Correlation analysis between occupational stress and metabolic syndrome in workers of a petrochemical enterprise: based on two assessment models of occupational stress.

BACKGROUND: Occupational stress is becoming a common phenomenon around the world. Being in a high occupational stress state for a long time may destroy the metabolic balance of the body, thereby increasing the risk of metabolic diseases. There is limited evidence regarding the correlation between occupational stress and metabolic syndrome (MetS), particularly in the petrochemical workers. METHODS: A total of 1683 workers of a petrochemical enterprise in China were included in the survey by cluster sampling method. The occupational stress assessment was carried out by the Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire, and the general demographic characteristics, work characteristics, occupational hazards, lifestyle and health examination data of the participants were collected. Logistic regression and multiple linear regression were used to analyze the correlations and influencing factors between occupational stress and its dimensions with MetS and its components. RESULTS: A total of 1683 questionnaires were sent out, and 1608 were effectively collected, with an effective recovery rate of 95.54%. The detection rates of occupational stress in Job Demand-Control (JDC) and Effort-Reward Imbalance (ERI) models were 28.4% and 27.2%, respectively. In this study, 257 participants (16.0%) were diagnosed with MetS. Compared with the non-MetS group, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG) and fasting blood-glucose (FBG) levels were significantly higher in the MetS group, and high density lipoprotein-cholesterol (HDL-C) levels were significantly lower (P < 0.001). The results of multiple linear regression showed that after adjusting for nation, marital status, education, work system, smoking and drinking, and further adjusting for occupational hazards, the D/C ratio was significantly negatively correlated with SBP in the JDC model. Social support was negatively correlated with WC. In the ERI model, there was a significant positive correlation between over-commitment and FBG. CONCLUSIONS: The detection rates of occupational stress and MetS were high in workers of a petrochemical enterprise. In the JDC model, occupational stress was negatively correlated with SBP, and social support was negatively correlated with WC. In the ERI model, there was a significantly positive correlation between over-commitment and FBG.

The role of the visceral adiposity index in the assessment of metabolic syndrome of polycystic ovary syndrome patients: a new anthropometric index.

PURPOSE: Polycystic ovary syndrome (PCOS) is a common endocrine disorder often linked to metabolic syndrome (MS), raising the risk of cardiovascular disease and type II diabetes. Certain indicators, such as the lipid accumulation product (LAP) and homeostatic model assessment for insulin resistance (HOMA-IR), can predict MS in PCOS patients. This study aimed to assess the predictive power of the visceral adiposity index (VAI) in comparison to LAP and HOMA-IR as predictors of MS in PCOS patients. METHODS: In this cross-sectional observational study, data from 317 diagnosed PCOS women were analyzed. VAI, LAP, and HOMA-IR were computed as indexes. Participants were categorized into two groups for index accuracy comparison: PCOS patients with and without MS. The data were assessed using a ROC curve. RESULTS: Among PCOS women with MS, 92.3% had abnormal VAI results, 94.5% had abnormal LAP results, and only 50.5% had abnormal HOMA-IR results. Conversely, the majority of PCOS women without MS had normal HOMA-IR (64.6%). When comparing these indexes using the ROC curve, VAI displayed the highest accuracy, followed by LAP and HOMA-IR. CONCLUSION: The VAI index proved to be a superior predictor of metabolic MS in PCOS women when compared to other indexes.

Assessment of eight insulin resistance surrogate indexes for predicting metabolic syndrome and hypertension in Thai law enforcement officers.

