Prevalence of metabolic syndrome in adults in Khanh Hoa, Viet Nam

Background The metabolic syndrome (MS) is characterized by a specific clustering of risk factors, including dyslipidemia, central adiposity, systemic hypertension, insulin resistance, and dysglycemia. It is associated with an increased risk of developing cardiovascular disease (CVD). Accurate data on prevalence and characteristics of MS will facilitate the development of preventive strategies for CVD. Objective To estimate accurately the prevalence of MS among Vietnamese adults with the usual criteria or with the criteria modified for Asian populations. Design and methods We studied a representative, cross-sectional, population-based sample of 856 subjects (mean age 52.82 ± 16.36) classified in three age groups from 15-34 years, 35-54 years and ＞ 54 years of age, living in Khanh Hoa Province, Viet Nam. MS was diagnosed according to the criteria defined by the Third Report of the National Cholesterol Education Program Expect Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel Ⅲ) (NCEP-ATP Ⅲ) and by the modified criteria for some Asian populations in which the waist circumference (WC) is considered abnormal if it is ＞ 90 cm for males and ＞ 80 cm for females.Results Using the NCEP-ATP Ⅲ criteria, the prevalence of MS in the studied population was 10.0％ (CI 95 ％:8.1-12.3). It was 2.4 ％ in the 15-34 age group (men 4.5％ and women 1.2％),5.2％ (men 6.3％,women 4.5％ ) in 35-54 age group and 15.8％ (men 9.7％, women 21.7％) in over 54 age group, respectively. And it was more common in women than in men (11.7％ vs 8.0％, P ＜0.001). Using 2001 population census data of the whole province over 15 years (695 218 habitants) we estimated that about 35 193 people suffered from the MS.The WC was the least common feature of MS (2.1％ for men and in 6.1％ for women).Overall,45.2 ％ of the studied population had one feature of MS, 23.1％ had two features, 8.2％ had three features, 1.6％ had four features, and 0.2％ had all five features. No feature of MS was identified in 21.7％.Using the modified criteria,the prevalence of MS in the studied population was 15.7％. It was 4.0％ in the 15-34 age group, 12.5％ in the 35-54 age group and 21.5％ in the＞54 age group. Prevalence of modified WC feature was 10.9％ for men and 23.6％ for women.Conclusions MS is more accurately identified among Vietnamese adults using the modified criterion of the WC for some Asian populations. Its prevalence is similar to that in the developed countries. ( J Geriatr Cardiol 2004;1(2) :95-100.)     

Protective effect of alcohol consumption for fatty liver but not metabolic syndrome

AIM:To investigate the effect of alcohol on the metabolic syndrome (MS) and fatty liver in Japanese men and women.METHODS:A cross-sectional study was conducted in a medical health checkup program at a general hospital.This study involved 18 571 Japanese men and women,18-88 years of age,with a mean body mass index of 22.6 kg/m 2.A standardized questionnaire was administered.The total amount of alcohol consumed per week was calculated,and categorized into four grades.Fatty liver was examined by ultrasound modified criteria of the revised National Cholesterol Educa-tion Program Adult Treatment Panel Ⅲ and the new International Diabetes Federation.RESULTS:The prevalence of fatty liver decreased in men and women with light to moderate alcohol consumption,whereas the prevalence of MS was not so changed.The prevalence of fatty liver of any grade in men was lower than that in those with no or minimal alcohol consumption.In women with light to moderate alcohol consumption,prevalence of fatty liver was lower than that in women with no or minimal alcohol consumption.By logistic regression analysis,the odds ratio (OR) for MS in women with light alcohol consumption was decreased to 1.0,but this change was not clear in men.The OR for fatty liver was clearly 1.0 in men with any level of alcohol consumption and in women with light to moderate consumption.CONCLUSION:Light to moderate alcohol consumption has a favorable effect for fatty liver,but not for MS in Japanese men and women.     

