Is the association of continuous metabolic syndrome risk score with body mass index independent of physical activity? The CASPIAN-III study

BACKGROUND/OBJECTIVES: Although the association of body mass index (BMI) with metabolic syndrome (MetS) is well documented, there is little knowledge on the independent and joint associations of BMI and physical activity with MetS risk based on a continuous scoring system. This study was designed to explore the effect of physical activity on interactions between excess body weight and continuous metabolic syndrome (cMetS) in a nationwide survey of Iranian children and adolescents. SUBJECTS/METHODS: Data on 5,625 school students between 10 and 18 years of age were analyzed. BMI percentiles, screen time activity (STA), leisure time physical activity (LTPA) levels, and components of cMetS risk score were extracted. Standardized residuals (z-scores) were calculated for MetS components. Linear regression models were used to study the interactions between different combinations of cMetS, LTPA, and BMI percentiles. RESULTS: Overall, 984 (17.5%) subjects were underweight, whereas 501 (8.9%) and 451 (8%) participants were overweight and obese, respectively. All standardized values for cMetS components, except fasting blood glucose level, were directly correlated with BMI percentiles in all models (P-trend < 0.001); these associations were independent of STA and LTPA levels. Linear associations were also observed among LTPA and standardized residuals for blood pressure, high-density lipoprotein, and waist circumference (P-trend < 0.01). CONCLUSIONS: Our findings suggest that BMI percentiles are associated with cMetS risk score independent of LTPA and STA levels.

Relationship between patients' perception of the importance of diabetes and metabolic control and pursuing chronic complications of disease

Type II diabetes is a metabolic disorder. Environmental factors and patient awareness have major roles on chronic complications. The purpose of this study was to determine the association of patients' perception of t the importance of diabetes and metabolic- control and pursuing of chronic complications. 194 patients with diabetes enrolled from diabetes clinic of Institute Endocrinology and Metabolism in a cross-sectional study, from February to March 2010. Data were collected using a questionnaire to assess the personal demographics, individual approach in pursuit of complications, and glycemic control, as well as patient perception and attitude toward the importance of disease process and follow-up. Level of perceptions was determined as well, moderate and weak. Out of 194 patients, 77 [39.7%] were male and 117 [60.3%] female. Mean age was 52.18 +/- 10.17 years. 69.2% did not know what the glycosylated hemoglobin was. In 71.4%, willing to participate in decisions making on medical treatment was good and they knew that with initiation of insulin therapy, they would have better metabolic control. 68.9% of patients had regular follow-up for eye complications, and 51% for cardiac complications. Follow-up for diabetic foot complication was poor. Patients with good perception had regular follow-up regarding cardiac, eye and renal complications. These results indicate that better perception of diabetic patients might improve their compliance for regular follow- up regarding the pursuit of chronic complications, especially cardiac, eye and renal problems. Although, the metabolic- control of patients had not the association with patient perception about the importance of diabetes

Anthropometric predictors of incident type 2 diabetes mellitus in Iranian women

Studies have shown a strong association between excess weight and risk of incident diabetes in Iranian women. Therefore, we investigated anthropometric indices in the prediction of diabetes in Iranian women. We examined 2801 females aged 220 years [mean [SD] age, 45.2 [12.9] years] in an Iranian urban population who were non-diabetic or had abnormal glucose tolerance at baseline. We estimated the predictive value of central obesity parameters [waist circumference [WC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR], body mass index [BMI]] in the prediction of diabetes. We classified each parameter in quartiles and compared the lowest with the highest quartile after adjusting for confounding variables, including age, hypertension, triglyceride levels, HDL-cholesterol, family history of diabetes, and abnormal glucose tolerance in a multivariate model. Receiver operator characteristic [ROC] curves were used to determine the predictive power of each variable. Over a median follow up of 3.5 years [11 months-6.3 years], 114 individuals developed diabetes [4.1%]. The risk for developing diabetes was significantly higher for the highest quartile of BMI, WC, WHR and WHtR, respectively, compared to the lowest quartile, and the risk decreased but remained statistically significant when abnormal glucose tolerance was included in the multivariate model. WHtR had the highest area under the ROC curve. In Iranian women, BMI, WC, WHR, WHtR were predictive of development of type 2 diabetes, but WHtR was a better predictor than BMI