Metabolic syndrome in the rural population of wardha, central India: an exploratory factor analysis

Factor Analysis of Metabolic Syndrome Components in a Population-Based Study in the South of Iran (PERSIAN Kharameh Cohort Study)

Background:

We aimed to estimate the exploratory factor analysis (EFA) of metabolic syndrome components based on variables including gender, BMI, and age groups in a population-based study with large sample size.

Methods:

This study was conducted on 10663 individuals 40-70 yr old in Phase 1 of the Persian Kharameh cohort study conducted in 2014–2017. EFA of the metabolic syndrome components, including waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), high-density lipoprotein (HDL) and fasting blood sugar (FBS), was performed on all participants by gender, BMI (Body Mass Index), and age groups.

Results:

EFA results in the whole population based on eigenvalues greater than one showed two factors explaining 56.06% of the total variance. Considering factor loadings higher than 0.3, the first factor included: DBP, SBP, and WC, named as hypertension factor. The second factor also included TG, negative-loaded HDL, FBS, and WC, named as lipid factor. Almost similar patterns were extracted based on subgroups.

Conclusion:

MetS is a multi-factorial syndrome. Both blood pressure and lipid had a central role in this study and obesity was an important factor in both ones. Hypertension, having the highest factor loading, can generally be a valuable screening parameter for cardiovascular and metabolic risk assessment.

Prevalence of metabolic syndrome and its associated risk factors among staffs in a Malaysian public university

Public health systems are concerned with the commensurate rise of metabolic syndrome (MetS) incidence across populations worldwide, due to its tendency to amplify greater risk of diabetes and cardiovascular diseases within communities. This study aimed to determine the prevalence of MetS and its associated risk factors among staffs in a Malaysian public university. A cross-sectional study was conducted among 538 staffs from the Universiti Kebangsaan Malaysia (UKM) between April and June 2019. MetS was defined according to JIS "Harmonized" criteria. A questionnaire that consisted of items on socio-demographics, lifestyle risk behaviors and personal medical history information was administered to participants. Subsequently, a series of physical examination and biochemical assessment was conducted at the hall or foyer of selected faculties in the university. Descriptive and inferential statistics were conducted using SPSS version 22.0. Multivariate models were yielded to determine the risk factors associated with MetS. Statistical significance was set at P < 0.05. The overall prevalence of MetS was 20.6%, with men having greater prevalence than women (24.9% vs. 18.3%). Prevalence of MetS increased with age. Factors contributed to MetS in the overall sample were BMI, hypertension, diabetes and physical activity of moderate intensity. Diabetes and hypertension were significantly associated with MetS in men, whereas BMI, diabetes and hyperlipidemia were significantly associated with MetS in women. Lifestyle behaviors and cardio-metabolic risk factors were associated with MetS for the overall sample, and across genders.

Prevalence of metabolic syndrome among adult population in India: A systematic review and meta-analysis

OBJECTIVE

This review was done to determine the prevalence of metabolic syndrome (MS) among adult general population in India. We also wanted to find the gender, setting, and region-wide distribution of MS in India.

METHODS

We conducted systematic searches in various databases including Medline, ScienceDirect, Cochrane library and Google Scholar from inception until August 2019. We included studies conducted in India reporting the prevalence of MS among adults aged 18 years or more. We used the Newcastle Ottawa scale to assess the quality of included studies. We carried out a meta-analysis with random-effects model and reported pooled prevalence with 95% confidence intervals (CIs). We used the Funnel plot to assess publication biases.

RESULTS

In total, we analysed 113 data from 111 studies with 133,926 participants. Majority of the included studies (76 out of 111) had low risk of bias. We found significant heterogeneity among the included studies (p<0.001). We also found a symmetrical funnel plot indicating an absence of publication bias. The prevalence of MS among adult population in India was 30% (95%CI: 28%-33%). There was a steady increase in the burden across the age groups from 13% (18-29 years group) to 50% (50-59 years). We also found that people living in urban areas (32%; 95%CI: 29%-36%) had higher prevalence when compared to tribal (28%; 95%CI: 21%-36%) or rural adults (22%; 95%CI: 20%-25%). Gender distribution of MS showed that the females had higher prevalence (35%; 95%CI: 31%-38%) when compared to males 26% (95%CI: 22%-29%).

