Gender- and Age-Specific Prevalence of Metabolic Syndrome Among Korean Adults: Analysis of the Fifth Korean National Health and Nutrition Examination Survey

The prevalence and clustering of metabolic syndrome risk components in Chinese population: a cross-sectional study

Objective

The metabolic syndrome (MetS) is diagnosed upon the manifestation of ≥ 3 out of 5 specific components. The present study evaluated the epidemiological characteristics of the MetS components and their clustering condition among Chinese adults.

Methods

68383 participants aged 18-80 years from TIDE were scored on a six-point (0-5) MetS severity score (MSSS), which quantified their cumulative amount of MetS risk components. We evaluated the epidemiological characteristics of these components and their clustering conditions. Additionally, we examined the relation of age with the prevalence of different MSSSs or specific MetS components using restricted cubic splines.

Results

Among 68383 participants, 26113 men and 24582 women had abnormal MetS components. There were significant differences in most epidemiological characteristics between the 6 MSSS groups. The top three prevalence of abnormal metabolic components were high systolic blood pressure (SBP) (9.41%, n=6568), high waist circumference (WC) (8.13%, n=6120), and the cooccurrence of high SBP and high WC (6.33%, n=4622). Participants were more likely to have all five MetS components when HDL-C was low. Restricted cubic splines showed that when the MSSS ≥3, the MetS prevalence of male peaked and that of the female population increased most rapidly at 40-60 age group.

Conclusion

The 40-60 age group can be regarded as the high-risk period of MetS, and elderly women have a higher risk of multiple metabolic disorders than men. The top three clustering of abnormal metabolic components were high SBP, high WC, and their combination. Multiple components aggregation was more likely to occur when HDL-C decreased.

Differences in the components of metabolic syndrome by age and sex: a cross-sectional and longitudinal analysis of a cohort of middle-aged and older Japanese adults

BACKGROUND

The prevalence of metabolic syndrome (MetS) in Japan, a super-aged society, is increasing and poses a major public health issue. Several studies have reported sex differences in the association between age and MetS prevalence. This study aimed to examine the association between age and the prevalence of MetS based on multiple screening criteria and MetS components by sex.

METHODS

We used 6 years of individual-level longitudinal follow-up data (June 2012 to November 2018; checkup year: 2012-2017) of middle-aged and older adults aged 40-75 years in Japan (N = 161,735). The Joint Interim Statement criteria, International Diabetes Federation criteria, and another set of criteria excluding central obesity were used as the screening criteria for MetS. The prevalence of MetS and MetS components was cross-sectionally analyzed according to sex and age. A longitudinal association analysis of age, MetS, and MetS components by sex was performed using a multilevel logistic model, adjusted for lifestyle- and regional-related factors.

RESULTS

Sex differences were observed in the prevalence and association of MetS and MetS components. In all age groups, the prevalence of central obesity was higher among women, and the prevalence of high blood pressure and fasting glucose was higher among men (P < 0.001). The prevalence of high triglyceride and low high-density lipoprotein cholesterol was higher among women aged > 60 years (P < 0.05). Based on the criteria of the Joint Interim Statement and International Diabetes Federation, the prevalence of MetS was higher among women than in men aged > 55 years (P < 0.001). Men had a higher prevalence of MetS without central obesity than women in all age groups (P < 0.001). The odds ratio for MetS and MetS components with aging was greater among women than in men.

CONCLUSIONS

Medical management should be based on the prevalence of MetS and its components according to sex and age. In particular, the high prevalence of MetS without central obesity in middle-aged and older Japanese men suggests that the adoption of the Joint Interim Statement criteria, which do not precondition central obesity, should be considered.

Approaches and Components of Health Workforce Planning Models: A Systematic Review

Background

To date, there is still no uniformity in forecasting models for health workforce planning (HWFP). Different countries use various HWFP models, some of which are context-specific. The objective of this systematic review is to determine approaches and components of HWFP models.

Methods

A systematic review of studies published in English and Persian between 2004 and 2021 was performed by searching PubMed Central, MEDLINE, Web of Science, Scopus, Eric, and Elmnet databases. Articles that assessed HWFP models, focused on health service delivery, used input-output models, and a clear formulation process were included. Articles that scored ≥20 points on the "strengthening the reporting of observational studies in epidemiology" checklist were considered of acceptable quality for inclusion.

Results

Twenty articles were included for qualitative synthesis based on the inclusion and exclusion criteria. Most studies used the mixed method approach "supply and demand", whereas target- and needs-based approaches were used less frequently. The number of components used to estimate supply, demand, needs, and targets were 42, 32, 11, and 6, respectively. In addition, several unique factors used in the various HWFP models were identified.

Conclusion

Different approaches are used in HWFP models, which is indicative of the lack of consensus on this topic. High diversity in the identified factors is related to the approach used and the context in which the model is applied.

Sex differences in risk factors for metabolic syndrome in middle-aged and senior hospital employees: a population-based cohort study

BACKGROUND

Several cross-sectional studies have reported risk factors for metabolic syndrome (MetS). However, these studies did not focus on sex differences in middle-aged and senior populations or employ a longitudinal design. These study design differences are important, as there are sex differences in lifestyle habits associated with MetS, and middle-aged and senior individuals have increased MetS susceptibility. Therefore, the purpose of this study was to examine whether sex differences influenced MetS risk over a ten-year follow-up period among middle-aged and senior hospital employees.

METHODS

This population-based and prospective cohort study enrolled 565 participants who did not have MetS in 2012 for a ten-year repeated-measurement analysis. Data were retrieved from the hospital's Health Management Information System. Analyses included Student's t tests, χ² tests and Cox regression. P < 0.05 indicated statistical significance.

RESULTS

Male middle-aged and senior hospital employees had an elevated MetS risk (hazard ratio (HR) = 1.936, p < 0.001). Men with more than four family history risk factors had an increased risk of MetS (HR = 1.969, p = 0.010). Women who worked shift duty (HR = 1.326, p = 0.020), had more than two chronic diseases (HR = 1.513, p = 0.012), had three family history risk factors (HR = 1.623, p = 0.010), or chewed betel nuts (HR = 9.710, p = 0.002) had an increased risk of MetS.

CONCLUSIONS

The longitudinal design of our study improves the understanding of sex differences in MetS risk factors in middle-aged and senior adults. A significantly elevated risk of MetS over the ten-year follow-up period was associated with male sex, shift work, the number of chronic diseases, the number of family history risk factors, and betel nut chewing. Women who chewed betel nuts had an especially increased risk of MetS. Our study indicates that population-specific studies are important for the identification of subgroups susceptible to MetS and for the implementation of hospital-based strategies.

