Gender-Specific Associations between Socioeconomic Status and Psychological Factors and Metabolic Syndrome in the Korean Population: Findings from the 2013 Korean National Health and Nutrition Examination Survey

Sugary snack restriction enhances body composition improvement in overweight women engaging in non-face-to-face walking during COVID-19

Introduction

This study assesses the impact of dietary modification, specifically sugary snack restriction, in conjunction with a brisk walking program on overweight management in young overweight women, with a focus on changes in body composition and glucose metabolism.

Method

An 8-week randomized controlled trial was conducted amidst the COVID-19 pandemic, utilizing a remote intervention approach to comply with health guidelines and ensure participant safety. The study's remote nature highlights adaptability in health interventions during challenging periods, such as the COVID-19 pandemic. Twenty-one overweight Korean women aged 20-39, with an average BMI of 24.6, were selected for the study. They were divided into two groups: one engaging in brisk walking and the other combining this exercise with a sugary snack restriction, demonstrating the study's focus on comparative intervention efficacy.

Results

The exercise-only group showed notable reductions in glucose, insulin, HOMA-IR (p < 0.05), and total cholesterol levels (p < 0.01). In contrast, the group that combined exercise with dietary modification displayed more pronounced improvements in body weight, fat mass, and waist circumference (p < 0.05). This differential outcome emphasizes the added benefit of integrating dietary control with physical activity.

Discussion

The findings suggest that adding a dietary component, particularly a sugary snack restriction, to an exercise regimen can significantly enhance the effectiveness of overweight management in young women. This study underscores the importance of holistic lifestyle interventions that combine dietary and physical activity modifications for improved health outcomes.

The association of psychological stress with metabolic syndrome and its components: cross-sectional and bidirectional two-sample Mendelian randomization analyses

Background

Metabolic syndrome (MetS) is a group of co-occurring conditions that increase the risk of cardiovascular disease, which include the conditions of hypertension, overweight or obesity, hyperglycemia, and dyslipidemia. Psychological stress is gradually being taken seriously, stemming from the imbalance between environmental demands and individual perceptions. However, the potential causal relationship between psychological stress and MetS remains unclear.

Method

We conducted cross-sectional and bidirectional Mendelian randomization (MR) analyses to clarify the potential causal relationship of psychological stress with MetS and its components. Multivariable logistic regression models were used to adjust for potential confounders in the cross-sectional study of the Chinese population, including 4,933 individuals (70.1% men; mean age, 46.13 ± 8.25). Stratified analyses of sexual characteristics were also performed. Bidirectional MR analyses were further carried out to verify causality based on summary-level genome-wide association studies in the European population, using the main analysis of the inverse variance-weighted method.

Results

We found that higher psychological stress levels were cross-sectionally associated with an increased risk of hypertension in men (odds ratio (OR), 1.341; 95% confidence interval (CI), 1.023-1.758; p = 0.034); moreover, higher levels of hypertension were cross-sectionally associated with an increased risk of psychological stress in men and the total population (men: OR, 1.545 (95% CI, 1.113-2.145); p = 0.009; total population: OR, 1.327 (95% CI, 1.025-1.718); p = 0.032). Genetically predicted hypertension was causally associated with a higher risk of psychological stress in the inverse-variance weighted MR model (OR, 2.386 (95% CI, 1.209-4.710); p = 0.012). However, there was no association between psychological stress and MetS or the other three risk factors (overweight or obesity, hyperglycemia, and dyslipidemia) in cross-sectional and MR analyses.

Conclusion

Although we did not observe an association between psychological stress and MetS, we found associations between psychological stress and hypertension both in cross-sectional and MR studies, which may have implications for targeting hypertension-related factors in interventions to improve mental and metabolic health. Further study is needed to confirm our findings.

Association of socioeconomic status with metabolic syndrome and its components among adult population: a community-based cross-sectional study in Nanjing Municipality of China

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.

