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Kim HJ, Kim BS, Kim DW, Shin JH. Estimated pulse wave velocity as a forefront indicator of developing metabolic syndrome in Korean adults. Korean J Intern Med 2024; 39:612-624. [PMID: 38910511 PMCID: PMC11236817 DOI: 10.3904/kjim.2024.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/28/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND/AIMS The predictive value of the estimated pulse wave velocity (ePWV) for the development of metabolic syndrome has not yet been extensively explored. This study aimed to fill this gap by evaluating ePWV as a potential predictor of metabolic syndrome development in middle-aged Korean adults. METHODS Using prospective data obtained from the Ansan-Ansung cohort database, participants without metabolic syndrome at baseline were studied. ePWV was calculated using specific equations based on age and blood pressure. The primary outcome was the incidence of metabolic syndrome during a median follow-up period of 187 months. RESULTS Among the 6,186 participants, 2,726 (44.1%) developed metabolic syndrome during the follow-up period. ePWV methvalues were categorized into tertiles to assess their predictive value for the development of metabolic syndrome. An ePWV cut-off of 7.407 m/s was identified as a predictor of metabolic syndrome development, with a sensitivity of 0.743 and a specificity of 0.464. Participants exceeding this cut-off, especially those in the third tertile (8.77-14.63 m/s), had a notably higher risk of developing metabolic syndrome. Specifically, the third tertile exhibited a 52.8% cumulative incidence compared with 30.8% in the first tertile. After adjustments, those in the third tertile faced a 1.530-fold increased risk of metabolic syndrome (95% confidence interval, 1.330-1.761). CONCLUSION ePWV is a significant predictor of the development of metabolic syndrome. This finding underscores the potential of ePWV as a cardiometabolic risk assessment tool and can thus provide useful information for primary prevention strategies.
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Affiliation(s)
- Hyun-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Byung Sik Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Dong Wook Kim
- Division of Endocrinology, Diabetes and Hypertension, Center for Weight Management and Wellness, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jeong-Hun Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
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Feng T, Zheng J, Wang X, Wang Y, Shen P, Zhu B, Zhao H, Zhao L, Xu Y. Decadal Trends in the Prevalence of Metabolic Syndrome in Economically Developed Regions in China. J Endocr Soc 2024; 8:bvae128. [PMID: 39021418 PMCID: PMC11252499 DOI: 10.1210/jendso/bvae128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Indexed: 07/20/2024] Open
Abstract
Objective To estimate decadal trends in the prevalence of metabolic syndrome (MetS) in economically developed regions in China and its association with city economic levels. Methods Using a comprehensive Chinese healthcare database, repeated cross-sectional studies were conducted on adults who had annual health check-ups from 2012 to 2021 in 4 economically developed cities. MetS was defined by the criteria of the Chinese Diabetes Society in 2013. The crude prevalence of MetS adjusted for sex and age was reported. The association between prevalence, calendar year, and city gross domestic product (GDP) per capita was analyzed by regression model. Results 158 274 participants aged 18 years and older were included. The unadjusted prevalence of MetS increased from 15.5% (95% CI: 14.2%-16.8%) to 20.0% (95% CI: 19.5%-20.5%) from 2012 to 2021. The adjusted overall prevalence has increased steadily from 12.8% to 20.8% after controlling age and sex (P < .001). Male and older age groups had a higher MetS prevalence. In the regression model of the association between the MetS prevalence, calendar year, and city GDP per capita, calendar year had a positive association with the prevalence (P < .001, 95% CI: 0.648-1.954) and city GDP per capita had a negative association (P = .030, 95% CI: -0.136 to -0.007). Conclusion The MetS prevalence increased steadily in the economically developed regions in China among the health check-up population during 2012-2021. The MetS prevalence is shown to be negatively associated with GDP per capita in the study population.