Effects of qigong exercise on cardiovascular risk factors in patients with metabolic syndrome: A systematic review and meta-analysis

Background: As a traditional Chinese exercise system, Qigong includes many types of exercises, including Baduanjin, Wuqinxi, Yijinjing, and Liuzijue. However, reviews highlighting the effects of a specific type of Qigong exercise in patients with metabolic syndrome or risk factors for metabolic syndrome are limited, and no articles have systematically evaluated the effects of Qigong exercise on cardiovascular risk factors in patients with metabolic syndrome. Therefore, this systematic review aimed to evaluate the effects of Qigong exercise on cardiovascular risk factors in patients with metabolic syndrome. Objective: Relevant randomized controlled trials were identified to conduct a meta-analysis of the effects of Qigong exercise on patients with metabolic syndrome, and to further explore the overall impact, heterogeneity, and publication bias related to the effects of Qigong exercise on metabolic syndrome. Methods: We searched for RCTs of Qigong exercise in patients with metabolic syndrome from the following databases: Pubmed, Web of Science, The Cochrane Library, Scopus, Embase, Physiotherapy Evidenced Database (PEDro), Google Scholar, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database (CNKI), Chinese Science, Wanfang Data, and the VIP database. The search duration was set from the establishment of the database to 16 April 2022. We used the "Bias Risk Assessment" tool recommended by Cochrane Manual 5.0 to assess the methodological quality of the included literature and the R (version 3.6.2) package gemtc to analyze the data. Results: A total of seven RCTs with 486 participants were included in the meta-analysis. The results showed that Qigong exercise had significant effects on waist circumference (standardized mean difference [SMD] = -0.67; 95% CI, -1.16 to -0.17), systolic blood pressure (standardized mean difference = -0.53; 95% CI, -0.78 to -0.28) and triglyceride level (SMD = -0.60; 95% CI, -0.79 to -0.41). Subgroup analyses showed that 6-month Qigong exercise significantly improved diastolic blood pressure (SMD = -1.06; 95% CI, -1.57 to -0.56), high-density lipoprotein cholesterol level (SMD = 1.45; 95% CI, 1.06-1.85), total cholesterol level (SMD = -0.65; 95% CI, -1.04 to -0.27), and body mass index (SMD = -0.97; 95% CI, -1.23 to -0.72). For fasting blood glucose (SMD = -1.12; 95% CI, -1.58 to -0.67), the effect of a 3-month intervention seemed more effective than 6 months of Qigong exercise, but the evidence was insufficient. In addition, Qigong exercise had minimal effects on low-density lipoprotein cholesterol levels (SMD = -1.22; 95% CI, -1.95 to -0.50). Conclusion: Qigong may be an alternative exercise mode to improve cardiovascular risk factors in patients with metabolic syndrome. However, the findings are limited by the number and quality of the included studies, and require validation through more high-quality studies.

Sex-specific prevalence of metabolic syndrome in older adults: results from the Neyshabur longitudinal study on aging, Iran

Purpose

The prevalence of metabolic syndrome (MetS) and associated diseases grows as the population ages. This study aimed to investigate sex differences in the prevalence of MetS and its components among people aged 50 years and older in Iran.

Methods

Data were drawn from the Neyshabur Longitudinal Study on Ageing (NeLSA), which is an ageing component of the Prospective Epidemiological Research Studies in IraAn (PERSIAN). The NCEP ATP III and IDF criteria were used to identify the prevalence of MetS among 3383 men and 3873 women aged 50 years and older. Sociodemographic information, lifestyle and clinical factors were collected via an interview-based questionnaire. Weight and height, waist circumferences and blood pressure were measured. Laboratory measures such as fasting blood sugar, triglycerides and high-density cholesterol were also assessed.

Results

The overall prevalence of the MetS according to the NCEP ATP III and IDF definitions were 45% and 47%, respectively. The prevalence of the MetS in men and women was 37% and 63% according to the NCEP ATP III definition, 33% and 67% by the IDF definition, respectively. The prevalence of MetS components was significantly higher in women than in men.

Conclusion

In the current study, the prevalence of MetS and its components was significantly higher among women than men. We also observed good concordance between IDF and NCEP ATP III criteria.

Gender Differences in the Prevalence of Metabolic Syndrome Among Taiwanese Air Force Personnel: A Population-Based Study

BACKGROUND

Authors of several studies have reported differences in the prevalence of metabolic syndrome (MetS) between men and women. However, information is lacking on gender difference among military personnel.

OBJECTIVE

The aim of this study was to examine the prevalence of MetS and its component abnormalities among Taiwanese Air Force personnel by gender and age groups.

METHODS

A population-based study was conducted including 14 872 Taiwanese Air Force personnel. Data were retrieved from the military's Health Management Information System. Analyses were performed using Student t test, χ test, and linear-by-linear χ test. Statistical significance was defined as P < .05.

RESULTS

The MetS prevalence was 14.0% (15.1% in men and 5.3% in women). Metabolic syndrome was associated with age for both men and women (both Ptrend < .001), with a greater prevalence of MetS in men aged 18 to 44 years than in women, but not in the age group of 45 years or older. In men, MetS was most prevalent in those with increased waist circumference (78.2%), followed by those with elevated blood pressure (75.6%). By contrast, in women, it was most prevalent in those with increased waist circumference (86.5%), followed by those with reduced high-density lipoprotein cholesterol (84.3%).

CONCLUSIONS

Our findings suggest that military nurses and other health providers should consider the gender- and age-based MetS prevalence trend among Taiwanese Air Force personnel when designing interventions to identify vulnerable subgroups at a high risk of MetS. Health management programs should be adapted to minimize metabolic risks.

Metabolic Syndrome and Its Related Factors among Hospital Employees: A Population-Based Cohort Study

Several studies have reported on metabolic syndrome (MetS) based on cross-sectional designs, which cannot show a long-term result. Information is lacking on MetS and related factors based on a longitudinal cohort. This study aimed to examine the relationship between MetS and related factors for a total of six years among hospital employees. A population-based study was conducted, including 746 staff. A total of 680 staff without MetS in 2012 were enrolled in the analysis for repeated measurement of six years of the longitudinal cohort. Data were retrieved from the hospital’s Health Management Information System. Analyses were performed using Student’s t-test, chi-square test, logistic regression, and generalised estimating equations. Statistical significance was defined as p < 0.05. Hospital employees aged between 31 and 40 (odds ratio (OR) = 4.596, p = 0.009), aged between 41 and 50 (OR = 7.866, p = 0.001), aged greater than 50 (OR = 10.312, p < 0.001), with a body mass index (BMI) of 25.0~29.9 kg/m² (OR = 3.934, p < 0.001), a BMI ≥ 30 kg/m² (OR = 13.197, p < 0.001), higher level of white blood counts (β = 0.177, p = 0.001), alanine aminotransferase (β = 0.013, p = 0.002), and uric acid (β = 0.223, p = 0.005) were at risk of being diagnosed with MetS. The identification of at-risk hospital employees and disease management programs addressing MetS-related factors are of great importance in hospital-based interventions.

