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Ma YL, Jin CH, Zhao CC, Ke JF, Wang JW, Wang YJ, Lu JX, Huang GZ, Li LX. Waist-to-height ratio is a simple and practical alternative to waist circumference to diagnose metabolic syndrome in type 2 diabetes. Front Nutr 2022; 9:986090. [PMID: 36419559 PMCID: PMC9676651 DOI: 10.3389/fnut.2022.986090] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/20/2022] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND As an indicator of abdominal obesity, waist circumference (WC) varied with race and gender in diagnosing metabolic syndrome (MetS). Therefore, it is clinically important to find an alternative indicator of abdominal obesity independent of these factors to diagnose MetS. Our aims were to evaluate the association between waist-to-height ratio (WHtR) and MetS and further determine whether WHtR could be used as a simple and practical alternative to WC to diagnose MetS in patients with type 2 diabetes mellitus (T2DM). METHODS This cross-sectional, real-world study recruited 8488 hospitalized T2DM patients including 3719 women (43.8%) aged from 18 to 94 years and 4769 men (56.2%) aged from 18 to 91 years. A WHtR cut-off of 0.52 was used to diagnose MetS in both men and women T2DM patients based on our previous study. The association of WHtR with MetS in T2DM patients was analyzed by binary logistic regression. The consistency of two diagnostic criteria for MetS according to WC and WHtR was determined by Kappa test. RESULTS The prevalence of MetS according to WHtR was 79.4% in women and 68.6% in men T2DM patients, which was very close to the prevalence of MetS according to WC in both women (82.6%) and men (68.3%). The prevalence of MetS diagnosed by WC in both men and women with WHtR ≥ 0.52 was significantly higher than in those with WHtR < 0.52 after adjustment for age and duration of diabetes (89.2 vs. 38.7% for men; 92.8 vs. 57.4% for women; respectively, all p < 0.001). Binary logistic regression analysis displayed that after adjusting for confounding factors, WHtR was significantly associated with the presence of MetS in both men and women (men: OR = 4.821, 95% CI: 3.949-5.885; women: OR = 3.096, 95% CI: 2.484-3.860; respectively, all p < 0.001). Kappa test revealed that there was an excellent consistency between the diagnosis of MetS based on WC and on WHtR in T2DM patients (men: kappa value = 0.929, 95% CI: 0.918-0.940; women: kappa value = 0.874, 95% CI: 0.854-0.894; total: kappa value = 0.911, 95% CI: 0.901-0.921; respectively, all p < 0.001). CONCLUSION WHtR is independently associated with the presence of MetS and can be used as a simple and practical alternative to WC to diagnose MetS regardless of gender in T2DM patients.
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Affiliation(s)
- Yi-Lin Ma
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Chun-Hua Jin
- Department of Endocrinology and Metabolism, Shanghai Songjiang District Central Hospital, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (Preparatory Stage), Shanghai, China
| | - Cui-Chun Zhao
- Department of VIP, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang-Feng Ke
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Jun-Wei Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Yu-Jie Wang
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Jun-Xi Lu
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
| | - Gao-Zhong Huang
- Department of VIP, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lian-Xi Li
- Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China
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Obsa MS, Ataro G, Awoke N, Jemal B, Tilahun T, Ayalew N, Woldegeorgis BZ, Azeze GA, Haji Y. Determinants of Dyslipidemia in Africa: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2022; 8:778891. [PMID: 35284497 PMCID: PMC8904727 DOI: 10.3389/fcvm.2021.778891] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/29/2021] [Indexed: 12/18/2022] Open
Abstract
Background Dyslipidemia is a common public health problem in Africa. It has emerged as an important cardiovascular risk factor. It has been steadily increasing due to economic growth, urbanization, and unhealthy dietary pattern. Therefore, it is essential to identify determinants of dyslipidemia to prevent the condition and reduce its long-term sequel. Methods Combinations of search terms with Boolean operators were used to retrieve studies from PubMed, EMBASE, Cochrane Database, Cinahl, Scopus, Mednar, and Google Scholar. The methodological quality of each article was evaluated based on the 2017 Joanna Briggs Institute (JBI) Critical Appraisal checklist for prevalence studies. After evaluation of each study against these criteria, studies with a minimum score of 7 or above out of 9 JBI checklists were included. We included articles