Prevalence and factors associated with Metabolic Syndrome in elderly users of the Unified Health System

Sociodemographic and reproductive risk factors associated with metabolic syndrome in a population of Brazilian women from the city of Ribeirão Preto: a cross-sectional study

Objective

To identify sociodemographic and reproductive risk factors associated with MetS in women in their fourth decade of life.

Methods

Cohort study conducted on women born from June 1978 to May 1979 in Ribeirão Preto, Brazil. Sociodemographic, clinical, and obstetric data were collected by interview and clinical evaluation. Univariable and multivariable binomial logistic regression models were constructed to identify the risk factors of metabolic syndrome and the adjusted relative risk (RR) was calculated.

Results

The cohort included 916 women, and 286 (31.2%) of them have metabolic syndrome. MetS was associated with lack of paid work (RR 1.49; 95% CI 1.14-1.95), marital status of without a partner (RR 1.33; 95% CI 1.03-1.72), low educational level (less than 8 years of schooling [RR 1.72; 95% CI 1.23-2.41], 8 to 12 years of schooling [RR 1.37; 95% CI 1.06-1.76], when compared with more than 12 years of schooling), and teenage pregnancy (RR 2.00; 95% CI 1.45-2.77). There was no association between MetS, and the other covariates studied.

Conclusion

Metabolic syndrome in a population of women in the fourth decade of life was associated with lack of employment, lack of a partner, low educational level, and teenage pregnancy.

Low muscle mass and mortality risk later in life: A 10-year follow-up study

Introduction

Little is known about the impact of low muscle mass (MM) assessed by calf circumference (CC), arm circumference (AC), arm muscle circumference (AMC), and corrected arm muscle circumference (CAMC)—on mortality risk later in life. We aimed to investigate the impact of low MM assessed by CC, AC, AMC and, CAMC on all-cause, cardiovascular, and cancer mortality risk.

Methods

Data came from 418 older adults who participated in a 10-year follow-up prospective cohort study. Low MM was defined as a CC < 33 cm for women and < 34 cm for men and by the lowest tertile of AC, AMC, and CAMC stratified by sex. The log rank test, Kaplan-Meier curves, and Cox regression were used.

Results

There were 147 deaths: 49 related to CVD and 22 to cancer. A small CC (HR = 1.57, 95% CI, 1.12–2.20), AMC (HR = 1.61, 95% CI, 1.13–2.30) and CAMC (HR = 1.45, 95% CI, 1.03–2.04) were associated with all-cause mortality. A small CAMC was a protective factor for CVD mortality (HR = 0.46, 95% CI, 0.22–0.98). In the Kaplan-Meier analysis, older adults with LMM presented low all-cause mortality survival, with AC (p < 0.05), AMC (p < 0.005), CAMC (p < 0.002), and CC (p < 0.001). Cancer mortality was associated with low CAMC (p < 0.020).

Conclusions

Low MM assessed by anthropometric measures (AC, AMC, CAMC and CC) increased the all-cause mortality risk. A small CAMC decreased the CVD mortality.

Metabolic syndrome and its association with changes in modifiable risk factors: Epifloripa aging study

Purpose

To estimate the prevalence of Metabolic Syndrome (MetS) and its association with changes in modifiable risk factors in older adults from southern Brazil.

Methods

A longitudinal study was performed with data from EpiFloripa Aging study. We defined MetS by the existence of three or more of the following risk factors for cardiovascular disease (CVD): waist circumference (WC) (≥ 92 cm in men and ≥ 87 cm in women); fasting glucose (≥100 mg/dl); decreased HDL cholesterol (<40 mg/dl in men and <50 mg/dl in women); hypertriglyceridemia (≥150 mg/dl) and blood pressure (≥130/85 mmHg). We evaluated the changes in modifiable risk factors (smoking, alcohol consumption, fruit and vegetable consumption, physical activity, and body mass index) between the two moments of the study (2009/10 and 2013/14). Directed acyclic graph and logistic regression models were used.

