Prevalence and Influencing Factors of Metabolic Syndrome among Adults in China from 2015 to 2017

The prevalence and influencing factors of metabolic syndrome (MetS) in Chinese residents aged 20 or older were investigated. The data were collected from China Nutrition and Health Surveillance (2015–2017), which used a stratified, multistage, random sampling method. A total of 130,018 residents aged 20 years or older from 31 provinces were included in this study. The National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria were used to define MetS. The standardised prevalence of high waist circumference, high blood pressure and low high-density lipoprotein cholesterol were 40.8%, 49.4% and 41.1%, respectively. The following factors were associated with a higher prevalence of MetS: female [odds ratio (OR) = 1.773, 95% CI = 1.709–1.840]; older age (OR = 1.037, 95% CI = 1.036–1.039); living in north China (OR = 1.087, 95% CI = 1.058–1.117); high body mass index (OR = 1.402, 95% CI = 1.395–1.408); higher income [OR (95% CI): 1.044 (1.007–1.083), 1.083 (1.044–1.124) and 1.123 (1.078–1.170) for moderate, high, and very high income, respectively]; family history of hypertension (OR = 1.237, 95% CI = 1.203–1.273); family history of diabetes (OR = 1.491, 95% CI = 1.426–1.558) and current smoking status (OR = 1.143, 95% CI = 1.098–1.191). Living in the countryside (OR = 0.960, 95% CI = 0.932–0.988), moderate alcohol consumption (OR = 0.917, 95% CI = 0.889–0.946) and being physically active (OR = 0.887, 95% CI = 0.862–0.913) were associated with a lower prevalence of MetS. The prevalence of MetS among residents aged 20 years or older in China is increasing, especially among women, people aged 45 years or older and urban residents. Preventive efforts, such as quitting smoking and engaging in physical activity, are recommended to reduce the risk of MetS.

Association of Obesity with the Risk of Hyperhomocysteinemia among the Chinese Community Residents: A Prospective Cohort Study in Shanghai, China

A prospective community-based cohort study was conducted to investigate the effects of obesity on hyperhomocysteinemia (HHcy) in community residents from Shanghai, China, with a median follow-up period of 2.98 years. The exposures were high body mass index (BMI) (BMI ≥ 28.0 kg/m2) and high waist circumference (WC) (WC ≥ 85.0 cm for female and WC ≥ 90.0 for male) at baseline investigation, and the outcome was the incident of HHcy after the follow-up. A restricted cubic spline (RCS) was performed to assess the possible nonlinear relationship of BMI and WC with HHcy. A Cox proportional hazard regression model was used to evaluate the association between BMI and WC measured obesity and the risk of HHcy (Hcy level > 15 µmol/L). No significant non-linearity was found between BMI and WC with HHcy. Cox regression model showed that underweight measured by BMI was negatively associated with the risk of HHcy after controlling for confounder variables (adjusted HR = 0.64, 95% CI = 0.42 to 0.99). While abdominal obesity was positively associated with the risk of HHcy for those without CVD-related comorbidities (adjusted HR = 1.26, 95% CI = 1.05 to 1.51). Our results suggested that individuals could maintain a relatively low BMI and normal WC to lower the risk of HHcy.

Pulmonary functions in kidney transplant recipients: Single centre observational study

Background: Kidney transplantation in India is steadily increasing with advancement in medicines and surgical expertise. Subjects with kidney disease have spectrum of pulmonary pathologies but little is known regarding status on pulmonary function after kidney transplantation. Method: 149 kidney transplant recipients between 18 to 60 years of age, having stable graft function and more than 6months of post-transplant duration were included in the study. Forced vital capacity (FVC), forced expiratory volume in first second (FEV1), the ratio of FEV1/FVC and peak expiratory flow rate (PEFR) were evaluated. Result: 11 (7.4%) had a restrictive ventilatory impairment, none had obstructive lung function. FEV1 and FVC were lower among subjects with high waist circumference, over weight and obese. FEV1/FVC ratio were lower in subjects with comorbidities or physical inactivity. Conclusion: Restrictive lung functions present in few kidney transplant recipients. High waist circumference, over weight, obesity, comorbidity and physical inactivity alters pulmonary functions in kidney transplant recipients. KEY WORDS: Kidney transplantation, pulmonary function test, anthropometry, physical activity, comorbidity.

