Regional Variation in Comorbid Prediabetes and Diabetes and Associated Factors among Hypertensive Individuals in Rural Bangladesh, Pakistan, and Sri Lanka

We aimed to explore the cross-country variation in the prevalence of comorbid prediabetes or diabetes and determine the sociodemographic, lifestyle, and clinical factors, especially body mass index (BMI) and waist circumference, associated with comorbid diabetes in individuals with hypertension in rural South Asia. We analyzed cross-sectional data of 2426 hypertensive individuals of ≥40 years from 30 randomly selected rural communities in Bangladesh, Pakistan, and Sri Lanka. Prediabetes was defined as fasting plasma glucose (FPG) between 100 and 125 mg/dL without use of antidiabetic treatment and diabetes as FPG ≥126 mg/dL or use of antidiabetic medication. The prevalence (95% CI) of prediabetes or diabetes (53.5% (51.5%, 55.5%)) and diabetes (27.7% (25.9%, 29.5%)) was high in the overall hypertensive study population in rural communities in 3 countries. Rural communities in Sri Lanka had the highest crude prevalence of prediabetes or diabetes and diabetes (73.1% and 39.3%) with hypertension, followed by those in Bangladesh (47.4% and 23.1%) and Pakistan (39.2% and 20.5%). The factors independently associated with comorbid diabetes and hypertension were residing in rural communities in Sri Lanka, higher education, international wealth index, waist circumference, pulse pressure, triglyceride, and lower high-density lipoprotein. The association of diabetes with waist circumference was stronger than with BMI in hypertensive individuals. Prediabetes or diabetes are alarmingly common among adults with hypertension and vary among countries in rural South Asia. The high prevalence of comorbid diabetes in Sri Lanka among hypertensives is not fully explained by conventional risk factors and needs further etiological research. Urgent public health efforts are needed to integrate diabetes control within hypertension management programs in rural South Asia, including screening waist circumference.

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Prevalence and correlates of cardiometabolic multimorbidity among hypertensive individuals: a cross-sectional study in rural South Asia—Bangladesh, Pakistan and Sri Lanka

BMJ Open ◽

10.1136/bmjopen-2019-030584 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030584 ◽

Cited By ~ 2

Author(s):

Liang Feng ◽

Imtiaz Jehan ◽

H Asita de Silva ◽

Aliya Naheed ◽

Hamida Farazdaq ◽

...

Keyword(s):

Rural Communities ◽

Sri Lanka ◽

South Asia ◽

South Asians ◽

Wealth Index ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Rural South ◽

Physically Active

ObjectiveTo determinate the prevalence and correlates of cardiometabolic multimorbidity (CMM), and their cross-country variation among individuals with hypertension residing in rural communities in South Asia.DesignA cross-sectional study.SettingRural communities in Bangladesh, Pakistan and Sri Lanka.ParticipantsA total of 2288 individuals with hypertension aged ≥40 years from the ongoing Control of Blood Pressure and Risk Attenuation- Bangladesh, Pakistan and Sri Lanka clinical trial.Main outcome measuresCMM was defined as the presence of ≥2 of the conditions: diabetes, chronic kidney disease, heart disease and stroke. Logistic regression was done to evaluate the correlates of CMM.ResultsAbout 25.4% (95% CI 23.6% to 27.2%) of the hypertensive individuals had CMM. Factors positively associated with CMM included residing in Bangladesh (OR 3.42, 95% CI 2.52 to 4.65) or Sri Lankan (3.73, 95% CI 2.48 to 5.61) versus in Pakistan, advancing age (2.33, 95% CI 1.59 to 3.40 for 70 years and over vs 40–49 years), higher waist circumference (2.15, 95% CI 1.42 to 3.25) for Q2–Q3 and 2.14, 95% CI 1.50 to 3.06 for Q3 and above), statin use (2.43, 95% CI 1.84 to 3.22), and higher levels of triglyceride (1.01, 95% CI 1.01 to 1.02 per 5 mg/dL increase). A lower odds of CMM was associated with being physically active (0.75, 95% CI 0.57 to 0.97). A weak inverted J-shaped association between International Wealth Index and CMM was found (p for non-linear=0.058), suggesting higher risk in the middle than higher or lower socioeconomic strata.ConclusionsCMM is highly prevalent in rural South Asians affecting one in four individuals with hypertension. There is an urgent need for strategies to concomitantly manage hypertension, cardiometabolic comorbid conditions and associated determinants in South Asia.

