Prevalence of metabolic syndrome and its association with obesity indices in a Chinese population

Associations between anthropometric parameters and lipid profiles in Chinese individuals with age ≥40 years and BMI <28kg/m2

BACKGROUND

Lipid abnormalities are associated with overweight and obesity. Some simple anthropometric measurements such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR), may link to increased risk of dyslipidemia. However, diverse results were found in different population studies. We focused on the associations between these measurements and dyslipidemia in non-obese (BMI <28kg/m2) population aged more than 40 years.

METHODS AND FINDINGS

Cross-sectional study of 4185 non-obese adults aged more than 40 years was conducted in Nanchang, Jiangxi province, China. Questionnaire, anthropometric and laboratory tests were conducted. The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) criteria were used to define high total cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), low high-density lipoprotein cholesterol (HDL-C), hypertriglyceridemia and dyslipidemia. The overall prevalence of high TC, high LDL-C, low HDL-C, hypercholesterolemia, hypertriglyceridemia and dyslipidemia were 15.68%, 27.98%, 20.12%, 44.01%, 21.98% and 49.06% respectively. Multiple logistic regressions showed only BMI (per quartile increment) increased risks for prevalent high LDL-C, low HDL-C, hypercholesterolemia, hypertriglyceridemia, and dyslipidemia. Regardless of sex, age and prevalent metabolic syndrome, increasing BMI was persistently independent risk factor for having low HDL-C, hypercholesterolemia and dyslipidemia, however was not associated with high TC.

CONCLUSIONS

In non-obese Chinese population aged more than 40 years, increasing BMI may better identify the prevalent dyslipidemia than other anthropometric measurements. However, due to the different meanings, both BMI and WC should be measured and monitored for metabolic risk assessment.

Optimal cut-off levels of obesity indices by different definitions of metabolic syndrome in a southeast rural Chinese population

AIMS/INTRODUCTION

The aim of the present study was to compare the cut-off values and prediction effect of different obesity indices by different definitions of metabolic syndrome (MetS) in Zhejiang Province of China.

MATERIALS AND METHODS

We carried out a cross-sectional survey of 10,100 individuals (age 40 years and older) in Jiashan, Zhejiang Province. Receiver operating characteristic analysis was used to examine discrimination and find optimal cut off values of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) to predict two or more non-adipose components of MetS by The National Cholesterol Education Program Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) definition modified by the Asia-Pacific region criteria, International Diabetes Federation definition for the Chinese population and Chinese Diabetes Society definitions of MetS.

RESULTS

The age-standardized prevalence of MetS was 23.78% vs 28.76% vs 19.37% by The National Cholesterol Education Program Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III), International Diabetes Federation and Chinese Diabetes Society definitions, respectively. Cut-off values of BMI were approximately 24 kg/m(2) both in men and women by three definitions; the average cut-off values of WC, WHR and WHtR were 83 cm in men vs 81 cm in women, 0.89 in men vs 0.86 in women and 0.50 in men vs 0.51 in women, respectively. The area under receiver operating characteristic curve of BMI was larger than WC both in men and women (P < 0.05); in women, the area under receiver operating characteristic curve of WHtR was larger than WC, and WHR was smaller.

CONCLUSIONS

MetS is prevalent in Zhejiang Province of China, especially in the female population. BMI and WHtR might be more useful than WC and WHR for predicting two or more non-adipose components of MetS.

Association of the ADRA1A gene and the severity of metabolic abnormalities in patients with schizophrenia

Patients with schizophrenia have a higher risk of developing metabolic abnormalities and their associated diseases. Some studies found that the accumulative number of metabolic syndrome components was associated with the severity of metabolic abnormalities. The purpose of this study was to examine the roles of the ADRA1A, ADRA2A, ADRB3, and 5HT2A genes in the risk of having more severe metabolic abnormalities among patients with schizophrenia. We studied a sample of 232 chronic inpatients with schizophrenia (120 males and 112 females) to explore the associations between the four candidate genes and the severity of metabolic syndrome by accumulative number of the components. Four single nucleotide polymorphisms in the candidate genes were genotyped, including the Arg347Cys in ADRA1A, the C1291G in ADRA2A, the Try64Arg in ADRB3, and the T102C in 5HT2A. An association between the accumulative number of metabolic syndrome components and the ADRA1A gene was found after adjusting age, sex, and other related variables (p-value=0.036). Presence of the Arg347 allele in the ADRA1A gene is a risk factor for having more severe metabolic abnormalities. These findings suggest a medical attention of closely monitoring metabolic risks for schizophrenia patients with high-risk genotypes.

Gender and age-related differences in patients with the metabolic syndrome in a highly endogamous population

The objective of the study was to examine the differences in gender and age prevalences of metabolic syndrome (MetS) among adult Qatari population according to the revised criteria of NCEP ATP III and IDF, assess which component contributed to the higher prevalence of the MetS and identify the characteristics of the subjects with MetS. The study was designed as a cross-sectional study. The survey was carried out in urban and semi-urban primary health care centers. The survey was conducted in the period from January 2007 to July 2008 among Qatari nationals above 20 years of age. Of the 1536 subjects who were approached to participate in the study, 1222 (79.6%) gave their consent. Face to face interviews were conducted using a structured questionnaire followed by laboratory tests. MetS was defined using the National Cholesterol Education Program - Third Adult Treatment Panel (ATP III) as well as the International Diabetes Federation (IDF). The overall prevalence of MetS in studied subjects was 26.7% and 33.9% according to ATPIII and IDF (p<0.001) criteria respectively. The prevalence of MetS by both definitions peaked in the 30-39 years age group among males, and the 40-49 years age group among females. The greatest number of males with MetS were university educated; while the greatest number of females with MetS were either illiterate or had a primary school education. The prevalence of MetS was higher among females. Among the components of MetS, the prevalence of central obesity was significantly higher in studied subjects. The overall prevalence of MetS and its components according to IDF criteria was higher in studied subjects than the estimates given by the ATPIII criteria. Overall, the prevalence of the metabolic syndrome in the State of Qatar is about 10-15% higher than in most developed countries, with generally higher prevalence rates for women. Preventive strategies will require identifying socio-demographic factors and addressing modifiable risk behaviours, including lack of physical activity, and dietary intake.