不同诊断标准下腹膜透析患者代谢综合征与大动脉僵硬度的关系

目的 对腹膜透析患者在不同诊断标准下诊断的代谢综合征与大动脉僵硬度的关系进行研究,从而确定一个最适合腹膜透析患者的标准,同时对影响大动脉僵硬度的因素进行分析.方法 选取稳定透析的持续不卧床腹膜透析患者155例,测量颈股动脉脉搏波速度作为大动脉僵硬度的评价指标,用WHO 1999、IDF 2007和ATPⅢ2001三个标准分别诊断代谢综合征,比较不同标准下代谢综合征组与非代谢综合征组脉搏波速度有无差别,并对脉搏波速度的相关因素进行分析.结果 用WHO 1999、IDF 2007和ATPⅢ2001标准诊断的合并代谢综合征的持续不卧床腹膜透析患者均比无代谢综合征患者有较高的脉搏波速度(P<0.05).脉搏波速度与持续不卧床腹膜透析患者的年龄、腰围、收缩压及血糖呈正相关(P<0.05或P<0.01),与血高密度脂蛋白胆固醇呈负相关(P<0.05),它们都是脉搏波速度的独立影响因素.结论 无论用WHO 1999、IDF 2007和ATPⅢ2001中任何一个代谢综合征标准,合并代谢综合征的持续不卧床腹膜透析患者大动脉僵硬度均较非代谢综合征患者增加.年龄和代谢综合征中多数因子均是脉搏波速度的独立影响因素.经多方考虑,我们推荐在持续不卧床腹膜透析患者用ATPⅢ标准诊断代谢综合征.     

Prevalence of the metabolic syndrome in the United States National Health and Nutrition Examination Survey 1999-2002 according to different defining criteria

The authors studied the prevalence of the metabolic syndrome in the 1999-2002 National Health and Nutrition Examination Survey (NHANES) according to the World Health Organization, National Cholesterol Education Program (NCEP), and International Diabetes Federation (IDF) definitions. There was 92.9% agreement between the NCEP and IDF definitions. The IDF prevalence was higher (p = 0.001) due to more men fulfilling its criteria than the NCEP's (39.9 +/- 1.7% vs. 33.6 +/- 1.6%; p = 0.007). If central obesity were not a prerequisite, the IDF prevalence would increase slightly to 40.3 +/- 1.1%. Subjects categorized as having the metabolic syndrome under IDF but not NCEP tended to be men, younger, and leaner. Their prevalence of self-reported coronary heart disease was not significantly different from that of other metabolic syndrome patients. Whether waist circumference is a prerequisite does not affect the diagnosis of the metabolic syndrome in the United States. The IDF definition identifies additional individuals at risk for cardiovascular disease.     

Correlates of aortic stiffness in elderly individuals: a subgroup of the cardiovascular health study

Background:Arterial stiffness has been associated with aging, hypertension, and diabetes; however, little data has been published examining risk factors associated with arterial stiffness in elderly individuals.Methods:Longitudinal associations were made between aortic stiffness and risk factors measured approximately 4 years earlier. Aortic pulse wave velocity (PWV), an established index of arterial stiffness, was measured in 356 participants (53.4% women, 25.3% African American), aged 70 to 96 years, from the Pittsburgh site of the Cardiovascular Health Study during 1996 to 1998.Results:Mean aortic pulse wave velocity (850 cm/sec, range 365 to 1863) did not differ by ethnicity or sex. Increased aortic stiffness was positively associated with higher systolic blood pressure (SBP), age, fasting and 2-h postload glucose, fasting and 2-h insulin, triglycerides, waist circumference, body mass index, truncal fat, decreased physical activity, heart rate, and common carotid artery wall thickness (P < .05). After controlling for age and SBP, the strongest predictors of aortic stiffness in men were heart rate (P = .001) and 2-h glucose (P = .063). In women, PWV was positively associated with heart rate (P = .018), use of antihypertensive medication (P = .035), waist circumference (P = .030), and triglycerides (P = .081), and was negatively associated with physical activity (P = .111). Results were similar when the analysis was repeated in nondiabetic individuals and in those free of clinical or subclinical cardiovascular disease in 1992 to 1993.Conclusions:In these elderly participants, aortic stiffness was positively associated with risk factors associated with the insulin resistance syndrome, increased common carotid intima–media thickness, heart rate, and decreased physical activity measured several years earlier.     

