Gender difference in the association of metabolic syndrome and its components with age-related cataract: the Korea National Health and Nutrition Examination Survey 2008-2010

Potential of GJA8 gene variants in predicting age-related cataract: A comparison of supervised machine learning methods

Cataracts are the problems associated with the crystallins proteins of the eye lens. Any perturbation in the conformity of these proteins results in a cataract. Age-related cataract is the most common type among all cataracts as it accounts for almost 80% of cases of senile blindness worldwide. This research study was performed to predict the role of single nucleotide polymorphisms (SNPs) of the GJA8 gene with age-related cataracts in 718 subjects (400 age-related cataract patients and 318 healthy individuals). A comparison of supervised machine learning classification algorithm including logistic regression (LR), random forest (RF) and Artificial Neural Network (ANN) were presented to predict the age-related cataracts. The results indicated that LR is the best for predicting age-related cataracts. This successfully developed model after accounting different genetic and demographic factors to predict cataracts will help in effective disease management and decision-making medical practitioner and experts.

Cardiometabolic syndrome among general adult population in Ghana: The role of lipid accumulation product, waist circumference-triglyceride index, and triglyceride-glucose index as surrogate indicators

Background

Visceral obesity and insulin resistance contribute to developing cardiometabolic syndrome (MetS). We investigated the predictive abilities of lipid accumulation product (LAP), waist circumference-triglyceride index (WTI), and triglyceride-glucose (TyG) index for MetS screening among the general Ghanaian adults.

Methods

The final prospective analysis included 4740 healthy adults aged 30-90 years from three communities comprising Ejisu, Konongo, and Ashanti Akim Agogo in Ghana. Self-structured questionnaire pretested was used to collect sociodemographic, anthropometric, and clinical data. Blood samples were taken after fasting to measure glucose and lipid levels. LAP, WTI, and TyG were calculated from standard equations. MetS was defined by the International Diabetes Federation criteria. Receiver operating characteristic (ROC) curves and multivariable logistic regression were utilized to evaluate the potential of the three indices in identifying MetS.

Results

Of the 4740 participants, 39.7% had MetS. MetS was more common in females (50.3%) than in males (22.2%). Overall, LAP ≥ 27.52 yielded as the best index for MetS with the highest area under the ROC curve (AUC) (0.866). At cut-off LAP point of ≥23.87 in males and ≥33.32 in females, an AUC of 0.951 and 0.790 was identified in MetS prediction, respectively. LAP was an independent risk measure of MetS for both males (45.6-fold) and females (3.7-fold) whereas TyG was an independent risk measure for females (3.7-fold) only.

Conclusions

MetS is increasing among the general adult population. LAP and TyG are important sex-specific risk measures to screen for MetS among the general adult population in our cohort.

The Relationship between Nutrient Intake and Cataracts in the Older Adult Population of Korea

Cataracts are a prevalent ophthalmic disease worldwide, and research on the risk factors for cataracts occurrence is actively being conducted. This study aimed to investigate the relationship between nutrient intake and cataracts in the older adult population in Korea. We analyzed data from Korean adults over the age of 60 years (cataract: 2137, non-cataract: 3497) using the Korean National Health and Nutrition Examination Survey. We performed univariate simple and multiple logistic regressions, adjusting for socio-demographic, medical history, and lifestyle, to identify the associations between nutrient intake and cataracts. A higher intake of vitamin B1 in the male group was associated with a lower incidence of cataracts. A lower intake of polyunsaturated fatty acids and vitamin A, and a higher intake of vitamin B2 in the female group were associated with a higher incidence of cataracts. Our study demonstrated that polyunsaturated fatty acids, vitamin A, and vitamin B2 could affect the incidence of cataracts according to sex. The findings could be used to control nutrient intake for cataract prevention.

Correlation of uric acid with body mass index based on NHANES 2013-2018 data: A cross-sectional study

