Effect of age on the phenotype of metabolic syndrome in developing country

A higher TyG index level is more likely to have enhanced incidence of T2DM and HTN comorbidity in elderly Chinese people: a prospective observational study from the reaction study

BACKGROUND

Triglyceride glucose index (TyG index) was related with both type 2 diabetes (T2DM) and hypertension (HTN). Prospective studies linking the TyG index to the incidence of T2DM and HTN comorbidity remain unclear. This study aimed to to explore the longitudinal association between TyG and new-onset T2DM with HTN.

METHODS

4,434 subjects (1249 males and 3185 females) without initial T2DM and HTN were followed up for 7 years. This study was conducted from November 2011 to August 2018 in the Gucheng, Laoshan and Jinding communities of Beijing. The incidence of T2DM with HTN during the 7-year follow-up was identified as the endpoint. The TyG index was divided into four quartiles: the < 25% level, the 25-50% level, the 50-75% level and the ≥ 75% level. The relationships between the TyG index and T2DM with HTN were evaluated by Cox proportional hazards regression models.

RESULTS

During 7 years, the augmented trend of T2DM with HTN was observed in the participants. After adjusting for all confounding factors, compared with those in the lowest quartile of TyG index, the population in the highest quartile of TyG index had a higher risk of T2DM with HTN (hazard ratio (HR), 2.878; 95% confidence intervals (95% CI), 1.230-6.731, P = 0.015), however, the association remained significant only in the female population (HR 2.753, 95% CI, 1.061-7.139, p = 0.037). The TyG had superior predictive ability of increased risk of T2DM with HTN for the populations of older age (≥ 65 years) (HR 2.694, 95% CI 1.212-5.989, p = 0.015), higher eGFR (≥ 90 mL/(min·1.73 m2)) (HR 2.603, 95% CI 1.164-5.818, p = 0.020) or obesity (BMI ≥ 28 kg/m2) (HR 2.547, 95% CI 1.001-6.478, p = 0.020).

CONCLUSION

A population with a higher TyG index level was more likely to have an enhanced incidence of T2DM and HTN comorbidity. TyG index could have the significance of clinical in early protection against T2DM with HTN.

The levels and trends of metabolic risk factors in the elderly population at the national and sub-national scale in Iran from 1990 to 2016

Purpose

Describing the trends of metabolic risk factors (MRFs) in the elderly population.

Methods

We used modeled data from previous comprehensive systematic reviews for MRFs among adults aged ≥ 60 years. Two stages of age-specific Spatio-temporal modeling and Gaussian process regression were used to estimate the mean of MRFs. We used crosswalk modeling to estimate the prevalence of elevated and raised Total cholesterol (TC), overweight/obesity and obesity, hypertension, and diabetes. Estimates were analyzed based on combinations of sex, age, year, and province from 1990 to 2016.

Results

Comparing prevalence estimates from 2016 with those of 1990, in the elderly population, the age-standardized prevalence of overweight/obesity, obesity, diabetes, and hypertension increased, conversely, the prevalence of hypercholesteremia decreased. The prevalence of hypertension increased about 141.5% and 129.9% in men and women respectively. The age-standardized prevalence of diabetes increased about 109.5% in females, and 116.0% in males. Prevalence of elevated TC at the national level decreased to 67.4% (64.1-70.4) in women and to 51.1% (47.5-54.8) in men. These findings were almost shown across provinces. In general, the northern and western provinces had the highest prevalence of overweight/obesity in women in 2016.

Conclusion

The rising prevalence of most MRFs, as well as the greater prevalence and mean of all MRFs in women, necessitate effective public health policies to reduce the burden of non-communicable diseases and run preventive programs.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-023-01297-z.

Reported organic food consumption and metabolic syndrome in older adults: cross-sectional and longitudinal analyses

PURPOSE

Examine cross-sectional and longitudinal relationships between organic food consumption, metabolic syndrome (MetS), and its components among older adults.

