Journal du syndrome métabolique

Background & Aims: Non-alcoholic fatty liver disease (NAFLD) can be early diagnosed by noninvasive ultrasonography. Currently, there is no cost-effectiveness analysis of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients. This study aimed to estimate costs and clinical outcomes of such program in Thailand. Methods: A cost-effectiveness analysis using decision tree and Markov models to estimate lifetime costs and health benefits of screening program versus no screening based on a cohort of 509 Thai metabolic syndrome patients from the largest university hospital in Thailand under societal perspective was done. Effectiveness and utility parameters were based on literatures, while costs and mortality parameters were determined using Thailand database. Costs were presented as year 2014 United States Dollar (USD) values. The results were reported as incremental cost-effectiveness ratios (ICERs) in USD per quality-adjusted life year (QALY) gained with discount rate of 3%. A series of sensitivity analyses including a Monte Carlo simulation were performed to assess the influence of parameter uncertainty on the results. 

Results: Ultrasonography screening of 50 years-old metabolic syndrome patients with intensive weight reduction program was cost-effective with ICERs of 958 USD/QALY gained when compared with no screening. According to willingness-to-pay of Thailand (4,848 USD/QALY gained), the probability of being cost-effective was 67%. Screening at ages before 45 years was cost-savings while screening at age between 45-64 years was cost-effective. Conclusion: For patients with metabolic syndromes, ultrasonography screening for NAFLD with intensive weight reduction program is a cost-effective program in Thailand. Our findings can be used as part of evidence-informed decision making.

While the relationship of leisure time physical activity (LPA) and metabolic syndrome (MetS) is well documented, effect of occupational physical activity (OPA) on MetS is conflicting. Aim of this study is to examine the relationship between different type of physical activity and risk of metabolic syndrome using a representative sample of South Korean adults. Study included 7057 workers (3795 men and 3262 women) aged 20 to 65 without cancer and arthritis at baseline, from the Korea National Health and Nutrition Examination Survey in 2014-2016. Information on OPA, LPA and commuting physical activity (CPA) were self-reported and blood pressure and biochemical determinations of the blood were also obtained. MetS was defined as the presence of three or more of the National Cholesterol Education Program-Adult Treatment Panel III criteria. Chi-square test and multiple logistic regression analysis were used to investigate relationship between different type of physical activity and MetS. The prevalence of MetS was 25.7 % in the study subject. 

The percentages of active OPA in MetS and non-MetS groups were 6.7% and 5.0%, respectively. Compared with inactive level of LPA, sufficient level of LPA showed a significantly lower risk of MetS (OR 0.73, 95% CI 0.60-0.89) after adjustment for confounding factors. Conversely, active OPA showed increased risk of MetS (OR 1.09, 95% CI 0.77-1.52), but not reaching statistical significance. CPA was not associated with MetS. LPA showed protective effect of MetS, but OPA showed marginal negative effect on MetS. This difference needs to be considered when recommendations for prevention of MetS are developed

Objectives: To determine the prevalence of metabolic syndrome among obese patients using the IDF definition and to identify factors that are associated with it. Materials and Methods: A cross-sectional randomized study was conducted at four primary care centers inside Doha, Qatar. One hundred and thirty-six Adults, ≥18 Qatari obese patients, were chosen by systematic random sampling. They were interviewed and screened for the presence of metabolic syndrome, which was diagnosed according to the International Diabetes Federation criteria: An abdominal circumference ≥94 cm in males or ≥80 cm in females, plus any two of the following: HDL cholesterol <1.03 mmol/mL (<40 mg/dL) [males] or <1.3 mmol/mL (<50 mg/dL) [females], Triglycerides ≥1.7 mmol/mL (≥150 mg/dL), Blood pressure ≥130/85 mmHg or the patient receiving antihypertensive treatment and baseline glycemia >5.6 mmol/mL (>100 mg/dL), or previously-diagnosed type 2 diabetes mellitus. 

