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Razbek J, Bao L, Zhang Y, Daken M, Cao M. Causal association study of the dynamic development of the metabolic syndrome based on longitudinal data. Sci Rep 2024; 14:5448. [PMID: 38443462 PMCID: PMC10914715 DOI: 10.1038/s41598-024-55693-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 02/27/2024] [Indexed: 03/07/2024] Open
Abstract
The dynamic progression of metabolic syndrome (MetS) includes developmental deterioration and reverse recovery; however, the key factors in this bidirectional progression have not been identified. Our study aimed to use the data obtained from the China Health and Retirement Longitudinal Study (CHARLS) and construct a Bayesian network to explore the causal relationship between influential factor and the development and recovery of MetS. Followed up at 4 years, forward progression of MetS occurred in 1543 and reverse recovery of MetS occurred in 1319 of 5581 subjects. Bayesian Networks showed that hyperuricemia and body mass index (BMI) levels directly influenced progression of MetS, and gender, exercise and age play an indirect role through hyperuricemia and BMI levels; high hemoglobin A1c (HbA1c) and BMI levels directly influenced recovery of MetS, and gender and exercise play an indirect role through BMI levels. Bayesian Network inference found that the rate of progression of MetS in subjects with hyperuricemia increases from 36 to 60%, the rate of progression of MetS in subjects with overweight or obese increases from 36 to 41% and the rate of reverse recovery rate of MetS in subjects with high HbA1c decreased from 33 to 20%. Therefore, attention to individuals at high risk of hyperuricemia, high HbA1c levels, and overweight/obesity should be enhanced, with early detection and following healthy behavioral interventions to prevent, control and delay the progression of MetS and its components.
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Affiliation(s)
- Jaina Razbek
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Liangliang Bao
- Department of Postgraduate Management Section, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yan Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Mayisha Daken
- Department of Epidemic Prevention, Karamay Centre for Disease Control and Prevention, Karamay, China
| | - Mingqin Cao
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, China.
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Rahmawati ND, Andriani H, Wirawan F, Farsia L, Waits A, Karim Taufiqurahman KA. Body mass index as a dominant risk factor for metabolic syndrome among indonesian adults: a 6-year prospective cohort study of non-communicable diseases. BMC Nutr 2024; 10:43. [PMID: 38438946 PMCID: PMC10913611 DOI: 10.1186/s40795-024-00856-8] [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: 06/28/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs), notably cardiovascular disease and type 2 diabetes mellitus, are largely driven by metabolic syndrome (MetS), a cluster of critical risk factors. Despite extensive research, the progression of MetS, especially in Indonesia, has received limited attention. This research tracks adult MetS risk dynamics in a populous Bogor District cohort, providing crucial insights into its evolving nature. METHODS This prospective open cohort study analysed secondary data from the Special Research - Cohort Study of Non-Communicable Diseases by the Ministry of Health, Republic of Indonesia from 2011 to 2018. The final sample was 1,376 Indonesian adult participants, all residents of Bogor District. MetS outcome, dietary assessment, physical activity, and biomarkers were analysed every two consecutive years. RESULTS The risk of overweight and obese participants developing MetS was 2.4 and 4.4 times higher, respectively (95% CI: 1.176-3.320 and 3.345-5.740) than those with body mass index (BMI) in the normal range. Participants who reported less intentional physical exercise had a MetS risk 1.5 times higher (95% CI: 1.034-2.109) than those with more intentional physical exercise. The role of diet is also significant, evidenced by a 30% reduction in MetS risk for people with fat intakes in the 2nd quartile compared to the 1st quartile (95% CI: 0.505-0.972). Meanwhile, a carbohydrate intake in the 2nd quartile increased the risk of MetS 1.5 times (95% CI: 1.063-2.241) in comparison with the 1st quartile. CONCLUSIONS Notably, participants with underweight BMI exhibited the highest cumulative survival of MetS, while those with obese BMI recorded the lowest cumulative survival. There is an urgent need for strategic interventions to enhance the existing early detection and NCD monitoring program. This involves a targeted focus on promoting a community-based healthy lifestyle in the Bogor District. The study emphasizes the importance of tailored public health measures to address specific risk factors identified in the local context, aiming to mitigate the prevalence and impact of MetS in the population.
