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Introduction: Diabetes mellitus seems to be the final stage of metabolic syndrome. The purpose of this study was to determine the importance of metabolic syndrome and its components in development of diabetes. Material and Methods: In Tehran Lipid and Glucose Study, 3995 people above the age of 20 (2353 females), were followed up for 1 to 4 years till December 2003. In this cohort study, metabolic syndrome at the beginning of the follow-up was defined, according to NCEP criteria, by the presence of three or more of the following components: abdominal obesity, hypertriglyceridemia, low HDL-C, high blood pressure, and high fasting glucose (above 110 mg/dL). Diabetes was defined as a fasting blood glucose above 126 or 2-hour post glucose load above 200 mg/dL, or use of hypoglycemic medication. The incidence of diabetes after follow up was compared between those with non-diabetic metabolic syndrome at the beginning of the study and healthy controls. Chi-square test and logistic regression along with ROC analysis were used. Results: The mean follow-up interval was 3.2 years. 117 non-diabetic individuals developed diabetes in this period which means an incidence risk of 4%. The incidence of diabetes in individuals with metabolic syndrome was more than in normal subjects (8% vs. 2.3%, P<0.001). The chances of developing diabetes after this period were higher in non-diabetics with metabolic syndrome than in normal subjects (OR=3.1 95%CI: 2.1-4.6). Multivariate logistic regression showed that high FPG below diabetic range (OR=11.4, 95%CI: 7.0-18.63), abdominal obesity (OR=2.1 95%CI: 1.4-3.1) and hypertension (OR=2.0 95%CI: 1.4-3.0) at the beginning of the study, were independent risk factors for developing diabetes after 3.2 years. The risk of developing IGT and IFG in normal individuals was also related to all components of the metabolic syndrome. Conclusions: Non-diabetic patients with metabolic syndrome have a greater chance of developing diabetes mellitus and milder forms of glucose metabolism disorders, and those with high plasma glucose, hypertension and abdominal obesity are at greater risk.

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Introduction: Because of the high prevalence of the metabolic syndrome in Iran, this study used factor analysis to examine how the major components of the metabolic syndrome relate to each other and the role of hyperlipidemia in Iranian subjects. Materials and Methods: 8990 subjects aged over 18 years, participants of the Tehran Lipid and Glucose Study, were selected. Anthropometry, blood pressure, serum glucose and lipid concentrations were measured to estimate the prevalence of the metabolic syndrome. Before and after excluding individuals with diabetes and hypertension, we used factor analysis to examine the pattern of the metabolic syndrome in 3956 men and 5034 women. Result: 26.6% of men and 36.3% of women had metabolic syndrome by ATPIII criteria and low HDL-C was the most frequent finding in subjects. Factor analysis reduced 8 anthropometric and metabolic variables into four uncorrelated factors. Four factors, which together account for 83.3% of the variance, can be identified: the first was obesity, blood pressure and hyperglycemia were second (hypertension) and the third factor was hypoglycemia. Dyslipidemia was the last factor and had a correlation with obesity. Conclusion: Findings support a concept in which the metabolic syndrome represents several distinct entities (dyslipidemia, obesity, hypertension and hyperglycemia) and obesity is the most important factor, having a strong correlation with dislipidemia in the Iranian population.

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Introduction: This study aims at determining the effects of the Dietary Approach to Stop Hypertension (DASH) eating plan on metabolic risks, in patients with metabolic syndrome. Materials and Methods: This was a randomized controlled outpatient trial conducted on 116 patients with metabolic syndrome. Three diets were prescribed for 6 months a control diet, a weight reducing diet emphasizing on healthy food choice, and the DASH diet with reduced in calories and increased in fruit, vegetables, low fat dairies, whole grain and reduced in saturated fat, total fat, cholesterol and restricted to 2400 mg Na. The main outcome measures were the components of the metabolic syndrome. Results: Relative to the control diet, the DASH diet resulted in higher HDL (7 and 10 mg/dL), lower TG (-18 and –14 mg/dL), SBP (-12 and –11 mmHg), DBP (-6 and –7 mmHg), weight (-16,-14 Kg), FBS (-15 and –8 mg/dL), and weight (-16 and –15 kg), among men and women respectively. (all P<0.001). The net reduction among men and women in TG (-17 and –18 mg/dL), SBP (-11 and –11 mmHg), DBP (-5 and –6 mmHg) and FBS (-4 and –6 mg/dL), weight (-16,-15 Kg) and increase in HDL (5 and 10 mg/dL) was higher in the DASH group (all p<0.05). The weight reducing diet resulted in significant change in TG (-13 and –10 mg/dL), SBP (-6 and –6 mmHg), weight (-13 and –12 kg) among men and women, respectively (all p<0.05). Conclusions: The DASH diet can likely reduce most of the metabolic risks both in men and women the related mechanisms need further study.