The epidemiological profile associated with lifestyle risk factors and nutritional status for COVID-19 patients in the Iraqi population

Objectives

To determine the prevalence of COVID-19 infection and to identify the lifestyle factors and nutritional status associated with the epidemiological profile of COVID-19 patients.

Materials and Methods

This cross-sectional survey was carried out in the eighteen Iraqi governorates, from 1^st August to 20^th of October 2020. At the end of this study, 433 participants were recruited.

Results

The prevalence of coronavirus infection was 37.18%. Smoking and active physical activity were relatively higher for COVID-19 patients who are male, and belonged to the under-45 age range were 91.3%. It notices that COVID-19 patients who smoked and had active physical activity were married, residents in urban, and worked. Likewise, COVID-19 patients who had equal or more than an institute/college level of education are smokers and had active physical activity. Obesity prevalence was higher for patients aged <45 (92.2%), and higher for females (51%). The proportion of obesity was generally higher for married and for those living in urban areas (92.2%). Obesity was significantly more common among those in worked (70.6%).

Conclusions

Of note is the high prevalence of COVID-19 infection observed. A strong correlation between the prevalence of active physical activity among COVID-19 patients and gender, marital status, residence, education, and occupation. Unexpectedly, the prevalence rate of obesity among COVID-19 patients correlating with socio-demographic status did not yield a significant difference.

A prospective registry analysis of psychosocial and metabolic health between women with and without metabolic syndrome after a complicated pregnancy

PURPOSE

Pregnancy complications affect over one quarter of Australian pregnancies, and this group of mothers is vulnerable and more likely to experience adverse cardiometabolic health outcomes in the postpartum period. Metabolic syndrome is common in this population and may be associated with postpartum mental health issues. However, this relationship remains poorly understood. To compare the differences in psychosocial parameters and mental health outcomes between women with metabolic syndrome and women without metabolic syndrome 6 months after a complicated pregnancy.

METHODS

This study is prospective registry analysis of women attending a postpartum healthy lifestyle clinic 6 months following a complicated pregnancy. Mental health measures included 9-item Patient Health Questionnaire (PHQ-9), 7-item Generalised Anxiety Disorder questionnaire (GAD-7), self-reported diagnosed history of depression, anxiety and/or other psychiatric condition, and current psychotropic medication use.

RESULTS

Women with metabolic syndrome reported significantly more subjective mental health concerns, were more likely to have a history of depression and other psychiatric diagnoses and were more likely prescribed psychotropic medications. However, there were no significant differences in PHQ-9 and GAD-7 scores.

CONCLUSION

Amongst new mothers who experienced complications of pregnancy, those with metabolic syndrome represent a particularly vulnerable group with regards to psychosocial disadvantage and mental health outcomes. These vulnerabilities may not be apparent when using common standardised cross-sectional mental health screening tools such as PHQ-9 and GAD-7.

Sex Differences in the Relationship between Excessive Alcohol Consumption and Metabolic Abnormalities: A Community-Based Study in Taiwan

Excessive alcohol consumption, as part of an unhealthy lifestyle, can contribute to metabolic abnormalities. This study investigated the sex differences in the relationship between excessive drinking and the risk of metabolic abnormalities. This community-based study included 3387 participants (age range: 30–103 years, mean age ± SD: 57 ± 13.5 years, 38.2% males) from the northeastern region of Taiwan. All participants completed a demographic survey and were subjected to blood tests. The risks of excessive drinking were evaluated using the Alcohol Use Disorder Identification Test (AUDIT). The results showed that males were at higher risks of obesity, hypertension, and hypertriglyceridemia, but at a lower risk of abdominal obesity than females. Males with hazardous drinking were at greater risks of hypertension, hyperglycemia, low serum levels of high-density lipoprotein cholesterol, and hypertriglyceridemia compared to those with no drinking. Females with hazardous drinking were at a greater risk of hypertension than those with no drinking. There was no interaction effect of sex and excessive drinking on the risks of metabolic abnormalities after controlling for demographics and lifestyle-related habits. Future studies are warranted to explore the sex-specific risk factors for metabolic abnormalities and to elucidate the mechanism underlying this association between alcohol consumption and metabolic abnormalities.

