Can We Apply the National Cholesterol Education Program Adult Treatment Panel Definition of the Metabolic Syndrome to Asians?

Tan, Chee Eng; Ma, Stefan; Wai, D.C.H.; Chew, Suok Kai; Tai, E. Shyong

doi:10.2337/diacare.27.5.1182

Cited by 736 publications

(541 citation statements)

References 32 publications

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“…38,39 The implications of these are that there is need for standardization of assays used for the estimation of adiponectin. Furthermore, as the expression of the metabolic syndrome may be dependent on several factors that are linked to ethnicity, 40,41 it would also be necessary to establish the adiponectin cutoff level for the diagnosis of the metabolic syndrome for different populations. Variability in measured adiponectin should not be construed as a disadvantage because other criteria for diagnosis of the metabolic syndrome (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…WC, HDL-C, TG) have the same analytical limitations and also show wide variations in different populations. [41][42][43] In summary, Type 2 diabetes mellitus represents an ideal paradigm for the study of the interplay between obesity and the multiple factors that confer increased risk of developing the metabolic syndrome and cardiovascular disease. In view of the current controversy on the precise definition, criteria for diagnosis and pathophysiology of the metabolic syndrome, 3,43,44 some physicians may have problems with including another criterion for the definition of the metabolic syndrome.…”

Section: Discussionmentioning

confidence: 99%

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Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes

et al. 2006

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Background: Obesity and the metabolic syndrome have emerged as clinical and public health crises in many populations, but not all obese patients have the syndrome. As adipocytes produce several adipokines that modulate insulin action as well as glucose and lipid metabolism, we postulate that estimation of adipokines may be useful addition to the criteria used to identify obese individuals with the metabolic syndrome. Objective: To evaluate the determinants and associations of plasma adiponectin in relation to the metabolic syndrome in patients with Type 2 diabetes. Design: Cross-sectional study. Setting: General Teaching Hospital. Patients: One hundred and thirty five (57 M, 78 F) patients with Type 2 diabetes mellitus. Measurements: Adiponectin, leptin, high-sensitivity C-reactive protein (hs-CRP), fasting plasma insulin, glucose, glycated hemoglobin and full lipid profile. Patients were classified on the basis of the degree of adiposity, insulin resistance (IR) (homeostasis model assessment of insulin resistance (HOMA-IR)) and the number of the American Heart Association and the National Heart, Lung and Blood Institute criteria of the metabolic syndrome. Results: Adiponectin levels were inversely correlated with age, indices of obesity, IR and hs-CRP. Overweight/obese and nonobese insulin-sensitive patients had significantly higher (Po0.05) adiponectin levels than those with IR despite similar body mass index and waist circumference. Therefore, within each category of obesity stratification, lower adiponectin levels were associated with IR. Adiponectin showed stepwise decrease with increasing number of the criteria for diagnosis of the metabolic syndrome. Using multiple logistic regression, the odds ratio of the metabolic syndrome as predicted by adiponectin was 0.73 (95% confidence interval 0.53-0.96; P ¼ 0.04). At cutoff point of 18 ng/ml, the diagnostic sensitivity and specificity of adiponectin for the metabolic syndrome were 83 and 65%, respectively, in male patients and 92 and 41%, respectively, in female patients. Receiver operating characteristic analysis showed that adiponectin had significantly higher area under the curve compared with leptin, leptin:adiponectin ratio and triglycerides for the detection of the metabolic syndrome. Conclusions: In patients with Type 2 diabetes, adiponectin concentrations are closely related to IR and the components of the metabolic syndrome. Adiponectin concentration may be a useful addition to the criteria used for identifying obese subjects with the metabolic syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes

et al. 2006

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“…Depending on the criteria used, the prevalence of metabolic syndrome in the United States and Europe is around 20-30% in adults, [1][2][3] while in Asia, the prevalence is about 10-20%. [3][4][5] Recently, Hwang et al also present the prevalence of metabolic syndrome is 20% in men and 15.3% in women among Taiwanese adults. Metabolic syndrome has been shown to associate with increased risk for all-cause and cardiovascular disease mortality, and also increase the risk for cardiovascular disease and type 2 diabetes in later life.…”

Section: Introductionmentioning

confidence: 98%

Obesity and hepatitis B infection are associated with increased risk of metabolic syndrome in university freshmen

