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Hee JY, Protani MM, Koh ET, Leong KP. Metabolic syndrome and its effect on the outcomes of rheumatoid arthritis in a multi-ethnic cohort in Singapore. Clin Rheumatol 2021; 41:649-660. [PMID: 34655002 DOI: 10.1007/s10067-021-05945-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/22/2021] [Accepted: 09/25/2021] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Over-expression of common inflammatory mediators in the metabolic syndrome (MetS) and in rheumatoid arthritis (RA) may lead to mutually adverse outcomes. AIM We investigate the prevalence of MetS in a multi-ethnic population of RA patients and its effect on clinical and patient-reported outcomes. METHOD Six hundred sixty RA (561 women) patients from a public-sector specialist clinic in a hospital in Singapore were assessed for MetS according to the 2009 Joint Consensus (JC) and the 2004 National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) definitions. Univariable and multivariable regression modelling were used to investigate the associations between patients' demographics with MetS and MetS with RA outcomes. RESULTS The prevalence of MetS in our RA cohort was 49.4% and 44.9% according to the JC and NCEP ATP III definitions, respectively. The diagnosis of MetS was largely due to hypertriglyceridemia, hypertension, and obesity. MetS was associated with older age (OR 1.06 [95% CI 1.04-1.08]), Malay ethnicity (OR 1.78 [95% CI 1.02-3.09]), or Indian ethnicity (OR 3.07 [95% CI 1.68-5.59]). No significant associations between MetS and RA outcomes were observed. RA patients with MetS are more likely to suffer from stroke and ischemic heart disease. CONCLUSION The prevalence of MetS in RA patients in Singapore was almost double that in the general population. MetS does not adversely affect RA outcomes but raises the risks of stroke and heart disease. RA patients, especially those older and of Indian and Malay ethnicities, should be routinely screened for MetS. Any MetS-defining condition should be actively controlled. Key Points • Approximately half of the RA sample from the Singapore RA population can be diagnosed with MetS. • Older patients, and patients of Malay and Indian ethnicities have higher odds of MetS. • MetS does not adversely affect RA outcomes but raises the risks of stroke and heart disease.
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Affiliation(s)
- Jia Yi Hee
- School of Public Health, The University of Queensland, 288 Herston Road, Brisbane, Queensland, 4006, Australia.
| | - Melinda M Protani
- School of Public Health, The University of Queensland, 288 Herston Road, Brisbane, Queensland, 4006, Australia
| | - Ee Tzun Koh
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Khai Pang Leong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
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Hypertension Incidence Risk in a Cohort of Russian Workers Exposed to Radiation at the Mayak Production Association Over Prolonged Periods. Hypertension 2019; 73:1174-1184. [DOI: 10.1161/hypertensionaha.118.11719] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Herningtyas EH, Ng TS. Prevalence and distribution of metabolic syndrome and its components among provinces and ethnic groups in Indonesia. BMC Public Health 2019; 19:377. [PMID: 30943932 PMCID: PMC6448251 DOI: 10.1186/s12889-019-6711-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 03/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Global increase of metabolic syndrome (MetS) may have affected Indonesia, however, lack of data in this multiethnic group country warrants a nationwide study for MetS and its components. This study aims to determine the prevalence of metabolic syndrome and its components among Indonesian people based on the province and ethnic groups. METHODS We obtained 8573 subjects from the Indonesian Family Life Survey Wave 4 (IFLS4), spread over 20 provinces in Indonesia and consisting of 27 ethnic groups. MetS was operationalized according to an adapted Harmonized MetS definition. Prevalence ratios with 95% confidence interval were estimated using log-binomial regression. RESULTS The prevalence of MetS in Indonesia is 21.66% with provincial prevalence ranging from 0 to 50%, while the ethnic prevalence ranging from 0 to 45.45%. Significant higher MetS prevalence ratios were found in Jakarta (PR 1.826; 95CI 1.628-2.048), West Nusa Tenggara (PR 1.412; 95CI: 1.222-1.630), West Sumatra (PR 1.404; 95CI: 1.202-1.641), East Java province (PR 1.109; 95CI: 1.001-1.229) and in Sasak (PR 1.532; 95CI:1.304-1.800), Minangkabau (PR 1.469; 95CI:1.251-1.726), Betawi (PR 1.597; 95CI:1.346-1.895), Acehnese ethnic group (PR 2.101; 95CI:1.099-4.020) while significant lower prevalence ratios were observed in Central Java (PR 0.668; 95CI: 0.580-0.770), Yogyakarta (PR 0.695; 95CI: 0.575-0.840), Banten (PR 0.718; 95CI: 0.533-0.968), Bali province (PR 0.724; 95CI: 0.590-0.889) and in Javanese (PR 0.855; 95CI:0.788-0.928), also Balinese ethnic groups (PR 0.669; 95CI:0.535-0.836). The highest prevalence of MetS components among Indonesians was low HDL cholesterol (66.41%), followed by hypertension (64.45%), and central obesity (43.21%). CONCLUSIONS The prevalence of MetS in Indonesia is moderate with provincial and ethnic prevalence varied. Provincial and ethnic group differences in MetS prevalence ratios were observed. The top two most prevalent MetS components in Indonesian were low HDL cholesterol and hypertension.