Waist circumference cutoff points for Chinese adults with metabolic syndrome defined by the International Diabetes Federation

Objective To investigate the appropriate waist circumference (WC) cutoff points for central obesity in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of the International Diabetes Federation (IDF). Methods A total of 2,344 Beijing residents aged ≥40 years were investigated. They answered questionnaires, received physical examinations, and underwent plasma glucose and lipid profile measurement. Those non-diabetic subjects underwent a 75g oral glucose tolerance test. All data were analyzed to calculate the appropriate WC cutoff points for central obesity reaching the diagonsis of MS. Results 1) Both in males and females, the triglyceride (TG), systolic blood pressure, diastolic blood pressure and fasting plasma glucose (FPG) increased linearly with WC, and the high density lipoprotein cholesterol (HDL-C) decreased linearly with WC (P<0.05). 2)The prevalence of elevated TG, reduced HDL-C, elevated blood pressure, elevated FBG, or ≥ 2 of these factors increased with WC (P<0.05). 3) Based on the receiver operating characteristic (ROC) curve analysis and Youden index, the WC values for central obesity and for detecting BMI ≥ 25 kg/m2 were about 90 cm for men and 80 cm for women. 4) The odds ratio for the presence of two or more metabolic risk factors increased abruptly in men with WC ≥ 90 cm and in women with WC ≥ 80 cm. Conclusions The appropriate WC cutoff point for central obesity was determined to be 90 cm for men and 80 cm for women in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of IDF.     

Recent Trends of Epidemic Hypertension in Guangdong Province

Hypertension survey was carriedout in Guangdong Province in 1991, according to a national sampling survey program. 42 899 urban and rural men and women aged ≥15 were involved in the survey. The results revealed that the standardized prevalence rate of hypertension was 8. 99% (definite 4. 24% , borderline 4. 75% ) . It was higher in men than in women, in urban than in rural samples. Compared with the survey in 1979, the prevalence rate increased by 90% and the curve of aged - prevalence rates shifted leftward. This article also discuss the possible factors that lead to the increase of hypertension.     

Prevalence of fatty liver disease and its risk factors in the population of South China

AIM: To investigate the population-based prevalence of fatty liver disease (FLD) and its risk factors in Guangdong Province,China. METHODS: A cross-sectional survey with multiple-stage stratified cluster and random sampling of inhabitants over 7-year-old was performed in 6 urban and rural areas of Guangdong Province,China. Questionnaires,designed by co-working of epidemiologists and hepatologists,included demographic characteristics,current medication use,medical history and health-relevant behaviors,i.e. alcohol consumption,smoking habits,dietary habits and physical activities. Anthropometric measurements,biochemical tests and abdominal ultrasonography were carried out. RESULTS: Among the 3543 subjects,609 (17.2%) were diagnosed having FLD (18.0% males,16.7% females,P > 0.05). Among them,the prevalence of confirmed alcoholic liver disease (ALD),suspected ALD and nonalcoholic fatty liver disease (NAFLD) were 0.4%,1.8%,and 15.0%,respectively. The prevalence rate (23.0%) was significantly higher in urban areas than (12.9%) in rural areas. After adjustment for age,gender and residency,the standardized prevalence of FLD in adults was 14.5%. Among them,confirmed ALD,suspected ALD and NAFLD were 0.5%,2.3%,and 11.7%,respectively,in adults and 1.3% (all NAFLD) in children at the age of 7-18 years. The overall prevalence of FLD increased with age in both genders to the peak of 27.4% in the group of subjects at the age of 60-70 years. The prevalence rate was significantly higher in men than in women under the age of 50 years (22.4% vs 7.1%,P < 0.001). However,the opposite phenomenon was found over the age of 50 years (20.6% vs 27.6%,P < 0.05). Multivariate and logistic regression analysis indicated that male gender,urban residency,low education,high blood pressure,body mass index,waist circumference,waist to hip ratio,serum triglyceride and glucose levels were the risk factors for FLD. CONCLUSION: FLD,especially NAFLD,is prevalent in South China. There are many risk factors for FLD.     

