A comparison of the prevalence of metabolic syndrome and its components in high and low altitude populations in peru

Background: Prevalence of the metabolic syndrome has been described in populations with ethnic and cultural differences. The aim of this study was to determine the prevalence of the metabolic syndrome on a population from the Andes Mountains of Peru and compare it to a sea-level population. Methods: A cross-sectional study of subjects aged 30 years old or more from the high-altitude population of San Pedro de Cajas (SPC) (13,450 feet) and the sea-level population of Rimac (331 feet) was done. The metabolic syndrome was identified according to the revised National Cholesterol Education Program definition. The prevalence of metabolic abnormalities was calculated by gender, age, and population. A multivariate analysis was done with metabolic syndrome as the dependant variable. Results: Ninety-nine subjects from SPC and 172 from Rimac were included. The prevalence of metabolic syndrome was higher in SPC (22.2% versus 16.9%; p = 0.28). Prevalence of hypertriglyceridemia was significantly higher in SPC (56.6% versus 29.7%; p < 0.001) and prevalence of high blood pressure was significantly higher in Rimac (30.8% versus 18.2%; p < 0.05). In the multivariate analysis female gender was a risk factor for metabolic syndrome (odds ratio [OR] = 4.2; 95% confidence interval [CI]: 1.76-9.15). Conclusions: We found an overwhelming predominance of females with the metabolic syndrome in both populations due to high prevalences of abdominal obesity and low highdensity lipoprotein (HDL) Hypertriglyceridemia prevalence was elevated in both men and women of high altitude. Lower prevalence of high blood pressure and of high fasting glucose was found in the high-altitude natives. The prevalence and characteristics of the metabolic syndrome apparently varies among different ethnic groups and this indicates the need for more epidemiologic studies.     

Prevalence of metabolic syndrome in population-based study, Vitória, ES-Brazil

Metabolic Syndrome (MS) is a complex disorder including several factors predisposing to development of cardiovascular diseases and diabetes. Despite the importance of MS for the health system, the epidemiological characteristics of this condition in the Brazilian population are still scarce. The prevalence of MS as a function of gender, age and socioeconomic level was determined in a population-based study in Vitória, ES, Brazil, by using the NCEP-ATPIII diagnosis criteria. Socioeconomic, biochemical, anthropometric, and hemodynamic data were obtained in 1,663 individuals from a random sample of Vitória population (25-64 y). The estimated prevalence of MS was 29,8% (CI95 = 28-32%). No significant sex-related differences were observed. Prevalence increased from the youngest (26-34 y) to the oldest (55-64 y) group (15.8% and 48.3%, respectively). A progressive increase of MS frequency was observed in women from the higher to the lowest socioeconomic level. The most frequent trait of MS in males was high blood pressure, followed by hypertriglyceridemia, low HDL-c levels, hyperglycemia, and central obesity. In females, hypertension was also the most frequent factor, followed by low HDL-c levels, abdominal obesity, hypertriglyceridemia and hyperglycemia. Our data show that prevalence of MS is high in the studied population, even in the youngest group. Moreover, high blood pressure gives a significant contribution to the diagnosis of this syndrome in both sexes. The precocious control of risk factors is necessary to reduce the impact of cardiovascular morbidity and mortality.     

Alcohol consumption and metabolic syndrome among Shanghai adults： A randomized multistage stratified cluster sampling investigation

