BackgroundElevated ferritin levels have been associated with single cardiovascular risk factors but the relationship to the presence of metabolic syndrome is inconclusive.The aim of this systematic review and meta-analysis of published observational studies was to estimate the association between serum ferritin levels and metabolic syndrome in adults.MethodsThe Pubmed, SCOPUS and the Cochrane Library databases were searched for epidemiological studies that assessed the association between ferritin levels and metabolic syndrome and were published before September 2013. There were no language restrictions. Two investigators independently selected eligible studies. Measures of association were pooled by using an inverse-variance weighted random-effects model. The heterogeneity among studies was examined using the I2 index. Publication bias was evaluated using the funnel plot.ResultsTwelve cross-sectional, one case–control and two prospective studies met our inclusion criteria including data from a total of 56,053 participants. The pooled odds ratio (OR) for the metabolic syndrome comparing the highest and lowest category of ferritin levels was 1.73 (95% CI: 1.54, 1.95; I2 = 75,4%). Subgroup analyses indicate that pooled OR was 1.92 (95% CI: 1.61, 2.30; I2 = 78%) for studies adjusting for C-reactive protein (CRP), and 1.52 (95% CI:1. 36, 1.69; I2 = 41%) for studies that did not adjust for CRP (P = 0.044). This finding was remarkably robust in the sensitivity analysis. We did not find publication bias.ConclusionsThe meta-analysis suggests that increased ferritin levels are independently and positively associated with the presence of the metabolic syndrome with an odds ratio higher than 1.73.
IntroductionIn Ecuador, the prevalence of overweight and obesity among school-age children is more than triple that of preschool-age children; however, preschoolers have not been the target of interventions.MethodsWe developed an educational and behavioral intervention that included games, singing, and storytelling. Children were recruited from municipal preschools in Cuenca and were enrolled in the pilot intervention (PI) (N=155) for the 2015–2016 school year, which consisted of a 3-month in-school program. For the 2016–2017 school year, a separate group of children was enrolled in the enhanced intervention (EI) (N=152), which consisted of a 7-month program at both school and home.ResultsParents in both groups reported a post-intervention reduction in their child’s daily at-home consumption of sugar-sweetened beverages (PI: −23.2%, P < .001; EI: −16.8%, P < .001). Additional beneficial effects of the EI not observed with the PI were an increase in drinking water daily at home (+8.3%, P = .04) and eating fruits and vegetables daily for snacks at home (+21.8%, P < .001), a reduction in excessive weekend screen time (−7.6%, P = .03), and a reduction of 0.11 in mean BMI-for-age z score (P = .003). When comparing the PI and EI, the EI was associated with a greater difference in mean BMI-for-age z score (−0.25; P < .001) and fruit and vegetable consumption (+15.9%; P = .01).ConclusionOur preschool-based intervention appeared to be successful in promoting healthy lifestyle habits, especially when combined with a household component. Further research is needed to determine if the intervention had long-term effects, as well as to adapt it for different settings.
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