Differences in traditional and emerging cardiovascular risk factors of subjects discordantly classified by metabolic syndrome definitions of the International Diabetes Federation and the National Cholesterol Education Program

Background and aimSeveral working definitions of metabolic syndrome have been proposed for clinical use. However, individuals can be discordantly classified as having or not having metabolic syndrome depending on the choice of one or another definition. This study compared the cardiovascular risk profile of subjects concordantly and discordantly diagnosed by the criteria of the National Cholesterol Education Program (NCEP) and the criteria of the International Diabetes Federation (IDF).Methods and resultsNine hundred and twenty-nine non-diabetic adult subjects belonging to a cross-sectional population-based study in Gran Canaria island (Spain) were assessed. Participants completed a questionnaire and underwent physical examination, fasting blood analyses, and a standardized oral glucose tolerance test.Two hundred and four subjects (22%) had metabolic syndrome according to both definitions, 31 (3.3%) only by the IDF criteria, and 5 (0.5%) only by the NCEP criteria. Participants fulfilling both proposals showed more adverse age and sex-adjusted measures of BMI, waist, HDL cholesterol, triglycerides, post-load glucose, HOMA-IR and plasminogen inhibitor activator-1 (PAI-1) than individuals exclusively satisfying the IDF criteria. Moreover, in contrast to subjects meeting both criteria, those that fulfilled only the IDF criteria had levels of BMI, waist, total and HDL cholesterol, post-load glucose, glycated HbA1c, C-reactive protein, PAI-1 and fibrinogen not significantly different from those observed in subjects without metabolic syndrome.ConclusionThe IDF definition identifies a surplus of individuals whose cardiovascular risk profile, particularly regarding to some non-traditional cardiovascular risk factors, is less adverse than that observed in subjects also diagnosed by the NCEP definition.     

Effects of metabolic syndrome on cardio-ankle vascular index in middle-aged and elderly Chinese

Metabolic syndrome is characterized by multiple risk factors and is associated with increased risk of diabetes and cardiovascular disease. The rapid change in the lifestyle and food habits of Chinese people has resulted in metabolic syndrome becoming one of the most widespread health challenges in China. Recently, the cardio-ankle vascular index (CAVI) was developed as a new parameter reflecting arterial stiffness and providing an index of vascular status. The purpose of this study was to investigate the effect of metabolic syndrome on CAVI. A total of 222 Chinese subjects aged 50-92 years participated in this study. We measured CAVI and examined blood samples to define metabolic syndrome according to the International Diabetes Federation criteria. CAVI in the subjects with abnormal waist circumference was significantly higher than that obtained in the normal subjects (P?相似文献   

Components of the metabolic syndrome predictive of its development: a 6-year longitudinal study in Hong Kong Chinese

Objective To investigate which of the components of the metabolic syndrome best predict its development. Design Long‐term cohort of randomly selected adults. Patients One thousand five hundred and forty‐eight subjects from the Hong Kong Cardiovascular Risk Factor Prevalence Study who did not have the metabolic syndrome by the US National Cholesterol Education Program (NCEP) or International Diabetes Federation (IDF) criteria at baseline. Measurements Waist circumference, blood pressure, glucose, triglycerides and high‐density lipoprotein‐cholesterol (HDL). Results After a median interval of 6·4 years, there were 219 and 143 new cases (21·9 and 14·3 per 1000 person‐years) of the metabolic syndrome by the NCEP and IDF criteria, respectively. The odds ratio for the NCEP metabolic syndrome was highest for low HDL, 4·08 [95% confidence interval (CI): 2·90–5·73] and that for the IDF metabolic syndrome was highest for central obesity, 5·94 [95% CI: 3·98–8·87]. Low HDL, found in 27·8% men and 34·3% women, had the highest sensitivity for the NCEP metabolic syndrome (48% in men and 57% in women) and the IDF metabolic syndrome (41% in men and 54% in women). Central obesity had the highest positive predictive values except that triglycerides had the highest positive predictive value for the NCEP metabolic syndrome in women. The areas under the receiver operator characteristic curve for waist circumference, triglycerides and HDL were similar. A model that included waist circumference and HDL predicted the metabolic syndrome as well as a model that included all five metabolic syndrome components. Conclusion Obese Chinese adults should be periodically screened for the metabolic syndrome and have waist and HDL measurement.     