presented in the English language. The Cochrane Q test was used to assess the heterogeneity across studies. The visual assessment of publication bias was done by creating a funnel plot. The possible causes of heterogeneity were explored by subgroup analyses. Egger's weighted regression test was used to assess the presence of publication bias. Statistical analyses were done by using the STATA software version 14. Result A total of 24 articles involving 37,902 participants from 10 African countries were included. The overall pooled prevalence of dyslipidemia was 52.8 (95% CI 40.8–64.9). Individuals with a body mass index (BMI) >25.0 kg/m2 and waist circumference (WC) >94 cm were, respectively, 2.36 (95% CI (1.33–4.18), p < 0.001) and 2.33 (95% CI (0.75–0.29) p < 0.001) times more likely to develop dyslipidemia than those with lower values. Furthermore, patients with diabetes mellitus (DM) and hypertension (HTN) were 2.32 (95% CI (0.89–6.05) p < 0.001) and 2.05 (95% CI (1.31–3.21), p < 0.001) times more likely to present with dyslipidemia than non-diabetic patients and those without HTN. Conclusion This study revealed that the prevalence of dyslipidemia is relatively high among study participants in African countries and the independent predictors of dyslipidemia were BMI >25.0 kg/m2, WC > 94 cm, raised blood glucose level, and raised blood pressure. Therefore, there should be a pressing public health measure to prevent, identify, and treat dyslipidemia with the special emphasis on obese, diabetic, and hypertensive patients.
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Affiliation(s)
- Mohammed S Obsa
- College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Getu Ataro
- College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Nefsu Awoke
- College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Bedru Jemal
- College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Tamiru Tilahun
- College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Nugusu Ayalew
- Department of Anesthesia, Kotebe Metropolitan University, Addis Ababa, Ethiopia
| | - Beshada Z Woldegeorgis
- College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Gedion A Azeze
- College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Yusuf Haji
- College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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Wu Q, Qin K, Wang Y, Nie H. Anthropometric indices and their predictive ability on metabolic syndrome in west China. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-01020-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Oliveira MS, Torquato BGS, Soares MH, Monteiro MLGDR, Juliano GR, Aguiar LS, Teixeira VDPA, Ferraz MLDF. Macroscopic Evaluation of Atherosclerosis in the Arteries: An Autopsy Assessment Tool. Arq Bras Cardiol 2021; 116:1119-1126. [PMID: 34133598 PMCID: PMC8288540 DOI: 10.36660/abc.20190846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 05/20/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Atherosclerosis, in some cases, is an asymptomatic condition, and it is important to know the degree of arterial impairment caused by plaques and its association with risk factors. Autopsy examination provides understanding of basic disease processes and assessment to data about macroscopic characteristic of atherosclerotic involvement. OBJECTIVE To macroscopically assess and standardize atherosclerotic involvement of aorta, carotid and iliac arteries and compare with age, gender and causes of death. METHODS We collected 53 aortic arteries, 53 right carotid arteries, 53 left carotid arteries, 53 right iliac arteries and 53 left iliac arteries. For this assessment, the extension of fatty streaks, atheromatous plaques, fibrosis and calcification were considered, being the reference to score the degree of atherosclerotic involvement. Many degrees of atherosclerosis and accurate values were observed for mild, moderate and severe classification. For statistical analysis, data were analyzed using the software GraphPad Prism® 7.0. Differences were considered statistically significant if p-value was less than 5% (p <0.05). RESULTS Carotid arteries had greater atherosclerotic involvement compared to the other arteries (K = 15.73, p = 0.0004). Atherosclerosis was progressive and significant with increasing age (carotid arteries: t = 6.321; p <0.0001; aorta: U = 83.5; p <0.0001; iliac: U = 306; p <0.0001) and as cause of cardiovascular death (carotids: t = 5.047; p <0.0001; aorta: U = 98.5; p = 0.0068; iliac: U = 467.5; p = 0.0012). CONCLUSION Macroscopic assessment of atherosclerosis is an innovative and low-cost way of direct visualization of atherosclerotic plaques, enabling an association with risk factors such as increasing age and cardiovascular diseases, providing important data for clinical practice.