Effects of Tai Chi on health outcomes among community-dwelling adults with or at risk of metabolic syndrome: A systematic review

OBJECTIVES

This systematic review evaluated the effects of Tai Chi on health outcomes among community-dwelling adults with or at risk of metabolic syndrome (MetS).

METHODS

Randomized controlled trials (RCTs) were searched in 10 databases. Data were statistically pooled for meta-analysis.

RESULTS

Twenty RCTs were included. One study involved adults with MetS, and the other 19 studies involved adults with at least one risk factor for MetS. Tai Chi was found to reduce waist circumference and increase high-density lipoprotein cholesterol in obese adults. Tai Chi also reduces waist circumference, body mass index, blood glucose level, insulin resistance, and increases the quality of life (QoL) in adults with elevated blood glucose/type 2 diabetes (T2DM). Among participants with hypertension, Tai Chi improves blood pressure, lipid profiles, anxiety, depression, and physical QoL.

CONCLUSIONS

Tai Chi may be effective for enhancing the physiological and psychosocial wellbeing of community-dwelling adults at risk of MetS. Further RCTs are needed to examine its effects in adults with MetS and identify optimal regimes.

Combined Effects of Unhealthy Lifestyle Behaviors on Metabolic Syndrome among Postmenopausal Women

This study aimed to identify the combined effects of unhealthy lifestyle behaviors, including diet, sedentary behavior, and physical activity on metabolic syndrome (MS) and components of MS among postmenopausal women. Secondary data analysis was conducted using the Korean National Health and Nutrition Examination Survey (2014–2018) with a cross-sectional study design. Logistic regression analysis was conducted with data from 6114 Korean postmenopausal women. While no significant effects of unhealthy lifestyle behaviors, either individually or as a combination, were found for MS, prolonged sedentary behavior without poor dietary behavior and insufficient physical activity was associated with increased likelihood of abdominal obesity (adjusted odds ratio [AOR]: 1.59, 95% confidence interval [CI]: 1.10–2.29) and impaired fasting glucose (AOR: 1.54, 95% CI: 1.13–2.10). The combination of poor dietary behavior and prolonged sedentary behaviors was also associated with increased likelihood of abdominal obesity (AOR: 1.48, 95% CI: 1.10–2.00) and impaired fasting glucose (AOR: 1.49, 95% CI: 1.14–1.96). In addition, prolonged sedentary behavior and insufficient physical activity together were associated with increased likelihood of abdominal obesity (AOR: 2.81, 95% CI: 1.90–4.20) and impaired fasting glucose (AOR: 1.59, 95% CI: 1.13–2.24). Finally, combining poor dietary behavior, prolonged sedentary behavior, and insufficient physical activity was also associated with increased likelihood of abdominal obesity (AOR: 2.05, 95% CI: 1.50–2.80) and impaired fasting glucose (AOR: 1.71, 95% CI: 1.32–2.23). Strategies for replacing sedentary behavior of postmenopausal women with activities are warranted for prevention of abdominal obesity and impaired fasting glucose.

The role of multiparity and maternal age at first pregnancy in the association between early menarche and metabolic syndrome among middle-aged and older women

OBJECTIVE

To analyze whether maternal age at first pregnancy and parity are mediators of the association between early menarche and metabolic syndrome in a sample of middle-aged and older women.

METHODS

Cross-sectional study of 428 women (40 to 80 y), who had experienced a pregnancy in their lifetime, was performed between 2014 and 2016. Age at first pregnancy, parity, and early menarche were self-reported. Metabolic syndrome was assessed using the criteria described by the National Cholesterol Education Program's Adult Treatment Panel III. The association between metabolic syndrome and early menarche was assessed by logistic regression analysis. The mediating role of age at first pregnancy and multiparity in the relationship between early menarche and metabolic syndrome was assessed through mediation analysis, adjusted for covariates.

RESULTS

According to adjusted logistic regression models, early menarche was associated with higher odds of prevalent metabolic syndrome (OR: 2.26; 95% CI: 1.15-4.46). Mediation analysis showed a significant direct effect of early menarche on metabolic syndrome (β: 0.808; 95% CI: 0.107-1.508). Of the two mediators tested, age at first pregnancy was significant (β: 0.065; 95% CI: 0.004-0.221), ie, participants with and without early menarche differ, on average, by 0.879 SDs in the log odds of MetS (total effect), of which 0.065 SDs (8%), on average, would be attributable to the effect of early menarche on age at first pregnancy (indirect effect), which, in turn, affects MetS.

CONCLUSIONS

Age at first pregnancy may partially contribute to the association between early menarche and metabolic syndrome among middle-aged and older women who had experienced a pregnancy over their lifetime.

Prevalence of metabolic syndrome and its associated factors among Iranian steel workers

BACKGROUND

Metabolic syndrome (MetS) is composed of a collection of risk factors for heart diseases and diabetes. In recent decades, metabolic syndrome has been identified as one of the important risk factors leading to the development of work-related diseases.

OBJECTIVE

Since few studies have been conducted on evaluating the prevalence of MetS among Iranian workers, this cross-sectional study aimed at assessing the prevalence of MetS and the factors affecting it among Iranian steel workers.

METHODS

This study was carried out on 510 employees working in a large steel producing company. The data pertaining to blood pressure, triglycerides, cholesterol, glucose, and demographic information were collected and the Adult Treatment Panel (ATP III) criteria were implemented to diagnose MetS.

RESULTS

The prevalence of Mets was obtained equal to 13% and a significant positive relationship was observed between age and the prevalence of metabolic syndrome. From among MetS elements, low HDL cholesterol and increased waist circumference were recognized as the most and the least frequently involved elements with 39.3% and 6.5% prevalence, respectively. Chi-square test was run and the results showed that the prevalence of MetS and some of its components rose at higher BMI values. It was also indicated that MetS and its components had no significant relationship with shift work.

CONCLUSION

The current findings revealed that the prevalence of MetS increased with aging. Low HDL and high triglycerides levels were among the main risk factors for MetS. Therefore, considering these risk factors, it should be attempted to develop relevant strategies at workplace to encourage workers to go for a healthier lifestyle so that they can prevent the incidence of MetS.

LPS-enriched small extracellular vesicles from metabolic syndrome patients trigger endothelial dysfunction by activation of TLR4

BACKGROUND

Metabolic syndrome (MetS) is characterized by a cluster of interconnected risk factors -hyperglycemia, dyslipidemia, hypertension and obesity- leading to an increased risk of cardiovascular events. Small extracellular vesicles (sEVs) can be considered as new biomarkers of different pathologies, and they are involved in intercellular communication. Here, we hypothesize that sEVs are implicated in MetS-associated endothelial dysfunction.