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Affiliation(s)
- Nurul Dina Rahmawati
- Department of Public Health Nutrition, Faculty of Public Health, Universitas Indonesia, 16424, Depok, West Java, Indonesia
| | - Helen Andriani
- Department of Health Policy and Administration, Faculty of Public Health, Universitas Indonesia, 16424, Depok, West Java, Indonesia.
| | - Fadila Wirawan
- Department of Public Health Nutrition, Faculty of Public Health, Universitas Indonesia, 16424, Depok, West Java, Indonesia
| | - Latifah Farsia
- Department of Public Health Nutrition, Faculty of Public Health, Universitas Indonesia, 16424, Depok, West Java, Indonesia
| | - Alexander Waits
- Institute of Public Health, School of Medicine, National Yang-Ming Chiao Tung University, Taipei, 112, Taiwan
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Razbek J, Zhang Y, Xia WJ, Xu WT, Li DY, Yin Z, Cao MQ. Study on Dynamic Progression and Risk Assessment of Metabolic Syndrome Based on Multi-State Markov Model. Diabetes Metab Syndr Obes 2022; 15:2497-2510. [PMID: 35996564 PMCID: PMC9392490 DOI: 10.2147/dmso.s362071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
AIM Metabolic syndrome (MetS) coexists with the occurrence and even death of cardiovascular disease and diabetes mellitus. It is essential to study the factors in the dynamic progression of MetS in the interest of prevention and control. PURPOSE The aim of this study was to analyze the dynamic progression of Mets and explore the potential factors influencing the progression or reversal of MetS. PATIENTS AND METHODS This study involved 5581 individuals from two waves of the China Health and Retirement Longitudinal Study: 2011 and 2015. A multistate Markov model containing 4 states (free of metabolic disorder (FMD), mild metabolic disorder (MMD), severe metabolic disorder (SMD) and MetS) was adopted to study the dynamic progression of MetS and its influencing factors. RESULTS After follow-up, a total of 2862 cases (50.28% of the total number) had disease state transition. The intensity of transition from MetS to SMD is the same as that from SMD to MMD, and is greater than that from MMD to Mets (0.06 vs 0.05). For the MetS state, a mean of 1/0.08=12.5 years was spent in the MetS state before recovery. The exercise, smoke, drink, BMI level, hyperuricemia had statistically significant effects on progression of MetS status (P<0.05). The obesity or overweight, little exercise, smoke, drink and hyperuricemia increased the risk of forward progression of MetS disease status. There were significant nonmodifiable (age, gender) and modifiable factors (exercise, drink, BMI level, or high HbA1c) associated with reversion of MetS state. CONCLUSION The likelihood of progression from MMD to MetS is less likely than that of reversion from MetS to SMD and SMD to MMD. Old females were more resistant to recover from worse states than males. Prevention and intervention measures should be adopted early when MMD or SMD onset occurs.
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Affiliation(s)
- Jaina Razbek
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, People’s Republic of China
| | - Yan Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, People’s Republic of China
| | - Wen-Jun Xia
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, People’s Republic of China
| | - Wan-Ting Xu
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, People’s Republic of China
| | - De-Yang Li
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, People’s Republic of China
| | - Zhe Yin
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, People’s Republic of China
| | - Ming-Qin Cao
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, People’s Republic of China
- Correspondence: Ming-Qin Cao, Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, No. 393 Xinyi Road, Urumqi, 830011, People’s Republic of China, Tel +86-13319912419, Email
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Rezaianzadeh A, Morasae EK, Khalili D, Seif M, Bahramali E, Azizi F, Bagheri P. Predicting the natural history of metabolic syndrome with a Markov-system dynamic model: a novel approach. BMC Med Res Methodol 2021; 21:260. [PMID: 34837958 PMCID: PMC8627615 DOI: 10.1186/s12874-021-01456-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 11/01/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Markov system dynamic (MSD) model has rarely been used in medical studies. The aim of this study was to evaluate the performance of MSD model in prediction of metabolic syndrome (MetS) natural history. METHODS Data gathered by Tehran Lipid & Glucose Study (TLGS) over a 16-year period from a cohort of 12,882 people was used to conduct the analyses. First, transition probabilities (TPs) between 12 components of MetS by Markov as well as control and failure rates of relevant interventions were calculated. Then, the risk of developing each component by 2036 was predicted once by a Markov model and then by a MSD model. Finally, the two models were validated and compared to assess their performance and advantages by using mean differences, mean SE of matrices, fit of the graphs, and Kolmogorov-Smirnov two-sample test as well as R2 index as model fitting index. RESULTS Both Markov and MSD models were shown to be adequate for prediction of MetS trends. But the MSD model predictions were closer to the real trends when comparing the output graphs. The MSD model was also, comparatively speaking, more successful in the assessment of mean differences (less overestimation) and SE of the general matrix. Moreover, the Kolmogorov-Smirnov two-sample showed that the MSD model produced equal distributions of real and predicted samples (p = 0.808 for MSD model and p = 0.023 for Markov model). Finally, R2 for the MSD model was higher than Markov model (73% for the Markov model and 85% for the MSD model). CONCLUSION The MSD model showed a more realistic natural history than the Markov model which highlights the importance of paying attention to this method in therapeutic and preventive procedures.
