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

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

10.21203/rs.2.21445/v2 ◽

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 ◽

Cross Sectional Study ◽

Major Adverse Cardiovascular Events ◽

Operating Characteristics ◽

Clinical Predictors ◽

Cross Sectional

Abstract Background: In the general population, metabolic syndrome (MetS) is 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 associated 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 (coronary diseases, peripheral arteriopathy, stroke or cardiac failure), was 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.Conclusions: MetS is frequent and significantly associated with MACE in our haemodialysis cohort and probably in other European dialysis populations as well. In HD patients, a new simplified definition could be proposed in keeping with the concept of the "hypertriglyceridaemic waist".

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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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The Prevalence and Predictors of Hypertension and the Metabolic Syndrome in Police Personnel

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18136728 ◽

2021 ◽

Vol 18 (13) ◽

pp. 6728

Author(s):

James D. Yates ◽

Jeffrey W. F. Aldous ◽

Daniel P. Bailey ◽

Angel M. Chater ◽

Andrew C. S. Mitchell ◽

...

Keyword(s):

Metabolic Syndrome ◽

Density Lipoprotein ◽

Cross Sectional ◽

Job Type ◽

The Metabolic Syndrome ◽

High Prevalence ◽

Police Personnel ◽

Behavioural Factors ◽

Cardiometabolic Risk Markers ◽

Police Forces

Hypertension and metabolic syndrome (METSYN) are reportedly high in police forces. This may contribute to health deterioration and absenteeism in police personnel. Police forces comprise of staff in ‘operational’ and ‘non-operational’ job types but it is not known if job type is associated to hypertension and METSYN prevalence. This study aimed to explore the prevalence of hypertension and METSYN, the factors associated with the risk of hypertension and METSYN, and compare physiological, psychological, and behavioural factors between operational and non-operational police personnel. Cross-sectional data was collected from 77 operational and 60 non-operational police workers. Hypertension and METSYN were prevalent in 60.5% and 20% of operational and 60.0% and 13.6% of non-operational police personnel, respectively (p > 0.05). Operational job type, moderate organisational stress (compared with low stress) and lower high-density lipoprotein cholesterol were associated with lower odds of hypertension, whereas increasing body mass index was associated with increased odds of hypertension (p < 0.05). None of the independent variables were significantly associated with the odds of METSYN. Operational police had several increased cardiometabolic risk markers compared with non-operational police. Given the high prevalence of hypertension and METSYN in operational and non-operational personnel, occupational health interventions are needed for the police and could be informed by the findings of this study.

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Cortisol, DHEAS, their ratio and the metabolic syndrome: evidence from the Vietnam Experience Study

Acta Endocrinologica ◽

10.1530/eje-09-1078 ◽

2010 ◽

Vol 162 (5) ◽

pp. 919-923 ◽

Cited By ~ 28

Author(s):

Anna C Phillips ◽

Douglas Carroll ◽

Catharine R Gale ◽

Janet M Lord ◽

Wiebke Arlt ◽

...

Keyword(s):

Metabolic Syndrome ◽

Military Service ◽

Fasting Blood Glucose ◽

Density Lipoprotein ◽

Cross Sectional ◽

Us Army ◽

Telephone Interviews ◽

The Metabolic Syndrome ◽

Increased Risk ◽

Vietnam Era

ObjectivesThe aim of these analyses was to examine the association of cortisol, DHEAS and the cortisol:DHEAS ratio with the metabolic syndrome (MetS) and its components.DesignThe analyses were cross-sectional.MethodsParticipants were 4255 Vietnam era US army veterans. From military service files, telephone interviews and a medical examination, occupational, socio-demographic and health data were collected. MetS was ascertained from data on body mass index; fasting blood glucose or a diagnosis of diabetes; blood pressure or a diagnosis of hypertension; high-density lipoprotein cholesterol; and triglyceride levels. Contemporary morning fasted cortisol and DHEAS concentrations were determined. The outcomes were MetS and its components. Analysis was by logistic regression, first adjusting for age and then additionally for an array of candidate confounders.ResultsCortisol, although not in the fully adjusted analysis, and DHEAS were both related to MetS. Whereas high cortisol concentrations were associated with an increased risk of MetS, high DHEAS concentrations appeared protective. By far, the strongest associations with MetS were observed for the cortisol:DHEAS ratio; the higher the ratio, the greater the risk of having MetS. The ratio was also significantly related to four of the five MetS components.ConclusionsThe cortisol:DHEAS ratio is positively associated with MetS. Prospective analyses are needed to help untangle direction of causality, but this study suggests that the cortisol:DHEAS ratio is worthy of further study in this and other health contexts.