METHODS

Circulating sEVs of non-MetS (nMetS) subjects and MetS patients were isolated from plasma and characterized. Thereafter, sEV effects on endothelial function were analyzed by measuring nitric oxide (NO) and reactive oxygen species (ROS) production, and mitochondrial dynamic proteins on human endothelial aortic cells (HAoECs).

RESULTS

Circulating levels of sEVs positively correlated with anthropometric and biochemical parameters including visceral obesity, glycaemia, insulinemia, and dyslipidemia. Treatment of HAoECs with sEVs from MetS patients decreased NO production through the inhibition of the endothelial NO-synthase activity. Injection of MetS-sEVs into mice impaired endothelium-dependent relaxation induced by acetylcholine. Furthermore, MetS-sEVs increased DHE and MitoSox-associated fluorescence in HAoECs, reflecting enhanced cytosolic and mitochondrial ROS production which was not associated with mitochondrial biogenesis or dynamic changes. MetS patients displayed elevated circulating levels of LPS in plasma, and, at least in part, it was associated to circulating sEVs. Pharmacological inhibition and down-regulation of TLR4, as well as sEV-carried LPS neutralization, results in a substantial decrease of ROS production induced by MetS-sEVs.

CONCLUSION

These results evidence sEVs from MetS patients as potential new biomarkers for this syndrome, and TLR4 pathway activation by sEVs provides a link between the endothelial dysfunction and metabolic disturbances described in MetS.

Burnout syndrome and metabolic syndrome: a cross-sectional population-based study

In the population of Primary Health Care Nursing (PHC) professionals, the association between Burnout Syndrome (BS) and Metabolic Syndrome (MS) has not been investigated. The objective was to evaluate the association between BS and MS among PHC Nursing Professionals. A cross-sectional, multicenter, population-based study was conducted in the state of Bahia, Brazil, with 1,125 professionals. The prevalence of BS and MS corresponded to 18.3% and 24.4%, respectively. The prevalence in women of BS was 16.4% and of MS 23.7%, in men 31.6% for BS and 29.4% for MS. Men with BS are 3.23 times more likely to develop MS, and women 1.48 times more. BS was associated between men and women and exhibited a good discriminatory predictive power.

Sex-Specific Energy Intakes and Physical Activity Levels According to the Presence of Metabolic Syndrome in Korean Elderly People: Korean National Health and Nutrition Examination Survey 2016-2018

This study aimed to analyze the differences in energy intake and physical activity (PA) levels according to sex and the presence of metabolic syndrome (MetS) among elderly people in Korea. Data of 3720 elderly people (aged >65 years) were obtained from the Korean National Health and Nutrition Examination Survey (2016–2018). We analyzed PA levels (occupational and recreational PA) and energy intakes (carbohydrate, protein, and fat). The MetS group showed lower levels of moderate intensity recreational PA and place movement than the non-MetS group (p < 0.05); in the MetS group, PA levels were significantly lower in women than in men (p < 0.05). The intakes of total energy, carbohydrate, fat, and protein were lower in the MetS group than in the non-MetS group (p < 0.001). Both the non-MetS and MetS groups showed lower energy intakes in women than men (p < 0.001). Our study shows that elderly people, especially women, with MetS have significantly lower total PA levels and total energy intakes. We confirmed the importance of increased PA and proper nutritional intake in elderly people. Therefore, it is believed that practical measures such as nutrition education and nutrition guidance and PA education are urgently needed to reduce the incidence of MetS among the elderly.

Level of leisure-time physical activity and its association with the prevalence of metabolic syndrome in adults: a population-based study

OBJECTIVE

To analyze the associations between changes in the level of leisure-time physical activity in adults and the prevalence of metabolic syndrome.

METHODS

This is a population-based study conducted with 818 adults aged 20 years or older from Florianópolis, Santa Catarina, Southern Brazil, between 2009 and 2014. We tested the association of maintenance and/or changes in the level of physical activity with the prevalence of metabolic syndrome, adjusted for sociodemographic variables (gender, age, schooling, income, marital status, and ethnicity) and smoking habits. We used logistic regression and estimated the odds ratios (OR) and their respective confidence intervals (95%CI).

RESULTS

The overall prevalence of metabolic syndrome was 30.9% (95%CI 27.2-34.7). Regardless of adjustment variables, adults who ceased to be active and/or remained physically inactive during leisure time in the study period presented, respectively, 108 and 124% higher odds of developing metabolic syndrome (OR=2.08; 95%CI 1.30-3.33 and OR=2.24; 95%CI 1.38-3.65). Women and individuals younger than 45 years showed lower odds of having metabolic syndrome.

CONCLUSIONS

This sample presented a significant association between remaining or becoming inactive and a greater chance of developing metabolic syndrome.

Gender heterogeneity in dyslipidemia prevalence, trends with age and associated factors in middle age rural Chinese

Background

Heterogeneity should be carefully addressed to facilitate establishment of effective population-level blood lipid management. The primary aim of the study was to investigate gender heterogeneity in prevalence of dyslipidemia, including trends with age and associated factors in middle age rural Chinese.

Methods

This is a cross-sectional study based on a baseline investigation of a population-based randomized controlled trial in rural China, involving 26,378 permanent residents of age 45–69. The age-specific prevalence of dyslipidemia was estimated for men and women, and the trends of prevalence with age were compared. Logistic regression was used to explore the factors associated with prevalent risk of dyslipidemia.

Results

The overall prevalence of dyslipidemia was significantly higher in females than in males for borderline high and above (BHA) total cholesterol (TC ≥ 200 mg/dL), BHA triglycerides (TG ≥ 150 mg/dL) and BHA low-density lipoprotein cholesterol (LDL-C ≥ 130 mg/dL), but was lower for low high-density lipoprotein cholesterol (HDL-C < 40 mg/dL) in females than the corresponding prevalence in males. The prevalence of borderline high and above TC, TG and LDL-C all rose with age in females, but was stable or even decreased with age in males. In contrast, graphic representation of the prevalence of low HDL-C showed no striking age related trend in both genders. Risk of dyslipidemia was associated predominantly with obesity in males, but was more predominantly associated with hypertension in females.

Conclusion

Heterogeneity was found in comparing the prevalence of dyslipidemia in men and women, and gender heterogeneity was found in its trend with age and associated factors in middle aged rural Chinese. The effectiveness of population-level blood lipid management and CVD primary prevention programs in China is expected to be improved if gender heterogeneity is considered.