Prevalence of Metabolic Syndrome in Women After Maternal Complications of Pregnancy: An Observational Cohort Analysis

Introduction

Certain complications of pregnancy, including hypertensive disorders of pregnancy, gestational diabetes mellitus, intrauterine growth restriction, spontaneous preterm birth, and placental abruption, are established independent risk factors for premature cardiovascular disease in women. Metabolic syndrome, which is associated with an increased risk of cardiovascular disease, may be a suitable alternative to traditional cardiovascular risk calculators that underestimate risk in young women. This study aimed to investigate the prevalence of metabolic syndrome in women who experienced a complicated pregnancy 6 months earlier.

Methods

This observational study investigated the prevalence of metabolic syndrome as defined by the International Diabetes Federation in all eligible participants (n = 247) attending a postpartum lifestyle intervention clinic from August 2018 to June 2021 at the Lyell McEwin Hospital in Adelaide, South Australia.

Results

A total of 89 (36%) participants met the criteria for metabolic syndrome at a mean follow up time of 7 months postpartum. Almost 90% of the cohort were abdominally obese, and over two thirds of the total cohort met at least two of the criteria for metabolic syndrome.

Conclusions

Women with a prior history of one of the common major pregnancy complications are at high risk of future cardiovascular and metabolic disease, with many showing either metabolic syndrome or multiple risk factors at only 7 months postpartum. The results indicate that follow-up within 1 year postpartum is an appropriate time to commence preventative strategies, as many women are already showing early signs of disease.

Association Between Socioeconomic Status and Prevalence of Cardio-Metabolic Risk Factors: A Cross-Sectional Study on Residents in North China

Studies have found associations between cardio-metabolic disorders and socioeconomic status (SES) in developed areas. However, little epidemiological data are available on residents of less developed areas in North China. A cross-sectional study that consisted of 2,650 adults randomly selected from local residents was conducted on a developing province, Hebei. SES was assessed in terms of education, personal income per year, and occupation. The association between SES and metabolic syndrome (MetS) was determined by multivariate logistic regression. The weighted prevalence of MetS was 26.8% among residents of Hebei province. The lower prevalence of MetS and abdominal obesity was associated with increase in SES groups. After adjustments regarding age, sex, body mass index, living area, smoking, salt intake, and family history of diabetes, odds ratio (OR) for elevated blood pressure (BP) of individuals with higher SES level was 0.71 [95% confidence interval (CI): 0.542–0.921] compared with those with lower SES level. Cardio-metabolic risk factors were commonly identified among residents of Hebei province in north China and were associated with SES conditions. This study indicated that from a public health perspective, more attention should be paid to screening of cardio-metabolic disorders in less developed areas.

Gender differences in cardiometabolic health and disease in a cross-sectional observational obesity study

Background

Beyond the degree of adiposity, the pattern of fat distribution has a profound influence on cardiometabolic risk. It is unclear if sex differences in body fat distribution can potentially explain any sex differences in the prevalence of the metabolic syndrome (MetS) and in individual cardiometabolic risk factors among obese men and women.

Methods

In this cross-sectional analysis, 432 persons from the ongoing Obesity Weight Reduction Study (n = 356 obese, ØBMI 41 ± 8 kg/m², and 76 non-obese, ØBMI 25 ± 3 kg/m²), were included. The relations of sex to MetS prevalence and selected cardiometabolic risk factors were assessed using univariate and multivariate adjusted regression models.