The metabolic syndrome and incidence of cardiovascular disease in non-diabetic subjects--a population-based study comparing three different definitions.

Aims Between 1998 and 2005, a number of definitions of the metabolic syndrome (MetS) have been proposed. The aim of this population‐based cohort study was to compare prevalence rates and the prediction of cardiovascular disease (CVD) using different definitions of MetS. Methods A total of 5047 non‐diabetic subjects (66% women), from the city of Malmö, Sweden, were followed. The incidence of fatal and non‐fatal CVD (cardiac events, n = 176, and stroke, n = 171) was monitored over 11 years of follow‐up. MetS was defined in three different ways [by International Diabetes Federation (IDF), National Cholesterol Education Program—Adult Treatment Panel III (NCEP‐ATPIII), or European Group for the study of Insulin Resistance (EGIR) criteria] based on data on waist circumference, blood pressure, serum triglycerides, High‐density lipoprotein cholesterol and fasting blood glucose. The IDF definition identified 21.9% of the subjects having the MetS. Corresponding figures for the NCEP‐ATPIII and EGIR definitions were 20.7 and 18.8%, respectively. Results After taking age, gender, low‐density lipoprotein cholesterol and lifestyle factors into account, the hazard ratio (HR) for CVD event according to the IDF, NCEP‐ATPIII and EGIR definitions were HR 1.11 (95% CI: 0.86–1.44), 1.59 (1.25–2.03) and 1.35 (1.05–1.74), respectively. The results were largely similar for cardiac and stroke events. Conclusions The prevalence of Mets according to the IDF definition was higher in comparison with NCEP‐ATPIII and EGIR definitions, but the IDF definition was not superior to these definitions for prediction of CVD events. This was true for both genders and questions the usefulness of the current IDF criteria of MetS in a North‐European, Caucasian population. In addition, single risk factors such as smoking had an equal prediction as the metabolic syndrome.     

The prevalence of the metabolic syndrome in young adults. The Cardiovascular Risk in Young Finns Study

OBJECTIVES: The prevalence of the metabolic syndrome is increasing worldwide. We studied its prevalence in Finnish young adults. Three definitions were applied: National Cholesterol Education Program (NCEP), European Group for the Study of Insulin Resistance (EGIR) and International Diabetes Federation (IDF) criteria. We also investigated the secular trend in the metabolic syndrome amongst 24-year-old adults from 1986 to 2001. DESIGN: Population-based follow-up study. SUBJECTS: 2182 healthy young adults (1007 men; 1175 women) aged 24-39 years. MAIN OUTCOME MEASURES: Metabolic syndrome and its components. RESULTS: The prevalence of the metabolic syndrome was 13.0% with NCEP criteria, 9.8% with EGIR criteria and 14.3% with IDF criteria. With NCEP and IDF criteria, the prevalence increased with age in both sexes, but more dramatically in men. There was over sixfold increase in the metabolic syndrome from 4.0% to 25.2% (P < 0.0001) in men between ages 24 and 39 years using the IDF criteria. Increases in obesity and serum triglycerides accounted much for the increase in the prevalence by age. The significant secular trend was seen between years 1986 and 2001 in 24-year-old subjects. The prevalence of the metabolic syndrome increased significantly from 1.0% to 7.5% (P < 0.0001) in 15 years. CONCLUSIONS: There is a substantial increase in the prevalence of the metabolic syndrome in healthy young adults between ages 24 and 39 driven mostly by the increase in obesity. The prevalence of the metabolic syndrome is higher amongst Finnish young adult men compared with women. The secular trend between 1986 and 2001 suggest a dramatic increase in the prevalence of the metabolic syndrome in 24-year-old young adults. Condensed abstract The prevalence of the metabolic syndrome may be increasing in young people. We studied the prevalence of the metabolic syndrome in 2182 young Finnish adults aged 24-39 years using NCEP, EGIR and IDF criteria. The prevalence of the metabolic syndrome was higher amongst Finnish men than women and increased dramatically with age. There was also a dramatic increase in the prevalence of the metabolic syndrome in 24-year-old adults between 1986 and 2001.     

