Incidence and prediction nomogram for metabolic syndrome in a middle-aged Vietnamese population: a 5-year follow-up study (original) (raw)
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Metabolic syndrome among a middle-aged population in the Red River Delta region of Vietnam
BMC Endocrine Disorders, 2014
Background: Metabolic syndrome (MetS) is a clustering of metabolic risk factors for cardiovascular diseases and type 2 diabetes. The study aimed to estimate the prevalence of MetS, its components, and their associations among rural middle-aged population in Vietnam. Methods: A cross-sectional study with a representative sample (n = 2443) was conducted to collect data on demographic, socioeconomic, anthropometric, lifestyles, plasma glucose, and lipid profile. The age-and sex-adjusted prevalences of MetS and its components were calculated using the direct standardization. Associations of risk factors with MetS were evaluated using logistic regression, taken into account the confounding factors. Results: The total age-and sex-adjusted prevalence (95% CI) of MetS was 16.3% (14.0 − 18.6). The most frequent component of MetS was high triglycerides (43.2%), followed by low HDL-C (42.0%), elevated blood pressure (29.2%), high plasma glucose (14.3%), and central obesity (12.3%). Of the total population, only 17.6% did not have any component of MetS and more than 40% had at least two MetS components. The association of MetS with residence, age, body mass index, marital status, and siesta time per day was statistically significant in univariate analysis and replicated in multivariate analysis. Conclusion: The MetS prevalence and its components are common and major public health burden in the middle-aged adults in Vietnam. Habitants living in urban, being never-married, having an increase in age, BMI, and siesta time per day are significantly associated with MetS, and they should be paid much more attention for screening and implementing preventive activities.
Determinant components of newly onset versus improved metabolic syndrome in a population of Iran
Scientific Reports, 2020
This study aimed to determine the risk factors related to regression and progression of metabolic syndrome, in a 4-year cohort study. A total of 540 individuals (≥ 18 years old) participated in both phase of the study. Participants were categorized into 3 categories of regressed, progressed and unchanged metabolic syndrome (MetS). Demographic, anthropometric and biochemical parameters were assessed for each individual in both phase. Variables differences (delta: Δ) between the two phase of study were calculated. Unchanged group was considered as baseline category. Based on IDF, MetS had been regressed and progressed in 42 participants (7.7%) and 112 (20.7%) participants respectively, in the second phase. More than 47% of people, whose MetS regressed, experienced also NAFLD regression. Results of multiple variable analysis revealed that increased age, positive Δ-TG, and Δ-FBS, significantly increased the odds of MetS progression based on IDF and ATP III definitions, while negative Δ-HDL and Δ-neutrophil to lymph ration increased the odds of progression. On the other hand, negative Δ-TG and positive Δ-HDL significantly increased the odds of Mets regression based of both IDF and ATP III. Management of hypertriglyceridemia, hyperglycemia, and HDL is a critical, non-invasive and accessible approach to change the trend of MetS. Metabolic syndrome (MetS) as a non-communicable disease (NCD) had become epidemic in many countries of the world 1. MetS is highly prevalent with multidimensional characteristics and a collection of abnormalities such as obesity, hypertension, dyslipidemia, and high blood glucose 2. Over the past 20 years, population of people with MetS, has significantly increased, which is directly associated to the global epidemic of obesity and diabetes. This is in addition to elevated threat of diabetes and cardiovascular disorders that arise from the MetS 3 and influences more than 25% of the world population 4. The description by the Adult Treatment Panel III-2005 (ATP III) seems to be the most internationally accepted description. In 2009, the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung and Blood Institute standardized their criteria for defining MetS 5. The prevalence of MetS varies, based on the criteria used to define it. For instance, a study in Iran revealed the frequency of MetS to be 34.7% based on ATP III criteria, 37.4% based on IDF description, and 41.6% according to ATP III/AHA/NHLBI criteria 1. In a systematic review and meta-analysis, according to ATP III criteria, MetS prevalence amongst people of Iran who were 20 years old or older was 23.8% and for under 20 years old was 10.9% 5. MetS risk factors were investigated in different studies. Central obesity was significantly associated with MetS mechanisms 6 , independent of insulin resistance 7. Apart from the accessible intervention approaches, alterations such as suitable diet, regular exercise, anti-obesity medication and bariatric operation, and failure to manage MetS prevalence and its associated complications depend on the disease nature and patients not following the foregoing strategies 8. Individuals with MetS are at higher risk of developing coronary artery disease (CAD). Coronary heart disease (CHD) were assessed by Framingham algorithms over a decade, and it was shown that many CHD incidences in MetS patients were prevented by controlling lipids and/or blood pressure 9. This study is among scarce studies that assessed factors affect the progression and regression of the MetS have not been reported in any longitudinal study. Hence, this study aimed to investigate the risks related to regression and progression of MetS in a 4-year cohort study.
