Egg and Dietary Cholesterol Consumption and the Prevalence of Metabolic Syndrome: Findings from a Population-Based Nationwide Cohort

BackgroundAlthough the Chinese Dietary Guidelines (2016) removed restrictions on dietary cholesterol intake, evidence of egg and dietary cholesterol intake and cardiometabolic diseases is inconsistent. Associations between egg and cholesterol consumption and metabolic syndrome (MetS) in non-Western populations are still poorly documented.ObjectiveOur aim was to assess egg and dietary cholesterol intake in relation to the prevalence of MetS among participants in a Chinese nationwide study.DesignThis cross-sectional study used data from the China Health and Nutrition Survey (1991-2009).Participants/settingThe sample consisted of 8,241 healthy Chinese adults (20 years and older).Main outcome measuresMetS cases were defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria.Statistical analysisCumulative means of egg and cholesterol consumption were calculated in accordance with 3 consecutive 24-hour dietary recalls in each examination cycle. Logistic regression models were conducted to assess the associations with prevalent MetS.ResultsOverall, 2,580 (31.3%) participants were identified as MetS cases in 2009. After multivariate adjustment, total egg consumption (>1 egg/d) was associated with 20% higher odds of MetS (odds ratio [OR] 1.20, 95% CI 1.06 to 1.37; P trend = .001) compared with consumption of ≤1/2 egg/d. Examining cooking methods, a positive association was observed between fried egg consumption and MetS odds (OR comparing the highest category [>1/2 egg/d] with the lowest category [≤1/7 egg/d] 1.22, 95% CI 1.08 to 1.39; P trend = .001), and nonfried egg intake was not associated with MetS odds (P trend = .08). Total dietary intake and egg-sourced cholesterol intake were both positively correlated with MetS odds (OR 1.31, 95% CI 1.12 to 1.53; P trend = .005) comparing the highest consumption (>371 mg · 2,000 kcal^–1 · d^–1) with the lowest consumption (≤132 mg · 2,000 kcal^–1 · d^–1) for total dietary cholesterol (OR 1.36; 95% CI 1.17 to 1.58; P trend < .001) and comparing the highest consumption (>232 mg · 2,000 kcal^–1 · d^–1) with the lowest consumption (≤46 mg · 2,000 kcal^–1 · d^–1) for egg-sourced cholesterol; similar associations were not observed for non–egg-sourced cholesterol consumption (P trend = .83). Substituting eggs and fried eggs for other protein sources, including low-fat and whole-fat dairy products; nuts and legumes; total red meat; processed meat; poultry meat; or seafood, was still associated with higher odds of MetS.ConclusionsConsumption of >1 egg/d and >1/2 fried egg/d was associated with a higher prevalence of MetS than consumption of ≤1/2 egg/d and ≤1/7 fried egg/d. Future longitudinal cohort studies and randomized controlled trials are needed to further investigate the relationship between egg consumption and MetS and explore possible mechanisms of action.     

Association between interaction and ratio of ω-3 and ω-6 polyunsaturated fatty acid and the metabolic syndrome in adults

ObjectiveTo investigate the association of the intakes of ω-3 (including α-linolenic acid [ALA], eicosapentaenoic acid [EPA] plus docosahexaenoic acid [DHA]) and ω-6 polyunsaturated fatty acids (PUFAs), the interaction, and the ratio of these PUFAs with the metabolic syndrome (MetS) in adults.MethodsThis cross-sectional study was conducted in a random sample of participants (n = 2451, 19–84 y old) in the Tehran Lipid Glucose Study. Dietary intake was assessed using a validated semiquantitative food-frequency questionnaire. Anthropometric characteristics, blood pressure, and fasting plasma concentrations of glucose and lipids were measured. The MetS was defined according to the Adult Treatment Panel III guidelines.ResultsAmong the PUFAs, the ALA and ω-6 PUFA intakes were inversely associated with the MetS. Subjects in the highest quartile of ALA and ω-6 fatty acid intakes had a 38% (odds ratio 0.62, 95% confidence interval 0.41–0.95) and a 0.47% (odds ratio 0.53, 95% confidence interval 0.31–0.89) lower prevalence of MetS, respectively, compared with those in the lowest quartile. The dietary ratio of ω-6 to ω-3 fatty acids was not associated with the MetS. When the interaction between ALA and ω-6 fatty acid was assessed, the ALA intake was associated with a lower prevalence of the MetS, without modification by the ω-6 PUFA intake. Subjects with at least the median ALA intake (1084 mg/d) had a lower prevalence of the MetS, irrespective of an ω-6 PUFA intake lower or higher than the median compared with subjects with intakes below the median for both.ConclusionThe ALA intake was inversely associated with the MetS, irrespective of the background intake of ω-6 PUFAs, in adults.     