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Affiliation(s)
- Elizabeth Henny Herningtyas
- Clinical Pathology and Laboratory Medicine Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Radioputro Building 5th floor, Jalan Farmako, Sekip Utara, Yogyakarta, Indonesia.
| | - Tian Sheng Ng
- Undergraduate Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Grha Wiyata Building, Jalan Farmako, Sekip Utara, Yogyakarta, Indonesia
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Law JH, Tan JKH, Wong KYM, Ng WQ, Tan PS, Bonney GK, Iyer SG, Krishnakumar M, Kow WCA. Does persistent anti-HBc positivity influence the prognosis of HBsAg-negative hepatocellular carcinoma? comparative outcomes of anti-Hbc positive versus anti-Hbc negative non-B non-C HCC. HPB (Oxford) 2019; 21:242-248. [PMID: 30087053 DOI: 10.1016/j.hpb.2018.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 07/09/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND To compare the presentations and outcomes of anti-HBc seropositive Hepatocellular Carcinoma (HBc-HCC) with anti-HBc seronegative (NHBc-HCC) patients in HBsAg negative Non-HBV Non-HCV (NBNC-HCC) HCC population. METHODS 515 newly diagnosed HCC patients from January 2011 to September 2016 were retrospectively reviewed. 145 (66.5%) NHBc-HCC and 73 (33.5%) HBc-HCC patients were identified. Patient demographics, disease characteristics, details of treatments, recurrence and survival outcomes were analysed. RESULTS A significantly lower proportion of HBc-HCC patients were diagnosed through surveillence (6.8% vs 26.2%, p = 0.001). HBc-HCC patients were less likely cirrhotic (p < 0.001), portal hypertensive (p < 0.001), ascitic (p = 0.008) and thrombocytopenic (p = 0.003). A higher proportion of HBc-HCC patients had treatment with curative intent (46.6% vs 30.3%, p = 0.018) and surgery (39.7% vs 16.6%, p < 0.001). Although HBc-HCC patients had larger median tumor size (74.0 mm vs 55.0 mm, p = 0.016) with a greater proportion of patients having tumors ≥5 cm, there was no difference in the overall median survival (19.0 months vs 22.0 months, p = 0.919) and recurrence rates (38.2% vs 40.9%). CONCLUSION Isolated anti-HBc seropositivity in HbsAg negative patients tend to present incidentally with delayed diagnoses resulting in larger tumors, but their long-term survival remain comparable.
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Affiliation(s)
- Jia Hao Law
- Department of Surgery, National University Health System
| | | | | | - Wan Qi Ng
- Yong Loo Lin School of Medicine, National University of Singapore
| | - Poh Seng Tan
- Department of Gastroenterology and Hepatology, National University Health System, Singapore
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Nikitenko TM, Shcherbakova LV, Malyutina SK, Mustafina SV, Verevkin EG, Ragino YI, Voytsitsky VE, Pyatibratova AV, Rymar OD. The metabolic syndrome as a risk factor for colorectal cancer. ОЖИРЕНИЕ И МЕТАБОЛИЗМ 2017. [DOI: 10.14341/omet2017224-32] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective. To evaluate the prognostic significance of metabolic syndrome (MS) in the development of colorectal cancer (CRC) using various MS criteria in Novosibirsk population.
Materials and Methods. The study was designed as nested case-control. Baseline population cohort (9360 men, women aged 4569) was examined in the HAPIEE project and followed-up during 11 years. The cases included all subjects, who had CRC during 11-year follow-up according to the Register of Cancer (n=99, M-52, M-47). The matched control group (2/1) was selected from HAPIEE cohort (n=198, m-104, w-94). The prospective study of CRC was supported by RSF. MS criteria were determined in accordance to VNOK (2009), IDF (2005), NCEP ATP III (2001). Statistical package SPSS v.11.0 was used. Logistic regression was used to estimate the association between MS and risk of CRC.
Results. Women with glucose levels 6.1 mmol/l had 3 times higher 11-year risk of CRC then those with glucose 6.1 mmol/l (OR=3.11;
95%CI:1.237.87, VNOK, 2009; OR=3.20; 95%CI:1.278.08, NCEP ATP III, 2001). Blood pressure (BP) 130/85 mmHg was associated with decreased risk of CRC in women and in both sexes, but the relationship became insignificant after controlling for antihypertensive treatment. Other components of the MS were not significantly associated with CRC risk.
Conclusions. In studied sample the 11-year risk of developing CRC was significantly increased in women with elevated glucose levels. The negative relationship between elevated BP and the risk of CRC in women and both sexes became insignificant when adjusted for antihypertensive treatment; this finding requires further exploration.