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A Three-Month Consumption of Eggs Enriched with ω-3, ω-5 and ω-7 Polyunsaturated Fatty Acids Significantly Decreases the Waist Circumference of Subjects at Risk of Developing Metabolic Syndrome: A Double-Blind Randomized Controlled Trial

Nutrients ◽

10.3390/nu13020663 ◽

2021 ◽

Vol 13 (2) ◽

pp. 663

Author(s):

Monique T. Ngo Njembe ◽

Barbara Pachikian ◽

Irina Lobysheva ◽

Nancy Van Overstraeten ◽

Louis Dejonghe ◽

...

Keyword(s):

Metabolic Syndrome ◽

At Risk ◽

Randomized Controlled Trial ◽

Waist Circumference ◽

Controlled Trial ◽

Density Lipoprotein ◽

Test Group ◽

Double Blind ◽

Randomized Controlled ◽

The Metabolic Syndrome

Alpha-linolenic acid (ALA), docosahexaenoic acid (DHA), rumenic acid (RmA), and punicic acid (PunA) are claimed to influence several physiological functions including insulin sensitivity, lipid metabolism and inflammatory processes. In this double-blind randomized controlled trial, we investigated the combined effect of ALA, DHA, RmA and PunA on subjects at risk of developing metabolic syndrome. Twenty-four women and men were randomly assigned to two groups. Each day, they consumed two eggs enriched with oleic acid (control group) or enriched with ALA, DHA, RmA, and PunA (test group) for 3 months. The waist circumference decreased significantly (−3.17 cm; p < 0.001) in the test group. There were no major changes in plasma insulin and blood glucose in the two groups. The dietary treatments had no significant effect on endothelial function as measured by peripheral arterial tonometry, although erythrocyte nitrosylated hemoglobin concentrations tended to decrease. The high consumption of eggs induced significant elevations in plasma low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol (p < 0.001), which did not result in any change in the LDL/HDL ratio in both groups. These results indicate that consumption of eggs enriched with ALA, DHA, RmA and PunA resulted in favorable changes in abdominal obesity without affecting other factors of the metabolic syndrome.

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Metabolic syndrome in fixed-shift workers

Revista de Saúde Pública ◽

10.1590/s0034-8910.2015049005524 ◽

2015 ◽

Vol 49 (0) ◽

Cited By ~ 6

Author(s):

Raquel Canuto ◽

Marcos Pascoal Pattussi ◽

Jamile Block Araldi Macagnan ◽

Ruth Liane Henn ◽

Maria Teresa Anselmo Olinto

Keyword(s):

Metabolic Syndrome ◽

Educational Level ◽

Skin Color ◽

Leisure Time Physical Activity ◽

Density Lipoprotein ◽

Processing Plant ◽

Cross Sectional ◽

Shift Workers ◽

Work Shift ◽

The Metabolic Syndrome

OBJECTIVE To analyze if metabolic syndrome and its altered components are associated with demographic, socioeconomic and behavioral factors in fixed-shift workers.METHODS A cross-sectional study was conducted on a sample of 902 shift workers of both sexes in a poultry processing plant in Southern Brazil in 2010. The diagnosis of metabolic syndrome was determined according to the recommendations from Harmonizing the Metabolic Syndrome. Its frequency was evaluated according to the demographic (sex, skin color, age and marital status), socioeconomic (educational level, income and work shift), and behavioral characteristics (smoking, alcohol intake, leisure time physical activity, number of meals and sleep duration) of the sample. The multivariate analysis followed a theoretical framework for identifying metabolic syndrome in fixed-shift workers.RESULTS The prevalence of metabolic syndrome in the sample was 9.3% (95%CI 7.4;11.2). The most frequently altered component was waist circumference (PR 48.4%; 95%CI 45.5;51.2), followed by high-density lipoprotein. Work shift was not associated with metabolic syndrome and its altered components. After adjustment, the prevalence of metabolic syndrome was positively associated with women (PR 2.16; 95%CI 1.28;3.64), workers aged over 40 years (PR 3.90; 95%CI 1.78;8.93) and those who reported sleeping five hours or less per day (PR 1.70; 95%CI 1.09;2.24). On the other hand, metabolic syndrome was inversely associated with educational level and having more than three meals per day (PR 0.43; 95%CI 0.26;0.73).CONCLUSIONS Being female, older and deprived of sleep are probable risk factors for metabolic syndrome, whereas higher educational level and higher number of meals per day are protective factors for metabolic syndrome in fixed-shift workers.

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Optimal waist circumference cut-off points and prediabetic state as predictors of metabolic syndrome prevalence among Saudi adults in Jeddah city

World Journal of Biology Pharmacy and Health Sciences ◽

10.30574/wjbphs.2021.7.2.0076 ◽

2021 ◽

Vol 7 (2) ◽

pp. 072-084

Author(s):

Bashaer O Alhejaili ◽

Rajaa M Al-Raddadi ◽

Suhad M Bahijri ◽

Al-Mutairi khalid Dakhil Allah ◽

Salma Mohammed Yehya Suhluli ◽

...

