The utility of visceral fat level measured by bioelectrical impedance analysis in predicting metabolic syndrome

BackgroundVisceral adipose tissue dysfunction contributes to metabolic syndrome (MetS) and cardiovascular diseases. This study aims to investigate the association between visceral fat level measured by bioelectric impedance analysis (BIA) and MetS.Material and methodsThis cross-sectional study recruited Taiwanese volunteers aged ≥20 years between 2012 and 2014. Anthropometric measurements and plasma concentrations of glucose, insulin, and lipid profiles were collected after at least 8 h of fasting. Insulin resistance was calculated by the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Visceral fat level (VFL, ranges: 1–59) and trunk fat percentage were measured through by the Body Composition Analyzer TANITA AB 140 Viscan.ResultsA total of 1086 volunteers (mean age = 44.2 ± 13.2 years) were enrolled. Multiple regression analyses showed that triglycerides levels and blood pressure increased while high-density lipoprotein-cholesterol decreased with VFL in both genders (p < 0.05). Increased HOMA-IR and VFL had a synergistic effect on MetS. Higher VFL was independently associated with MetS in both men (OR = 1.33, 95% CI: 1.19–1.48) and women (OR = 1.28, 95% CI: 1.17–1.39).ConclusionsHigher VFL is associated with MetS and its components. The portable BIA machine is easily applicable and useful tool to measure visceral fat in the community setting.     

Visceral adipose tissue quantity and dysfunction and the occurrence of major bleeding in patients with established cardiovascular disease

ObjectivesTo determine the association between both visceral fat quantity and adipose tissue dysfunction, and major bleeding in patients with established cardiovascular disease.MethodsPatients from the Second Manifestations of ARTerial disease study with established cardiovascular disease were included. Visceral fat was measured using ultrasound and adipose tissue dysfunction was depicted using metabolic syndrome criteria (revised National Cholesterol Education Program). Cox regression models were fitted to study the relation with major bleeding defined as Bleeding Academic Research Consortium (BARC) type 3 or 5, or International Society on Thrombosis and Haemostasis (ISTH) major bleeding. Sensitivity analyses were performed using C-reactive protein levels to reflect adipose tissue dysfunction.ResultsIn 6927 patients during a median follow up of 9.2 years, a total of 237 BARC type 3 or 5 bleedings and 224 ISTH major bleedings were observed. Visceral fat quantity was not related to major bleeding (HR 1.01, 95%CI 0.88–1.16 for BARC type 3 or 5 bleeding and HR 1.00, 95%CI 0.87–1.15 for ISTH major bleeding), nor was metabolic syndrome (HR 0.97, 95%CI 0.75–1.26 for BARC type 3 or 5 bleeding and HR 0.98, 95%CI 0.75–1.28 for ISTH major bleeding). Sensitivity analyses using C-reactive protein levels showed similar results. No effect modification was observed by sex, antithrombotic therapy, presence of metabolic syndrome or diabetes.ConclusionIn patients with cardiovascular disease, no association was found between visceral fat quantity measured with ultrasound or measures of adipose tissue dysfunction and the risk of major bleeding, irrespective of antithrombotic agent use.     

湖南省某乡村成年人群中代谢综合征与慢性肾脏病的关系

目的 研究中国南方某乡村成年人群代谢综合征(MS)和慢性肾脏病(CKD)的关系.方法 在湖南省某乡村采用分层多级随机抽样的方法,抽取18岁以上的常住居民1953人,进行MS组分、肾脏损伤指标及其他相关危险因素的问卷调查和检测.结果 在资料完整的1709名居民中,用年龄、性别及MS组分校正后.有MS的参与者CKD的患病率比没有MS的参与者高(19.3% vs.13.2%,P＜0.001).CKD患病率随MS组分数的增多而升高.MS与CKD之间存在强而独立的关联.不合并高血压和糖尿病的参与者,MS也与CKD有关(OR=1.733,95%CI:1.20～2.41,P=0.004).结论 中国南方某乡村1709名研究对象中,MS与CKD存在关联.     

