1
|
Comparison of the Three Most Commonly Used Metabolic Syndrome Definitions in the Chinese Population: A Prospective Study. Metabolites 2022; 13:metabo13010012. [PMID: 36676936 PMCID: PMC9860556 DOI: 10.3390/metabo13010012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Metabolic syndrome (MetS) is associated with cardiovascular risk, and there are various definitions, but which is most predictive of future cardiovascular disease (CVD) in the Chinese population is still unclear. MetS was defined with the revised ATP III (Third Adult Treatment Panel Report), International Diabetes Federation (IDF), and the Joint Committee for Developing Chinese Guidelines (JCDCG) definitions. Cox regression was used to estimate the hazard risk of cardiovascular disease among 20,888 participants using the Chinese Hypertension Survey (CHS) data. Sensitivity, specificity, and receiver operating characteristic (ROC) curve distance were used to test the ability of three MetS criteria to identify CVD. During an average follow-up of 4.89 years of 20,888 participants, 925 CVD events occurred (stroke, 560; coronary heart disease, 275; and other cardiovascular events, 119). The revised ATP III criteria identified the most individuals with MetS and had the highest prevalence of MetS. In addition, MetS was associated with a high risk of CVD in both men and women, according to three criteria. The highest diagnostic specificity was for IDF in men and JCDCG in women. The revised ATP III criteria had the highest sensitivity and shortest ROC curve distance in both men and women. Although the MetS definitions, including the revised ATP III, IDF, and JCDCG, are all related to the increased risks of CVD, overall, the revised ATP III performs best and is the most recommended for the Chinese population.
Collapse
|
2
|
Zheng X, Yu H, Qiu X, Chair SY, Wong EML, Wang Q. The effects of a nurse-led lifestyle intervention program on cardiovascular risk, self-efficacy and health promoting behaviours among patients with metabolic syndrome: Randomized controlled trial. Int J Nurs Stud 2020; 109:103638. [PMID: 32553996 DOI: 10.1016/j.ijnurstu.2020.103638] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Metabolic syndrome is a cluster of cardio-metabolic risk factors and a major burden for public health due to its increasing prevalence and adverse effects on cardiovascular health. Lifestyle modification is the first-line intervention for metabolic syndrome management. However, adopting healthy behaviours is challenging among patients with metabolic syndrome. OBJECTIVE To examine the effects of a nurse-led lifestyle intervention program on cardiovascular risks, self-efficacy and the implementation of health promoting behaviours. DESIGN A two-armed randomized controlled trial. SETTINGS AND PARTICIPANTS A total of 173 patients that satisfied the metabolic syndrome definition of International Diabetes Federation was recruited from a hospital in North China. METHODS The participants were randomly assigned to either attend the lifestyle interventions (n = 86) or receive usual care from the study hospital (n = 87). The lifestyle intervention followed the framework of Health Promotion Model and consisted of one face-to-face education session (30-40 min), one educational booklet and six telephone follow-ups (bi-weekly, 20-30 min per call) in three months. The Framingham 10-year risk score was calculated to measure the participants' cardiovascular risks at baseline and 3-month. The Self-rated Abilities for Health Practices and Health Promoting Lifestyle Profile II was employed to measure the self-efficacy and health promoting behaviours at baseline, 1-month, and 3-month. The generalized estimating equation model was employed to examine the effects of the lifestyle intervention program. RESULTS No difference was detected in the baseline characteristics between the two groups. Decreased cardiovascular risk was found in the lifestyle intervention group, but no significant group-by-time effect was detected. The self-efficacy for nutrition, stress dimension and sum score of health promoting behaviours revealed significant improvements at 1-month (all p < 0.05). Significant improvements were also detected in all subscales, total scale of self-efficacy, all dimensions and the sum score of health promoting behaviours at 3-month (all p < 0.05). CONCLUSIONS The nurse-led Health Promotion Model guided lifestyle intervention program effectively improved the self-efficacy and implementation of health promoting behaviours in patients with metabolic syndrome. We recommend that nurses apply lifestyle interventions in routine care for patients with metabolic syndrome. Tweetable abstract: The RCT revealed that nurse-led lifestyle intervention was effective to improve self-efficacy and healthy behaviours among 173 MetS patients.
