Incidence of metabolic syndrome according to combinations of lifestyle factors among middle-aged Japanese male workers

Prevalence of metabolic syndrome, its risk factors and associated lifestyles in Myanmar adult people: A community based cross-sectional study

OBJECTIVES

Metabolic syndrome (MetS) is the constellation of cardio-metabolic risk factors, and it can illustrate the coming burden of cardiovascular diseases and diabetes mellitus. Myanmar faces larger pressure from cardio-metabolic diseases and there is no existing data to understand the magnitude of MetS in adult population. This study aimed to investigate the extent of existing people with MetS in the community and to know the related lifestyle factors to MetS.

METHODS

A community based cross-sectional study was performed in convenient sample of 302 Myanmar adult people. Prevalence of MetS and associated risk factors were identified by collecting sociodemographic information, anthropometric measurements, and blood investigation of glucose and lipid profiles. Logistic regression analysis was performed for developing statistical models to estimate the odd ratios (OR) and confidence intervals (CI).

RESULTS

Prevalence of MetS is 29.1%, and there is no significant difference between male and female prevalence. Abdominal obesity is the highest component of MetS (OR: 28.37, CI: 12.41-64.85, p < 0.001) especially for female (OR: 44.52, CI: 17.19-115.31, p < 0.001), and hypertriglyceridemia (OR: 11.05, CI: 6.20-19.66, p < 0.001) is the commonest in male. Age is the constant risk for developing MetS (OR: 4.06, CI: 1.91-8.64, p < 0.001) whereas the practice of midday nap is the behavior related to increased occurrence of MetS (OR: 1.97, CI: 1.16-3.38, p < 0.05). Dietary pattern, smoking status, drinking alcoholic beverages and physical activity involvement do not impact on the development of MetS. Education, occupation, income and other sociodemographic factors do not produce significant effect on cardio-metabolic status. Obesity, diabetes, and hypertensive conditions of community residents are also explored.

CONCLUSIONS

Modifiable pathophysiological conditions such as abdominal obesity, and obesity play a vital role in preventing MetS before it occurs while unmodifiable risk factor such as getting older and female sex are not as much important as changeable lifestyle habits.

Association Between Eating Speed and Metabolic Syndrome: A Systematic Review and Meta-Analysis

Objective: This review aimed to systematically summarize and meta-analyze the association between eating speed and metabolic syndrome (MetS). Methods: Following the Preferred Reporting Items for Systematic Reviews, and Meta Analyses (PRISMA) guidelines, four electronic databases (PubMed, Web of Science, MEDLINE, and EMBASE) were searched until March 2021 to identify eligible articles based on a series of inclusion and exclusion criteria. Heterogeneity was examined using I ² statistics. Using random-effects models, the pooled odds ratios (ORs), and 95% CIs were calculated to evaluate the association between eating speed with MetS and its components, including central obesity, blood pressure (BP), high-density lipoprotein cholesterol (HDL), triglyceride (TG), and fasting plasma glucose (FPG). Results: Of the 8,500 original hits generated by the systematic search, 29 eligible studies with moderate-to-high quality were included, involving 465,155 subjects. The meta-analysis revealed that eating faster was significantly associated with higher risks of MetS (OR = 1.54, 95% CI: 1.27-1.86), central obesity (OR = 1.54, 95% CI: 1.37-1.73), elevated BP (OR = 1.26, 95% CI: 1.13-1.40), low HDL (OR = 1.23, 95% CI: 1.15-1.31), elevated TG (OR = 1.29, 95% CI: 1.18-1.42), and elevated FPG (OR = 1.16, 95% CI: 1.06-1.27) compared to eating slowly. Conclusions: The results of the review indicated that eating speed was significantly associated with MetS and its components. Interventions related to decreasing eating speed may be beneficial for the management of MetS. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021242213, identifier: CRD42021242213.

Diet Quality, Physical Activity, and Weight Changes and Their Association With 6-Year Risk of Metabolic Syndrome in Mexican Adults

Background. Among lifestyle factors, obesity has been postulated as the most important risk factor for metabolic syndrome (MS). Lifestyle factors such as physical activity (PA), diet quality, and weight management are so closely related, it is not clear if the role of lifestyle factors is exclusively through its effect on weight, or if they contribute independently. Objective. To examine the effect of lifestyle factors such as diet quality, weight change, and leisure time PA on MS occurrence in lean and overweight/obese (OW/OB) adults over a 6-year period. Methods. This was a longitudinal analysis of data from adults participating in the Health Workers Cohort Study. Results. A total of 1046 participants were included; 37.2% of the OW/OB group and 16.2% of the lean participants developed MS. Becoming overweight had a hazard ratio (HR) of 3.06 for developing MS compared with remaining lean (95% CI = 1.98, 4.74). Going from OW/OB to lean was associated with lower risk of MS (HR = 0.41; 95% CI = 0.22, 0.79). Among OW/OB, becoming active was associated with lower risk (HR = 0.63; 95% CI = 0.42, 0.95) in comparison with an inactive pattern; diet quality was not associated with occurrence of MS. Conclusion. Weight change was the most relevant factor predicting MS over a 6-year period.

The dynamics of metabolic syndrome development from its isolated components among Iranian adults: findings from 17 years of the Tehran lipid and glucose study (TLGS)

Background

Evaluating the process of changes in the Metabolic Syndrome (MetS) components over time is one of the ways to study of the MetS natural history. This study aimed to determine the trend of changes in the progression of MetS from its isolated components.