182Higher preference for spicy foods increases the risk of central obesity: a prospective cohort study

Background Central obesity, characterized by high waist circumference (WC), has been independently associated with higher chronic diseases and mortality risk. To date, controversial evidence is available concerning the beneficial effects of spicy foods on central obesity. We aimed to prospectively examine the association between preference for spicy foods and incident central obesity in Korean adults aged 40 and over. Methods We included 6,042 participants free of central obesity at baseline. Central obesity was defined as having WC ≥ 90 cm for men and ≥ 85 cm for women. As an exposure, preference for spicy foods was measured using a five-scale response option from the lowest to the highest preference and a Cox proportional hazard model was used to estimate the hazard ratios (HR) with confidence intervals (CI) for central obesity. Results During 45,654 person-years (median 9 years) of follow-up, 1,778 incident central obesity cases occurred. Compared to the lowest preference for spicy foods, the highest preference for spicy foods was associated with greater central obesity risk (HR = 1.43, 95% CI = 0.99-2.05, p trend=0.002). No interaction existed between preference for spicy foods and gender on central obesity incidence (p interaction > 0.05). Conclusions Appreciated for spicy foods was associated with an excess risk of central obesity incidence in Korean adults aged 40 years and older. Key messages These findings may provide informative evidence on primary prevention of central obesity, particularly for populations with a higher preference for spicy foods.

Metabolic, Affective and Neurocognitive Characterization of Metabolic Syndrome Patients with and without Food Addiction. Implications for Weight Progression

According to the food addiction (FA) model, the consumption of certain types of food could be potentially addictive and can lead to changes in intake regulation. We aimed to describe metabolic parameters, dietary characteristics, and affective and neurocognitive vulnerabilities of individuals with and without FA, and to explore its influences on weight loss progression. The sample included 448 adults (55–75 years) with overweight/obesity and metabolic syndrome from the PREDIMED-Plus cognition sub-study. Cognitive and psychopathological assessments, as well as dietary, biochemical, and metabolic measurements, were assessed at baseline. Weight progression was evaluated after a 3-year follow up. The presence of FA was associated with higher depressive symptomatology, neurocognitive decline, low quality of life, high body mass index (BMI), and high waist circumference, but not with metabolic comorbidities. No differences were observed in the dietary characteristics except for the saturated and monounsaturated fatty acids consumption. After three years, the presence of FA at baseline resulted in a significantly higher weight regain. FA is associated with worse psychological and neurocognitive state and higher weight regain in adults with metabolic syndrome. This condition could be an indicator of bad prognosis in the search for a successful weight loss process.

Sudden cardiac death among Iranian population: a two decades follow-up of Tehran lipid and glucose study

Sudden cardiac death (SCD) is described as death within one hour, if observed, from the onset of symptoms, and within 24 h of being alive and well if not observe. Study population includes 3705 men and 4446 women, aged ≥ 30 years. Multivariable Cox proportional hazard models were used to determine the risk factors associated with SCD. After a median follow-up of 17.9 years, 244 SCD (165 in males) occurred. The age-standardized incidence rate (95% confidence intervals (CI)) of SCD was 2.3 (2.1–2.7) per 1000 person-year. Current smoking [Hazard ratio (HR): 2.43, 95% CI: 1.73–3.42], high waist circumference [1.49: 1.04–2.12], hypertension [1.39: 1.05–1.84], type 2 diabetes mellitus [2.78: 2.09–3.69], pulse rate ≥ 90 beats per/minute [1.72: 1.22–2.42] and prevalent cardiovascular disease [1.75: 1.26–2.45] were significant risk factors. The corresponding population attributed fractions (PAF) were 14.30, 16.58, 14.03, 19.60, 7.62, and 8.30, respectively. Being overweight [0.58: 0.40–0.83] and obese [0.61: 0.38–0.98] decreased the risk of SCD. After excluding known diabetes cases from our data analysis, the newly diagnosed diabetes still showed an HR of 2.0 (1.32–3.00) with a PAF of 7.15% in the full adjustment model. To deal with sudden death as a catastrophic outcome, multi-component strategies by policy health makers are suggested.

Evaluation of predominant risk factors for type 2 diabetes mellitus among out-patients in two Nigerian secondary health facilities

Background: Prevention of type 2 diabetes is enabled by identification and effective management of risk factors. Objectives: To evaluate the predominant risks for type 2 diabetes and identify persons at highest risk in a population; to facilitate the understanding of implications for practice. Methods: Cross-sectional survey using Canadian diabetes risk assessment questionnaire was conducted among non-diabetic persons who visited two secondary hospitals. SPSS version 18 was used for data analysis. Results: A total of 300 respondents participated in the study, with 25.7% having family history of type 2 diabetes, while 160 (53.3%) were at high risk of developing the disease. Males (62.5%), overweight (65.1%) and obese (82.6%) participants, were at higher risk. Others found to be at high risk were respondents with high waist circumference (55.6%), respondents who did not exercise (77.0%), those who did not eat fruits/vegetable daily (54.4% ), those with high blood pressure (67.5%) and those who have had raised blood sugar in the past (71.0% ). Conclusion: Majority of the study participants was at high risk for type 2 diabetes, male participants had higher risks and lifestyles/habits were the major risks for developing the disease. Keywords: Evaluation; type 2 diabetes; risk factors; Nigeria; primary prevention.