Results

In crude analyses, %fat mass and the fat mass/lean mass ratio were significantly higher in women than in men, regardless of increasing obesity categories, from normal weight to grade-3-obesity. In contrast, markers of abdominal obesity, such as waist circumference and waist-to-hip ratio were higher in men than in women, despite similar BMI. The prevalence of the MetS was higher in obese men than in women (67.6 vs. 45.0%, p < 0.0001), particularly in younger individuals < 40 years (72.5 vs. 36.8%, p < 0.0001), but “metabolically healthy obesity” (BMI ≥ 30, no other NCEP ATPIII MetS component) was more common in women than in men (15.6 vs. 4.1%, p < 0.0001). After adjusting for age, %body fat and height, sex differences were observed for HDL-cholesterol (p < 0.001), triglycerides (p < 0.001), fasting glucose (p = 0.002), insulin and HOMA-IR levels (p < 0.001), ALAT (p < 0.001), adiponectin (p < 0.001), and sE-selectin (p = 0.005). In contrast, crude sex differences in other variables, such as leptin levels (68 ± 4 in obese women vs. 33 ± 2 µg/L in men, p < 0.0001), disappeared after accounting for differences in %body fat (least-squares means of leptin: 52 ± 4 vs. 55 ± 6 µg /L, p = 0.740). A logistic regression model adjusting for age and lifestyle factors revealed a lower risk of having MetS for women as compared to men (OR = 0.38[0.22–0.60]). That risk estimate did not materially alter after adding BMI to the model. In contrast, no statistically significant association between sex and MetS prevalence was observed after adding waist circumference and adiponectin to the model (OR = 1.41[0.59–3.36]).

Conclusions

Different body fat distribution patterns, particularly abdominal adiposity, adiponectin, and related biomarkers, may contribute to sex differences in cardiometabolic risk factors and to the prevalence of the MetS.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13293-022-00416-4.

The Incidence and Determinants of Metabolic Syndrome Amongst a Group of Migrants to Qatar: A Prospective Longitudinal Observational Cohort Study 24-Months Post-Migration

While there is some evidence that migration to Western countries increases metabolic syndrome (MetS) risk, there is a lack of data pertaining to migration to the Middle East. This study aimed to investigate the relationship between migration and MetS incidence following 24-months of residency in Qatar and identify possible MetS determinants. Migrants to Qatar employed at Hamad Medical Corporation (the national health service) aged 18–65 years were invited to participate. Baseline and follow-up screening for MetS included HbA1c, triglycerides, HDL-cholesterol, blood pressure, and waist circumference. MetS-free migrants were rescreened 24-months post-migration, and the World Health Organization STEPwise questionnaire was administered, assessing changes in lifestyle from baseline. Of 1095 migrants contacted, 472 consented to participate, 205 of whom had normal metabolic parameters at baseline; 160 completed follow-up screening. Most participants were males (74.6%, n = 153) and Asian (81.0%, n = 166/205), and two thirds (66.3%, n = 136/205) were nurses. The incidence of new-onset MetS was 17.0% (n = 27/160, 95%CI; 11.0–23.0%), with 81.0% (n = 129/160, 95%CI; 73.8–86.0%) having at least one MetS element 24-months post-residency in Qatar. Male gender was a risk factor for MetS (adjusted odds ratio (AOR) = 3, p = 0.116), as was consuming medication that could induce MetS (AOR = 6.3, p < 0.001). There is merit in further research targeting these groups.

Relationship between socio-demographics, body composition, emotional state, and social support on metabolic syndrome risk among adults in rural Mongolia

Background

In Mongolia, where there is a large regional gap in the quality of healthcare services, metabolic syndrome (MetS) is steadily increasing. However, there are few studies on the risk level of MetS and affecting factors among adults living in rural Mongolia. This study aims to explore the relationship between socio-demographics, clinical characteristics, emotional state, and social support on the risk level of MetS prevalence among adults living in rural Mongolia.