PLoS ONE, 2013
To determine, the predictors of incident metabolic syndrome (MetS) in a community-based cohort of West Asians, during a mean follow-up of 9.3 years, a sample of 2858 non-MetS Iranian adults aged ≥ 20 years were examined at baseline and followed at three year intervals during three consecutive phases. The MetS was defined using the joint interim statement. Cox proportional hazard regression was used to determine the independent variables associated with incident MetS. Overall, 1117 new cases MetS were identified resulting in an incidence rate of 550.9/10000 person years (95% CI: 519.5-584.2). The corresponding incidence rates among women and men were 433.5/10000 person years (95% CI: 398.8-471.2) and 749.2/10000 person years (95% CI: 689.9-813.5), respectively. Baselineadjusted predictors of developing MetS included all of the MetS components, being overweight or obese in both gender, and family history of diabetes and age only in women. There were significant effect modifications of gender on age (P<0.001), high blood pressure (0.026), high waist circumference (P<0001) and obesity categories (all P ≤ 0.01) in multivariate analysis. After considering HOMA-IR in the model, among women, all of the MetS predictors as well as those with HOMA-IR ≥ 2.23 showed a significant risk for incident MetS [HR: 1.63 (1.16-2.28)]; however, among men all the MetS components (WC was marginally significant) as well as the fourth quartile of HOMA-IR [HR: 1.50 (1.03-2.17)] and being overweight showed a significant risk. Finally, in the pooled analysis, we showed that female gender had lower risk for incident MetS than male [HR: 0.58 (0.47-0.70)]. In the Iranian population, high incidence of MetS, especially among men, was shown. Our findings confirmed that sex-specific risk predictors should be considered in primary prevention for incident MetS.
PubMed, 2015
Background: There has been a few studies about the predictability of metabolic syndrome (MetS) based on the Framingham risk score (FRS) as a tool for predicting the risk of 10-years cardiovascular diseases (CVD) in Iranian population. The aim of this study was to compare the risk stratification obtained with the FRS and MetS in a cohort of the Iranian population. Methods: In this population-based study Kerman Coronary Artery Disease Risk study, Iran, MetS was diagnosed as defined by the revised National Cholesterol Education Program definition criteria (ATPIII) and the FRS was calculated using a computer program, previously reported algorithm. Results: Overall, the prevalence 10-years risk of CVD for patients with MetS was significantly different with those without MetS (74.3 vs. 86.4% for low-risk patients, 18.1 vs. 12.3% for intermediate-risk people, and 7.6 vs. 1.3% for high-risk individuals) (P < 0.001). The frequency of intermediate-risk and high-risk for 10-year CVD in men with MetS (39.5 and 18.3%, respectively) was considerably higher than women with MetS (3.2 and 0.1%, respectively). Using multiple logistic regression, the odds ratio of MetS in intermediate-risk and high-risk FRS group was 1.7 and 6.7, respectively (P < 0.001). Conclusion: Significant association between the presence of MetS and high risk for CVD based on FRS was revealed in both men and women indicating a good concordance between MetS and FRS in predicting the risk of CVDs. However, the odds ratio of the development of risk of cardiovascular events among women was higher than men with MetS.
The applicability of the Asian modified criteria of the metabolic syndrome in the Korean population
International Journal of Cardiology, 2007
Background: We compared the metabolic profiles and risk of coronary artery disease (CAD) in Koreans with non-diabetic metabolic syndrome (MetS). [We applied four criteria of MetS: the NCEP criteria, the Asian modified NCEP (a-NCEP) criteria, the WHO criteria and the Asian modified WHO (a-WHO).] Methods: The study group composed of 2724 subjects enrolled in the cardiovascular genome center. There were 728 patients with significant CAD. The different criteria of the MetS were applied for the study population. Results: Among the 2724 participants, 522 (19.2%) met the NCEP criteria, 796 (29.2%) met the a-NCEP criteria, 361 (13.3%) met the WHO criteria and 576 (21.1%) met the a-WHO criteria. The clinical parameters, lipid profile, apoA1 and apoB level were not different between the participants classified as MetS by using the different criteria. The odds ratio for CAD prediction were not significantly different according to the metabolic criteria (odd ratio: 1.755 [95% CI: 1.423 -2.163] in NCEP criteria, 2.120 [1.763 -2.549] in a-NCEP criteria, 1.854 [1.466 -2.343] in WHO criteria,] in a-WHO criteria). The serum level of apoA1 and apoB showed strong correlations with MetS classified by all criteria and the HOMA index and insulin level showed better correlations with WHO-MetS criteria. Conclusions: All the MetS criteria showed similar metabolic profiles and all four criteria had similar predictive value for CAD. Conventional MetS criteria, applied to the non-diabetic Asian population, may underestimate the population at risk. Our data suggests that the Asian modified criteria will decrease the risk for underdiagnosis while demonstrating similar metabolic profiles and CAD risk compared to the conventional criteria. D
. The metabolic syndrome adds utility to the prediction of mortality over its components: the Vietnam Experience Study. Atherosclerosis, 210, 256-261. http://dx.