Methods

This longitudinal study was performed on four follow-up periods of the Tehran Lipid and Glucose Study (TLGS) between 1999 and 2015. The research population consisted of 3905 adults over the age of 18 years. MetS was diagnosed based on the Joint Interim Statement (JIS). The considered components were abdominal obesity, hypertension, hyperglycemia, and dyslipidemia.

Results

The highest incidence of MetS from its components was related to hypertension in the short term (3.6-year intervals). In the long run, however, the highest increase in the MetS incidence occurred due to abdominal obesity. Overall, the incidence of MetS increased due to obesity and dyslipidemia, but decreased due to the other factors. Nonetheless, the trend of MetS incidence from all components increased in total. The most common components were dyslipidemia with a decreasing trend and obesity with an increasing trend during the study.

Conclusion

The results indicated that obesity and hypertension components played a more important role in the further development of MetS compared to other components in the Iranian adult population. This necessitates careful and serious attention in preventive and control planning.

Risk and population attributable fraction of metabolic syndrome and impaired fasting glucose for the incidence of type 2 diabetes mellitus among middle-aged Japanese individuals: Aichi Worker's Cohort Study

AIMS/INTRODUCTION

The Japanese government started a nationwide screening program for metabolic syndrome (MetS) to prevent cardiovascular diseases and diabetes in 2008. Although impaired fasting glucose (IFG) is a strong predictor for type 2 diabetes mellitus, the program does not follow up IFG in non-MetS individuals. This study aimed to examine the risk and the population attributable fraction (PAF) of MetS and IFG for incidence of type 2 diabetes mellitus.

MATERIALS AND METHODS

Japanese workers (3,417 men and 714 women) aged 40-64 years without a history of diabetes were prospectively followed. MetS was defined as either abdominal obesity plus two or more metabolic risk factors, or being overweight in the case of normal waist circumference plus three or more metabolic risk factors. IFG was defined as fasting blood glucose 100-125 mg/dL.

RESULTS

During a mean 6.3 years, 240 type 2 diabetes mellitus cases were identified. Compared with those without MetS and IFG, the multivariable-adjusted hazard ratios (95% confidence interval) of non-MetS individuals with IFG, MetS individuals without IFG and MetS individuals with IFG for type 2 diabetes mellitus were 4.9 (3.4-7.1), 2.4 (1.6-3.5) and 8.3 (5.9-11.5), respectively. The corresponding PAFs for type 2 diabetes mellitus incidence were 15.6, 9.1 and 29.7%, respectively.

CONCLUSIONS

IFG represented a higher risk and PAF than MetS for type 2 diabetes mellitus incidence in middle-aged Japanese individuals. The coexistence of MetS and IFG showed the highest risk and PAF for type 2 diabetes mellitus incidence. The current Japanese MetS screening program should be reconsidered to follow up non-MetS individuals with IFG.

The prevalence of metabolic syndrome among Iranian bakers

BACKGROUND

Metabolic syndrome (MetS) is a group of risk factors that are associated with increased risk for atherosclerotic cardiovascular disease.

OBJECTIVE

The objective of this study was to determine the prevalence of metabolic syndrome and its individual components among Iranian bakery workers.

METHODS

A cross-sectional study enrolling 163 randomly selected bakery workers from Semnan province (Northeast Iran), was conducted in 2017. A standard questionnaire was used for data collection. Analyses were performed using t-test, one-way ANOVA and Latent Class Analysis (LCA) in R software.

RESULTS

The prevalence of MetS was 19.8% among bakery workers. More bakery workers with MetS had no regular exercise (p = 0.001) and worked more than eight hours a day (p = 0.001). In this study, the International Diabetes Federation (IDF) diagnostic criteria had more agreement with the American Heart Association (AHA) (49.1%) than the World Health Organization (WHO) and Adult Treatment Panel (ATP) criteria. Also, the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) had the highest sensitivity for diagnosing MetS. The sensitivity of the four diagnostic methods, WHO, IDF, ATP and AHA, were 45.2%, 61.7%, 67.9% and 64.8%; and their specificity were 98.2%, 100%, 100% and 100%, respectively.

CONCLUSION

The prevalence of MetS is high among bakery workers in Iran. Increased physical activity and intake of fruit and vegetables are recommended for the prevention of MetS.

Assessment of the relationship between metabolic syndrome and obstructive sleep apnea in male drivers of Shahroud city in 2018: a cross sectional study

BACKGROUND

Metabolic syndrome involves a set of metabolic risk factors that directly increases the risk of atherosclerotic cardiovascular disease. Physical inactivity due to driving can increase the risk of metabolic syndrome. It is also known that sleep disorders (sleep apnea) can result in MetS. Driving in Iran is considered a very popular but risky occupation, so paying attention to this profession is of special importance. Therefore, the researchers aimed to investigate the association between sleep disorders and metabolic syndrome in drivers in Shahroud city in 2018.

METHODS

This cross-sectional study was carried out on 948 drivers from Shahroud city in 2018. After obtaining consent from participants, 3 questionnaires including demographic, Epworth Sleepiness Scale and STOP-BANG were completed. Clinical and anthropometric measurements were assessed, including blood pressure, waist circumference, hip circumference, weight, height, and body mass index. In addition, blood was drawn to measure High Density Lipoprotein, Low Density Lipoprotein, Triglyceride, cholesterol, and Fasting Blood Sugar levels. The relationship between metabolic syndrome and sleep disorders was then studied. In this study, statistical analyses were performed using SPSS software version 23 at a significance level of 0.05.