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Determinants of Uncontrolled Hypertension in Rural Communities in South Asia—Bangladesh, Pakistan, and Sri Lanka

American Journal of Hypertension ◽

10.1093/ajh/hpy071 ◽

2018 ◽

Vol 31 (11) ◽

pp. 1205-1214 ◽

Cited By ~ 11

Author(s):

Tazeen H Jafar ◽

Mihir Gandhi ◽

Imtiaz Jehan ◽

Aliya Naheed ◽

H Asita de Silva ◽

...

Keyword(s):

Rural Communities ◽

Sri Lanka ◽

South Asia ◽

Wealth Index ◽

Uncontrolled Hypertension ◽

Multivariable Logistic Regression Model ◽

Antihypertensive Medications ◽

Cross Sectional ◽

Rural South ◽

Factors Associated

Abstract BACKGROUND Uncontrolled blood pressure (BP) is a leading risk factor for death and disability in South Asia. We aimed to determine the cross-country variation, and the factors associated with uncontrolled BP among adults treated for hypertension in rural South Asia. METHODS We enrolled 1,718 individuals aged ≥40 years treated for hypertension in a cross-sectional study from rural communities in Bangladesh, Pakistan, and Sri Lanka. Multivariable logistic regression model was used to determine the factors associated with uncontrolled BP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg). RESULTS Among hypertensive individuals, 58.0% (95% confidence interval (CI) 55.7, 60.4) had uncontrolled BP: 52.8% (49.0, 56.6) in Bangladesh, 70.6% (65.7, 75.1) in Pakistan, and 56.5% (52.7, 60.1) in Sri Lanka. The odds (odds ratio (95% CI)) of uncontrolled BP were significantly higher in individuals with lower wealth index (1.17 (1.02, 1.35)); single vs. married (1.46 (1.10, 1.93)); higher log urine albumin-to-creatinine ratio (1.41 (1.24, 1.60)); lower estimated glomerular filtration rate (1.23 (1.01, 1.49)); low vs. high adherence to antihypertensive medication (1.50 (1.16, 1.94)); and Pakistan (2.91 (1.60, 5.28)) vs. Sri Lanka. However, the odds were lower in those with vs. without self-reported kidney disease (0.51 (0.28, 0.91)); and receiving vs. not receiving statins (0.62 (0.44, 0.87)). CONCLUSIONS The majority of individuals with treated hypertension have uncontrolled BP in rural Bangladesh, Pakistan, and Sri Lanka with significant disparities among and within countries. Urgent public health efforts are needed to improve access and adherence to antihypertensive medications in disadvantaged populations in rural South Asia.

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Waist Circumference, Blood Pressure and Lifestyle of Sudanese Population, Khartoum Locality, Sudan 2016

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2019/v29i1130139 ◽

2019 ◽

pp. 1-8

Author(s):

Asma Abdelaal Abdalla ◽

Siham Ahmed Balla ◽

Amna Abdalla Babiker ◽

Safaa Abdelhameed Medani ◽

Rania Abdalla Osman Khalfa ◽

...

Keyword(s):

Blood Pressure ◽

Waist Circumference ◽

Physical Exercise ◽

Age Distribution ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Men And Women ◽