Does the metabolic syndrome predict subclinical atherosclerotic damage in an asymptomatic population at intermediate cardiovascular risk?

Background and AimsIt is not clear whether the metabolic syndrome (MetS) is a distinct entity or a combination of risk factors. Several studies showed the association between MetS and cardiovascular disease (CVD). Subclinical target organ damage (TOD) is a recognized marker of atherosclerosis and predictor of cardiovascular events. Increased burden of subclinical atherosclerosis was detected in individuals with MetS. We thus aimed to examine the association between MetS and cumulative or specific TOD and to assess whether MetS predicts TOD better than the risk factors included in current definitions.Methods and ResultsWe recorded TOD in 979 patients at intermediate cardiovascular risk with and without MetS according to IDF and NCEP criteria. We measured common carotid intima-media thickness, left ventricular mass index (LVMI), urine albumin to creatinine ratio (UACR), and ankle-brachial index. We found no correlation between having at least one TOD and being positive for MetS. A high UACR was associated with MetS using both IDF and NCEP criteria, while only NCEP identified individuals with increased LVMI. Using a multivariate logistic regression model including MetS, age, sex, waist circumference, triglycerides, HDL cholesterol, blood pressure and blood glucose levels we found no correlations between the presence of MetS and at least one TOD. The associations with high UACR and LVMI disappeared when age, blood pressure and glycemia were counted in.ConclusionAlthough MetS showed some relation with subclinical renal and cardiac damage, it does not predict TOD any better than the risk factors specified in the definitions.     

Determination of most suitable cut off point of waist circumference for diagnosis of metabolic syndrome in Kerman

ObjectivesMetabolic syndrome is a determining indicator of cardiovascular diseases and diabetes. Abdominal obesity, determined by measuring waist circumference, is one of the most important criteria for diagnosing this syndrome. This criterion varies between men and women and among different races. The present study aims at the assessment of the sensitivity and specificity of the commonly used cut off point of waist circumference, and the estimation of the most suitable cut off point of waist circumference for the diagnosis of metabolic syndrome in the urban society of Kerman.Methods5332 subjects consisting of 2966 women and 2366 men, 20 years old and above were studied in a population based, cross sectional study. Waist circumference, blood pressure, blood sugar, and blood lipids were measured. People with at least two of the NCEP ATP III criteria – high blood pressure (BP > 130/80), high triglycerides (TG > 150), high glucose (FBG > 100) and low HDL (HDL < 40 in men and <50 in women) – were taken as population at risk. ROC analysis was used for determining the most suitable cut off point of waist circumference. The prevalence of metabolic syndrome was then assessed based on IDF, NCEP criteria and the proposed criterion, and agreement among the three methods in diagnosing people suffering from metabolic syndrome was examined.ResultsThe average ± standard deviation of waist circumference in women and in men was 83.90 ± 12.55 and 87.99 ± 11.94 cm respectively. The most suitable cut off point of waist circumference for metabolic syndrome diagnosis was 86 in women and 89 in men. These circumferences had the highest specificity and sensitivity. The prevalence of metabolic syndrome in IDF, NCPE, and the proposed criterion was 30.4%, 27.7%, and 35.2% respectively. The new criterion and the NCEP criterion achieved the highest agreement (kappa factor = 83%).ConclusionThe cuts off point of waist circumference in men and women are close. It is possible, then, to determine a common cut off point of waist circumference for both in Iran. Therefore, the cut point of 90-cm of waist circumference proposed by the National Obesity Committee seems to be appropriate for the Iranian society. These clinical findings should nevertheless be verified by simulation.     

Metabolic syndrome in overweight and obese young Palestinian students at An-Najah National University: a cross-sectional study

Background

Metabolic syndrome is one of the main reasons for elevated mortality worldwide. The aim of this study was to characterise and establish sex-adjusted prevalence of metabolic syndrome in young Palestinian adults.