RESULTS

Mean age of drivers was 44.15 ± 11.66 (years). The mean waist circumference and mean hip circumference in subjects with a Class 1 Driver's License (a certificate for trucks and buses) were higher than those with a Class 2 Driver's License (a certificate for motorcars, minibuses, vans, etc. (seating< 20)) (P = 0.01 and P = 0.003, respectively). Moreover, the BMI in subjects with a Class 1 Driver's License was higher compared to subjects with a Class 2 Driver's License. The correlation between metabolic syndrome with sleep apnea based on STOP-BANG questionnaire was significant (p < 0.001) irrespective of definition (ATP and IDF).

CONCLUSIONS

According to the results of this study, there was a bi-directional association between sleep disorders and Mets, so this group should pass periodic medical examinations and training courses. Moreover, their families should be informed of prevention and treatment of this syndrome.

MRI assessment of ectopic fat accumulation in pancreas, liver and skeletal muscle in patients with obesity, overweight and normal BMI in correlation with the presence of central obesity and metabolic syndrome

Purpose: Obesity, defined as a body mass index (BMI) exceeding 30 kg/m², is a serious health problem, which can be called an epidemic on a global scale and is one of the most important causes of preventable death. The aim of this study was to assess ectopic fat accumulation in pancreas, liver and skeletal muscle in patients with obesity, overweight and normal BMI in correlation with metabolic syndrome (MetS). Patients and methods: The study included 267 consecutive patients who underwent a standard clinical assessment with BMI calculation. Ectopic fat accumulation in pancreas, liver, and skeletal muscle was evaluated by magnetic resonance imaging (MRI) using fat-water separated Dixon imaging. MetS was defined according to the criteria modified by the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Central obesity was defined using gender and ethnic-specific values for waist circumference. Results: There was a statistically significant correlation between the degree of steatosis of the assessed organs and BMI value as well as waist circumference ratio, that determined the degree of central obesity. It was found that the most rapid relative fat accumulation was in muscle, then in pancreas and then in liver. Higher steatosis of pancreas, liver, and muscle was demonstrated depending on the number of the satisfied MetS criteria. Conclusion: Knowing that pancreatic fatty disease is a risk factor for MetS, it seems that assessment and monitoring of ectopic fat accumulation may have important clinical implications and may be used in the prediction of metabolic risk and its early prevention.

Association between self-reported eating speed and metabolic syndrome in a Beijing adult population: a cross-sectional study

Background

Research on the relationship between metabolic syndrome (MetS), its components and eating speed is limited in China. The present study aimed to clarify the association between MetS, its components and eating speed in a Beijing adult population.

Methods

This cross-sectional study included 7972 adults who were 18–65 years old and who received health check-ups at the Beijing Physical Examination Center in 2016. Logistic regression was conducted to explore the associations between MetS, its components and eating speed.

Results

The prevalence of MetS in this population was 24.65% (36.02% for males and 10.18% for females). Eating speed was significantly associated with a high risk for MetS, elevated blood pressure, and central obesity for both genders. Eating speed was associated with a high risk for elevated triglycerides and with a reduction in high-density lipoprotein in males, and eating speed was associated with a high risk for elevated fasting plasma glucose in females. Compared with slow eating speed, the multivariate-adjusted odds ratios of medium eating speed and fast eating speed for MetS were 1.65 (95% confidence interval 1.32–2.07) and 2.27 (95% confidence interval 1.80–2.86) for all subjects, 1.58 (95% confidence interval 1.21–2.07) and 2.21 (95% confidence interval 1.69–2.91) for males, and 1.75 (95% confidence interval 1.15–2.68) and 2.27 (95% confidence interval 1.46–3.53) for females, respectively.

Conclusions

Eating speed is positively associated with MetS and its components. Future recommendations aiming to prevent MetS and its components may focus on eating speed.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5784-z) contains supplementary material, which is available to authorized users.

Effect of dietary habits on the risk of metabolic syndrome: Yazd Healthy Heart Project

Objective

Metabolic syndrome (MetS) refers to a group of risk factors that increase the risk of cardiovascular mortality and morbidity. Dietary habits are among the most important risk factors for MetS. The current study aimed at assessing the effect of dietary habits on the risk of MetS in a 10-year follow-up study in central Iran.

Design

Cohort study.

Setting

Yazd, Iran.

Subjects

Participants aged 20–74 years without any history of MetS, who were originally recruited for Yazd Healthy Heart Project (YHHP) during 2005–2006, were revisited during 2015–2016. At phase I of YHHP, demographic data, anthropometric measurements, five components of MetS, biochemical tests and dietary habits were evaluated; and the same data were collected in phase II.

Results

A total of 1092 participants were eligible to be included in the present study. After follow-up, the 10-year cumulative incidence of MetS was 56·1 %. After adjustment for potential confounders, increased risk of MetS (hazard ratio; 95 % CI) was found in those who did not try to control their body weight (1·57; 1·06, 2·35), did not usually eat salad (1·91; 1·22, 3·00) and added salt to their food (1·57, 1·06, 2·33). These associations were stronger in men than in the total population after subgroup analysis, but were not present in women.