Study Population ◽

The Mean

Aims: To measure the waist circumference of Sudanese adults in Khartoum Locality and its relationship to blood pressure and lifestyle during celebration of international day of hypertension in May 2016 . Study Design: It was a descriptive cross-sectional study. Place of the Celebration: Khartoum Locality at Alsahaa Alkhadraa (The Green Park). Methodology: A total of 364 adult participants, 196 men and 168 women were interviewed using structured questionnaire. Blood pressure (BP) was measured considering hypertension as ≥ 140 mmHg and ≥ 90 mmHg for systole and diastole BP respectively. Waist circumference was measured using an anthropometric measuring tape at cut-off point of 94 cm and 80 cm for men and women respectively. Data was managed by SPSS version 20 and Chi-square test at 95% CL was used to test the association between waist circumference, blood pressure and life style characteristics. Results: Age distribution of the study population showed 48.2% females and 45.4% males in the middle age group (38-57 years). Two thirds of the study population were hypertensive, 62.8% of males and 64.3% of females. The mean waist circumference of men was 97.82 cm + 16.7, mean Systolic BP was 127 + 22 and mean Diastolic BP was 85 + 15. The mean waist circumference of women was 99.31 + 16.2, mean Systolic was 128 + 24 and mean Diastolic BP was 84 +17. Abnormal waist circumference was found in 61.2% of males and 86.9% of females. Fifty nine (30.1%) of the males and 86 (51.2%) of the females with abnormal waist circumference were hypertensive. The association between abnormal waist circumference and high blood pressure was significant among both sexes, P value = 0.001. Physical exercise and fat and salt foods were not significantly associated waist circumference in both men and women. Conclusion: Two thirds of women and men in the celebrating areas were hypertensive. Half of women and one third of men were significantly hypertensive and having abnormal waist circumference. Doing physical exercise, avoiding fat and salt foods was insignificantly associated with normal waist circumference. Large survey with representative sample is needed to estimate the real Sudanese waist circumference.

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Validation of Surrogate Anthropometric Indices in Older Adults: What Is the Best Indicator of High Cardiometabolic Risk Factor Clustering?

Nutrients ◽

10.3390/nu11081701 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1701 ◽

Cited By ~ 6

Author(s):

Robinson Ramírez-Vélez ◽

Miguel Ángel Pérez-Sousa ◽

Mikel Izquierdo ◽

Carlos A. Cano-Gutierrez ◽

Emilio González-Jiménez ◽

...

Keyword(s):

Blood Pressure ◽

Waist Circumference ◽

Cardiometabolic Risk ◽

Characteristic Curve ◽

Risk Index ◽

International Diabetes Federation ◽

Density Lipoprotein ◽

Screening Tools ◽

Anthropometric Indices ◽

Cross Sectional

The present study evaluated the ability of five obesity-related parameters, including a body shape index (ABSI), conicity index (CI), body roundness index (BRI), body mass index (BMI), and waist-to-height ratio (WtHR) for predicting increased cardiometabolic risk in a population of elderly Colombians. A cross-sectional study was conducted on 1502 participants (60.3% women, mean age 70 ± 7.6 years) and subjects’ weight, height, waist circumference, serum lipid indices, blood pressure, and fasting plasma glucose were measured. A cardiometabolic risk index (CMRI) was calculated using the participants’ systolic and diastolic blood pressure, triglycerides, high-density lipoprotein and fasting glucose levels, and waist circumference. Following the International Diabetes Federation definition, metabolic syndrome was defined as having three or more metabolic abnormalities. All surrogate anthropometric indices correlated significantly with CMRI (p < 0.01). Receiver operating characteristic curve analysis of how well the anthropometric indices identified high cardiometabolic risk showed that WtHR and BRI were the most accurate indices. The best WtHR and BRI cut-off points in men were 0.56 (area under curve, AUC 0.77) and 4.71 (AUC 0.77), respectively. For women, the WtHR and BRI cut-off points were 0.63 (AUC 0.77) and 6.20 (AUC 0.77), respectively. In conclusion, BRI and WtHR have a moderate discriminating power for detecting high cardiometabolic risk in older Colombian adults, supporting the idea that both anthropometric indices are useful screening tools for use in the elderly.

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G. Rodgen (ed) Population Growth and Poverty in Rural South Asia. New Delhi: Sage Publications. 1989.

The Pakistan Development Review ◽

10.30541/v29i3-4pp.355-357 ◽

1990 ◽

Vol 29 (3-4) ◽

pp. 355-357

Author(s):

Zeba A. Sathar

Keyword(s):