Study on the prevalence rate and optimal waist circumference cut-off points of obesity for the components of metabolic syndrome in Uygur from Xinjiang

正Objective To investigate the prevalence of metabolic syndrome and appropriate cut-off point of waist circumference of abdominal obesity for components of metabolic syndrome in Uygur population in Xinjiang.Methods A questionnaire-based survey,physical examination,and blood testing were conducted according to cluster random     

Measurement of biological age may help to assess the risk of colorectal adenoma in screening colonoscopy

AIM To investigate the clinical utility of biological age(BA) measurement in screening colonoscopy for the detection of colorectal adenomas in the average-risk population.METHODS A consecutive series of asymptomatic subjects aged ≥ 30 years who underwent colonoscopy in routine check-ups were enrolled. Colorectal adenoma was classified according to size, number, and location. BAs were calculated using the MEDIAGETM Biological Age Measurement System.RESULTS A total of 2696 subjects were investigated(1876 men and 820 women). The mean chronological age(CA) was 46.0 years and the mean BA was 44.7 years. Metabolic syndrome(MS) was diagnosed in 218 subjects(8.1%). The prevalence of overall colorectal adenoma was 23.1%(622/2,696). When the subjects were divided into four groups based on BA(≤ 39 years; 40-49 years; 50-59 years; ≥ 60 years), the prevalence of colorectal adenoma was increased as BA increased(P 0.001). Colorectal adenoma located in the proximal colon was more prevalent in the BA-dominant group(BA-CA ≥ 5years) than the CA-dominant group(CA-BA ≥ 5 years)(P = 0.034). When the subjects were categorized into four groups according to MS and age gap between BA and CA, the incidence of colorectal adenoma increased with MS and BA-dominance(P 0.05).CONCLUSION Measurement of BA may help to assess the risk of colorectal adenoma in screening colonoscopy.     

NAFLD prevalence differs among hispanic subgroups:The multi-ethnic study of atherosclerosis

AIM:To compare prevalence rates of non-alcoholic fatty liver disease(NAFLD)between Hispanics of Mexican origin and Hispanics of Dominican and Puerto Rican origin.METHODS:We evaluated prevalence rates of NAFLD between the two largest sub-populations of Hispanics in the United States;Hispanics of Mexican origin and Hispanics of Caribbean origin(Dominican and Puerto Rican),in the multi-ethnic study of atherosclerosis(MESA)cohort.MESA is a large,population based,multi-center cohort study comprised of 6814 healthy Caucasian,African-American,Hispanic,and Asian men and women aged 45-84.We utilized the baseline serum,anthropometric and radiographic measurements obtained between 2000 and 2002.NAFLD was measured via computed tomography scan and was defined as liver/spleen attenuation ratio<1.RESULTS:There were 788 Hispanic participants included in the study after exclusions.The prevalence of NAFLD was 29%(n=225).Hispanics of Mexican origin had a significantly higher prevalence of NAFLD(33%),compared to Hispanics of Dominican origin(16%),(P<0.01)and Hispanics of Puerto Rican origin(18%),(P<0.01).After controlling for age,sex,BMI,waist circumference,hypertension,serum HDL,triglyceride and CRP level and insulin resistance,Hispanics of Mexican origin remained significantly more likely to have NAFLD than those of Dominican and Puerto Rican origin.CONCLUSION:United States Hispanics of Mexican origin have a significantly higher prevalence of NAFLD when compared to United States Hispanics of Dominican or Puerto Rican origin after controlling for known risk factors.Care should be taken when performing risk assessment in Hispanic populations not to make assumptions of homogeneity.     

Fatty liver index vs waist circumference for predicting non-alcoholic fatty liver disease