Hypoadiponectinemia Is Strongly Associated with Metabolic Syndrome in Korean Type 2 Diabetes Patients

Objective: To evaluate the relationship between serum adiponectin level, dietary intake, and metabolic syndrome (MetS) in type 2 diabetes mellitus (DM) patients, and to identify factors associated with serum adiponectin level.

Methods: A cross-sectional study was performed using 789 type 2 DM patients (406 men and 383 women) 40–80 years old. Subjects were classified into 3 groups on the basis of serum adiponectin level. General characteristics and anthropometric, hematologic, and dietary data were obtained for each subject.

Results: The prevalence of hypoadiponectinemia (<4.0 µg/mL) was 57.4% in men and 32.4% in women. Serum adiponectin level was negatively correlated with body mass index (BMI), waist circumference, body fat percentage, and serum concentrations of insulin and triglyceride, and was positively correlated with high-density lipoprotein (HDL)-cholesterol level. Even though the direct association of nutrient intake with serum adiponectin concentration was not strong, various contributing factors for hypoadiponectinemia were strongly correlated with micronutrient intake, such as calcium, iron, and niacin. Both sexes in the group with the lowest adiponectin concentration had a higher prevalence of MetS and MetS components than corresponding sexes in the group with the highest adiponectin concentration.

Conclusions: Our findings show that hypoadiponectinemia is strongly associated with MetS in type 2 DM patients. Dietary intake may be indirectly associated with adiponectin levels through factors such as BMI, waist circumference, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride, HDL-cholesterol, and blood pressure. Therefore, our results suggest that manipulation of the level of adiponectin may prevent MetS and reduce the risk of cardiovascular disease in type 2 DM patients.     

饮食摄入种类和体力活动与2型糖尿病患者死亡风险的前瞻性研究

目的 探讨2型糖尿病（T2DM）患者饮食摄入种类和体力活动及其联合作用与全因死亡和特定原因死亡风险的关联。方法 2013年12月至2021年12月,对江苏省常熟市、淮安市清江浦区（原清河区）和淮安区纳入国家基本公共卫生服务管理的T2DM患者19 863人开展前瞻性队列研究。死亡信息和根本死因源于江苏省CDC死亡监测系统。利用Cox比例风险回归模型估计T2DM患者饮食摄入种类、体力活动以及联合作用与全因死亡及特定原因死亡风险的关联强度。结果 截至2021年12月31日,研究对象累计随访150 283人年,中位随访时间8.15年,随访期间共死亡3 293人,其中1 124人死于心血管疾病（CVD）,875人死于肿瘤。Cox比例风险回归模型分析结果显示,与摄入0~1种食物的T2DM患者相比,摄入5~9种食物的患者全因死亡风险降低19%［风险比（HR）=0.81,95%CI：0.70~0.94］,CVD死亡风险降低33%（HR=0.67,95%CI：0.52~0.87）。与体力活动Q₁组的T2DM患者相比,Q₄组全因、CVD和肿瘤死亡风险分别降低50%（HR=0.50,95%CI：0.45~0.56）、50%（HR=0.50,95%CI：0.41~0.61）和27%（HR=0.73,95%CI：0.60~0.88）。联合作用显示,与摄入0~2种食物和低体力活动的T2DM患者相比,摄入4~9种食物和高体力活动的T2DM患者全因、CVD和肿瘤死亡风险分别降低55%（HR=0.45,95%CI：0.38~0.53）、56%（HR=0.44,95%CI：0.32~0.59）和40%（HR=0.60,95%CI：0.44~0.82）。结论 饮食摄入种类和体力活动及其联合作用与T2DM患者死亡风险降低相关。     