CONCLUSION

Almost one in three adults in India suffer from MS. Females, people living in urban areas and in northeast region had higher prevalence of MS. Development and implementation of policies and protocols for the screening of MS would enable us in early diagnosis and treatment with special focus towards the vulnerable and high-risk groups.

Exploratory factor analysis of gender-based metabolic syndrome components: Results from the PERSIAN Guilan cohort study (PGCS)

BACKGROUND

One of the important issues related to metabolic syndrome is the underlying factor that remains controversial. The purpose of this study was estimating exploratory factor analysis (EFA) to reveal underlying factors that may explain the observed variants of metabolic syndrome (MetS) components in a population-based study.

METHODS

In this cross-sectional study, the target population consisted of 10,520 individuals aged 35-70 years from Phase 1 of the PERSIAN Guilan cohort study conducted between 2014 and 2017. Exploratory factor analysis (EFA) of components of the metabolic syndrome, including waist circumference (WC), systolic (SBP) and diastolic (DBP) blood pressure, triglyceride (TG), high-density lipoprotein (HDL) and fasting blood glucose (f-Glc) was performed across the population as well as by gender.

RESULTS

EFA results in the whole population based on eigen values > 1 showed two factors that explain 55.46% of the total variance. Taking factor loadings above 0.3, the first factor included systolic blood pressure, diastolic blood pressure, and waist circumference - called the blood pressure factor. Also, the second factor included triglycerides, negative-loaded HDL, and fasting blood glucose, which was named as lipid factor. In terms of gender, the first factor was similar to the whole population pattern, but in the second factor, in addition to the two components of blood lipids, waist size for men and in fasting blood glucose for women was launched.

CONCLUSION

Hypertension and lipids were substantial factors, and obesity is an important factor in this study. Hypertension, having the highest factor load, can generally be a valuable screening parameter for cardiovascular and metabolic risk assessment.

Factor analyses of metabolic syndrome: A systematic review with special reference to Asian Indians

BACKGROUND

Metabolic syndrome is the constellation of cardiovascular disease risk factors and a growing public health issue affecting more than 20% of world population. Factor analysis is a powerful mathematical tool in exploring the underlying factors of any chronic diseases. Although it is most often criticized for its contrasting results for a common expression differently interpreted by the researchers yet fit the original data equally well.

OBJECTIVE

The present study aims to find out the underlying physiological domains for the phenotypic attribution of metabolic syndrome as documented in several studies.

METHODOLOGY

Literature search was done using Google Scholar, PUBMED, Research Gate and manual searching to identify relevant studies of the selected topic.

CONCLUSION

More than one physiological domain has been explored for the expression of metabolic syndrome explored in different studies. A reason for this disparity may be because most of explored factors are just mathematically significant but not biologically. Another reason may be the varied factor load concern. Therefore, a fixed factor load value is needed to be restricted for all studies across world.

Evolution of metabolic syndrome and its biomarkers

The evolution of human from ancient times to modern era has witnessed several environmental and social changes which contributed to genetic and epigenetic makeup of human beings and in turn is responsible for its present phenotype. In the recent past, owing to socioeconomic developmental pressure, a large epidemiologic shift towards non-communicable disease pattern has been noticed in many developing countries including India which resulted into incidence of diabetes and cardiovascular diseases in epidemic proportion. These two pathologies form a subset associated with metabolic derangement, popularly termed as metabolic syndrome. Earlier its status and the pathophysiological rationale were largely obscure and hence it was given a rather disguised name - Syndrome X, as an icon of unknown. While initially contemplated to be an endocrine problem associated with insulin resistance, the scientific insight about this pathology has undergone a gradual evolution. Therefore the pathogenic and consequent diagnostic modality consistently changed. Quite fascinatingly its phenomenal conversion from an endocrine etiopathology to an inflammatory pathogenesis has imprinted a paradigm shift. From laboratory medicine perspective, these evidences have immense impact to steer the research towards development of the apposite diagnostic modality for this very significant and nationally relevant health problem.

Metabolic syndrome prevalence and its risk factors among adults in China: A nationally representative cross-sectional study

OBJECTIVES

The aim of this study was to examine sex disparity in metabolic syndrome prevalence and its risk factors among Chinese adults.