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Introduction: Different results have been reported on the association between metabolic syndrome (MS) and cardiovascular diseases (CVD). The aim of this study is to determine the role of the Adult Treatment Cholesterol Program (ATP III) and International Diabetes Federation (IDF) definitions of metabolic syndrome in predicting CVD. Material and Methods: In this cohort study, all individuals aged over 40 yrs, phase I participants of the TLGS, with no histories of CVD were selected. Based on the APT III and IDF criteria of the MS syndrome, they were divided into those with and those without the condition. All of the subjects were followed for a mean duration of 4.9±0.8 years for occurrence of CVD. The predictive ability of different definitions of the MS was evaluated in different regression models that included only the MS (model 1) and were also adjusted for age, sex, family history of premature CVD and smoking (model 2), serum LDL (model 3) and other components of the MS (model 4). Results: There were 3777 individuals’ aged 54±10 years 1536 (41%) where normal according to the both criteria of the MS and 1714 (45%) and 1900 (50%) subjects had MS according to the ATP III and IDF criteria respectively. New CVD occurred in 143 individuals (3.7%). In our study, the MS was the predictor of CVD in the first three models according to ATP III and IDF criteria however, in model 4, none of the definitions of MS predicted CVD. After calculation of the area under the curve (AUC) for model 2 and 3, it was observed that the power of the ATP III criteria in model 2 for prediction of CVD was significantly higher than the IDF (AUC 0.760 vs. 0.735, p<0.001) but no significant difference was observed between the 2 criteria in model 3. Conclusion: The ATP III and IDF definitions of the MS, it seems can similarly predict CVD after adjustment for the common CVD risk factors and LDL, whereas neither of the 2 definitions had this predictive power after adjustment of their components in addition to the earlier mentioned ones.

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Introduction: Heart disease is the primary cause of mortality in most countries. Different approaches have been designed for the prevention of heart disease risk factors, of which nutritional interventions is a main one. Materials and Methods: In the Tehran Lipid and Glucose Study, a sub-sample of 1474 subjects, were selected as cases for dietary assessment and implementation of nutritional interventions. After a 3. 8 year follow up, data were collected in both the intervention and case groups. Three hundred and sixteen subjects, aged 20 and over, that were not pregnant and did not use any hypoglycemic agents, lipid-lowering and anti-hypertensive prescription medications were enrolled for the study they were divided into controls (183 subjects) and cases (133 subjects). Mean energy intakes and macronutrients, were measured and compared within the two groups, using the paired t- test and ANCOVA was used between the two groups after controlling for age, sex, and baseline variables. Chi square and Mantel-Haenszel tests were performed to assess the prevalence of risk factors and metabolic syndrome between and within groups. McNemar test was used to assess the change of risk factors before and after intervention. Results: Mean energy, carbohydrate and fat intake decreased and cholesterol intake increased significantly in both groups. The prevalence of low HDL and central obesity increased in controls whereas hypercholesterolemia and high LDL cholesterol decreased significantly in the cases. The prevalence of high LDL decreased in cases as compared to the controls, with and without controlling for age, sex, and BMI. Pre- and post intervention evaluations showed improvement in hypercholesterolemia (p<0. 01) and high LDL (p<0. 01) in cases vs controls, whereas lesser improvement were seen in low HDL (p<0. 01) and central obesity (p<0. 01) in controls vs cases. Conclusion: The present study shows the effectiveness of nutritional interventions in curtailing and improving some risk factors of heart disease.

