The Association Between Employment Status and Metabolic Syndrome in Women: Modifying Effect of Education

Relation of Dietary n-3 and n-6 Fatty Acid Intakes to Metabolic Syndrome in Middle-Aged People Depending on the Level of HbA1c: A Review of National Health and Nutrition Survey Data from 2014 to 2016

Background and Objectives: The relation of dietary n-6 fatty acid to metabolic syndrome has not been examined and clearly defined. To improve health in the general population, this study was to investigate the role of n-3 and n-6 fatty acids in the reduction in metabolic syndrome and to observe changes in the effects of these fatty acids depending on the level of insulin resistance. Materials and Methods: This cross-sectional study utilized national health and nutrition survey data from 2014 to 2016. From the data, a relation of n-3 and n-6 fatty acid intakes to metabolic syndrome and Hemoglobin A1c (HbA1c)’s role in the relation was evaluated and analyzed for 4852 patients between 40 and 64 years old. Intake frequency of 112 nutrition and daily consumption amounts were identified, and intakes of n-3 and n-4 fatty acids were calculated from this data. Metabolic syndrome was determined for each participant using diagnostic standards for the Asian population published by the National Cholesterol Education Program. Results: Among the total 4852 subjects, 1583 (32.6%) had metabolic syndrome; 736 of 1875 (39.3%) males and 847 of 2977 (28.5%) females had the syndrome. In males, when their HbA1c was low (<5.4%), intakes of both n-3 and n-6 fatty acids were related to a 43−63% decreased prevalence of metabolic syndrome with significance, and a similar negative tendency was also observed in females. On the contrary, for both males and females, no statistically significant correlation was present when HbA1c was high. Conclusion: It was considered that consistent and regular dietary intakes of n-3 and n-6 fatty acids may contribute greatly to prevent or treat metabolic syndrome in healthy males with normal insulin sensitivity, but the effect of their dietary intakes was found to be limited in a group with strong insulin resistance. The conclusion of this study presents a valuable reference and knowledge to provide nutritional education to the general population.

Gender-related factors and out-of-hospital cardiac arrest incidence in women and men: analysis of a population-based cohort study in the Netherlands

BACKGROUND

The incidence of out-of-hospital cardiac arrest (OHCA) differs consistently between women and men. Besides sex-related (biological) factors, OHCA risk may relate to gender-related (sociocultural) factors. We explored the association of selected gender-related factors with OHCA incidence in women and men.

METHODS

We combined data on emergency medical services-attended OHCA with individual-level data from all women and men aged ≥25 years living in North Holland, the Netherlands. We estimated the associations between employment status, primary earner status, living with children and marital status and the OHCA incidence with Cox proportional hazards models stratified by sex and adjusted for age and socioeconomic status. To determine if metabolic factors explain the associations, we added hypertension, diabetes mellitus and dyslipidaemia to the models. Population attributable fractions (PAF) for all gender-related factors were calculated.

RESULTS

All four gender-related factors were associated with OHCA incidence (eg, unemployed vs employed; HR 1.98, 95% CI 1.67 to 2.35 in women; HR 1.60, 95% CI 1.44 to 1.79 in men). In both sexes, those unemployed, those who are not primary earners, those living without children, and married or divorced individuals had an increased OHCA risk. The PAF ranged from 4.9 to 40.3 in women and from 4.4 to 15.5 in men, with the highest PAF for employment status in both sexes. Metabolic risk factors did not explain the observed associations.

CONCLUSION

Gender-related factors were associated with risk of OHCA and contributed substantially to the OHCA burden at the population level, particularly in women. Employment status contributed most to the OHCA burden.

Quantifying gender inequalities in obesity: findings from the Turkish population-based Balcova Heart Study

OBJECTIVES

Sparse evidence is available to explain obesity variations between genders in the Turkish population. To our knowledge, no previous study has analysed the magnitude of gender differences in obesity using common social determinants of health. We aimed to quantify gender inequalities in obesity in terms of education, employment status, occupation and perceived income in a Turkish population.

STUDY DESIGN

The study design used is a cross-sectional study.

METHODS

Population-based data from the Balcova Heart Study (n = 16,080) were analysed. Logistic regression models were used to calculate the crude and adjusted odds ratios (ORs) when comparing obesity prevalence in women vs men within each category of social determinants.