Clinical investigation of obesity-related risk factors aids in the early detection, prevention, and management of obesity. We aimed to examine the association between obesity and serum uric acid (sUA). A cross-sectional study was conducted including 18473 subjects from the National Health and Nutrition Examination Survey (NHANES). The exposure and outcome variables were sUA and body mass index (BMI), respectively. The weighted multivariate linear regression models and smooth curve fittings were conducted to assess the association between sUA and BMI. There were significantly positive correlations between sUA and BMI in both males and females (β = 1.414, 95% CI: 1.323-1.505, P < .0001, β = 1.853, 95% CI: 1.740-1.966, P < .0001, respectively). Furthermore, individuals in the higher sUA quartiles had higher BMI than those in the lowest quartile in both males and females. Subgroup analyses were stratified by race/ethnicity, results indicated the positive association of sUA with BMI in males remained in all races including Mexican American (β = 1.203, 95% CI: 0.965-1.442, P < .0001), other Hispanic (β = 1.126, 95% CI: 0.858-1.395, P < .0001), non-Hispanic White (β = 1.493, 95% CI: 1.343-1.642, P < .0001), non-Hispanic Black (β = 1.331, 95% CI: 1.122-1.540, P < .0001), and other races (β = 1.329, 95% CI: 1.115-1.544, P < .0001). And the positive association of sUA with BMI in females also remained in all races including Mexican American (β = 1.806, 95% CI: 1.520-2.092, P < .0001), other Hispanic (β = 2.033, 95% CI: 1.687-2.379, P < .0001), non-Hispanic White (β = 1.847, 95% CI: 1.657-2.037, P < .0001), non-Hispanic Black (β = 2.141, 95% CI: 1.874-2.408, P < .0001), and other races (β = 1.348, 95% CI: 1.081-1.615, P < .0001). The current cross-sectional study with 18473 US participants found that an elevated sUA was positively correlated with a higher BMI in males, females, and all kinds of races.

Epidemiology of metabolic syndrome in Tunisia. HSHS 5 study

OBJECTIVE

To measure the prevalence of metabolic syndrome and its components in the HSHS cohort (Hammam Sousse, Tunisia), in 2009, and to identify its determining factors.

METHODS

This was a descriptive epidemiological study of the "community based" type having focused on a random sample of people aged 20 and over. The metabolic syndrome was defined according to the criteria of the "International Diabetes Federation" (IDF 2005) and those of the "National Cholesterol Education Program-Adult Treatment Panel III" (NCEP-ATP III, 2001).

RESULTS

The study involved 1441 people including 960 women (66.6%). The age- and sex-adjusted prevalences of increased waist circumference, blood pressure, blood sugar and triglycerides, and decreased HDL-cholesterol were respectively 63.2%, 95%CI[62.5-63.8]; 47.7%, 95%CI[47.4-48.6]; 25.7%, 95%CI[25.1-26.2]; 11.9%, 95%CI[11.4-12.3] and 65,6%, 95%CI[65.0-66.2], according to IDF thresholds and 37.4%, 95%CI[36.3-37.6]; 45.7%, 95%CI[45.4-46.6]; 13.8%, 95%CI[13.4-14.2]; 8.4%, 95%CI[8.0-8.7] and 61.9%, 95%CI[61.2-62.5], according to those of the NCEP-ATP III. The prevalence of metabolic syndrome adjusted for age and sex was 36.5% 95%CI[33.0%-38.9%] according to the IDF definition and 23.0% 95%CI[20.4%-25.6%] according to that of NCEP-ATP III. The multivariate study by logistic regression made it possible to retain three significant independent determining factors of the metabolic syndrome: age ≥40 years, low level of physical activity and family history of diabetes mellitus with respectively adjusted ORs of 3.77 95%CI[2.70-5.27], 1.39 95%CI[1.01-1.89], 1.62 95%CI[1.21-2.15], according to IDF and 5.87 95%CI[3.88 -8.88], 1.47 95%CI[1.07-2.01] and 1.45 95%CI[1.07-1.96], according to NCEP-ATP III .

CONCLUSION

With this high prevalence rate of the metabolic syndrome, the establishment of an action plan would be essential. This plan should be based on the combination of the promotion of physical activity and screening for the components of the metabolic syndrome, particularly in subjects aged 40 or over, with a family history of diabetes mellitus.

Metabolic Syndrome Is Associated with Cataract in a Large Taiwanese Population Study

Cataract is the leading cause of blindness worldwide, and metabolic syndrome (MetS) is a known risk factor. In this study, we investigated the association between the risk of cataract with MetS and its components in a large-scale study. Data were derived from the Taiwan Biobank, and 121,380 individuals were included. The NCEP-ATP III criteria modified for use in an Asian population were used to define MetS and its components. The occurrence of cataract was identified through a standardized interview and self-reported questionnaire. Multivariable analysis showed that MetS (OR, 1.129; 95% CI, 1.0175−1.184; p < 0.001), low high-density lipoprotein (HDL)-cholesterol (OR, 1.057; 95% CI, 1.005−1.113; p = 0.032), and hyperglycemia (OR, 1.162; 95% CI, 1.108−1.218; p < 0.001) were significantly associated with cataract. Furthermore, a stepwise increase in the prevalence of cataract corresponding to the number of MetS components was found. The presence of three MetS components (vs. 0; OR, 1.103; 95% CI, 1.024−1.188; p = 0.010), four MetS components (vs. 0; OR, 1.137; 95% CI, 1.040−1.242; p = 0.005), and five MetS components (vs. 0; OR, 1.208; 95% CI, 1.059−1.378; p = 0.005) were significantly associated with cataract. In conclusion, significant associations were found between a high incidence of cataract with MetS and its components, including low HDL-cholesterolemia and hyperglycemia. Further, a stepwise increase in the prevalence of cataract corresponding to the number of MetS components was also found. The results of this study indicate that MetS may increase the development of cataract in Taiwan.