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Ranasinghe P, Mathangasinghe Y, Jayawardena R, Hills AP, Misra A. Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review. BMC Public Health 2017; 17:101. [PMID: 28109251 PMCID: PMC5251315 DOI: 10.1186/s12889-017-4041-1] [Citation(s) in RCA: 420] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 01/14/2017] [Indexed: 01/08/2023] Open
Abstract
Background The Asia-Pacific region is home to nearly half of the world’s population. The region has seen a recent rapid increase in the prevalence of obesity, type-2 diabetes and cardiovascular disease. The present systematic review summarizes the recent prevalence and trends of Metabolic Syndrome (MetS) among adults in countries of the Asia-Pacific Region. Methods Data on MetS in Asia-Pacific countries were obtained using a stepwise process by searching the online Medline database using MeSH terms ‘Metabolic Syndrome X’ and ‘Epidemiology/EP’. For the purpose of describing prevalence data for the individual countries, studies that were most recent, nationally representative or with the largest sample size were included. When evaluating secular trends in prevalence in a country we only considered studies that evaluated the temporal change in prevalence between similar populations, prospective studies based on the same population or National surveys conducted during different time periods. Results This literature search yielded a total of 757 articles, and five additional article were identified by screening of reference lists. From this total, 18 studies were eligible to be included in the final analysis. Of the 51 Asia-Pacific countries (WHO) we only located data for 15. There was wide between country variation in prevalence of MetS. A national survey from Philippines conducted in 2003 revealed the lowest reported prevalence of 11.9% according to NCEP ATP III criteria. In contrast, the highest recorded prevalence in the region (49.0%) came from a study conducted in urban Pakistan (Karachchi, 2004). Most studies reported a higher prevalence of MetS in females and urban residents. Data on secular trends were available for China, South Korea and Taiwan. An increase in the prevalence of MetS was observed in all three countries. Conclusion Despite differences in methodology, diagnostic criteria and age of subjects studied, the Asia-Pacific region is facing a significant epidemic of MetS. In most countries nearly 1/5th of the adult population or more were affected by MetS with a secular increase in prevalence. Strategies aimed at primary prevention are required to ameliorate a further increase in the epidemic and for the reduction of the morbidity and mortality associated with MetS. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4041-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- P Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Y Mathangasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - R Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - A P Hills
- School of Health Sciences, Faculty of Health, University of Tasmania, Tasmania, Australia
| | - A Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, New Delhi, India
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Sy RG, Llanes EJB, Reganit PFM, Castillo-Carandang N, Punzalan FER, Sison OT, Khaing NEE, Poulton R, Woodward M, Tai ES. Socio-demographic factors and the prevalence of metabolic syndrome among filipinos from the LIFECARE cohort. J Atheroscler Thromb 2014; 21 Suppl 1:S9-17. [PMID: 24452117 DOI: 10.5551/jat.21_sup.1-s9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Metabolic syndrome(MetS) is an aggregation of multiple metabolic risk factors shown to lead to the development of cardiovascular disease. The International Diabetes Federation(IDF) and the modified National Cholesterol Education Program Adult Treatment Panel Ⅲ(mNCEP) criteria are used in identifying MetS. This report will determine the prevalence of MetS and its component risk factors of the Philippine cohort of the LIFE course study in CARdiovascular disease Epidemiology(LIFECARE). METHODS Our study recruited 3,072 participants aged 20-50 years old from Metro Manila and four nearby provinces. Baseline anthropometric and clinical parameters were measured. Prevalence of MetS and its component factors were determined. Associations with socio-demographic factors were determined. RESULTS The prevalence of MetS was 19.7% and 25.6% by IDF and mNCEP, respectively(kappa 0.83). Both were associated with increasing age, urban residence, and employed status. It was higher in females by IDF and in males by mNCEP. IDF missed 40% of males and 10% of females identified with MetS by mNCEP. More males were identified by the mNCEP as MetS despite relatively normal waist circumference. CONCLUSION MetS is common in the Philippines among older, educated, and urban residents. The mNCEP criteria identified more MetS than the IDF criteria.
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Affiliation(s)
- Rody G Sy
- Department of Medicine, University of the Philippines (U.P.) - Philippine General Hospital (P.G.H.)
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Meng Khoo C, Tai ES. Trends in the incidence and mortality of coronary heart disease in asian pacific region: the Singapore experience. J Atheroscler Thromb 2014; 21 Suppl 1:S2-8. [PMID: 24452111 DOI: 10.5551/jat.21_sup.1-s2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The rates of coronary heart disease are lower in Asia than in developed countries. Singapore has undergone rapid urbanization over the past several decades. In the several decades between the 1960s and 1980s, a rapid increase in the rates of ischemic heart disease was observed, to the extent that Singapore exhibits one of the highest rates of mortality from cardiovascular disease in the Asia-Pacific region, higher even than the rates in North America. Rates of cardiovascular disease have now stabilized, and are declining. This is, a pattern that has been observed in many developed countries. Increased life expectancy has resulted in an epidemiologic transition that has seen chronic non-communicable diseases replace malnutrition and infections as the major causes of mortality. At the same time, there have been changes in nutrient intake and physical activity as well as rapid increases in the levels of several cardiovascular risk factors including obesity, hypertension, hyperlipidemia, diabetes mellitus and systemic inflammation. Furthermore, when present, there is a lack of awareness and sub-optimal treatment of these risk factors. In addition to the changes in environmental exposures related to socio-economic development, it does appear that specific populations are particularly prone to the development of cardiovascular disease and its risk factors. In particular, Asian Indians experience a high rate of coronary heart disease and diabetes mellitus. Emerging data suggests that Chinese may be particularly prone to the adverse effects of obesity in relation to insulin resistance and inflammation. A concerted effort to change lifestyles to prevent the development of coronary heart disease risk factors, and to improve awareness and treatment of risk factors when then develop, is required to halt the epidemic of coronary heart disease that is occurring in Asia.