Conclusions

Dietary habits affect the risk of MetS in the Iranian population. Lifestyle interventions are needed to improve dietary habits to reduce the risk of MetS. Future studies are highly recommended to confirm our results in other populations.

Gender Differences in Lifestyle Factors Associated with Metabolic Syndrome and Preliminary Metabolic Syndrome in the General Population: The Watari Study

Objective In Japan, metabolic syndrome (MetS) and preliminary metabolic syndrome (preMetS) are more prevalent in men; however, it remains unclear whether the relationship between these metabolic disorders and lifestyle factors is similar between genders. Methods We examined waist circumference, blood pressure, fasting blood, and various lifestyle factors in 3,166 individuals aged from 30-79 years of age from the Japanese general population. MetS was diagnosed on the basis of central obesity - assessed by waist circumference - plus two or more of the following cardio-metabolic risks according to Japanese criteria: high blood pressure, hyperglycemia, and lipid abnormality. Central obesity plus one of the risks was defined as preMetS. Results Men had a significantly higher prevalence of MetS (23.3% vs. 8.7%, p<0.001) and preMetS (21.2% vs. 10.2%, p<0.001) than women. An age-adjusted logistic regression analysis revealed that heavy drinkers were associated with an increased probability of MetS (odds ratio, 1.91: 95% confidence interval, 1.29-2.83) and preMetS (1.69: 1.11-2.58); fast eaters were also related to preMetS (1.83: 1.33-2.55) and MetS (1.55: 1.12-2.15) in men. Lacking regular exercise was significantly associated with preMetS (1.38: 1.03-1.85), but not MetS. In women, preMetS was significantly associated with fast eaters and lacking regular exercise (1.44: 1.01-2.07 and 1.41: 1.02-1.96, respectively); a stepwise increase in each odds ratio (2.02: 1.40-2.91 and 1.47: 1.03-2.09, respectively) was also observed for MetS. Conclusion The relationships between lifestyle factors and MetS or preMetS differed between men and women, which suggests the need for gender-specific lifestyle modification to effectively prevent MetS.

The association between changes in lifestyle behaviors and the incidence of chronic kidney disease (CKD) in middle-aged and older men

Background

This study was designed to evaluate whether changes in lifestyle behaviors are correlated with the incidence of chronic kidney disease (CKD).

Methods

The subjects consisted of 316 men without a history of cardiovascular disease, stroke, or renal dysfunction or dialysis treatment. The following lifestyle behaviors were evaluated using a standardized self-administered questionnaire: habitual moderate exercise, daily physical activity, walking speed, eating speed, late-night dinner, bedtime snacking, skipping breakfast, and drinking and smoking habits. The subjects were divided into four categories according to the change in each lifestyle behavior from baseline to the end of follow-up (healthy–healthy, unhealthy–healthy, healthy–unhealthy and unhealthy–unhealthy).

Results

A multivariate analysis showed that, with respect to habitual moderate exercise and late-night dinner, maintaining an unhealthy lifestyle resulted in a significantly higher odds ratio (OR) for the incidence of CKD than maintaining a lifestyle (OR 8.94; 95% confidence interval [CI], 1.10–15.40 for habitual moderate exercise and OR 4.00; 95% CI, 1.38–11.57 for late-night dinner). In addition, with respect to bedtime snacking, the change from a healthy to an unhealthy lifestyle and maintaining an unhealthy lifestyle resulted in significantly higher OR for incidence of CKD than maintaining a healthy lifestyle (OR 4.44; 95% CI, 1.05–13.93 for healthy–unhealthy group and OR 11.02; 95% CI, 2.83–26.69 for unhealthy–unhealthy group).

Conclusions

The results of the present study suggest that the lack of habitual moderate exercise, late-night dinner, and bedtime snacking may increase the risk of CKD.

•

The lack of exercise habit is associated with the incidence of CKD.

•

Late-night dinner and bedtime snacking increase the risk of CKD.

•

Early lifestyle intervention is necessary to prevent CKD incidence.

Leisure-time exercise, physical activity during work and commuting, and risk of metabolic syndrome

Data are limited regarding effect of intensity of leisure-time physical activity on metabolic syndrome. Furthermore, no prospective data are available regarding effect of occupational and commuting physical activity on metabolic syndrome. We compared metabolic syndrome risk by intensity level of leisure-time exercise and by occupational and commuting physical activity in Japanese workers. We followed 22,383 participants, aged 30-64 years, without metabolic syndrome until 2014 March (maximum, 5 years of follow-up). Physical activity was self-reported. Metabolic syndrome was defined by the Joint Statement criteria. We used Cox regression models to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of metabolic syndrome. During a mean follow-up of 4.1 years, 5361 workers developed metabolic syndrome. After adjustment for covariates, compared with engaging in no exercise, the HRs (95 % CIs) for <7.5, 7.5 to <16.5, and ≥16.5 metabolic equivalent hours of exercise per week were 0.99 (0.90, 1.08), 0.99 (0.90, 1.10), and 0.95 (0.83, 1.08), respectively, among individuals engaging in moderate-intensity exercise alone; 0.93 (0.75, 1.14), 0.81 (0.64, 1.02), and 0.84 (0.66, 1.06), among individuals engaging in vigorous-intensity exercise alone; and 0.90 (0.70, 1.17), 0.74 (0.62, 0.89), and 0.81 (0.69, 0.96) among individuals engaging in the two intensities. Higher occupational physical activity was weakly but significantly associated with lower risk of metabolic syndrome. Walking to and from work was not associated with metabolic syndrome. Vigorous-intensity exercise alone or vigorous-intensity combined with moderate-intensity exercise and worksite intervention for physical activity may help prevent metabolic syndrome for Japanese workers.