Population Growth ◽

South Asia ◽

New Delhi ◽

Cross Sectional ◽

Rural South ◽

Rural Pakistan ◽

Interesting Contribution ◽

Demographic Patterns ◽

The Relationship ◽

Country Specific

Rapid population growth and high levels of poverty continue to be outstanding features of the South Asian region. It is often acknowledged, both implicitly and explicitly, that these two features have close linkages especially in the case of South Asia. This book addresses this very issue through five case studies of Rural Bihar, Rural Pakistan, India, Rural Bangladesh, and Nepal. The book makes an interesting contribution to the literature on population in South Asia. In particular, it has a strong empirical base. However, most of the enquiries, as is quite understandable, are limited by the type of data typically collected in cross-sectional sample surveys. Their limitations are pointed out by the authors themselves. Each chapter makes a significant contribution in its own area and the country-specific results are interesting. In Chapter 2, Rodgers, Gupta, Sharma and Sharma, examine, as their title says, "Demographic Patterns and Poverty among Households in Rural Bihar". The associations between family planning, fertility, child mortality, and incomerelated measures are studied: the relationship between economic variables and fertility is found to be weak; mortality and poverty are more directly related; and the conclusion, therefore, is that there is no evidence to warrant the conclusion that reducing poverty (even if a desirable objective in itself) would reduce fertility.

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CUT OFF VALUES OF WAIST CIRCUMFERENCE AND WAIST-TO-HIP RATIO FOR PREDICTING METABOLIC SYNDROME AMONG POPULATION IN TWO COMMUNES, QUANG DIEN DISTRICT, THUA THIEN HUE PROVINCE

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.6.4 ◽

2018 ◽

Vol 8 (6) ◽

pp. 27-33

Author(s):

Huong Nguyen Thi ◽

Thuoc Doan Phuoc ◽

Chi Le Van

Keyword(s):

Metabolic Syndrome ◽

Waist Circumference ◽

Early Identification ◽

Central Obesity ◽

Density Lipoprotein ◽

Sampling Procedure ◽

Metabolic Abnormalities ◽

Cross Sectional ◽

Indirect Measure ◽

Waist To Hip Ratio

Background:Metabolic syndrome (MetS) is a cluster of metabolic abnormalities, characterized as central obesity, dysglycemia, raised blood pressure, elevated triglyceride (TG) level, and low high-density lipoprotein cholesterol (HDL-C) level. MetS is associated with cardiovascular disease, type 2 diabetes morbidity and mortality, and all-cause mortality. It is alarming that the prevalence of MetS is high and increasing in both developing and developed nations. Thus, early identification and treatment of individuals with MetS is essential to prevent the adverse consequences related to its development. However, the diagnostic criteria of MetS are complex to conduct, which makes early identification of individuals with MetS challenging. Of these components of MetS, central obesity is considered as the most important component. As an indirect measure of visceral fat, waist circumference (WC) and waist-to-hip ratio (WHR) are an easy, cost-effective, and non-invasive metric useful for identification of central obesity and, in turn, may be an effective predictor of the risk of metabolic syndrome. However, ethnic and racial variation among populations from different regions warrants different cutoff points to diagnose metabolic syndrome. Objective: To identify the optimal cut off values for waist circumference (WC), waist-to-hip ratio (WHR) for predicting metabolic syndrome (MetS) among population in Quang Dien District, Thua Thien Hue Province. Methods: A cross-sectional study carried out 386 people over 25 years olds chosen from two communities from Quang Dien district by stratified sampling procedure. Metabolic syndrome was defined according to the IDF, NHLBI, AHA, WHF, IAS, IASO (2009). Receiver operating characteristic (ROC) curves were generated to assess sensitivity and specificity for different cut off values of WC, WHR. Results: The optimal cut off values for WC for predicting MetS were 87 cm for men (AUC= 0.852, sensitivity = 85.7% and specificity = 83.8%) and 76 cm for women (AUC= 0.871, sensitivity = 85% and specificity = 74.73%). The optimal cut off values for WHR for predicting MetS were 0.9 for men (AUC= 0.823, sensitivity = 85.71% and specificity = 76.15%) and 0.86 for women (AUC= 0.801, sensitivity = 80% and specificity = 66.48%). Conclusion: We propose the optimal cut off point for WC, WHR for the best predictor of MetS as 87 cm, 0.9 in men and 76 cm, 0.86 in women respectively in Quang Dien population. Key words: Metabolic syndrome (MetS), metabolic abnormalities, Quang Dien district

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Geriatric Health Problems in a Rural Community of Bangladesh

Ibrahim Medical College Journal ◽

10.3329/imcj.v1i2.2900 ◽

1970 ◽

Vol 1 (2) ◽

pp. 17-20 ◽

Cited By ~ 3

Author(s):

Shaila Ahmed ◽

Sonia Shirin ◽

Masuda Mohsena ◽

Nargis Parvin ◽

Niru Sultana ◽

...

