Non-HDL-C is an indicator of dyslipidemia calculated by subtracting high-density lipoprotein (HDL) choles- terol from total cholesterol (TC) and reflects the choles- terol in all atherogenic lipoprotein particles [10, 11]. The Adult Treatment Panel III of the National Cholesterol Education Program has considered non HDL-C as a rec- ommended screening algorithm and American Diabetes Association and American College of Cardiology Foun- dation, suggested non-HDL-C as a better marker than LDL-C for predicting dyslipidemia and high-risk patients with CVD [12, 13]). Also in children, non-HDL-C has been shown to be a better indicator in anticipating dys- lipidemia and subclinical atherosclerosis in adulthood compared to other lipid measures such as LDL-C [14, 15]. Because metabolic abnormalities are strongly associ- ated with atherosclerosis, non-HDL-C can be an appro- priate index for identifying individuals with MetS ). The strong association between non-HDL-C and MetS has been previously demonstrated [17–19]. However, the other evidences show that non-HDL-C levels varied in terms of sex, age group, and ethnic group . Therefore, with respect to racial and genetic heterogeneities within and among populations, it seems necessary to determine the specific cut-points of non-HDL-C for each population. Thus, this study aims at evaluating the association between non-HDL cholesterol and MetS among Iranian children and adolescents and de- termining the optimal cut-off points of non-HDL-C fractions for recognition of MetS in these age groups. This study also determined the optimal cut-off points of TG/HDL-C ratio and Diff-C as important surrogate markers in cardiovascular risks.
The MI group did not display many of the typical features of atherogenic dyslipidemia seen in Western populations: they had lower TC than controls and had comparable concentrations of NEFA, LDL-C, apoA1, apoB, and apoB/apoA1 to controls. However, the MI group did have elevated TG and low HDL-C. Also, the MI group did not have an elevated BMI, which is typi- cally seen in Western populations with this disease. The factors used to identify 10 year risk of CVD by the Third Report of the National (USA) Cholesterol Education Program Adult Treatment Panel III are age (> 45 years for men and > 55 years considered as high risk), gender (male at higher risk), elevated total cho- lesterol, low HDL-C, elevated SBP, and smoking status . Much research has also indicated that high apoB and low apoA1 may be are better indicators of risk than cholesterol alone . However, in this Chi- nese population positive for MI, only a low HDL-C was present. Therefore, many of the Western criteria used to calculate the risk for developing CVD may not be applicable in a lean Chinese population which is nonetheless at risk for developing CVD. Other, non-traditional, risk factors may need to be imple- mented to correctly identify those at risk, such as adi- pokines. And, in fact, ASP, which has been linked with CVD in several studies , was higher in the MI group compared to controls.
BC: Breast cancer; MS: Metabolic syndrome; ATP III: Adult treatment panel III; NCEP: National cholesterol education program; IGF1: Insulin like growth factor 1; IGF1-R: Insulin like growth factor 1 receptor; HOMA-IR: Homeostasis model assessment – insulin resistance; BMI: Body mass index; WC: Waist circumference; WHR: Waist hip ratio; LDL cholesterol: Low density lipoprotein - cholesterol; HDL cholesterol: High density lipoprotein - cholesterol; ER: Estrogen receptor; PR: Progesterone receptor; HER2: Human epidermal growth factor receptor 2; TN: Triple negative.
Diagnosis of metabolic syndrome (MetS) was made using the two most recognized definitions of “metabolic syndrome” including the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) cri- teria and the International Diabetes Foundation (IDF) criteria to enable comparison with other studies [24, 25]. See Tables 1 and 2 for specific criteria used to define each MetS in each system. Both these criteria consider blood pressure, dyslipidemia and glucose abnormalities and measures of obesity. One difference between NCEP-ATP III and IDF is that the former uses BMI and latter uses waist circumference as a measure of central obesity although BMI > 30 can be used in IDF if waist measurements are lacking. More significantly, NCEP-ATP
WC was defined as >102 cm for males and >88 cm in fe- males. The Homeostatic Model of Assessment-Insulin Resistance (HOMA-IR), used to evaluate insulin resist- ance, was calculated as: fasting serum insulin/fasting plasma glucose . Metabolic syndrome (MetS) was defined using the National Heart Lung and Blood Insti- tute Adult Treatment Panel III criteria : having 3 or more of the following risk factors: abdominal obesity, WC > 102 cm (males), >88 cm (females); hypertension, SBP ≥130 mmHg or DBP ≥85 mmHg or taking anti- hypertensive medications; HDL-cholesterol, <40 mg/dL (males), <50 mg/dL (females); high triglycerides, ≥150 mg/ dL or taking anti-hyperlipidemic medications; high fast- ing glucose, ≥110 mg/dL or taking insulin or other hypoglycemic agents. An elevated LDL-C was defined as ≥100 mg/dL.