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.

Prevalence of cataract and cataract surgery in urban and rural Chinese populations over 50 years old: a systematic review and Meta-analysis

AIM

To summarize the data of epidemiological studies on cataract prevalence over 50 years old in urban and rural areas of China from 2000 to 2020, and to analyze the prevalence of cataract and operation rate in China.

METHODS

By searching PubMed, EMBASE, Web of Science, Wanfang Data and CNKI, Chinese and English literatures on the prevalence of cataract in China were retrieved, and the relevant characteristic data were extracted. Then, Stata v15SE software was used for Meta-analysis and heterogeneity test. According to the results of heterogeneity, the corresponding effect models were selected to combine the extracted data.

RESULTS

A total of 20 studies were included in this study, with a total of 111 434 cases. Meta-analysis showed heterogeneity. According to the random effect model, the overall prevalence of cataract in Chinese people over 50 years old was 27.45%, that in rural was 28.79%, and that in urban was 26.66%. The overall coverage rate of cataract surgery was 9.19%.

CONCLUSION

The prevalence of cataract is high in China, and there is still room for improvement in surgical coverage, so it is very important to promote cataract screening and prevention.

FACTORS ASSOCIATED WITH PREVALENT LENS OPACITIES IN CHINESE AMERICAN ADULTS: THE CHINESE AMERICAN EYE STUDY

PURPOSE

To identify risk factors associated with lens opacities in Chinese Americans.

METHODS

A cross-sectional population-based study of 4,582 Chinese Americans ≥50 years residing in Monterey Park, California. Participants completed a comprehensive clinical examination with lens assessment using the Lens Opacities Classification System II, with lens opacities defined by a grade ≥2 in either eye. Participants were considered to have nuclear-only, cortical-only, or posterior subcapsular (PSC)-only if that was the only type of opacity present in both eyes.

RESULTS

Cortical-only opacity was associated with older age, diabetes mellitus (OR 1.5, 95%CI 1.1-2.1), and family history of cataracts (OR 1.5, 95%CI 1.2-1.9). Nuclear-only opacity was associated with older age, diabetes mellitus (OR 1.4, 95%CI 1.1-1.9), greater waist-to-hip ratio (OR 1.2, 95%CI 1.1-1.4), and high-density lipoprotein (OR 1.1, 95%CI 1.02-1.2). Mixed-type opacities were associated with older age, greater waist-to-hip ratio (OR 1.3, 95%CI 1.1-1.6), and higher HbA1 c (OR 1.3, 95%CI 1.1-1.4). Taller height (OR 0.7, 95%CI 0.6-0.8), greater weight (OR 0.98, 95%CI 0.97-0.99), and higher diastolic pressure (OR 0.98, 95%CI 0.96-0.99) were protective.

CONCLUSION

CHES identified a strong, dose-response association between age and all types of prevalent lens opacities, which suggests an increasing cataract burden in Chinese Americans based on aging populations. CHES results demonstrate general consistency with previous population-based studies in regard to more sedentary lifestyle exposures (e.g., Westernized lifestyle) and prevalent cortical-only, nuclear-only, and mixed-type opacities, yet also identified further sedentary lifestyle exposures associated with prevalent lens opacities. Improved glycemic control and a more active lifestyle that minimizes factors contributing to metabolic syndrome may help reduce the burden of vision loss associated with lens opacities.

High-Density Lipoprotein Cholesterol in Age-Related Ocular Diseases

There is limited understanding of the specific role of high-density lipoprotein cholesterol (HDL-C) in the development of various age-related ocular diseases, despite it being a common measurable biomarker in lipid profiles. This literature review summarizes current knowledge of the role of HDL-C, if any, in pathogenesis and progression of four age-related ocular diseases, namely age-related macular degeneration (AMD), age-related cataract, glaucoma, and diabetic retinopathy (DR), and will primarily discuss epidemiological and genetic evidence.

