Association between Metabolic Syndrome and Leukocytes: Systematic Review and Meta-Analysis.

Background: Metabolic syndrome (MetS) is a group of metabolic abnormalities characterised by central obesity, hypertension, dyslipidaemia, and dysregulation of blood glucose, which is associated with the risk of diabetes, cardiovascular disease, and overall mortality. White blood cell count is a selective marker of acute infection and inflammation, which could provide information on the metabolic status of subjects. This study aims to provide the best evidence on the association between MetS and white blood cell count by determining the effect size of this biomarker. Methods: A systematic review and meta-analysis of studies indexed in the PubMed and Scopus databases were performed. Methodological quality was assessed using the STROBE tool, overall risk of bias using RevMan (Cochrane Collaboration), and quality of evidence using Grade Pro. Results: We included 14 articles comparing leukocyte concentrations in 21,005 subjects with MetS and 66,339 controls. Subjects with MetS had a higher mean leukocyte count, 0.64 cells ×109/L; CI95% 0.55-0.72; p < 0.00001; I2 = 93%. Conclusions: An in-depth evaluation of the relationship of leukocytes in the pathophysiological process of MetS could lead to new insights into early diagnosis.

Metabolic syndrome and transaminases: systematic review and meta-analysis.

BACKGROUND: Metabolic syndrome (MetS) is a group of metabolic abnormalities characterised by hypertension, central obesity, dyslipidaemia and dysregulation of blood glucose, associated with the risk of diabetes, cardiovascular disease and overall mortality. The presence of elevated liver enzymes may precede the development of MetS, with alterations of the liver being observed that are directly related to metabolic problems. The study aims to provide the best evidence on the association between liver enzymes (ALT, AST, GGT) and MetS by determining the effect size of these biomarkers. METHODS: A systematic review and meta-analysis of studies indexed in PubMed and Scopus databases were performed. Study quality was assessed using the STROBE tool. The Grade Pro tool was used to evaluate the evidence, and the quantitative synthesis was performed using RevMan (Cochrane Collaboration). RESULTS: Seventeen articles comparing liver enzyme concentrations between 76,686 with MetS (MetS+) and 201,855 without MetS (MetS-) subjects were included. The concentration of ALT, AST and GGT in the MetS + subjects was significantly higher than in the control group 7.13 IU/L (CI95% 5.73-8.54; p < 0.00001; I2 = 96%), 2.68 IU/L (CI95% 1.82-3.54; p < 0.00001; I2 = 96%) and 11.20 IU/L (CI95% 7.11-15.29; p < 0.00001; I2 = 96%), respectively. CONCLUSIONS: The evaluation of the relationship of liver enzymes in the pathophysiological process of MetS could lead to new insights into early diagnosis.

Diagnostic accuracy of anthropometric indices for metabolically healthy obesity in child and adolescent population.

BACKGROUND: A variable percentage of children and adolescents with obesity do not have cardiometabolic comorbidities. A phenotype called metabolically healthy obese (MHO) has emerged to describe this population subgroup. Early identification of this condition may prevent the progression to metabolically unhealthy obesity (MUO). MATERIAL AND METHODS: A cross-sectional descriptive study of 265 children and adolescents from Cordoba (Spain) conducted in 2018. The outcome variables were MHO, established based on three criteria: International Criterion, HOMA-IR, and a combination of the previous two. RESULTS: The prevalence of MHO ranged from 9.4% to 12.8% of the study population, between 41% and 55.7% of the sample with obesity. The highest agreement was reached between the HOMA-IR definitions and the combined criteria. The waist-to-height ratio (WHtR) was the indicator with the highest discriminant capacity for MHO in 2 of the three criteria, with its best cut-off point at 0.47 for both. CONCLUSION: The prevalence of MHO in children and adolescents differed according to the criteria used for diagnosis. The anthropometric variable with the most remarkable discriminating capacity for MHO was WHtR, with the same cut-off point in the three criteria analysed. IMPACT STATEMENT: This research work defines the existence of metabolically healthy obesity through anthropometric indicators in children and adolescents. Definitions that combine cardiometabolic criteria and insulin resistance are used to identify metabolically healthy obesity, as well as the prediction of this phenomenon through anthropometric variables. The present investigation helps to identify metabolically healthy obesity before metabolic abnormalities begin.

Effectiveness of Multicomponent Interventions and Physical Activity in the Workplace to Reduce Obesity: A Systematic Review and Meta-Analysis.