Gender differences in metabolic syndrome risk factors among patients with serious mental illness

The prevalence of metabolic syndrome and its components continue to increase among patients with serious mental illness. This cross-sectional study investigated whether metabolic syndrome prevalence and risk factors differ between male and female patients with serious mental illness. In total, 260 eligible patients were recruited from two hospitals. The data on demographic characteristics, lifestyle behaviour factors, biochemistry, and anthropometry were collected. Analyses were performed using multivariate logistic regression. Metabolic syndrome prevalence was 40.8% (35.1% in men and 46.8% in women). Among patients aged 40-49 years, metabolic syndrome prevalence was higher in men; however, the trend was reversed among patients aged 50 years or older. Notably, gender-specific metabolic syndrome risk factors were observed. In men, they included low education level, high body mass index (BMI), prolonged illness, comorbid physical illness, and diagnosis of bipolar disorder, whereas they included being married, old age, and high BMI in women. Our findings suggest that mental health professionals should consider the gender- and age-based metabolic syndrome prevalence trend in patients with serious mental illness when designing interventions for the study population to minimize metabolic syndrome prevalence.

Gender Differences in the Pattern of Socio-Demographics Relevant to Metabolic Syndrome Among Kenyan Adults with Central Obesity at a Mission Hospital in Nairobi, Kenya

INTRODUCTION

Metabolic syndrome (MetS) is a risk factor for cardiovascular-related morbidity and mortality. Although the risk factors for MetS are well documented, differences in gender-based demographics among Kenyan adults with central obesity are lacking.

AIM

Determine gender differences in the pattern of socio-demographics relevant to metabolic syndrome among Kenyan adults with central obesity at a mission hospital, Nairobi.

METHODS

A cross-sectional baseline survey involving adults (N = 404) with central obesity aged 18-64 years, as part of a community-based lifestyle intervention study. Respondents were systematically sampled using the International Diabetes Federation definition for MetS. Lifestyle characteristics, anthropometric, clinical and biochemical markers were measured and analyzed using SPSS.

RESULTS

High (87.2%) MetS prevalence associated with advanced age in males (p < 0.001) and females (p = 0.002) was observed. MetS was likely among divorced/separated/widowed (p = 0.021) and high income males (p = 0.002) and females (p = 0.017) with high income. Unemployed males (p = 0.008) and females with tertiary education (p = 0.019) were less likely to have MetS. Advanced age was likely to lead to high blood pressure, fasting blood glucose and triglycerides (p < 0.05). Males were more likely (p = 0.026) to have raised triglycerides, while females (p < 0.001) had low high density lipoproteins.

CONCLUSION

A high prevalence of MetS associated with social and gender differences among Kenyan adults with central obesity. These underscore the need to look beyond the behavioral and biological risks and focus on every nuance of gender differences in addressing MetS and CVDs.

Gender Difference in the Relationship Among Family Function, Health Behavior, and Stress in Midlife

This study investigated whether there are gender-based differences in the process wherein family functions influence stress through various health behaviors in midlife adults. A cross-sectional study was done using a convenience sample of 250 middle-aged Koreans. Data on the family APGAR index, four health behaviors (i.e., seeking health information, physical activity, healthy diet, and social interaction), and stress were collected by a self-administered survey and analyzed using hierarchical multiple linear regression analyses and a PROCESS macro for SPSS. The study results showed that an indirect effect of family function on stress through health behaviors was significant in women, whereas such a relationship was not shown in men. This study found that the process wherein family function is linked with stress through health behaviors differs by gender. Developing gender-specific interventions is essential to decrease stress in midlife adults.

The Cognitive Impact of Chronic Diseases on Functional Capacity in Community-Dwelling Adults

Background:

People with chronic diseases may experience poor cognitive functioning associated with advanced age, progression of disease, or other comorbid chronic conditions. Empirical evidence of this phenomenon is limited despite the clinical relevance of cognitive decline and associated adverse outcomes such as poor physical functioning.

Purpose:

The purpose of this study was to examine cognitive functioning in the domains of memory, attention, and executive function and its association with functional capacity in a sample of community-dwelling adults with a spectrum of chronic diseases.

Methods:

An exploratory cross-sectional study was conducted in a sample of community-dwelling adults with chronic diseases, including hypertension (58.9%), diabetes mellitus (DM; 20.0%), and dyslipidemia (14.4%). Participants’ mean age was 64.1 ± 11.2 years, and 48.9% were male. Ninety persons completed the face-to-face interviews, which evaluated cognitive functioning in the domains of memory, attention, and executive function using neuropsychological tests and the physical well-being test, which measured functional capacity using the Duke Activity Status Index.

Results:

Compared with those with other chronic diseases, our sample with hypertension and DM had significantly more memory loss and poorer executive function. These significant differences were nullified when adjusting for age, gender, and education. Approximately one third had functional limitations (n = 29, 32.2%), using a cutoff point of 35 or less (Duke Activity Status Index). Memory loss (delayed recall, b = 1.5, p = .016) and poor executive function (Trail Making Test Part A, b = −0.2, p < .001) were predicting factors of functional decline, independent of age, gender, education, and comorbidity.

Conclusions/Implications for Practice:

Cognitive function, particularly memory and executive function, was poorer among chronically ill Korean adults in the community with hypertension or DM than their counterparts. Functional decline was worse in the presence of memory loss and poor executive function. Studies examining the mechanism by which overall functioning is impacted by cognitive decline and its relevance to functional declines in a larger representative sample are warranted.

Gender differences in lifestyle and risk factors of metabolic syndrome: Do women have better health habits than men?

AIMS AND OBJECTIVES

To examine the gender-specific lifestyles of adults with metabolic syndrome in the Taiwanese community.

BACKGROUND

Many studies show different prevalence of metabolic syndrome in males and females; however, few studies have investigated gender-specific lifestyle risk factors, which are important for effectively reducing prevalence.

DESIGN

A cross-sectional study design was used.

METHODS

Between 2012 and 2015, a total of 1,066 individuals were recruited in northern Taiwan. Data were collected by questionnaires and analysed by descriptive statistics, chi-square tests and logistic regression. This study followed the STROBE guidelines.

RESULTS

The prevalence of metabolic syndrome was 40.8% in men and 36.0% in women. Women had healthier dietary habits, a higher rate of moderate-vigorous physical activity, and a lower rate of smoking and obesity than men. Men, who were overweight or obese, lacked vigorous physical activity, often consumed excess amounts of salt and fat, and seldom consumed appropriate amounts of protein tended to have metabolic syndrome. Women with an unhealthy metabolism tended to be overweight or obese and seldom consumed dairy products.

CONCLUSIONS

Men, who had normal body weight, performed vigorous physical activity, seldom consumed excess amounts of salt and fat, and often consumed appropriate amounts of protein tended not to have metabolic syndrome. Women with a healthy metabolism were of normal body weight and often consumed dairy products. There exist gender differences in health habits with metabolic syndrome.