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Affiliation(s)
- Tianxing Feng
- Department of Medical Affairs, Shanghai Clinical Research and Trial Center, Shanghai 201203, China
| | - Jiali Zheng
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiaoxiao Wang
- Center for RNA Therapeutics; Houston Methodist Research Institute, Houston, TX 77030, USA
| | - Yilei Wang
- Division of Health Check-up, Rici Health Care Holdings Limited, Shanghai 200232, China
| | - Ping Shen
- Division of Health Check-up, Rici Health Care Holdings Limited, Shanghai 200232, China
| | - Beili Zhu
- Division of Health Check-up, Rici Health Care Holdings Limited, Shanghai 200232, China
| | - Huiyan Zhao
- Division of Health Check-up, Rici Health Care Holdings Limited, Shanghai 200232, China
| | - Li Zhao
- Division of Health Check-up, Rici Health Care Holdings Limited, Shanghai 200232, China
| | - Yaqing Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Wall J, Xie H, Wang X. Temporal Interactions between Maintenance of Cerebral Cortex Thickness and Physical Activity from an Individual Person Micro-Longitudinal Perspective and Implications for Precision Medicine. J Pers Med 2024; 14:127. [PMID: 38392561 PMCID: PMC10890462 DOI: 10.3390/jpm14020127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/30/2023] [Accepted: 01/09/2024] [Indexed: 02/24/2024] Open
Abstract
Maintenance of brain structure is essential for neurocognitive health. Precision medicine has interests in understanding how maintenance of an individual person's brain, including cerebral cortical structure, interacts with lifestyle factors like physical activity. Cortical structure, including cortical thickness, has recognized relationships with physical activity, but concepts of these relationships come from group, not individual, focused findings. Whether or how group-focused concepts apply to an individual person is fundamental to precision medicine interests but remains unclear. This issue was studied in a healthy man using concurrent micro-longitudinal tracking of magnetic resonance imaging-defined cortical thickness and accelerometer-defined steps/day over six months. These data permitted detailed examination of temporal relationships between thickness maintenance and physical activity at an individual level. Regression analyses revealed graded significant and trend-level temporal interactions between preceding activity vs. subsequent thickness maintenance and between preceding thickness maintenance vs. subsequent activity. Interactions were bidirectional, delayed/prolonged over days/weeks, positive, bilateral, directionally asymmetric, and limited in strength. These novel individual-focused findings in some ways are predicted, but in other ways remain unaddressed or undetected, by group-focused work. We suggest that individual-focused concepts of temporal interactions between maintenance of cortical structure and activity can provide needed new insight for personalized tailoring of physical activity, cortical, and neurocognitive health.
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Affiliation(s)
- John Wall
- Department of Neurosciences, University of Toledo College of Medicine & Life Sciences, Toledo, OH 43614, USA
| | - Hong Xie
- Department of Neurosciences, University of Toledo College of Medicine & Life Sciences, Toledo, OH 43614, USA
| | - Xin Wang
- Department of Neurosciences, University of Toledo College of Medicine & Life Sciences, Toledo, OH 43614, USA
- Department of Psychiatry, University of Toledo College of Medicine & Life Sciences, Toledo, OH 43614, USA
- Department of Radiology, University of Toledo College of Medicine & Life Sciences, Toledo, OH 43614, USA
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Ye Q, Wang Z, Deng T, Lou Q, Wu H, Tang W, Xu F. Association of socioeconomic status with metabolic syndrome and its components among adult population: a community-based cross-sectional study in Nanjing Municipality of China. BMJ Open 2023; 13:e074059. [PMID: 37844993 PMCID: PMC10582845 DOI: 10.1136/bmjopen-2023-074059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVES To investigate the association of metabolic syndrome (MetS) and its components with socioeconomic status (SES) among general and gender-specific adult population in Nanjing municipality, China. DESIGN Cross-sectional study. PARTICIPANTS 13287 participants completed the survey. A participant: (1) must be a local registered resident, (2) aged 18+ years, (3) had no literal or physical/mental problems and (4) was not pregnant. STUDY MEASURES MetS was the outcome variable, which was defined based on the diagnostic criteria released by the Chinese Diabetes Society. SES was the main explanatory measure, which was indicated with educational attainment and family average income (FAI), separately. RESULTS The prevalence of MetS was 19.7% (95% CI=19.0% to 20.4%) among overall participants, and 24.6% (95% CI=23.5% to 25.6%) and 15.5% (95% CI=14.7% to 16.4%) for men and women, respectively. After controlling for potential confounders, participants with either college level (OR=0.51, 95% CI=0.43 to 0.60) or high school level education (OR=0.78, 95% CI=0.70 to 0.90) were at lower odds to experience MetS compared with those with primary education, while only those within upper FAI tertile were at significantly lower risk of MetS relative to their counterparts within lower FAI category (OR=0.85, 95% CI=0.76 to 0.97) among overall participants. Meanwhile, with respect to the five components of MetS, higher educational level predicted lower waist circumference (WC), triglycerides, systolic blood pressure (SBP) and diastolic blood pressure (DBP) and fasting glucose concentration among all participants. And higher FAI was associated with lower WC and SBP and DBP in women, and with lower SBP and DBP in men. CONCLUSIONS Education and FAI each were inversely associated with MetS and its components at the present stage of economic development in Nanjing Municipality of China. It has important public health implications that the tailored prevention strategies for MetS should be put into consideration of the intervention of MetS components and subgroups of people with different SES.