AIM： To examine the relations of alcohol consumption to the prevalence of metabolic syndrome in Shanghai adults. METHODS： We performed a cross-sectional analysis of data from the randomized multistage stratified cluster sampling of Shanghai adults, who were evaluated for alcohol consumption and each component of metabolic syndrome, using the adapted U.S. National Cholesterol Education Program criteria. Current alcohol consumption was defined as more than once of alcohol drinking per month. RESULTS： The study population consisted of 3953 participants （1524 men） with a mean age of 54.3 ± 12.1 years. Among them, 448 subjects （11.3%） were current alcohol drinkers, including 405 males and 43 females. After adjustment for age and sex, the prevalence of current alcohol drinking and metabolic syndrome in the general population of Shanghai was 13.0% and 15.3%, respectively. Compared with nondrinkers, the prevalence of hypertriglyceridemia and hypertension was higher while the prevalence of abdominal obesity, low serum high-density-lipoprotein cholesterol （HDL-C） and diabetes mellitus was lower in subjects who consumed alcohol twice or more per month, with a trend toward reducing the prevalence of metabolic syndrome. Among the current alcohol drinkers, systolic blood pressure, HDL-C, fastingplasma glucose, and prevalence of hypertriglyceridemia tended to increase with increased alcohol consumption. However, low-density-lipoprotein cholesterol concentration, prevalence of abdominal obesity, low serum HDL-C and metabolic syndrome showed the tendency to decrease. Moreover, these statistically significant differences were independent of gender and age.CONCLUSION： Current alcohol consumption is associated with a lower prevalence of metabolic syndrome irrespe- ctive of alcohol intake （g/d）, and has a favorable influence on HDL-C, waist circumference, and possible diabetes mellitus. However, alcohol intake increases the likelihood of hypertension, hypertriglyceridemia and hyperglycemia. The clinical signi     

2型糖尿病家系一级亲人群代谢综合征患病情况及与肥胖相关指标的关系

目的 比较美国国家胆固醇教育计划成人治疗疗案第三次报告(ATPⅢ)2005年、国际糖尿病联盟(IDF)2005年、中华医学会糖尿病学分会(CDS)2004年和<中国成人血脂异常防治指南>制定联合委员会(JCDCG)2007年建议的代谢综合征(MS)工作定义中不同的肥胖标准在2型糖尿病家系一级亲人群中应用的差异及与肥胖相关指标的关系.方法 对715个2型糖尿病家系中有完整血压、血脂及血糖资料的2 372名一级亲成员.分别用ATeⅢ、IDF、CDS和JCDCG定义诊断MS及肥胖.结果 (1)四种定义诊断的一级亲MS患病率分别为45.40%、38.74%、25.08%和39.29%,按ATPⅢ、IDF定义诊断时,女性MS患病率明显高于男性(均P<0.01);(2)除CDS定义在女性中最常见的组合是血脂紊乱+高血压+高血糖外,其余定义下MS的常见异常组合均表现为四种代谢异常同时存在;(3)四种定义诊断的一级亲中具备肥胖组分的比例分别为58.18%、58.18%、33.90%和42.96%;肥胖患者中分别有66.59%、66.59%、54.85%和68.99%伴有MS;(4)应用ATPⅢ/IDF以及JCDCG定义中腹型肥胖的诊断切割点,分别有28.58%及16.78%个体表现为体重指数(BMI)<25 kg/m2,但已旱腹型肥胖,其中女性的比例明显高于男性(38.90% vs 15.02%,21.01% vs 11.22%,均P<0.01).结论 (1)MS及肥胖的发病有明显家族聚集倾向,2型糖尿病家系一级亲人群是其高危人群;(2)采用腰围作为MS中肥胖组分的判别指标,较BMI可能更有助于临床早期识别和防治MS.     

Prevalence rate of metabolic syndrome and dyslipidemia in a large professional population in Beijing

The metabolic syndrome (MS) was a clustering of some cardiovascular risk factors, including hypertriglyceridemia, obesity, insulin resistance, glucose intolerance and hypertension. MS patients are at a risk of cardiovascular morbidity and mortality. Although the prevalence of MS in variety of ethnic group has been well documented, limited information is available about the prevalence in Chinese population. The aim of this study is to investigate the prevalence of the MS and dyslipidemia among 16,342 subjects (8801 males and 7541 females) aged 20-90 years in Beijing. 51.9% males and 40.8% females had at least one abnormal serum lipid concentration. The age-standardized prevalence of MS was 13.2% according to Chinese Diabetes Society (CDS) definition of the MS. The prevalence increased with age in both genders. MS was more commonly seen in males than in females (15.7% versus 10.2%). According to the diagnostic criterion, dyslipidemia was observed in 51.9% of males and 40.8% of females, and there was obvious difference between them (P < 0.001). This report on the MS and dyslipidemia from Beijing professional population showed a high prevalence of these disorders. Efforts on promoting healthy diets and physical activity in China should be undertaken.     