Police officers in Thailand have an increased risk of heart disease, stroke, and type 2 diabetes, possibly due to a high prevalence of hypertension and metabolic syndrome (MetS). In this study, the researchers aimed to understand the relationship between surrogate markers of insulin resistance (IR) and the prevalence of MetS and hypertension in Thai police officers. The study included 7,852 police officer participants, of which 91.8% were men with an average age of 48.56 years. The prevalence of hypertension and MetS were found to be 51.1% and 30.8%, respectively, and the participants with MetS and hypertension were older compared to the regular group. The study looked at eight IR indices, including markers such as atherogenic index of plasma (AIP), lipid accumulation product (LAP), metabolic score for insulin resistance (METS-IR), triglyceride glucose (TyG) index, TyG index with body mass index (TyG-BMI), TyG index with waist circumference (TyG-WC), the ratio of triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-c), and visceral obesity index (VAI). These indices were found to be positively correlated with waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), and triglycerides (TG), while being negatively correlated with high-density lipoprotein cholesterol (HDL-c). In addition, the multiple regression analysis showed that higher quartiles of all IR indices were significantly associated with increased risks of MetS and hypertension. Interestingly, the IR indices were more accurate in predicting MetS (ranges 0.848 to 0.892) than traditional obesity indices, with the AUC difference at p < 0.001. Among the IR indices, TyG-WC performed the best in predicting MetS (AUC value 0.892 and Youden index 0.620). At the same time, TyG-BMI had the highest accuracy in predicting hypertension (AUC value of 0.659 and Youden index of 0.236). In addition, this study found that when two markers were combined for diagnosing metabolic syndrome, a significantly improved predictive value for disease risk was observed, as evidenced by higher AUC and Yoden index. Moreover, the IR indices were found to have higher predictive power for MetS and hypertension in younger police personnel (age < 48 years) than older personnel. In conclusion, this study highlights the importance of reducing cardiovascular disease risks among law enforcement personnel as a strategic goal to improve their health and wellness. The findings suggest that IR indices may be valuable tools in predicting MetS and hypertension in law enforcement personnel and could potentially aid in the early identification and prevention of law enforcement personnel health conditions.

[Prevalence of metabolic syndrome : Analysis based on routine statutory health insurance data]. / Prävalenz des metabolischen Syndroms : Eine Analyse auf Basis von Routinedaten einer gesetzlichen Krankenversicherung.

BACKGROUND: The metabolic syndrome is a decisive risk factor for the manifestation of cardiovascular and metabolic diseases. Metabolic syndrome is the term used to describe the joint presence of specific diseases (obesity, hypertension, type 2 diabetes mellitus, disorders of fat metabolism). A classification is made more difficult by inconsistent definition criteria and a missing International Statistical Classification of Diseases and Related Health Problems (ICD) code. There are no known prevalence studies for Germany based on routine data of the statutory health insurance (GKV). OBJECTIVE: The main aim of the present study was to classify the metabolic syndrome based on routine data of the GKV and to estimate the frequency of diagnosis. In addition, the influence of social factors (school and educational qualifications) was examined for the subgroup of employees with social insurance. MATERIAL AND METHODS: A retrospective routine data analysis was carried out based on routine administrative data from the AOK Lower Saxony (AOKN). In contrast to the established definitions, which use medical parameters, the risk factors are taken into account via four coded diagnoses according to the ICD-10 classification: 1) obesity (E66.0, E66.8, E66.9), 2) type 2 diabetes mellitus (E11), 3) hypertension (I10) and 4) metabolic disorders (E78). A metabolic syndrome is present if at least two of the four diagnoses are present. RESULTS: The prevalence of metabolic syndrome in the population of the AOKN in 2019 was 25.7%. The standardized comparison according to the census population of 2011 showed an increase in the frequency of diagnosis (2009: 21.5% and 2019: 24%). The frequency of diagnosis differed according to school and educational qualifications. CONCLUSION: A classification and analysis of the frequency of the metabolic syndrome based on routine data of the GKV is possible. Between 2009 and 2019 there was a clear increase in the frequency of diagnoses.

Application of Indian Diabetic Risk Score (IDRS) and Community Based Assessment Checklist (CBAC) as Metabolic Syndrome prediction tools.