The Association Between Unhealthy Lifestyle Behaviors and the Prevalence of Chronic Kidney Disease (CKD) in Middle-Aged and Older Men

Background

This cross-sectional study evaluated the association between unhealthy lifestyle behaviors and the prevalence of chronic kidney disease (CKD) in middle-aged and older men.

Methods

The subjects included 445 men without a history of cardiovascular disease, stroke, or dialysis treatment, who were not taking medications. Unhealthy lifestyle behaviors were evaluated using a standardized self-administered questionnaire and were defined as follows: 1) lack of habitual moderate exercise, 2) lack of daily physical activity, 3) slow walking speed, 4) fast eating speed, 5) late-night dinner, 6) bedtime snacking, and 7) skipping breakfast. The participants were divided into four categories, which were classified into quartile distributions based on the number of unhealthy lifestyle behaviors (0–1, 2, 3, and ≥4 unhealthy behaviors).

Results

According to a multivariate analysis, the odds ratio (OR) for CKD (defined as estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m² and/or proteinuria) was found to be significantly higher in the ≥4 group than in the 0–1 group (OR 4.67; 95% confidence interval [CI], 1.51–14.40). Moreover, subjects’ lack of habitual moderate exercise (OR 3.06; 95% CI, 1.13–8.32) and presence of late-night dinner (OR 2.84; 95% CI, 1.40–5.75) and bedtime snacking behaviors (OR 2.87; 95% CI, 1.27–6.45) were found to be significantly associated with the prevalence of CKD.

Conclusions

These results suggest that an accumulation of unhealthy lifestyle behaviors, especially those related to lack of habitual moderate exercise and presence of late-night dinner and bedtime snacking may be associated with the prevalence of CKD.

The accumulation of healthy lifestyle behaviors prevents the incidence of chronic kidney disease (CKD) in middle-aged and older males

AIM

This study was retrospectively designed to evaluate the influence of healthy lifestyle behaviors on the incidence of chronic kidney disease (CKD) during a 5-year follow-up period in middle-aged and older males.

METHODS

The subjects included 252 males without a history of cardiovascular disease, stroke, renal dysfunction and/or dialysis treatment who were not taking any medications. Their lifestyle behaviors were evaluated using a standardized self-administered questionnaire and defined as follows: (1) habitual moderate exercise, (2) daily physical activity, (3) fast walking speed, (4) slow eating speed, (5) no late-night dinner, (6) no bedtime snacking and (7) no skipping breakfast. The participants were divided into four categories, which were classified into quartile distributions according to the number of healthy lifestyle behaviors (7-6, 5, 4 and ≤3 groups).

RESULTS

After 5 years, the incidence of CKD [estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2) and/or proteinuria] was observed in 23 subjects (9.1%). The Kaplan-Meier survival curves showed that the cumulative incidence of CKD significantly decreased according to an increase in the number of healthy lifestyle behaviors (log-rank test: p = 0.003). According to a multivariate analysis, habitual moderate exercise [hazard ratio (HR) 0.20, 95% confidence of interval (CI) 0.06-0.69, p = 0.011] and no bedtime snacking (HR 0.19, 95 % CI 0.08-0.48, p = 0.004) were significantly associated with the incidence of CKD.

CONCLUSIONS

These results suggest that the accumulation of healthy lifestyle behaviors, especially those related to habitual moderate exercise and no bedtime snacking, is considered to be important to reduce the risk of CKD.

Biological markers, lifestyles and metabolic syndrome in workers

OBJECTIVE

The association between metabolic syndrome (MetS) and biological inflammatory or anti-coagulant markers were clarified in combination with lifestyle factors.

PATIENTS AND METHODS

The target subjects were 5102 working men without metabolic diseases, aged 30-60 years old. The authors measured the serum levels of high-sensitivity C-reactive protein (CRP), uric acid and plasma fibrinogen as potential key biomarkers of MetS.

RESULTS

Mean values of uric acid, log-transformed serum CRP and plasma fibrinogen increased significantly as the number of components of MetS increased after adjustment for age. Multivariate analysis revealed significant associations between the presence of MetS and age, habitual exercise, not current smoking, the log-transformed value of serum CRP and serum uric acid, with odds ratios (ORs) of 1.03 (95% confidence interval (CI): 1.02-1.04; p<0.001), 0.77 (95% CI: 0.65-0.90; p<0.01), 0.82 (95% CI: 0.70-0.96; p<0.05), 3.2 (95% CI: 2.6-3.9; p<0.001) and 1.5 (95% CI: 1.4-1.6; p<0.001), respectively for the presence of MetS.

CONCLUSION

Elevated serum level of CRP, uric acid, not habitual exercise and current smoking were associated with MetS in this cross-sectional study.