Prevalence of metabolic syndrome estimated by International Diabetes Federation criteria in a Hungarian population

Aims. In recent years, metabolic syndrome (MS) became a distinct pathological entity. MS is positively associated with cardiovascular mortality. The prevalence of MS is high and a continuing increase is expected. For this reason, all attempts to prevent or manage MS by interventions are extremely important. The new set of definition by International Diabetes Federation (IDF) standardizes criteria for the diagnosis of MS and facilitates its recognition. In a large sample (n = 13 383) of outpatients visiting their general practitioners, we determined the prevalence of risk factors of MS according to the earlier Adult Treatment Panel (ATP) III and the new IDF criteria. Methods and results. The age-standardized prevalence of MS was 14.9% in males and 8.6% in females (11.5% for all). The most prevalent factors were obesity (ATP III: 38.8% and IDF: 60%) and hypertriglyceridemia (34.1%). Hypertension dominated in men (28.7%), whereas in women obesity was the most prevalent factor (ATP III: 47.4% and IDF: 64%). Conclusion. The prevalence of MS depends on applied definition. The new IDF criteria offer the possibility of focusing on the importance of different components. The real comparison of prevalence among special populations has to be based on age-standardized data and the use of the same components. In our study, the dominance of obesity, hypertension and hypertriglyceridemia appears to be the major detrimental factors. The 11.5% general prevalence of MS in Hungarians, which means a 25-30% value in the middle-aged population, needs an urgent preventive approach with lifestyle changes.     

Prevalence of the metabolic syndrome in renal transplant recipients

Introduction: The cause of the metabolic syndrome (MS) is incompletely understood but represents a complex interaction between genetic, environmental, and metabolic factors, clearly including diet, and level of physical activity. The prevalence of MS is continuously increasing in the general population. Recently it has been found that MS is also common in renal transplant recipients (RTRs). The aim of this study was to determine the prevalence and characteristics of MS in a group of Libyan renal transplant recipients, using two different diagnostic criteria. Methods: This study was conducted at the Nephrology Department of the National Heart Center, Tripoli, Libya. We determined the prevalence of MS in a group of renal transplant recipients using both the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria and the International Diabetes Federation (IDF) criteria. All patients were more than six months post transplantation. Patients with Pre-transplant diabetes mellitus were excluded from the analysis. Results: By using the NCEP-ATP III criteria 26 out of 91 patients (28.6%) had the metabolic syndrome. MS was commoner in females than males, affecting 12 out of 35 females (34.3%) and 14 out of 56 males (25%). Using the IDF criteria the metabolic syndrome was diagnosed in 23 patients (25.3%). In this group of patients the most common component of the metabolic syndrome was high blood pressure and the least common was impaired glucose tolerance and diabetes. Conclusions: The prevalence of MS in our renal transplant patients is high, affecting females more than males. Key words: International Diabetes Federation; Metabolic Syndrome; NCEP-ATP III; Renal Transplant Recipients.     

Prevalence and risk factors associated with the metabolic syndrome and dyslipidemia in White, Black, Amerindian and Mixed Hispanics in Zulia State, Venezuela

Studies have highlighted the association between insulin resistance (IR) and several cardiovascular (CV) risk factors, including hypertension (HTN), obesity, dyslipidemia (i.e. high triglyceride and low HDL-cholesterol) and glucose intolerance, in a cluster known as the metabolic syndrome (MS). There are few data on the frequency of the MS and dyslipidemia in developing countries, and none in South America. To estimate the prevalence of the MS and its components in Zulia State, Venezuela, and to establish associated demographic and clinical factors, we evaluated 3108 Hispanic men and women aged 20 years or older from a cross-sectional survey of a random representative sample from each health district in Zulia State, Venezuela (1999-2001). Prevalence of the MS and dyslipidemia was defined according to the National Cholesterol Education Program (NCEP)/Adult Treatment Panel III (ATP III) criteria. The age-adjusted prevalence of MS and dyslipidemia was 31.2% and 24.1%, respectively, with higher rates in men than in women. Prevalence rates increased with age and with the degree of obesity. MS prevalence was lower in Amerindian (17.%) compared to Black (27.2%), White (33.3%) and Mixed (37.4%) men, but no differences were found among women. Overall, low HDL-cholesterol (65.3%), abdominal obesity (42.9%) and HTN (38.1%) were the most frequent MS components. After adjusting for age, sex and race groups, family history of diabetes, obesity and HTN were associated with the MS. Sedentary lifestyle also increased the risk of MS, event after adjusting for the same covariates, obesity and the degree of IR. These results suggest that MS is found in approximately one-third of the Venezuelan adult population in Zulia State, with higher prevalence in men related to the presence of dyslipidemia. Lifestyle interventions in MS subjects are needed in Venezuela to halt the burden of CV disease and diabetes.     