METHODS

Respondents of the 2012 Health and Retirement Study (HRS), and Health Care and Nutrition Study (HCNS) were included in this study. Organic food consumption was measured with a crude binary question asking about past-year consumption (yes/no). Cross-sectional analyses were conducted with 6,633 participants (mean (SE) age, 65.5 (0.3) years). Longitudinal analyses were conducted with a subset of 1,637 respondents who participated in the HRS Venous Blood Study (mean (SE) age, 63.8 (0.4) years). Hemoglobin A1C and high-density lipoprotein cholesterol were assessed using dried blood spots at baseline. Glucose, high-density lipoprotein cholesterol, and triglycerides were assessed using fasting blood samples collected 4 years after baseline. Waist circumference and blood pressure were measured at baseline and follow-up. Logistic and linear regressions were used to assess the associations between organic food consumption, MetS, and its components.

RESULTS

Any organic food consumption over the previous year was reported among 47.4% of cross-sectional and 51.3% of longitudinal participants. Unadjusted models showed inverse cross-sectional associations between organic food consumption and waist circumference, blood pressure, and hemoglobin A1C, and positive longitudinal association with high-density lipoprotein cholesterol. No significant associations were detected in the fully adjusted models.

CONCLUSIONS

No association was observed between organic food consumption and MetS among older adults after adjusting for confounders. Future studies with a precise definition, quantitative assessment of the consumption, and duration of organic food consumption, together with pesticides biomarkers, are warranted.

A high triglyceride glucose index is more closely associated with hypertension than lipid or glycemic parameters in elderly individuals: a cross-sectional survey from the Reaction Study

Background

Both lipid and glucose abnormalities are associated with hypertension (HTN). However, it is unclear whether the triglyceride-glucose (TyG) index is associated with HTN. Therefore the aim of this study is to investigate the association of the TyG index and HTN and to compare the discriminative power of the TyG index, lipid, glycemic parameters for the risk of HTN in elderly individuals.

Methods

The present study was nested in a longitudinal (REACTION) study from May 2011 to December 2011, which was designed to demonstrate the association of abnormal glucose metabolism with the risk of cancer in the Chinese population. In total, 47,808 participants were recruited in this cross-sectional study. The TyG index was divided into five groups: the < 20% group, the 20–39% group, the 40–59% group, the 60–79% group and the ≥ 80% group, according to quintile division of the subjects. Three multivariate logistic regression models were used to evaluate the association between the TyG vs. lipid parameters, glycemic parameters and HTN.

Results

Multivariate logistic regression analysis shows that compared with lipid and glycemic parameters, the TyG index remains significantly associated with HTN in either total subjects or subjects separated into men and women (odds ratio (OR) 1.33, 95% confidence interval (CI) 1.18–1.51, p < 0.0001 in total subjects; OR 1.39, 95% CI 1.11–1.74, p = 0.0042 in men; OR 1.28, 95% CI 1.11–1.49, p = 0.0010 in women). In a stratified analysis, an elevated TyG index is significantly associated with HTN in the subgroup of the oldest age (≥ 65) (OR 1.67, 95% CI 1.30–2.14, p < 0.0001), as well as with obesity (Body mass index (BMI) ≥ 28 kg/m²) (OR 1.85, 95% CI 1.29–2.66, p = 0.0009) or lower estimated glomerular filtration rate (eGFR) (< 90 mL/(min·1.73 m²)) (OR 1.72, 95% CI 1.33–2.21, p < 0.0001).

Conclusion

The TyG index is significantly associated with HTN and shows the superior discriminative ability for HTN compared with lipid and glycemic parameters in the Chinese elderly population.

Application of Latent Class Analysis to Identify Metabolic Syndrome Components Patterns in adults: Tehran Lipid and Glucose study

In this study, using latent class analysis (LCA), we investigated whether there are any homogeneous subclasses of individuals exhibiting different profiles of metabolic syndrome (MetS) components. The current study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS), a population-based cohort including 6448 subjects, aged 20-50 years. We carried out a LCA on MetS components and assessed the association of some demographic and behavioral variables with membership of latent subclasses using multinomial logistic regression. Four latent classes were identified:(1) Low riskclass, with the lowest probabilities for all MetS components (its prevalence rate in men: 29%, women: 64.7%), (2) MetS with diabetes medication (men: 1%, women: 2.3%), (3) Mets without diabetes medication (men: 32%, women: 13.4%), (4) dyslipidemia (men: 38%, women: 19.6%). In men the forth subclass was more significantly associated with being smoker (odds ratio: 4.49; 95% CI: 1.89-9.97). Our study showed that subjects with MetS could be classified in sub-classes with different origins for their metabolic disorders including drug treated diabetes, those with central obesity and dyslipidemia associated with smoking.