Association between leisure time physical activity and metabolic syndrome: a meta-analysis of prospective cohort studies

A great number of prospective studies have investigated the relationship between leisure time physical activity (LTPA) and metabolic syndrome (MetS) risk. However, the results have been inconsistent. The aim of this study was to clarify the relationship between LTPA and MetS risk. Literature databases were searched including PubMed and Embase up to June 2013. A total of 17 studies, including 64,353 participants and 11,271 incident cases, were included in the meta-analysis. A high level of LTPA was statistically associated with decreased risk of MetS [high vs. low: relative risk (RR) = 0.80, 95 % confidence interval (CI) 0.75-0.85], whereas a moderate level of LTPA was weakly associated with decreased risk of MetS (moderate vs. low: RR = 0.95, 95 % CI 0.91-1.00). Subgroup analyses indicated that the association between a moderate level of LTPA and decreased risk of MetS was only significant in men (moderate vs. low: RR = 0.88, 95 % CI 0.81-0.97) and in studies with more than a 10-year follow-up period (moderate vs. low: RR = 0.90, 95 % CI 0.84-0.97). A high level of LTPA was statistically associated with decreased risk of MetS in each subgroup. A higher level of LTPA is associated with a lower risk of MetS. These findings could have public health implications with regard to prevention of MetS through lifestyle interventions.

Correlation between Body Mass Index and Waist Circumference in Patients with Metabolic Syndrome

Metabolic syndrome is defined as a group of coexisting metabolic risk factors, such as central obesity, lipid disorders, carbohydrate disorders, and arterial hypertension. According to the 2005 IDF criteria, subsequently revised in 2009, abdominal obesity is identified as the waist circumference of ≥80 cm in women and ≥94 cm in men. It is responsible for the development of insulin resistance. The aim of our study was to demonstrate a correlation between waist circumference (WC) and body mass index (BMI) in patients with metabolic syndrome in relation with hypertension, lipid disorders, and carbohydrate disorders. A cross-sectional two-site study was conducted in the Kuyavian-Pomeranian Voivodeship for 24 months. The study group consisted of 839 patients with diagnosed metabolic syndrome: 345 men (41.1%) and 494 women (58.9%) aged 32-80. In the study group, WC was found to be significantly correlated with BMI (R = 0.78, P < 0.01). The presence of overweight in men (BMI 25, 84 kg/m(2)) and even normal body weight in women (BMI 21,62 kg/m(2)) corresponds to an increased volume of visceral tissue in the abdomen. Introduction of primary prophylaxis in those people to limit the development of diabetes mellitus type 2 and cardiovascular diseases should be considered.

Insulin-related biomarkers to predict the risk of metabolic syndrome

BACKGROUND

The predictive ability of insulin resistance or insulin sensitivity, in combination with traditional cardiovascular risk factors for metabolic syndrome (MetS), has not yet been clearly evaluated in Japanese male subjects.

OBJECTIVES

A one-year follow-up study was conducted to determine the ability of the insulin-related biomarkers to predict the risk of MetS development.

PATIENTS AND METHODS

A total of 2642 male workers of a Japanese company free from MetS at the baseline were monitored. The homeostasis model assessment for insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) were selected as the insulin-related markers.

RESULTS

The incidence of metabolic syndrome after one year was 8.8%. A multiple logistic regression analysis identified regular physical activity, age (≥ 45 years old), serum uric acid (≥ 7 mg/dL), serum alanine aminotransferase (≥ 45 IU/L), serum C-reactive protein (≥ 0.1 mg/L) and HOMA-IR (≥ 2.5) as significant risk factors for the development of MetS, with odds ratios (95% confidence intervals) of 0.68 (0.50 - 0.92), 2.0 (1.5 - 2.6), 2.2 (1.6 - 3.0), 1.5 (1.02 - 2.2), 1.4 (1.01 - 2.0), and 2.3 (1.6 - 3.3), respectively. When QUICKI was used instead of HOMA-IR, age (≥ 45 years old), serum uric acid (≥ 7 mg/dL), serum gamma-glutamyl transferase (≥ 50 IU/L), and QUICKI (≤ 0.33) were identified as significant contributors to the risk of MetS, with odds ratios (95% confidence intervals) of 0.68 (0.51 - 0.93), 2.0 (1.5 - 2.6), 2.2 (1.6 - 3.0), 1.4 (1.01 - 2.0), and 2.5 (1.7 - 3.6), respectively.

CONCLUSIONS

The mathematical meaning of the two insulin-related biomarkers examined was the same, and the odds ratios of the two biomarkers were almost the same after adjustments for other independent variables.

Adherence index to the American Heart Association Diet and Lifestyle Recommendation is associated with the metabolic syndrome in Japanese male workers

BACKGROUND

As Japanese societies rapidly undergo Westernization, the prevalence of metabolic syndrome is increasing. We investigated the association between dietary habits and the prevalence of metabolic syndrome using a new adherence index to optimal dietary habits based on the American Heart Association Diet and Lifestyle Recommendation (AHA-DLR).

METHODS

We conducted a cross-sectional study of 503 male workers who completed a brief food frequency questionnaire. Adherence to the AHA-DLR was assessed using a 10-component adherence index (AI-84; a total possible score of 84 points). Metabolic syndrome was defined according to the most recently published harmonized criteria by the International Diabetes Federation in conjunction with the National Heart, Lung, and Blood Institute, American Heart Association, World Heart Federation, International Atherosclerosis Society, and International Association for the Study of Obesity.

RESULTS

The prevalence of metabolic syndrome was 26.6% and the AI-84 score ranged from 5 to 56 points. Subjects with metabolic syndrome had a significantly lower AI-84 score compared with those without (27.1 ± 9.1 vs. 28.9 ± 9.2, p=0.042). After adjusting for age, energy intake, smoking habit and physical activity, a higher AI-84 score was associated with a significantly lower prevalence of metabolic syndrome, with an odds ratio of 0.778 (95% CI 0.614-0.986, p=0.038) for each 10-point score increment.