Fatty liver and the metabolic syndrome among Shanghai adults

BACKGROUND AND AIM: To explore the relationship between fatty liver and the metabolic syndrome in the adults of Shanghai and evaluate the value of fatty liver as a marker for risk factor clustering. METHODS: Questionnaires, physical examinations, laboratory tests (blood lipid and glucose) and real-time liver ultrasonographies were performed in Shanghai adults and analyzed using randomized, multistage, stratified cluster sampling. Prevalence of the metabolic syndrome was defined by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) criteria with the exception of abdominal obesity (waist circumference > 90 cm in men and > 80 cm in women); fatty liver was diagnosed in accordance with the presence of an ultrasonographic pattern consistent with 'bright' liver (brightness and posterior attenuation of liver). RESULTS: The study population consisted of 3175 subjects (1218 men) with a mean (+/- SD) age of 52.4 +/- 15.1 years. Metabolic syndrome and fatty liver were found in 726 (22.87%) and 661 (20.82%) of sampled cases, respectively. After adjustment by age and sex, the prevalence of the metabolic syndrome and fatty liver in the general population of Shanghai were 15.30 and 17.29%, respectively. The risk for fatty liver in subjects with abdominal obesity, diabetes, dyslipidemia and hypertension increased 32.78-fold (95% confidence interval (CI) 14.85-72.35), 31.58-fold (95% CI 14.18-70.35), 22.64-fold (95% CI 10.26-49.99) and 23.25-fold (95% CI 10.54-51.30), respectively, compared with controls, whereas the risk for fatty liver in subjects with metabolic syndrome was increased by 39.33-fold (95% CI 17.77-87.05). After the 661 patients with fatty liver had been stratified by body mass index (BMI), the prevalence of abdominal obesity, hypertension and the metabolic syndrome were increased from 25.0, 47.2 and 36.1%, respectively, in people with normal BMI to 81.0, 73.8 and 55.4%, respectively, in obese persons. However, the prevalence of hypertriglyceridemia, high fasting glucose and low high-density lipoprotein-cholesterol showed no significant changes with increased BMI. Moreover, among fatty liver patients with normal BMI, the detection rate for one or more features of metabolic disorders was as high as 83.3% and that for five features was 2.8%. Compared with obesity (BMI > or = 25 kg/m2) and abdominal obesity, fatty liver had the highest clustering rate, specificity, positive predictive value and attributable risk percentage in detecting risk factor clustering in both sexes. CONCLUSIONS: There is a high prevalence of metabolic syndrome and fatty liver among Shanghai adults. Metabolic disorders are closely related to fatty liver; moreover, fatty liver appears to be a good predictor for the clustering of risk factors for metabolic syndrome.     

Prevalence of the metabolic syndrome in Peruvian Andean hispanics: the PREVENCION study

Data regarding the prevalence of metabolic syndrome (MTS) in Andean populations are limited. We evaluated the prevalence of MTS according to American Heart Association/National Heart, Lung and Blood Institute criteria among 1878 subjects in the PREVENCION study in Peru. In women, the most common component was low HDL cholesterol (60.9%) followed by abdominal obesity (36.9%). In men, the most common component was elevated triglycerides (52.0%) followed by low HDL cholesterol (32.5%), whereas the prevalence of abdominal obesity was 14%. Abnormal fasting glucose was the least common component in men (5.4%) and women (5.0%). The prevalence of MTS was significantly higher in women compared to men (23.2% versus 14.3%) and increased steeply with age, particularly in women (p<0.0001). Using body mass index (BMI>or=30kg/m2) instead of waist circumference as a component of the MTS lead to equivalent prevalence estimates of MTS in men but significantly underestimated the prevalence in women. The MTS is highly prevalent among Peruvian Andeans, particularly in older women. The pattern of MTS components in this Andean population is characterized by a high prevalence of dyslipidemia and a relatively low prevalence of elevated fasting glucose. Further studies are required to characterize genetic and environmental determinants of these patterns.     