代谢综合征与动脉僵硬度的关系

目的探讨代谢综合征与动脉僵硬度的关系。方法根据2005年国际糖尿病联盟代谢综合征诊断标准将522例受试者分为对照组、代谢综合征组亚组1(1项指标异常)、亚组2(2项指标异常)和亚组3(3项或以上指标异常)。应用脉搏波速度自动测量系统测定颈—股动脉脉搏波速度作为反映大动脉僵硬度的指标,并与各临床观察指标进行多元回归分析。结果代谢综合征各亚组颈—股动脉脉搏波速度均显著高于对照组(P<0.01和0.001),亚组3与亚组1和亚组2间差异也有显著性(P<0.05)。颈—股动脉脉搏波速度与年龄(r=0.432,P<0.001)、收缩压(r=0.341,P<0.001)、腰围(r=0.151,P=0.001)、空腹血糖(r=0.257,P<0.001)和甘油三酯(r=0.103,P=0.019)存在显著正相关。多元逐步回归分析显示,年龄、收缩压和空腹血糖是影响颈—股动脉脉搏波速度的独立因素。结论代谢综合征组成成分的聚集可能促进动脉僵硬度的发生发展。开展人群代谢综合征成分聚集的评估及进行脉搏波速度检测有助于心血管事件的一级预防。     

White fish reduces cardiovascular risk factors in patients with metabolic syndrome: The WISH-CARE study,a multicenter randomized clinical trial

Background and aimsReduction of cardiovascular risk with high consumption of fish in diet is still a matter of debate, and concerns about heavy metal contamination have limited consumption of oily fish. We aimed to evaluate the effect of regular ingestion of white fish on cardiovascular risk factors in patients with metabolic syndrome.Methods and resultsMulticenter randomized crossover clinical trial including 273 individuals with metabolic syndrome. An 8-week only-one dietary intervention: 100 g/d of white fish (Namibia hake) with advice on a healthy diet, compared with no fish or seafood with advice on a healthy diet. Outcomes were lipid profile, individual components of the metabolic syndrome, serum insulin concentrations, homeostasis model of insulin resistance, serum C-reactive protein and serum fatty acid levels. We found a significant lowering effect of the intervention with white fish on waist circumference (P < 0.001) and diastolic blood pressure (P = 0.014). A significant lowering effect was also shown after the dietary intervention with fish on serum LDL concentrations (P = 0.048), whereas no significant effects were found on serum HDL or triglyceride concentrations. A significant rise (P < 0.001) in serum EPA and DHA fatty acids was observed following white fish consumption. Overall adherence to the intervention was good and no adverse events were found.ConclusionIn individuals with metabolic syndrome, regular consumption of hake reduces LDL cholesterol concentrations, waist circumference and blood pressure components of the metabolic syndrome.Clinical trial registryWhite Fish for Cardiovascular Risk Factors in Patients with Metabolic Syndrome Study, Registered under ClinicalTrials.gov Identifier: NCT01758601.     

Prominent role of low HDL-cholesterol in explaining the high prevalence of the metabolic syndrome in polycystic ovary syndrome

Background and aimsThe main objective was to evaluate the prevalence of the metabolic syndrome in Caucasian women with PCOS, using either of the currently proposed definitions (NCEP/ATPIII, IDF and AHA/NHLBI) and, therefore, to estimate the concordance between these three classifications. Secondary objectives were to evaluate: i) which individual criterion of the metabolic syndrome is most strongly associated with PCOS; and ii) whether the severity of hyperandrogenemia, hyperinsulinemia and insulin resistance may influence the presence of the metabolic syndrome in PCOS women.Methods and resultsThe metabolic syndrome was assessed in 200 Caucasian women with PCOS and in 200 Caucasian controls, matched for age and BMI, considering the NCEP/ATPIII, IDF and AHA/NHLBI definitions. PCOS women had an increased prevalence of the metabolic syndrome compared with controls: 32 versus 23% with the NCEP/ATPIII, 39 versus 25% with the IDF and 37 versus 24% with the AHA/NHLBI, respectively (Cohen's Kappa index between the three classifications, P < 0.001). Multivariate logistic regressions revealed that among the individual criteria of the metabolic syndrome, only low HDL-cholesterol levels were significantly associated with PCOS (P < 0.001) which, in turn, are related to insulin_AUC (P = 0.029) but not to androgens.ConclusionThis case-control study indicates a high prevalence of the metabolic syndrome in Caucasian PCOS women that is independent of the diagnostic classification used. Furthermore, it shows that low HDL-cholesterol is the criterion which best explains the high prevalence of the metabolic syndrome in PCOS subjects which, in turn, is influenced by hyperinsulinemia, rather than by hyperandrogenemia.     