代谢综合征与女性乳腺癌发病风险的前瞻性队列研究

目的研究代谢综合征(MS)与女性乳腺癌发病风险关联。方法基于“开滦女性动态队列”,于2006年5月至2015年12月,纳入25618名开滦集团在职及离退休女性职工为研究对象,并进行随访。采用问卷调查、身体测量和实验室检测的方法收集基线社会人口学特征、身高、体重、血糖、血脂、血压及肿瘤发病结局信息。采用Cox比例风险回归模型分析MS及其组分(体重指数、血压、血糖、血脂)与女性乳腺癌发病风险的关系。结果25618名研究对象年龄为(47.65±12.02)岁,中位随访时间为8.78年;乳腺癌新发病例为235例,发病密度为113.19/10万人年。调整年龄、教育程度、经济收入、吸烟状态、饮酒状态等因素后,与体重指数正常者相比,超重或肥胖者的乳腺癌发病风险较高,HR(95%CI)值为1.47(1.12~1.93);与无MS异常组分相比,具有2个MS异常组分的女性乳腺癌发病风险增加(HR=1.70,95%CI:1.16~2.50);随着MS异常组分个数的增加,乳腺癌发病风险逐渐增加(P趋势<0.05)。结论超重/肥胖、MS异常组分的个数均可增加女性乳腺癌发病风险。     

Metabolic syndrome (MetS) and associated factors in middle-aged women: a cross-sectional study in Northeast Brazil

ABSTRACT

We determined the prevalence of Metabolic Syndrome (MetS) and associated factors in 419 women (aged 40 to 65 years) in Northeast Brazil in a cross-sectional study conducted from April to November 2013. We defined MetS using the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Socio-demographic variables, reproductive factors, lifestyle factors, anthropometrics, body composition, quality of life, and physical performance were assessed for their associations. We constructed multivariate Poisson regression models to estimate prevalence rate ratios (PRR) and 95% confidence intervals (CI). We identified 275 (65.6%) cases of MetS. The three most prevalent indicators were obesity (73.5%), reduced high-density lipoprotein level (63.0%), and elevated blood pressure (60.9%). In the final adjusted model, black race (PR 1.30, 95% CI: 1.07–1.57), lower grip strength/body mass index (PR 1.31, 95% CI: 1.15–1.50), and low estradiol levels (PR 1.17, 95% CI: 1.00–1.35) were associated with MetS. MetS is a long-term threat to the health of middle-aged women and a potential public health burden. These results may help in developing health promotion strategies to prevent morbidity and mortality associated with MetS in this vulnerable population.     

新疆15~18岁城市人群连续性代谢综合征评分筛查价值

探讨“连续性代谢综合征评分”(continuous metabolic syndrome score,cMetS)对新疆15~ 18岁人群代谢综合征(metabolic syndrome,MetS)筛查价值,为确定cMetS对不同性别最佳截断点提供参考.方法 分层整群抽取新疆13座城市15~18岁人群共4 745名.cMetS是按年龄和性别进行计算标准化腰围、平均动脉压、高密度脂蛋白、三酰甘油、空腹血糖的Z分,再对单个变量的Z分进行累加计算.结果 4 745名城市人群中,有16.3%为超重,5.2%属于肥胖,其中男性超重和肥胖比例(18.1%,13.8%)高于女性(6.0%,4.1%)(x2值分别为15.36,7.89,P值均<0.05).总MetS患病率为6.1%,男性和女性分别为6.6%,5.4%.cMetS与MetS组分之间具有相关性,平均cMetS值随着MetS组分增加而增加(P<0.05).cMetS总截断值为0.99(灵敏度为68.0%,特异度为80.7%),ROC曲线下面积为84.9%.男生和女生的cMetS评分分别为0.80和1.48.结论 与MetS相比,cMets在筛查不同性别人群患MetS中是一种更灵敏的代谢变化标志物.     

Development of a fragile X syndrome (FXS) knowledge scale: towards a modified multidimensional measure of informed choice for FXS population carrier screening

Background

Genetic carrier screening is increasingly possible for many conditions, but it is important to ensure decisions are informed. The multidimensional measure of informed choice (MMIC) is a quantitative instrument developed to evaluate informed choice in prenatal screening for Down syndrome, measuring knowledge, attitudes and uptake. To apply the MMIC in other screening settings, the knowledge scale must be modified.