AIM: To determine the discriminatory performance of fatty liver index(FLI) for non-alcoholic fatty liver disease(NAFLD).METHODS: The data of 5052 subjects aged over 18 years were analyzed. FLI was calculated from body mass index, waist circumference(WC), triglyceride, and gamma glutamyl transferase data. Logistic regression analysis was conducted to determine the association between FLI and NAFLD. The discriminatory performance of FLI in the diagnosis of NAFLD was evaluated by receiver operating characteristic analysis. Area under the curves(AUCs) and related confidence intervals were estimated. Optimal cutoff points of FLI in the diagnosis of NAFLD were determined based on the maximum values of Youden's index.RESULTS: The mean age of men and women in the study population were 44.8 ± 16.8 and 43.78 ± 15.43, respectively(P = 0.0216). The prevalence of NAFLD was 40.1% in men and 44.2% in women(P 0.0017). FLI was strongly associated with NAFLD, so that even a one unit increase in FLI increased the chance of developing NAFLD by 5.8%(OR = 1.058, 95%CI: 1.054-1.063, P 0.0001). Although FLI showed good performance in the diagnosis of NAFLD(AUC = 0.8656(95%CI: 0.8548-0.8764), there was no significant difference with regards to WC(AUC = 0.8533, 95%CI: 0.8419-0.8646). The performance of FLI was not significantly different between men(AUC = 0.8648, 95%CI: 0.8505-0.8791) and women(AUC = 0.8682, 95%CI: 0.8513-0.8851). The highest performance with regards to age was related to the 18-39 age group(AUC = 0.8930, 95%CI: 0.8766-0.9093). The optimal cutoff points of FLI were 46.9 in men(sensitivity = 0.8242, specificity = 0.7687, Youden's index = 0.5929) and 53.8 in women(sensitivity = 0.8233, specificity = 0.7655, Youden's index = 0.5888).CONCLUSION: Although FLI had acceptable discriminatory power in the diagnosis of NAFLD, WC was a simpler and more accessible index with a similar performance.     

The relationship of body mass index and hyperuricemia in hypertensive adults over 80 years

Background Hyperuricemia (HUA) and hypertension are associated with the increasing risk and mortality of cardiovascular disease (CVD) . However,the relationship between body mass index (BMI) and HUA in hypertensive adults over 80 years remains uncertain. Methods Observational trial was designed and 308 patients who were newly diagnosed as essential hypertension without anti-hypertensive therapy were enrolled into our study. According to the cut-off value of serum UA,participants were stratified into normal (420 μmol/L for men and 360 μmol/L for women) and increased UA groups (≥420 μmol/L for men and ≥360 μmol/L for women) . Serum UA level,blood pressure and other baseline characteristics were compared,logistic regression analysis and receiver operating characteristic curve (ROC) were performed. Results The mean (SD) serum uric level was 382.2 (108.7) μmol/L and the prevalence of hyperuricemia was 45% among men and 50% among women.BMI was significantly higher (22.6 vs. 24.0 kg/m~2,P=0.003) and FBG was lower (5.13 vs. 4.98 mmol/L,P=0.025) in increased UA group among aged women,and BMI and FBG were found the independent determinants for UA increase in female subjects according to logistic regression analysis,and the odd ratio were 1.154 (95% interval confidence 1.058-1.259,P=0.001) and 0.646 (95% interval confidence 0.44-0.949,P=0.026),respectively.Moreover,evaluation of receiver operating characteristic curve (ROC) showed that area under the curve for BMI to predict UA increase was 0.627+0.039,P=0.001 in women. However,the results mentioned above were only found in elderly women,not in men. Conclusions Our study indicates that aged women have higher prevalence of HUA than men,and that BMI is independently associated with serum uric acid level for hypertensive women but not for men over 80 years old. Therefore,BMI is a useful predictor of serum uric acid level in elderly women with hypertension.     

上海市奉城社区30岁以上人群代谢综合征腰围切点的研究

目的：分析上海农村30岁以上人群代谢综合征（MS）腰围的适宜切点。方法：随机整群抽取上海市奉贤区奉城镇灯民村及洪南村30岁以上人群1041人。分析男性和女性不同腰围水平与MS其他成分聚集的关系，并寻找检出2个及以上危险成分假阳性和假阴性率均较低的腰围切点，作为30岁以上人群腰围切点的建议。据此计算各性别年龄组MS的患病率以及成分组合特点。结果：随腰围增大，MS成分聚集的比数比（0R）显著增高，以男性腰围≥85．0cm．女性腰围≥80．0cm．接受者运行曲线（ROC）距离最短。以此为腰围切点，30岁以上人群男性MS患病率为15．32％，女性为12．35％．其中以腰围超标、血压升高和高血糖3项的组合为最多。结论：建议男性腰围≥85．0cm，女性腰围≥80．0cm，收缩压≥130mmHg（1mmHg=0．133kPa）和（或）舒张压≥85mmHg，血清三酰甘油（TG）≥1．7mmol／L，男性高密度脂蛋白胆固醇（HDL—C）〈1．03mmol／L、女性HDL—C〈1．29mmol／L，空腹血糖（FBG）≥5．6mm01／L，5项中具备3项及以上作为上海农村MS的临床检出标准。     