BACKGROUND: Indian Diabetic Risk Score (IDRS) and Community Based Assessment Checklist (CBAC) are easy, inexpensive, and non-invasive tools that can be used to screen people for Metabolic Syndrome (Met S). The study aimed to explore the prediction abilities of IDRS and CBAC tools for Met S. METHODS: All the people of age ≥30 years attending the selected rural health centers were screened for Met S. We used the International Diabetes Federation (IDF) criteria to diagnose the Met S. ROC curves were plotted by taking Met S as dependent variables, and IDRS and CBAC scores as independent/prediction variables. Sensitivity (SN), specificity (SP), Positive and Negative Predictive Value (PPV and NPV), Likelihood Ratio for positive and negative tests (LR+ and LR-), Accuracy, and Youden's index were calculated for different IDRS and CBAC scores cut-offs. Data were analyzed using SPSS v.23 and MedCalc v.20.111. RESULTS: A total of 942 participants underwent the screening process. Out of them, 59 (6.4%, 95% CI: 4.90-8.12) were found to have Met S. Area Under the Curve (AUC) for IDRS in predicting Met S was 0.73 (95%CI: 0.67-0.79), with 76.3% (64.0%-85.3%) sensitivity and 54.6% (51.2%-57.8%) specificity at the cut-off of ≥60. For the CBAC score, AUC was 0.73 (95%CI: 0.66-0.79), with 84.7% (73.5%-91.7%) sensitivity and 48.8% (45.5%-52.1%) specificity at the cut-off of ≥4 (Youden's Index, 2.1). The AUCs of both parameters (IDRS and CBAC scores) were statistically significant. There was no significant difference (p = 0.833) in the AUCs of IDRS and CBAC [Difference between AUC = 0.00571]. CONCLUSION: The current study provides scientific evidence that both IDRS and CBAC have almost 73% prediction ability for Met S. Though CBAC holds relatively greater sensitivity (84.7%) than IDRS (76.3%), the difference in prediction abilities is not statistically significant. The prediction abilities of IDRS and CBAC found in this study are inadequate to qualify as Met S screening tools.

Prediction of Metabolic Syndrome in U.S. Adults Using Homeostasis Model Assessment-Insulin Resistance.

Background: The prevalence of obesity among U.S. adults has risen steadily over recent decades. Consequently, interest in identification of those at greatest metabolic risk necessitates the periodic assessment of underlying population characteristics. Thus, the aim of this study is to assess the efficacy of using insulin resistance (IR) as a predictor of metabolic syndrome (MetS). Methods: We performed a serial, cross-sectional analysis of nationally representative data from the National Health and Nutrition Examination Survey (NHANES). Data included nonpregnant adults who participated in NHANES between 2011 and 2018. IR was estimated using the homeostasis model assessment (HOMA). Optimal HOMA-IR cut points for MetS were identified using receiver operating characteristic curve analysis. Results: Data from 8897 participants representing 222 million individuals were analyzed. The estimated prevalence of MetS was 31.7% (n = 2958; 95% confidence interval 30.1-33.3). The optimal HOMA-IR to discriminate between individuals with and without MetS in the general population was 2.83 (sensitivity = 73.8%; specificity = 73.8%; area under the curve = 0.82). Conclusion: The HOMA-IR is a sensitive and specific method of screening for individuals with MetS. Prospective evaluation of this approach's efficacy in identifying those at risk for progression to MetS is warranted.

[Recommendations for individual comorbidity risk assessment in adult patients with psoriasis]. / Handlungsempfehlungen zur individuellen Risikoermittlung von Komorbidität bei erwachsenen Patienten mit Psoriasis.

It has long been known that chronic inflammatory systemic diseases, such as psoriasis, pose a high risk of developing comorbidities. In everyday clinical practice, it is therefore of particular importance to identify patients who have an individually increased risk profile. In patients with psoriasis, the comorbidity patterns "metabolic syndrome", "cardiovascular comorbidity" and "mental illness" were identified as particularly relevant in epidemiological studies depending on the duration and severity of the disease. In the everyday care of patients with psoriasis in dermatological practice, the use of an interdisciplinary checklist for risk analysis and the initiation of professional follow-up care has proven valuable. On the basis of an existing checklist, the contents were critically evaluated by an interdisciplinary group of experts and a guideline-oriented update was prepared. In the opinion of the authors, the new analysis sheet represents a practicable, factually focused and updated tool for comorbidity risk assessment in patients with moderate and severe psoriasis.

Assessment of metabolic syndrome predictors in relation to inflammation and visceral fat tissue in older adults.