CONCLUSIONS

A lower AI-84 score was associated with increased prevalence of metabolic syndrome. Our findings support a potential beneficial impact of nutritional assessment using adherence to the AHA-DLR for prevention of metabolic syndrome.

Active smoking and risk of metabolic syndrome: a meta-analysis of prospective studies

Background

Epidemiological evidence suggests that smoking has been associated with emergence of metabolic syndrome. However, data on this issue are inconsistent and controversial. We therefore conducted a meta-analysis to examine the association between smoking and metabolic syndrome.

Methodology and Principal Findings

We searched the Medline, Embase and the Cochrane Library database up to March 2012 to identify prospective cohort studies related to smoking and metabolic syndrome. Reference lists of retrieved articles were also reviewed. Summary effect estimates were derived using a random-effects model and stratified by gender, smoking dose, follow-up duration and geographical area. Primary analysis of 13 studies involving 56,691 participants and 8,688 cases detected a significant positive association between active smoking and risk of metabolic syndrome (pooled relative risk [RR] 1.26, 95% CI: 1.10–1.44). Estimates of effects were substantially consistent in the stratified analyses. In the dose-response analysis, risk of metabolic syndrome was stronger for active male smokers (pooled RR 1.34, 95% CI: 1.20–1.50) than it was for former male smokers (pooled RR 1.19, 95% CI: 1.00–1.42), and greater for heavy smokers (pooled RR 1.42, 95% CI: 1.27–1.59) compared with light smokers (pooled RR 1.10, 95% CI: 0.90–1.35). No evidence of statistical publication bias was found (Egger' s test P = 0.227, Begg' s test P = 0.113).

Conclusions

Active smoking is associated with development of metabolic syndrome. Smoking cessation appears to reduce the risk of metabolic syndrome.

Long working hours and metabolic syndrome among Japanese men: a cross-sectional study

Background

The link between long working hours and health has been extensively studied for decades. Despite global concern regarding metabolic syndrome, however, no studies to date have solely evaluated the relationship between long working hours and that syndrome. We therefore examined the association between long working hours and metabolic syndrome in a cross-sectional study.

Methods

Between May and October 2009, we collected data from annual health checkups and questionnaires from employees at a manufacturing company in Shizuoka, Japan. Questionnaires were returned by 1,601 workers (response rate: 96.2%; 1,314 men, 287 women). After exclusions, including women because of a lack of overtime work, the analysis was performed for 933 men. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for metabolic syndrome. Further, we conducted a stratified analysis by age-group (<40 years vs. ≥40 years).

Results

Metabolic syndrome was identified in 110 workers (11.8%). We observed a positive association between working hours and metabolic syndrome after adjusting for age, occupation, shift work, smoking status, frequency of alcohol consumption, and cohabiting status. Compared with subjects who worked 7–8 h/day, multivariate ORs for metabolic syndrome were 1.66 (95% CI, 0.91–3.01), 1.48 (95% CI, 0.75–2.90), and 2.32 (95% CI, 1.04–5.16) for those working 8–9 h/day, 9–10 h/day, and >10 h/day, respectively. Similar patterns were obtained when we excluded shift workers from the analysis. In age-stratified analysis, the corresponding ORs among workers aged ≥40 years were 2.02 (95% CI, 1.04–3.90), 1.21 (95% CI, 0.53–2.77), and 3.14 (95% CI, 1.24–7.95). In contrast, no clear association was found among workers aged <40 years.

Conclusions

The present study suggests that 10 h/day may be a trigger level of working hours for increased risk of metabolic syndrome among Japanese male workers.

Relationship between several markers and presence of metabolic syndrome or components of the metabolic syndrome in Japanese workers

BACKGROUND

The reported associations between metabolic syndrome (MetS) and systemic vascular inflammation/insulin resistance prompted the author to determine the predictive ability of markers for MetS in the occupational field.

METHODS

The study was performed in 3460 working men aged 30 to 64 years. The author measured the serum levels of high-sensitivity C-reactive protein and insulin as potential key biomarkers of MetS.

RESULTS

Multivariate analysis revealed significant associations between the presence of MetS and the log-transformed value of serum insulin and log-transformed value of serum C-reactive protein, with odds ratios of 29.4 (95% confidence interval, 18.0 to 48.2; P < 0.001) and 1.87 (95% confidence interval, 1.47 to 2.38; P < 0.001) of these two markers, respectively, for the presence of MetS.

CONCLUSION

Elevated serum levels of insulin were found to be strongly associated with MetS in this cross-sectional study.

Incidence of Metabolic Syndrome and Its Risk Factors among Type 2 Diabetes Clinic Attenders in Isfahan, Iran

Aim. At present, little data exist about incidence and the risk factors associated with metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (T2DM). The objectives of present study were to assess the incidence and risk factors of MetS in people with T2DM. Methods. During the mean (SD) follow-up period of 11.7 (4.8) years, 3,047 patients with T2DM and free of MetS at baseline have been examined to determine incidence and predictors of progression to MetS. A modified the National Cholesterol Education Program-Adult Treatment Panel III definition with body mass index (BMI) instead of waist circumference was used for the MetS. Results. The prevalence of MetS was 63.2% (95% CI: 62.3, 64.1). The incidence of MetS was 28.5 (95% CI: 26.8, 30.2) (25.9 men and 30.9 women) per 1,000 patient-years based on 35,677 patient-years of follow-up. Multivariate analysis revealed that higher BMI and education, lower HbA(1c) and treatment with oral agent or insulin were associated with MetS. Conclusion. These are the first estimate of incidence and risk factors of MetS in patients with T2DM in Iran. These findings showed that the natural course of MetS is dynamic. The clinical management of patients with T2DM will contribute significantly to MetS prevention.

