Description and prediction of the development of metabolic syndrome in Dongying City: a longitudinal analysis using the Markov model

Chen, Xiaoxiao; Chen, Qi‐Cai; Chen, Lili; Zhang, Pengpeng; Wang, Shumei

doi:10.1186/1471-2458-14-1033

Cited by 15 publications

(26 citation statements)

References 37 publications

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“…Their findings confirmed that the development of MS was different in men and women [ 18 ]. In 2014, our research group included a total of 7510 subjects and constructed a 7-state Markov model to investigate the natural development of MS in different gender and age groups, with the results indicating that there were gender and age differences in the progression of MS [ 19 ]. However, the limitation of this study was that the six states were composed of a 2-component condition were not completely separated.…”

Section: Introductionmentioning

confidence: 99%

Dynamic development of metabolic syndrome and its risk prediction in Chinese population: a longitudinal study using Markov model

Jia

Chen

et al. 2018

Diabetol Metab Syndr

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BackgroundWith the increasing prevalence of metabolic syndrome (MS), there is a need to track and predict the development of MS. In this study, we established a Markov model to explore the natural history and predict the risk of MS.MethodsA total of 21,777 Chinese individuals who had at least two consecutive health check-ups between 2010 and 2015 were studied. MS was defined using the Chinese Diabetes Society criteria. Twelve metabolic abnormal states (the no component state, four isolated component states, six 2-component states, and the MS state) were contained in each Markov chain. The transition probability was the mean of five probabilities for the transition between any two states in 2 consecutive years.ResultsThe dyslipidemia or overweight/obesity components were most likely to initiate the progress of MS in individuals aged 18–49. However, for individuals over 50 years old, the most likely initiating component of MS was dyslipidemia or hypertension. People who initially had dyslipidemia were most likely to develop the combined state of dyslipidemia with overweight/obesity before the age of 50, but after 50 years of age, the state of dyslipidemia merged with hypertension was the most common. Subjects (with the exception of males over 50 years of age who initially had an isolated state of hyperglycemia) who initially had an isolated state of overweight/obesity, hypertension, or hyperglycemia were most likely to develop a combination of one of these initial states with dyslipidemia. Males who initially had isolated hyperglycemia tended to develop hypertension after age 50. There was a greater chance for subjects who initially had an isolated hyperglycemia state or 2-component state that contained hyperglycemia to develop MS within 10 years compared to those who initially had other abnormal metabolic states.ConclusionsThe occurrence of MS primarily began with overweight/obesity or dyslipidemia in people aged 18–49. However, for those over 50 years old, MS primarily initiated under the conditions of dyslipidemia or hypertension. When MS started under the conditions of overweight/obesity, hypertension or hyperglycemia, dyslipidemia tended to occur next. People who initially had isolated hyperglycemia or a 2-component state that contained hyperglycemia had a higher risk of developing MS than those with other initiating states.

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Section: Introductionmentioning

confidence: 99%

Dynamic development of metabolic syndrome and its risk prediction in Chinese population: a longitudinal study using Markov model

Jia

Chen

et al. 2018

Diabetol Metab Syndr

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“…Although, proteinuria as a semiquantitative analysis has the problem of stability, it is still the most convenient and low-cost way to reflect renal function in clinical practice. Some studies showed that the severity of proteinuria was significantly associated with maternal and fetal complications in HDP [10][11][12] .…”

Section: Resultsmentioning

confidence: 99%

Mode of Delivery in Stable Patients with Hypertensive Disorders of Pregnancy Based on the Classification Tree