The diagnosis of metabolic syndrome (MetS) focuses on the assessment of risk factors such as insulin resistance, dyslipidemia, central adiposity and elevated blood pressure. Evidence suggests that markers of systemic inflammation may also be included in the definition of MetS and play some role in its pathogenesis. The study was designed to evaluate low-grade inflammation status in older adults with MetS in relation to increased body fat tissue and an attempt was made to evaluate new predictors for MetS through the analysis of the ROC Curve. Ninety-six middle-aged (69.2 ± 4.9) individuals from University of Third Age (women n = 75 and men n = 21) were allocated to two groups: without metabolic syndrome (n = 37) and with metabolic syndrome (n = 59) according to International Diabetes Federation criteria in agreement with American Heart Association/National Heart, Lung and Blood Institute 2009. Participants' current health status was assessed using medical records from a routine follow-up visit to a primary care physician. Statistical analysis was performed using R studio software. Depending on the normal distribution, ANOVA or the Kruskal-Wallis test was used. The optimal threshold value for clinical stratification (cut-off value) was obtained by calculating the Youden index. The AUC was observed to be the highest for a new anthropometric index i.e. lipid accumulation product (0.820). Low-grade inflammation dominated in MetS group (BMI 28.0 ± 4.4 kg/m2, WHR 0.9 ± 0.1, FM 24.7 ± 7.9 kg) where significantly higher values of TNF-α (p = 0.027) and HGMB-1 protein (p = 0.011) were recorded.The optimal threshold values for immunological indices assessed as new predictors of the metabolic syndrome were: 93.4 for TNF-α, 88.2 for HGMB-1 protein and 1992.75 for ghrelin. High AUC values for these indices additionally confirmed their high diagnostic usefulness in MetS.

Handgrip Strength Cutoff Value Among Korean Adolescents with Metabolic Syndrome Components: Korean National Health and Nutrition Examination Survey Data 2014-2017.

Abstract Objectives: To propose the cutoff value of handgrip strength (HGS) for each metabolic syndrome component in Korean adolescents. Methods: Total of 2303 adolescents (1226 boys and 1077 girls; age 10-18 years) who participated in the Korea National Health and Nutrition Examination Survey from 2014 to 2017. We used the International Diabetes Federation metabolic syndrome guideline for children to define metabolic syndrome. The highest HGS for both hands were recorded. The optimal HGS cutoff for predicting metabolic syndrome components was determined by receiver operating characteristic curve analysis. Results: Adolescents with metabolic syndrome components defined by each criterion had higher HGS, systolic blood pressure, waist circumference, body mass index, fasting glucose, cholesterol, triglyceride (TG), alanine aminotransferase, and aspartate aminotransferase compared with average participants' data. The cutoff value of HGS defining waist circumference, TG level, high-density lipoprotein, and blood pressure was 24, 21.5, 30.9, and 30.2, respectively. The cutoff value of HGS defining metabolic syndrome was 28.9. For HGS to body weight ratio, the cutoff value defining metabolic syndrome was 0.38. Conclusions: This study showed that cutoff values of HGS have relation with metabolic syndrome in adolescents. Although cutoff has been suggested, it may not be sufficient for clinical use. Additional data are need to be accumulated in actual clinical trials for more accurate cutoff HGS value.

IS HOMEOSTASIS MODEL ASSESSMENT FOR INSULIN RESISTANCE >2.5 A DISTINGUISHED CRITERIA FOR METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE IDENTIFICATION?