Methods

In this cross-sectional study, 143 adults living in the soum area of Dondgovi aimag in Mongolia were recruited. Data collection was conducted from July 2 to 3, 2019. The self-reported questionnaires including socio-demographic, clinical characteristics and emotional status, anthropometric tests using the InBody, and blood sampling tests were conducted. The number of individual diagnostic criteria met was scored as a MetS risk score and classified into 6 groups, from the lowest score of 0 to the highest score of 5. The ordinal logistic regression analysis was used to identify the factors affecting the risk of MetS.

Results

The prevalence of MetS among adults living in rural Mongolia was 58.0%, and the mean MetS risk score was 2.70±1.34 points. In the ordinal logistic regression analysis, age, regular exercise of moderate intensity or higher, InBody score reflecting obesity or sarcopenia, and depression level were statistically significantly associated with the risk score for MetS.

Conclusions

Our study demonstrated that MetS risk levels among adults living in rural Mongolia with limited medical resources were strongly associated with demographic characteristics, body composition and emotional health condition, particularly depression.

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.

Sex Differences in Risk Factors for Metabolic Syndrome in the Korean Population

With an increase in the obese population, the prevalence of metabolic syndrome is increasing in Korea. This study aimed to identify sex- and age-specific risk factors for metabolic syndrome. A secondary data analysis was performed using the Korean National Health and Nutritional Examination Survey. Participants comprised 6144 adults aged 20-79 years. The prevalence of metabolic syndrome was high in the middle- and old-aged men (31.9% and 34.5%, respectively) and in old-aged women (39.1%). Risk factors for metabolic syndrome showed different patterns for men and women. In men, alcohol drinking was identified as the main risk factor for hypertension (odds ratio (OR); young = 3.3 vs. middle age = 2.0), high triglycerides (young = 2.4 vs. middle age = 2.2), and high fasting blood sugar (middle age = 1.6). In women, the main risk factors were household income and education level, showing different patterns in different age groups. In conclusion, the vulnerable groups at high risk of metabolic syndrome are those of middle-aged men and women. The pattern of risk factors is sex-specific.

Metabolic syndrome and its associations with socio-demographic and behavioral risk factors in the Russian population aged 25-64 years

Aim. To assess the associations of metabolic syndrome (MS) with sociodemographic and  behavioral factors  in the  Russian population  aged 25-64 years.

Material and methods. As part of the ESSE-RF 2 study, representative samples of the population of four Russian regions (Krasnodar Krai, Omsk and Ryazan Oblasts, Republic of Karelia) were examined: men (n=3011) and women (n=3721) aged 25-64 years. The response rate was approximately 80%. The study was approved by the Independent Ethics Committee of National Medical Research Center for Therapy and Preventive Medicine. All subjects were interviewed using a standard questionnaire. We analyzed the region and type of residence (urban/ rural area), age, educational level, marital and economic status, behavioral habits, and medical history data. Anthropometric measurements were performed. Blood pressure (BP) was measured with an Omron BP monitor. Lipid profile were assessed. MS was diagnosed according to the IDF criteria (2006). Statistical analysis was performed using the R 3.6.1 software package.

Results. Abdominal obesity (AO) was found in 49,7% of men and 61,6% of women. Obesity according to body mass index was noted in 31,6% of subjects (men — 28,6% and women — 34%). MS prevalence in the entire sample was 33,0% and increased with age. In the group of subjects 35-44 years old, the prevalence of MS was significantly higher among men, and among those 55-64 years old — among women. We also found that AO in combination with two MS components was observed in 17,2% of participants; AO  with three components  — in 11,8%, AO with four components — in 4%. The highest prevalence of MS was noted in theRyazan region (men — 42,0%, women — 37,4%), the lowest — in theRepublic ofKarelia (men — 25,8%, women — 29,6%). In men, age-adjusted univariate logistic regression revealed significant associations of MS with former smoking, low physical activity, and alcohol abuse. Elevated BP and lipid profile abnormalities were significantly associated with low income level. AO was significantly associated with marriage. Similarly, the risk of diabetes and elevated blood glucose levels was lower in single men. Among women, the risk of MS was higher in those without higher education, with low income, smoking, and low consumption of vegetables and fruits. Women living in rural areas have a higher risk of AO and high BP. The risk of lipid metabolism disorders was higher among women with secondary education. Most of these associations were confirmed by multivariate analysis.