Chiu

et al. 2007

Int J Obes

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Objective: To investigate the prevalence of metabolic syndrome and its associated risk factors in a cohort of university freshmen. Design: A cross-sectional study in a university health center in North Taiwan. Subjects: A total of 8226 students (mean age: 19.272.3 years) receiving pre-entrance health examinations and lifestyle questionnaires during the 2005-2006 academic year were recruited. Measurements: A fasting plasma glucose, lipids, uric acid and hepatitis B serology were measured for each subject. The prevalence of metabolic syndrome and its individual components were examined using the America Heart Association and National Heart Lung Blood Institute criteria. The risk factors for metabolic syndrome were identified using a multivariate logistic regression analysis. Results: The prevalence of overweight, obesity and metabolic syndrome was 12.7% (17.0% in men and 7.6% in women), 13.0% (18.4% in men and 6.4% in women) and 4.6% (6.4% in men and 2.4% in women). The risk for metabolic syndrome increased with an increase of body mass index and plasma uric acid level, and decreased with the vigorous physical activity and current alcohol drinking. Furthermore, as compared to subjects with seroprotective titers from hepatitis B vaccination (antiHBs( þ ) and anti-HBc(À)), those without protective titers of anti-HBs after vaccination or without hepatitis B infection (antiHBs(À) and anti-HBc(À)) had 34% higher risk for metabolic syndrome, and those with natural infection of hepatitis B (anti-HBc( þ )) had 58% higher risk for metabolic syndrome. Conclusions: Overweight, obesity and metabolic syndrome were more common among men than women in university freshmen. Hepatitis B vaccination with anti-HBs( þ ) was associated with a lower risk of metabolic syndrome as compared to antiHBs(À). However, hepatitis B infection presented with anti-HBc( þ ) was associated with a higher risk of metabolic syndrome. The interplay between hepatitis B infection, hepatitis B vaccination and metabolic syndrome needs further investigation.

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“…Therefore, the inappropriateness of the recommended cutoff value of WC for diagnosis of CVD risk in Asian population, owing to their smaller build, was noted. In a study to determine the appropriate cutoff value of WC for metabolic syndrome among Asian population, Tan et al (2004) had found that cutoff value of WC higher than 90 cm among male is more appropriate for the said purpose than the conventional 94 cm cutoff value for WC. In present article, therefore, the cut-off value of 490 cm WC has been considered as one of the CVD risk condition (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…The cutoff value 426.6 cm (obtained from ROC curve analysis) for UAC has been used for diagnosis of CVD risk condition. Again the cutoff value of 490 cm (Tan et al, 2004) for WC has been used for the same …”

Section: Validity Of the Upper Arm Circumferencementioning

confidence: 99%

Validity of an alternative anthropometric trait as cardiovascular diseases risk factor: example from individuals with traumatic lower extremity amputation

Mozumdar

2006

Eur J Clin Nutr

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Background: Published studies reveal that individuals with lower extremity amputation are vulnerable to cardiovascular diseases (CVD) because of poor physical activity level. Many cardiovascular risk assessment studies have utilized anthropometric traits (primarily body mass index and waist circumference) as cardiovascular risk factor. However, some studies emphasized the technical limitations of measuring waist circumference for studying cardiovascular risk, and so it is difficult to obtain correct measurement from the individuals with lower extremity amputation. Objectives: The objectives of the present article are to study the prevalence of CVD risk factors among the individuals with traumatic lower extremity amputation and to test the validity of upper arm circumference (UAC) as an alternative anthropometric measurement for screening the CVD risk condition. Subjects and setting: Anthropometric data and other cardiovascular traits data have been collected from unilateral traumatic lower extremity amputated adult males (n ¼ 85) residing in Calcutta and adjoining areas. Results: Results show higher prevalence of cardiovascular risk factor among individuals with above-knee amputation than below-knee amputation. The receiver operating characteristics curve analysis shows significant ability of upper arm circumference to diagnose cardiovascular risk condition. The cutoff value of UAC426.6 cm show maximum sensitivity and specificity for the diagnosis of cardiovascular risk condition. Although, binomial tests for equality of proportion does not show any significant difference, however, agreement statistics reveal better diagnostic ability of cutoff value of UAC than the existing cutoff value of waist circumference. Conclusions: Therefore, UAC provides a better assessment of cardiovascular risk condition than does waist circumference especially for individuals with lower extremity amputation.

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Can We Apply the National Cholesterol Education Program Adult Treatment Panel Definition of the Metabolic Syndrome to Asians?

Cited by 736 publications

References 32 publications

Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes

Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes

Obesity and hepatitis B infection are associated with increased risk of metabolic syndrome in university freshmen

Validity of an alternative anthropometric trait as cardiovascular diseases risk factor: example from individuals with traumatic lower extremity amputation

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