BACKGROUND: Overweight and obesity are public health problems that affects the workplace. This paper aims to analyse the effectiveness of workplace health promotion interventions in reducing Body Mass Index (BMI); Methods: Following PRISMA guidelines, a systematic review was conducted using PubMed, MEDLINE, and SCOPUS databases. The inverse variance statistical method was used for the meta-analysis with a random effects analysis model and standardised means. The results have been represented by Forest Plots and Funnel Plots graphs; Results: The multicomponent approach had the best results for reducing BMI (-0.14 [-0.24, -0.03], 95% CI; p = 0.009) compared to performing physical activity only (-0.09 [-0.39, 0.21], 95% CI; p = 0.56). However, both methods resulted in positive changes in reducing BMI in the general analysis (-0.12 [-0.22, -0.02], 95% CI; p = 0.01). The GRADE evaluation showed low certainty due to the high heterogeneity between interventions (I2 = 59% for overall analysis). CONCLUSIONS: The multicomponent approach could be an effective intervention to reduce obesity in the working population. However, workplace health promotion programs must be standardised to conduct quality analyses and highlight their importance to workers' well-being.

Diagnostic accuracy of the waist-to-height ratio and other anthropometric indices for metabolically healthy obesity in the working population.

Approximately one-third of overweight individuals, and half of those with obesity, do not have cardiometabolic disorders. For this reason, a phenotype called metabolically healthy obese (MHO) has emerged to describe this population group. The early detection of this situation could save costs associated with the development of comorbidities or pharmacological interventions. Therefore, the aim is to know the prevalence of MHO in the working population and propose variables for its detection. Cross-sectional descriptive study of 635 workers of the Cordoba City Council was carried out based on the results of the 2016 health surveillance. The outcome variables were the MHO, established based on the criteria of the IDF, NCEP-ATP III, and Aguilar-Salinas. In addition, the degree of agreement between the different MHO criteria was studied using Cohen's kappa (k), and the predictive capacity of the anthropometric variables was assessed with Receiver Operator Curves. The prevalence of MHO ranged from 6.6 to 9%. The highest agreement was reached between the IDF and NCEP-ATP III definitions (k = 0.811; 95% CI 0.724-0.898; p < 0.001). The waist-to-height ratio (WHtR) showed the highest discriminant capacity for MHO, with its best cut-off point at 0.55 for all criteria used. Sensitivity ranged from 84 to 93%. The prevalence of MHO in the working population differed according to the criteria used for diagnosis. The anthropometric variable with the highest discriminant capacity for MHO was WHtR, presenting the same cut-off point in the three criteria analyzed. Therefore, WHtR is the variable that best detects the presence of MHO.

Association between metabolic syndrome and uric acid: a systematic review and meta-analysis.

This systematic review and meta-analysis aim to provide the best evidence on the association between metabolic syndrome (MetS) and uric acid (UA) by determining the size of the effect of this biomarker on MetS. The review protocol is registered with PROSPERO (CRD42021231124). The search covered the PubMed and Scopus databases. Methodological quality was assessed with the STROBE tool, overall risk of bias with RevMan (Cochrane Collaboration) and quality of evidence with Grade Pro. Initially, 1582 articles were identified. Then, after excluding duplicates and reviewing titles and abstracts, 1529 articles were excluded from applying the eligibility criteria. We included 43 papers (56 groups) comparing UA concentrations between subjects 91,845 with MetS and 259,931 controls. Subjects with MetS had a higher mean UA of 0.57 mg/dl (95% CI 0.54-0.61) (p < 0.00001). Given the heterogeneity of the included studies, the researchers decided to perform subgroups analysis. Men with MetS have a higher UA concentration mg/dl 0.53 (95% CI 0.45-0.62, p < 0.00001) and women with MetS 0.57 (95% CI 0.48-0.66, p < 0.00001) compared to subjects without MetS. Assessment of UA concentration could provide a new avenue for early diagnosis of MetS, as a new biomarker and the possibility of new therapeutic targets.

[Comparison of classic and new anthropometric indexes for the screening of metabolic syndrome on the working population.] / Comparación de índices antropométricos, clásicos y nuevos, para el cribado de Síndrome Metabólico en población adulta laboral.

OBJECTIVE: Metabolic syndrome (MetS) has become a worldwide epidemy as the result of a high prevalence of obesity and a sedentary lifestyle. This study was aimed to determine the predictive capacity of some anthropometric indexes on the metabolic syndrome MetS. METHODS: A cross-sectional study was carried out in 636 workers with an overall prevalence of MetS of 14.3%. Receiver Operating Characteristic curves have been carried out to determine the cut-off values. Diagnostic accuracy was determined from the sensitivity and specificity, predictive values, validity index, and Youden index. RESULTS: Waist-to-Height Ratio (WHtR) and Body Round Index (BRI) were the variables with the highest area under the curve (AUC) both with 0.89 CI 95% (0.858-0.927), followed by Waist Circumference with 0.87 CI 95% (0.83-0.909). The most outstanding cut-off values were: WtHR (0.54), with a sensitivity of 90.1% and a specificity of 76.1% and BRI (4.15) achieved a sensitivity and specificity of 90.1% and 76.1%, respectively. CONCLUSIONS: WHtR and BRI are the anthropometric indicators that best discriminate the incidence and prevalence of MetS on the working population. In addition, they show a significant discriminatory capability of abdominal obesity.