ACE: Angiotensin-converting enzyme; ADA: American Diabetes Association; ARBs: Angiotensin receptor blockers; ATP III: Adult Treatment Panel III; BMI: Body mass index; BP: Blood pressure; BUN: Bblood urea nitrogen; CHD: Coronary heart disease; CIs: Confidence intervals; CKD: Chronic kidney disease; CKD-EPI: Chronic Kidney Disease Epidemiology Collaboration; DN: Diabetic nephropathy; eGFR: Estimated glomerular filtration rate; FPG: Fasting blood glucose; HDL-C: high-density lipoprotein-C; LDL-C: low- density lipoprotein-C; MRGFR: Mildly reduced eGFR; MS: Metabolic syndrome; NGFR: Normal eGFR; OGTT: Oral glucose tolerance test; PBG: Postprandial blood glucose; TC: Total cholesterol; TG: Triglycerides
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(ATP III): Adult Treatment Panel III; (BP): Blood Pressure; (BMI): Body Mass Index; (CVD): Cardiovascular disease; (CDC):Centers for Disease Control; (EHR): Electronic Health Record; (HEDIS): Healthcare Effectiveness Data and Information Set; (ICD-9): International Classification of Diseases, Ninth Revision; (LDL): Low-density Lipopro- tein; (MGH): Massachusetts General Hospital; (NCQA): National Committee for Quality Assurance; (NHLBI): National Heart, Lung, and Blood Institute; (NIDDK): National Institute of Diabetes and Digestive and Kidney Diseases; (NW): Normal weight; (OB): Obese; (OW): Overweight; (PBRN): Practice-Based Research Network; (PCP): Primary Care Physician; (RPDR): Research Patient Data Repository; (US): United States.
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Methods: Three hundred and seventy six (218 females and 158 males) first year college students (average age 19.8 years), attending Kentucky State University, Frankfort with no prior diagnosis of illness participated in the cross sectional study. Anthropometric screenings included measurement of height, weight, waist circumference and body mass index (BMI). The clinical screenings included measurement of blood pressure and determination of fasting lipid and glucose concentrations. The National Cholesterol Education Program ’ s Adult Treatment Panel III (NCEP ATP III) and International Diabetes Federation (IDF) definitions for MetS were applied. Statistics: Analysis of variance (ANOVA) scores on the Means procedure were used to examine differences between genders for all
ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ATP III: Adult treatment panel III; AUC: Area under the curve; BMI: Body mass index; BP: Blood pressure; CholRem: Cholesterol remnants; CI: Confidence interval; cLDL-C: Calculated low density lipoprotein cholesterol; C-RIDL: Committee of reference intervals and decision limits; CT: Computed tomography; CVD: Cardiovascular disease; FPG: Fasting plasma glucose; GGT: Gamma glutamyl transferase; HDL-C: High density lipoprotein cholesterol; hsCRP: Highly sensitive c-reactive protein; IDF: International diabetes federation; IDL: Intermediate density lipoprotein; IFCC: International Federation of Clinical Chemistry; IQR: Interquartile range; ISO: International Organization of Standards; LAP: Lipid accumulation product; LDL-C: Low density lipoprotein cholesterol; MetS: Metabolic syndrome; mLDL- C: Measured low density lipoprotein cholesterol; MRI: Magnetic resonance imaging; NCD: Non communicable disease; OR: Odds ratio; ROC: Receiver operator curves; SAT: Subcutaneous adipose tissue; SSA: Sub -Saharan Africa; TC: Total cholesterol; TG: Triglyceride; UA: Uric acid; VAI: Visceral adiposity index; VAT: Visceral adipose tissue; VLDL: Very low density lipoprotein; WC: Waist circumference; YI: Youden index
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Methods: A total of 12,126 Saudi subjects were randomly recruited from the 13 administrative regions, and evaluated for metabolic syndrome and its risk factors. This exercise was carried out by trained physicians, through clinical evaluations and overnight fasting blood glucose and lipid profile measurements. Both the International Diabetes Federation (IDF) and modified National Cholesterol Education Program and Adult Treatment Panel III (NCEP ATP III) Criteria were employed, and subjects with metabolic syndrome were identified using country-specific waist circumference cutoff values.