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Introduction:To examine the association between changes in body weight and body fat distribution and development of metabolic syndrome. Materials and Methods: Changes in body weight and body fat distribution and the appearance of metabolic syndrome over a 3 year duration were assessed in 2176 women of the Tehran Lipid and Glucose Study. Metabolic syndrome was defined according to ATPIII criteria. Body fat distribution was determined by waist to hip ratio, waist circumference and hip girth. Stable waist and hip were defined successively as±2cm and -2cm to 0cm, respectively. Results: The mean age of subjects was 36.4±12.7 years and the incidence of metabolic syndrome was 19 percent during this period. After controlling for age, family history, smoking status and physical activity, weight gain was monotonically related to the risk of development of metabolic syndrome (for each Kg of weight gained, risk increased by 1.15%). Changes in waist to hip ratio of over 0.07 cm, were significantly associated with risk (P<0.05), independent of the risk associated with weight change. Compared with women who had a stable waist, ≥ 3cm increase in waist circumference had 3.33 times (95%CI: 2.14-5.22) the risk of metabolic syndrome and ≥ 5cm increase in hip girth had 1.58 times (95%CI: 0.99-2.54) the risk of metabolic syndrome. Conclusion: Findings show that changes in weight and body fat distribution are associated with the risk of metabolic syndrome.

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Introduction: While many studies have reported cross-sectional associations between metabolic syndrome components, few have prospectively examined the development of the metabolic syndrome and comprehensive set of risk factors in a cohort. The objective was to evaluate the role of nutritional and anthropometrical factors in the incidence of metabolic syndrome in adults. Materials and Methods: In this population-based cohort study a representative sample of 410 subjects (male and female), aged 18-74 years who were free of the metabolic syndrome at baseline, were categorized based on quartile cut-points of metabolic syndrome components and food consumption. Baseline blood pressure, waist circumference, serum glucose and lipids, physical activity and dietary intake were measured and tested for predictors of the metabolic syndrome. Results: Metabolic syndrome developed in 71 subjects during the subsequent 3.5 years. The best predictors of incident metabolic syndrome were hypertension [odds ratio (OR) by quartile:1, 1.2, 1.6, 4.2, p for trend<0.05], waist circumference(1, 1.1, 2, 5.3, p for trend<0.05), triacylglycerol(1, 1, 2, 3, p for trend<0.05) and HDL cholesterol(1, 0.4, 0.4, 0.3 p for trend<0.05). In multivariate analysis increased waist circumference was the optimum predictor [OR 8(4-12.2)]. A prominent dose–response relationship across the carbohydrate and fat intake categories and the odds of metabolic syndrome was observed. Conclusion: This report confirms the role of blood pressure, waist circumference and lipid measurements in risk stratification of metabolic syndrome in adulthood. Interventions that address obesity and reduce waist circumference and an appropriate diet may reduce the incidence of the metabolic syndrome in adults.

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Introduction: Recent studies have shown that dairy consumption is inversely associated with the metabolic syndrome. Calcium and vitamin D, two major components of dairy products, have been postulated as being primarily responsible for the beneficial effect of dairy consumption. The objective was to examine whether and to what extent intakes of calcium and vitamin D are related to the metabolic syndrome in adults. Materials and Methods: In this population-based cross sectional study, a representative sample of 808 subjects (male and female) aged 18-74 y were randomly selected. Subjects were categorized based on quartile cut-points of dietary intakes of calcium and vitamin D. Multivariate logistic regression was used in 4 models to compare different dietary intake levels of calcium and vitamin D adjusted for lifestyle and nutritional confounders. Each model was additionally adjusted for more variables than the previous one. Results: After adjusting for age, calories, smoking status, exercise, BMI and parental history of myocardial infarction before age 60 years, dietary calcium levels were significantly and inversely associated with the prevalence of metabolic syndrome, and the ORs of having the metabolic syndrome for increasing quartiles of dietary calcium intake were 1.00 (reference), 0.90 (95% CI 0.61–1.04), 0.85 (0.78–0.99) and 0.74 (0.62–0.95) P for trend <0.02, and was not appreciably altered by additional adjustment for dietary vitamin D intake. Dietary vitamin D was inversely associated with the prevalence of metabolic syndrome but was not independent of total calcium intake. Similar strong relations between intakes of dairy products and metabolic syndrome were also observed and the multivariable OR comparing highest with lowest intake quartiles was 0.81(0.64-0.98), P for trend <0.03. Conclusion: It is concluded that intakes of calcium and dairy products may be associated with a lower prevalence of the metabolic syndrome in adults.