Keyword(s):

Metabolic Syndrome ◽

Waist Circumference ◽

High Educational Level ◽

Prediabetic State ◽

Cross Sectional ◽

Jeddah City ◽

The Metabolic Syndrome ◽

Primary Health Care Centers ◽

Health Care Centers ◽

High Educational

With increasing prevalence of metabolic syndrome and absence of local waist circumference cut-off point, it is important to determine the local cut-off point of waist circumference to predict metabolic syndrome. The aim of this study is to estimate the prevalence of metabolic syndrome among Saudi adults who attend primary health care centers (PHC) in Jeddah city in 2017, and to determine the appropriate waist circumference cut-off value for identifying a person at risk for the metabolic syndrome. A cross-sectional analytic study was conducted. Results shows; mean age of participants was 30.94±9.70 and waist circumference was 96.87±17.40 in males and 86.51±15.30 in females. The prevalence (CI: 95%) of pre-diabetes was 16.3% (12.9%; 20.1%), while the prevalence of metabolic syndrome was {(95% CI = 10.6%) (7.80%; 13.8%)}. Abdominal obesity was the most frequent component of MetS, detected in 60.6%, and followed by high blood pressure in 25.0%. In males, a waist circumference≥93.5 cm is likely to indicate MetS with 100% sensitivity and 47.2% specificity; whereas, in females, optimal waist circumference cut-off was determined as ≥83.5 cm, showing 92.3% sensitivity and 46.4% specificity. In multivariate logistic regression, extended waist circumference was the strongest predictor of MetS {OR (95%CI) =3.75 (1.30; 10.81); p=0.014}, followed by the presence pre-diabetes {OR (95%CI) =2.31 (1.06; 5.04); p=0.035}. Further, high educational level was a significant predictor for MetS {OR (95%CI) = 0.34 (0.12; 0.99); p=0.047}; while age and marital status were not significant predictors.

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Isotemporal substitution of inactive time with physical activity and time in bed: cross-sectional associations with cardiometabolic health in the PREDIMED-Plus study

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-019-0892-4 ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Aina M. Galmes-Panades ◽

Veronica Varela-Mato ◽

Jadwiga Konieczna ◽

Julia Wärnberg ◽

Miguel Ángel Martínez-González ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Older Adults ◽

Metabolic Syndrome ◽

Body Composition ◽

Waist Circumference ◽

Biochemical Parameters ◽

Cross Sectional ◽

The Metabolic Syndrome ◽

Time In Bed

Abstract Background This study explored the association between inactive time and measures of adiposity, clinical parameters, obesity, type 2 diabetes and metabolic syndrome components. It further examined the impact of reallocating inactive time to time in bed, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) on cardio-metabolic risk factors, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Methods This is a cross-sectional analysis of baseline data from 2189 Caucasian men and women (age 55–75 years, BMI 27–40 Kg/m2) from the PREDIMED-Plus study (http://www.predimedplus.com/). All participants had ≥3 components of the metabolic syndrome. Inactive time, physical activity and time in bed were objectively determined using triaxial accelerometers GENEActiv during 7 days (ActivInsights Ltd., Kimbolton, United Kingdom). Multiple adjusted linear and logistic regression models were used. Isotemporal substitution regression modelling was performed to assess the relationship of replacing the amount of time spent in one activity for another, on each outcome, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Results Inactive time was associated with indicators of obesity and the metabolic syndrome. Reallocating 30 min per day of inactive time to 30 min per day of time in bed was associated with lower BMI, waist circumference and glycated hemoglobin (HbA1c) (all p-values < 0.05). Reallocating 30 min per day of inactive time with 30 min per day of LPA or MVPA was associated with lower BMI, waist circumference, total fat, visceral adipose tissue, HbA1c, glucose, triglycerides, and higher body muscle mass and HDL cholesterol (all p-values < 0.05). Conclusions Inactive time was associated with a poor cardio-metabolic profile. Isotemporal substitution of inactive time with MVPA and LPA or time in bed could have beneficial impact on cardio-metabolic health. Trial registration The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.

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Vasculometabolic and Inflammatory Effects of Aldosterone in Obesity

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa356 ◽

2020 ◽

Vol 105 (8) ◽

pp. 2719-2731

Author(s):

Charlotte D C C van der Heijden ◽

Rob ter Horst ◽

Inge C L van den Munckhof ◽

Kiki Schraa ◽

Jacqueline de Graaf ◽

...