Dietary Insulin Index and Dietary Insulin Load in Relation to Metabolic Syndrome: The Shahedieh Cohort Study

BackgroundInsulin resistance and hyperinsulinemia are involved in the etiology of metabolic syndrome (MetS) and its components.ObjectiveThe current study assessed the association of dietary insulin load (DIL) and dietary insulin index (DII) with the odds of having MetS among a large population of Iranian adults.DesignThis study was a cross-sectional analysis of the Shahedieh cohort study, which began in 2015-2016 and continues to the present day.Participants/settingA total of 5,954 Iranian adults, aged 35 to 70 years, were included in the current analysis. To collect dietary data, the validated block-format 120-item semiquantitative Food Frequency Questionnaire was used. MetS was defined using the criteria belonging to the Iranian-modified National Cholesterol Education Program for Adults.Main outcome measuresEnzymatic colorimetric tests were used to measure fasting blood glucose, triglyceride, and high-density lipoprotein cholesterol concentrations; blood pressure and waist circumference were measured using the standard protocols.Statistical analysisBinary logistic regression with adjusted models was used to examine the association of DIL and DII with MetS.ResultsAfter taking potential confounders into account, moderate DIL was associated with increased odds of MetS in men, meaning that men in the third quartile of DIL had 61% greater odds for having MetS compared with those in the first quartile (odds ratio [OR]: 1.61, 95% confidence interval [CI]: 1.02-2.54). Such a significant association was not seen for DII. In women, DIL was significantly associated with increased odds of developing MetS. After controlling for potential confounders, women in the top quartile of DIL had 77% greater odds for having MetS compared with women in the bottom quartile (OR: 1.77; 95% CI: 1.08-2.91). This significant positive association was also seen for DII, such that a higher score of DII was associated with 41% greater odds of MetS (OR: 1.41, 95% CI: 1.08-1.83).ConclusionsAdherence to a diet with a high DIL and DII is associated with greater odds of having MetS in women. Also, moderate DIL was associated with increased odds of MetS in men.     

Effects of energy-dense nutrient-poor snacks on the incidence of metabolic syndrome: A prospective approach in Tehran Lipid and Glucose Study

ObjectivesIncreased consumption of energy-dense, nutrient-poor snacks is one of the major, growing concerns in relation to the alarming trend of overweight, obesity, and metabolic disorders worldwide. The aim of this study was to investigate whether consumption of energy-dense snacks could affect the occurrence of metabolic syndrome after 3 y of follow-up in adults.MethodsThis longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study between 2006 and 2008 and 2009 and 2011, on 1466 adults, ages 19 to 70 y. The usual intake of participants was measured using a validated semiquantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were assessed at baseline and 3 y later. Multiple logistic regression models were used to estimate the occurrence of metabolic syndrome (MetS) in each quartile of energy-dense snacks.ResultsParticipants in the highest quartile of energy-dense snack consumption were significantly younger (33.8 versus 43.1 y; P < 0.01). There were non-significant increased risks for MetS in the highest quartile of biscuits and cakes (odds ratio [OR], 1.13; 95% confidence interval [CI], 0.77–1.66), and candies and chocolates (OR, 1.31; 95% CI, 0.88–1.94). The risk for MetS in participants with highest consumption of salty snacks increased more than 50% (OR, 1.56; 95% CI, 1.01–2.40). Consumption of soft drinks had a borderline effect on the risk for MetS. More than 361 kcal/d from total energy-dense snacks independently increased the occurrence of MetS in the fourth compared the first quartile category (OR, 1.53; 95% CI, 1.03–2.29).ConclusionThe findings of this study demonstrated that higher consumption of energy-dense snacks could be a dietary risk factor for development of MetS.     