Selenium Homeostasis and Clustering of Cardiovascular Risk Factors: A Systematic Review

Selenium is a trace element required for a range of cellular functions. It is widely used for the biosynthesis of the unique amino acid selenocysteine [Sec], which is a structural element of selenoproteins. This systematic review focused on the possible relation between selenium and metabolic risk factors. The literature was searched via PubMed, Scopus, ISI Web of Science, and Google Scholar. Searches were not restricted by time or language. Relevant studies were selected in three phases. After an initial quality assessment, two reviewers extracted all the relevant data, whereas the third reviewer checked their extracted data. All evidence came from experimental and laboratory studies. Selenoprotein P is the best indicator for selenium nutritional levels. In addition, high levels of selenium may increase the risk of metabolic syndrome while the lack of sufficient selenium may also promote metabolic syndrome. selenium supplementation in subjects with sufficient serum selenium levels has a contrary effect on blood pressure, LDL, and total cholesterol. According to the bioavailability of different types of selenium supplementation such as selenomethionine, selenite and selenium-yeast, it seems that the best nutritional type of selenium is selenium-yeast. Regarding obtained results of longitudinal studies and randomized controlled trials, selenium supplementation should not be recommended for primary or secondary cardio-metabolic risk prevention in populations with adequate selenium status.

Selenium Homeostasis and Clustering of Cardiovascular Risk Factors: A Systematic Review

Selenium is a trace element required for a range of cellular functions. It is widely used for the biosynthesis of the unique amino acid selenocysteine [Sec], which is a structural element of selenoproteins. This systematic review focused on the possible relation between selenium and metabolic risk factors. The literature was searched via PubMed, Scopus, ISI Web of Science, and Google Scholar. Searches were not restricted by time or language. Relevant studies were selected in three phases. After an initial quality assessment, two reviewers extracted all the relevant data, whereas the third reviewer checked their extracted data. All evidence came from experimental and laboratory studies. Selenoprotein P is the best indicator for selenium nutritional levels. In addition, high levels of selenium may increase the risk of metabolic syndrome while the lack of sufficient selenium may also promote metabolic syndrome. selenium supplementation in subjects with sufficient serum selenium levels has a contrary effect on blood pressure, LDL, and total cholesterol. According to the bioavailability of different types of selenium supplementation such as selenomethionine, selenite and selenium-yeast, it seems that the best nutritional type of selenium is selenium-yeast. Regarding obtained results of longitudinal studies and randomized controlled trials, selenium supplementation should not be recommended for primary or secondary cardio-metabolic risk prevention in populations with adequate selenium status.

The cut-off values of anthropometric indices for identifying subjects at risk for metabolic syndrome in Iranian elderly men

AIM

This study aimed to investigate which anthropometric indices could be a better predictor of metabolic syndrome (MetS) and the cut-off points for these surrogates to appropriately differentiate MetS in the Iranian elderly.

METHOD

The present cross-sectional study was conducted on a sample of Isfahan Healthy Heart Program (IHHP). MetS was defined according to Third Adult Treatment Panel (ATPIII). In total, 206 elderly subjects with MetS criteria were selected. Anthropometric indices were measured and plotted using receiver operating characteristic (ROC) curves.

RESULTS

WC followed by WHtR yielded the highest area under the curve (AUC) (0.683; 95% CI 0.606-0.761 and 0.680; 95% CI 0.602-0.758, resp.) for MetS. WC at a cut of 94.5 cm resulted in the highest Youden index with sensitivity 64% and 68% specificity to predict the presence of ≥2 metabolic risk factors. BMI had the lowest sensitivity and specificity for MetS and MetS components. WC has the best ability to detect MetS which followed by WHtR and BMI had a lower discriminating value comparatively.

CONCLUSION

WC is the best predictor for predicting the presence of ≥2 metabolic risk factors among Iranian elderly population and the best value of WC is 94.5 cm. This cut-off values of WC should be advocated and used in Iranian men until larger cross-sectional studies show different results.