Keyword(s):

Metabolic Syndrome ◽

Systemic Inflammation ◽

Carotid Atherosclerosis ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Metabolic Disturbances ◽

Cross Sectional ◽

Metabolic Dysregulation ◽

Markers Of Inflammation ◽

The Metabolic Syndrome

Abstract Context Not all obese individuals develop cardiovascular disease (CVD). Hyperaldosteronism is suggested to cause inflammation and metabolic dysregulation, and might contribute to CVD development in obese individuals. Objective We aimed to investigate the association of aldosterone concentrations with inflammation, metabolic disturbances, and atherosclerosis in overweight and obese individuals. Additionally, we measured renin concentrations to investigate whether the observed effects reflected general activation of the renin-angiotensin-aldosterone system (RAAS). Design A cross-sectional cohort study (300-OB study) was conducted. Various inflammatory parameters, traits of the metabolic syndrome, lipidome and metabolome parameters, fat distribution, and carotid atherosclerosis were associated with plasma aldosterone and renin levels. Setting The setting of this study was the Radboudumc (i.o. Radboudumc), the Netherlands. Patients A total of 302 individuals with a body mass index greater than or equal to 27 kg/m2 participated. Main Outcome Measures and Results Aldosterone was associated with various markers of inflammation and metabolic dysregulation, which partly differed from the associations observed for renin. Although both were associated with inflammatory cell numbers, only renin was associated with classical markers of systemic inflammation. Both were associated with the metabolic syndrome and hepatic steatosis. Of the traits that constitute metabolic syndrome, aldosterone, but not renin, was associated with triglyceride concentrations. Accordingly, aldosterone was associated with large very low-density lipoprotein particles; metabolomics studies further associated aldosterone with urate concentrations and derivatives of the linoleic acid metabolism pathway. Neither aldosterone nor renin was associated with atherosclerotic plaque thickness. Conclusions Aldosterone is not an important driver of systemic inflammation in the obese, whereas aldosterone concentrations and metabolic dysregulation are strongly intertwined in these individuals. Although prospective studies are necessary to validate these results, the independent effects of aldosterone on carotid atherosclerosis appear modest.

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The prevalence of metabolic syndrome and its association with body fat distribution in middle-aged individuals from Indonesia and the Netherlands: a cross-sectional analysis of two population-based studies

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-019-0503-1 ◽

2020 ◽

Vol 12 (1) ◽

Cited By ~ 13

Author(s):

Fathimah S. Sigit ◽

Dicky L. Tahapary ◽

Stella Trompet ◽

Erliyani Sartono ◽

Ko Willems van Dijk ◽

...

Keyword(s):

Metabolic Syndrome ◽

Waist Circumference ◽

The Netherlands ◽

Abdominal Obesity ◽

Dutch Population ◽

Middle Aged ◽

Cross Sectional ◽

Metabolic Complications ◽

Men And Women ◽

The Metabolic Syndrome

Abstract Background The prevalence of metabolic syndrome varies among populations with different ethnicities. Asian populations develop metabolic complications at lower amounts of adiposity than western populations. The role of abdominal obesity in the metabolic differences between the two populations is poorly understood. Objectives Our objectives were to estimate the prevalence of metabolic syndrome and the relative contribution of its components in the Indonesian and the Dutch population, as well as to examine the associations of overall and abdominal obesity with metabolic syndrome. Methods In this cross-sectional study of middle-aged adults in the Netherlands Epidemiology of Obesity Study (n = 6602) and the Indonesian National Health Surveillance (n = 10,575), metabolic syndrome was defined by the unified IDF and AHA/NHLBI criteria. We performed logistic and linear regressions to examine associations of BMI and waist circumference with the metabolic syndrome, mutually adjusted for waist circumference and BMI. Results The prevalence of metabolic syndrome was 28% and 46% in Indonesian men and women, and 36% and 24% in Dutch men and women. The most prominent components were hypertension (61%) and hyperglycemia (51%) in the Indonesian, and hypertension (62%) and abdominal obesity (40%) in the Dutch population. Per SD in BMI and waist circumference, odds ratios (ORs, 95% CI) of metabolic syndrome were 1.5 (1.3–1.8) and 2.3 (1.9–2.7) in Indonesian men and 1.7 (1.2–2.5) and 2.9 (2.1–4.1) in Dutch men. The ORs of metabolic syndrome were 1.4 (1.2–1.6) and 2.3 (2.0–2.7) in Indonesian women and 1.0 (0.8–1.3) and 4.2 (3.2–5.4) in Dutch women. Conclusion More Indonesian women than men have metabolic syndrome, whereas the opposite is true for the Dutch population. In both the Indonesian and the Dutch populations, hypertension is the primary contributor to the prevalence of metabolic syndrome. In both populations, abdominal adiposity was more strongly associated with metabolic syndrome than overall adiposity.

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