蒙古族农牧民代谢综合征诊断的腰围切点观察

目的研究我国蒙古族农牧民代谢综合征（MS）诊断的腰围（WC）适宜切点。方法以内蒙古自治区通辽市科左后旗朝鲁吐苏木和奈曼旗固日班花苏木32个自然村2589名年龄大于20岁的蒙古族农牧民为研究对象,以国际糖尿病联盟（IDF）MS全球共识诊断标准为基础,分析蒙古族男女不同WC水平与MS其他组分聚集的关联,检出至少两个组分存在时灵敏度和特异度均较高的WC界限,作为诊断蒙古族农牧民MS的WC切点,并以此计算不同年龄组MS的检出率。结果随WC增大,MS组分聚集的OR值显著增高。当男性WC≥84cm、女性WC≥81cm时,ROC曲线下面积最大。结论IDF标准在蒙古族农牧民男性中WC切点偏高,宜降至男性≥85cm、女性≥80cm。     

中国成人代谢综合征腰围切点的研究

目的　根据中国成人较近期的调查数据 ,分析代谢综合征中腰围的适宜切点。方法　利用国家“九五”科技攻关课题 1998年在 15组人群进行心血管病危险因素调查 13732例 35～ 5 9岁成人的数据库 ,分析男性和女性不同腰围水平和代谢综合征其他成分聚集的关系 ,并寻找检出两个及以上危险成分假阳性和假阴性率均较低的腰围切点 ,作为成人腰围切点的建议。据此计算各性别年龄组代谢综合征的患病率 ,以及成分组合特点。结果　随腰围增大 ,代谢综合征成分聚集的OR值显著增高 ,以男性腰围≥ 85cm ,女性腰围≥ 80cm ,ROC曲线距离最短。以此为腰围切点中年男性人群代谢综合征患病率为 19 3% ,女性为 13 9% ,其中以腰围超标 ,血压升高和高甘油三酯三项的组合为最多。结论　建议男性腰围≥ 85cm ,女性腰围≥ 80cm ,收缩压≥ 130mmHg(1mmHg =0 133kPa)和 (或 )舒张压≥ 85mmHg ,血清甘油三酯≥ 1 6 9mmol/L ,高密度脂蛋白胆固醇 <1 0 3mmol/L ,空腹血糖≥ 6 1mmol/L ,5项中具备 3项及以上作为中国成人代谢综合征的临床检出标准。以上初步结果需要在有全国代表性的样本中进一步验证。     

Prevalence of obesity and metabolic syndrome in Korean adults

We studied the prevalence and trend of obesity and metabolic syndrome in Korean adults aged at least 20 years using Korean National Health Examination and Nutrition Survey data from 1998 and 2001. The prevalence of body mass index (BMI) ≥ 25 kg m^?2 among Korean adults in 2001 was 32.9% in men and 27.4% in women, and the number of Korean men with BMI ≥ 25 kg m^?2 has increased markedly since 1998. A significant positive association between obesity and socioeconomic status was found in Korean men, whereas a significant negative association was identified in Korean women. The prevalence rates of waist circumference (WC) ≥ 90 cm in men and WC ≥ 85 cm in women were 23.4% and 23.1% in 2001 respectively. The prevalence of metabolic syndrome among Korean adults was 15–30% according to various criteria of metabolic syndrome. Future studies are needed to determine the changes in prevalence of obesity and contributing factors for obesity in Koreans.     

北京社区2型糖尿病患者颈围与中心性肥胖及代谢综合征的相关性

目的探讨颈围与中心性肥胖及代谢综合征(MS)的相关性。方法在北京城区整群抽样,纳入2型糖尿病及糖尿病前期患者3191例,男性1 249例,女性1 942例。检测身高、体重、颈围、腰围、臀围、血压、血糖、血脂,并进行分析。结果总体人群的颈围(36.5±3.8)cm;男性和女性患者颈围与腰围、体重指数、腰臀比、血压和TG均呈显著正相关,与HDLC呈显著负相关;在调整MS相关因素后,颈围仍为MS的独立危险因素。男性颈围与中心性肥胖和MS诊断的ROC曲线下面积分别为0.747和0.725,最佳切点值均为38.5 cm;女性颈围与中心性肥胖和MS诊断的ROC曲线下面积分别为0.742和0.688,最佳切点值分别为34.5 cm和34.7 cm。结论颈围是反映中心性肥胖的有效指标;颈围粗是MS的独立危险因素,对MS的发生具有预测能力。     