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Affiliation(s)
- Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Bahramali
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pezhman Bagheri
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Shiraz University of Medical Sciences, Shiraz, Iran
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Bagheri P, Khalili D, Seif M, Rezaianzadeh A. Dynamic behavior of metabolic syndrome progression: a comprehensive systematic review on recent discoveries. BMC Endocr Disord 2021; 21:54. [PMID: 33752643 PMCID: PMC7986266 DOI: 10.1186/s12902-021-00716-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 03/04/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The assessment of the natural history of metabolic syndrome (MetS) has an important role in clarifying the pathways of this disorder. OBJECTIVE This study purposed to provide a rational statistical view of MetS progression pathway. METHODS We performed a systematic review in accordance with the PRISMA Statement until September 2019 in the Medline/PubMed, Scopus, Embase, Web of Science and Google Scholar databases. From the 68 found studies, 12 studies were eligible for review finally. RESULTS The selected studies were divided in 2 groups with Markovian and non-Markovian approach. With the Markov approach, the most important trigger for the MetS chain was dyslipidemia with overweight/obesity in the under-50 and with hypertension in the over-50 age group, where overweight/obesity was more important in women and hypertension in men. In non-Markov approach, the most common trigger was hypertension. Transition probability (TP) from no component to MetS were higher in all Markovian studies in men than in women. In the Markovians the combination of dyslipidemia with overweight/obesity and in non-Markovians, hyperglycemia with overweight/obesity were the most common combinations. Finally, the most important components, which predict the MetS, were 2-component states and hyperglycemia in Markovian approach and overweight/obesity in non-Markovians. CONCLUSIONS Among the components of the MetS, dyslipidemia and hypertension seems to be the main developer components in natural history of the MetS. Also, in this chain, the most likely combination over time that determines the future status of people seems to be the combination of dyslipidemia with obesity or hyperglycemia. However, more research is needed.
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Affiliation(s)
- Pezhman Bagheri
- Student research committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Biostatistics and Epidemiology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rezaianzadeh
- Colorectal research center, Shiraz University of Medical Sciences, Shiraz, Iran
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Dynamics of detailed components of metabolic syndrome associated with the risk of cardiovascular disease and death. Sci Rep 2021; 11:3677. [PMID: 33574366 PMCID: PMC7878780 DOI: 10.1038/s41598-021-83118-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/22/2021] [Indexed: 12/02/2022] Open
Abstract
Few studies quantify a cascade of dynamic transitions on the detailed components of metabolic syndrome (MetS) and subsequent progressions to cardiovascular disease (CVD) and its death. A total of 47,495 subjects repeatedly attending a community-based integrated screening program in Taiwan were recruited. The refined MetS-related classification (RMRC) in relation to five criteria of MetS was defined as free of metabolic disorder (FMD, none of any criteria), mild metabolic disorder (MMD, 1–2 criteria) and MetS. A multistate Markov model was used for modelling such a multistate process. The estimated progression rate from FMD to MMD was 44.82% (95% CI 42.95–46.70%) whereas the regression rate was estimated as 29.11% (95% CI 27.77–30.45%). The progression rate from MMD to MetS was estimated as 6.15% (95% CI 5.89–6.42%). The estimated annual incidence rates of CVD increased with the severity of RMRC, being 1.62% (95% CI 1.46–1.79%) for FMD, 4.74% (95% CI 4.52–4.96%) for MMD, to 20.22% (95% CI 19.52–20.92%) for MetS. The estimated hazard rate of CVD death was 6.1 (95% CI 4.6–7.7) per thousand. Elucidating the dynamics of MetS-related transition and quantifying the incidence and prognosis of CVD provide a new insight into the design and the evaluation of intervention programs for CVD.