Objective

To develop and validate a modified MMIC knowledge scale for use with women undergoing carrier screening for fragile X syndrome (FXS).

Setting and participants

Responses to MMIC items were collected through questionnaires as part of a FXS carrier screening pilot study in a preconception setting in Melbourne, Australia.

Design

Ten knowledge scale items were developed using a modified Delphi technique. Cronbach''s alpha and factor analysis were used to validate the new FXS knowledge scale. We summarized the knowledge, attitudes and informed choice status based on the modified MMIC.

Results

Two hundred and eighty‐five women were recruited, 241 eligible questionnaires were complete for analysis. The FXS knowledge scale items measured one salient construct and were internally consistent (alpha = 0.70). 71% (172/241) of participants were classified as having good knowledge, 70% (169/241) had positive attitudes and 27% (65/241) made an informed choice to accept or decline screening.

Discussion and conclusions

We present the development of a knowledge scale as part of a MMIC to evaluate informed choice in population carrier screening for FXS. This can be used as a template by other researchers to develop knowledge scales for other conditions for use in the MMIC.     

Role of a critical visceral adipose tissue threshold (CVATT) in metabolic syndrome: implications for controlling dietary carbohydrates: a review

There are likely many scenarios and pathways that can lead to metabolic syndrome. This paper reviews mechanisms by which the accumulation of visceral adipose tissue (VAT) may contribute to the metabolic syndrome, and explores the paradigm of a critical VAT threshold (CVATT). Exceeding the CVATT may result in a number of metabolic disturbances such as insulin resistance to glucose uptake by cells. Metabolic profiles of patients with visceral obesity may substantially improve after only modest weight loss. This could reflect a significant reduction in the amount of VAT relative to peripheral or subcutaneous fat depots, thereby maintaining VAT below the CVATT. The CVATT may be unique for each individual. This may help explain the phenomena of apparently lean individuals with metabolic syndrome, the so-called metabolically normal weight (MONW), as well as the obese with normal metabolic profiles, i.e., metabolically normal obese (MNO), and those who are "fit and fat." The concept of CVATT may have implications for prevention and treatment of metabolic syndrome, which may include controlling dietary carbohydrates. The identification of the CVATT is admittedly difficult and its anatomical boundaries are not well-defined. Thus, the CVATT will continue to be a work in progress.     

人工智能乳腺超声系统（AIBUS）应用于乳腺癌筛查中的人群满意度及意愿研究

目的 调查接受人工智能乳腺超声系统（AIBUS）检查对象的满意度和意愿情况,为改善和提升智能筛查设备提供评价证据。方法 根据美国顾客满意度指数模型,采用Likert 5级评分设计问卷,包含检查效率、检查感知、医疗AI价值感知和意愿4个维度。现场调查成都市双流区参与AIBUS筛查的481名社区女性。采用结构方程模型分析满意度的影响因素。结果 检查对象对AIBUS的满意度总分为（65.58±7.09）（得分率82.0%）,满意人数有262人（除意愿维度外满意问卷总分≥48分,占62.83%）。对满意度影响的效应值由大到小依次为检查感知（β = 0.893）、医疗AI价值感知（β = 0.635）、检查效率（β = - 0.256）,满意度对意愿影响明显（β = 0.885）,所有效应值显著。结论 总的说来,检查人群对AIBUS接受程度尚可,还需加强公众对医疗AI的认知,改善检查体验,提高社会对此类设备的接受度。本研究为人工智能筛查设备的推广应用提供需方视角评价思路。     

The single point insulin sensitivity estimator (SPISE) index as a predictor of metabolic syndrome in Korean adults