我国中年人群向心性肥胖和心血管病危险因素及其聚集性

目的 分析在中国人群中,反映向心性肥胖的指标－－腰围与心血管病危险因素及其聚集性的关系。并探讨中国人群适宜的腰围切点。方法 分析数据来自1993－1994年对14组中年（35－59）岁人群进行的抽样调查,职业包括产业工人,农民,城市居民和渔民,地点分布于东北,华北,华东,华南,西南和中部。调查项目均采用国际标准化方法,由合作中心进行统一培训,考核和质量控制。资料完整可供分析16466人。结果 显示中国人群腰均值男,女性均小于西方人群,北方高于南方,城市居民和工人高于农民,将腰围从＜65cm至大于等于100cm,每5cm进行分层,可见无论男性或女性,高血压,高血清总胆固醇,低高密度脂蛋白胆固醇和空腹血糖升高的检出率及具有2个及以上危险因素的聚集率均随腰围的增大而逐步上升。危险因素聚集的年龄调整比值比（OR值）男性和女性分别增高7．8倍和8．5倍,以不同腰围切点计算对于检出危险因素聚集的敏感度和特异度,显示男性腰围大于等于85cm,检出危险因素聚集的敏感度为54．2％,特异度为77．3％,女性腰围大于等于80cm,相应的敏感度和特异度为59．8％和70．3％,较其他各切点为优,结论 研究表明,向心性肥胖的程度和心血管病危险因素升高及聚集密切相关,应重视对以腹部肥胖为特征的向心性肥胖进行防治,;男性腰围应控制在85cm以下,女性应控制在80cm以下。     

Optimal waist circumference cutoff values for predicting metabolic syndrome among older adults in Ecuador

AimsTo determine optimal waist circumference cutoff values for predicting metabolic syndrome (MetS) among adults aged 60 years and older in Ecuador.Material and methodsThe National Survey of Health, Wellbeing, and Aging survey was used to describe the prevalence of MetS according to standard definitions. Receiver operating characteristics (ROC) curve analyses and the Younden index J (YI) were performed to examine optimal waist circumference cutoff values for predicting MetS. Moreover, the prevalence of MetS according to country-specific waist circumference cutoff values was compared with those using standard definitions.ResultsAmong 2306 participants with a mean age of 70.6 years, the optimal waist circumference cutoff value for predicting MetS was 90.7 cm in women with a sensitivity of 66.1%, specificity of 65.6% and YI of 0.31. In men, a waist circumference of 91.2 cm with a sensitivity of 73.2%, specificity of 62.8%, and YI of 0.36 was the optimal cutoff point for predicting MetS. In general, applying country-specific cutoff values decreased the prevalence of MetS among older Ecuadorian women. In men, except with the ATP III definition, similar MetS prevalence rates were seen whether the country-specific or standard waist circumference cutoff values were applied.ConclusionsThe optimal waist circumference cutoff values for predicting metabolic syndrome among older Ecuadorians adults were 90.7 cm for women and 91.2 cm for men. Moreover, current standard definitions of abdominal obesity may overestimate the prevalence of MetS, particularly in Latin American women.     

Secular trends in the prevalence of general and abdominal obesity among Chinese adults, 1993-2009

The objective of this study is to examine the trends in body mass index (BMI), waist circumference (WC) and prevalence of overweight (BMI 25-27.49 kg m(-2) ), general obesity (BMI ≥ 27.5 kg m(-2) ) and abdominal obesity (WC ≥ 90 cm for men and ≥80 cm for women) among Chinese adults from 1993 to 2009. Data were obtained from the China Health and Nutrition Survey, which was conducted from 1993 to 2009 and included a total of 52,621 Chinese adults. During the period of 1993-2009, mean BMI values increased by 1.6 kg m(-2) among men and 0.8 kg m(-2) among women; mean WC values increased by 7.0 cm among men and 4.7 cm among women. The prevalence of overweight increased from 8.0 to 17.1% among men (P < 0.001) and from 10.7 to 14.4% among women (P < 0.001); the prevalence of general obesity increased from 2.9 to 11.4% among men (P < 0.001) and from 5.0 to 10.1% among women (P < 0.001); the prevalence of abdominal obesity increased from 8.5 to 27.8% among men (P < 0.001) and from 27.8 to 45.9% among women (P < 0.001). Similar significant trends were observed in nearly all age groups and regions for both men and women. The prevalence of overweight, general obesity and abdominal obesity among Chinese adults has increased greatly during the past 17 years.     