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Affiliation(s)
- Chin Meng Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore
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Suction-assisted lipectomy fails to improve cardiovascular metabolic markers of disease: A meta-analysis. J Plast Reconstr Aesthet Surg 2013; 66:1557-63. [DOI: 10.1016/j.bjps.2013.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 06/24/2013] [Accepted: 07/01/2013] [Indexed: 11/22/2022]
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Ramli AS, Daher AM, Noor Khan Nor-Ashikin M, Mat-Nasir N, Keat Ng K, Miskan M, Ambigga KS, Ariffin F, Yasin Mazapuspavina M, Abdul-Razak S, Abdul-Hamid H, Abd-Majid F, Abu-Bakar N, Nawawi H, Yusoff K. JIS definition identified more Malaysian adults with metabolic syndrome compared to the NCEP-ATP III and IDF criteria. BIOMED RESEARCH INTERNATIONAL 2013; 2013:760963. [PMID: 24175300 PMCID: PMC3794630 DOI: 10.1155/2013/760963] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Accepted: 06/22/2013] [Indexed: 02/06/2023]
Abstract
Metabolic syndrome (MetS) is a steering force for the cardiovascular diseases epidemic in Asia. This study aimed to compare the prevalence of MetS in Malaysian adults using NCEP-ATP III, IDF, and JIS definitions, identify the demographic factors associated with MetS, and determine the level of agreement between these definitions. The analytic sample consisted of 8,836 adults aged ≥30 years recruited at baseline in 2007-2011 from the Cardiovascular Risk Prevention Study (CRisPS), an ongoing, prospective cohort study involving 18 urban and 22 rural communities in Malaysia. JIS definition gave the highest overall prevalence (43.4%) compared to NCEP-ATP III (26.5%) and IDF (37.4%), P < 0.001. Indians had significantly higher age-adjusted prevalence compared to other ethnic groups across all MetS definitions (30.1% by NCEP-ATP III, 50.8% by IDF, and 56.5% by JIS). The likelihood of having MetS amongst the rural and urban populations was similar across all definitions. A high level of agreement between the IDF and JIS was observed (Kappa index = 0.867), while there was a lower level of agreement between the IDF and NCEP-ATP III (Kappa index = 0.580). JIS definition identified more Malaysian adults with MetS and therefore should be recommended as the preferred diagnostic criterion.
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Affiliation(s)
- Anis Safura Ramli
- Primary Care Medicine Discipline, Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Aqil Mohammad Daher
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Population Health & Preventive Medicine Discipline, Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Mohamed Noor Khan Nor-Ashikin
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Physiology Discipline, Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Nafiza Mat-Nasir
- Primary Care Medicine Discipline, Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Kien Keat Ng
- Primary Care Medicine Discipline, Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Maizatullifah Miskan
- Primary Care Medicine Discipline, Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Krishnapillai S. Ambigga
- Primary Care Medicine Discipline, Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Farnaza Ariffin
- Primary Care Medicine Discipline, Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Md Yasin Mazapuspavina
- Primary Care Medicine Discipline, Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Suraya Abdul-Razak
- Primary Care Medicine Discipline, Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Hasidah Abdul-Hamid
- Primary Care Medicine Discipline, Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Fadhlina Abd-Majid
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Najmin Abu-Bakar
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Hapizah Nawawi
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Centre for Pathology & Diagnostic Research Laboratory (CPDRL), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
| | - Khalid Yusoff
- Centre for Translational Research and Epidemiology (CenTRE), Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
- Cardiology Discipline, Faculty of Medicine, Universiti Teknologi MARA, 47000 Sungai Buloh, Selangor, Malaysia
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Leow MKS, Griva K, Choo R, Wee HL, Thumboo J, Tai ES, Newman S. Determinants of Health-Related Quality of Life (HRQoL) in the Multiethnic Singapore Population - A National Cohort Study. PLoS One 2013; 8:e67138. [PMID: 23826215 PMCID: PMC3695030 DOI: 10.1371/journal.pone.0067138] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Accepted: 05/14/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND HRQoL is an important outcome to guide and promote healthcare. Clinical and socioeconomic factors may influence HRQoL according to ethnicity. METHODOLOGY A multiethnic cross-sectional national cohort (N = 7198) of the Singapore general population consisting of Chinese (N = 4873), Malay (N = 1167) and Indian (N = 1158) adults were evaluated using measures of HRQoL (SF-36 version 2), family functioning, health behaviours and clinical/laboratory assessments. Multiple regression analyses were performed to identify determinants of physical and mental HRQoL in the overall population and their potential differential effects by ethnicity. No a priori hypotheses were formulated so all interaction effects were explored. PRINCIPAL FINDINGS HRQoL levels differed between ethnic groups. Chinese respondents had higher physical HRQoL (PCS) than Indian and Malay participants (p<0.001) whereas mental HRQoL (MCS) was higher in Malay relative to Chinese participants (p<0.001). Regressions models explained 17.1% and 14.6% of variance in PCS and MCS respectively with comorbid burden, income and employment being associated with lower HRQoL. Age and family were associated only with MCS. The effects of gender, stroke and musculoskeletal conditions on PCS varied by ethnicity, suggesting non-uniform patterns of association for Chinese, Malay and Indian individuals. CONCLUSIONS Differences in HRQoL levels and determinants of HRQoL among ethnic groups underscore the need to better or differentially target population segments to promote well-being. More work is needed to explore HRQoL and wellness in relation to ethnicity.