Comparison of visceral fat and liver fat as risk factors of metabolic syndrome

The principal objective of this study was to determine whether visceral fat or liver fat is a more relevant risk factor for metabolic syndrome. A total of 98 subjects aged 18-65 yr, who visited a health promotion center in a university hospital, were enrolled in this study. Metabolic syndrome was diagnosed based on the modified National Cholesterol Education Program's Adult Treatment Panel III report (NCEP-ATPIII) criteria. We defined the visceral obesity as a visceral fat area of ≥ 100 cm(2) which was acquired by CT at the L4-5 level. To evaluate fatty liver, we applied a liver-to-spleen attenuation ratio ≤ 1.1 as measured by CT at the T12 level. We employed binary logistic regression models that used the presence or absence of metabolic syndrome as a dependent variable and age, sex, and the presence or absence of visceral obesity and fatty liver as independent variables. Visceral obesity was not found to be an independent variable as a risk factor of metabolic syndrome (odds ratio 2.7; 95% confidence interval 0.55-13.30), but fatty liver was found to be significant in this model (odds ratio 71.3; 95% CI 13.04-389.53). Our study suggests that liver fat may be a more important risk factor than visceral fat in terms of its association with metabolic syndrome.

Lack of leisure-time physical activity in non-obese Japanese men with components of metabolic syndrome

A focus exclusively on waist circumference, the main component used in the diagnosis of metabolic syndrome (MetS), may lead to ignoring non-obese individuals with other MetS components, including high levels of blood pressure, fasting blood glucose, and triglycerides and low levels of high-density lipoprotein. This study investigated lifestyles and eating behaviors among non-obese individuals with components of MetS. Of the 918 Japanese male workers, 151 subjects (16.4%) had a waist circumference < 85 cm with more than one MetS component. This non-obese high-risk group for MetS gained weight in adulthood, consume alcohol, and engage in less leisure-time physical activity compared to 317 subjects (34.5%) with a waist circumference < 85 cm and without MetS components (p < 0.05). The remaining 450 subjects (49%) were obese with a waist circumference ≥ 85, including 93 men with MetS. A lack of leisure-time physical activity was associated with the non-obese high-risk group for MetS [odds ratio 1.59, 95% confidence interval 1.02 - 2.49] compared to the 317 non-obese men without MetS (reference group). Such a difference in physical activity was not found between the 450 obese subjects and the reference group. Instead, eating behaviors, such as eating rapidly, preference for fatty foods, and eating out for dinner, were significantly associated with MetS. Thus, men with smaller waist circumferences and any MetS component should be carefully monitored for physical activity to prevent further development of MetS, while men with larger waist circumferences including MetS need to be monitored for unfavorable eating behaviors.

[Incidence of metabolic syndrome and associated lifestyle factors in a worksite male population]

OBJECTIVES

The prevention of metabolic syndrome (MetS) is one of the main targets of health promotion activities in the workplace. The present study aimed to clarify the incidence of MetS and associated lifestyle factors in a worksite male population.

METHODS

The study subjects consisted of 948 working men (mean age: 44 yr old) who did not meet the Japanese criteria for MetS during the annual health examination at a precision instrument development plant in Kanagawa, Japan, 2005. New-onset MetS was followed using the health examination data from 2006 to 2009. The incidence of MetS according to the combination of the presence of abdominal obesity and the number of other components of MetS (elevated blood pressure, dyslipidemia, and elevated fasting glucose) at baseline were calculated. The incidence of MetS was also compared among the groups with regard to differences in lifestyles (dietary habits, smoking status, sleep duration, exercise habits, and alcohol intake). A Cox proportional hazard model was used to identify independent factors contributing to an increased risk of MetS.

RESULTS

New-onset MetS was observed in 76 subjects during a mean follow-up period of 3.7 yr. The incidence of MetS was 2.2/100 person-years and the 4-year incidence of MetS according to Kaplan-Meier analysis was 8.5%. The highest 4-year incidence of MetS was found in the group without abdominal obesity but with two or more components of MetS (37.9%) and the second highest incidence was found in the group with abdominal obesity and one other component of MetS (24.6%). The presence of abdominal obesity and each increase in the number of other components of MetS had an increased age-adjusted hazard ratio for an increased risk of MetS (5.23 and 4.79, respectively, both p<0.001). Similarly, sleep duration 5 h or less, current smoking, and ethanol intake 300 g/wk or more had an increased age-adjusted hazard ratio for an increased risk of MetS.

CONCLUSIONS

The present study showed a high incidence of MetS in not only the group with abdominal obesity, but also the group without abdominal obesity but with two or more components of MetS. Sleep deprivation, current smoking, and excess alcohol intake were found to be factors contributing to an increased risk of MetS among several lifestyle factors examined. The usefulness of health promotion activities that preferentially target subjects who have such medical conditions and/or lifestyles are therefore expected to reduce the incidence of MetS in the workplace, from a high-risk strategy viewpoint.