RELEVANCE TO CLINICAL PRACTICE

Although the associated risk factors differed between men and women, controlling body weight and maintaining a healthy lifestyle may reduce the risk of metabolic syndrome.

Relationship Between Metabolic Syndrome Severity and Kidney Function as Related to Gender: A Population-Based Longitudinal Study

The purpose of this study was to explore the relationship between the metabolic syndrome severity Z-score and kidney function by gender. We also examined the estimated glomerular filtration rate in relation to other known risk factors. The study used was a population-based prospective longitudinal research design. A total of 4,838 participants (2,683 females and 2,155 males) included individuals aged >30 years who were undergoing a health examination from 2006 to 2014 in Pingzhen City, Taiwan. In the initial generalized estimated equation model analysis, which included the covariates of age of first visit, period between the first and current visit, and metabolic syndrome severity Z-score, the results indicated that the interaction between age and metabolic syndrome severity Z-score is significantly related to the estimated glomerular filtration rate for males (p = .040). For females, the interaction between age and metabolic syndrome severity Z-score was not significant, but a higher metabolic syndrome severity Z-score was significantly associated with lower estimated glomerular filtration rate (p = .001). After controlling for the confounders, unhealthy behaviors, and comorbidities, the metabolic syndrome severity Z-score was still a negative predictor of estimated glomerular filtration rate in both the male (p = .005) and female (p = .023) models.

Resistance training reduces metabolic syndrome and inflammatory markers in older women: A randomized controlled trial

BACKGROUND

This study analyzed the effects of a 12-week resistance training (RT) program without dietary interventions on metabolic syndrome (MetS) components and inflammatory biomarkers in older women.

METHODS

Fifty-three older women (mean [±SD] age 70.4 ± 5.7 years; mean body mass index 26.7 ± 4.0 kg/m² ) were randomly assigned to a training group (TG; n = 26) that performed 12 weeks of an RT program or a control group (CG; n = 27) that did not perform any type of physical exercise over the same period. Body composition (dual energy X-ray absorptiometry), muscular strength (one-repetition maximum tests), blood pressure (BP), and blood sample measurements were performed before and after intervention.

RESULTS

After the 12-week period, there were significantly reductions (P < 0.05) in glucose levels (-20.4% vs -0.3%), waist circumference (-1.5% vs +2.0%), and systolic BP (-6.2% vs +0.9%), and complete normalization of MetS prevalence (18% at baseline vs. 0% after 12-weeks RT) in the TG. Moreover, C-reactive protein and tumor necrosis factor-α concentrations decreased in the TG (-28.6% and -21.6%, respectively), but increased in the CG (+34.5% and +13.3%, respectively). In addition there were positive improvements in the MetS Z-score in the TG but not CG (-21.6% vs +13.3%, respectively).

CONCLUSION

The results suggest that a 12-week RT program seems to effectively reduce MetS components and inflammatory biomarkers in older women, regardless of dietary intervention. The RT-induced adaptations in body composition and inflammatory biomarkers appear to be related to healthy adaptations in risk factors for MetS.

Metabolic syndrome and its components among Korean submariners: a retrospective cross-sectional study

PURPOSE

Metabolic syndrome (MetS) is a cluster of inter-related risk factors for cardiovascular disease and diabetes. Although submariners tend to be exposed to unhealthy environmental factors, such as a confined work environment, physical inactivity, and circadian disruption, little is known regarding whether the risks of MetS and its components are associated with submarine service. The present study aimed to evaluate the risks of MetS and its components among submariners.

METHODS

A total of 5090 subjects (513 submariners and 4577 non-submariners) were included in the present study. We calculated the age-standardized and age-specific prevalences of MetS. The associations between submarine service and the risks of MetS and its components were evaluated using logistic regression analysis after adjusting for age, service rank, and lifestyle factors.

RESULTS

The age-standardized prevalences of MetS were 17.6 and 15.1% among submariners and non-submariners, respectively. Compared to non-submariners, submariners had higher risks of MetS (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.02, 1.68), low high-density lipoprotein cholesterol (OR 1.73, 95% CI 1.36, 2.20), and impaired fasting glucose (OR 1.46, 95% CI 1.21, 1.76). When we stratified the subjects according to physical activity, an increased risk of elevated blood pressure associated with submarine service was evident only in the subgroup with moderate or vigorous physical activity (P for interaction = 0.006).

CONCLUSION

Submariners had higher risks of MetS and some MetS components, compared to non-submariners. These findings suggest that special efforts are needed to prevent and manage MetS among individuals who are expected to be exposed to submarine environment.

Association of daily physical activity level with health-related factors by gender and age-specific differences among Korean adults based on the sixth (2014-2015) Korea national health and nutrition examination survey

[Purpose]

This study examined the effects of daily physical activity level on health-related factors according to gender and identified age-specific differences among Korean adults.

[Methods]

Using data from the Korea National Health and Nutrition Examination Survey VI (2014-2015), we selected adults aged 19-64 years who participated in both a health examination and health interview survey. The study included 6,457 participants 19-64 years of age (2,611 men, 3,846 women).

[Results]

Assessment of the differences in health-related factors according to age and physical activity in men and women by repeated two-way analysis of variance (ANOVA) revealed significant interaction effects on total cholesterol (TC) and triglyceride (TG) levels and diastolic blood pressure (DBP) in male participants, but there were no significant interaction effects for any health-related factors in female participants. The group of female participants aged 40-64 years with daily physical activity levels over 200 kcal showed a significantly increased prevalence of 46% for dyslipidemia compared to that in female participants with daily physical activity levels below 200 kcal. Physical activity was positively correlated with weight and high-density lipoprotein cholesterol (HDL-C) levels in men 19-39 years of age, compared to weight, waist circumference (WC), body mass index (BMI), and DBP in men 40-64 years of age, and weight, WC, BMI, glycated hemoglobin (HbA1c) and triglyceride (TG) levels in women 19-39 years of age. In women 40- 64 years of age, physical activity was especially significantly positively correlated with weight, BMI, HDL-C and negatively correlated with fasting glucose and TG levels.

[Conclusion]

In male and female participants, the 40-64-year age group showed negative results for health-related factors compared to those in the 19-39-year age group. The higher the weight, WC, BMI, the higher is the physical activity level. Physical activity levels were significantly positively correlated with health-related variables.