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Affiliation(s)
- Melvin Khee-Shing Leow
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Republic of Singapore
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Republic of Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
- Office of Clinical Sciences, Duke-NUS Graduate School of Medicine, Singapore, Republic of Singapore
| | - Konstadina Griva
- Department of Psychology, Faculty of Science, National University of Singapore, Singapore, Republic of Singapore
| | - Robin Choo
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Republic of Singapore
| | - Hwee-Lin Wee
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Republic of Singapore
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Republic of Singapore
| | - Julian Thumboo
- Office of Clinical Sciences, Duke-NUS Graduate School of Medicine, Singapore, Republic of Singapore
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Republic of Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - E. Shyong Tai
- Division of Endocrinology, Department of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Stanton Newman
- School of Community & Health Sciences, City University, London, United Kingdom
- * E-mail:
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Nurjono M, Lee J. Waist Circumference is a Potential Indicator of Metabolic Syndrome in Singaporean Chinese. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2013. [DOI: 10.47102/annals-acadmedsg.v42n5p241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction: Metabolic Syndrome (MetS) is associated with cardiovascular morbidity and mortality. Studies proposed that waist circumference (WC) and body mass index (BMI) are good indicators of MetS. In this study, we examined and compared the predictive utility of clinical measures such as WC, blood pressure and BMI and determined the cut off points in which these measures are most reliable in identifying MetS in Singaporean Chinese. Materials and Methods: Two hundred and forty-four subjects aged between 21 and 50 years of Chinese ethnicity were recruited into the study. Sociodemographic, height, weight and blood pressure information were obtained. High-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and glucose levels were evaluated. Presence of MetS was examined according to American Heart Association (AHA)/National Heart, Lung and Blood Institute (NHLBI) guidelines. Predictive utility of BP, WC and BMI was examined using receiver operating curve and discriminant indices were determined accordingly. Results: Forty-one (16.8%) subjects were identified to have MetS. Our analysis revealed that waist circumference was most accurate in identifying MetS (area under the curve (AUC) = 0.88, 95% confidence interval (CI), 0.83 to 0.93, P 92.5 cm in males and >86.5 cm in females were found to be most sensitive and specific in discriminating MetS. Conclusion: Our finding has immediate and significant clinical implications as WC can be easily obtained. However, as the study included only Singaporean Chinese, findings cannot be generalised for other ethnic groups.
Key words: Chinese, Metabolic syndrome, Waist circumference
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Affiliation(s)
| | - Jimmy Lee
- Institute of Mental Health, Singapore
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Nurjono M, Lee J. Predictive utility of blood pressure, waist circumference and body mass index for metabolic syndrome in patients with schizophrenia in Singapore. Early Interv Psychiatry 2013; 7:205-9. [PMID: 22747854 DOI: 10.1111/j.1751-7893.2012.00384.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 05/04/2012] [Indexed: 01/01/2023]
Abstract
AIMS This study aims to examine and compare the predictive utility of blood pressure (BP), waist circumference (WC) and body mass index (BMI), and to determine optimal cut-off values in prediction of metabolic syndrome (MetS) in patients with chronic schizophrenia. METHODS About 100 patients with chronic schizophrenia were recruited. BMI and BP were measured and laboratory tests to evaluate patients' high-density lipoprotein cholesterol, triglycerides and glucose levels were performed. Presence of MetS was examined according to AHA/NHLBI guidelines. Predictive utility of BP, WC and BMI was examined using receiver operating curve and discriminant indices were determined accordingly. RESULTS Forty-six (46%) patients were identified to have MetS. BMI of ≥23 kg m(-2) was most accurate (AUC = 0.83, P < 0.001), with sensitivity of 93.5%, specificity of 48.1%, positive predictive value of 60.6% and negative predictive value of 92.9% in identifying MetS. CONCLUSION This finding has immediate and significant clinical implications in the local population with schizophrenia.
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Affiliation(s)
- Milawaty Nurjono
- Research Division, Institute of Mental Health, Singapore, Singapore
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Yang T, Chu CH, Bai CH, You SL, Chou YC, Hwang LC, Chien KL, Su TC, Tseng CH, Sun CA. Uric acid concentration as a risk marker for blood pressure progression and incident hypertension: a Chinese cohort study. Metabolism 2012; 61:1747-55. [PMID: 22656272 DOI: 10.1016/j.metabol.2012.05.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 11/08/2011] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Little is known about serum uric acid (SUA) role for hypertension in the Asian countries with low cardiovascular events. We aimed to explore the relationship in a comprehensive Chinese cohort. METHODS Participants in the Taiwanese Survey on Prevalences of Hypertension, Hyperglycemia, and Hyperlipidemia (TwSHHH) who were free of hypertension at baseline recruitment in 2002 (n=3257) were evaluated for the longitudinal association between baseline SUA and blood pressure progression (BPP) and incident hypertension. RESULTS During a mean follow-up of 5.41 years, 1119 persons (34.3%) had experienced progression to a higher blood pressure stage and 496 persons (15.2%) had developed hypertension. In multivariate analyses, the adjusted hazard ratios (HRs) [95% confidence intervals (CIs)] comparing the highest and lowest SUA quartiles were 1.78 (1.11-2.02, P for trend .004) for BPP and 1.68 (1.23-2.04, P for trend .028) for incident hypertension. The positively graded relationships between SUA concentration and blood pressure outcomes were observed in both males and females. More interestingly, a statistically significant trend for increasing risk of BPP and incident hypertension across SUA quartiles was most pronounced in participants with abdominal obesity. CONCLUSION We concluded that SUA level was an independent predictor of blood pressure progression and incident hypertension in a Chinese population.
