STUDY OF METABOLIC SYNDROME IN INDIAN POPULATION WITH COMPARISON OF TWO DEFINITIONS

Neha Rajwal; Jasjot Singh; Nurakant Neupane

doi:10.22159/ajpcr.2022.v15i9.44760

Authors

Neha Rajwal Department of Laboratory Medicine, Shri Mata Vaishno Devi Narayana Superspeciality Hospital, Katra, Jammu and Kashmir, India. https://orcid.org/0000-0002-8538-268X
Jasjot Singh American Society for Clinical Pathology, USA.
Nurakant Neupane Medical Genetics Unit, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal. https://orcid.org/0000-0002-5956-4594

DOI:

https://doi.org/10.22159/ajpcr.2022.v15i9.44760

Keywords:

Metabolic syndrome, International diabetes federation, National Cholesterol Education Program-Adult Treatment Panel-III, Obesity, Cardiovascular diseases

Abstract

Objectives: Metabolic syndrome (MetS) is described as the collection of risk factors for cardiovascular disease such as hypertension, hyperglycemia/ insulin resistance, abdominal obesity, and dyslipidemia. In developed countries, MetS is highly prevalent among adults and is an emerging health problem in developing countries. In this study, we used the International Diabetes Federation (IDF) and National Cholesterol Education Program- Adult Treatment Panel-III (NCEP-ATP III) to define the Mets. The aim of this research was to evaluate the prevalence of MetS, its components, and its major risk factors among adults ≥20 in Jammu and Kashmir according to IDF and the NCEP ATP III criteria.

Methods: The project was conducted in the Department of Biochemistry, Laboratory Medicine, Shri Mata Vaishno Devi Narayana Superspeciality Hospital, Katra, and Jammu and Kashmir in 100 subjects between the age groups of 20 and 80 years old attending the OPD from 2 January to 30 April 2017.

Results: MetS was diagnosed in 57% and 55%, gender-wise distribution came out to be 45.6% and 52.7% in men, and in women, we found 54.3% and 47.3%, according to IDF and the NCEP ATP III definition, respectively.

Conclusion: In our study, IDF criteria were better for the early diagnosis of MetS. On the basis of gender prevalence in all parameters in IDF, females are at risk, and in NCEP ATP III, males are more at risk. According to the IDF, central obesity is the only the risk for women.

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Author Biography

Nurakant Neupane, Medical Genetics Unit, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.

Working as Genetic Scientist in Medical Genetic Unit of NAMS, Bir Hospital. Nepal.

References

Miranda PJ, DeFronzo RA, Califf RM, Guyton JR. Metabolic syndrome: Definition, pathophysiology, and mechanisms. Am Heart J 2005;149:33-45. doi: https://doi.org/10.1016/j.ahj.2004.07.013

Falkner B, Hassink S, Ross J, Gidding S. Dysmetabolic syndrome: Multiple risk factors for premature adult disease in an adolescent girl. Pediatrics 2002;110:e14-4. doi:10.1542/peds.110.1.e14

Hjermann I. The metabolic cardiovascular syndrome: Syndrome X, Reaven’s syndrome, insulin resistance syndrome, atherothrombogenic syndrome. J Cardiovasc Pharmacol 1992;20 Suppl 8:S5-10. Available from: https://journals.lww.com/cardiovascularpharm/ Fulltext/1992/00208/The_Metabolic_Cardiovascular_Syndrome__ Syndrome_X.,2.aspx

Huang PL. A comprehensive definition for metabolic syndrome. Dis Model Mech 2009;2:231-7. doi:10.1242/dmm.001180

Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato A, et al. Harmonizing the metabolic syndrome. Circulation 2009;120:1640- 5. doi:10.1161/CIRCULATIONAHA.109.192644

Cameron AJ, Shaw JE, Zimmet PZ. The metabolic syndrome: Prevalence in worldwide populations. Endocrinol Metab Clin North Am 2004;33:351-75. doi: https://doi.org/10.1016/j.ecl.2004.03.005

Reaven GM. Role of insulin resistance in human disease. Diabetes 1988;37:1595-607. doi:10.2337/diab.37.12.1595

Sarafidis PA, Nilsson PM. The metabolic syndrome: A glance at its history. J Hypertens 2006;24:621-6.

Kylin E. Studien ueber das hypertonie-hyperglyka “mie-Hyperurika” miesyndrom. Zentralbl Inn Med. 1923;44:105-27.

Vague J. Sexual differentiation, a factor affecting the forms of obesity. Presse Med 1947;30:339-40.

Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005;365:1415-28. doi:10.1016/S0140-6736(05)66378-7

Kaur J. A Comprehensive Review on Metabolic Syndrome. Cardiol Res Pract 2014;2014:943162. doi:10.1155/2014/943162

International Diabetes Federation. The IDF Consensus Worldwide Definition of the Metabolic Syndrome. Brussels, Belgium: International Diabetes Federation; 2006. p. 1-24.