Hong¹,

Zhang²,

Yan³

et al. 2019

Preprint

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Purpose It is very critical to consider features of Hypertensive Disorders of Pregnancy (HDP) when choosing mode of delivery, which are rarely reported in present studies. This study is to construct a user-friendly combination of HDP patients’ features to choose optimal mode of delivery for stable patients without other indications for cesarean section. Methods A retrospective analysis was performed in 307 stable HDP patients with clinical cure. 116 patients underwent vaginal delivery (VD) and 191 patients underwent cesarean delivery (CD). Univariate analysis was done between VD group and CD group on demographic, anthropometric and laboratory variables. Then, with classification tree, separate set of HDP features were enabled to be linked into mode of delivery. Results The levels of edema, proteinuria, systolic blood pressure (SBP), hematocrit (HCT), β-2 microglobulin and aspartate aminotransferase (AST) were higher in CD group than those in VD group (P<0.001). The classification tree was consisted of 3 layers: the first layer was edema, the second layer were β-2microglobulin and proteinuria, and the third layer was HCT. Node 3 (no edema; β-2microglobulin ≤1.71ug/ml) reached VD rate of 86.4%, which was the highest VD rate among all terminal nodes. Node 6 (edema is limited to the ankle or above,proteinuria>1+) had the lowest VD rates of 11.3%. Conclusions The classification tree explores the collection of HDP features suitable for different modes of delivery, which offers the ability of assisting obstetricians to select proper mode of delivery for HDP patients without other certain indications for cesarean section.

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“…Hwang et al claimed that the primary initiating components in young men were hypertension and the 2-component state, while in young women, the primary initiating states were obesity and low HDL [ 20 ]. Chen et al found that obesity and dyslipidemia were the most likely components in men under 60 years old and women under 50 years old, while the 2-component state and hypertension were the most likely states (besides those described above) in the elderly population [ 21 ]. Our data indicated that obesity and dyslipidemia were the components most likely to initiate the development of MetS in women, regardless of whether they were young or middle-aged.…”

Section: Discussionmentioning

confidence: 99%

“…This result indicated that obesity was the best predictor of the development of MetS. Chen et al conducted a 10-year prediction study with the population of Dongying City in China; the authors claimed that individuals with isolated dyslipidemia had a greater chance of developing MetS than those with any other isolated state [ 21 ]. This result was not consistent with the results of the current study.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of the development of metabolic syndrome by the Markov model based on a longitudinal study in Dalian City

Tang

Liu

2018

BMC Public Health

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BackgroundMetabolic syndrome (MetS) increases the incidence of cardiovascular disease and diabetes mellitus. It is essential to study the natural progression of MetS in the interest of prevention. Information on the dynamic changes in MetS in developing countries is limited. This study aimed to simulate the progression of each component of MetS and explore the potential role of these components in early prevention and intervention.MethodsThis study involved 5881 individuals, aged 20 to 60 at study entry, who underwent at least two consecutive years of health check-ups in the seven-year study period at our institution’s health check-up center. Participants were divided into four groups by age (a 20- to- 40-year-old group and a 40- to 60-year-old group) and gender. A Markov model containing 7 stages (no components, isolated hypertension, isolated obesity, isolated hyperglycemia, isolated dyslipidemia, a 2-component state, and the MetS state) was constructed for each group.ResultsIn women and young men (20- to 40-year-old men), dyslipidemia and obesity were the two most probable states for individuals who were transitioning from no components to one of the other six states. Among those who had no components and were 30 years old at study entry, MetS was estimated to develop within 10 years in 11.42% of men and 3.04% of women. Among those who had no components and were 50 years old at study entry, MetS was estimated to develop within 10 years in 25.04% of men and 7.09% of women. The estimated prevalence of MetS over the next 10 years was higher in individuals starting with the obesity component than in individuals starting with any other isolated component. In a comparison of interventions targeting single components, simulations showed that the obesity intervention produced the largest relative reduction in the prevalence of MetS.ConclusionMarkov models are suitable for describing and predicting the dynamic development of MetS. The occurrence of MetS most frequently began with dyslipidemia or obesity. Obesity played a predominant role in the development of MetS. Early obesity intervention was extremely important for MetS prevention.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5599-y) contains supplementary material, which is available to authorized users.

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Description and prediction of the development of metabolic syndrome in Dongying City: a longitudinal analysis using the Markov model

Cited by 15 publications

References 37 publications

Dynamic development of metabolic syndrome and its risk prediction in Chinese population: a longitudinal study using Markov model

Dynamic development of metabolic syndrome and its risk prediction in Chinese population: a longitudinal study using Markov model

Mode of Delivery in Stable Patients with Hypertensive Disorders of Pregnancy Based on the Classification Tree

Prediction of the development of metabolic syndrome by the Markov model based on a longitudinal study in Dalian City

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