Results

Among the 599 participants, the prevalence of MetS was 64.0% (95% CI, 58.7-68.9). In the adjusted analysis, those who remained or became persons who are overweight (OR = 4.59; 95% CI: 3.05-6.89) and those who remained or became insufficiently active (OR = 1.92; 95% CI: 1.23-2.98) were more likely to present MetS.

Conclusion

Our findings suggest that being or becoming overweight and being or becoming insufficiently active are modifiable factors associated with MetS. These results highlight the need for developing preventive strategies for the observed risk indicators to mitigate the prevalence of MetS in older adults.

Risco cardiovascular aumentado e o papel da síndrome metabólica em idosos hipertensos

RESUMO Objetivo avaliar a síndrome metabólica e o risco cardiovascular de idosos hipertensos atendidos na atenção primária. Métodos estudo transversal realizado com 154 idosos hipertensos de uma Unidade Básica de Saúde do Distrito Federal. Um instrumento estruturado investigou o perfil dos idosos. Para a classificação da síndrome metabólica, consideraram-se os critérios propostos pela National Cholesterol Education Program – Adult Treatment Panel III. Para análise do risco cardiovascular, utilizou-se o escore de risco de Framingham. Foi realizada análise estatística e inferencial com a utilização da ANOVA, teste qui-quadrado e exato de Fisher, além da odds ratio e seu intervalo de confiança de 95% para estimar o risco cardiovascular entre os grupos. Resultados 64,9% dos idosos hipertensos eram obesos. Síndrome metabólica foi evidenciada em 70,8%. Observou-se que 27,2% apresentaram baixo, 46,8% moderado e 26,0% elevado risco cardiovascular, sendo que o sexo feminino e a idade avançada influenciaram negativamente o risco. Idosos com síndrome metabólica apresentaram 7,19 vezes mais chances de terem elevado risco cardiovascular. Considerações finais e implicações para a prática os idosos hipertensos apresentaram uma elevada prevalência de síndrome metabólica que aumentou significativamente o risco cardiovascular. Este resultado possibilita um melhor planejamento da assistência de enfermagem pelo enfermeiro da atenção primária à saúde.

Association between metabolic syndrome and work: an integrative review of the literature

The aim of this study was to highlight the association between occupational aspects and the occurrence of metabolic syndrome among various occupational groups. This is an integrative review of the literature that included articles indexed in the following databases: LILACS, SciELO, PubMed, and CINAHL. We evaluated 32 articles, most of which were published in Englishlanguage medical journals and with level 4 scientific evidence. The occupational aspects most commonly reported as associated with metabolic syndrome were occupation, work shift, and occupational stress. Our results indicated that occupational aspects could negatively interfere with workers' health; more robust longitudinal studies should contribute to further uncovering the reported associations.

Síndrome metabólica em idosos diabéticos tipo 2 atendidos em ambulatório de uma capital brasileira

Objetivo: identificar a prevalência de síndrome metabólica e seus fatores associados em idosos com diabetes mellitus tipo 2. Métodos: estudo descritivo observacional realizado com idosos diagnosticados com diabetes mellitus tipo 2, no período de 2017-2018, recrutados no Ambulatório de Nutrição/Diabetes do Núcleo de Assistência ao Idoso da Universidade Federal de Pernambuco. Foram coletados os dados: sexo e faixa etária e, para a avaliação antropométrica dos participantes, foram mensurados o índice de massa corporal e a circunferência de cintura. Também foram coletados os valores de colesterol total e frações, além de glicemia em jejum, hemoglobina glicosilada e diagnóstico prévio de hipertensão arterial. Para analisar os dados obtidos foram utilizados os testes t de Student, Qui-quadrado de Pearson e teste de MannWhitney. Para as análises, foi adotado um intervalo de confiança de 95% e nível de significância de 0,05. Resultados: a amostra foi de 273 participantes, com média de idade de 68,77±5,65 anos e cerca de 89,8% (n=158) apresentaram síndrome metabólica. A presença dessa condição foi associada a valores maiores de peso corporal (p=0,04), índice de massa corporal (p=0,003), circunferência de cintura (p<0,001) e glicemia em jejum (p=0,007). Conclusões: ocorreu alta prevalência de síndrome metabólica nos idosos estudados com essa condição associada a valores maiores de peso corporal, índice de massa corporal, circunferência de cintura e glicemia em jejum. Esses achados demonstram a importância na identificação precoce e na intervenção preventiva dessas condições na população idosa, diminuindo a morbimortalidade por ocorrência de eventos cardiovasculares e melhorando sua qualidade de vida.

