Retrospective analysis of metabolic syndrome: prevalence and distribution in executive population in urban pakistan

Prevalence of undiagnosed metabolic syndrome using three different definitions and identifying associated risk factors among apparently healthy adults in Karachi, Pakistan: a cross-sectional survey in the year 2022

OBJECTIVE

To determine the prevalence and associated risk factors of undiagnosed metabolic syndrome (MetS) using three different definitions among apparently healthy adults of Karachi, Pakistan.

METHODS

This community-based cross-sectional survey was conducted in Karachi, Pakistan, from January 2022 to August 2022. A total of 1065 healthy individuals aged 25-80 years of any gender were consecutively included. MetS was assessed using the National Cholesterol Education Program for Adult Treatment Panel (NCEP-ATP) III guidelines, International Diabetes Federation (IDF), and modified NCEP-ATP III.

RESULTS

The prevalence of MetS was highest with the modified NCEP-ATP III definition at 33.9% (95% CI: 31-36), followed by the IDF definition at 32.2% (95% CI: 29-35). In contrast, the prevalence was lower at 22.4% (95% CI: 19-25) when using the NCEP ATP III definition. The risk of MetS significantly increases with higher BMI, as defined by the IDF criteria (adjusted OR [ORadj] 1.13, 95% CI 1.09-2.43), NCEP-ATP III criteria (ORadj 1.15, 95% CI 1.11-1.19), and modified NCEP-ATP III criteria (ORadj 1.16, 95% CI 1.12-1.20). Current smokers had significantly higher odds of MetS according to the IDF (ORadj 2.72, 95% CI 1.84-4.03), NCEP-ATP III (ORadj 3.93, 95% CI 2.55-6.06), and modified NCEP-ATP III (ORadj 0.62, 95% CI 0.43-0.88). Areca nut use was associated with higher odds of MetS according to both IDF (ORadj 1.71, 95% CI 1.19-2.47) and modified NCEP-ATP III criteria (ORadj 1.58, 95% CI 1.10-2.72). Furthermore, low physical activity had significantly higher odds of MetS according to the NCEP-ATP III (ORadj 1.36, 95% CI 1.01-1.84) and modified NCEP-ATP III criteria (ORadj 1.56, 95% CI 1.08-2.26).

CONCLUSION

One-third of the healthy individuals were diagnosed with MetS based on IDF, NCEP-ATP III, and modified NCEP-ATP III criteria. A higher BMI, current smoking, areca nut use, and low physical activity were significant factors.

Metabolic Syndrome and Its Components among Taxi Drivers in the City of Tshwane, South Africa

The occupation of taxi driving predisposes drivers to health risks, including obesity, cardiovascular and metabolic disorders. Although individual components of metabolic syndrome (MetS) are documented, data is scarce on concurrent metabolic disturbances among commercial drivers. The prevalence of MetS and its components were determined in a cross-sectional study among taxi drivers (n = 362) in the City of Tshwane, South Africa. Sociodemographic, occupational, and lifestyle factors were assessed using a structured questionnaire. Anthropometry, blood pressure, and glucose were measured. MetS was defined based on BMI strata, hypertension, and glucose levels. Data was analyzed using SPSS. The mean age of taxi drivers was 42 ± 10.9 years. Overall prevalence of MetS was 17.1%, with higher prevalence observed among older taxi drivers (24.2%) and those with longer experience in the industry (22.9%). Individual components of MetS were obesity (36%), hypertension (36%) and diabetes (46%), while smoking (30%), alcohol use (59%), and physical inactivity (71%) were observed. MetS was associated with duration in the taxi industry, and family history of diabetes among taxi drivers. The presence of MetS and its components among taxi drivers calls for early identification of cardiometabolic risks in the taxi industry and efforts towards achieving a healthier workforce.

Does Lipocalin-2 Affect Metabolic Syndrome in Hepatic Infections?

Background and objective

Lipocalin-2 (LCN-2) is an adipokine that plays a protective role in various inflammatory disorders and regulates innate immune response to acute and chronic infections. However, scant information is available regarding the relationship between serum LCN-2 levels and type 2 diabetes mellitus (T2DM) occurring concurrently with chronic hepatic infections. The present study sought to investigate the association of LCN-2 with T2DM patients with hepatic infections.

Methods

The association of LCN-2 with T2DM, hepatic steatosis, and inflammation was tested in 37 non-T2DM noninfectious individuals (group A, control group) and 55 age-matched patients with T2DM and chronic infection (group B). Anthropometric data were measured and the body-fat percentage was calculated using bioelectrical impedance analysis (BIA). Hemoglobin (Hb), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), liver function enzymes (LFEs), lipid profile, and total leukocyte count (TLC) were measured. Serum LCN-2 levels were measured using a commercially available sandwich enzyme-linked immunosorbent assay method.

Results

Levels of LCN-2 were significantly elevated in group B (1896.90 ± 73.13 ng/ml) versus control group A (263.58 ± 15.66 ng/mL; p<0.001). LCN-2 correlated moderately with alanine aminotransferase (ALT) (r=0.369), alkaline phosphatase ALP (r=0.419), and HbA1c (r=0.341) (p<0.01). All correlations were lost when adjusted for the presence of hepatitis, indicating that liver infection exacerbates insulin resistance.