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Introduction: While consumption of vegetable and fruit are increasingly being recommended to prevent chronic diseases in dietary guidelines, epidemiologic data on the association between vegetable and fruit intakes and the metabolic syndrome is limited. The aim of this study was to investigate the hypothesis that higher fruit and vegetable intakes reduce metabolic risk factors in Tehranian adults. Materials and Methods: In a cross-sectional study, quartiles of vegetables and fruit consumption were determined using the food frequency questionnaire, for 606 subjects, aged 18-74 years. Blood pressure was assessed according to standard methods and fasting blood samples were taken for biochemical measurements. Hypertriglyceridemia, hypercholestrolemia, high LDL, low HDL and metabolic syndrome were defined according to ATP III guidelines. Results: Mean ±SD consumption of starchy vegetables, vegetables and fruit intake was 50.8±49, 304±179 and 211±147 g/day, respectively. The prevalence of metabolic syndrome was higher among subjects in lower quartiles of fruits (17.2% in first vs 15.4% in fourth quartile, P<0.05). Those in the higher quartile of vegetable intake had higher intakes of fat (31.7±8 in fourth vs 28.5±9 g/day in first quartile), cholesterol (208±13 in fourth vs 153±12 g/day in first quartile),(P<0.05). Significant differences were seen in mean vegetable and fruit intakes across the 3 risk factor groups (0,1-2 and ≥ 3 risk factors) after adjustments for fat and saturated fat intakes (310±14, 194±17 in individuals with ≥ 3 risk factors vs 364±18, 248±15 g/day in individuals with no risk factors respectively, P<0.05). There was a significant difference in mean fruit intake across the 3 risk factor groups before and after adjustments for fat and saturated fat intakes (P<0.05). Conclusion: Fruit and vegetable intake is inversely associated with the risk of having metabolic syndrome

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Abstract:

Introduction: Syndrome X or metabolic syndrome is a collection of risk factors which can lead to diabetes and cardiovascular diseases and result in death. Considering the important role of oxidative stress in causing the complications of this syndrome, the aim of this study was to investigate the effect of vitamin E supplementation on insulin resistance and associated risk factors in patients with metabolic syndrome. Materials and Methods: A randomized double blind placebo controlled clinical trial with parallel design was conducted on 70 metabolic syndrome patients, 29-57 years old, who were randomly divided into two groups one using 400 mg vitamin E (n=35), and group 2- given placebos (n=35) for 3 months 24 hour dietary recalls were completed in the beginning, and end of first, second and third months for each patient. Serum glucose and lipoprotein by enzymatic, Insulin by RIA, uric acid and CRP by colorimetric, insulin resistance by HOMA-IR methods were measured. For statistical analyses, student’s t-test, paired t-test, chi square and ANOVA were used. Results: There was significant difference in systolic and also diastolic blood pressure at the end of study in the vitamin E group compared to initial values (p=0.00, p=0.09 respectively). In this group, systolic blood pressure, serum glucose and triglycerides (TG) had significant decrease at the end of the study compared to the control (p= 0.003, p= 0.02, p= 0.04 respectively). Serum glucose, TG, insulin and insulin resistance had significant differences in the vitamin E group at the end of study compared to the beginning (p=0.03, p=0.01, p=0.03, p=0.04) Serum TG, glucose and insulin were 221.08±59.54, 114.07±9.64, and 8.3±1.6 at the beginning and 197.65±56.77, 101.05±9.7 and 7.48±1.55, respectively at the end of study. Conclusion: In metabolic syndrome patients, 400 mg vitamin E for 3 months had benetical effects on blood pressure, TG, glucose, insulin and insulin resistance.