Conclusion. MS was diagnosed in 33% of Russians aged 25-64 years. The proportion of people with MS increases with age, which, due to the  life expectancy increase, suggests an increase in the total number of MS people. Risk factors associated with MS in women are smoking, insufficient consumption of vegetables and fruits, no higher education, and low income. In men, MS are associated with excessive alcohol consumption, smoking, and low physical activity. MS prevalence can be reduced by changing the lifestyle and habits, and if necessary, in combination with drug therapy.

Factors Associated with Metabolic Syndrome among Middle-Aged Women in their 50s: Based on National Health Screening Data

This study aimed to identify the risk factors associated with metabolic syndrome among middle-aged women in their 50s to provide a strategy for managing the metabolic syndrome of those whose prevalence is rapidly increasing. Secondary data from the 2012 Korean National Health Insurance Service Medical check-up cohort database were analyzed. Participants included 36,582 middle-aged women in their 50s from the cohort who received a general medical check-up. The risk factors were estimated using logistic regression analysis. Metabolic syndrome was identified in 14.6% of the surveyed persons among middle-aged women in their 50s. Working women, low household income levels, country residents, high body mass index (BMI), total cholesterol of over 240 mg/dL, non-drinker, non-exerciser, history of diabetes or hypertension, and family history of diabetes were associated with increased risk of metabolic syndrome. It is necessary to prepare a strategy to increase access to health care services so that socioeconomic vulnerability does not lead to negative health behavior such as obesity and lack of physical activity. In particular, we recommend active interventions at workplaces for the working women who have a higher risk of metabolic syndrome.

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.

Age at Menarche in Women With Bipolar Disorder: Correlation With Clinical Features and Peripartum Episodes

BACKGROUND

Bipolar disorder (BD) is related to reproductive cycles. However, findings on putative correlation between age at menarche and course of BD are particularly scarce and conflicting. The aim of the present study is to analyze the relationship between age at menarche and characteristics of BD, including comorbid medical conditions and peripartum mood episodes.

METHODS

The study sample consists of 288 women with BD type I, II, or not otherwise specified (NOS). Age at menarche was both considered as a continuous variable and categorized into three groups: early menarche (≤11 years), normal menarche (12-14 years), and late menarche (≥15 years). The study focused on two sets of comparisons, by age at menarche and women with vs. without children. Spearman correlation matrix was produced to calculate correlations between the variables of interest. Socio-demographic and clinical characteristics between early, normal and late menarche, and women with vs. without children were examined through descriptive statistics. Finally, adjusted logistic regression analysis was run to examine the association between variables.

RESULTS

Out of 288 women included in the study, 21.5% had early menarche, 55.6% had normal, and 22.9% had late menarche. Women with early menarche had higher rates of metabolic syndrome compared to women with normal menarche even after adjustment for age. The subgroup of women with children does not present clinical differences compared to women without children except a lower rate of psychiatric comorbidities. At least one mood episode with peripartum onset occurred in 29.6% of the women with children. After controlling for confounding variables, women with late menarche were associated with lower probability of BD peripartum episodes compared to women with normal menarche.

CONCLUSION

Age at menarche may be related to specific characteristics of women with BD. The results deserve to be deepened in further studies.

