Incidence of Metabolic Syndrome and Its Risk Factors among Type 2 Diabetes Clinic Attenders in Isfahan, Iran

Comparing the activity level of salivary matrix metalloproteinase-8 in patients with diabetes and moderate to severe chronic generalized periodontitis

OBJECTIVES

The response of the host to plaque can be affected by systemic diseases like diabetes, hormonal changes, or immunological deficits, which can hasten the progression and severity of periodontitis. This study aimed to compare the activity of salivary matrix metalloproteinase-8 (MMP-8) in patients with moderate to severe generalized chronic generalized periodontitis between healthy individuals and those with type 2 diabetes who were referred to the Tabriz School of Dentistry.

MATERIALS AND METHODS

For this cross-sectional study, 90 patients were randomly divided into three groups based on inclusion and exclusion criteria: patients with chronic generalized periodontitis with diabetes, patients with generalized chronic periodontal disease with normal blood glucose, and a control group of 30 healthy individuals. Participants were instructed not to brush their teeth for 12 h and not to eat or drink for 90 min before saliva sampling. Saliva samples were immediately stored at -80°C and analyzed using an ELISA test.

RESULTS

The results showed that there was a significant difference in salivary MMP-8 levels among the three groups. Patients with periodontitis and diabetes had the highest levels of salivary MMP-8, while the control group had the lowest levels. This indicates that chronic generalized periodontitis is strongly associated with the activity level of salivary MMP-8, and elevated levels of MMP-8 in diabetic patients demonstrate the impact of diabetes on periodontal disease.

CONCLUSION

This study highlights the importance of monitoring salivary MMP-8 levels in patients with periodontitis, especially those with diabetes. It also emphasizes the need for proper management of systemic diseases to prevent or slow down the progression of periodontal disease.

Determinants of metabolic syndrome among patients attending diabetes clinics in two sub-urban hospitals: Bono Region, Ghana

BACKGROUND

Over 70% of individuals with type 2 diabetes mellitus (T2DM) may have metabolic syndrome in sub-Saharan Africa. Evidence about the prevalence, clustering, and determinants of metabolic syndrome components is needed to guide the implementation of interventions to prevent cardiovascular diseases in low-income countries.

METHODS

A clinic-based cross-sectional study was conducted among 430 out-patients attending two-selected diabetes mellitus clinics in the Bono Region of Ghana. Data was collected in June 2016 among participants aged 30-79 years. The prevalence of metabolic syndrome was assessed using the harmonized definition. Patients were interviewed using semi-structured questionnaires and T2DM status was confirmed by reviewing medical records. The components of MS that were assessed included body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein (HDL)-cholesterol, and blood glucose. Multiple logistic regression models were constructed to evaluate the risk factors of MS.

RESULTS

The mean age of participants was 58.8 ± 11.49 years. The prevalence of MS was 68.6% (95% CI: 64.0-72.8), higher among women (76.3%, 95% CI: 70.6-81.2) than men (58.0%, 95% CI: 35.0-49.4) and in the 50-59-year age group (32.1%). The majority of participants [248 (57.7%)] had either two [124 (28.8%)] or four [124 (28.8%)] components of MS. Excluding fasting blood glucose (78.4%), the predominant components of MS identified in the study were reduced HDL cholesterol (70.2%), high waist circumference (60.9%), and elevated systolic blood pressure (49.8%). The study found that the odds of MS in women are 2.2-fold higher than in men (95% CI: 1.29-3.58, p = 0.003). Duration of T2DM (OR 5.2, 95% CI: 2.90-9.31, p < 0.001) and overweight status (OR 6.1, 95% CI: 3.70-10.07 p < 0.001) were also found to be significant determinants of MS.

CONCLUSIONS

Metabolic syndrome was common among patients attending routine diabetes mellitus clinics in sub-urban hospitals in the middle belt of Ghana. Significant factors associated with metabolic syndrome included being female, living with diabetes for more than five years, and being overweight. Nationwide advocacy for routine screening and prevention of the syndrome should be initiated to prevent cardiovascular disease and mortality in this vulnerable population.

Using Machine Learning Techniques to Predict Factors Contributing to the Incidence of Metabolic Syndrome in Tehran: Cohort Study

Background

Metabolic syndrome (MetS), a major contributor to cardiovascular disease and diabetes, is considered to be among the most common public health problems worldwide.

Objective

We aimed to identify and rank the most important nutritional and nonnutritional factors contributing to the development of MetS using a data-mining method.

Methods

This prospective study was performed on 3048 adults (aged ≥20 years) who participated in the fifth follow-up examination of the Tehran Lipid and Glucose Study, who were followed for 3 years. MetS was defined according to the modified definition of the National Cholesterol Education Program/Adult Treatment Panel III. The importance of variables was obtained by the training set using the random forest model for determining factors with the greatest contribution to developing MetS.