Methods: This is a cross-sectional study which included 3063 adult Saudis (1156 males and 1907 females) with a mean age of 38.6 ± 14.1 years. Anthropometric measurements and blood pressure were assessed by a standardized methodology. Blood tests including fasting lipid panel, blood glucose, fasting blood glucose and hemoglobin A1c (HBA1c) were measured for all participants. We identified the MetS based on Adult Treatment Panel III (ATPIII definition). Data were analyzed using SPSS®19 (PASW statistics data document 19); NC was compared to relevant anthropometric measures to predict obesity and MetS using Receiver Operator Characteristic (ROC) analyses. The cutoff value of NC which possessed good discriminating power between obese and non-obese patients was estimated by Youden index, and we estimated the adjusted Odds Ratio (OR) to delineate the association between NC and the outcome variables by multiple logistic regression analysis.
ADA: American Diabetes Association; ATPIII: Adult treatment panel III; BMI: Body mass index; BP: Blood pressure; cm: Centimetre; COOP/ WONCA: World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) in the Darmouth Primary Care Cooperative Information Project (COOP Project); COOP/WONCA SI: COOP/WONCA summary index; DBP: Diastolic blood pressure; dl: Decilitre; ENAC: Accreditation National Entity; HbA1c: Glycated hemoglobin or glycosylated hemoglobin; HDL: High density lipoprotein; HRqol: Health related quality of life; ISAK: International Society for the Advancement of Kinanthropometry; kg: Kilogram or kilogramme; L: Litre; LDL: Low density lipoprotein; mg: Milligram; mmHg: Millimetre of mercury; SBP: Systolic blood pressure; SEEDO: Spanish society for the study of diabetes and obesity; PAIN VAS: Pain visual analogic scale.
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when it comes to treating various problems associated with blood pressure, blood glucose, and triglycerides . Lifestyle modification may have lesser influence than drug therapy but it can prove to be very useful in controlling metabolic risk factors . Patients with Met S are recommended in reducing their weight by limiting calorie intake, behavioral change, physical activity, and anti-obesity medications [39,40]. This helps in reducing fasting blood glucose, insulin, hemoglobinA1c levels, and contributes to abdominal fat loss and also helps in lowering blood pressure, affects lipid profile (decrease triglyceride and increase high-density lipoprotein levels), and improving insulin resistance [41,42]. These could be achieved by increasing physical activity and decreasing calorie intake by 500–1000 calories per day . About 30-60 minutes of moderate rate of physical workout coupled along with everyday escalating lifestyle variations could serve as the physical activity component [44,45]. This could help in the treatment of Met S and limit the escalation of diabetes .
mined using waist circumference measurements, where WCs greater than 90 cm for men and greater than 80 cm for women defined abdominal obesity, as per the Asian region standards outlined in ATP III. Waist circumference was measured from the narrowest point between the lower borders of the rib cage and the iliac crest. Overall obesity was determined by BMI, where scores greater than 25 represented obesity and those lower than 25 represented normal weight irrespective of sex. BMI was calculated as weight in kilograms divided by the square of the height in meters, and body weight and height were measured with subjects wearing light clothing without shoes. A family history of diabetes was obtained through a review of the diabetes history of parents, siblings, and both paternal and maternal grandparents, where the presence of a single rela- tive with a history of diabetes was considered an indication of such a family history. Health behaviors that affect dia- betes included smoking, obesity, and overweight status due to lack of physical activity, exercise, etc. 9 Smoking
this study (6.4%). People with diabetes have an increased risk of developing a number of serious health problems. High blood glucose levels can lead to serious diseases affecting the heart, blood vessels, eyes, kidneys, and nerves. On the other side, HIV/AIDS is not curable, and it is a disastrous disease that compromises the immune system of the patient. So, the combination of the two diseases will increase the burden of morbidity and mortality of the HIV-infected individuals. HAART might have an impact on the cause of diabetes. This could be the probable reason why the present study is hav- ing higher prevalence of DM than the general and the adult population of Ethiopia.
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Note: SBP, systolic blood pressure; DBP, diastolic blood pressure; WC, waist circumference; HDL, high-density lipoprotein cholesterol; TG, triglyceride; FPG, fasting plasma glucose; HbA1c, haemoglobin A1c. Data are expressed as frequency count (%). Metabolic syndrome (MetS) was diagnosed according to the guideline of the United States National Cholesterol Education Program (NCEP) Expert Panel Adult Treatment Panel (ATP) III criteria, in which an individual diagnosed with MetS has three or more of following characteristics: 1) WC exceeds 90 cm or 80 cm for Asian male and female, respectively, 2) SBP equals or exceed 130 mmHg or DBP equals or exceeds 85 mmHg, 3) FPG equals or exceeds 5.6 mmol/L [100 mg/dL], 4) TG equals or exceeds 1.70 mmol/L [150 mg/dL]), and 5) HDL-C equals or is less than 40 mg/dL for male and 50 mg/dL for female) . Elevated HbA1c is defined as HbA1c ≧ 5.7%.