Lower SHBG level is associated with higher leptin and lower adiponectin levels as well as metabolic syndrome, independent of testosterone

In addition to testosterone (T), the emerging role of sex hormone-binding globulin (SHBG) in pathogenesis of metabolic syndrome (MetS) has been noted recently. However, reports of associations with serum adipocytokine levels are still limited. Therefore, we conducted this study to evaluate whether serum T and SHBG levels are independent predictors for the risk of MetS that are associated with adiponectin and leptin levels in 614 Taiwanese men over 40 years old collected from a free health screening. Subjects in the lowest quartile of TT and SHBG levels are exposed to a 1.58 and 3.22 times risk of developing MetS, as compared to those in the highest quartile of TT and SHBG levels. However, SHBG retains its significance independent of TT as a MetS risk predictor, but not vice versa. In addition, SHBG was significantly correlated with both adiponectin and leptin levels even after adjusting for TT levels. In conclusion, SHBG served as a major predictor for the risk of MetS and was correlated with serum adiponectin and leptin levels that are independent of T. Further studies are needed to elucidate the true role of SHBG in the pathogenesis of MetS and possible mechanisms associated with serum adiponectin and leptin levels.

Unhealthy Lifestyle Behaviors in Korean People with Metabolic Syndrome

This study identified factors associated with unhealthy lifestyle behaviors in people with metabolic syndrome in South Korea. The sample consisted of 1,207 subjects with metabolic syndrome from the Sixth Korea National Health and Nutrition Examination Survey conducted in 2014. High-risk alcohol consumption, smoking, aerobic physical activity, leisure physical activity, excessive carbohydrate intake, and fat intake were measured. A secondary data analysis was performed using chi-square tests and logistic regression. Gender was associated with all unhealthy behaviors. The number of metabolic syndrome components, a poor perceived health status, and attempts to control weight were associated with physical inactivity. Those findings may be helpful to develop a tailored lifestyle modification programs for people with metabolic syndrome.

Associations of visceral fat area and physical activity levels with the risk of metabolic syndrome in postmenopausal women

This study was aimed at the evaluation of relationship between visceral fat area (VFA) and physical activity (PA) with the metabolic syndrome (MetS) risk in the physically active postmenopausal women. A total of 85 attendants of the University of the Third Age (U3A) aged 62.8 ± 5.9 years (median time since menopause 11.8 y), participated in this study. VFA was assessed by bioimpedance method using InBody 720 analyzer. PA was assessed using the ActiGraph GT1 M accelerometer. Fasting levels of serum lipids (TG, HDL), serum glucose, waist circumference (WC) and blood pressure were measured to diagnose MetS according to NCEP-ATP III criteria. In 73 out of 85 participants the VFA exceeded the upper normal level of 100 cm², however, in almost a half of this group (n = 36) with elevated VFA (139.5 ± 26.1 cm² on average), only 2 out of 5 criteria for MetS diagnosis were met. Participants were physically active, making on average 10,919 ± 3435 steps/day. The risk of MetS occurrence in women with VFA > 100 cm² was twelve times higher (OR 12.33; CI 95% [1.5; 99.8]) than in the group with VFA < 100 cm². The participants from the group with the highest PA level (≥12,500 steps/day) were at almost 4 times lower risk for MetS, than their less active counterparts (OR 3.84; CI 95% [1.27;11.64]). Increased level of VFA is a strong risk factor for the MetS in postmenopausal women, however high level of regular PA above the threshold of 12,500 steps/day may substantially reduce it.

Effects of telephone-based motivational interviewing in lifestyle modification program on reducing metabolic risks in middle-aged and older women with metabolic syndrome: A randomized controlled trial

BACKGROUND

Lifestyle modification is often difficult for middle-aged and older women living in the community who are at high risk of physical inactivity and metabolic syndrome.

OBJECTIVES

To examine the effects of telephone-based motivational interviewing in a 12-week lifestyle modification program on physical activity, MetS, metabolic risks (fasting plasma glucose, blood pressure, triglyceride, high-density lipoprotein, and central obesity), and the number of metabolic risks in community-living middle-aged and older women diagnosed with metabolic syndrome.

RESEARCH DESIGN AND METHOD

A randomized controlled trial was conducted. Recruited were 328 middle-aged and older women from a community health center in Taiwan. Eligible women medically diagnosed with metabolic syndrome (n=115) were randomly assigned to one of three groups: The experimental group received an individualized telephone delivered lifestyle modification program that included motivational interviewing delivered by an experienced nurse. The brief group received a single brief lifestyle modification counseling session with a brochure. The usual care group received standard care. Physical activity was assessed with the International Physical Activity Questionnaire and metabolic risks were determined by serum markers and anthropometric measures at pre- and post-intervention. One hundred women completed the study and an intention-to-treat analysis was performed. Generalized estimating equations were used to examine the intervention effects.

RESULTS

Women in the experimental group increased physical activity from 1609 to 1892 MET-min/week (β=846, p=.01), reduced the percentage of diagnosed with metabolic syndrome to 81.6% (β=-0.17, p=.003), and decreased the number of metabolic risks from 4.0 to 3.6 (β=-0.50, p<.001), compared to the usual care group (4.4-4.6). There was not a reduction in the percentage of diagnosed with metabolic syndrome in the brief group, but they had fewer metabolic risks after 12 weeks (mean=4.0 vs. 4.6, β=-0.2, p=.02) compared to the usual care group.

CONCLUSIONS

Motivational interviewing as a component of an individualized physical activity and lifestyle modification program has positive benefit in reducing metabolic risks in middle-aged and older women.

Gender differences in metabolic syndrome components among the Korean 66-year-old population with metabolic syndrome

Background

Gender is thought to be an important factor in metabolic syndrome and its outcomes. Despite a number of studies that have demonstrated differences in metabolism and its components that are dependent on gender, limited information about gender differences on the characteristics of metabolic syndrome and its components is available regarding the Korean old adult population. This study aimed to identify gender differences in characteristics of the metabolic syndrome and other risk factors for cardiovascular disease.

Methods

Secondary analysis of data from a nationwide cross-sectional survey for health examination at the time of transitioning from midlife to old age was performed. Multiple logistic regression models were used to estimate adjusted odds ratios and 95 % confidence intervals for gender differences among the Korean 66-year-old population with metabolic syndrome.

Results

Gender differences in metabolic syndrome components that contributed to the diagnosis of metabolic syndrome were identified. In males, the most common component was high blood sugar levels (87.5 %), followed by elevated triglyceride levels (83.5 %) and high blood pressure (83.1 %). In females, the most commonly identified component was elevated triglyceride levels (79.0 %), followed by high blood sugar levels (78.6 %) and high blood pressure (78.5 %). Gender differences for other risk factors for cardiovascular disease, including family history, health habits, and body mass index were observed.

Conclusions

Gender-specific public health policies and management strategies to prevent cardiovascular disease among the older adult population should be developed for Koreans undergoing the physiological transition to old age.