Reaven GM. The metabolic syndrome: Is this diagnosis necessary? Am J Clin Nutr 2006;83:1237-47. doi:10.1093/ajcn/83.6.1237

Desroches S, Lamarche B. The evolving definitions and increasing prevalence of the metabolic syndrome. Appl Physiol Nutr Metab. 2007;32(1):23-32. doi:10.1139/h06-095

Kolovou GD, Anagnostopoulou KK, Salpea KD, Mikhailidis DP. The prevalence of metabolic syndrome in various populations. Am J Med Sci. 2007;333(6):362-371. doi:10.1097/MAJ.0b013e318065c3a1

Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The metabolic syndrome: Prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2003;163:427-36. doi:10.1001/archinte.163.4.427

Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults findings from the third national health and nutrition examination survey. JAMA 2002;287:356-9. doi:10.1001/jama.287.3.356

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome. Circulation 2005;112:2735-52. doi:10.1161/ CIRCULATIONAHA.105.169404

Carey DG, Jenkins AB, Campbell LV, Freund J, Chisholm DJ. Abdominal fat and insulin resistance in normal and overweight women: direct measurements reveal a strong relationship in subjects at both low and high risk of NIDDM. Diabetes 1996;45:633-8. doi:10.2337/ diab.45.5.633

Cnop M, Landchild MJ, Vidal J, Havel PJ, Knowles NG, Carr DR, et al. The concurrent accumulation of intra-abdominal and subcutaneous fat explains the association between insulin resistance and plasma leptin concentrations: Distinct metabolic effects of two fat compartments. Diabetes 2002;51:1005-15. doi:10.2337/diabetes.51.4.1005

Pascot A, Després JP, Lemieux I, Bergeron J, Nadeau A, Prud’homme D, et al. Contribution of visceral obesity to the deterioration of the metabolic risk profile in men with impaired glucose tolerance. Diabetologia 2000;43:1126-35. doi:10.1007/s001250051503

Pascot A, Lemieux I, Prud’homme D, Tremblay A, Nadeau A, Couillard C, et al. Reduced HDL particle size as an additional feature of the atherogenic dyslipidemia of abdominal obesity. J Lipid Res 2001;42:2007-14. doi:10.1016/S0022-2275(20)31529-7

Nicklas BJ, Penninx BW, Ryan AS, Berman DM, Lynch NA, Dennis KE. Visceral adipose tissue cutoffs associated with metabolic risk factors for coronary heart disease in women. Diabetes Care 2003;26:1413-20. doi:10.2337/diacare.26.5.1413

Nieves DJ, Cnop M, Retzlaff B, Walden CE, Brunzell JD, Knopp RH, et al. The atherogenic lipoprotein profile associated with obesity and insulin resistance is largely attributable to intra-abdominal fat. Diabetes 2003;52(1):172-9. doi:10.2337/diabetes.52.1.172

Phillips GB, Jing T, Heymsfield SB. Relationships in men of sex hormones, insulin, adiposity, and risk factors for myocardial infarction. Metab Clin Exp 2003;52:784-90. doi:10.1016/S0026-0495(03)00072-6

Katsuki A, Sumida Y, Urakawa H, Gabazza EC, Murashima S, Maruyama N, et al. Increased visceral fat and serum levels of triglyceride are associated with insulin resistance in japanese metabolically obese, normal weight subjects with normal glucose tolerance. Diabetes Care 2003;26:2341-4. doi:10.2337/diacare.26.8.2341

Wagenknecht LE, Langefeld CD, Scherzinger AL, Norris JM, Haffner SM, Saad MF, et al. Insulin sensitivity, insulin secretion, and abdominal fat: The insulin resistance atherosclerosis study (IRAS) family study. Diabetes 2003;52:2490-6. doi:10.2337/diabetes.52.10.2490

Fujimoto WY, Abbate SL, Kahn SE, Hokansno JE, Brunzell JD. The visceral adiposity syndrome in Japanese-American men. Obes Res 1994;2:364-71. https://doi.org/10.1002/j.1550-8528.1994.tb00076.x

Rattarasarn C, Leelawattana R, Soonthornpun S, Setasuban W, Thamprasit A, Lim A, et al. Regional abdominal fat distribution in lean and obese thai Type 2 diabetic women: Relationships with insulin sensitivity and cardiovascular risk factors. Metab Clin Exp 2003;52:1444-7. doi:10.1016/S0026-0495(03)00257-9

Kanai H, Tokunaga K, Fujioka S, Yamashita S, Kameda-Takemura K, Matsuzawa Y. Decrease in intra-abdominal visceral fat may reduce blood pressure in obese hypertensive women. Hypertension 1996;27:125-9. doi:10.1161/01.HYP.27.1.125