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The dynamics of metabolic syndrome development from its isolated components among Iranian adults: findings from 17 years of the Tehran lipid and glucose study (TLGS). J Diabetes Metab Disord 2021; 20:95-105. [PMID: 34178824 DOI: 10.1007/s40200-020-00717-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 12/22/2020] [Indexed: 12/20/2022]
Abstract
Background Evaluating the process of changes in the Metabolic Syndrome (MetS) components over time is one of the ways to study of the MetS natural history. This study aimed to determine the trend of changes in the progression of MetS from its isolated components. Methods This longitudinal study was performed on four follow-up periods of the Tehran Lipid and Glucose Study (TLGS) between 1999 and 2015. The research population consisted of 3905 adults over the age of 18 years. MetS was diagnosed based on the Joint Interim Statement (JIS). The considered components were abdominal obesity, hypertension, hyperglycemia, and dyslipidemia. Results The highest incidence of MetS from its components was related to hypertension in the short term (3.6-year intervals). In the long run, however, the highest increase in the MetS incidence occurred due to abdominal obesity. Overall, the incidence of MetS increased due to obesity and dyslipidemia, but decreased due to the other factors. Nonetheless, the trend of MetS incidence from all components increased in total. The most common components were dyslipidemia with a decreasing trend and obesity with an increasing trend during the study. Conclusion The results indicated that obesity and hypertension components played a more important role in the further development of MetS compared to other components in the Iranian adult population. This necessitates careful and serious attention in preventive and control planning.
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Tang X, Zhang H, Zhao Y, Lei F, Liu Q, Hu D, Li G, Song G. Transition Patterns of Weight Status and Their Predictive Lipid Markers Among Chinese Adults: A Longitudinal Cohort Study Using the Multistate Markov Model. Diabetes Metab Syndr Obes 2021; 14:2661-2671. [PMID: 34163194 PMCID: PMC8215687 DOI: 10.2147/dmso.s308913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/21/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Obesity is well recognized as a risk factor for cardiometabolic diseases. The development of obesity is a dynamic process that can be described as a multistate process with an emphasis on transitions between weight states. However, it is still unclear what convenient biomarkers predict transitions between weight states. The aim of this study was to show the dynamic nature of weight status in adults stratified by age and sex and to explore blood markers of metabolic syndrome (MetS) that predict transitions between weight states. METHODS This study involved 9795 individuals aged 18 to 56 at study entry who underwent at least two health check-ups in the eight-year period of study in the health check-up centre of our institution. Weight, height and biochemical indices were measured at each check-up. The participants were divided into four groups based on age and sex (young male, middle-aged male, young female and middle-aged female groups). A multistate Markov model containing 3 states (healthy weight, overweight and obesity) was adopted to study the longitudinal weight data. RESULTS Young people were more likely to transit between weight states than middle-aged people, and middle-aged people were more resistant to recover from worse states. The mean sojourn time in obesity was greatest in the middle-aged male group (6.23 years), and the predicted rate of obesity beginning with healthy weight was greatest in the young male group (13.7%). In multivariate models, age group and triglyceride (TG) and high-density lipoprotein cholesterol (HDL) levels were significant for specific transitions in females, whereas age group and HDL levels were significant in males. In females, if HDL levels increased 1 mmol/L, the probability of progression from healthy weight to overweight decreased by 37.0% (HR= 0.63), and the probabilities of recovery (overweight to healthy weight and obesity to overweight) increased by 62.0% (HR= 1.62) and 1.23-fold (HR= 2.23), respectively. In males, if TG levels increased 1 mmol/L, the risk of progression from healthy weight to overweight increased by 24.0% (HR= 1.24). Each unit increase in HDL levels was associated with a 0.99-fold (HR= 1.99) increase in the chance of recovery from overweight to healthy weight and with a 0.37-fold (HR= 0.63) decrease in the risk of progression from healthy weight to overweight. CONCLUSION The weight status of young people was less stable than that of middle-aged people. Males were more likely to become overweight and more resistant to recover from worse states than females. Young males with healthy weight were more likely to develop obesity than other healthy weight groups. Blood lipid levels, especially HDL, were predictors of weight transitions in adults. Prevention and intervention measures should be applied early.