BACKGROUND: Insulin resistance (IR), assessed by different criteria, is an important factor in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). More recently with the characterization of this metabolic dysfunction-associated fatty liver disease (MAFLD), one of the proposed criteria for this diagnosis has been the determination of the homeostasis model assessment-insulin resistance (HOMA-IR). OBJECTIVE: The purpose of this study was to evaluate the relationship of HOMA-IR>2.5 with clinical, metabolic, biochemical and histological data obtained in non-diabetic patients diagnosed with NAFLD by liver biopsy. METHODS: Cross-sectional, retrospective study was carried out with data from 174 adult individuals of both genders with non-diabetics NAFLD, without obvious signs of portal hypertension. The body mass index (BMI) was classified according to the World Health Organization (1998), and the metabolic syndrome by the criteria of NCEP-ATP-III. Biochemical tests were evaluated using an automated method and insulinemia through immunofluorometric assay. Histological findings were classified according to Kleiner et al. (2005). RESULTS: The mean age of the studied population was 53.6±11.2 years, with 60.3% being female. The average BMI was 30.3 kg/m2 and 75.9% of the patients had increased waist circumference. Among evaluated metabolic parameters, there was a higher prevalence of metabolic syndrome (MS) in patients with HOMA-IR>2.5, with no statistical difference in relation to BMI between studied groups. Values of liver enzymes and serum ferritin were significantly higher in patients with this marker of IR, who had a higher prevalence of non-alcoholic steatohepatitis (NASH) and advanced liver fibrosis. In the multivariate analysis, the clinical diagnosis of MS, hyperferritinemia and the presence of NASH in the liver biopsy were the factors independently associated with the presence of altered HOMA-IR. CONCLUSION: HOMA-IR values >2.5 identify patients with NAFLD with distinct clinical and metabolic characteristics and with a greater potential for disease progression, which validates this parameter in the identification of patients with MAFLD.

Prevalence of Metabolic Syndrome and Its Components in Urban Cambodia: A Cross-Sectional Study.

BACKGROUND: The incidence of noncommunicable diseases, such as cardiovascular diseases and diabetes mellitus, is increasing in Cambodia. Urbanization and lifestyle changes due to rapid economic development have affected the components of metabolic syndrome (MetS). This study aimed to determine the prevalence of MetS, MetS components, and health status among Cambodians living in urban areas. METHODS: This cross-sectional study enrolled adult Cambodians (age ≥ 20 years) who underwent a health checkup at a Japanese hospital in Phnom Penh. MetS was defined based on the harmonized diagnostic definition from the joint interim statement. RESULTS: Among the 6090 (3174 men and 2916 women) participants who were enrolled in the study, the prevalence of MetS was 60.1% in men and 52.4% in women. The prevalence of elevated blood pressure was 73.2% in men and 65.3% in women, and was the highest MetS component in both men and women. In contrast, the lowest prevalence rates were observed for abdominal obesity (44.8%) in men and for high triglyceride levels (33.5%) in women. The MetS group showed a significantly higher proportion of patients with hypertension, diabetes, dyslipidemia, and obesity compared with the non-MetS group. CONCLUSION: The high prevalence of MetS in this study was attributed to urbanization, as in economically developed countries. It is necessary to explore the lifestyle habits of Cambodians that contribute to MetS and to develop preventive measures to reduce the incidence and prevalence of MetS.

Assessment of serum chemerin levels in acanthosis nigricans: A case-control study.

BACKGROUND: Acanthosis nigricans (AN) is an asymptomatic skin condition linked to several underlying systemic conditions. Chemerin is an adipokine that increases during inflammatory disorders such as metabolic syndrome (MetS). AIMS: This case-control study investigates the link between AN and the underlying MetS and serum levels of chemerin in individuals with obesity. PATIENTS/METHODS: Twenty-five adults with AN and obesity (body mass index [BMI] > 30 kg/m2 ), 25 adults with obesity but no AN, and 25 healthy controls (BMI < 30 kg/m2 ) had their lipid profiles and serum chemerin concentrations examined. RESULTS: The neck (80.0%) and axilla (68.0%) were the most common sites of AN. In participants with obesity, either alone or with AN, serum chemerin concentrations were significantly higher than in the control group (p < 0.001). Participants with obesity and AN had significantly higher levels of cholesterol, triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), and serum chemerin levels (p < 0.001), and significantly lower high-density lipoprotein cholesterol (HDL-c) levels (p < 0.001) when compared to participants with obesity alone. All participants with obesity and AN (100%) and 88% of those with obesity alone had MetS. Logistic regression revealed that systolic blood pressure >130 mmHg, diastolic blood pressure >85 mmHg, waist circumference >90 cm, TG >150 mg/dl, HDL-c <45 mg/dl, fasting blood glucose >100 mg/dl, and serum chemerin >300 ng/ml were significant (p < 0.05) risk factors for AN. CONCLUSIONS: Acanthosis nigricans is a non-invasive and reliable sign of the underlying MetS and increased serum chemerin levels among individuals with obesity.