The association between psychological stress and metabolic syndrome: A systematic review and meta-analysis

Literature suggests that occupational stress is associated with a higher risk of metabolic syndrome; yet less is known whether other sources of stress have similar effects. This review aims to examine whether the relationship between psychological stress and metabolic syndrome differs by sources of stress. Three databases (PubMed, Web of Science, and CINAHL) were searched for eligible articles; meta-analyses were conducted using the random effects model. After controlling for covariates, adults in the high-stress groups had 45% higher chance of having metabolic syndrome than adults in the low-stress groups (odds ratio [OR] = 1.450; 95% confidence interval [CI], 1.211-1.735; P < .001). The subsequent meta-analysis based on cross-sectional studies suggested that occupational stress showed the strongest effect (OR = 1.692; 95% CI, 1.182-2.424; P = .004), while perceived general stress showed the weakest effect (OR = 1.217; 95% CI, 1.017-1.457; P = .032). Unfortunately, there is a lack of longitudinal studies for subsequent meta-analysis based on sources of stress. There is a need for continued research to examine the long-term relationship between different sources of stress and the risk of metabolic syndrome. Traditional recommendations for preventing metabolic syndrome (eg, low-fat diet and exercise) may not achieve the best outcome if clinicians overlook patients' psychosocial stress.

Socio-economics status and metabolic syndrome: A meta-analysis

OBJECTIVE

The metabolic syndrome (MetS) is responsible for an increased risk of type 2 diabetes, cardiovascular diseases and is associated with all-cause and cardiovascular mortality. Economic and social vulnerability is not an easy concept to grasp, but some studies investigate the association between MetS and socioeconomic and demographic factors, deprivation (more often correlations rather than causal one due to data). This work aims to assess the association between MetS and socio-economic gradient (SEG) in the literature by performing a meta-analysis.

DESIGN

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for systematic reviews were followed.

SETTING

The raw list of studies extracted from PubMed as regard to the inclusion/exclusion criteria was imported in Word. Studies were filed with regard to our three definitions of SEG and their title.

PARTICIPANTS

Subgroup analysis were performed considering several definitions of Mets: NCEP-ATPIII and IDF2006.

RESULTS

The overall multivariable-adjusted OR showed that the risk of MetS was significantly increased in association with SEG The results of the subgroup analysis showed an increased risk of MetS in association with SEG when IDF definition was considered.

CONCLUSIONS

Targeted interventions must be implemented in a specific way as prevention campaigns aimed at the general population are generally not adapted to this particular vulnerable population.

Effects of a T'ai Chi-Based Health Promotion Program on Metabolic Syndrome Markers, Health Behaviors, and Quality of Life in Middle-Aged Male Office Workers: A Randomized Trial

OBJECTIVES

To determine the effects of a t'ai chi-applied worksite health promotion program on metabolic syndrome markers, health behaviors, and quality of life in middle-aged male office workers at a high risk of metabolic syndrome.

DESIGN

A prospective randomized controlled study.

SETTING

Health center of a government office building in Korea.

SUBJECTS

Forty-three male office workers with two or more metabolic syndrome markers.

INTERVENTIONS

The office workers were randomly assigned either to an experimental group that received t'ai chi combined with health education twice weekly for 12 weeks, or to a control group that received health education only.

OUTCOME MEASURES

Blood sampling for metabolic syndrome markers and structured questionnaires for health behaviors and quality of life.

RESULTS

The experimental group showed significant reductions in systolic (t = -3.103, p = 0.003) and diastolic (t = -2.159, p = 0.037) blood pressures and the triglyceride level (t = -2.451, p = 0.019) compared with the control group. Those in the experimental group also performed health behaviors more frequently (t = 4.047, p < 0.001) and reported a significantly better quality of life (t = 3.193, p = 0.003) than those in the control group.

CONCLUSION

The study findings show that t'ai chi was an effective adjunctive intervention in a worksite health promotion program for middle-aged office workers at a high risk of metabolic syndrome. Future studies should examine the long-term effects of t'ai chi-applied worksite health promotion programs in individuals with confirmed metabolic syndrome.