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Abstract

Introduction: The aim of the present study was to assess the diagnostic accuracy of the modified ATP III and IDF definitions of the metablic syndrome in identifying of insulin resistant individuals by HOMA_IR and to assess levels of agreement between these definitions and insulin resistance. Materials and Methods: The sample consisted of 347 nondiabetic subjects from the TLGS population (140 men and 207 women aged 27-87 years). The reference standard for insulin resistance was determined by HOMA-IR and insulin resistance was defined as HOMA-IR≥2.5. Results: According to ATP III and IDF criteria 38.9%, 45% had metabolic syndrome respectively. The sensitivity and specificity of ATP III was 52.3% and 65% respectively, and this was 60% and 59% for IDF criteria respectively. Kappa agreement between modified ATP III and IDF with HOMA-IR was 0.14 and 0.15. Based on the area under the receiver operating characteristic curve constructed by counting metabolic syndrome components as recommended by modified ATP III and IDF diagnostic accuracy was fair. When each component of metabolic syndrome measures were considered as continous traits, waist circumference and fasting plasma glucose each separately had diagnostic accuracy equal or grater than at all the metabolic syndrome as a whole by ATP III and IDF criteria. Conclusion: ATP III and IDF definition, have low sensitivities for detecting insulin resistance and there is poor agreement between those criteria and insulin resistance. Measuring just waist circumference and fasting plasma glucose is simpler and may provide greater accuracy for identifying insulin resistance.

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Abstract

Introduction: Athough a controversial issue, the Metabolic Syndrome (MS) is known to by be related to certain genetic and lifestyle factors such as hypertension. The object of this study is to evaluate the prevalence of MS and its association to hypertension among diabetic patients with and without hypertension, in the Fatemeh Zahra hospital in Najafabad, Iran. Materials and Methods: This cross-sectional descriptive study was performed on diabetic patients referring to the Fatemeh Zahra Hospital, of whom 66 subjects were randomly selected and data was obtained from their hospital files, including systolic and diastolic blood pressure, Body Mass Index (BMI), Fasting Blood Sugar (FBS), lipid profiles, waist circumference, age, sex, family history and history of diabetes. Patients with blood pressure 140/90 were considered hypertensive. MS was confirmed according to the Adult Treatment Panel (ATP) III criteria. Data was analyzed with SPSS software using the independent Student t- test, regression and chi-square, P<0.05. Results: MS was more prevalent in hypertensive than in normotensive patients (93.3% vs 62.7%, p<0.02). Mean systolic and diastolic blood pressures were higher in MS patients than in patients without the syndrome, (136.85±25.20 vs 121.25± 28.00 and 81.63±17.00 vs 72.00±11.96 respectively). Conclusion: The findings of this study indicate the need for MS screening among diabetic hypertensive patients and importance of primary and secondary prevention of hypertension in order to curtail the impending epidemic of non-communicable diseases in our society.

 

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Abstract

Introduction: Recent studies indicate that Visfatin, a newly identified adipocytokine, may have potential proinflammatory effects. Since, the relationship between serum visfatin levels and metabolic syndrome (MetS) has not been established, the aim of this study was to explore the association between serum visfatin levels and anthropometric variables and the metabolic syndrome. Materials and Methods: Thirty-seven patients with MetS and 37 age matched controls (mean age 46.35±1.6 years) were included. Metabolic syndrome in patients was defined based on the 2005 criteria of the International Diabetes Federation, and anthropometric and biochemical profiles were documented. Serum Visfatin was measured using an enzyme immunoassay (EIA) kit. Using the t-test, data were compared between groups and Pearson's correlation coefficient was used to evaluate the relationship between continuous variables. P values <0.05 were considered as statistically significant. Results: Serum Visfatin level was significantly lower in metabolic syndrome patients (P<0. 05) compared controls, log visfatin: 1.74 ± 0.27ng/ml vs. 1.86 ±0.13 ng/ml, respectively. There was no significant correlation between serum visfatin levels and any anthropometric or any metabolic parameters in patients with metabolic syndrome or the control group. Conclusions: The results of this study showed that serum visfatin level was decreased in patients with MetS, indicating that Visfatin cannot be considered as a new proinflammatory adipocytokine for the metabolic syndrome.