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Affiliation(s)
- Tsan Yang
- Department of Health Business Administration, Meiho University, Pingtung, County, Taiwan
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Lee J, Nurjono M, Wong A, Salim A. Prevalence of Metabolic Syndrome Among Patients with Schizophrenia in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2012. [DOI: 10.47102/annals-acadmedsg.v41n10p457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Schizophrenia has been associated with an increased risk of cardio-metabolic morbidity and mortality. Metabolic syndrome (MetS), a reliable predictor of cardiovascular-related morbidity and mortality, has also been shown to be more prevalent in patients with schizophrenia. In this study, we investigated the prevalence of MetS in a sample of patients with schizophrenia in Singapore, and the potential risk factors associated with it. Materials & Methods: One hundred patients with schizophrenia and 300 community controls were recruited. All subjects provided a fasted sample of venous blood to measure high-density lipoprotein cholesterol (HDL-C), triglycerides and glucose levels. Weight, height and waist circumference were measured. Presence of MetS was assessed according to the American Heart Association and the National Heart, Lung and Blood Institute (AHA/NHLBI) guidelines. Results: The prevalence of MetS in patients with schizophrenia was 46.0%. The adjusted odds ratio (OR) for MetS among patients was 2.79 (CI, 1.50 to 5.20, P = 0.001) when compared with controls. Increasing body mass index (BMI) was identified to be significantly associated with the prevalence of MetS. Conclusion: This study found a high prevalence of MetS in Singapore patients with schizophrenia, and that BMI might be a risk factor in the development of MetS. This information is clinically relevant as BMI is routinely measured in psychiatric practice today, and could be used to monitor for development of MetS in schizophrenia.
Key words: Mental illness, Obesity, Smoking
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Affiliation(s)
- Jimmy Lee
- Institute of Mental Health, Singapore
| | | | | | - Agus Salim
- Saw Swee Hock School of Public Health, National University of Singapore
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Konradi AO, Rotar OP, Korostovtseva LS, Ivanenko VV, Solntcev VN, Anokhin SB, Bart VA, Shlyakhto EV. Prevalence of Metabolic Syndrome Components in a Population of Bank Employees from St. Petersburg, Russia. Metab Syndr Relat Disord 2011; 9:337-43. [DOI: 10.1089/met.2011.0028] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Alexandra O. Konradi
- Almazov Federal Heart, Blood and Endocrinology Center, St. Petersburg, Russian Federation
| | - Oxana P. Rotar
- Almazov Federal Heart, Blood and Endocrinology Center, St. Petersburg, Russian Federation
| | | | - Viktoria V. Ivanenko
- Almazov Federal Heart, Blood and Endocrinology Center, St. Petersburg, Russian Federation
| | - Vladislav N. Solntcev
- Almazov Federal Heart, Blood and Endocrinology Center, St. Petersburg, Russian Federation
| | - Sergei B. Anokhin
- Almazov Federal Heart, Blood and Endocrinology Center, St. Petersburg, Russian Federation
| | - Victor A. Bart
- Almazov Federal Heart, Blood and Endocrinology Center, St. Petersburg, Russian Federation
| | - Eugene V. Shlyakhto
- Almazov Federal Heart, Blood and Endocrinology Center, St. Petersburg, Russian Federation
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Taslim S, Tai ES. The Relevance of the Metabolic Syndrome. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2010. [DOI: 10.47102/annals-acadmedsg.v38n1p29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Introduction: To review the definitions of the metabolic syndrome according to various expert groups and assess their relevance to clinical practice.
Materials and Methods: Medline searches were conducted to identify studies which addressed: (i) the utility of the metabolic syndrome compared to multivariable predictive functions for the identification of individuals at high risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), (ii) the importance and definition of obesity in the definition of the metabolic syndrome and (iii) the impact of lifestyle and pharmacological interventions designed to reduce the risk of cardiovascular disease in those with and without the metabolic syndrome.
Results: Although inferior to multivariable risk scores in predicting T2DM and CVD, the metabolic syndrome represents a simple clinical tool, particularly for the prediction of T2DM. Obesity is not a critical component of the metabolic syndrome for identifying those at increased risk of CVD but may be important for predicting T2DM. If anything, pharmacological therapy, especially lipid lowering is as, if not more, effective in those with the metabolic syndrome than in those without.
Conclusions: Although the metabolic syndrome appears to have limited utility for the identification of individuals at increased risk of T2DM or CVD, the diagnosis of the metabolic syndrome presents an opportunity to rationalise health services to deliver coordinated care to those with metabolic syndrome.
Key words: Cardiovascular disease, Diabetes mellitus, Insulin resistance, Obesity
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Lin CC, Liu CS, Li CI, Lin WY, Lai MM, Lin T, Chang PC, Lee YD, Chen CC, Lin CH, Yang CW, Hsiao CY, Chen W, Li TC. The relation of metabolic syndrome according to five definitions to cardiovascular risk factors--a population-based study. BMC Public Health 2009; 9:484. [PMID: 20028565 PMCID: PMC2805641 DOI: 10.1186/1471-2458-9-484] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Accepted: 12/23/2009] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Although National Cholesterol Education Program (NCEP), International Diabetes Federation (IDF), American Heart Association and National Heart, Lung and Blood Institute (AHA/NHLBI), World Health Organization (WHO), and the European Group for the Study of Insulin Resistance (EGIR) definitions of metabolic syndrome (MetS) have been commonly used by studies, little is known about agreement among these five definitions. We examined the agreement among these five definitions and explored their relationship with risk factors of cardiovascular disease in a Taiwan population. METHODS A total of 1305 subjects aged 40 years and over in Taiwan were analyzed. Biomedical markers and anthropometric indices were measured. Agreement among definitions was determined by the kappa statistic. Logistic regression models were fit to estimate the odds of a high cardiovascular risk group for five definitions of MetS. RESULTS The agreement among the NCEP, IDF, and AHA/NHLBI definitions was from substantial to very good, and agreement between the WHO and EGIR definitions was also substantial. All MetS definitions were significantly associated prevalence of microalbuminuria, elevated highly sensitive CRP (hs-CRP), and arterial stiffness only in women. In men, MetS by NCEP and AHA/NHLBI was associated with elevated level of hs-CRP and arterial stiffness. MetS by WHO and EGIR were significantly associated with microalbuminuria. And MetS by WHO was the only MetS definition that significantly associated with prevalence of arterial stiffness (OR: 2.75, 95% CI: 1.22-6.19). CONCLUSIONS The associations of these five definitions with cardiovascular risk factors were similar in women, and it was evident that the five definitions performed better in women than in men, with higher ORs observed in relation to arterial stiffness, elevated hs-CRP, and higher Framingham risk scores.