Keyword(s):

Rural Communities ◽

Family Income ◽

Health Problems ◽

Left Ventricular ◽

Cross Sectional ◽

Respiratory Problems ◽

Prostatic Enlargement ◽

Study Population ◽

The Mean ◽

Urinary Dribbling

This cross sectional descriptive study was conducted in some rural communities of Sreepur Thana during the month of April 2007. The study population included those aged 50 years or more and residing in the study areas. A total of 226 respondents were selected purposively and were interviewed using a pre-tested questionnaire. The objective of this study was to assess their socio economic condition and identify their health problems. The mean age of the respondents was found to be 62 years. Mean family size and monthly family income was estimated to be 5.31 and Taka 5857.52 respectively. More than half (64.2%) of the respondents were illiterate. Fifty eight percent of them were unemployed and 67.3% were found to be dependent on their family members. Most of them (65.5%) were found to be suffering from joint pains. Some cardio-respiratory problems like palpitation, dyspnea and chest pain was found to be significantly higher among the female respondents (p<0.03). ECG was done on 22 of them. Left ventricular hypertrophy was detected in 22.7% and ischemic heart disease in 27.27% of them. Systolic hypertension was significantly higher in the females (p<0.01). Majority of the respondents (64.5%) were found to have a normal fasting blood sugar level. Symptoms of prostatic enlargement like frequency, urgency, hesitation and post void dribbling of urine was respectively found to be present among 15.9, 62.8, 10.7 and 24.8% of the male respondents. In 11.4% of the female respondents, urinary dribbling was found. The mean age of menopause was estimated to be 48.46 years. Ibrahim Med. Coll. J. 2007; 1(2): 17-20 Key Words: Geriatric problems, old age, community health, RFST. doi: 10.3329/imcj.v1i2.2900

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Association of 25(OH)D and PTH with Metabolic Syndrome and Its Traditional and Nontraditional Components

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2010-1439 ◽

2011 ◽

Vol 96 (1) ◽

pp. 168-175 ◽

Cited By ~ 81

Author(s):

Sheena Kayaniyil ◽

Reinhold Vieth ◽

Stewart B. Harris ◽

Ravi Retnakaran ◽

Julia A. Knight ◽

...

Keyword(s):

Metabolic Syndrome ◽

Vitamin D ◽

Waist Circumference ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Cross Sectional ◽

Supplement Use ◽

The Metabolic Syndrome ◽

Multivariate Adjustment ◽

25 Hydroxy Vitamin D

Context: Emerging evidence suggests that 25-hydroxy vitamin D [25(OH)D] and PTH may play a role in the etiology of the metabolic syndrome (MetS). However, evidence to date is limited and inconsistent, and few studies have examined associations with nontraditional MetS components. Objective: The objective of the study was to examine the association of vitamin D and PTH with MetS and its traditional and nontraditional components in a large multiethnic sample. Design, Setting, and Participants: In this cross-sectional study, we examined 654 participants from London and Toronto, Ontario, Canada, aged 30 yr and older with risk factors for type 2 diabetes. Main Outcome Measures: Presence of MetS and its traditional and nontraditional components was measured. Results: Approximately 43% of the study participants were classified as having MetS. Higher 25(OH)D was significantly associated with a reduced presence of MetS after adjustment for age, sex, season, ethnicity, supplement use, physical activity, and PTH (odds ratio 0.76, 95% confidence interval 0.62–0.93). PTH was not associated with the presence of MetS after multivariate adjustment. Multivariate linear regression analyses indicated significant adjusted inverse associations of 25(OH)D with waist circumference, triglyceride level, fasting insulin, and alanine transaminase (P < 0.041). Elevated PTH was positively associated with waist circumference and high-density lipoprotein cholesterol (P < 0.04). Other associations between PTH and MetS components were attenuated after adjustment for adiposity. Conclusions: Serum 25(OH)D, but not PTH, was significantly associated with MetS as well as a number of MetS components after multivariate adjustment. These results suggest that low 25(OH)D may play a role in the etiology of the MetS.