Conclusion

Based on our findings, circulating LCN-2 is elevated in T2DM subjects with hepatitis B co-infection and may contribute towards deranged inflammatory response.

Association of tissue inhibitor of metalloproteinase 2 with non-alcoholic fatty liver disease in metabolic syndrome

The aim of this case-control study was to assess TIMP2 level in subjects with or without metabolic syndrome (MetS) and to associate levels with non-alcoholic fatty liver changes (NAFLD). Thirty-three MetS subjects and 55 controls were recruited. Anthropometric data, lipid and glucose profile, TIMP2 and liver ultrasound was performed. High TIMP2 was seen in MetS group (145.28 ± 23.11 pg/ml) versus controls (19.06 ± 1.19 pg/ml; p < .001). Serum cholesterol, triglyceride, LDL-c and glucose levels were significantly higher in MetS subjects (p < .05). MetS individuals (72.72%) showed positive fatty liver changes versus 14.5% controls. Elevated TIMP2 positively correlated with waist circumference, body fat, blood glucose and NAFLD. Furthermore, every unit rise in waist circumference and TIMP2 and a unit decrease in HDL were associated with higher odds of developing NAFLD (p < .05). There may be concurrent relationship between TIMP2 and NAFLD in MetS that requires further evaluation to improve risk assessment and early diagnosis of MetS.

Prevalence of Metabolic Syndrome in Overweight and Obese Patients and Their Measurement of Neck Circumference: A Cross-sectional Study

Background The utilization of neck circumference (NC) as a valuable tool to evaluate metabolic syndrome (MetS) is still unclear. MetS has been extensively reported worldwide mainly due to the increasing trend of central obesity and the risk of developing coronary artery disease. In Pakistan, its incidence is reported to be between 18% and 49% among the urban population. Methods This cross-sectional study was conducted at the Indus Hospital, Karachi, Pakistan; in total, 392 patients (body mass index [BMI] >23 kg/m², age ≥18 years, both genders) were recruited through consecutive sampling, and informed consent was obtained. Results The majority of patients were females (n = 344, 87.8%), and the mean ± SD of age and NC of all patients was 50.5 ± 9.6 years and 38 ± 4.6 cm, respectively. The majority (n = 375, 95.7%) of patients were found to have MetS, with 90% of both males and females having NC ≥38 cm and 34 cm, respectively. Conclusion The prevalence of MetS was found to be very high in overweight and obese patients. Moreover, the majority of patients with MetS were found to have higher NC.

Association of genetic polymorphism of PC-1 gene (rs1044498 Lys121Gln) with insulin-resistant type 2 diabetes mellitus in Punjabi Population of Pakistan

BACKGROUND

Insulin resistance (IR), known to reduce the response to insulin action, develops with obesity leading to type 2 diabetes mellitus (T2DM). The PC-1 gene has been associated with dyslipidemia, polycystic ovarian disease and T2DM in different regions of the world. The objective of the present study was to investigate the genetic association of PC-1 rs1044498 polymorphism with insulin resistance in type 2 diabetes in the Punjabi population of Pakistan.

METHODS

This study was carried out on 161 healthy controls and 161 patients of T2DM with insulin resistance. Whole blood was collected for DNA extraction and molecular studies. PCR-RFLP with AvaII was performed to determine the genotype in cases and controls. Chi-square and Hardy Weinberg analyses were carried out. Statistical analysis was performed by SPSS software.

RESULTS

The demographic data of cases and controls showed significant differences for different parameters like glucose, insulin, Homeostatic model assessment-insulin resistance (HOMA-IR) and lipid profiles (p < 0.000). Different statistical models revealed that all the dominant models were found associated in between alleles for disease risk (p < 0.001) while no association of PC-1 rs1044498 (K121Q) polymorphism was found with insulin-resistant parameters in T2DM cases.

CONCLUSION

Overall, the results indicate that the K121Q polymorphism was not found associated with insulin resistance in type 2 diabetes in a Pakistani Punjabi population. This is the first-ever report about the genotype of PC-1 gene in this population.

Metabolic syndrome: an update on diagnostic criteria, pathogenesis, and genetic links

Metabolic syndrome (MetS), today a major global public health problem, is a cluster of clinical, metabolic, and biochemical abnormalities, such as central adiposity, hypertension, insulin resistance, and dyslipidemias. These MetS-related traits significantly increase the risk of type 2 diabetes mellitus, adverse cardiac events, stroke, and hepatic steatosis. The pathogenesis of MetS is multifactorial, with the interplay of environmental, nutritional, and genetic factors. Chronic low-grade inflammation together with visceral adipose tissue, adipocyte dysfunction, and insulin resistance plays a major role in the progression of the syndrome by impairing lipid and glucose homeostasis in insulin-sensitive tissues, such as the liver, muscle, and adipocytes. Adipose-derived inflammatory cytokines and non-esterified fatty acids establish the link between central obesity IR, inflammation, and atherogenesis. Various studies have reported an association between MetS and related traits with single-nucleotide polymorphisms of different susceptibility genes. Modulation of cytokine levels, pro-oxidants, and disturbed energy homeostasis, in relation to the genetic variations, is described in this review of the recent literature, which also provides updated data regarding the epidemiology, diagnostic criteria, and pathogenesis of MetS.