The metabolic syndrome and high C-reactive protein: prevalence and differences by sex in a southern-European population-based cohort

BACKGROUND: To evaluate the prevalence of the metabolic syndrome (MS) and its components in a population-based cohort, and to analyse the association between gender, environmental conditions, C-reactive protein (CRP), and the syndrome. METHODS: Out of 1877 subjects aged 45-64, who represented all the patients of six family physicians, representative of the sanitary districts of Asti (north-western Italy), 88% accepted to participate in an interview on personal habits, and several clinical and laboratory measurements. RESULTS: The MS (National Cholesterol Education Program criteria) was present in 24% of males and 22% of females. Males had a significantly higher percentage of hyperglycaemia, hypertension, hypertriglyceridemia, whereas females had a higher prevalence of central obesity and low HDL-cholesterol. In a multiple logistic regression model, the MS was significantly associated with increasing age, BMI, and >30 g/day alcohol intake (OR = 1.42; 95% CI 1.27-1.58), and negatively to higher education level (OR = 0.52; 95% CI 0.28-0.99) and moderate exercise (OR = 0.65; 95% CI 0.57-0.76). CRP levels are highly correlated to BMI and the components of the syndrome. The association between CRP and the MS remains significant in women only, in a multivariate analysis, after multiple adjustments (OR = 1.73; 95% CI 1.42-2.11). Higher CRP levels, correlated to smoking and, inversely, to alcohol intake, identify a further 12% of the cohort at higher cardiovascular risk. CONCLUSIONS: The MS affects more than 20% of this middle-aged cohort, but more than 30%, with higher CRP levels are at high cardiovascular risk. Healthier lifestyle habits are inversely associated with the MS and CRP levels, suggesting the need for strategies and their implementation in the general population.     

尿酸与腹型肥胖及代谢综合征相关性研究

 目的 探讨血清尿酸(UA)水平的变化与腹型肥胖及代谢综合征(MS)的相关性。方法 875例40~65岁杭州社区居民进入研究,其中男350例,女525例。对所有研究对象均进行问卷调查、体检和血清学检查,并进行腹部MRI扫描,测量腹内脂肪面积和皮下脂肪面积,分析UA水平与腹型肥胖和MS的相关性,并确定UA作为MS诊断的参考指标的最佳界值。结果 该人群中随着 UA 水平增加,腹型肥胖(男性OR=4.35,95%CI 1.91~9.90;女性OR=5.44,95%CI 2.41~12.31) 和MS(男性OR=4.47,95%CI 2.08~9.62;女性OR=11.62,95%CI 3.43~39.37)风险增加。多项logistic 回归分析显示,UA 是TG升高(男性OR=2.23,95%CI 1.02~4.87;女性OR=3.04,95%CI 1.49~6.23)、女性腹型肥胖(OR=3.23,95%CI 1.32~7.91)和血压升高(OR=2.35,95%CI 1.37~4.05)的独立危险因素。在女性中,根据腹内脂肪面积建立多元线性回归模型,UA的最佳切点为244.0 μmol/L,而通过受试者ROC曲线获得MS诊断的最佳界值为258.8 μmol/L。结论 在我国中年人群中,UA与腹型肥胖和MS密切相关。UA水平升高是女性腹型肥胖和MS的独立危险因素。     