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Affiliation(s)
- Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Medical Research, China Medical University Hospital, Taichung, Taiwan
- Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan
- School and Graduate Institute of Health Care Administration, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chiu-Shong Liu
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Ing Li
- Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Yuan Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Ming-May Lai
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Tsann Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Pei-Chia Chang
- Administration Center, China Medical University Hospital, Taichung, Taiwan
| | - Yih-Dar Lee
- Lilly Taiwan, Eli Lilly and Company, Taipei, Taiwan
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chuan-Wei Yang
- Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Yi Hsiao
- Institute of Health Care Administration, College of Public Health, China Medical University, Taichung, Taiwan
| | - Walter Chen
- Department of Medicine, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Institute of Biostatistics, China Medical University, Taichung, Taiwan
- Biostatistics Center, China Medical University, Taichung, Taiwan
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Chung HY, Ferreira ALA, Epstein S, Paiva SAR, Castaneda-Sceppa C, Johnson EJ. Site-specific concentrations of carotenoids in adipose tissue: relations with dietary and serum carotenoid concentrations in healthy adults. Am J Clin Nutr 2009; 90:533-9. [PMID: 19587090 DOI: 10.3945/ajcn.2009.27712] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Dietary carotenoids are related to a decreased risk of certain diseases. Serum and adipose tissue carotenoid concentrations are used as biomarkers of intake. OBJECTIVES The objectives of this study were to evaluate site-specific concentrations of carotenoids in adipose tissue and to examine relations between carotenoid concentrations in the diet, serum, and adipose tissue. DESIGN Healthy adults (12 women and 13 men) participated in this cross-sectional study. Dietary carotenoids over the past year were assessed with a food-frequency questionnaire. Serum and adipose tissue biopsy samples were collected from the abdomen, buttock, and inner thigh for the measurement of carotenoids by HPLC. RESULTS Many adipose carotenoids were inversely related to percentage body fat, although lycopene was the only carotenoid inversely correlated with all 3 sites. Most of the carotenoids were significantly higher in the abdominal adipose tissue than in the thigh (P < 0.05). Concentrations of alpha-carotene, beta-carotene, 5-cis-lycopene, and total carotenoids were significantly higher in the buttocks than in the thigh (P < 0.05). Concentrations of alpha-carotene, cis-lycopene, and lutein (with or without zeaxanthin) were significantly higher in the abdomen than in the buttocks (P < 0.05). Dietary intake was significantly correlated with serum concentrations of alpha-carotene, beta-carotene, beta-cryptoxanthin, and total carotenoids. Carotenoid intake was significantly correlated with adipose tissue concentrations of alpha-carotene, beta-carotene, beta-cryptoxanthin, cis-lycopene, and total carotenoids (P < 0.05) but varied by site. Of all the adipose tissue sites evaluated, the abdomen showed the strongest correlation with long-term dietary carotenoid intakes and with serum (indicator of short-term intake) for most carotenoids. CONCLUSIONS Body fat may influence the tissue distribution of carotenoids. Abdominal adipose tissue carotenoid concentrations may be a useful indicator of carotenoid status.
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Sun F, Tao Q, Zhan S. Components of metabolic syndrome and the incidence of type 2 diabetes in an elderly Taiwanese cohort. Diabetes Metab Syndr 2009. [DOI: 10.1016/j.dsx.2009.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Cho YG, Song HJ, Kang JH. Prevalence of the Metabolic Syndrome in Korean Children and Adolescents according to the International Diabetes Federation Definition in Children and Adolescents. Korean J Fam Med 2009. [DOI: 10.4082/kjfm.2009.30.4.261] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Young-Gyu Cho
- Department of Family Medicine, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Hong-Ji Song
- Department of Family Medicine, Hallym Sacred-Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Jae-Heon Kang
- Department of Family Medicine, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea
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Bibliography. Current world literature. Obesity and nutrition. Curr Opin Endocrinol Diabetes Obes 2008; 15:470-5. [PMID: 18769222 DOI: 10.1097/med.0b013e328311f3cb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wen CJ, Lee YS, Lin WY, Huang HL, Yao CA, Sung PK, Huang KC. The metabolic syndrome increases cardiovascular mortality in Taiwanese elderly. Eur J Clin Invest 2008; 38:469-75. [PMID: 18505405 DOI: 10.1111/j.1365-2362.2008.01965.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The prevalence of the metabolic syndrome (MetS) is high among the elderly. However, evidence that mortality increases with MetS is rare. In this study, we investigated the relationship between MetS, cardiovascular disease (CVD) and all cause mortality in the elderly. MATERIALS AND METHODS A total 10 547 participants, aged 65 years and older, of baseline cohort were recruited from four nationwide Health Screening Centres in Taiwan from 1998 to 1999. The metabolic syndrome was defined according to the America Heart Association/National Heart Lung Blood Institute definition. Cox proportional hazards regression analyses were used to estimate the relative risks (RRs) of CVD and all cause mortality for those with MetS for up to 8 years of follow-up. RESULTS The baseline prevalence of MetS was 50.1% (45.6% in men and 54.4% in women, respectively). A total of 1312 participants died; of these, 300 participants died from CVD. Adjusted for age, gender, smoking, total cholesterol and estimated glomerular filtration rate, the RRs for CVD and all cause mortality among participants with MetS were 1.48 (95% confidence interval = 1.16-1.90) and 1.16 (1.03-1.30), respectively, for participants compared to those without MetS. The mean RRs for CVD, however, ranged from 1.21 to 5.31 among different combinations of MetS components. CONCLUSION The elderly with MetS, compared to those without MetS, had a higher CVD and all cause mortality in Taiwan. Furthermore, different combinations of MetS components posed different risks to the mortality, which deserves further research in the future.