Metabolic risk assessment in children and adolescents using the tri-ponderal mass index.

We assessed the risk of metabolic syndrome in children and adolescents who were classified using the tri-ponderal mass index (TMI) with data from the Korea National Health and Nutrition Examination Survey (KNHANES). Data from 10 to 18-year-old subjects that were overweight or obese (n = 1362) were extracted from the KNHANES 2007-2018. Weight classifications were determined by TMI and included overweight and Class I, Class II, and Class III obesity. The standard deviation scores (SDS) of weight, waist circumference, and body mass index (BMI) as well as cardiometabolic risk factors, including blood pressure, serum glucose levels, total cholesterol (T-C), triglycerides, HDL-c, and low-density lipoprotein cholesterol (LDL-c), worsened with the severity of obesity. Most risk factors showed a linear association with the severity increase, except for fasting glucose levels, T-C, and LDL-c. The prevalence of cardiometabolic risks also increased with the severity of obesity, which developed earlier in boys than in girls. The risk of metabolic syndrome significantly increased with the severity of obesity in both unadjusted and adjusted analyses. TMI reflected the severity of obesity and predicted the risk of metabolic syndrome and its components. Therefore, clinical applications of TMI could be a useful to identify the incidence of childhood obesity and metabolic syndromes.

Distinct racial and ethnic metabolic syndrome characteristics: A comparative assessment in low-income children 7-10 years of age.

BACKGROUND: Pediatric MetS prevalence varies due to lack of consensus on evaluative criteria and associated thresholds, with most not recommending a diagnosis <10 years. However, MetS risk components are becoming evident earlier in life and affect races and ethnicities disproportionately. OBJECTIVES: To compare the prevalence of MetS based on existing definitions and elucidate racial- and ethnic-specific characteristics associated with MetS prevalence. METHODS: The baseline and follow-up samples included 900 and 557 children 7-10 years, respectively. Waist circumference, BMI percentile, blood pressure, fasting plasma glucose (FPG), insulin, triglycerides, and high-density lipoprotein cholesterol (HDL-C) were measured. Agreement between MetS definitions was quantified via kappa statistics. MetS and risk factor prevalence and the predictability of metabolic parameters on MetS eight months later was evaluated via logistic regression. McFadden pseudo-R2 was reported as a measure of predictive ability, and the Akaike information criterion evaluated fit of each model. RESULTS: The baseline sample was 55.0% male and 71.6% Hispanic, followed by non-Hispanic White (NHW) (17.3%) and non-Hispanic Black (NHB) (11.1%), with an average age of 9.2 years. MetS prevalence ranged from 7.6% to 21.4%, highest in Hispanic (9.0%-24.0%) and lowest in NHB children (4.0%-14.0%). Highest agreement was between Ford et al. and Cook et al. definitions (K = 0.88) and lowest agreements were consistently with the International Diabetes Federation criteria (K ≤ 0.57). Compared to NHW children, Hispanic children had higher odds for MetS (OR: 1.7; p = 0.03) and waist circumference, HDL-C, and FPG risk factors (p < 0.05), while NHB children had higher odds for the FPG risk factor (p ≤ 0.007) and lower odds for the plasma triglycerides risk factor (p = 0.002), across multiple MetS definitions. In longitudinal analyses, HDL-C was the strongest independent predictor of MetS in Hispanic and NHW children (p < 0.001 and p < 0.01, respectively), while plasma triglycerides was the strongest independent predictor of MetS in NHB children (p < 0.05). CONCLUSIONS: MetS prevalence was high in children ≤10 years, and proposed criteria are susceptible to racial and ethnic bias, diagnosing some populations more than other populations with high cardiovascular risk. Earlier preventative measures should be imposed in clinical settings, accounting for racial and ethnic differences, to mitigate disease onset.

Assessment of liver fibrosis using non-invasive screening tools in individuals with diabetes mellitus and metabolic syndrome.