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Affiliation(s)
- Qing Ye
- Department of Non-communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
- Dept. of Epidemiology, Nanjing Medical University School of Public Health, Nanjing, Jiangsu, China
| | - Zhenglin Wang
- Geriatric Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Jiangsu Province Official Hospital, Nanjing, Jiangsu, China
| | - Tianrui Deng
- Dept. of Epidemiology, Nanjing Medical University School of Public Health, Nanjing, Jiangsu, China
| | - Qinglin Lou
- Geriatric Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Jiangsu Province Official Hospital, Nanjing, Jiangsu, China
| | - Haidi Wu
- Geriatric Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Jiangsu Province Official Hospital, Nanjing, Jiangsu, China
| | - Wei Tang
- Geriatric Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Jiangsu Province Official Hospital, Nanjing, Jiangsu, China
| | - Fei Xu
- Dept. of Epidemiology, Nanjing Medical University School of Public Health, Nanjing, Jiangsu, China
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
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Zhao Q, Tan X, Su Z, Manzi HP, Su L, Tang Z, Zhang Y. The Relationship between the Dietary Inflammatory Index (DII) and Metabolic Syndrome (MetS) in Middle-Aged and Elderly Individuals in the United States. Nutrients 2023; 15:nu15081857. [PMID: 37111075 PMCID: PMC10146265 DOI: 10.3390/nu15081857] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
(1) Background: With the aging demographic shift in society, there is a growing number of middle-aged and elderly individuals affected by metabolic syndrome (MetS), a risk factor contributing to all causes of mortality. Inflammation plays a crucial role in the development of MetS. This study aims to examine the correlation between MetS and pro-inflammatory diets in middle-aged and elderly individuals, utilizing the Dietary Inflammation Index (DII) as a measure. (2) Methods: Data were extracted from the 2007-2016 National Health and Nutrition Examination Survey (NHANES) database for individuals who were 45 years of age or older. The DII was determined for each participant through 24-h dietary recall interviews. The relationship between DII and MetS was assessed using binary logistic regression analysis, and the association between DII and MetS-related indicators was further explored through generalized linear model (GLM) and quantile regression analysis. (3) Results: A total of 3843 middle-aged and elderly individuals were included in the study. After controlling for confounding factors, the highest quartile of DII was associated with a higher risk of MetS (ORQ4:Q1 = 1.339; 95% CI: 1.013, 1.769; p for trend = 0.018). The top DII quartile also increased the risk of reduced HDL-C (ORQ4:Q1 = 1.499; 95% CI: 1.005, 2.234; p for trend = 0.048) and raised FG (ORQ4:Q1 = 1.432; 95% CI: 1.095, 1.873; p for trend = 0.010) compared to the lowest DII quartile. The levels of DII were found to be positively correlated with BMI (β = 0.258, p = 0.001), FPG (β = 0.019, p = 0.049), TG (β = 2.043, p = 0.013), waistline (β = 0.580, p = 0.002), and negatively correlated with HDL-C (β = -0.672, p = 0.003). (4) Conclusions: In middle-aged and elderly individuals in the United States, a high DII score has been linked to the presence of MetS, low HDL-C, and hyperglycemia. Therefore, dietary recommendations for the middle-aged and elderly should focus on reducing the DII by choosing foods rich in antioxidants, dietary fiber, and unsaturated fatty acids.