Results

Among the 3048 participants, 701 (22.9%) developed MetS during the study period. The mean age of the participants was 44.3 years (SD 11.8). The total incidence rate of MetS was 229.9 (95% CI 278.6-322.9) per 1000 person-years and the mean follow-up time was 40.5 months (SD 7.3). The incidence of MetS was significantly (P<.001) higher in men than in women (27% vs 20%). Those affected by MetS were older, married, had diabetes, with lower levels of education, and had a higher BMI (P<.001). The percentage of hospitalized patients was higher among those with MetS than among healthy people, although this difference was only statistically significant in women (P=.02). Based on the variable importance and multiple logistic regression analyses, the most important determinants of MetS were identified as history of diabetes (odds ratio [OR] 6.3, 95% CI 3.9-10.2, P<.001), BMI (OR 1.2, 95% CI 1.0-1.2, P<.001), age (OR 1.0, 95% CI 1.0-1.03, P<.001), female gender (OR 0.5, 95% CI 0.38-0.63, P<.001), and dietary monounsaturated fatty acid (OR 0.97, 95% CI 0.94-0.99, P=.04).

Conclusions

Based on our findings, the incidence rate of MetS was significantly higher in men than in women in Tehran. The most important determinants of MetS were history of diabetes, high BMI, older age, male gender, and low dietary monounsaturated fatty acid intake.

Body Composition and the Components of Metabolic Syndrome in Type 2 Diabetes: The Roles of Disease Duration and Glycemic Control

PURPOSE

Data about body compositional changes throughout the course of type 2 diabetes (T2D) are limited and inconsistent. We investigated the roles of the disease duration and glycemic control in T2D-associated changes of body composition and the components of metabolic syndrome (MetS).

PATIENTS AND METHODS

A total of 25 non-diabetic controls and 92 individuals aged 20-60 years with T2D were included in a case-control study conducted at King Faisal Specialist Hospital, Saudi Arabia. Based on disease duration (newly diagnosed: within the first year and long duration: ≥5 years) and glycemic control (glycated hemoglobin [HbA1C] level ≤7%), the patients were divided into the following groups: newly diagnosed and controlled (N&C, n=25), newly diagnosed and uncontrolled (N&U, n=17), old and controlled (O&C, n=25), and old and uncontrolled (O&U, n=25). Blood samples were collected to assess fasting blood glucose level, HbA1C level, and lipid profile. Anthropometric data were evaluated, and body composition was assessed using a bio-impedancemetry analyzer. Nonparametric tests and multivariable logistic regression analyses were performed.

RESULTS

Compared to the control group, the fat mass (FM) was significantly higher in all groups; furthermore, the fat mass/fat-free mass (FM/FFM) ratio was significantly higher in the N&C. The N&U and O&U groups showed significantly higher percentages of all components of MetS. Among all selected independent factors, only age increased the likelihood of MetS diagnosis by 7% (OR: 1.07; 95% CI: 1.004-1.149; P<0.05). Besides, age, gender, adherence to diet regimen, and T2D duration showed lower odds of increased FM/FFM ratio.

CONCLUSION

This study provided evidence about the impact of T2D on body composition and the other components of MetS. Thus, further characterization of T2D contributes to defining the etiology of the disease to detect and treat poor cardiometabolic health.

Prevalence of dyslipidemia and hypertension in Indian type 2 diabetic patients with metabolic syndrome and its clinical significance

OBJECTIVES

The present study was designed to estimate the prevalence of dyslipidemia and hypertension based on the National Cholesterol Educational Programme Adult Treatment Panel III definition of metabolic syndrome (MetS). The study also focuses on prevalence for MetS with respect to the duration of disease in Gwalior-Chambal region of Madhya Pradesh, India.

METHODS

Type 2 diabetic patients (n = 700) were selected from a cross-sectional study that is regularly being conducted in the School of Studies in Biochemistry, Jiwaji University Gwalior, India. The period of our study was from January 2007 to October 2009. Dyslipidemia and hypertension were determined in type 2 diabetic patients with MetS as per National Cholesterol Educational Programme Adult Treatment Panel III criteria.

RESULTS

The mean age of the study population was 54 ± 9.3 years with 504 (72%) males and 196 (28%) females. The prevalence of MetS increased with increased duration of diabetes in females; however, almost constant prevalence was seen in the males. Notable increase in the dyslipidemia (64.1%) and hypertension (49%) in type 2 diabetic patients were seen. The steep increase in dyslipidemia and hypertension could be the reason for the growing prevalence of diabetes worldwide. The study also noted a close association between age and occurrence of MetS.

CONCLUSION

Individual variable of MetS appears to be highly rampant in diabetic population. Despite treatment, almost half of patients still met the criteria for MetS. Effective treatment of MetS components is required to reduce cardiovascular risk in diabetes mellitus hence accurate and early diagnosis to induce effective treatment of MetS in Indian population will be pivotal in the prevention of cardiovascular disease and type 2 diabetes.