panel 111 (NCEP ATP 111) metabolic diagnostic criteria were utilised to determine prevalence. After examining 214 charts we observed that waist circumference varied from 68 to 142 cm, elevated waist circumference over the recommended parameters was recorded in 145 charts. Forty-five percent (n = 98) had blood pressure (BP) readings over 130/85. The range for body mass index (BMI)'s varied from 16 to 54, BMIs over 25 was recorded in 44% (n = 95) of charts. Elevated triglycerides (TG) were recorded in 37% (n = 80) and 45% (n = 97) had reduced HDL-C levels. Elevated glucose levels were found in 25% (n = 54) of the charts examined. The chart review found an overall prevalence rate of 44% (n = 94) for this sample. Regular audit of screening data used for the presence of MetS in individuals with SMI is essential in the detection of physical comorbidities and to improving the quality of life and prevention of premature deaths.

Socio-economics status and metabolic syndrome: A meta-analysis

OBJECTIVE

The metabolic syndrome (MetS) is responsible for an increased risk of type 2 diabetes, cardiovascular diseases and is associated with all-cause and cardiovascular mortality. Economic and social vulnerability is not an easy concept to grasp, but some studies investigate the association between MetS and socioeconomic and demographic factors, deprivation (more often correlations rather than causal one due to data). This work aims to assess the association between MetS and socio-economic gradient (SEG) in the literature by performing a meta-analysis.

DESIGN

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for systematic reviews were followed.

SETTING

The raw list of studies extracted from PubMed as regard to the inclusion/exclusion criteria was imported in Word. Studies were filed with regard to our three definitions of SEG and their title.

PARTICIPANTS

Subgroup analysis were performed considering several definitions of Mets: NCEP-ATPIII and IDF2006.

RESULTS

The overall multivariable-adjusted OR showed that the risk of MetS was significantly increased in association with SEG The results of the subgroup analysis showed an increased risk of MetS in association with SEG when IDF definition was considered.

CONCLUSIONS

Targeted interventions must be implemented in a specific way as prevention campaigns aimed at the general population are generally not adapted to this particular vulnerable population.

The Physical Health of Individuals Receiving Antipsychotic Medication: A Qualitative Inquiry on Experiences and Needs

Individuals with a mental illness are reported to have a reduced life expectancy and a greater risk of being affected by preventable physical illnesses such as cardiovascular disease and Type 2 diabetes. This inquiry sought to identify the physical health beliefs, experiences and needs of individuals with mental health problems in receipt of antipsychotic medication who live in the community. A qualitative inquiry was undertaken using three focus groups in a community mental health service in Ireland with 21 participants with mental health problems who were treated with antipsychotic medication. The participants were clear about the importance of good physical health as well as good mental health. They disliked the adverse effects of antipsychotic medication and experienced many barriers in accessing general practitioners/primary care services. They also preferred to receive health advice and self-management advice from the mental health services. The participants in this study were aware of the need to engage in health protective behaviours but were often overwhelmed by their comorbid health issues and the organizational and communication barriers in accessing their general practitioners.