原发性高血压患者代谢综合征发病情况的调查与分析

目的调查原发性高血压患者代谢综合征(MS)的发病情况并分析其特点。方法选择原发性高血压患者843例,依据是否合并MS将患者分为MS组(494例)和非MS组(349例)。结果MS组与非MS组比较,年龄、体重指数、腰围、腰臀比、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、空腹血糖、血尿酸有显著性差异;在MS各单组分中,腹型肥胖的发生率最高(71.2%),女性腹型肥胖发生率显著高于男性(75.9%vs66.5%,P=0.003);原发性高血压患者MS发生率随年龄增长而增加,55岁以前,男性MS发生率高于女性,但差异无显著性意义(P>0.05),55岁以后,女性MS发生率显著高于男性(P<0.05)。结论MS的发生率在原发性高血压人群中显著高于正常人群,应高度重视原发性高血压患者,尤其是女性MS及腹型肥胖的预防和控制。     

Prevalence of metabolic syndrome after acute coronary syndrome and its prognostic significance

Metabolic syndrome (MS) consists of a cluster of metabolic and hemodynamic disorders that promote the development of atherosclerosis and increase cardiovascular morbidity/mortality. We evaluated the prevalence and characteristics of MS after acute coronary syndrome (ACS) and the effect of intensive risk factor management on the morbidity/mortality associated with MS in a therapeutic cohort; 480 consecutive patients were summoned 3 months after an ACS for cardiovascular evaluation and management. Follow-up was carried out 16 months later. At 3 months after ACS, prevalence of MS was 20.8%, as assessed by criteria of the National Cholesterol Education Program Adult Treatment Panel III and 27.7% according to the definition of the International Diabetes Federation. The most common metabolic disorders were abdominal obesity, hypertriglyceridemia, and fasting hyperglycemia. Characteristics of the initial ACS showed no significant difference between the MS and non-MS groups. Atherosclerotic extent was greater in the MS group according to Adult Treatment Panel III. At follow-up, the MS and non-MS groups achieved optimal low-density lipoprotein cholesterol and blood pressure levels. During follow-up, there was an increase in total mortality in the MS group compared with the non-MS group (5.2% vs 1.4%, p <0.01) as assessed by International Diabetes Federation criteria; however, no difference in minor or major cardiovascular events was found between the 2 groups. In conclusion, MS was highly prevalent after an ACS, notably in young patients, and was not associated with a specific ACS presentation.     

Prevalence of the metabolic syndrome in the middle-aged and older Chinese population

Prevalence of the metabolic syndrome (MetS) is rapidly increasing in developing countries. The aim of the study was to provide the latest nationwide estimate on the prevalence of MetS in china. Using a complex, multistage, probability sampling design, a cross-sectional study was performed in a nationally representative sample of 17,708 adults aged 45 years and older from 28 provinces in 2011–2012. MetS was defined by the “Harmonizing the Metabolic Syndrome (HMS),” the guidelines from the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (modified ATP III) and the International Diabetes Federation (IDF) definition, respectively. Overall, the age-standardized prevalence of MetS defined by the modified ATP III criteria was 33.7 %, but the prevalence defined by the new HMS and IDF definition significantly increased to 43.4 and 36.2 %, respectively. And prevalence of central obesity was considerably higher (52.1 vs. 24.0 %) with the HMS (or IDF) criteria than with the modified ATP III criteria. The age-standardized prevalence of high blood pressure, hyperglycemia, hypertriglyceridemia, and low HDL cholesterol was 54.1, 57.7, 27.6, and 43.1 %, respectively. Prevalence of the metabolic syndrome was rapidly increasing in the middle-aged and older Chinese population. We may bear a higher MetS-related burden and underscore the need for strategies aimed at the prevention, detection, and treatment of MetS and special attention should be paid to elderly women population.     