Adiponectin gene SNP 276G �� T, nutrient intakes, and cardiovascular disease risk in Korean type 2 DM patients

Single nucleotide polymorphism (SNP) in adiponectin gene has been associated with insulin resistance, diabetes, and cardiovascular disease (CVD). This study was performed to investigate the association of SNP 276G→T at adiponectin gene with CVD risk factors in Korean type 2 diabetes mellitus (DM) patients. The subjects were 351 type 2 DM patients visited a DM clinic in Seoul, and the patients with known CVD were excluded. The adiponectin SNP 276G→T was analyzed and dietary intakes were assessed by a Food Frequency Questionnaire. The prevalence of G/G, G/T, and T/T genotype was 47.6%, 43.3%, and 9.1%, respectively. Male subjects with T/T genotype showed significantly lower level of adiponectin and HDL-cholesterol and significantly higher C-reactive protein (CRP) level compared to G/G and G/T genotypes. In G/G genotype, protein intake was negatively correlated to body weight, BMI, and waist circumference, and there were positive correlation between carbohydrate intake and BMI, waist-hip ratio, and ApoB/apoA-1 ratio in G/T genotype. However, in T/T genotype, there was no significant association between macronutrient intakes and anthropometric and hematological values. In conclusion, CVD risk would be high in type 2 DM patients with T/T genotype, and the association of macronutrient intakes with anthropometric and hematologic factors was different among the three adiponectin genotypes. These results may imply the need for different dietary management regime according to adiponectin genotype to lower CVD complications in Korean type 2 DM patients.     

Apolipoprotein A-I positively associated with diabetes in women independently of apolipoprotein E genotype and apolipoprotein B levels

ObjectiveGiven the elevated apolipoprotein (apo) A-I level enhancement of type 2 diabetes among Turks, the interrelation among it, apoB, and apoE genotype with respect to the likelihood of diabetes and metabolic syndrome (MetS), and the role of gender need further investigation.MethodsA random sample of Turkish adults genotyped for apoE with measured serum apoB and apoA-I concentrations was studied cross-sectionally. Apo ?2/?4 genotype was excluded to avoid confounding. MetS was identified by modified criteria of the Adult Treatment Panel III.ResultsAmong 1673 participants, ?3 homozygotes prevailed in 74%, apoE2 (?2/?3, ?2/?2) in 12%, and apoE4 (?3/?4, ?4/?4) in 13%. Low-density lipoprotein cholesterol and apoB levels were significantly lower and apoE concentrations higher in the apoE2 than in the remaining groups. ApoA-I levels in female subjects were significantly higher than in the E4 group. Multivariable analysis for determinants of apoB showed apoE genotype, serum apoE, C-reactive protein, apoA-I, and triacylglycerol levels to be major independent covariates. Logistic regression analyses for MetS, adjusted for potential confounders, revealed that apoB is linked to MetS in men independently of serum triacylglycerols and apoE2 group, whereas that in women in the apoE2 group was associated with MetS by mediation by triacylglycerols or apoB. The independent inverse association of apoA-I with MetS was considered apparent. Multi-adjusted likelihood of diabetes was associated only with triacylglycerol levels and, in women, with apoA-I (odds ratio 1.43, 95% confidence interval 1.10–1.86, per 1 SD increment).ConclusionThe confirmed positive association of serum apoA-I with diabetes in Turkish women is independent of apoE genotype and apoB levels.     

Association of Spicy Food Consumption Frequency with Serum Lipid Profiles in Older People in China

Objectives

There has been recent interest in spicy foods and their bioactive ingredients for cardiovascular health. This study aims to explore relationship between spicy food consumption frequency and serum lipid profiles in a cross-sectional sample of older Chinese from China Health and Nutrition Survey (CHNS).

Methods

A total of 1549 participant aged 65 years and above from CHNS 2009 were included in the analysis. Information on spicy food consumption was obtained using a questionnaire survey and 24h dietary recalls over three consecutive days combined with weighted food inventory. Fasting blood samples were analyzed for total cholesterol (TC), triglycerides, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (apoA1) and apolipoprotein B (apoB). Correlations between spicy food consumption frequency and serum lipid profiles were evaluated by multivariate linear regression models.

Results

The result shows a significant positive association between frequency of spicy food consumption estimated by the frequency question and daily spicy food intake calculated from 24h recall. After adjustment for potential lifestyle and dietary confounding factors, men with higher frequency of spicy food consumption showed higher apoA1 level, and lower ratio of LDL-C/apoB (p for trend <0.05). For female, frequency of spicy food consumption was significantly associated with TC, LDL-C, apoB, LDL-C/HDL-C, and apoB/apoA1 in an inverse manner, and positively correlated with apoA1 level (p for trend <0.05).