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Abstract:

Introduction: In recent years, much attention has been focused on the metabolic syndrome and its association with development of non insulin dependent diabetes mellitus (NIDDM) and cardiovascular disease. Although androgen deficiency in men is associated with obesity, whether the deficiency predisposes to, or is a consequence of the syndrome is still unclear. This study aimed at assessing the association between low levels of total testosterone, the sex hormone binding globulin (SHBG) and free testosterone index, and development of the syndrome, based on ATP III and IDF criteria. Materials and Methods: We assessed 836 men, aged ≥ 20 years, participants of the Tehran Lipid Glucose Study, at baseline and over 6.5 years follow-up, according to both definitions for occurrence of metabolic syndrome, following adjustment for confounding factors such as age, physical activity, smoking, education, fasting plasma glucose, triglycerides, serum HDL-C, waist circumference, systolic and diastolic hypertension. Using logistic regression models, the association between serum total, free testosterone index and SHBG and metabolic syndrome was investigated. Results: After 6.5 years of follow-up, metabolic syndrome was found to have developed in 131 men and 207 men according to ATP III and IDF criteria respectively. Multiple logistic regression analysis showed an inverse relationship for total testosterone in the lower tertile concentration and serum triglycerides according to both criteria [odds ratio (OR)=1.6 95% confidence interval (CI), 1.02-2.5)]. According to ATP III criteria, adjustment of waist circumference eliminated most of the correlations between total testosterone and metabolic syndrome (OR=1.34, 95% CI (0.8-2.3), while SHBG and free testosterone index were not significantly associated with the syndrome. According to IDF criteria, statistical adjustment of waist circumference eliminated most of the correlations between total testosterone and metabolic syndrome [(OR=1.45, 95% CI (0.9-2.3)], and adjustment with triglycerides eliminated any correlation between SHBG and metabolic syndrome (OR=1.5, 95% CI (0.9-2.5). Conclusion: Our data do not support a predictive or causative role androgen deficiency in the development of metabolic syndrome according to ATP III and IDF definitions but do demonstrate that androgen deficiency may be consequence of the effect of poorly controlled triglycerides and increased waist circumference on, rather that a cause of, poor metabolic status.

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Abstract

Introduction: This study amis at determining which components of the metabolic syndrome are the best predictors of its development. Material and Methods: In this cohort study, from the participants of the cross sectional phase of the Tehran Lipid and Glucose Study(TLGS), 2279 subjects (aged 20-87) who did not have the metabolic syndrome, based on modified ATP III criteria, and 2310 subjects (aged 20-87) without the metabolic syndrome according to IDF criteria were followed. Results: After a mean interval of 6.5 years, 462 and 602 new cases of the metabolic syndrome were diagnosed on basis of the modified ATP III and IDF criteria, respectively. The adjusted odds ratio for development of the metabolic syndrome by ATP III criteria was highest for central obesity in men, 2.8 (2.2-3.7) and for triglycerides in women, 2.8 (2.0-4.1). The adjusted odds ratio for development of the metabolic syndrome by IDF criteria was highest for triglycerides in both men and women, OR being: 2.8 (2.2-3.7) and 2.9 (1.9-4.3) respectively. The area under the ROC curves for waist circumference, triglycerides and HDL were the highest. A model that included waist circumference and triglycerides or waist circumference and HDL predicted the metabolic syndrome as well as a model that included all five metabolic syndrome components. Conclusion: High risk subjects should undergo periodic screening, including measurement of waist circumference, triglycerides and plasma HDL, for timely prediction of development of metabolic syndrome.

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Abstract

Introduction: Metabolic syndrome is a clustering of metabolic abnormalities that increase the risk of chronic disease such as obesity, cardiovascular disease and diabetes. This study aimed at examing the associations between dietary glycemic index (GI) and glycemic load (GL) intake using the three definition of metabolic syndrome (Mets) and each of their components. Materials and Methods: Blood samples and 24-hour dietary recalls were obtained from 120 healthy adults, without Mets or diabetes, aged ≥40 yr, participants of the Tehran Glucose and Lipid study, in the east of Tehran. Anthropometric indices, blood pressure, fasting blood glucose, trygliceride, LDL-cholestrol and HDL-cholestrol were determined and GI and GL were measured in those who developed Mets after six years and results were compared to those subjects without Mets. Mets was defined according to criterias set by ATPIII, WHO and IDF. Results: After adjustment for potential confounding variables, GI and GL were inversely associated with ATPIII and IDF definitions. After adjustment for confounding lifestyle and dietary factors the prevalence of Mets was significantly higher among those in the highest quintile of GI (OR: 4. 5 95%CI: 1-19. 2) and GL(OR: 4. 8 95%CI: 1. 1-20. 6) compared to those in the lowest quintile category. On the other hand, after controlling for potential confounders, subjects in the highest quintile of GI, had higher LDL-cholestrol (P= 0. 005), body mass index (P=0. 003) and lower HDL-cholestrol (P=0. 01) , than did those in the lowest quintile. Highest quintile of GL was associated with higher LDL-cholestrol (P= 0. 001) and lower HDL-Cholestrol (P=0. 015). Conclusion: Results suggest that GI and GL may have unfavorable effects on metabolic syndrome and its components