代谢综合征各成分与臂踝脉搏波速度的关系研究

目的:探讨代谢综合征异常各成分与臂踝脉搏波速度(baPWV)的关系.方法:按照2005年国际糖尿病联盟(IDF)代谢综合征诊断标准,将571例研究对象(男269例,女302例,平均年龄56.2岁)分为对照组40例、1项代谢异常组108例、2项代谢异常组154例、3项代谢异常组269例,应用脉搏波速度自动测量系统测定baPWV,并结合各临床观察指标进行分析.结果:简单相关分析结果显示年龄、收缩压、舒张压、空腹血糖、总胆固醇、甘油三酯和腰围与baPWV的相关性有统计学意义(P<0.05).采用多元线性逐步回归方法分析显示年龄、平均动脉压、空腹血糖及甘油三酯与baPWV呈正向独立相关.调整性别和年龄后,baPWV值在对照组13.1 m/s,1项代谢异常组14.5 m/s,2项代谢异常组15.1 m/s,3项代谢异常组15.9 m/s,各组间比较差异均有统计学意义(P<0.05).结论:baPWV在代谢综合征异常者中显著增加,提示代谢综合征异常项目的增加反映动脉僵硬度的指标变化.     

The new definition of metabolic syndrome by the international diabetes federation is less likely to identify metabolically abnormal but non-obese individuals than the definition by the revised national cholesterol education program: the Korea NHANES study

OBJECTIVE: The new definitions for metabolic syndrome (MS) proposed by the IDF and revised NCEP have caused some confusion because patients have emerged that have satisfied the revised NCEP but not the IDF criteria. We performed this study to compare the prevalence of these criteria and to investigate the characteristics of discrepant cases. RESEARCH DESIGN AND METHODS: A total of 7962 individuals aged >or= 20 years (3597 men; 4365 women) who participated in the 1998 Korean NHANES were included. We assessed the agreement between the revised NCEP and IDF criteria and investigated the characteristics of cases satisfying the revised NCEP criteria but not the IDF criteria. RESULTS: The prevalence of MS by the revised NCEP (25.7% of men and 31.9% of women) was higher than that according to the IDF (14.2% of men and 26.6% of women). The IDF criteria failed to identify 44.9% of men and 16.6% of women identified as having MS according to the revised NCEP criteria. The discrepant group showed more adverse metabolic profiles and unfavorable lifestyles despite lower waist circumference as compared with those having MS by both the IDF and revised NCEP criteria. The prevalence of discrepant cases was higher among the elderly. CONCLUSIONS: The IDF criteria were inferior to the revised NCEP criteria in identifying the metabolically abnormal but nonobese groups known to be predisposed to type 2 diabetes and cardiovascular disease. Further research regarding the appropriateness of central obesity as an obligatory criterion proposed by the IDF seems to be warranted.     

代谢综合征对老年糖尿病患者动脉僵硬度的影响

目的探讨老年糖尿病患者合并代谢综合征(MS)动脉僵硬度的变化及影响因素。方法选择老年糖尿病患者305例,根据是否合并MS分为MS组143例、非MS组162例;另选老年葡萄糖耐量试验正常者65例为对照组。检测颈-股脉搏波传导速度(PWV)、体重指数、腰围、血压、高敏C反应蛋白、血脂、空腹血糖、胰岛素及胰岛素抵抗指数,进行比较分析。结果 MS组和非MS组患者PWV明显高于对照组(P<0.05);随着MS组分增加,PWV呈阶梯样增加(P<0.05)。多元回归分析显示,PWV与年龄、血压、MS组分、高敏C反应蛋白、胰岛素抵抗指数及空腹血糖呈正相关(P<0.05)。结论老年糖尿病患者动脉僵硬度明显增加,合并MS加重动脉僵硬。     

