Prevalence of metabolic syndrome by the Adult Treatment Panel III, International Diabetes Federation, and World Health Organization definitions and their association with coronary heart disease in an elderly Iranian population

<p><b>INTRODUCTION</b>To determine the prevalence of the metabolic syndrome (MS) in an Iranian elderly population and show its association with coronary heart disease (CHD).</p><p><b>MATERIALS AND METHODS</b>This is a cross-sectional study on 720 Iranian men and women aged > or = 65 years who participated in the Tehran Lipid and Glucose Study (TLGS). Logistic regression analysis was used to estimate the odds ratio (OR) of developing CHD in model 1, an age-adjusted model; model 2, adjusted for age, smoking status, premature history of CHD and low-density lipoprotein (LDL) cholesterol; and model 3, adjusted for mentioned variables plus the MS components.</p><p><b>RESULTS</b>The prevalence of MS was 50.8%, 41.8% and 41.9% based on the Adult Treatment Panel (ATPIII), the World Health Organisation (WHO), and the International Diabetes Federation (IDF) definitions, respectively. The IDF definition showed high agreement with the ATPIII definition. Age-adjusted OR (95% CI) of the MS for CHD was 1.6 (1.2 to 2.2) by both the ATPIII and WHO definitions and 1.4 (1.0 to 1.9) by the IDF definition. IDF-defined MS lost its association with CHD in model 2. In model 3, obesity (WHO definition) and high blood pressure (ATPIII and WHO definitions) were associated with CHD.</p><p><b>CONCLUSIONS</b>In an elderly Iranian population MS is highly prevalent. ATPIII and WHO definitions seem to be more pertinent than IDF for screening CHD risk. None of these definitions showed association with CHD when considering their components.</p>

Metabolic syndrome in normal-weight Iranian adults

This study provides the first reported estimates of the prevalence of the metabolic syndrome in a normal-weight Iranian population. In this population-based cross-sectional study, the study population consisted of a representative sample of 1 737 males and 1 707 females aged >/= 20 years with normal body mass index [BMI] [18.5-24.9 kg/m [2] for both genders]. The metabolic syndrome was defined according to the Adult Treatment Panel III guidelines. We present means and proportions, and multivariate odds ratios that quantify the association between metabolic syndrome and normal BMI quartiles, controlling for age, physical activity, smoking and education. The overall prevalence of the metabolic syndrome in normal-weight men and women were 9.9% and 11.0% [P=0.2] respectively. Men had a lower BMI than women, while their waist circumference [WC] was higher. The prevalence of high WC and low high-density lipoprotein cholesterol [HDL-C] was higher in women, while high blood pressure, high triglyceride levels and having at least one metabolic risk factor were more prevalent in men. Individuals in the highest category of normal BMI had significantly higher odds for being at risk for metabolic syndrome compared to those in the first category [OR: 5.21 for men and 2.15 for women]. There was an increasing trend in odds for having all the metabolic syndrome components except for high fasting blood sugar [FBS] and high WC in men. Women showed a similar increasing trend except for high FBS across normal BMI quartiles. The prevalence of the metabolic syndrome in normal-weight Iranian adults is relatively high. Therefore, interventions for prevention of cardiovascular disease could be considered in this population

Anthropometric parameters as helpful factors for prediction of type 2 diabetes onset, Tehran lipid and glucose study

The aim of this study was to determine the best Anthropometric indices for prediction of the risk of type 2 Diabetes in lower and higher 60 years old population in Tehran. As a prospective study among 4479 non-diabetic men and women over 20 years from the participants of Tehran Lipid and Glucose Study [TLGS] who had complete data of blood pressure, plasma glucose in the fasting state and 2 hours after ingestion of 75 g glucose [2-hPG] as well as fasting serum lipids, anthropometric measurement including body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR] and demographic data at baseline and were followed for a mean duration of 3.6 years. Subjects reevaluated for measurement of fasting Glucose and 2-hPG at follow-up. Diabetes and its associated risk factors were defined according to the ADA criteria. Different measurements of general and central obesity were defined based on the WHO criteria. Logistic regression analysis with stepwise conditional method was used to estimate the Odds Ratio [OR] with 95% CI. A total of 166 new cases of type 2 diabetes [3.7%] were diagnosed during 3.6 years of follow-up, with an approximately one percent per year incidence rate [men=3.7% and women =3.7%, P= 0.95]. Diabetic subjects of follow-up were significantly more obese than nondiabetics considering their BMI, WC and WHR. In subjects aged< 60 years high WC was a predictor of diabetes only in model 1 and 2, while general obesity and high WHR predicted diabetes risk in all the 3 models. In these 3 models the OR of general obesity were 5.3 [2.9-9.5], 3.4[1.8-6.3], 2.4[1.1-5.1] and the OR of high WHR were 3.5[2.1-5.8], 3.4[1.4-5.8] and 2.6[1.3-4.9], respectively. In subjects aged >/= 60 years general obesity predicted diabetes only in models 1 and 2, while high WHR was a predictor of diabetes risk only in model 1. In this age group, high WC predicted diabetes in all models 1, 2, 3 with the OR of 4.6 [2.3-4.1], 4.5 [2.3-8.9] and 3.8 [1.8-7.7], respectively. General obesity and high WHR in young Iranian subjects [< 60years] and high WC in older ones [>/= 60 years] are the important anthropometric indices for prediction of type 2 diabetes. Age should be considered when using different anthropometric indices for predicting the risk of type 2 diabetes