Results: The overall prevalence of the metabolic syndrome among obese patients was 46.3%. The prevalence was higher in females (50%) than in males (42.4%). It was seen to increase with increasing body mass index class, from class 1 to class 2. The prevalence of metabolic comorbidities of abnormal waist circumference, raised blood pressure, raised fasting blood glucose, high triglycerides, and reduced high density lipoprotein was 88.2, 42.6, 32.4, 31.6, and 27.9%, respectively. Based on the logistic regression multivariable analysis, increasing age and being diabetic were the only significant associated factors that influenced the risk of having the metabolic syndrome. Conclusion: The prevalence of the metabolic syndrome was high, and the highest comorbidities were abnormal waist circumference and high blood pressure. Diabetes and increasing age were the only significant risk factors of having this syndrome.

 Background: Multiple factors are involved in the pathogenesis of hypertension in obese individuals. Recent studies have reported a strong association between blood pressure (BP) and resting metabolic rate (RMR). However, it is not known whether this relationship exists for systolic BP (SBP) and diastolic BP (DBP) in obese subjects patients with the metabolic syndrome, in whom several homeostatic mechanisms are impaired. Objective: To evaluate the relationship existing between RMR, to SBP and DBP, Fat Body Mass (FBM), Lean Body Mass (LBM), Body Mass Index (BMI), Blood parameters, in obese subjects with the metabolic syndrome. Methods: Sixty three non-diabetic subjects (27 women, 36 men) who fulfilled the ATPIII criteria for the metabolic syndrome, with a mean age of 50.4±12.5 yrs were evaluated. Mean BMI was 34.6±3.9 kg/m²; % FBM- 40.9±6.6 %; and LBM- 59±0.7%. Basal RMR was 1875.2±420.1 cal/day. Baseline assessment also included 24h ambulatory blood pressure monitoring, clinical and biochemical profiling, subcutaneous periumbilical fat biopsy, region-defined body composition with DEXA and carotid intima-media thickness. The intervention targeted all assessed risk factors and was implemented through frequent interactions with dietitians, an endocrinologists, and physiotherapist expert for physical activity. Results: At the baseline assessment RMR was significantly related to mean 24 h systolic blood pressure (r=0.3 p<0.05). 

There were significant inverse correlation between RMR to %FBM (r=0.45, p<0.05). RMR was also positively related to BMI (r=0.37, p<0.05) and fasting triglycerides (r=0.28, p<0.05). Conclusion: This report extends and strengthens previous findings that RMR is independently related to SBP. Prior to this study, the relationship between RMR and SBP in metabolic obese subjects had not been explored. This study expanded the findings of Brock and colleagues by showing that REE was significantly related to SBP, independent of several possible confounders found in metabolic obesity.

The metabolic syndrome is a public health problem that is more common with the changing habits and the effect of increasing obesity. The aim of this study is to assess the frequency of the metabolic syndrome in Turkish adolescents and the affecting factors. The study was conducted with 382 adolescent children aged 10-17 years. The data were collected using a face-to-face interview method with questionnaire form. The questionnaire contains general information, nutritional habits, physical activity status, some biochemical blood data and anthropometric measurements of the adolescents. Analyzes were evaluated with appropriate statistical methods. 38.7% of the participants were male (n=148) and 61.3% were female (n=234). It was determined that 90.2% of the females and 72.3% of the males entered puberty. 33.5% of the people consumed three main meals regularly every day. The most frequently skipped main meal was morning breakfast (52.8%). More than half of adolescents (56.5%) consumed fast food. 37.2% of the females and 55.2% of the males had metabolic syndrome. A statistically significant difference was found between the presence of metabolic syndrome and gender status (p<0.05). 53.3% of those with metabolic syndrome frequently consumed fast food and this was statistically significant (p<0.05). 

Fasting blood glucose level, triglycerides and TG: HDL ratio in females with metabolic syndrome was high compared to those without metabolic syndrome (p<0.05). Similarly, fasting blood glucose level, total cholesterol, triglyceride, TG: HDL, LDL, fasting plasma insulin and HOMA-IR levels were higher in males with metabolic syndrome compared to those without metabolic syndrome and there was a statistically significant difference between fasting blood glucose, cholesterol, TG: HDL ratio and HOMA-IR levels (p<0.05). 15.4% of adolescents with metabolic syndrome and 21.4% of those without metabolic syndrome had physical activity (p<0.05). Improving nutrition and physical activity habits may be effective in preventing the development of the metabolic syndrome. There is a need for interventions to reduce risk factors for healthy growth and development in Turkish adolescents