Caveolin-1 (CAV-1) up regulation in metabolic syndrome: all roads leading to the same end

Metabolic syndrome (MS) is a set of clinical conditions such as insulin resistance, hyperglycemia, systemic arterial hypertension (SAH), dyslipidemia, obesity and high abdominal circumference. Some of these clinical characteristics have been associated with caveolin-1, a caveolae structural protein, responsible for insulin activation, storage and degradation of cholesterol, and so on. Herein we assessed CAV-1 mRNA levels in MS patients comparing to healthy controls (HC) and according patients' clinical features. We included 87 patients in the study, 25 patients with MS, 30 patients with at least one clinical condition (diabetes, SAH, dyslipidemia, obesity and high abdominal circumference), 13 with two clinical conditions and 19 HC. CAV-1 mRNA levels from peripheral blood samples were assessed by Real Time qPCR using specific Taqman probe. The analysis was performed using ∆Cq method and the statistical tests Shapiro-Wilk, One-Way ANOVA and Mann-Whitney. We found CAV-1 increased mRNA levels in patients with MS (1.645 FC, p = 9.794 × 10^-20) and even higher in patients with only one or two clinical conditions (2.215 FC, p = 1.215 × 10^-32 and 1.716 FC, p = 4.197 × 10^-05, respectively). When individual clinical conditions were observed, individuals with high abdominal circumference and obesity present a significantly up regulation when compared to HC (2.956 FC, p = 0.0004 and 3.643 FC, p = 0.002, respectively). This work indicates that CAV-1 gene expression from whole blood samples is associated to MS clinical conditions and may become a potential target for MS treatment and prevention.

Factors associated with metabolic syndrome in older adults: a population-based study

OBJECTIVE

To estimate the prevalence of the metabolic syndrome and clusters of its components and to identify possible associated factors in older adults.

METHOD

Cross-sectional and population-based study, involving 271 older people. We collected sociodemographic, behavioral, clinical, biochemical, and anthropometric data. Data were analyzed by descriptive and logistic regression techniques.

RESULTS

The prevalence of metabolic syndrome was 59% and was associated with women, overweight/obesity, and the C-reactive protein. Concerning the clusters, 11.4% of the sample had all the components of the metabolic syndrome, and only 5.2% of individuals did not have any of its components.

CONCLUSION

We found there is a high prevalence of metabolic syndrome and clusters of its components in older adults. It is important to deepen studies on this matter, considering clinical aspects in relation to sex and healthy behavioral habits for creating public policies as well as emphasizing actions aimed at promoting self-care in all cycles of life.

Performance of Anthropometric Indicators in the Prediction of Metabolic Syndrome in the Elderly