Indirect and direct effects of factors associated with diabetes amongst the rural black population in the Dikgale Health and Demographic Surveillance System, South Africa

Background: Diabetes is an enormous, growing clinical and public health problem, which together with hypertension contributes significantly to the high risk of cardiovascular diseases (CVDs) globally.Aim: To examine the indirect and direct effects of risk factors simultaneously as a network of multiple pathways leading to diabetes in the rurally based adult population (aged 15+) using a household survey.Methods: This investigation was based on a predictive model using a cross-sectional community-based study to identify the direct and indirect effects of diabetes risk factors in the Dikgale Health and Demographic Surveillance System (HDSS) consisting of 15 villages, with 7200 households and a total population of approximately 36 000. Fasting blood glucose and total cholesterol were measured using ILAB 300 with the following cut-off values: high fasting blood glucose 7 mmol/L and triglycerides 1.70 mmol/L.Results: A total of 1407 individuals were interviewed, of whom 1281 had their blood pressure (BP) measured. The conceptual model was validated by the goodness-of-fit indexes (comparative fit index [CFI] = 1.00, Tucker Lewis index [TLI] = 1.041, root mean square error of approximation [RMSEA] = 0.001). Hypertension had the strongest direct effect of 0.0918 on diabetes, followed by age (0.0039) and high waist circumference (−0.0023). Hypertension also mediates the effects that high waist circumference (0.0005) and triglycerides (0.0060) have on diabetes status.Conclusion: The results in this study confirm the conceptual model considered in the risk factors for diabetes and suggest that hypertension, age and high waist circumference are the key variables directly affecting the diabetes status in the South African rural black population. The direct effect of triglycerides on diabetes suggests mediation by some measured factor(s).

Selenium intake is not associated with metabolic syndrome in Brazilian adolescents: an analysis of the ERICA study

Selenium acts reducing cellular inflammation and lipid peroxides; therefore, its association with cardiovascular diseases and metabolic syndrome (MetS) has been studied. We aimed to investigate the association between selenium intake and MetS/its parameters (high waist circumference, hyperglycemia, high blood pressure, high triglycerides, and low HDL-c) in Brazilian adolescents between 12-17 years old. This research is part of the Study of Cardiovascular Risks in Adolescents (ERICA), a Brazilian nationwide school-based study with regional and national relevance. We assessed: 1) socio-demographic data (sex, age, type of school, and maternal education) using a self-administered questionnaire; 2) dietary intake using a 24h recall applied for the whole sample and a second one applied to a subsample to allow within-person variability adjustment; 3) anthropometric data (weight, height, waist circumference) and blood pressure using standardized procedures; 4) biochemical analyses (fasting glucose, triglycerides, and HDL-c). Logistic regression was applied, basing the analysis on a theoretical model. Median Se intake was 98.3µg/day. Hypertension and hyperglycemia were more prevalent among boys, while a high waist circumference was more frequent in girls, and low HDL-c levels were higher among private school students. The prevalence of MetS was 2.6%. No association between MetS/its parameters and Se intake was found. This lack of association could be due to an adequate Se intake in the studied population.

Prevalence and Determinants of Underweight, Overweight, and Obesity: A Cross-Sectional Study of Sociodemographic, Dietary, and Lifestyle Factors Among Adolescent Girls in Jutiapa, Guatemala

Background: As the incidence of overweight continues to increase among children and adolescents in Guatemala, underweight remains a prominent health problem. However, the prevalence of overweight or underweight and associated risk factors has not been investigated among adolescent girls. Objective: To determine the prevalence of underweight and overweight/obesity and associated sociodemographic, dietary, and lifestyle factors among adolescent girls in Jutiapa, Guatemala. Methods: A cross-sectional study of a subsample of 392 girls aged 12 to 17 years from an agriculture-nutrition trial was conducted. Anthropometric data were obtained using standard methods. Sociodemographic, dietary, and lifestyle data were collected using a structured questionnaire. Multivariable logistic regression was conducted using underweight (body mass index [BMI] for age <5th percentile) and overweight/obesity (BMI for age ≥85th percentile) as outcome variables. Results: The prevalence of underweight and overweight/obesity was 9.9% and 15.6%, respectively. Age (15-17 years), high waist circumference, high blood pressure, father being a farmer, large family (>5 persons), hours spent watching TV, and high red meat consumption were significantly associated with underweight. Whereas being in school, high waist circumference, high blood pressure, overweight/obese mother, unemployed father, watching TV for more than 2 hours, having soft drinks at home, and meeting fruit recommendations were significantly associated with overweight/obesity. Conclusions: Our findings highlight the importance of concurrently addressing underweight and overweight/obesity among adolescent girls in rural Guatemala. Studies in various parts of the country are needed to confirm the results of the present study and for appropriate strategies to be implemented to reduce both underweight and overweight.