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Association between asymptomatic intracranial arterial stenosis and insulin resistance or diabetes mellitus: a cross-sectional study in rural Shandong, China

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001788 ◽

2020 ◽

Vol 8 (2) ◽

pp. e001788

Author(s):

Qiao Wang ◽

Yuanyuan Zhao ◽

Xiang Wang ◽

Xiaokang Ji ◽

Shaowei Sang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Arterial Stenosis ◽

Sectional Study ◽

Intracranial Arterial Stenosis ◽

Cross Sectional ◽

Total Study Population ◽

Study Population

IntroductionRecent studies have shown that insulin resistance (IR) is correlated to atherosclerosis development. However, few studies have investigated the association between IR and asymptomatic intracranial arterial stenosis (aICAS).Research design and methodsThis cross-sectional study enrolled 2007 rural residents in China who were aged ≥40 years without a clinical history of stroke and transient ischaemic attack. We used transcranial Doppler ultrasonography in combination with magnetic resonance angiography to diagnose aICAS (stenosis ≥50%). IR was defined as a homeostasis model assessment of insulin resistance ≥3.0 based on the 75th percentile for all the participants. Multivariate logistic regression models were employed to assess the relationship of diabetic parameters with aICAS in all participants, as well as with aICAS in non-diabetic participants, and further stratified by sex.ResultsAfter adjusting for age, gender, smoking habit, drinking habit, low-density lipoprotein cholesterol, raised blood pressure, triglycerides, high-density lipoprotein cholesterol and waist circumference, diabetes mellitus (DM) (OR=2.09, 95% CI 1.31 to 3.32), fasting plasma glucose (FPG) (OR=1.34, 95% CI 1.14 to 1.57), and IR (OR=1.75, 95% CI 1.11 to 2.75) were associated with aICAS in the total study population; however, these relationships remained significant only in men after the analyses were stratified by sex (DM: OR=3.40, 95% CI 1.62 to 7.13; FPG: OR=1.64, 95% CI 1.26 to 2.13; IR: OR=3.04, 95% CI 1.44 to 6.42). When further excluding the diabetic participants from the total study population, positive associations between IR and aICAS were similarly observed only in men (OR=4.65, 95% CI 1.69 to 12.82).ConclusionsIR might predict the prevalence of aICAS independently of major cardiovascular risk factors and metabolic syndrome components among men living in rural China.

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Metabolic syndrome in haemodialysis patients: Prevalence, determinants and association to cardiovascular outcomes

10.21203/rs.2.21445/v1 ◽

2020 ◽

Author(s):

Arnaud Delautre ◽

François Chantrel ◽

Yves Dimitrov ◽

Alexandre Klein ◽

Olivier Imhoff ◽

...

Keyword(s):

Metabolic Syndrome ◽

Waist Circumference ◽

Visceral Obesity ◽

Density Lipoprotein ◽

Roc Curves ◽

Major Adverse Cardiovascular Events ◽

Operating Characteristics ◽

Clinical Predictors ◽

Cross Sectional ◽

The Metabolic Syndrome

Abstract Background In the general population, the metabolic syndrome (MetS) has been identified as predictive of major adverse cardiovascular events (MACE). Waist circumference (WC), a component of the MetS criteria, is linked to visceral obesity, which in turn is correlated with MACE. However, in haemodialysis (HD) patients, the association between MetS, WC and MACE is unclear.Methods In a cross-sectional study of 1000 HD patients, we evaluated the prevalence and characterised the clinical predictors of MetS. The relationship between MetS and its components, alone or in combination, and MACE, as defined by comorbidity among coronary diseases, peripheral arteriopathy, stroke or cardiac failure, was further studied using receiver operating characteristics (ROC) curves and logistic regression.Results A total of 753 patients were included between October 2011 and April 2013. The prevalence of MetS was 68.5%. Waist circumference (> 88 cm in women, 102 cm in men) was the best predictor of MetS (sensitivity 80.2; specificity 82.3; AUC 0.80; p < 0.05). In multivariate analysis, MetS was associated with MACE (OR: 1.85; 95CI 1.24-2.75; p < 0.01), but not WC alone. There was a stronger association between the combination of abdominal obesity, hypertriglyceridaemia and low high-density lipoprotein cholesterol with MACE after exclusion of impaired fasting glucose and hypertension.ConclusionsMetS is frequent and associated with MACE in HD patients in our region and probably in other European dialysis populations. In HD patients, a new simplified definition could be proposed, in keeping with the concept of hypertriglyceridaemic waist.

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