Introduction: Studies have demonstrated the relevance of anthropometric indicators in the prediction of metabolic syndrome (MetS). However, researches involving older people are still scarce. Therefore, the objective was to describe the frequency of MetS and to determine the performance of anthropometric indicators as predictors of MetS in the total sample, in men and women. Methods: Cross-sectional study involving 479 elderly individuals attended in primary health care. The revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) guidelines were used for the MetS diagnosis. The anthropometric indicators evaluated were neck circumference, sagittal abdominal diameter (SAD), SAD/height, sagittal index, and conicity index (C-Index). The predictive performance of the MetS anthropometric indicators was determined using a receiver operating characteristic (ROC) curve. A cutoff point >0.700 was used to evaluate diagnostic performance. Results: The frequency of MetS was 60.5%. The anthropometric indicators demonstrating adequate performance were in total sample: SAD/height (auROC = 0.810), SAD (auROC = 0.777), and C-Index (auROC = 0.706); in women: SAD (auROC = 0.820), SAD/height (auROC = 0.810), neck circumference (auROC = 0.782), and C-Index (auROC = 0.727); in men: SAD/height (auROC = 0.768), SAD (auROC = 0.760), and C-Index (auROC = 0.724). Conclusions: A high frequency of MetS was observed. Of the five anthropometric indicators investigated, three presented good performance in the total sample (SAD, SAD/height, and C-Index), four in women (SAD, SAD/height, neck circumference, and C-Index), and three in men (SAD, SAD/height, and C-Index). The anthropometric indicators, SAD, SAD/height, and C-Index, proved to perform adequately in all the three segments investigated.

Frequency of metabolic syndrome and associated factors in institutionalized elderly individuals

INTRODUCTION

Population aging generally accompanies an increase in chronic noncommunicable diseases, such as metabolic syndrome (MS). Nursing homes have provided a solution for the decreased ability of elderly individuals for self-care and familial difficulties in meeting the health care needs of elderly individuals.

PURPOSE

The aim of the present study was to determine the frequency of MS and its associated factors in elderly individuals living in nursing homes.

PATIENTS AND METHODS

This cross-sectional study was conducted with 202 institutionalized elderly individuals. MS was diagnosed according to the National Cholesterol Education Program - Adult Treatment Panel III criteria. Sociodemographic, clinical, and lifestyle factors were assessed to verify their association with MS by logistic regression.

RESULTS

The MS frequency was 29.2%. The most frequent MS components were low high-density lipoprotein cholesterol level (63.9%) and abdominal obesity (42.7%). Factors associated with MS were female sex (prevalence ratio [PR]=2.16; 95% CI, 1.04-4.49), age-adjusted institutionalization time >50% (PR=2.38, 95% CI, 1.46-3.88), and high concentrations of interleukin-6 (PR=2.01; 95% CI, 1.21-3.32) and tumor necrosis factor-α (PR=1.70; 95% CI, 1.05-2.77). Moreover, it was verified that the likelihood of having MS was 1.85-fold higher (95% CI, 1.11-3.10) in the group with a diet characterized by very high energy, very low fat, and high dietary fiber.

CONCLUSION

The occurrence of MS in institutionalized elderly individuals was higher in females, and individuals with longer age-adjusted institutionalization time, higher concentrations of immunologic biomarkers, and a dietary intake consisting of higher energy and fiber and lower total fat. The results of the study are useful for guiding health care programs aimed at institutionalized elderly individuals.

Prevalence of Metabolic Syndrome and Its Associated Factors among Vegetarians in Malaysia

The prevalence and factors associated with metabolic syndrome (MetS) remain unknown in Malaysian vegetarians. This cross-sectional study aimed to determine the prevalence of MetS among vegetarians in Kuala Lumpur and Selangor and its associated factors. The data on socio-demographic characteristics, vegetarianism practises, lifestyle behaviours, body weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), and blood lipid profiles were collected from 273 vegetarians. A majority of the respondents were lacto-ovo vegetarians (44.0%), females (64.8%) and Chinese (54.9%). The prevalence of MetS was 24.2%. High BP (48.7%) and high WC (43.6%) were the most common MetS components. Females had lower WC, SBP, DBP, FBG, TG and higher HDL-c (p < 0.05) as compared to males. Multiple logistic regression analysis showed that being overweight and obese (Odds Ratio (OR) = 7.74, 95% Confidence Interval (CI): 4.04–14.82) was the main risk factor of MetS after being adjusted for sex and age. This study found that one in four vegetarians had MetS. An intervention programme should be developed to reduce Body Mass Index (BMI) among vegetarians, especially among those who are found to be overweight and obese.