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Affiliation(s)
- C J Wen
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Can AS, Bersot TP. Analysis of agreement among definitions of metabolic syndrome in nondiabetic Turkish adults: a methodological study. BMC Public Health 2007; 7:353. [PMID: 18088443 PMCID: PMC2249584 DOI: 10.1186/1471-2458-7-353] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2007] [Accepted: 12/19/2007] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND We aimed to explore the agreement among World Health Organization (WHO), European Group for the Study of Insulin Resistance (EGIR), National Cholesterol Education Program (NCEP), American College of Endocrinology (ACE), and International Diabetes Federation (IDF) definitions of the metabolic syndrome. METHODS 1568 subjects (532 men, 1036 women, mean age 45 and standard deviation (SD) 13 years) were evaluated in this cross-sectional, methodological study. Cardiometabolic risk factors were determined. Insulin sensitivity was calculated by HOMA-IR. Agreement among definitions was determined by the kappa statistic. ANOVA and post hoc Tukey's test were used to compare multiple groups. RESULTS The agreement between WHO and EGIR definitions was very good (kappa: 0.83). The agreement between NCEP, ACE, and IDF definitions was substantial to very good (kappa: 0.77-0.84). The agreement between NCEP or ACE or IDF and WHO or EGIR definitions was fair (kappa: 0.32-0.37). The age and sex adjusted prevalence of metabolic syndrome was 38% by NCEP, 42% by ACE and IDF, 20% by EGIR and 19% by WHO definition. The evaluated definitions were dichotomized after analysis of design, agreement and prevalence: insulin measurement requiring definitions (WHO and EGIR) and definitions not requiring insulin measurement (NCEP, ACE, IDF). One definition was selected from each set for comparison. WHO-defined subjects were more insulin resistant than subjects without the metabolic syndrome (mean and SD for log HOMA-IR, 0.53 +/- 0.14 vs. 0.07 +/- 0.23, respectively, p < 0.05) and had higher Framingham risk scores (mean and SD, 2.99 +/- 4.64% vs. 1.10 +/- 1.87%, respectively, p < 0.05). The additional subjects identified by IDF definition, but not by WHO definition also had more insulin resistance and higher Framingham risk scores than subjects without the metabolic syndrome (mean and SD, log HOMA-IR 0.18 +/- 0.18 vs. 0.07 +/- 0.23, p < 0.05 and Framingham risk score 2.93 +/- 4.54% vs. 1.10 +/- 1.87%, p < 0.05). The IDF-identified additional subjects had similar Framingham risk scores as WHO-identified subjects (p > 0.05), but lower log HOMA-IR values (p < 0.05). CONCLUSION The metabolic syndrome definitions that do not require measurement of insulin levels (NCEP, ACE and IDF) identify twice more patients with insulin resistance and increased Framingham risk scores and are more useful than the definitions that require measurement of insulin levels (WHO and EGIR).
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Affiliation(s)
- Ahmet Selcuk Can
- Department of Medicine, Istanbul Science University, Faculty of Medicine, Esentepe, Sisli, Istanbul, Turkey.
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Abstract
The metabolic syndrome is a clustering of risk factors which predispose an individual to cardiovascular morbidity and mortality. There is general consensus regarding the main components of the syndrome (glucose intolerance, obesity, raised blood pressure and dyslipidaemia [elevated triglycerides, low levels of high-density lipoprotein cholesterol]) but different definitions require different cut points and have different mandatory inclusion criteria. Although insulin resistance is considered a major pathological influence, only the World Health Organization (WHO) and European Group for the study of Insulin Resistance (EGIR) definitions include it amongst the diagnostic criteria and only the International Diabetes Federation (IDF) definition has waist circumference as a mandatory component. The prevalence of metabolic syndrome within individual cohorts varies with the definition used. Within each definition, the prevalence of metabolic syndrome increases with age and varies with gender and ethnicity. There is a lack of diagnostic concordance between different definitions. Only about 30% of people could be given the diagnosis of metabolic syndrome using most definitions, and about 3540% of people diagnosed with metabolic syndrome are only classified as such using one definition. There is currently debate regarding the validity of the term metabolic syndrome, but the presence of one cardiovascular risk factor should raise suspicion that additional risk factors may also be present and encourage investigation. Individual risk factors should be treated.
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Affiliation(s)
- Caroline Day
- Diabetes Research Group, School of Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK.
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