Global and regional prevalence of age-related cataract: a comprehensive systematic review and meta-analysis

The aim of our study was to estimate regional and global cataract prevalence, its prevalence in different age groups, and the determinants of heterogeneity and its prevalence. For that, we used international databases such as PubMed, Web of Science, Scopus, Embase, and other sources of information to conduct a systematic search for all articles concerning the prevalence of age-related cataract and its types in different age groups. Of the 9922 identified articles, 45 studies with a sample size of 161,947 were included in the analysis, and most of them were from the Office for the Western Pacific Region (19 studies). Age- standardized pooled prevalence estimate (ASPPE) and 95% confidence interval (95% CI) of any cataract, cortical cataract, nuclear cataract, and posterior subcapsular (PSC) cataract were 17.20% (13.39-21.01), 8.05% (4.79-11.31), 8.22% (4.93-11.52), and 2.24% (1.41-3.07), respectively. Significant effects on heterogeneity were observed for the WHO region in the prevalence of any cataract (b: 6.30; p: 0.005) and study year in the prevalence of nuclear cataract (b: -0.66, p: 0.042). In general, the prevalence of cataract not only varies by region but also by age group, and most cases are over the age of 60 years. We examined the sources of variance in the prevalence of cataract and its different types, and identified age as a responsible factor in the prevalence of any cataract, cortical cataract, nuclear cataract, and PSC of cataract, WHO region in the prevalence of any cataract, and study year in the prevalence of nuclear cataract.

Women with Metabolic Syndrome and General Obesity Are at a Higher Risk for Significant Hyperuricemia Compared to Men

Hyperuricemia is an emerging potential biomarker for metabolic syndrome (MetS) and its complications. This study aimed to investigate the risk factors of hyperuricemia, particularly, the association of hyperuricemia with MetS and general obesity according to sex. We performed multivariate logistic regression analyses using the 2016 Korean National Health and Nutrition Examination Survey data. Hyperuricemia was defined by a serum uric acid level ≥7.0 mg/dL for men and ≥6.0 mg/dL for women. General obesity was based on a body mass index (BMI) ≥25 kg/m². Among a total of 5591 Korean adult participants, 685 (12.3%) individuals had hyperuricemia. Hyperuricemia was significantly associated with MetS in men (odds ratio (OR): 2.38, 95% CI: 1.84–3.08) and in women (OR: 4.15, 95% CI: 2.75–6.28) after adjustments. General obesity was also independently related to hyperuricemia in both sexes (OR: 2.17, 95% CI: 1.76–2.68 in men, OR: 3.80, 95% CI: 2.82–5.12 in women). In subgroup analyses, the presence of concomitant MetS and general obesity posed a strikingly higher risk for hyperuricemia among women (OR: 7.24, 95% CI: 4.56–11.50) when compared to men (OR: 2.90, 95% CI: 2.12–3.96). More attention should be paid to the increased risk of hyperuricemia for females with both MetS and general obesity.

Metabolic syndrome and some of its components in relation to risk of cataract extraction. A prospective cohort study of men

PURPOSE

To evaluate the relationship between metabolic syndrome and some of its components with the incidence of cataract extraction.

METHODS

A population-based prospective cohort with a total of 45 049 men, aged 45-79 years, from the Cohort of Swedish Men completed in 1997 a self-administered questionnaire concerning anthropometric measurements and lifestyle factors. The men were followed from 1 January 1998 through 31 December 2012, and the cohort was matched with registers of cataract extraction. The main outcome measure was incident cases of age-related cataract extraction.

RESULTS

Over the 15-years of follow-up, 7573 incident cases of cataract extraction were identified. After controlling for potential confounders, the association between single components of metabolic syndrome, abdominal adiposity, diabetes and hypertension and risk of cataract extraction was rate ratio (RR): 1.04; 95% confidence interval (CI): 0.99-1.10, RR: 1.77; 95% CI: 1.64-1.92 and RR: 1.06; 95% CI 1.00-1.13, respectively. The risk of cataract extraction increased with increasing numbers of metabolic syndrome components (p < 0.0001). Men aged 65 years or younger at baseline with all three components of the metabolic syndrome had a relative risk of 2.43 (95% CI: 1.95-3.01) for cataract extraction.

CONCLUSION

In this cohort of middle-aged and elderly men, metabolic syndrome with the combination of abdominal adiposity, diabetes and hypertension was associated with an increased risk for cataract extraction, especially among men aged 65 years or younger. These findings put emphasis on the importance of weight control and healthy lifestyle behaviours in order to prevent cataract.