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Abstract:

Introduction: The metabolic syndrome is a constellation of risk factors that increase the incidence of cardiovascular disease and type 2 diabetes mellitus. The prevalence of obesity and metabolic syndrome in adolescents is escalating worldwide. Understanding the rising prevalence of this syndrome could help decrease the occurrence of fatal cardiovascular and diabetic complications. The present study was carried out to determine the prevalence of metabolic syndrome in adolescents with varying degrees of obesity, in order to conduct and implement, timely screening and interventions. Materials and Methods: In a cross-sectional study conducted within the framework of the

Tehran Lipid and Glucose Study (TLGS), phase 3, 1523 adolescents, 708 boys and 815 girls 10-19 years of age, were investigated. The prevalence of metabolic syndrome, based on modified definitions for ATP III, AHA, NHASES III and IDF, was determined in varing degrees of body weight (normal, at risk of overweight, moderate and severe overweight) and compared in different sex, age groups, menarche status and familial history of diabetes mellitus. Data was analyzed using the and Mann-Whitney tests and multiple logistic regression. Results: Overall, 15 percent of adolescents were at risk of overweight, 4. 2 percent had moderate overweight and 4. 6 percent were severely overweight, with no significant difference between the two sex groups (P=0. 381). Overall, the prevalence of metabolic syndrome, based on definitions for ATP III, AHA, NHANES III and IDF, was 9. 5, 5. 1, 17. 8 and 5. 8 percent, respectively, which was significantly higher in boys than in girls. Based on the 4 defintions, the prevalence of metabolic syndrome in the normal weight group was 2. 2, 0. 9, 8. 6, 0. 8 percent respectively, in the at risk of overweight group it was 21. 5, 11, 36. 4 and 11 percent, in moderate overweight group it was 42. 2, 23. 4, 64. 1 and 32. 8 percent, and in the severe overweight group it was 62. 9, 38. 6, 67. 1 and 47. 1 percent, respectively (P<0. 001). The prevalence of each metabolic risk factor and the number of these factors was higher in overweight adolescents. Only by the IDF definition, the prevalence of metabolic syndrome was significantly higher after-menarche than before it (P=0. 04). All definitions showed the higher prevalence of metabolic syndrome in positive familial history of diabetes mellitus (P<0. 001). Conclusion: This study showed a high prevalence of overweight, obesity and metabolic syndrome in Tehranian adolescents, with significantly higher prevalence of metabolic syndrome in more obese adolescents. Metabolic syndrome was more prevalent, in boys, thosepersons with positive familial history of diabetes mellitus and in after-menarche aged girls,which data can be put to use in lifestyle modification programs.

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Abstract

Introduction: Artificial neural networks as a modern modeling method have received considerable attention in recent years. The models are used in prediction and classification in situations where classic statistical models have restricted application when some, or all of their assumptions are met. This study is aimed to compare the ability of neural network models to discriminant analysis and logistic regression models in predicting the metabolic syndrome. Materials & Methods: A total of 347 participants from the cohort of the Tehran Lipid and Glucose Study (TLGS) were studied. The subjects were free of metabolic syndrome at baseling according to the ATPIII criteria. Demographic characteristics, history of coronary artery disease, body mass index, waist, LDL, HDL, total cholesterol, triglycerides, fasting and 2 hours blood sugar, smoking, systolic and diastolic blood pressure were measured at baseline. Incidence of metabolic syndrome after about 3 years of follow up was considered a dependent variable. Logistic regression, discriminant analysis and neural network models were fitted to the data. The ability of the models in predicting metabolic syndrome was compared using ROC analysis and the Kappa statistic, for which, MATLAB software was used. Results: The areas under receiver operating characteristic (ROC) curve for logistic regression, discriminant analysis and artificial neural network models (15: 8: 1) and (15: 10: 10) were estimated as 0. 749, 0. 739, 0. 748 and 0. 890 respectively. Sensitivity of models were calculated as 0. 483, 0. 677, 0. 453 and 0. 863 and their specificity as 0. 857, 0. 660, 0. 910 and 0. 844 respectively. The Kappa statistics for these models were 0. 322, 0. 363, 0. 372 and 0. 712 respectively. Conclusion: Results of this study indicate that artificial neural network models perform better than classic statistical models in predicting the metabolic syndrome.