Conclusion

In this study with Chinese aged 65y and above, increased spicy food consumption frequency may favorably associated with some risk factors for cardiovascular diseases.

     

非酒精性脂肪肝性别之间血清生化指标比较

目的比较非酒精性脂肪肝患者性别之间生化代谢差异,探讨预防控制策略。方法检测973名体检者的总蛋白(TP)、白蛋白(ALB)、球蛋白(GLO)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、葡萄糖(GLU)、总胆固醇(T-CHO)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1)、载脂蛋白B100(apoB100),计算non-HDL-C、apoB100/apoA1、LDL-C/HDL-C、apoB100/HDL-C、TC/HDL-C比值,并对89例非酒精性脂肪肝与202名体检健康者(对照组)进行比较。结果脂肪肝患病率为9.05%,男性患病率12.53%,显著高于女性的6.0%(P<0.05);与对照组比较,59例男性患者的ALT、IBIL、TG、HDL-C、LDL-C、apoA1、non-HDL-C、apoB100/apoA1、LDL-C/HDL-C、apoB100/HDL-C、TC/HDL-C差异有统计学意义(P<0.05,P<0.01),30例女性患者的AST、TBIL、DBIL、IBIL、GLU、T-CHO、TG、LDL-C、apoA1、non-HDL-C、apoB100/apoA1、LDL-C/HDL-C、apoB100/HDL-C、TC/HDL-C差异具有统计学意义(P<0.05,P<0.01);non-HDL-C与TC、LDL-C、TG、HDL-C、apoA1、apoB100、apoB100/apoA1、TC/HDL均显著相关(相关系数0.4113~0.9893,P<0.01)。结论非酒精性脂肪肝普遍具有代谢异常和肝脏受损特点,且性别之间表现不同,应采取针对性措施进行必要的预防和干预。     

Dietary Magnesium Intake Improves Insulin Resistance among Non-Diabetic Individuals with Metabolic Syndrome Participating in a Dietary Trial

Many cross-sectional studies show an inverse association between dietary magnesium and insulin resistance, but few longitudinal studies examine the ability to meet the Recommended Dietary Allowance (RDA) for magnesium intake through food and its effect on insulin resistance among participants with metabolic syndrome (MetS). The dietary intervention study examined this question in 234 individuals with MetS. Magnesium intake was assessed using 24-h dietary recalls at baseline, 6, and 12 months. Fasting glucose and insulin levels were collected at each time point; and insulin resistance was estimated by the homeostasis model assessment (HOMA-IR). The relation between magnesium intake and HOMA-IR was assessed using linear mixed models adjusted for covariates. Baseline magnesium intake was 287 ± 93 mg/day (mean ± standard deviation), and HOMA-IR, fasting glucose and fasting insulin were 3.7 ± 3.5, 99 ± 13 mg/dL, and 15 ± 13 μU/mL, respectively. At baseline, 6-, and 12-months, 23.5%, 30.4%, and 27.7% met the RDA for magnesium. After multivariate adjustment, magnesium intake was inversely associated with metabolic biomarkers of insulin resistance (P < 0.01). Further, the likelihood of elevated HOMA-IR (>3.6) over time was 71% lower [odds ratio (OR): 0.29; 95% confidence interval (CI): 0.12, 0.72] in participants in the highest quartile of magnesium intake than those in the lowest quartile. For individuals meeting the RDA for magnesium, the multivariate-adjusted OR for high HOMA-IR over time was 0.37 (95% CI: 0.18, 0.77). These findings indicate that dietary magnesium intake is inadequate among non-diabetic individuals with MetS and suggest that increasing dietary magnesium to meet the RDA has a protective effect on insulin resistance.     