Collapse
Affiliation(s)
- Xujuan Zheng
- School of Nursing, Shenzhen University, No.1066 Xueyuan Road, Nanshan District, Shenzhen 518055, China.
| | - Hongbo Yu
- Department of Endocrinology, Pingdu People's Hospital, Qingdao, China.
| | - Xichenhui Qiu
- School of Nursing, Shenzhen University, No.1066 Xueyuan Road, Nanshan District, Shenzhen 518055, China.
| | - Sek Ying Chair
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong.
| | - Eliza Mi-Ling Wong
- School of Nursing, The Hong Kong Polytechnic University. Hung Hom, Kowloon, Hong Kong.
| | - Qun Wang
- School of Nursing, Shenzhen University, No.1066 Xueyuan Road, Nanshan District, Shenzhen 518055, China.
| |
Collapse
|
3
|
Abstract
BACKGROUND The incidence of depression is very common among patients with post-acute coronary syndrome (ACS) and leads to adverse outcomes. AIMS The aim of this meta-analysis was to detect risk factors for depression among patients with ACS and to provide clinical evidence for its prevention. METHODS The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline to search the PubMed, Web of Science, EMBASE, and EBSCO databases from January 1996 to March 2018. Data that met the inclusion criteria were extracted to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk factors of post-ACS depression. RESULTS A total of 30 articles met the inclusion criteria, and 25 risk factors were found to be associated with depression. The top 5 risk factors are as follows: antidepression treatment (OR, 4.25; 95% CI, 3.41-5.31), housewife status (OR, 4.17; 95% CI, 1.83-9.53), history of depressive disorders (OR, 3.52; 95% CI, 2.69-4.61), widow status (OR, 2.34; 95% CI, 1.05-5.21), and history of congestive heart failure (OR, 2.03; 95% CI, 1.04-3.97). The authors also found that a married status, high education level, and employment are protective factors. CONCLUSION Clinical personnel should be alerted with regard to the high risk factors of depression, including female gender, low education level, unmarried status, living alone, unemployed status, unhealthy lifestyle, and complications such as cardiovascular, respiratory, and metabolic diseases. In particular, staff should pay attention to a history of previous depression, be concerned with the psychological condition of the patient, and monitor and perform early interventions to reduce the incidence of depression.
Collapse
|
4
|
Cheng HY, Chair SY, Wang Q, Cao X, Cheng L, Lee IFK. Measuring exercise self-efficacy in Hong Kong Chinese adults with cardiovascular risk: Validation of a Chinese version of the Cardiac Exercise Self-efficacy Instrument. Res Nurs Health 2019; 42:148-154. [PMID: 30710372 DOI: 10.1002/nur.21936] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 01/05/2019] [Indexed: 11/09/2022]
Abstract
About one-third of adults are physically inactive and thus prone to cardiovascular diseases. While self-efficacy mediates health behavior, its influences on exercise behavior among Chinese is yet to be explored by a validated instrument. This study aimed to examine the psychometric properties of the Hong Kong Chinese version of the Cardiac Exercise Self-efficacy Instrument (CESEI-C), which had been translated previously by these authors. The psychometric properties of the CESEI-C were tested with 160 Hong Kong Chinese with cardiovascular risk. Participants were asked to complete the CESEI-C, a physical activity assessment tool, and perform the exercise stress test. Exploratory factor analysis identified a unidimensional structure of the CESEI-C. Good internal consistency (Cronbach's alpha = 0.91) and good content validity (content validity indices: 0.93-1.00) had been reported previously. The convergent validity of the CESEI-C was supported by the significant positive correlations between the CESEI-C score and the amount of moderate-to-vigorous exercise (r = 0.18, p = 0.03), and exercise capacity (r = 0.30, p < 0.01). A comparison of CESEI-C scores by exercise capacities indicated that those with moderate-to-high exercise capacity had significantly higher CESEI scores than those with low exercise capacity (t = 2.105, p = 0.04). Thus, the CESEI-C is a valid and reliable instrument to measure exercise self-efficacy among Hong Kong Chinese.