Síndrome metabólico y actividad física en adultos mayores de la sierra ecuatoriana

Objetivo Determinar la prevalencia del síndrome metabólico, el nivel de actividad física y la asociación de estos factores en los adultos mayores de la sierra ecuatoriana.Métodos Estudio transversal que evaluó 387 adultos mayores de Cuenca-Ecuador, quienes desearon participar y firmaron el consentimiento informado. El diagnóstico de síndrome metabólico se realizó mediante los criterios del Programa Nacional de Educación sobre el Colesterol y el Panel de Tratamiento del Adulto III, para el valor de la Circunferencia Abdominal se consideró los criterios usados para la población asiática. El nivel de actividad física fue evaluado por la versión corta del Cuestionario Internacional de Actividad Física. Se compararon los grupos con y sin síndrome metabólico mediante el test Chi-cuadrado y el test t de student. El análisis de variancia fue usado para evaluar la asociación entre los componentes del síndrome metabólico y el nivel de actividad física.Resultados La prevalencia de síndrome metabólico fue alta (59,9 %), así como el nivel alto de actividad física (45 %), sin embargo no se evidenció asociación significativa entre el síndrome metabólico y nivel de actividad física.Conclusión Los adultos mayores diagnosticados con síndrome metabólico presentaron el mismo nivel de actividad física que los individuos sin este diagnóstico. Es necesario confirmar los presentes hallazgos usando instrumentos de medición directa de actividad física.

Alcohol Consumption and Metabolic Syndrome Among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos

BACKGROUND

The association between alcohol consumption and metabolic syndrome (MetS) among Hispanic/Latino populations has not been studied in great detail. Our study examined the relationship between alcohol consumption and MetS among U.S. Hispanics/Latinos and explored whether this relationship varied by age, body mass index, gender, and Hispanic/Latino backgrounds.

METHODS

The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a multisite, prospective, population-based, cohort study of Hispanics/Latinos, ages 18-74 years from four U.S. communities. Participants were categorized into never, former, occasional, low, moderate, and high alcohol consumption categories. A cross-sectional analysis of 15,905 participants with complete data was conducted. Survey design appropriate chi-squared and logistic regression models were run to detect significant associations between alcohol consumption categories and cases of MetS.

RESULTS

Almost half (47.4%) of the sample was classified as occasional, low, moderate, or heavy drinkers. Low and moderate alcohol consumers had lower odds of MetS than never drinkers. Low and heavy drinkers had higher odds of presenting with elevated central obesity, while occasional, low, moderate, and heavy drinkers had higher odds of having low high-density lipoprotein cholesterol levels compared to never drinkers. Low and moderate wine drinkers had lower odds of MetS compared to never drinkers. There were no significant findings among beer or liquor drinkers, or with binge drinking after model adjustments.

CONCLUSIONS

Our findings suggest that low and moderate alcohol consumption may lower the odds of MetS in a sample of Hispanic/Latino adults, but that the relationship of alcohol consumption varies with the individual components of MetS.

Metabolic syndrome and its risk factors among middle aged population of Iran, a population based study

AIMS

To determine the prevalence of metabolic syndrome (MS) and its risk factors in a middle-aged population in Iran.

METHODS

The sample was 5190 individuals aged 40-64 years participated in the first phase of the Shahroud eye cohort study. Prevalence of MS was determined in terms of the age and sex. Other variables were evaluated by using simple and multiple logistic regression methods.

RESULTS

The prevalence of MS was 10.88% in men, 13.03% in women and 12.14% in total. The prevalence proportion increased with increasing age. In multivariate logistic regression model, age (odds ratio (OR)=1.06), education (OR=0.98) and smoking (OR=0.50), had significant effects on MS. In this model, gender, marital status and economic status had no significant effect on MS. Higher prevalence of obesity and overweight in non-smokers (79.9%) compare to smokers (47.4%, P<0.001), indicated that the association of smoking and MS is confounded.

CONCLUSIONS

Despite the low prevalence of MS in this study, older age was associated with increased risk of developing MS and higher education was associated with decreased this risk, therefore health education, changing the lifestyle, and taking greater attention in elderly is needed in order to prevent the MS and its complications.