Metabolic syndrome, insulin resistance and sleepiness in real-life obstructive sleep apnoea

The metabolic syndrome shows a variable prevalence in obstructive sleep apnoea (OSA), and its association with insulin resistance or excessive daytime sleepiness in OSA is unclear. This study assessed the following in consecutive patients with newly diagnosed OSA: 1) the prevalence of metabolic syndrome; and 2) its association with insulin resistance and daytime sleepiness. Metabolic syndrome (National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP) III criteria), insulin resistance (Homeostatic Model Assessment (HOMA) index, n = 288) and daytime sleepiness (Epworth Sleepiness Scale) were assessed in 529 OSA patients. The prevalence of metabolic syndrome was 51.2%, which increased with OSA severity. Each metabolic syndrome component correlated with apnoea/hypopnoea index, but only blood pressure retained significance after correction for confounders. Both obesity and OSA contributed to metabolic abnormalities, with different sex-related patterns, since diagnosis of metabolic syndrome was significantly associated with neck circumference, age, body mass index and lowest arterial oxygen saturation in males, and with age and arousal index in females. The number of metabolic syndrome components increased with HOMA index (p<0.001). Prevalence of sleepiness was the same in patients with and without metabolic syndrome. The metabolic syndrome occurs in about half of "real-life" OSA patients, irrespective of daytime sleepiness, and is a reliable marker of insulin resistance.     

上海市成人代谢综合征的流行特征

目的 采用美国国家胆固醇教育项目成人治疗组第三次指南(NCEP ATPⅢ)工作定义,评价上海市社区成人代谢综合征(MS)的流行状况.方法 采用分层整群随机抽样方法,在上海市35～74岁人群中进行横断面调查,获得有效问卷7414份列入本次分析.结果 按照NCEP ATPⅢ工作定义,MS的粗患病率为19.81%,年龄标化后的患病率为16.21%(95%CI15.37%～17.05%),女性高于男性(22.59%对16.64%,P<0.01),城市高于农村(20.84%对17.16%,P<0.01).MS患病率随年龄的增长而增加,55岁以上女性患病率显著上升.人群中有3种以上组分的个体比例高达19.81%,各危险因素的组合形式在4项组合中以"中心性肥胖+高甘油三酯血症+低高密度脂蛋白胆固醇+高血压"为最多.结论 上述研究结果表明MS已越来越成为影响上海城乡居民健康和生命的重大公共卫生问题,急需对MS作出早期诊断并加强综合防治.     

The prevalence of metabolic syndrome among young adults in Izmir, Turkey.

OBJECTIVE: The aim of this study was to determine the prevalence of metabolic syndrome and its components among the young adult ages in Izmir, Turkey. METHODS: A population-based cross-sectional study was held including 885 subjects aged between 20 to 39 years from 45 primary health care centres in Konak, which is the biggest urban area in Izmir. A stratified sampling method was used to select the participants of 318 males and 567 females. In the study, metabolic syndrome was classified according to NCEP ATP III criterion on the basis of metabolic risk factors evaluated between December 2001 and April 2002. RESULTS: The crude prevalence of metabolic syndrome (having three or more of the metabolic risk factors) was 3.6% among 20 and 29 years old men and 19.6% among 30 and 39 years old men and the increase by age was significant (p<0.001). The results were similar in women and the crude prevalence of metabolic syndrome increased significantly from 7.5 % in 20 and 29 years old women to 24 % in 30 and 39 years old women (p<0.001). With regard to the highest prevalences of the first three metabolic risk factors, hypertriglyceridemia, low HDL-cholesterol and high blood pressure, the age-adjusted prevalence of the metabolic syndrome was significantly higher in women than in men and all subjects (15% vs 10.2% vs 13.6%, p<0.01) respectively. CONCLUSION: This study revealed that the prevalence of metabolic syndrome was extremely high between young adults in urban areas and the most prevalent components of the metabolic syndrome were found to be high triglycerides, low HDL cholesterol, high blood pressure, abdominal obesity and high fasting glucose, respectively.     

Prevalence of HIV-associated lipodystrophy in Brazilian outpatients: relation with metabolic syndrome and cardiovascular risk factors

