Prevalence of metabolic syndrome and its relationship to weight in the Thai population.

BACKGROUND: Although the prevalence of the metabolic syndrome (MetS) has been well-documented in Western Caucasian populations, there are few studies in non-Caucasian populations. The objectives of the present study were to estimate the prevalence of MetS and to find an optimal BMI cut-off value for defining obesity in the Thai population. MATERIAL AND METHOD: A sample of 307 men and 295 healthy women aged between 20 and 90 years (average age of 45 years) who came for a health check-up clinic in Khon Kaen, a northeast province of Thailand, were studied. The present study was conducted between 2003 and 2004. The modified ATP III criteria were used to estimate the age-and-sex specific prevalence of MetS, in which a BMI of > or = 27 kg/m(2) for men and 25 kg/m(2) for women were used in place of waist circumference. In the Thai population, these BMI cut-offs were equivalent to a percent body fat of 25% and 35% in men and women respectively. RESULTS: The overall prevalence of MetS was 15%, with no significant differences between men (15.3%) and women (14.6%). In men, the prevalence increased from 9.5% among the 20-39 age group to 24.7% among the 50+ age groups. In women, the respective prevalence was 7% and 29.5%. When BMI was removed from the classification ofMetS, the overall prevalence of "MetS-without-BMI" (still defined by the presence of at least 3 abnormalities) in both men and women was 7.8%. However the prevalence of MetS-without-BMI increased with higher BMI levels: among those with BMI < 25, the prevalence was 4.6% in men and 5.0% in women; among those with BMI > or = 25, the prevalence was 13% in men and 16% in women. CONCLUSION: The prevalence of MetS in this semi-rural Thai population was 15%, which is as common as in Caucasian populations. In the Thai population, obesity was a major component of MetS.

Association between waist circumference and percentage body fat among rural Thais.

OBJECTIVE: Determine the association between waist circumference (WC) and percentage body fat (%BF) and to develop cut-off values and evaluate the accuracy of WC in the definition of obesity in rural Thai population. MATERIAL AND METHOD: A cross-sectional, epidemiologic study in 181 men and 255 women aged 50+/-16 yr (mean+/-SD; range: 20-84 yr) sampled by stratified clustering sampling method, was designed. Percentage body fat was measured by dual energy X-ray absorptiometry (GE Lunar Corp, Madison, WI). The "golden standard"for defining obesity was%BF > or = 25 in men and%BF > or = 35 in women. Waist circumference in centimeter was measured. RESULTS: In this study, the %BF-based prevalence of obesity in men and women was 8.3% and 44%, respectively. However using the WC cut-off (WHO) of 102 cm in men and 88 cm in women, only 1.7% of men and 24% of women were classified as obese. WC was a significant predictor of %BF, such that in men, a WC of 93 cm would predict a %BF of25%, and in women a WC of 84 cm would correspond to a %BF of 35%. The area under the receiver operating characteristic curve was 0. 87 and 0. 88 in men and women, respectively. In conclusion, waist circumference is a reasonably useful indicator of obesity. CONCLUSION: The cut-off values of WC for diagnosing obesity should be lower in Thailand than in Western countries.

Prevalence of osteoporosis in Thai men.

BACKGROUND: Osteoporosis is a growing health problem not only in women but also in men. However, there is a scarcity of epidemiologic data to study osteoporosis in Thai men. OBJECTIVES: To examine the bone mineral density (BMD) and to determine the prevalence of osteoporosis in Thai men. MATERIAL AND METHOD: A total of 412 men (159 from Bangkok and 253 from Khon Kaen, respectively) averaging 51 +/- 16 years of age, were measured for BMD at the femoral neck and lumbar spine by dual energy X-ray absorptiometry (LUNAR Corporation, WI, USA). RESULTS: The peak BMD was observed in men 20-29 years of age at both the femoral neck (mean +/- SD, 1.10 +/- 0.15 g/cm2) and lumbar spine (mean +/- SD, 1.17 +/- 0.13 g/cm2). The prevalence of osteoporosis in the entire group of subjects was 12.6, 4.6 and 3.9 per cent at the femoral neck, lumbar spine and both sites, respectively. The prevalence of osteoporosis increased with advancing age and was significantly higher at the femoral neck in urban men than rural men (18.2 vs 9.2 per cent, p < 0.05) but comparable at the lumbar spine (5.0 vs 4.3 per cent, p = 0.81). The correlation between femoral neck and lumbar spine BMDs was 0.53 (p < 0.001). In univariate analysis, increased age, lower weight and lesser height were each associated with lower femoral neck BMD, whereas only lower weight and lesser height were associated with lower lumbar spine BMD. However, when the three factors were entered simultaneously, only increased age and lower weight were significantly associated with lower femoral neck BMD and only lower weight had a significant association with lower lumbar spine BMD. CONCLUSION: The present study demonstrated descriptive BMD data, normal BMD reference values for diagnosis and reported the prevalence of osteoporosis in Thai men.

Estimated volumetric bone mineral density in a rural Thai men and women: Khon Kaen Osteoporosis Study (KKOS).

The authors examined the areal bone mineral density (aFNBMD) and estimated volumetric bone mineral density at the femoral neck (vFNBMD) in rural Thai men and women. A total of 181 men and 255 women, between 20 and 84 years of age, living in rural areas of Khon Kaen province, were randomly selected. Areal FNBMD and estimated v FNBMD were determined using dual energy X-ray absorptiometry (DPX-IQ, GE Lunar Corp, Madison, WI). Men had a significantly higher aFNBMD than women, whereas the estimated vFNBMD was similar regardless of sex. The peak for the aFNBMD vs. vFNBMD was observed between 20 and 29 vs. 30 and 39 years of age in men and women, respectively. The prevalence of osteoporosis in men and women using estimated vFNBMD vs. aFNBMD cut-offs was 19 and 14.2 vs 11.8 and 26 percent, respectively. Prevalence increased with age. Estimated vFNBMD shows only small sex-correlated differences in bone density. Estimated vFNBMD was more sensitive than aFNBMD, when used to define the osteoporotic cut-offs in men, while it was less sensitive than aFNBMD in women.

Development and validation of a new clinical risk index for prediction of osteoporosis in Thai women.

The objective of this study was to develop and validate a new simple tool for identifying Thai women who are at high risk of having osteoporosis. A total of 322 women, aged > or = 45 years, were randomly divided into two cohorts: a development (n = 130) and a validation cohort (n = 192). Femoral neck and lumbar spine BMD were measured by LUNAR DPX-IQ densitometer. The prevalence of osteoporosis (defined by BMD T-scores < or = -2.5) was 33 per cent by either femoral neck or lumbar spine BMD. Khon Kaen Osteoporosis Study (KKOS), scoring based on age and weight was calculated and applied to the development cohort. Individuals with KKOS score < or = -1 were defined as "high risk"; otherwise a "low risk" was defined. In the validation cohort, the sensitivity and specificity of KKOS was 70 and 73 per cent, respectively. Furthermore, if the high risk individuals identified by KKOS are to be treated, and if the treatment reduces fracture incidence by 50 per cent and assuming that treatment cost is 10 bahts per day, then the cost to prevent one fracture is estimated to be 466,695 bahts per year. These data suggest that although age and body weight can be used to identify Thai women who are at high risk of having osteoporosis, its application to the general population requires further research to arrive at the optimal cost-benefit for the community.