RESULTS

Women had a higher risk of being obese than men (adjusted OR [aOR] = 2.04 [95% confidence interval {CI}: 1.7-2.1]). Gender inequality in obesity decreased as the level of education increased, from 'primary school' (aOR = 2.5 [95% CI: 2.2-2.8]) to 'university' (aOR = 0.9 [95% CI: 0.6-1.1]). Women had a higher risk of obesity within the 'unemployed' category compared with men (aOR = 2.2 [95% CI: 1.6-3.0]). Gender inequality in obesity decreased with a higher perception of income, from 'low' (aOR = 2.1 [95% CI: 1.6-3.0]) to 'high' (aOR = 1.5 [95% CI: 1.2-2.0]).

CONCLUSIONS

These findings highlight the fact that gender inequalities in obesity are greatest within populations of low education, unemployment and lower perception of income. Reduced gender inequality in obesity prevalence was seen for the subpopulation with professional occupations, with women having decreased odds of obesity compared with men. Conversely, unemployed women had increased odds of obesity compared with unemployed men. Increasing the status of women should be prioritised in policies to tackle obesity in the Turkish population and in similar developing populations elsewhere.

The Relationship Between Occupation Transition Status and Metabolic Syndrome in Adult Women: Tehran Lipid and Glucose Study

PURPOSE

Although occupation status may play a role in the risk of metabolic syndrome (MetS), data on this topic are limited. The aim was to examine the association between occupation transition status and the 12-year incidence of MetS in adult women of a population-based cohort study.

METHODS

A total of 2406 women, aged ≥20 years, were selected from the Tehran Lipid and Glucose Study. Subjects were free of MetS at baseline and followed for a mean of 12 years. Based on occupation transition from baseline to the end of follow-up, women were classified into four groups: employed-employed (group I), employed-unemployed (group II), unemployed-employed (group III), and unemployed-unemployed (group IV). The odds ratio (OR) for the occurrence of MetS and its components according to occupation transition status was assessed by multivariate logistic regression.

RESULTS

The incidence of MetS in group I and group IV was 15.6% and 29.3%, respectively. In comparison with women in group I, those in group IV had higher risk of MetS (OR = 2.45, 95% CI, 1.6-3.8); however, after adjustment for age, education level, marital status, smoking, and body mass index, the association between occupation status and MetS was not significant (OR = 1.38, 95% CI, 0.83-2.27). In the fully adjusted model, women who were employed at baseline and unemployed at the end of follow-up had greater risk of incident MetS (OR = 2.26, 95% CI, 1.26-4.06) and low high-density lipoprotein cholesterol (OR = 2.34, 95% CI, 1.40-3.85) compared with those who were constantly employed.

CONCLUSION

Occupation transition from employed to unemployed status was found to increase risk of incident MetS.

Epidemiologic features of metabolic syndrome in a general Mongolian population

BACKGROUND

Although cardiovascular health is a crucial problem for Mongolian people, little information about metabolic syndrome, which is well known to be associated with the development of cardiovascular disease, is available in Mongolia. The aim of this study was to observe the epidemiological features of metabolic syndrome in a general Mongolian population.

METHODS

This cross-sectional study was performed in 1911 general Mongolian subjects (717 men, 1194 women), who were ≥40 years old and free of ischemic heart disease, by using a dataset from a nationwide population-based cohort study in Mongolia. The prevalence of metabolic syndrome, as defined by International Diabetes Federation criteria, was determined. Alcohol consumption, smoking habits, and physical activity were evaluated. Education, marital status, income, and occupation were also examined as factors of socioeconomic status (SES). Their association with metabolic syndrome was determined by logistic regression models.

RESULTS

The prevalence of metabolic syndrome was significantly higher in women (n=488, 40.6%) than in men (n=138, 19.4%). The prevalence of metabolic syndrome was high, especially in the Khangai region, in women. Moderate-to-high alcohol consumption was a significantly positively associated factor of metabolic syndrome in men [odds ratio (OR)=2.01; 95% confidence interval (CI) 1.15-3.51; adjusted odds ratio (AOR)=2.41; 95% CI 1.31-4.44] and widowed status was a significantly positively associated factor of metabolic syndrome in women (OR=1.61, 95% CI 1.18-2.18; AOR=1.49, 95% CI 1.07-2.08).

CONCLUSIONS

Metabolic syndrome was prevalent in women compared with men among Mongolian adults. Preventive strategies aimed at men with a higher alcohol consumption and women with widowed status may help reduce metabolic syndrome, thereby improving cardiovascular health conditions in Mongolia.