Despite its rising prevalence, and its potential to lead to life threatening complications, there are no recommendations in the current guidelines for screening individuals with diabetes mellitus or high BMI for NAFLD(non-alcoholic fatty liver disease)/NASH (non alcoholic steatohepatitis),mainly due to the uncertain performance and feasibility of currently available screening tools. This research was carried out to assess the diagnostic accuracy of non-invasive screening tools in predicting liver fibrosis in individuals with diabetes mellitus and metabolic syndrome. MATERIAL: 140 patients with diabetes mellitus and metabolic syndrome, identified between March 2020 and October 2021 were studied. Liver stiffness measurement by point shear wave elastography was considered the gold standard. 5 non-invasive scores, AST/ALT (aspartate aminotransferase/alanine aminotransferase) Ratio, Aspartate aminotransferase/platelet ratio (APRI)Score, FIB-4 Index, BARD Score and NAFLD Fibrosis Score were determined in all of the study participants. Using receiver operator characteristic (ROC) curve analysis, sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were calculated for each of these scores. The area under the ROC curve (AUROC) was used to calculate the diagnostic accuracy of these scores. OBSERVATION: Out of the140 participants in the study, (83 males (59.29%)), 30 (21.43%) had liver fibrosis as per liver stiffness measurement by point shear wave elastography. The mean age and mean BMI were 54.53±12.42 and 27.37±2.73 respectively in the 'Fibrosis' group and 56.20 ±11.76 and 27.10±4.22 in the 'No fibrosis' group. The major finding of our study was that all these scores had relatively high NPV (>85 %) for predicting liver fibrosis in our cohort. The AST/ALT Ratio had the highest negative predictive value (90.28 %) followed by APRI Score (88.94 %). The AUROC (for FIB-4 Score, NAFLD-Fibrosis Score, APRI Score, AST/ALT Ratio, BARD Score were 0.6669, 0.657, 0.655, 0.637 and 0.599 respectively. FIB-4 Index(p = 0.005) had the highest AUROC, followed by NAFLD-Fibrosis Score(p =0.009) .But, all the scores had relatively low specificity(<60 %), PPV(<35 %) and accuracy(<63 %). CONCLUSION: FIB- 4 Index and NAFLD-Fibrosis Score can be used to reliably exclude liver fibrosis in individuals with diabetes mellitus and metabolic syndrome in the Indian population, but may not be useful in accurately diagnosing liver fibrosis. Utilization of these non-invasive and cost-effective screening tools in routine practice, may have promising results in predicting liver fibrosis in 'at risk' populations.

Assessment of Different Atherogenic Indices as Predictors of Metabolic Syndrome in Spanish Adolescents.

Background: Inconsistent results due to age, ethnic, and geographic differences have been found on the predictive capacity of atherogenic indices in previous studies. The aim of this study was to assess the predictive value of 6 atherogenic indices for MetS in a Spanish adolescent population. Methods: A cross-sectional study was performed on 981 adolescents (13.2 ± 1.2y) that were randomly recruited from schools in Southeastern Spain. Anthropometric and biochemical parameters were evaluated to identify the presence of MetS. The following atherogenic indices were calculated: triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), non-HDL cholesterol, triglycerides to HDL-cholesterol ratio (TG/HDL-c), LDL-cholesterol to HDL-cholesterol ratio (LDL-c/HDL-c), and total cholesterol to HDL-cholesterol ratio (TC/HDL-c). Results: The area under the curve (AUC) of receiver operating characteristic curves was used for discrimination purposes. AIP was the atherogenic index most strongly associated with MetS with an unadjusted odds ratio (OR) of 37.98 in boys and of 28.75 in girls. A high OR was maintained after adjustment by different factors. AUC values for all atherogenic indices were above 0.83 and 0.88 in boys and in girls, respectively. Conclusions: Among the 6 atherogenic indices studied, AIP was the one most strongly associated with MetS in Spanish adolescents. The AUC values obtained from ROC analyses suggest that all atherogenic indices have the ability to predict MetS. These atherogenic indices are interesting and useful predictive indicators for MetS. However, more studies are needed to explore in-depth this predictive capacity.