PurposeRecently, the single-point insulin sensitivity estimator (SPISE) has been developed as a simple surrogate of insulin resistance based on BMI, triglycerides (TG), and HDL-C. However, no studies have focused on the predictive power of the SPISE index for identifying metabolic syndrome (MetSyn) in Korean adults. Here, this study aimed to estimate the predictive power of the SPISE index for determining MetSyn and to compare its predictive power with other insulin sensitivity/resistance indices in South Korean adults.MethodsA total of 7837 participants from the 2019 and 2020 Korean National Health and Nutrition Examination Surveys were analyzed in the present study. MetSyn was defined by the AHA/NCEP criteria. In addition, HOMA-IR, inverse insulin, TG/HDL, TyG index (triglyceride-glucose index), and SPISE index were calculated based on the previous literature.ResultsPredictive power of the SPISE index for determining MetSyn (ROC-AUC [95 % CI] = 0.90 [0.90–0.91], sensitivity = 83.4 %, specificity = 82.2 %, cut-off point = 6.14, p < .001) was higher than that of HOMA-IR (ROC-AUC: 0.81), inverse insulin (ROC-AUC: 0.76), TG/HDL-C (ROC-AUC: 0.87), and TyG index (ROC-AUC: 0.88), the P value for ROC-AUC comparison < .001.ConclusionSPISE index has demonstrated superior predictive value for diagnosing MetSyn regardless of sex and is strongly correlated with blood pressure compared with other surrogate indices of insulin resistance, attesting to its utility as a reliable indicator of insulin resistance and MetSyn in Korean adults.     

PPAR-γ在多囊卵巢综合征大鼠脂肪组织中的表达及意义

目的:探讨过氧化物酶增殖物激活受体-γ(PPAR-γ)在多囊卵巢及正常大鼠脂肪组织中的表达及在多囊卵巢综合征(PCOS)发病中的作用。方法:应用脱氢表雄酮(DHEA)皮下注射23天龄SD雌性大鼠20天,建立PCOS大鼠模型,应用免疫组织化学技术对PPAR-γ在PCOS大鼠和对照组大鼠脂肪组织的表达强度变化进行研究。结果:PCOS大鼠模型建立成功;PPAR-γ在PCOS组脂肪组织基质细胞上的表达强度(102.7656±11.15510)明显低于对照组(146.3264±4.93102),P<0.001。结论:PPAR-γ在多囊卵巢大鼠发病中起着重要作用。     

Association of Coffee Consumption and Its Types According to Addition of Sugar and Creamer with Metabolic Syndrome Incidence in a Korean Population from the Health Examinees (HEXA) Study

Coffee is widely consumed worldwide, and numerous studies indicate that coffee consumption may potentially affect the development of chronic diseases. Metabolic syndrome (MetS) may constitute a risk factor for chronic diseases. We aimed to prospectively evaluate the association between coffee consumption and MetS incidence. All participants were selected from the Health Examinees study. MetS was defined by the Adult Treatment Panel III criteria of the National Cholesterol Education Program. A multivariate Cox proportional hazards regression model was used to assess the relationship between coffee consumption and MetS incidence. In comparison with non-consumers, male moderate consumers (≤3 cups/day) showed a lower risk for low high-density lipoprotein cholesterol (HDL-C) (≤1 cup/day, hazard ratio (HR): 0.445, 95% confidence interval (CI): 0.254–0.780; 1–3 cups/day, HR: 0.507, 95% CI: 0.299–0.859) and high fasting blood glucose (FPG) (≤1 cup/day, HR: 0.694, 95% CI: 0.538–0.895; 1–3 cups/day, HR: 0.763, 95% CI: 0.598–0.972). Male 3-in-1 coffee (coffee with sugar and creamer) consumers also showed a lower risk for low HDL-C (HR: 0.423, 95% CI: 0.218–0.824) and high FPG (HR: 0.659, 95% CI: 0.497–0.874). These findings indicate a negative association between moderate coffee consumption and low HDL-C and high FPG among Korean male adults.     

Urinary phthalate metabolites and metabolic syndrome in U.S. adolescents: Cross-sectional results from the National Health and Nutrition Examination Survey (2003–2014) data

Objective

There is limited research on the association between phthalates and metabolic syndrome (MetS). Among adolescents, phthalate exposure, which can occur from multiple sources, has been linked to several risk factors for MetS. The objective was to investigate the association between urinary phthalate metabolite concentrations (i.e., mono-ethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), mono-benzyl phthalate (MBzP), mono-(3-carboxylpropyl) phthalate (MCPP), and di(2-ethylhexyl phthalate (DEHP)) and MetS in adolescents aged 12–19 years using the National Health and Nutrition Examination Survey (NHANES) data (2003–2014). A secondary aim was to assess if observed associations varied by a measure of socioeconomic status, economic adversity, which was defined using parental income and educational attainment as well as household food security.