In addition to increasing the risk of CV disease, the metabolic syndrome may hasten the development of stroke and complication of diabetes mellitus like diabetic nephropathy, retinopathy and neuropathy . With respect to the NCEP-ATP III criteria, the type 2-diabetes mellitus subjects having already fulfilled one criteria and another two are needed to diagnose metabolic syndrome, suggesting that the patients with type 2 diabetes mellitus, exhibit the features of metabolic syndrome and it often results in hyperglycemia. In our study it was found that about 14.8 % were of impaired fasting glucose and 19.4 % cases were already having Type 2 diabetes. Waist Circumference has the strongest associations with health risk factors . The increased waist circumference has been thought to be a predictor of CV disease and is an important diagnostic marker for the metabolic syndrome . The recommended waist circumference cutoff values were 90 cm for Asian males and 80 cm for Asian females . In our study about 27.8% polices had a waist circumference above 90 cm. The studies done on the lifestyles of policemen indicate increased rate of addiction to smoking and alcohol habits. Smoking is associated with an increased prevalence of metabolic syndrome, independent of sex and BMI class. This increased risk is mainly related to lower HDL cholesterol, and higher triglycerides and waist circumference . Our study also showed that the alcohol and smoking habits were more among policemen followed by their greater triglyceride level, waist circumferences and lower HDL level.
) is defined by a constellation of interconnected physiological, biochemical, clinical, and metabolic factors that directly increases the risk of cardiovascular disease, type 2 diabetes mellitus, and all cause mortality. MetS started as a concept rather than a diagnosis its origin in 1920 when Kylin, a Swedish physician, demonstrated the association of The field moved forward significantly following the 1988 Banting lecture given He described “a cluster of risk factors for diabetes and cardiovascular disease” and named it “Syndrome X” With the introduction of Highly Active Antiretroviral Therapy (HAART), the treatment of HIV has tients live longer with improved quality of life. Several studies have described the increasing incidence of MeTS among patients on HAART. Over the last few years, chronic infection like HIV has been
Introduction: Obesity may be associated with more severe and disabling low backache (LBA) due to alteration in biomechanics, but there are no such studies from developing countries. Aims: We report the frequency of metabolic syndrome (MS) in chronic LBA (CLBA) and its association with severity and disability of CLBA. Subjects and Methods: Consecutive patients with CLBA attending to the neurology service from October 2015 to February 2016 were included in the study. Clinical and demographic parameters were recorded. Routine biochemical test was done. The severity of pain was assessed by a 0–10 Numeric Rating Scale (NRS) and disability by Oswestry Disability Index (ODI) version 2. Comparison of variables was done by Chi‑square or independent t‑test and correlation by Karl Pearson or Spearman’s rank correlation test. Results: Seventy‑none (39.3%) patients had MS as per the International Diabetic Federation (IDF) criteria and 68 (33.8%) as per the National Cholesterol Education Program Adult Treatment Panel III criteria. Abdominal obesity was the most common (171 [85.1%]) feature of MS. The patients with MS had longer duration of sitting work and did less frequently exercise. The NRS score (6.95 ± 1.06 vs. 6.65 ± 0.95; P = 0.04) and ODI score (54.91 ± 8.42 vs. 51.89 ± 8.54; P = 0.01) were higher in CLBA patients with MS compared to those without MS. Conclusion: About 40% patients with CLBA have metabolic syndrome, and they have more severe pain and disability. Keywords: Backache, chronic low backache, disability, metabolic syndrome, Numeric Rating Scale, obesity, severity
It has been hypothesised that stress resulting from a long-term infection, such as TB or HIV, could increase the occurrence of IR in the body [12–14]. Recent litera- ture has also described occurrences of impaired glucose tolerance, distortions in carbohydrate metabolism and altered insulin action among newly diagnosed TB patients [15–17]. The pro-inflammatory response accompanying a period of infection is postulated to result in decreased in- sulin production, which leads to a hyperglycaemic state . This process may also be accompanied by the release of certain stress hormones such as epinephrine, cortisol and glucagon, which further impair the action of insulin . The phenomenon of ‘transient hyperglycaemia’ (subsiding of glucose intolerance upon diagnosis after active TB treatment) can also not be discounted [18, 19]. The effect of Rifampicin, one of the pharmaceutical agents used in the treatment of TB, has also been found to result in transient hyperglycaemia soon after treatment com- mencement due to its strengthening of intestinal glucose absorption . Furthermore, according to Schwartz’s theories, it has been postulated that the pancreas could be assaulted by TB either via concomitant pancreatitis (result- ing in heightened susceptibility to inflammation and/or amyloidosis) or via the forced habitation of the pancreas [21, 22]. Moreover, the persistence of TB bacteria in adipose tissue has been thought to be a possible causative factor for systemic IR .
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