Measures of abdominal obesity assessed for visceral adiposity and relation to coronary risk

AIMS: We aimed to identify by computed tomography (CT) the best suited of three anthropometric indices that reflect the visceral adipose tissue (VAT), and to discern the relationship between VAT and certain atherogenic risk factors and coronary heart disease (CHD) diagnosis in a population sample which had a high (34%) prevalence of the metabolic syndrome (MS). METHODS: A single-scan CT was performed between the fourth and fifth lumbar vertebrae in 157 unselected men and women aged 34-69 y. Total adipose tissue area, abdominal VAT area and the abdominal sagittal diameter were determined. Diagnosis of CHD was based on clinical findings and Minnesota coding of resting electrocardiograms. RESULTS: Men had significantly higher VAT than women. Linear regression analysis for correlates of abdominal VAT area, in a model comprising age, sex, waist circumference, waist-to-hip ratio (WHR) and body mass index (BMI) identified waist circumference as the only independent variable (P<0.001). Waist circumference in men and BMI in women were the independently associated parameters of sagittal diameter (P<0.001). By stepwise linear regression, it was elicited that VAT area rose significantly by a mean of 6.8 cm2 in men and 3 cm2 in women for every 1 cm increment in waist circumference, independent of WHR. Age in women and (inversely) BMI in men were further independent variables, indicating in men that a lower BMI at a given waist girth suggests the existence of a higher VAT. Apo B and HDL-cholesterol (HDL-C) in men, and the latter in women were independently associated with VAT area in linear regression models that also comprised triglycerides, fasting insulin and C-reactive protein concentrations. In the study sample comprising 13 individuals with a CHD diagnosis, the age-adjusted odds ratio of cutpoints of VAT area > vs <140 cm2 in men and > vs <120 cm2 in women was 11.3 (95% CI (1.37, 93)). CONCLUSIONS: The best surrogate of visceral adiposity across a wide age range is waist circumference, in a population in which MS prevails. Apo B and HDL-C in men, and the latter in women were independently associated with VAT area, which proved to be closely related to CHD risk. A lower BMI at a given waist girth in men suggests the existence of a higher VAT.     

Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US

Background: Recently, a Joint Scientific Statement bridged differences between previous definitions of metabolic syndrome. Our objective was to estimate the prevalence of metabolic syndrome in a representative sample of US adults and to examine its correlates. Methods: We analyzed data for up to 3461 participants aged ≥20 years of the 2003–2006 National Health and Nutrition Examination Survey. Results: Using waist circumference thresholds of ≥102 cm for men and ≥88 cm for women, the age‐adjusted prevalence of metabolic syndrome was 34.3% among all adults, 36.1% among men, and 32.4% among women. Using racial‐ or ethnic‐specific International Diabetes Federation criteria for waist circumference, the age‐adjusted prevalence of metabolic syndrome was 38.5% for all participants, 41.9% for men, and 35.0% for women. Prevalence increased with age, peaking among those aged 60–69 years. Prevalence was lower among African American men than White or Mexican American men, and lower among White women than among African American or Mexican American women. In a multivariate regression model, significant independent associations were noted for age (positive), gender (men higher than women), race or ethnicity (African Americans and participants of another race lower than Whites), educational status (inverse), hypercholesterolemia (positive), concentrations of C‐reactive protein (positive), leisure time physical activity (inverse), microalbuminuria (positive), and hyperinsulinemia (positive). Additional adjustment for body mass index weakened many of the associations, with educational status and microalbuminuria no longer significant contributors to the model. Conclusion: Metabolic syndrome continues to be highly prevalent among adults in the US.