Assessing body shape index as a risk predictor for cardiovascular diseases and metabolic syndrome among Iranian adults

ObjectiveSeveral studies have concluded a positive association between abdominal obesity, general obesity, and chronic diseases. However, the best anthropometric measures to predict the risk for chronic diseases should be clarified in each population. Therefore, the aim of this study was to compare the predictive power of A Body Shape Index (ABSI), body mass index (BMI), and waist-to-height ratio and Clinica Universidad de Navarra-Body Adiposity Estimator for metabolic syndrome (MetS) and cardiovascular disease (CVD) risks among Iranians in different age and sex categories.MethodsThis population-based cross-sectional study conducted on 9555 individuals, ages ≥19 y. Anthropometric measures, blood pressure, and biochemical markers were measured using standard protocols. Hypertension, hyperglycemia, hypercholesterolemia, high low-density lipoprotein cholesterol and low high-density lipoprotein cholesterol levels were considered as the CVD risks.ResultsMean (SD) of age and BMI of participants were 38.7 y (mean 15.5) and 25.7 kg/m² (mean 4.6), respectively. ABSI demonstrated the weakest correlations and lowest area under curve (AUC) for various risk factors and MetS. However, the highest odds ratio was observed for ABSI and MetS in different age and sex categories.ConclusionsBased on the AUC, we concluded that ABSI is a weak predictor for CVD risks and MetS. More studies are needed to determine the best predictor of CVD risk among the Iranian population.     

Obesity and novel cardiovascular markers in a population without diabetes and cardiovascular disease in China

ObjectiveTo investigate associations of novel cardiovascular markers with obesity in a general population.MethodsA total of 9361 individuals without diabetes or cardiovascular disease were studied between 2009 and 2012 in China. High-sensitivity cardiac troponin T (hs-cTnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), brachial-ankle pulse wave velocity (baPWV), pulse pressure, and central systolic blood pressure (cSBP) were assessed according to body mass index (BMI) levels and different BMI/metabolic syndrome (MetS) combinations.Results'Levels of hs-cTnT, baPWV, pulse pressure, and cSBP increased across BMI levels. Obesity was positively associated with these markers in multivariate models (P < 0.05 for all). When stratified by MetS, these associations remained significant in the non-MetS group, and compared with normal weight participants, the obese participants had 1.87 (95% confidence interval: 1.48, 2.36), 1.27 (1.02, 1.57), 1.89 (1.39, 2.57), and 2.71 (2.11, 3.47) fold risks for having elevated hs-cTnT, baPWV, pulse pressure, and cSBP, respectively, and had 1.61 (1.26, 2.05), 1.75 (1.27, 2.42), 2.45 (1.46, 4.11), and 3.14 (2.13, 4.62) fold risks for having 1, 2, 3, and 4 elevated cardiovascular markers, respectively; while no relationship was observed between obesity and these novel markers in the MetS group, after multivariate adjustment. These results were unchanged when using a waist-hip ratio, body fat per cent, and visceral adiposity index to redefine obesity.ConclusionsObesity was positively associated with novel cardiovascular markers (except NT-proBNP) in participants without MetS rather than in participants with MetS. Obese participants without MetS also had higher odds of having more number of elevated cardiovascular markers.     

Lipid-related genes and myocardial infarction in 4685 cases and 3460 controls: discrepancies between genotype, blood lipid concentrations, and coronary disease risk