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Affiliation(s)
- Xiao Tang
- Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, 116044, People’s Republic of China
| | - Hongya Zhang
- Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, 116044, People’s Republic of China
| | - Yanxiang Zhao
- Department of Mathematics, George Washington University, Washington, DC, USA
| | - Fang Lei
- Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, 116044, People’s Republic of China
| | - Qigui Liu
- Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, 116044, People’s Republic of China
| | - Dongmei Hu
- Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, 116044, People’s Republic of China
| | - Guorong Li
- Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, 116044, People’s Republic of China
| | - Guirong Song
- Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian City, Liaoning Province, 116044, People’s Republic of China
- Correspondence: Guirong Song Department of Health Statistics, School of Public Health, Dalian Medical University, No. 9 South Road, Lvshun District, Dalian City, Liaoning Province, 116044, People’s Republic of ChinaTel +86-411-86110328 Email
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Bagheri P, Khalil D, Seif M, Khedmati Morasae E, Bahramali E, Azizi F, Rezaianzadeh A. The dynamics of metabolic syndrome development from its isolated components among iranian children and adolescents: Findings from 17 Years of the Tehran Lipid and Glucose Study (TLGS). Diabetes Metab Syndr 2021; 15:99-108. [PMID: 33321311 DOI: 10.1016/j.dsx.2020.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/28/2020] [Accepted: 12/03/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Careful evaluation of the progression trend of the metabolic syndrome (MetS) in children and adolescents (C&A) is one of the important methods of studying the natural history of MetS in them. This study was performed to determine the trend of changes in the progression of MetS from its components. METHODS This was a longitudinal study which was performed on data from 4 follow-up periods of Tehran Lipid and Glucose Study (TLGS) between 1999 and 2015. The research population consisted of 6-18-year-old children and adolescents creating 3895-person population. The criteria for the diagnosis of MetS was joint interim statement (JIS). The considered components were central adiposity, high blood pressure, insulin resistance, and dyslipidemia. RESULTS In this study, in the long term, the highest increase in the MetS' incidence in boys occurred in obesity and in girls in dyslipidemia and in total mode, in obesity. But in the short term (3.6 year follow-up periods) in the first to fourth periods, in total mode, the highest incidence occurred in dyslipidemia, hyperglycemia, dyslipidemia, and obesity. In terms of trend, in total mode, the highest increase in MetS incidence was related to the obesity component. Also, the incidence of MetS from all components was declining in overall mode. Also, the most common components at the beginning and end of the study in all groups were dyslipidemia with a decreasing and obesity with an increasing trend, respectively. CONCLUSION It seems that in Iranian C&As, obesity and dyslipidemia components play a more important role in the further development of the MetS than other components. This matter requires careful and serious attention in preventive and control planning.
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Affiliation(s)
- Pezhman Bagheri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Davood Khalil
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Biostatistics and Epidemiology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | - Ehsan Bahramali
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Noninvasive and Convenient Screening of Metabolic Syndrome Using the Controlled Attenuation Parameter Technology: An Evaluation Based on Self-Paid Health Examination Participants. J Clin Med 2019; 8:jcm8111775. [PMID: 31653028 PMCID: PMC6912761 DOI: 10.3390/jcm8111775] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 12/13/2022] Open
Abstract
Background: There is a medical need for an easy, fast, and non-invasive method for metabolic syndrome (MetS) screening. This study aimed to assess the ability of FibroScan to detect MetS, in participants who underwent a self-paid health examination. Methods: A retrospective cohort study was conducted on all adults who underwent a self-paid health examination comprising of an abdominal transient elastography inspection using FibroScan 502 Touch from March 2015 to February 2019. FibroScan can assess the level of liver fibrosis by using a liver stiffness score, and the level of liver steatosis by using the controlled attenuation parameter (CAP) score. The logistic regression analysis and receiver operating characteristic curve were applied to select significant predictors and assess their predictability. A final model that included all significant predictors that are found by univariate analysis, and a convenient model that excluded all invasive parameters were created. Results: Of 1983 participants, 13.6% had a physical status that fulfilled MetS criteria. The results showed that the CAP score solely could achieve an area under the curve (AUC) of 0.79 (0.76–0.82) in predicting MetS, and the AUC can be improved to 0.88 (0.85–0.90) in the final model. An AUC of 0.85 (0.83–0.88) in predicting MetS was obtained in the convenient model, which includes only 4 parameters (CAP score, gender, age, and BMI). A panel of predictability indices (the ranges of sensitivity, specificity, positive and negative likelihood ratio: 0.78–0.89, 0.66–0.82, 2.64–4.47, and 0.17–0.26) concerning gender- and BMI-specific CAP cut-off values (range: 191.65–564.95) were presented for practical reference. Conclusions: Two prediction systems were proposed for identifying individuals with a physical status that fulfilled the MetS criteria, and a panel of predictability indices was presented for practical reference. Both systems had moderate predictive performance. The findings suggested that FibroScan evaluation is appropriate as a first-line MetS screening; however, the variation in prediction performance of such systems among groups with varying metabolic derangements warrants further studies in the future.
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