Metabolic syndrome in the non-pregnant state is associated with the development of preeclampsia

BACKGROUND

The aim of this study was to investigate the association between metabolic syndrome in the non-pregnant state and the development of preeclampsia.

METHODS

We enrolled 212,463 Korean women who had their first delivery between January, 2011 and December, 2012 and had undergone a national health screening examination through the National Health Insurance during the 1-2 years before their first delivery. Women who had hypertension in the non-pregnant state were excluded. The presence of metabolic syndrome was defined using the modified criteria published in National Cholesterol Education Program Adult Treatment Panel III criteria.

RESULTS

The prevalence of metabolic syndrome in non-pregnant state was 1.2%. Preeclampsia developed in 3.1% and its prevalence among women with and without metabolic syndrome was 7.3% and 3.0%, respectively. The pre-pregnancy prevalence of metabolic syndrome was higher in women who developed preeclampsia compared to that in those who had a normal pregnancy (1.1% vs. 2.8%; p<0.001). On multivariate regression analysis, women with metabolic syndrome had an increased risk of developing preeclampsia (odds ratio: 1.48; 95% CI: 1.26 to 1.74) compared to that in those without metabolic syndrome, after adjusting for age, family history of hypertension, smoking status, and pre-pregnancy body mass index. The risk of preeclampsia increased with a rise in the number of components of metabolic syndrome.

CONCLUSION

Metabolic syndrome in the non-pregnant state was associated with the development of preeclampsia. Further studies are needed to evaluate whether early intervention for metabolic syndrome before pregnancy can decrease the risk of developing preeclampsia.

Prevalence and correlates of metabolic syndrome and its components in elderly Korean adults

PURPOSE

This study examined the determinants of the prevalence of factors related to five components of metabolic syndrome in the elderly.

METHODS

The study used raw data (2010-2012) from the Korea National Health and Nutrition Examination Survey-V. The 3971 study subjects were community-dwelling elderly adults aged over 65years. The criteria for the metabolic syndrome were based on those of the American Heart Association/National Heart, Lung and Blood Institute, and the waist circumference cutoff points for these factors were adapted from the standard suggested by the Korea Society for the Study of Obesity in 2005.

RESULTS

The overall prevalence of metabolic syndrome in Korean elderly adults was 43.6% (35.3% in men and 50.2% in women). Metabolic syndrome was 2.32 times more prevalent in women relative to men (95% confidence interval [CI]: 1.85-2.90, p<0.001), 1.26 times more prevalent in urban, relative to rural, residents (95% CI: 1.09-1.45, p=0.002), 1.43 times more prevalent in ex-smokers (95% CI: 1.14-1.80, p=0.002) and 1.45 times more prevalent in smokers (95% CI: 1.11-1.54, p=0.007) relative to nonsmokers, and 1.16 times more prevalent in sedentary, relative to active, subjects (95% CI: 1.02-1.32, p=0.028).

CONCLUSION

The results indicated that the prevalence of metabolic syndrome in elderly Korean adults was high, suggesting that the prevention and management of metabolic syndrome in the elderly should be addressed via individual components.

Modifiable Lifestyle Behaviors Are Associated With Metabolic Syndrome in a Taiwanese Population

PURPOSE

To explore associations between metabolic syndrome and modifiable lifestyle behaviors among the adult population in Taiwan.

DESIGN

This cross-sectional study analyzed data from a nationally representative sample that participated in the 2005-2008 Nutrition and Health Survey in Taiwan. The sample (2,337 participants older than 19 years) provided data on demographic characteristics, modifiable lifestyle behaviors, anthropometric measurements, and blood chemistry panel.

METHODS

These data were analyzed by descriptive statistics, univariate logistic regression, and multivariate logistic regression to determine factors associated with metabolic syndrome.

FINDINGS

Metabolic syndrome had a prevalence of 25.2%, and this prevalence increased with age. In univariate regression analysis, metabolic syndrome was associated with age, living with family members, educational level, and modifiable lifestyle behaviors (smoking, drinking, betel quid chewing, and physical activity). Individuals with a smoking history and currently chewing betel quid had the highest risk for metabolic syndrome.

CONCLUSIONS

The risk for metabolic syndrome might be reduced by public health campaigns to encourage people to quit smoking cigarettes and chewing betel quid. Implementing more modifiable lifestyle behaviors in daily life will decrease metabolic syndrome in Taiwan.

CLINICAL RELEVANCE

Considering that betel quid chewing and tobacco smoking interact to adversely affect metabolic syndrome risk, public health campaigns against both behaviors seem to be a cost-effective and efficient health promotion strategy to reduce the prevalence rate of metabolic syndrome.

A routine biomarker-based risk prediction model for metabolic syndrome in urban Han Chinese population

Background

Many MetS related biomarkers had been discovered, which provided the possibility for building the MetS prediction model. In this paper we aimed to develop a novel routine biomarker-based risk prediction model for MetS in urban Han Chinese population.

Methods

Exploring Factor analysis (EFA) was firstly conducted in MetS positive 13,345 males and 3,212 females respectively for extracting synthetic latent predictors (SLPs) from 11 routine biomarkers. Then, depending on the cohort with 5 years follow-up in 1,565 subjects (male 1,020 and female 545), a Cox model for predicting 5 years MetS was built by using SLPs as predictor; Area under the ROC curves (AUC) with 10 fold cross validation was used to evaluate its power. Absolute risk (AR) and relative absolute risk (RAR) were calculated to develop a risk matrix for visualization of risk assessment.

Results

Six SLPs were extracted by EFA from 11 routine health check-up biomarkers. Each of them reflected the specific pathogenesis of MetS, with inflammatory factor (IF) contributed by WBC & LC & NGC, erythrocyte parameter factor (EPF) by Hb & HCT, blood pressure factor (BPF) by SBP & DBP, lipid metabolism factor (LMF) by TG & HDL-C, obesity condition factor (OCF) by BMI, and glucose metabolism factor (GMF) by FBG with the total contribution of 81.55% and 79.65% for males and females respectively. The proposed metabolic syndrome synthetic predictor (MSP) based predict model demonstrated good performance for predicting 5 years MetS with the AUC of 0.802 (95% CI 0.776-0.826) in males and 0.902 (95% CI 0.874-0.925) in females respectively, even after 10 fold cross validation, AUC was still enough high with 0.796 (95% CI 0.770-0.821) in males and 0.897 (95% CI 0.868-0.921) in females. More importantly, the MSP based risk matrix with a series of risk warning index provided a feasible and practical tool for visualization of risk assessment in the prediction of MetS.

Conclusions

MetS could be explained by six SLPs in Chinese urban Han population. The proposed MSP based predict model demonstrated good performance for predicting 5 years MetS, and the MetS-based matrix provided a feasible and practical tool.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-1424-z) contains supplementary material, which is available to authorized users.