Income and Education are Independently Associated with Visual Impairment: The Korean National Health and Nutrition Examination Survey 2010-2012

Purpose: To investigate the association of visual impairment (VI) with socioeconomic status, including the highest educational level and household income when other confounding variables were adjusted. Methods: The Korean National Health and Nutrition Examination Survey 2010-2012 data were analyzed. The final analyses included a total of 16,905 subjects with their demographic, socioeconomic, and health data. The socioeconomic data included the household income and the highest educational level. Household income was categorized into quartiles. The educational attainment was categorized as ≤ elementary school, middle school, high school, and ≥ university. VI was defined when the distance-corrected VA was worse than 0.32 (20/63 Snellen) in the better-seeing eye according to the definition of the World Health Organization. Four multiple logistic regression models were used to determine the odds ratio (OR) and 95% confidence interval (CI) between VI and household income or between VI and the highest educational level, by adjusting for several confounding variables. Results: The prevalence of VI was 5.0% (844 subjects). Multiple logistic regression analyses indicated that the adjusted OR was 1.729 (95% CI: 1.108-2.697) for developing VI in subjects with ≤ elementary school as their highest education level compared to those with ≥ university education. Also, the adjusted OR of subjects in the first quartile of household income was 1.502 (95% CI: 1.061-2.127) for developing VI compared to those in the fourth quartile of household income. Conclusions: The present study showed that household income and education were independently associated with VI even after adjusting for significant confounding variables.

Comparison of medical comorbidity between patients with primary angle-closure glaucoma and a control cohort: a population-based study from Taiwan

OBJECTIVE

To determine the prevalence and risk of systemic comorbidities in primary angle-closure glaucoma in Taiwan population.

METHODS

We included 3322 primary angle-closure glaucoma (PACG) subjects and randomly selected patients without PACG from the Taiwan National Health Insurance Research Database and frequency matched four of them (n=13 288) to each PACG patient, based on age and sex. The univariable and multivariable unconditional logistic regression models were used to estimate the effect of comorbidities on the risk of PACG as indicated by the OR with 95% CI.

RESULTS

The mean age of the PACG group was 65.2±12.7 years, and 61.1% of the patients were female. The risk of PACG was greater for patients with the comorbidities of hyperlipidaemia (ORs: 1.11), headaches (ORs: 1.13), liver diseases (ORs: 1.14), peptic ulcers (ORs: 1.10) and cataract (ORs: 3.80). For the male group, diabetes (ORs: 1.19), liver diseases (ORs: 1.29) and cataract (ORs: 4.30) were significantly associated with increasing PACG risk. For the female group, hyperlipidaemia (ORs: 1.13), headaches (ORs: 1.15), peptic ulcers (ORs: 1.14) and cataract (ORs: 3.54) were significantly associated with increasing PACG risk. For the age group of 64 years and younger, patients with comorbidity of hyperlipidaemia (ORs: 1.20), peptic ulcers (ORs: 1.21) and cataract (ORs: 5.91) were significantly associated with increasing PACG risk. For the age group of 65 years and older, patients with cataract were significantly associated with increasing PACG risk (ORs: 5.07).

CONCLUSIONS

Clinicians should be aware of slightly increased PACG risk in the subjects with the medical comorbidities of hyperlipidaemia, headaches, liver diseases and peptic ulcers. However, cataract is the strongest risk factor of PACG.

Association between Blepharoptosis and Pterygium in Korea: A Population-Based Study during 2010-2012

PURPOSE

To investigate possible correlations between blepharoptosis and pterygium in a nationally representative sample of the Korean population.

METHODS

This population-based, cross-sectional study was comprised of 3,685 males and 4,792 females (≥ 19 years of age) participating in the fifth annual Korea National Health and Nutrition Examination Survey (KNHANES) from 2010 to 2012. The enrolled subjects underwent interviews, clinical examinations, and laboratory tests. Statistical tests were used to compare the prevalence of blepharoptosis, according to pterygium subtypes or pterygium existence. Multiple logistic regression analyses were also used to find the associations of blepharoptosis with pterygium.

RESULTS

Pterygium was present in 10.3% of males and 9.8% of females. The odds ratios (ORs) of pterygium in Korean males significantly decreased as the severity of blepharoptosis increased (p for trend = 0.0252). Using three models in multivariate analyses, males with blepharoptosis had an OR (95% confidence interval, (CI)) of 0.643 (0.435 ~ 0.951) for pterygium compared with males with no blepharoptosis, after adjusting for age, body mass index, smoking status, alcohol consumption, physical activity, serum vitamin D levels, diabetes mellitus, metabolic syndrome, high blood pressure, and stress intolerance. There was no significant association between blepharoptosis and females.

CONCLUSIONS

The association between blepharoptosis and pterygium in the Korean population showed a gender difference. Epidemiologic evidence only showed a negative correlation between blepharoptosis and pterygium in Korean males. Further studies are needed, therefore, to examine the sex difference in the pathogenesis of pterygium.