OBJETIVO: El síndrome metabólico (SMet) se ha convertido en una epidemia a nivel mundial, como resultado de una alta prevalencia de obesidad y de un estilo de vida sedentario. El objetivo de este trabajo fue determinar la capacidad predictiva de los índices antropométricos sobre el SMet. METODOS: Se realizó un estudio transversal en una muestra de 636 trabajadores, con una prevalencia global de SMet del 14,3%. Se realizaron Curvas Operador-Receptor para determinar los valores de corte. La precisión diagnóstica se determinó a partir de la sensibilidad y especificidad, los valores predictivos, el índice de validez y el índice de Youden. RESULTADOS: Las variables con mayor área bajo la curva (ABC) fueron el índice cintura-talla (ICT) y el índice de redondez del cuerpo (BRI) con 0,89 (IC 95% 0,858-0,927), seguidos de la circunferencia de cintura (CC) con 0,87 (IC 95% 0,83-0,909). Los valores de corte fueron: ICT=0,54, con una sensibilidad del 90,1% y una especificidad del 76,1%; BRI=4,15, con una sensibilidad y especificidad del 90,1% y 76,1%, respectivamente. CONCLUSIONES: El ICT y el BRI son los indicadores antropométricos que mejor discriminan la incidencia y prevalencia de SMet en población adulta laboral. Además, muestran una importante capacidad discriminatoria de obesidad abdominal.

Comparación de índices antropométricos, clásicos y nuevos, para el cribado de síndrome metabólico en población adulta laboral / Comparison of classic and new anthropometric indexes for the screening of metabolic syndrome on the working population

OBJETIVO: El síndrome metabólico (SMet) se ha convertido en una epidemia a nivel mundial, como resultado de una alta prevalencia de obesidad y de un estilo de vida sedentario. El objetivo de este trabajo fue determinar la capacidad predictiva de los índices antropométricos sobre el SMet. MÉTODOS: Se realizó un estudio transversal en una muestra de 636 trabajadores, con una prevalencia global de SMet del 14,3%. Se realizaron Curvas Operador-Receptor para determinar los valores de corte. La precisión diagnóstica se determinó a partir de la sensibilidad y especificidad, los valores predictivos, el índice de validez y el índice de Youden. RESULTADOS: Las variables con mayor área bajo la curva (ABC) fueron el índice cintura-talla (ICT) y el índice de redondez del cuerpo (BRI) con 0,89 (IC 95% 0,858-0,927), seguidos de la circunferencia de cintura (CC) con 0,87 (IC 95% 0,83-0,909). Los valores de corte fueron: ICT=0,54, con una sensibilidad del 90,1% y una especificidad del 76,1%; BRI=4,15, con una sensibilidad y especificidad del 90,1% y 76,1%, respectivamente. CONCLUSIONES: El ICT y el BRI son los indicadores antropométricos que mejor discriminan la incidencia y prevalencia de SMet en población adulta laboral. Además, muestran una importante capacidad discriminatoria de obesidad abdominal

OBJECTIVE: Metabolic syndrome (MetS) has become a worldwide epidemy as the result of a high prevalence of obesity and a sedentary lifestyle. This study was aimed to determine the predictive capacity of some anthropometric indexes on the metabolic syndrome MetS. METHODS: A cross-sectional study was carried out in 636 workers with an overall prevalence of MetS of 14.3%. Receiver Operating Characteristic curves have been carried out to determine the cut-off values. Diagnostic accuracy was determined from the sensitivity and specificity, predictive values, validity index, and Youden index. RESULTS: Waist-to-Height Ratio (WHtR) and Body Round Index (BRI) were the variables with the highest area under the curve (AUC) both with 0.89 CI 95% (0.858-0.927), followed by Waist Circumference with 0.87 CI 95% (0.83-0.909). The most outstanding cut-off values were: WtHR (0.54), with a sensitivity of 90.1% and a specificity of 76.1% and BRI (4.15) achieved a sensitivity and specificity of 90.1% and 76.1%, respectively. CONCLUSIONS: WHtR and BRI are the anthropometric indicators that best discriminate the incidence and prevalence of MetS on the working population. In addition, they show a significant discriminatory capability of abdominal obesity