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Affiliation(s)
- Qilong Zhao
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Xinyue Tan
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Zhenni Su
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | | | - Li Su
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Zhenchuang Tang
- Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing 100081, China
| | - Ying Zhang
- School of Public Health, Lanzhou University, Lanzhou 730000, China
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Xu X, Yang W, Deng Y, Liu L, Zhang X, Long C, Dong T, Zeng J, Kui J, Wu X. Association of socioeconomic status with glycated haemoglobin level and risk factors for diabetic retinopathy: a cross-sectional study in Sichuan, western China. BMJ Open 2023; 13:e067475. [PMID: 36797020 PMCID: PMC9936295 DOI: 10.1136/bmjopen-2022-067475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE Diabetes affects 1 in 10 adults in China. Diabetic retinopathy (DR) is a diabetes-related complication that, if untreated, impairs vision and causes blindness. Evidence on DR diagnosis and risk factors is limited. This study aimed to add evidence from socioeconomic factors. DESIGN A cross-sectional survey of people with diabetes conducted in 2019 was analysed by using logistic regression to evaluate the association of socioeconomic factors with the glycated haemoglobin (HbA1c) level and DR. SETTING Five counties/districts of western China (Sichuan) were included. PARTICIPANTS Registered participants with diabetes aged from 18 to 75 years were selected, and at last 2179 participants were included in the analysis. RESULTS In this cohort, 37.13% (adjusted value 36.52%), 19.78% (adjusted value 19.59%) and 17.37% of participants had HbA1c<7.0%, DR (24.96% of those in the high-HbA1c group) and non-proliferative DR, respectively. Participants with higher social health insurance coverage (urban employee insurance (UEI)), higher income and urban residents tended to have glycaemic control (HbA1c) compared with their counterparts (OR: 1.48, 1.08 and 1.39, respectively). Participants with UEI or higher income had a lower risk of DR (OR: 0.71 and 0.88, respectively); higher education was associated with a 53%-69% decreased risk of DR. CONCLUSION This study shows disparities in the effect of socioeconomic factors on glycaemic (HbA1c) management and DR diagnosis among people with diabetes in Sichuan. Lower socioeconomic (especially non-UEI) status conferred a higher risk of high HbA1c and DR. The insights from this study indicate the need for national programmes to implement community-level measures to facilitate access to better HbA1c management and early detection of DR in patients with lower socioeconomic status and diabetes. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registry (ChiCTR1800014432).
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Affiliation(s)
- Xinyin Xu
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
- Department of Global Health & Social Medicine, King's College London, London, UK
| | - Wei Yang
- Department of Global Health & Social Medicine, King's College London, London, UK
| | - Yin Deng
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Lingling Liu
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Xin Zhang
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Chengxu Long
- Department of Global Health & Social Medicine, King's College London, London, UK
| | - Ting Dong
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Jing Zeng
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Ji Kui
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Xianping Wu
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
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Alcohol consumption and metabolic syndrome: Clinical and epidemiological impact on liver disease. J Hepatol 2023; 78:191-206. [PMID: 36063967 DOI: 10.1016/j.jhep.2022.08.030] [Citation(s) in RCA: 76] [Impact Index Per Article: 76.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/04/2022] [Accepted: 08/19/2022] [Indexed: 02/01/2023]
Abstract
Alcohol use and metabolic syndrome are highly prevalent in the population and frequently co-exist. Both are implicated in a large range of health problems, including chronic liver disease, hepatocellular carcinoma, and liver-related outcomes (i.e. decompensation or liver transplantation). Studies have yielded mixed results regarding the effects of mild-moderate alcohol consumption on the risk of metabolic syndrome and fatty liver disease, possibly due to methodological differences. The few available prospective studies have indicated that mild-moderate alcohol use is associated with an increase in liver-related outcomes. This conclusion was substantiated by systems biology analyses suggesting that alcohol and metabolic syndrome may play a similar role in fatty liver disease, potentiating an already existing dysregulation of common vital homeostatic pathways. Alcohol and metabolic factors are independently and jointly associated with liver-related outcomes. Indeed, metabolic syndrome increases the risk of liver-related outcomes, regardless of alcohol intake. Moreover, the components of metabolic syndrome appear to have additive effects when it comes to the risk of liver-related outcomes. A number of population studies have implied that measures of central/abdominal obesity, such as the waist-to-hip ratio, can predict liver-related outcomes more accurately than BMI, including in individuals who consume harmful quantities of alcohol. Many studies even point to synergistic interactions between harmful alcohol use and many metabolic components. This accumulating evidence showing independent, combined, and modifying effects of alcohol and metabolic factors on the onset and progression of chronic liver disease highlights the multifactorial background of liver disease in the population. The available evidence suggests that more holistic approaches could be useful for risk prediction, diagnostics and treatment planning.
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