Collapse
Affiliation(s)
- Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Sek Ying Chair
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Qun Wang
- School of Nursing, Shenzhen University, Shenzhen, China
| | - Xi Cao
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Li Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Iris F K Lee
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| |
Collapse
|
5
|
Sun F, Gao B, Wang L, Xing Y, Ming J, Zhou J, Fu J, Li X, Xu S, Liu G, Ji Q. Agreement Between the JCDCG, Revised NCEP-ATPIII, and IDF Definitions of Metabolic Syndrome in a Northwestern Chinese Population. Diabetes Ther 2018; 9:1457-1468. [PMID: 29808362 PMCID: PMC6064597 DOI: 10.1007/s13300-018-0446-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION The Joint Committee for Developing Chinese Guidelines (JCDCG) introduced the Chinese definition for metabolic syndrome (MS), which has been verified in southern Chinese people but not in northwestern Chinese people. We evaluated the MS definition proposed by the JCDCG in a northwestern Chinese population, in comparison with those of the revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) and the International Diabetes Federation (IDF). METHODS This population-based cross-sectional study was a part of the China National Diabetes and Metabolic Disorders Study conducted in Shaanxi province. We included 3243 participants aged ≥ 20 years. The age-adjusted MS prevalence was assessed per the 2007 Chinese population structure. The agreement between different definitions was assessed by the kappa statistic. RESULTS The standardized prevalence of JCDCG-MS, revised ATPIII-MS, and IDF-MS was 22.4%, 29.4%, and 24.9%, respectively. Among women, the agreement of the JCDCG definition with the revised ATPIII and the IDF definition was not good (κ = 0.599 and 0.601, respectively); 54.6% of the revised ATPIII-MS and 56% of the IDF-MS were defined as MS according to the JCDCG definition. Among men, the agreement of JCDCG definition with the revised ATPIII and IDF definitions was very good (κ = 0.863) and substantial (κ = 0.741), respectively. CONCLUSION The agreement of the JCDCG definition with the revised ATPIII and IDF definitions was insufficient in women. Compared with the other two definitions, the JCDCG definition underestimates MS prevalence in northwestern women.
Collapse
Affiliation(s)
- Fei Sun
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Bin Gao
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Li Wang
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Ying Xing
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jie Ming
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jie Zhou
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jianfang Fu
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Xiaomiao Li
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Shaoyong Xu
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Guocai Liu
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
- The Third Department of Internal Medicine, The 273 Hospital of Chinese PLA, Korla, Xinjiang, China
| | - Qiuhe Ji
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
| |
Collapse
|
6
|
The effects of a lifestyle intervention program on physical outcomes, depression, and quality of life in adults with metabolic syndrome: A randomized clinical trial. Int J Cardiol 2017; 230:461-467. [DOI: 10.1016/j.ijcard.2016.12.084] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 11/25/2016] [Accepted: 12/16/2016] [Indexed: 01/22/2023]
|
7
|
Jeong JU, Jeon MJ, Sakong J. The association between long working hours and the metabolic syndrome: evidences from the 5th Korean National Health and Nutrition Examination Survey of 2010 and 2012. Ann Occup Environ Med 2014; 26:53. [PMID: 25763189 PMCID: PMC4355009 DOI: 10.1186/s40557-014-0053-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 11/08/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This study was conducted in order to evaluate the association between the working hours of Korean employees and the metabolic syndrome and the effects of long working hours on metabolic syndrome based on the 5th Korean National Health and Nutrition Examination Survey (2010-2012). METHODS Based on the 5th Korean National Health and Nutrition Examination Survey (2010-2012), 4,456 Korean employees without shift work, aged over 15, who work 30 hours or more per week were targeted in this study. The association between the general characteristics, including age, smoking, alcohol drinking, exercise, and the metabolic syndrome criteria defined by International Diabetes Federation (IDF) and weekly working hours were analyzed. In addition, the association between weekly working hours and the metabolic syndrome of the subjects stratified by gender was analyzed through multiple logistic regression analyses and generalized linear mixed model after adjusting the general characteristics. RESULTS In the results of stratified analysis by gender, in male subjects, in comparison with the 30-39 weekly working hours group, there were no significant adjusted odds ratios to the other working hours groups. In female subjects, in comparison with the 30-39 weekly working hours group, there were no significant adjusted odds ratios to the other working hours groups. In addition, no trend associations were observed among weekly working hour groups in both stratified genders. CONCLUSION No significant differences in prevalence of metabolic syndrome of the subjects stratified by gender were found according to weekly increasing working hours. However, due to some limitations of this study, further prospective studies may be necessary for verification.
Collapse
Affiliation(s)
- Jae Uk Jeong
- />Department of Occupational and Environmental Medicine, Yeungnam University Hospital, 170, Hyeonchung-ro, Nam-gu, Daegu, 705-802 Republic of Korea
| | - Man Joong Jeon
- />Department of Occupational and Environmental Medicine, Yeungnam University Hospital, 170, Hyeonchung-ro, Nam-gu, Daegu, 705-802 Republic of Korea
- />Department of Preventive Medicine and Public Health, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu, 705-802 Republic of Korea
| | - Joon Sakong
- />Department of Occupational and Environmental Medicine, Yeungnam University Hospital, 170, Hyeonchung-ro, Nam-gu, Daegu, 705-802 Republic of Korea
- />Department of Preventive Medicine and Public Health, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu, 705-802 Republic of Korea
| |
Collapse
|