Assessment and management of obesity and metabolic syndrome in children with CKD stages 2-5 on dialysis and after kidney transplantation-clinical practice recommendations from the Pediatric Renal Nutrition Taskforce.

Obesity and metabolic syndrome (O&MS) due to the worldwide obesity epidemic affects children at all stages of chronic kidney disease (CKD) including dialysis and after kidney transplantation. The presence of O&MS in the pediatric CKD population may augment the already increased cardiovascular risk and contribute to the loss of kidney function. The Pediatric Renal Nutrition Taskforce (PRNT) is an international team of pediatric renal dietitians and pediatric nephrologists who develop clinical practice recommendations (CPRs) for the nutritional management of children with kidney diseases. We present CPRs for the assessment and management of O&MS in children with CKD stages 2-5, on dialysis and after kidney transplantation. We address the risk factors and diagnostic criteria for O&MS and discuss their management focusing on non-pharmacological treatment management, including diet, physical activity, and behavior modification in the context of age and CKD stage. The statements have been graded using the American Academy of Pediatrics grading matrix. Statements with a low grade or those that are opinion-based must be carefully considered and adapted to individual patient needs based on the clinical judgment of the treating physician and dietitian. Research recommendations are provided. The CPRs will be periodically audited and updated by the PRNT.

Effect of Metabolic Syndrome on the Incidence of Dementia Based on National Insurance Data in Korea.

Background: To evaluate the association between metabolic syndrome (MetS) and the incidence of dementia using big data from national health claims and health examinations. Methods: This study involved 3,619,388 subjects categorized with MetS of three status based on the results of health examinations conducted in 2009. This was a longitudinal study of the incidence of dementia based on the national health claims from the date of health examinations in 2009 until December 31, 2018. This study was conducted for men and women aged 50 to 69 years living in Korea. A Cox proportional hazard regression was performed to analyze the risk of dementia according to the status of MetS. Results: The cumulative incidence of Alzheimer dementia was 0.41% in the non-Mets group, 0.54% in the pre-MetS group, and 0.67% in the MetS group. The cumulative incidence of vascular dementia was 0.19% in the non-Mets group, 0.27% in the pre-MetS group, and 0.34% in the MetS group. The risk of Alzheimer dementia in the pre-MetS group compared to the non-Mets group was 1.20-fold greater (95% confidence interval, CI: 1.14-1.26) and was 1.39-fold (95% CI: 1.31-1.48) greater in the MetS group. The risk of vascular dementia in the pre-MetS group compared to the non-Mets group was 1.30-fold greater (95% CI: 1.21-1.40) and the risk of vascular dementia was 1.53-fold (95% CI: 1.44 1.71) greater. Conclusions: This study showed that pre-MetS and MetS were related to an increased incidence of Alzheimer dementia and vascular dementia. Also, these results support efforts to decrease the incidence of Alzheimer dementia and vascular dementia through managing the Mets.

Assessment of insulin resistance and metabolic syndrome in young reproductive aged women with polycystic ovarian syndrome: analogy of surrogate indices.

BACKGROUND: Polycystic ovarian syndrome has emerged as a cardiometabolic disorder and aim of this study was to evaluate various surrogate indices and their diagnostic potential to determine the most convenient and cost-effective marker of IR, CVD, and MetS in these women. MATERIALS AND METHODS: Ninety-five PCOS women and 45 age matched healthy women were enrolled. Measures included anthropometric and biochemical parameters, BMI, WHR, WHtR, BAI, VAI, LAP, HOMA-IR, and lipid profile. RESULTS: LAP has highest AUC value 0.781 with cut-off value = 39.73 (sensitivity = 75% and specificity = 79.5%) for predicting IR and AUC value 0.83 with cut-off value = 35.63 (sensitivity = 94.4% and specificity = 77.3%) for predicting MetS in women with PCOS. LAP had statistically strong positive correlation with WC, BMI, WHR, fasting glucose, fasting insulin, HOMA-IR, TC, TG, and SBP. CONCLUSIONS: LAP is a powerful and reliable marker for assessment of IR, CVD, and MetS risk in young Indian women with PCOS.