BACKGROUND: Blood lipid concentrations are causally related to the risk of coronary heart disease (CHD). Various associations between CHD risk and genes that moderately affect plasma lipid levels have been described, but previous studies have typically involved too few 'cases' to assess these associations reliably. METHODS: The present study involves 4685 cases of myocardial infarction (MI) and 3460 unrelated controls without diagnosed cardiovascular disease. Six polymorphisms of four 'lipid-related' genes were genotyped. RESULTS: For the apolipoprotein E epsilon2/epsilon3/epsilon4 polymorphism, the average increase in the plasma ratio of apolipoprotein B to apolipoprotein A(1) (apoB/apoA(1) ratio) among controls was 0.082 (s.e. 0.007) per stepwise change from epsilon3/epsilon2 to epsilon3/epsilon3 to epsilon3/epsilon4 genotype (trend P < 0.0001). The case-control comparison yielded a risk ratio for MI of 1.16 (95% CI: 1.06, 1.27; P = 0.001) per stepwise change in these genotypes. But, this risk ratio was not as extreme as would have been expected from the corresponding differences in plasma apoB/apoA(1) ratio between genotypes. Hence, following adjustment for the measured level of the plasma apoB/apoA(1) ratio, the direction of the risk ratio per stepwise change reversed to 0.83 (95% CI: 0.74, 0.92; P < 0.001). Similarly, for the apolipoprotein B Asn4311Ser and Thr71Ile polymorphisms, genotypes associated with more adverse plasma apolipoprotein concentrations were associated with significantly lower risk of MI after adjustment for the apoB/apoA(1) ratio. The B2 allele of the cholesteryl ester transfer protein TaqIb polymorphism was associated with a significantly lower plasma apoB/apoA(1) ratio, but with no significant difference in the risk of MI. Finally, the lipoprotein lipase Asn291Ser and T4509C (PvuII) polymorphisms did not produce clear effects on either the plasma apoB/apoA(1) ratio or the risk of MI. CONCLUSIONS: It remains unresolved why some of these genetic factors that produce lifelong effects on plasma lipid concentrations have significantly less than the correspondingly expected effects on CHD rates in adult life.     

Prevalence of Metabolic Syndrome in Relation to Cardiovascular Biomarkers and Dietary Factors among Adolescents with Type 1 Diabetes Mellitus

The occurrence of metabolic syndrome (MetS) significantly affects the course of diabetes mellitus (DM), resulting in deterioration of insulin sensitivity and metabolic control, as well as many cardiometabolic complications. The aim of the study was to investigate the relationships between cardiovascular biomarkers, nutritional status, dietary factors and the occurrence of MetS among 120 participants from northeast Poland (adolescents with type 1 DM and healthy peers). MetS was assessed using several criteria: nutritional status by anthropometric measurements, body composition analysis by bioelectrical impedance, and diet using a food diary and questionnaire. MetS was diagnosed in every third diabetic. Compared to healthy peers, MetS patients had higher total body fat (26% vs. 14%, p < 0.001) and visceral fat (77 cm² vs. 35 cm², p < 0.001), and lower total antioxidant status (1.249 mmol/L vs. 1.579 mmol/L, p < 0.001). Additionally, their diet was rich in saturated fatty acids, but low in dietary fiber as well as mono- and polyunsaturated fatty acids. The group of diabetics reported many inappropriate eating behaviors. The combination of those with the presence of an excessive content of visceral fat tissue and abnormal values of MetS components may negatively affect metabolic control, thus accelerating the development of cardiometabolic complications.     

上海市松江地区40岁及以上居民膳食模式对2型糖尿病患病影响的研究

目的 探索上海市松江地区 ≥ 40岁居民的膳食模式与2型糖尿病的关联及作用模式。方法 使用上海市"高峰计划"松江人群队列基线调查得到的资料进行分析,选择符合纳入排除标准的2型糖尿病患者作为病例组,并根据性别、年龄和饮酒情况匹配非糖尿病患者作为对照组;采用因子分析确立研究人群的膳食模式;采用条件logistic回归模型探索不同膳食模式以及膳食模式之间的相乘交互作用与2型糖尿病之间的联系。结果 经因子分析,本研究得到6种膳食模式,分别为肉类模式、甜品杂粮模式、调味品蛋类模式、饮料模式、谷薯类模式和水果蔬菜模式。经单因素和多因素条件logistic回归分析,肉类模式和甜品杂粮模式与2型糖尿病的相关性无统计学意义,而调味品蛋类模式(OR=0.543,95%CI:0.377~0.781)、饮料模式(OR=0.590,95%CI:0.409~0.852)、谷薯类模式(OR=0.592,95%CI:0.414~0.848)和水果蔬菜模式(OR=0.604,95%CI:0.417~0.876)与2型糖尿病的发病风险降低有关。分析膳食模式两两之间的相乘交互作用之后,有3个交互项与2型糖尿病的联系有统计学意义:肉类模式与调味品蛋类模式的相乘交互项与2型糖尿病的发病风险升高有关;谷薯类模式与肉类模式、谷薯类模式与水果蔬菜模式的相乘交互项与2型糖尿病发病风险降低有关。结论 6种膳食模式中谷薯类模式和水果蔬菜模式可能具有预防2型糖尿病的意义。此外,以谷类、薯类为主,搭配适量肉类,减少调味品摄入的膳食模式对降低2型糖尿病的患病风险可能也有积极作用。     