Lipodystrophy in HIV-infected patients (LDHIV) affects 40-50% of HIV-infected patients, but there are no data on its prevalence in Brazil. The aim of this study was to assess the LDHIV prevalence among HIV-infected adult Brazilian individuals, as well as to evaluate LDHIV association with cardiovascular risk factors and the metabolic syndrome (MS). It was included 180 adult HIV-infected outpatients consecutively seen in the Infectology Clinic of Universidade Estadual de Londrina. Anthropometric and clinical data (blood pressure, family and personal comorbidities, duration of HIV infection/AIDS, antiretroviral drugs used, CD4+ cells, viral load, fasting glycemia and plasma lipids) were obtained both from a clinical interview as well as from medical charts. LDHIV was defined as the presence of body changes self-reported by the patients and confirmed by clinical exam. MS was defined using the NCEP-ATPIII criteria, reviewed and modified by AHA/NHLBI. A 55% prevalence of LDHIV was found. Individuals with LDHIV presented a longer infected period since HIV infection, longer AIDS duration and longer use of antiretroviral drugs. In multivariate analysis, women (p=0.006) and AIDS duration >8 years (p<0.001) were independently associated with LDHIV. Concerning MS diagnostic criteria, high blood pressure was found in 32%, low HDL-cholesterol in 68%, hypertriglyceridemia in 55%, altered waist circumference in 17% and altered glycemia and/or diabetes in 23% of individuals. Abnormal waist and hypertriglyceridemia were more common in LDHIV-affected individuals. MS was diagnosed in 36%. In multivariate analysis, the factors associated with MS were: BMI >25 kg/m(2) (p<0.001), family history of obesity (p=0.01), indinavir (p=0.001) and age >40 years on HIV first detection (p=0.002). There was a trend to higher frequency of LDHIV among patients with MS (65% versus 50%, p=0.051). LDHIV prevalence among our patients (55%) was similar to previous reports from other countries. MS prevalence in these HIV-infected individuals seems to be similar to the prevalence reported on Brazilian non-HIV-infected adults.     

Prevalence of risk factors in patients with peripheral arterial disease. A clinical and epidemiological evaluation.

The aim of this study was to evaluate the prevalence of arterial hypertension and other risk factors in patients suffering from peripheral arterial disease (PAD) in two clinical samples (1.: 102 patients with PAD 69 M, 33 F, studied in our angiology laboratory, matched for sex and age with 102 healthy volunteers; 2.: 184 hospitalized patients, 80 M, 104 F, mean age 57.2 +/- 10.8, with PAD) and in two epidemiological cohorts (1.: Trabia Study, 835 subjects; 2.: Casteldaccia Study, 723 subjects). All patients were subjected to a full clinical and laboratory examination, including the determination of the ankle/arm pressure ratio (Winsor index, positive for PAD when lower than 0.95). In the first clinical study we observed a significantly (p < 0.01) greater prevalence of arterial hypertension (51.9 vs 9.8%), hypercholesterolemia (48.2 vs 21.6%), hypertriglyceridemia (53.7 vs 26.1%), smoking habit (64.3 vs 44.2%), and hyperglycemia (26 vs 7,9%) in PAD patients than in controls. In the second clinical study considering separately the patients under and over 65 years, all risk factors resulted to be more prevalent in younger people than in the aged, except for diabetes and hypertension. In our epidemiological experience, the prevalence of PAD increases with aging, above all in males. In the Trabia Study the risk factors, more associated with PAD, were hypercholesterolemia, smoking and obesity (41.18%) in males and hypertension and hypercholesterolemia (33.3%) and obesity (25%) in females. In the Casteldaccia Study the most important risk factors were smoking (64.28%), hypercholesterolemia (42.86%) and hypertriglyceridemia (35.71%) in males, and obesity (60%), hypercholesterolemia (30%) and diabetes (20%) in females. Cholesterol levels and smoking were significantly higher in PAD patients than in the general population, whereas hypertriglyceridemia and glycemia were not. Arterial hypertension was significantly associated with PAD in the Trabia but not in the Casteldaccia Study. Obesity was significantly associated to PAD in females in both studies. In the Casteldaccia Study, lower HDL-cholesterol levels were observed in PAD patients, above all in males, whereas significantly greater Apo-B values and lower Apo-A1 levels (in males) were shown. The different levels of associated risk factors and their prevalence in PAD patients confirm the multifactorial pathogenesis of atherosclerosis. The exact role of each risk factor in the genesis of PAD is difficult to be evaluated due to the complex biological and statistical interrelationships among different risk factors. However, the management of associated risk factors may favourably influence the risk profile in each patient suffering from PAD.