Relationship between nonalcoholic fatty liver disease and metabolic syndrome

OBJECTIVE: The aim of this study was to investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) in subjects who underwent a routine health checkup. We intended to establish a clinical association between NAFLD and MS as well as to compare the diagnostic criteria of MS based on the definitions set forth by the International Diabetes Federation (IDF), the US National Cholesterol Education Program Adult Treatment Panel III (2001) (NCEP/ATP‐III) and the Metabolic Syndrome Study Group of Chinese Diabetes Society (CDS). METHODS: Weight, height, waist circumference, hip circumference, percentage of body fat, blood pressure and ultrasound of liver were performed on subjects undergoing routine health checkup. Serum triglyceride, total cholesterol, high density lipoprotein cholesterol and fasting plasma glucose level were measured. RESULTS: A total of 2394 subjects were included in this analysis and 437 had NAFLD. The prevalence of MS in the whole sample according to IDF, NCEP/ATP‐III and CDS definitions was 11.11%, 8.48% and 5.30%, respectively. The total degree of agreement between IDF, NCEP/ATP‐III and CDS definition was 87.76%. The prevalence of MS in NAFLD subjects is much higher than that in non‐NAFLD subjects. The prevalence of NAFLD in MS subjects is also much higher than that in non‐MS subjects. CONCLUSION: The prevalence of MS varied depending on the diagnostic criteria used. NAFLD was strongly associated with the MS, although it remains unknown whether NAFLD is a cause or effect of MS.     

Serum levels of angiopoietin-related growth factor are increased in metabolic syndrome

Angiopoietin-related growth factor (AGF), a novel hepatokine, showed therapeutic implications in diabetic and obese animal models. Although the physiologic functions of human AGF have not yet been identified, serum levels of AGF displayed up-regulation in groups with diseases including preeclampsia and diabetes; and there was little association between genetic variability of AGF and metabolic syndrome-related phenotypes. We analyzed serum levels of AGF and other biochemical and anthropometric markers in 216 Korean persons—the numbers of healthy controls and those with metabolic syndrome were 138 and 78, respectively—to confirm research data from animal models. Women had higher AGF than men (265.01 vs 311.84 ng/mL, P = .003). This study showed that serum AGF levels were significantly higher in subjects with metabolic syndrome (325.89 ng/mL) than those in the healthy group (272.44 ng/mL) (P = .003). Among the components of metabolic syndrome, subjects with high waist circumference or decreased high-density lipoprotein cholesterol had significantly increased serum AGF (271.92 vs 313.68 ng/mL, P = .013; 271.01 vs 310.58 ng/mL, P = .023, respectively). According to multivariate regression analysis, metabolic syndrome itself and waist circumference could be used, in addition to sex and age, as predictors of serum AGF level. In conclusion, serum AGF levels were paradoxically increased in metabolic syndrome, in comparison with data from animal experiments and data on sex, age, and waist circumference. Metabolic syndrome can be a predictor of serum AGF level. Further studies are needed to explore the possibilities of compensatory up-regulation, or AGF resistance, to explain the physiologic roles of AGF in metabolic syndrome.     

The association of low-grade inflammation, urinary albumin, and insulin resistance with metabolic syndrome in nondiabetic Taiwanese

Metabolic syndrome, which involves different pathological mechanisms in associated disorders including inflammation, endothelial dysfunction, and insulin resistance, results in the development of cardiovascular diseases. The effect of the accumulative abnormalities of metabolic components and the relationship of each component to these associated disorders have not been clearly delineated. We therefore conducted a cross-sectional study to investigate the accumulative effect and the correlation of components of the metabolic syndrome to C-reactive protein (CRP), urinary albumin excretion (UAE), and the homeostasis model assessment for insulin resistance index (HOMA-IR). A total of 200 nondiabetic subjects received assessment of metabolic syndrome and measurements of serum CRP, UAE, and HOMA-IR. As the number of abnormalities of metabolic syndrome increased in subjects, the CRP, UAE, and HOMA-IR were significantly elevated (P value for trend less than .001, all). Waist circumference was an independent risk factor for CRP (P = .012); waist circumference and systolic blood pressure were independent risk factors for UAE (P = .010 and P < .001, respectively); and waist circumference, triglyceride, and glucose were independent risk factors for HOMA-IR (P < .001, all). More metabolic abnormalities were associated with higher risk of inflammation, urinary albumin, and insulin resistance. Waist circumference was the only independent risk factor for all 3 associated diseases in metabolic syndrome.