Association between serum lipids concentration and patients with age-related cataract in China: a cross-sectional, case-control study

OBJECTIVE

Obesity and a high-fat diet have been found to be associated with an increased risk of age-related cataract (ARC). Thus, this study aimed to investigate whether serum lipid levels are associated with the incidence of ARC.

DESIGN

Cross-sectional, case-control study.

SETTING

EyeandENT Hospital of Fudan University, Shanghai, China.

PARTICIPANTS

A total of 219 ARC (male=94, female=125) subjects and 218 (male=110, female=118) normal control subjects were recruited in this study.

OUTCOME MEASURES

A detailed eye and systematic examination was performed. Serum high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and cholesterol (CHO) levels were measured by enzymatic colorimetry, and serum apolipoprotein A (APOA) and apoB (APOB) levels were measured by immunoturbidimetry. The subgroups were classified according to gender and types of disease (cortical, nuclear and posterior subcapsular cataract). Logistic regression analyses were performed to identify the association between serum lipid levels and ARC.

RESULTS

The serum LDL-C, TG, CHO and APOA levels were significantly higher (p<0.05) in the ARC group than in the control group. A similar result was observed when the serum lipid concentrations were compared between the ARC and control groups both in male and female subgroups. A higher proportion of individuals in the ARC group had higher LDL-C, TG, CHO and APOA levels (fold=3.45, 17.37, 3.27 and11.91, respectively; p<0.0001 in all cases) than in the control group. Results of the logistic regression analyses revealed that high LDL-C (ORs=1.897, 95% CI 0.960 to 3.678) and TG (OR=1.854, 95% CI 1.232 to 2.791) were the independent risk factors for ARC.

CONCLUSION

The serum LDL-C and TG levels were demonstrated to be independent risk factors for ARC.

Prevalence of metabolic syndrome in Mainland China: a meta-analysis of published studies

Background

Metabolic syndrome (MS) comprises a set of conditions that are risk factors for cardiovascular diseases and diabetes. Numerous epidemiological studies on MS have been conducted, but there has not been a systematic analysis of the prevalence of MS in the Chinese population. Therefore, the aim of this study was to estimate the pooled prevalence of MS among subjects in Mainland China.

Methods

We performed a systematic review by searching both English and Chinese literature databases. Random or fixed effects models were used to summarize the prevalence of MS according to statistical tests for heterogeneity. Subgroup, sensitivity, and meta-regression analyses were performed to address heterogeneity. Publication bias was evaluated using Egger’s test.

Results

Thirty-five papers were included in the meta-analysis, with a total population of 226,653 Chinese subjects. Among subjects aged 15 years and older, the pooled prevalence was 24.5 % (95 % CI: 22.0–26.9 %). By sex, the prevalences were 19.2 % (95 % CI: 16.9–21.6 %) in males and 27.0 % (95 % CI: 23.5–30.5 %) in females. The pooled prevalence of MS increased with age (15–39 years: 13.9 %; 40–59 years: 26.4 %; and ≥60 years: 32.4 %). Individuals living in urban areas (24.9 %, 95 % CI: 18.5–31.3 %) were more likely to suffer from MS than those living in rural areas (19.2 %, 95 % CI: 14.8–23.7 %). Hypertension was the most prevalent component of MS in males (52.8 %), while the most prevalent component of MS for females was central obesity (46.1 %).

Conclusions

Our systematic review suggested a high prevalence of MS among subjects in Mainland China, indicating that MS is a serious public health problem. Therefore, more attention should be paid to the prevention and control of MS.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-2870-y) contains supplementary material, which is available to authorized users.

Postprandial dietary fatty acids exert divergent inflammatory responses in retinal-pigmented epithelium cells

Postprandial triglyceride-rich lipoproteins (TRLs) lead to a complex series of events that are potentially oxidative and inflammatory.

An Overview of Ophthalmologic Survey Methodology in the 2008-2015 Korean National Health and Nutrition Examination Surveys

The Korea National Health and Nutrition Examination Survey (KNHANES) is a national program designed to assess the health and nutritional status of the noninstitutionalized population of South Korea. The KNHANES was initiated in 1998 and has been conducted annually since 2007. Starting in the latter half of 2008, ophthalmologic examinations were included in the survey in order to investigate the prevalence and risk factors of common eye diseases such as visual impairment, refractive errors, strabismus, blepharoptosis, cataract, pterygium, diabetic retinopathy, age-related macular degeneration, glaucoma, dry eye disease, and color vision deficiency. The measurements included in the ophthalmic questionnaire and examination methods were modified in the KNHANES IV, V, and VI. In this article, we provide detailed information about the methodology of the ophthalmic examinations in KNHANES in order to aid in further investigations related to major eye diseases in South Korea.