Bacha F, Saad R, Gungor N, Janosky J, Arslanian SA. Obesity, regional fat distribution, and syndrome X in obese black versus white adolescents: Race differential in diabetogenic and atherogenic risk factors. J Clin Endocrinol Metab 2003;88:2534-40. doi:10.1210/ jc.2002-021267

Carr MC, Hokanson JE, Deeb SS, Purnell JQ, Mitchell ES, Brunzell JD. A hepatic lipase gene promoter polymorphism attenuates the increase in hepatic lipase activity with increasing intra-abdominal fat in women. Arterioscler Thromb Vasc Biol 1999;19:2701-7. doi:10.1161/01. ATV.19.11.2701

Ribeiro-Filho FF, Faria AN, Kohlmann NE, Zanella MT, Ferreira SR. Two-hour insulin determination improves the ability of abdominal fat measurement to identify risk for the metabolic syndrome. Diabetes Care 2003;26:1725-30. doi:10.2337/diacare.26.6.1725

de Oliveira RM, do Verreschi IT, Lipay MV, Eça LP, Guedes AD, Bianco B. Y chromosome in Turner syndrome: Review of the literature. Sao Paulo Med J 2009;127:373-8. doi:10.1590/s1516- 31802009000600010

Barzilai N, She L, Liu BQ, Vuguin P, Cohen P, Wang J, et al. Surgical removal of visceral fat reverses hepatic insulin resistance. Diabetes 1999;48:94-8. doi:10.2337/diabetes.48.1.94

Brochu M, Tchernof A, Turner AN, Ades PA, Poehlman ET. Is there a threshold of visceral fat loss that improves the metabolic profile in obese postmenopausal women? Metab Clin Exp 2003;52:599-604. doi:10.1053/meta.2003.50095

Gabriely I, Ma XH, Yang XM, Atzmon G, Rajala MW, Berg AH, et al. Removal of visceral fat prevents insulin resistance and glucose intolerance of aging: An adipokine-mediated process? Diabetes 2002;51:2951-8. doi:10.2337/diabetes.51.10.2951

Vernay M, Salanave B, de Peretti C, Druet C, Malon A, Deschamps V, et al. Metabolic syndrome and socioeconomic status in France: The French nutrition and health survey (ENNS, 2006-2007). Int J Public Health 2013;58:855-64. doi:10.1007/s00038-013-0501-2

Gündogan K, Bayram F, Capak M, Tanriverdi F, Karaman A, Ozturk A, et al. Prevalence of metabolic syndrome in the mediterranean region of turkey: Evaluation of hypertension, diabetes mellitus, obesity, and dyslipidemia. Metab Syndr Relat Disord 2009;7:427-34. doi:10.1089/ met.2008.0068

Mozumdar A, Liguori G. Persistent increase of prevalence of metabolic syndrome among U.S. adults: NHANES III to NHANES 1999-2006. Diabetes Care 2010;34:216-9. doi:10.2337/dc10-0879

Salas R, del Bibiloni MM, Ramos E, Villarreal JZ, Pons A, Tur JA, et al. Metabolic syndrome prevalence among Northern Mexican adult population. PLoS One 2014;9:e105581. https://doi.org/10.1371/ journal.pone.0105581

Correia F, Poínhos R, Freitas P, Pinhão S, Maia A, Carvalho D, et al. Prevalência da sindrome metabólica comparação entre os critérios ATPIII e IDF numa população feminina com obesidade severa prevalence of the metabolic syndrome comparison between ATPIII and IDF criteria in a feminin population with severe obesity. Acta Med Port 2006;19:286-94.

do Vale Moreira NC, Hussain A, Bhowmik B, Mdala I, Siddiquee T, Fernandes VO, et al. Prevalence of metabolic syndrome by different definitions, and its association with Type 2 diabetes, pre-diabetes, and cardiovascular disease risk in Brazil. Diabetes Metab Syndr Clin Res Rev 2020;14:1217-24. https://doi.org/10.1016/j.dsx.2020.05.043

Tabatabaei-Malazy O, Moghaddam SS, Rezaei N, Sheidaei A, Hajipour MJ, Mahmoudi N, et al. A nationwide study of metabolic syndrome prevalence in Iran; a comparative analysis of six definitions. PLoS One 2021;16:e0241926. doi:10.1371/journal.pone.0241926

Ford ES. Prevalence of the metabolic syndrome defined by the international diabetes federation among adults in the U.S. Diabetes Care 2005;28:2745-9. doi:10.2337/diacare.28.11.2745

Mahmoud I, Sulaiman N. Prevalence of metabolic syndrome and associated risk factors in the United Arab Emirates: A cross-sectional population-based study. Front Public Health 2022;9:811006. doi:10.3389/fpubh.2021.811006