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Hamooya BM, Mulenga LB, Masenga SK, Fwemba I, Chirwa L, Siwingwa M, Halwiindi H, Koethe JR, Lipworth L, Heimburger DC, Musonda P, Mutale W. Metabolic syndrome in Zambian adults with human immunodeficiency virus on antiretroviral therapy: Prevalence and associated factors. Medicine (Baltimore) 2021; 100:e25236. [PMID: 33832083 PMCID: PMC8036111 DOI: 10.1097/md.0000000000025236] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
Metabolic syndrome (MetS) is a constellation of factors including hypertension, abdominal obesity, dyslipidemia, and insulin resistance that separately and together significantly increase risk for cardiovascular disease (CVD) and diabetes. In sub-Saharan Africa, with a substantial burden of human immunodeficiency virus (HIV) and increasing prevalence of CVD and diabetes, there is a paucity of epidemiological data on demographic, laboratory, and clinical characteristics associated with MetS among people with HIV (people with human [PWH]). Therefore, this study aimed to determine the burden and factors influencing MetS in antiretroviral therapy (ART)-experienced individuals in Zambia.We collected cross-sectional demographic, lifestyle, anthropometric, clinical, and laboratory data in a cohort of ART-experienced (on ART for ≥6 months) adults in 24 urban HIV treatment clinics of Zambia between August, 2016 and May, 2020. MetS was defined as having ≥3 of the following characteristics: low high density lipoprotein cholesterol (HDL-c) (<1.0 mmol/L for men, <1.3 for women), elevated waist circumference (≥94 cm for men, ≥80 cm for women), elevated triglycerides (≥1.7 mmol/L), elevated fasting blood glucose (≥5.6 mmol/L), and elevated blood pressure (BP) (systolic BP ≥130 or diastolic BP ≥85 mm Hg). Virological failure (VF) was defined as HIV viral load ≥1000 copies/mL. The following statistical methods were used: Chi-square test, Wilcoxon rank-sum test, and multivariable logistic regression.Among 1108 participants, the median age (interquartile range [IQR]) was 41 years (34, 49); 666 (60.1%) were females. The prevalence of MetS was 26.3% (95% confidence interval [CI] 23.9-29.1). Age (adjusted odds ratio [OR] 1.07; 95% CI 1.04-1.11), female sex (OR 3.02; 95% CI 1.55-5.91), VF (OR 1.98; 95% CI 1.01-3.87), dolutegravir (DTG)-based regimen (OR 2.10; 95% CI 1.05-4.20), hip-circumference (OR 1.03; 95% CI 1.01-1.05), T-lymphocyte count (OR 2.23; 95% CI 1.44-3.43), high-sensitivity C-reactive protein (hsCRP) (OR 1.14; 95% CI 1.01-1.29), and fasting insulin (OR 1.02; 95% CI 1.01-1.04) were significantly associated with MetS.Metabolic syndrome was highly prevalent among HIV+ adults receiving ART in Zambia and associated with demographic, clinical, anthropometric, and inflammatory characteristics. The association between MetS and dolutegravir requires further investigation, as does elucidation of the impact of MetS on ART outcomes in sub-Saharan African PWH.
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Affiliation(s)
- Benson M. Hamooya
- University of Zambia School of Public Health
- Mulungushi University School of Medicine and Health Sciences, Livingstone
- Vanderbilt Institute for Global Health
| | - Lloyd B. Mulenga
- Ministry of Health
- University of Zambia School of Medicine, Lusaka, Zambia
- University Teaching Hospital, Adult Infectious Disease Center, Zambia
| | - Sepiso K. Masenga
- Mulungushi University School of Medicine and Health Sciences, Livingstone
- Vanderbilt Institute for Global Health
- Department of Biomedical Sciences, University of Zambia School of Health Sciences, Lusaka
| | | | - Lameck Chirwa
- University Teaching Hospital, Adult Infectious Disease Center, Zambia
| | - Mpanji Siwingwa
- University Teaching Hospital, Adult Infectious Disease Center, Zambia
| | | | - John R. Koethe
- Vanderbilt Institute for Global Health
- Vanderbilt University Medical Center Nashville, Tennessee
| | - Loren Lipworth
- Vanderbilt University Medical Center Nashville, Tennessee
| | - Douglas C. Heimburger
- Vanderbilt Institute for Global Health
- University of Zambia School of Medicine, Lusaka, Zambia
- Vanderbilt University Medical Center Nashville, Tennessee
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