Metabolic Syndrome and Chronic Laryngitis: The Korean National Health and Nutrition Examination Survey 2008 to 2010

Metabolic syndrome (MetS) is associated with a higher risk of morbidity and/or mortality for various chronic diseases. The aim of this study was to investigate the relationship of chronic laryngitis (CL) with MetS and its components in a representative Korean population.Data from the Korean National Health and Nutrition Examination Survey (2008-2010) were analyzed. A total of 10,360 adults who had undergone otolaryngological examination were evaluated.The prevalence of CL in the study population was 3.1%. The prevalence of MetS was significantly higher in patients with CL than in those without CL for both sexes (men: 34.7 ± 4.0% versus 25.9 ± 0.8%, P = 0.0235; women: 40.6 ± 5.3% versus 23.7 ± 0.7%, P = 0.0003). Elevated fasting glucose, triglycerides, and blood pressure, however, were only significantly associated with CL in women. After controlling for confounders, CL was only significantly associated with MetS in women (odds ratio: 2.159; 95% confidence interval: 1.2974, 3.594). Furthermore, the association between CL and MetS was most robust in women who were classified as obese.In Korea, MetS and its components are significantly associated with CL in women.

Obesity as a Potential Risk Factor for Blepharoptosis: The Korea National Health and Nutrition Examination Survey 2008-2010

Purpose

To examine obesity parameters as potential risk factors associated with blepharoptosis in a representative Korean population.

Methods

We analyzed the Korea National Health and Nutrition Examination Survey (KNHANES), conducted between 2008 and 2010. 10,285 Korean adults (4,441 men and 5,844 women) aged 40 years or older was enrolled. We compared body mass index (BMI), waist circumference (WC) and percentage body fat (BF), according to the severity of blepharoptosis. Multiple logistic regression analysis was conducted to examine the associations of each obesity parameter with blepharoptosis.

Results

The overall prevalence of age-related blepharoptosis was 14.8 % in South Korea. There were significant and graded associations between increasing blepharoptosis severity and the mean value of obesity parameters (P for trend < 0.05). As marginal reflex distance 1 (MRD1) decreased, the prevalence of general obesity and overweight status increased (P for trend=0.121 in men and < 0.001 in women); the prevalence of abdominal obesity increased (P for trend < 0.001 for both genders); the prevalence of highest quartile of percentage BF increased (P for trend ≤0.001 for both genders). Blepharoptosis was significantly associated with general obesity in women (adjusted odds ratio (aOR), 2.14; 95% confidence intervals (CI), 1.32-3.47); and with the highest quartile of percentage BF in men (aOR, 2.01; 95% CI, 1.34-2.97) and in women (aOR, 1.52; 95% CI, 1.06-2.3317, after adjusting for age, smoking exercise, drinking alcohol, total energy intake, fat intake, total cholesterol, and high density lipoprotein cholesterol, diabetes, hypertension, and family history of eye disease.

Conclusions

The etiology of age-related blepharoptosis may be multifactorial and is unclear. Our results suggest that obesity parameters such as BMI, WC and percentage BF might be potential risk factors for age-related blepharoptosis in a representative Korean population.

Metabolic syndrome: a common problem among office workers

Background:

Metabolic syndrome (MSx) is associated with several health problems. Workers are an important part of any organization.

Objective:

To determine the prevalence of MSx and related variables among office workers.

Methods:

This cross-sectional study evaluated 1488 office workers in Qom province, Central Iran, by using a multi-stage cluster sampling. Diagnosis of MSx was based on blood HDL-cholesterol, triglyceride, and fasting blood sugar (FBS) levels and waist circumference, and blood pressure.

Results:

The overall prevalence of MSx was 35.9% (95% CI 33.5% to 38.3%), higher in men (37.2%) than in women (20.6%), and increased with age. The most common laboratory findings of MSx were hypertriglyceridemia (45.9%) and low HDL-cholesterol level (45.5%). Office workers with MSx had a significantly (p<0.001) higher body mass index than those without MSx. Lack of regular leisure time physical activity (p=0.003), and low intake of fruits (p=0.02) were associated with MSx.

Conclusion:

The prevalence of MSx was very high among office workers. Workplace health improvement programs through identifying and preventing MSx are necessary for improvement of staff's health.