METHODS

Using the 2010-2012 China National Nutrition and Health Survey (CNNHS), a nationally representative cross-sectional study on nutrition and non-communicable chronic diseases, a total of 98,042 participants aged 18 years and older were included in the analysis. Dietary information was collected with a food frequency questionnaire (FFQ). Metabolic syndrome was defined according to the updated NCEP ATP III criteria. A multivariable logistic regression model was performed to examine the associations between sociodemographic and dietary factors with metabolic syndrome prevalence, and the results are presented using odd ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

The overall standardized prevalence of metabolic syndrome was 24.2% (24.6% in men and 23.8% in women). The metabolic syndrome prevalence was positively associated with age in men and women. The prevalence of metabolic syndrome was negatively associated with the physical activity level among men and inversely associated with the education level among women (P for trend < 0.01). Frequent consumption of fungi and algae was an underlying risk factor for metabolic syndrome in men, whereas frequent consumption of nuts and pork was associated with a decreased prevalence of metabolic syndrome in women.

CONCLUSIONS

The prevalence of metabolic syndrome in men was not different from that in women. There are sex-specific associations between multiple risk factors and metabolic syndrome.

Factor analysis of metabolic syndrome components and predicting type 2 diabetes: Results of 10-year follow-up in a Middle Eastern population

BACKGROUND

The relationship among components of metabolic syndrome (MetS) and their association with diabetes is unclear in West Asia. The aim of the present study was to conduct factor analysis of MetS components and the effect these factors have on the incidence of type 2 diabetes (T2D) in a population-based cohort study of the Tehran Lipid and Glucose Study (TLGS).

METHODS

The present study enrolled 1861 men and 2706 women (20-60 years of age), from Tehran (Iran) who were free of diabetes at baseline and followed them for 10 years. A principal component analysis was performed to extract standardized factors from MetS components. Logistic regression was used to detect associations between the extracted factors and the incidence of diabetes. A propensity score was used to correct differential selection bias resulting from loss to follow-up.

RESULTS

Factor analysis identified three factors (blood pressure, lipids and glycemia). Waist circumference was shared in three all factors. Blood pressure, lipids and glycemia were related to the incidence of diabetes with odds ratios (95% confidence intervals) of 2.23 (1.31-3.78), 1.89 (1.27-3.67), and 7.54 (4.09-13.91), respectively, in men and 2.13 (1.34-3.40), 2.06 (1.35-3.15), and 13.91 (7.29-26.51), respectively, in women for the third versus the first tertile of these standardized factors.

CONCLUSIONS

Central adiposity may have a pivotal role in MetS linking other risk factors together. Glycemia had a high impact on the incidence of diabetes, whereas blood pressure and lipid had a similar moderate effect on the incidence of diabetes.

Sex difference in the prevalence of metabolic syndrome and cardiovascular-related risk factors in urban adults from 33 communities of China: The CHPSNE study

Little is known about the epidemiology of metabolic syndrome in urban areas of China. To estimate the prevalence of MetS and identify its cardiovascular-related factors in men and women, a representative sample of 15,477 urban adults aged 18-74 years in Northeast China was selected from 2009 to 2010. The diagnosis of metabolic syndrome was based on criteria set by the National Cholesterol Education Program/Adult Treatment Panel. The overall prevalence of metabolic syndrome was 27.4% (men 27.9% and women 26.8%). Multivariable logistic regression analysis revealed that a higher education level and a higher family income were associated with a higher prevalence of metabolic syndrome in men, but associated with lower prevalence of metabolic syndrome among women. Higher physical activity was associated with a decreased prevalence of metabolic syndrome in men (adjusted odds ratios (aORs) = 0.88, 95% confidence interval (CI): 0.79-0.99), but associated with an increased prevalence of metabolic syndrome in women (aOR = 1.14, 95% CI: 1.00-1.29). Compared with rice as the major staple food, cooked wheaten foods were associated with lower adjusted odds for metabolic syndrome both in men (aOR = 0.72, 95% CI: 0.58-0.90) and in women (aOR = 0.72, 95% CI: 0.56-0.92). In conclusion, metabolic syndrome is highly prevalent in urban areas of China, and there is heterogeneity by sex in the relationships between risk factors and metabolic syndrome prevalence.