Synergistic effect of gamma glutamyltransferase and obesity on metabolic syndrome,independent of hepatic steatosis

PurposeBoth obesity and gamma glutamyltransferase (GGT) are individually considered to be closely associated with metabolic syndrome (MetS). Whether the 2 factors synergistically associate with MetS is not yet confirmed. The purpose of this study was to investigate whether obesity and GGT are interactively associated with MetS.MethodsA cross-sectional study of 7390 adults (age 32–62 years old) was conducted from 2009 to 2010.ResultsOur results showed that greater serum GGT quartiles were positively associated with all MetS components and fatty liver (P < .001). The odds ratio of MetS increased significantly along with quartiles of GGT and obesity. In comparison with subjects with normal body mass index and first quartile GGT, the odds ratio of MetS in obese groups with 1st, 2nd, 3rd, and 4th quartile GGT were 6.8, 14.5, 20.3, and 45.2, respectively, and it remained tenable after adjustment for fatty liver. The synergy index of GGT and obesity on MetS is 2.2 (95% confidence interval, 1.9–2.6).ConclusionsSerum GGT level in combination with obesity can be a simple but useful tool for risk stratification of developing MetS. Obese individuals with high–normal GGT levels require close monitoring for high risk of MetS.     

Dietary polyphenols and metabolic syndrome among Iranian adults

Abstract

Aim: The aim of this study was to investigate the association between total polyphenol intake, its subclasses (including flavonoids, phenolic acids, stilbenes and lignans), and the metabolic syndrome (MetS). Methods: This population-based cross-sectional study was conducted on a representative of 2618 adults, aged 19 to 84 years. Dietary intake was assessed using a validated food-frequency questionnaire and intakes of total polyphenol and four main subclasses of polyphenol including flavonoids, phenolic acids, stilbenes and lignans were determined. Results: Higher consumption of flavonoid intakes was associated with lower odds of enlarged waist circumference, hypertriglyceridemia, low HDL cholesterol, hyperglycemia, hypertension and MetS. Subjects in the highest quartile of lignan intakes had higher odds of having hypertriglyceridemia and hyperglycemia. Subjects in the highest quartile of stilbene intakes had higher odds of having hypertension. Conclusion: Intakes of selected subclasses of polyphenol such as flavonoids are associated with a lower prevalence of MetS among Tehranians.     

Low intestinal cholesterol absorption is associated with a reduced efficacy of phytosterol esters as hypolipemic agents in patients with metabolic syndrome

Background & aims

Phytosterols (PS) lower LDLc, but their effect on metabolic syndrome (MetS) remains unknown. We evaluated whether low-fat milk enriched with PS improves cardiovascular risk factors in these patients.

Methods

A randomised parallel trial employing 24 moderate-hypercholesterolaemic MetS patients and consisting of two 3-month intervention phases. After a 3-month healthy diet, patients were divided into two intervention groups: diet (n = 10) and diet + PS (n = 14) (2 g/day). A control group of 24 moderate-hypercholesterolaemic patients without MetS (matched in age and BMI) underwent the same procedure.

Results

Neither dietary intervention nor enrichment of PS induced any improvement in the serum lipoprotein profile of MetS patients. By contrast, in the non-MetS population, a healthy diet effectively reduced TC, LDLc, non-HDLc and Apo B-100, with further decreases in TC (6.9%), LDLc (10.5%), non-HDLc (10.3%), Apo B-100 (6.2%) and Apo B-100/ApoA-I ratio (11.6%) being observed when PS were administered. No differences in LDL diameter, hsCRP or homocysteine were detected in any of the groups after consuming PS. This supplementation produced a significant increase in PS levels only in the non-MetS population.

Conclusions

PS therapy appears to be of little value to MetS patients, likely due to its reduced intestinal cholesterol absorption. The efficacy of PS as hypocholesterolaemic agents is thus limited.