Hemoglobin and Ferritin Concentrations in Subjects with Metabolic Syndrome

BACKGROUND

Metabolic syndrome (MetS), a clinical condition characterized by insulin resistance, glucose intolerance, dyslipidemia, hypertension, and obesity, has been linked with raised levels of serum ferritin (Sfr) concentrations.

OBJECTIVES

This study was carried out to compare hemoglobin (Hb) and Sfr concentrations in patients with MetS, regular donors and first-time donors.

MATERIALS AND METHODS

A total of 102 subjects who were between 18 and 60 years were enrolled for the study. They were divided into three groups. The first group (n = 20) was made up of 5 males and 15 females, all who met the criteria that define MetS. The second group (n = 52; M = 34, F = 18) were regular donors, while the last group (n = 30; M = 16, F = 14) were first-time donors or those who had not donated before. Following an overnight fast, 20 mL of venous blood was drawn from each subject. About 5 mL of this was put into sodium ethylenediaminetetraacetate (EDTA) specimen bottles for the full blood count parameters with Sysmex KX-21N hematology analyzer (made in Japan). The remaining 15 mL had serum separated for Sfr assay using enzyme-linked immunosorbent assay (ELISA) with a commercial assay kit manufactured by Teco Diagnostics.

RESULTS

Significant difference was found in the mean Sfr concentration of subjects with MetS (163 ± 136.92 ng/mL) and regular donors (41.46 ± 40.33 ng/mL), P = 0.001. The mean Sfr concentrations of subjects with MetS (163 ± 136.92 ng/mL) were also higher than that of first-time donors (102.46 ± 80.26 ng/mL), but it was not statistically significant, P = 0.053. The Hb concentrations of the three groups were not significantly different.

CONCLUSION

Sfr concentrations of regular donors were lower than that of subjects with MetS and first-time donors. The difference between regular donors and subjects with MetS was statistically significant. However, there is no significant difference in the Hb concentrations in the three groups. MetS is not associated with anemia or hyperferritinemia.

Risk factors for falls among seniors: implications of gender

Despite extensive literature on falls among seniors, little is known about gender-specific risk factors. To determine the prevalence of falls by gender and sociodemographic, lifestyle/behavioral, and medical factors, we conducted a cross-sectional study in a nationally representative sample of Canadian adults who were 65 years of age or older (n = 14,881) from the Canadian Community Health Survey-Healthy Aging (2008-2009). Logistic regression models were applied to investigate gender-specific associations between potential risk factors and falls. In men, stroke (odds ratio (OR) = 1.91), nutritional risk (OR = 1.86), post-secondary school degree (OR = 1.68), eye disorder (OR = 1.35), widowed/separated/divorced marital status (OR = 1.28), and arthritis (OR = 1.27) were independently associated with significantly higher odds of falls. In women, significant independent correlates of falls included stroke (OR = 1.53), age of 85 years or older (OR = 1.51), nutritional risk (OR = 1.39), consumption of at least 1 alcoholic drink per week (OR = 1.39), use of 5 or more medications (OR = 1.36), arthritis (OR = 1.36), diabetes (OR = 1.31), and osteoporosis (OR = 1.22). Higher physical activity levels were protective in both genders, and higher household income was protective in women. Gender should be considered when planning fall prevention strategies.

Age- and sex-specific relationships between household income, education, and diabetes mellitus in Korean adults: the Korea National Health and Nutrition Examination Survey, 2008-2010

Background

To investigate the effects of age and sex on the relationship between socioeconomic status (SES) and the prevalence and control status of diabetes mellitus (DM) in Korean adults.

Methods

Data came from 16,175 adults (6,951 men and 9,227 women) over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level. The adjusted odds ratios (ORs) and corresponding 95% confidence intervals (95% CI) for the prevalence or control status of diabetes were calculated using multiple logistic regression analyses across household income quartiles and education levels.

Results

The household income-DM and education level-DM relationships were significant in younger age groups for both men and women. The adjusted ORs and 95% CI for diabetes were 1.51 (0.97, 2.34) and 2.28 (1.29, 4.02) for the lowest vs. highest quartiles of household income and education level, respectively, in women younger than 65 years of age (both P for linear trend < 0.05 with Bonferroni adjustment). The adjusted OR and 95% CI for diabetes was 2.28 (1.53, 3.39) for the lowest vs. highest quartile of household income in men younger than 65 (P for linear trend < 0.05 with Bonferroni adjustment). However, in men and women older than 65, no associations were found between SES and the prevalence of DM. No significant association between SES and the status of glycemic control was detected.

Conclusions

We found age- and sex-specific differences in the relationship of household income and education with the prevalence of DM in Korea. DM preventive care is needed for groups with a low SES, particularly in young or middle-aged populations.