RESUMEN
AIM: To estimate the national prevalence, mortality risk and population mortality burden of metabolic syndrome, and compare the values with those of its individual components. METHODS AND RESULTS: A total of 486,341 apparently healthy adults who went through a screening programme in Taiwan were recruited from 1994 onwards. As of 2007, 15,268 deaths had occurred at least one year after the examination. Six definitions of metabolic syndrome were used. Components of metabolic syndrome include obesity, hypertension, hyperglycaemia, dyslipidaemia and albuminuria. Hazard ratios (HRs) were calculated using the Cox proportional hazard model. The population mortality burden considered both national prevalence and HRs. The national prevalence of metabolic syndrome defined by the Adult Treatment Panel (ATP) III was 16.3%, the HR for all causes was 1.36 (95%, CI 1.31-1.41) and the HR for cardiovascular disease (CVD) was 1.63 (95%, CI 1.51-1.77). The population mortality burden of metabolic syndrome was 5.5% for all causes, in contrast to 9.0% for hypertension, 8.9% for albuminuria, 6.6% for diabetes, 3.5% for dyslipidaemia and 1.5% for obesity. For CVD it was 9.4%, lower than 10.7% for albuminuria and 25.0% for hypertension. CONCLUSION: The mortality burden of metabolic syndrome was relatively small at national level. Three of the five components of metabolic syndrome alone, namely hypertension, diabetes and albuminuria, contributed more than metabolic syndrome to all-cause mortality. Successful management of any of these three components would have achieved a greater impact on mortality than management of metabolic syndrome.
Asunto(s)
Enfermedades Cardiovasculares/mortalidad , Síndrome Metabólico/mortalidad , Adulto , Anciano , Albuminuria/mortalidad , Dislipidemias/mortalidad , Femenino , Humanos , Hiperglucemia/mortalidad , Hipertensión/mortalidad , Estimación de Kaplan-Meier , Masculino , Síndrome Metabólico/diagnóstico , Persona de Mediana Edad , Obesidad/mortalidad , Oportunidad Relativa , Prevalencia , Modelos de Riesgos Proporcionales , Medición de Riesgo , Factores de Riesgo , Taiwán/epidemiología , Factores de Tiempo , Adulto JovenRESUMEN
BACKGROUND: Fatigue is one of the most frequent symptoms experienced by children with cancer during treatment. Effective management of fatigue is essential for improving children's quality of life. OBJECTIVE: The aim of this study was to examine the feasibility of a home-based aerobic exercise intervention to reduce fatigue in children with acute lymphoblastic leukemia (ALL). METHODS: A 6-week home-based aerobic exercise intervention was implemented for children who were in the intervention group, whereas patients in the control group received routine care. Multivariate analysis was used to examine the effects of the aerobic exercise intervention on the children's self-reported levels of fatigue at posttest and 1-month follow-up. Two types of analysis were used: intent-to-treat analysis and per-protocol analysis. RESULTS: This study was conducted with 22 children with ALL: 12 in the intervention group and 10 in the control group who were matched by age and sex. For per-protocol analysis, the finding indicated that children who received the exercise intervention reported significantly lower "general fatigue" subscale than those in the control group at the 1-month follow-up measurement. For intent-to-treat analysis, the findings indicated that there were no intervention and time effect for any of the 3 fatigue subscales at either posttest or 1-month follow-up. CONCLUSION: The finding indicated that the exercise program is feasible and warrants being tested in a clinical trial with a much larger sample of children for ALL. IMPLICATIONS FOR PRACTICE: It suggests that a home-based exercise program may reduce fatigue for ALL children who are undergoing maintenance chemotherapy.