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Introduction: The metabolic syndrome includes risk factors for non-communicable diseases such as central obesity, hyperglycemia, dyslipidemia and hypertension accompanied by pro-inflammatory and hypercoagulability states. The aim of this study was to determine the effects of weight change on incident metabolic syndrome. Materials and Methods: This was a prospective cohort study, the population of which included all participants of the TLGS, phases one and two, >20 yrs and above, free of metabolic syndrome, based on the Iranian waist circumference, and NHLBI. Iranian waist circumference was defined with different cutoff points, according to cross sectional and outcome-based studies. Data was obtained by interviews, questionnaires, observation, and physical and laboratory examinations.The incidence of metabolic syndrome after 3.1 years of follow up was determined. Percent of weight change (PWC) was divided in five quintiles. Using the logistic regression test, odds ratio and 95% confidence interval of incident metabolic syndrome and its components for these quintiles, after adjusting for confounders, were calculated. Results: Age adjusted incidences of metabolic syndrome after a 3.1 year follow up, according to Iranian WC outcome were 20.6% (males 26%, females 20.9%) and for Iranian WC cross sectional and NHLBI were 26.2% (males 34.4%, females 26.1%) and 23.7% (males 24.4%, females 29.4%) respectively. For both genders, based on Iranian W.C and NHLBI, a weight reduction of at least 1.3%, compared to baseline, in women had a protective effect against incident metabolic syndrome. In men a weight gain of at least 1.4% since baseline resulted in an increase in the odds ratio. In women, weight gain of at least 1.3% since baseline, based on the Iranian WC cross sectional, NHLBI and at least 4% based on Iranian W.C-outcome resulted in progressive incidence of metabolic syndrome. These reductions of at least 1.3% in males and 2.5% in females, decreased the relative risk of abdominal obesity, but had no effect on other components of metabolic syndrome, including: hypertriglyceridemia, low HDL, hyperglycemia, and hypertension. Although in both sexes, increase in weight resulted in abdominal obesity, the cut off points according to various definitions were different. Conclusion: Considering the preventive effect of weight loss against incident metabolic syndrome and abdominal obesity, we recommend educational programs to enhance awareness regarding overweight and obesity and motivate individuals to lose weight.

 

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Abstract

Introduction: Obesity is one of the risk factors of metabolic syndrome and type 2 diabetes. Considering that appropriate treatment of the each of several metabolic disorders is the key to effectively reducing mortality, morbidity and disability and the growing prevalence of obesity in the last century, this study was conducted to in vestigate the prevalence of abdominal obesity and to detect its qualitative relation with other components of the metabolic syndrome. Materials and Methods: This cross-sectional descriptive study was done on 1392 diabetics' type 2 patients between the ages 30 to 83 years. Following laboratory and clinical evaluations, and completion of questionnaires, data was statistically analyzed using two statistical tests the Chi-square and Fisher for qualitative data and the T test for quantitative data. Results: Of 1392 patients with type 2 diabetes, 810 patients (58.2 %) had abdominal obesity, including 46 men (5.7%) and 764 (94.3%) women. According to NCEP ATPIII1, 768 patients (94.8%) had metabolic syndrome. A significant relation was observed between abdominal obesity and sex, hypertension, decreased HDL and metabolic syndrome. (P‹ 0.01) However, there was no significant relationship between abdominal obesity, age and high TG (P‹0.01) Conclusion: The results of this study indicated that obesity had the strongest qualitative relation with metabolic syndrome, indicating the need to it control appropriately in diabetic patients.