Das Gupta R, Tamanna R, Akonde M, Biswas T, Chakraborty P, Hossain MB. Prevalence and associated factors of metabolic syndrome among Bangladeshi adults: Evidence from a nation-wide survey. Diabetes Epidemiol Manag 2021;5:100037. doi:10.1016/j. deman.2021.100037

Erem C, Hacıhasanoglu A, Deger O, Topbaş M, Hosver I, Ersoz HO, et al. Prevalence of metabolic syndrome and associated risk factors among Turkish adults: Trabzon MetS study. Endocrine 2008;33:9-20. doi:10.1007/s12020-008-9044-3

Rankinen T, Kim SY, Pérusse L, Després JP, Bouchard C. The prediction of abdominal visceral fat level from body composition and anthropometry: ROC analysis. Int J Obes 1999;23:801-9. doi:10.1038/ sj.ijo.0800929

Lemieux S, Prud’homme D, Bouchard C, Tremblay A, Després JP. A single threshold value of waist girth identifies normal-weight and overweight subjects with excess visceral adipose tissue. Am J Clin Nutr 1996;64:685-93. doi:10.1093/ajcn/64.5.685

Banerji MA, Lebowitz J, Chaiken RL, Gordon D, Kral JG, Lebovitz HE. Relationship of visceral adipose tissue and glucose disposal is independent of sex in black NIDDM subjects. Am J Physiol Metab 1997;273:E425-32. doi:10.1152/ajpendo.1997.273.2.E425

Sowers JR, Epstein M, Frohlich ED. Diabetes, hypertension, and cardiovascular disease. Hypertension 2001;37:1053-9. doi:10.1161/01. HYP.37.4.1053

Reaven GM. Syndrome X: 6 years later. J Intern Med Suppl 1994;736:13- 22. Available from: http://europepmc.org/abstract/MED/7986303

Timar O, Sestier F, Levy E. Metabolic syndrome X: A review. Can J Cardiol 2000;16:779-89.

Prabhakaran D, Anand SS. The metabolic syndrome: An emerging risk state for cardiovascular disease. Vasc Med 2004;9:55-68. doi:10.1191/1358863x04vm515ra

Kohler HP. Insulin resistance syndrome: Interaction with coagulation and fibrinolysis. Swiss Med Wkly 2002;132:241-52.

Haffner SM. The prediabetic problem: Development of non-insulin-dependent diabetes mellitus and related abnormalities. J Diabetes Complications 1997;11(2):69-76. doi: https://doi.org/10.1016/S1056- 8727(96)00099-2

Gerstein HC, Prem P, Janice P, Salim Y. Relationship of glucose and insulin levels to the risk of myocardial infarction: A case-control study. J Am Coll Cardiol 1999;33:612-9. doi:10.1016/S0735-1097(98)00637-8

Gerstein HC, Yusuf S. Dysglycaemia and risk of cardiovascular disease. Lancet 1996;347:949-50. doi:10.1016/S0140-6736(96)91420-8

Mitchell BD, Haffner SM, Hazuda HP, Valdez R, Stern MP. The relation between serum insulin levels and 8-year changes in lipid, lipoprotein, and blood pressure levels. Am J Epidemiol 1992;136:12- 22. doi:10.1093/oxfordjournals.aje.a116416

McKenney JM. Understanding and treating dyslipidemia associated with noninsulin-dependent diabetes mellitus and hypertension. Pharmacother J Hum Pharmacol Drug Ther 1993;13:340-52. doi: https://doi.org/10.1002/j.1875-9114.1993.tb02741.x

Grundy SM. Hypertriglyceridemia, insulin resistance, and the metabolic syndrome. Am J Cardiol 1999;83:25-9. doi:10.1016/S0002- 9149(99)00211-8

Sniderman AD, Scantlebury T, Cianflone K. Hypertriglyceridemic HyperapoB: The unappreciated atherogenic dyslipoproteinemia in Type 2 diabetes mellitus. Ann Intern Med 2001;135:447-59. doi:10.7326/0003-4819-135-6-200109180-00014

Reynisdottir S, Angelin B, Langin D, Lithell H, Eriksson M, Holm C, et al. Adipose tissue lipoprotein lipase and hormone-sensitive lipase. Arterioscler Thromb Vasc Biol 1997;17:2287-92. doi:10.1161/01. ATV.17.10.2287

Enas EA, Yusuf S, Mehta JL. Prevalence of coronary artery disease in Asian Indians. Am J Cardiol 1992;70:945-9. doi:10.1016/0002- 9149(92)90744-J

Haverinen E, Paalanen L, Palmieri L, Padron-Monedero A, Noguer- Zambrano I, Suárez RS, et al. Comparison of metabolic syndrome prevalence using four different definitions a population-based study in Finland. Arch Public Health 2021;79:231. doi:10.1186/s13690-021- 00749-3