Comparison of Ten Surrogate Insulin Resistance and Obesity Markers to Identify Metabolic Syndrome in Mexican Adults.

Metabolic syndrome (MetS) is a group of clinical traits directly linked to type 2 diabetes mellitus and cardiovascular diseases, whose prevalence has been rising nationally and internationally. We aimed to evaluate ten known and novel surrogate markers of insulin resistance and obesity to identify MetS in Mexican adults. The present cross-sectional study analyzed 10575 participants from ENSANUT-2018. The diagnosis of MetS was based on the Adult Treatment Panel III (ATP III) criteria and International Diabetes Federation (IDF) criteria, stratified by sex and age group. According to ATP III, the best biomarker was the metabolic score for insulin resistance (METS-IR) in men aged 20-39 and 40-59 years and lipid accumulation product (LAP) in those aged ≥60 years. The best biomarker was LAP in women aged 20-39 and triglyceride-glucose index (TyG) in those aged 40-59 and ≥60 years. Using the IDF criteria, the best biomarker was LAP in men of all ages. TyG gave the best results in women of all ages. The best biomarker for diagnosis of MetS in Mexican adults depends on the criteria, including sex and age group. LAP and TyG are easy to obtain, inexpensive, and especially useful at the primary care level.

Discordance of metabolic syndrome and abdominal obesity prevalence according to different criteria in Andean highlanders: A community-based study.

AIMS: There is no consensus as to which Metabolic Syndrome (MetS) definition to use for South-American populations. The aim of this study is to compare the prevalence of MetS and abdominal obesity using different criteria in Andean adults aged 40 and older living permanently at high altitude. METHODS: We conducted a cross-sectional study in Chivay (Andean highlands). 237 participants were included. Anthropometric measurements, glucose and lipid assessments were done in all subjects. Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) criteria for MetS were used. Abdominal obesity prevalence was determined using the American Diabetes Association (ADA), IDF, and PREVENCION Study criteria. Cohen's Kappa coefficient (κ) was analyzed to assess agreement level between different criteria. Multiple regression analyses were performed to find predictors for waist circumference. RESULTS: MetS was identified in 28.7% (95%CI=23.8-33.5) using ATPIII criteria, and 37.9% (95%CI=32.7-43.0) using IDF criteria, with higher prevalence in women. The κ statistics for agreement between both criteria was 0.775 (95%CI=0.690-0.859). Abdominal obesity prevalence according to ADA, IDF, and PREVENCION criteria was 35.9% (95%CI=29.7-42.0), 75.9% (95%CI=70.5-81.4), and 42.6% (95%CI=36.3-49.0), respectively. Agreement between ADA and PREVENCION criteria was highest (κ=0.859, 95%CI=0.792-0.925). The strongest predictors for higher waist circumference values were triglycerides and BMI in women, and systolic blood pressure, triglycerides, fasting plasma glucose, and HDL-cholesterol in men. CONCLUSIONS: MetS according to ATP III and IDF criteria was highly prevalent. IDF criteria identified a larger number of subjects with MetS. Different abdominal obesity criteria tended to show variation when applied to our sample population.

Coincidencias y divergencias en las prevalencias del síndrome metabólico según idf y atp III en adultos de caracas / Coincidence and divergence in the prevalence of metabolic syndrome by idf and atp III in adults from caracas

El objetivo del trabajo fue conocer y comparar las prevalencias del Síndrome Metabólico (SM) según los criterios del National Cholesterol Education Program´s Adult Treatment Panel III Report (ATP III) y los de la Federación Internacional de Diabetes (IDF) en adultos. Estudio descriptivo, corte transversal que incluyó a 183 adultos (63 hombres y 120 mujeres), con edades entre 20 y 60 años, de la Universidad Simón Bolívar, Caracas - Venezuela. Se midió peso, talla y circunferencia de cintura punto medio. Se calculó la prevalencia del SM según criterios del ATP III e IDF. Los datos se analizaron, utilizando el paquete estadístico SPSS versión 19. Se calcularon el promedio y la desviación estándar de las variables, para el grupo total y por sexo. Para las diferencias entre género se utilizó la prueba “t” de Student. En las coincidencias y divergencias de las prevalencias del SM por ambos criterios se aplicó el índice de Kappa (p<0,001). Se observó prevalencia de SM entre 13 a 16 % (ATPIII e IDF respectivamente) del grupo total. Por sexo, los hombres obtuvieron una mayor prevalencia (22,2 %ATP III y 27,0% IDF) con respecto a las mujeres (9,2% ATP III y 11,7% IDF) p< 0.001. Existe una alta coincidencia entre ambos métodos (p< 0,001) valores de kappa 0,7 para grupo total. Aun cuando hubo alta coincidencia entre criterios del SM, son necesarios los puntos de cortes para la circunferencia de cintura, para identificar el valor más sensible y específico para el diagnóstico del SM en la población Venezolana(AU)

The objective of the study was to determine and compare the prevalence of metabolic syndrome (MS) according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III Report (ATP III) and the International Diabetes Federation (IDF) in adults. A descriptive, cross-sectional included 183 adults (63 men and 120 women), aged between 20 and 60, from Universidad Simon Bolivar, Caracas - Venezuela. Weight, height and waist circumference midpoint were measured. Prevalence of MS according to ATP III criteria and IDF were calculated. Data were analyzed by SPSS version 19. Mean and standard deviation of the variables for the total group and by gender were calculated. A “t” Student was applied to establish differences by gender. On the similarities and differences in the prevalence of MS by both criteria was applied a Kappa test (p <0.001). The prevalence of metabolic syndrome was between 13-16% (ATP III and IDF respectively) in the total group. By sex, males obtained a higher prevalence (22.2% ATP III and IDF 27.0%) compared to females (9.2% ATP III and IDF 11.7%) p <0.001. There is a high agreement between the two methods (p <0.001) K =0.7 for the total group. Even was found a high agreement between MS criteria, further study of waist circumference cut-off points, to identify the most sensitive and specific value for diagnosis of MS in Venezuelan population(AU)

Effect of a GFOD2 variant on responses in total and LDL cholesterol in Mexican subjects with hypercholesterolemia after soy protein and soluble fiber supplementation.

BACKGROUND: Although dietary treatments can successfully reduce blood lipids in hypercholesterolemic subjects, individual variation in that response has on occasion been linked to allelic differences. SNP rs12449157 has shown association with HDL-C concentrations in GWAS and falls in the glucose-fructose oxidoreductase domain containing 2 (GFOD2) locus. Of interest, previous data suggest that this SNP may be under environmentally driven selection. Thus, the aim of this study was to assess if rs12449157 may mediate the response of lipid traits to a dietary supplementation (DS) with soy protein and soluble fiber in a Mexican population with hypercholesterolemia. METHODS: Forty-one subjects with hypercholesterolemia were given a low saturated fat diet (LSFD) for 1 month, followed by a LSFD+DS that included 25 g of soy protein and 15 g of soluble fiber (S/SF) daily for 2 months. Anthropometric, clinical, biochemical and dietary variables were determined. We analyzed the gene-diet interaction between the GFOD2 genotype, with the minor allele frequency of 0.24, and the DS on total cholesterol (TC) and LDL-C concentrations. RESULTS: Hypercholesterolemic subjects with GFOD2 rs12449157 G allele had higher serum TC and LDL-C at the baseline and showed a greater response to the LSCD+S/SF (-83.9 and -57.5mg/dl, respectively) than those with GFOD2 AA genotype (-40.1 and -21.8 mg/dl, respectively) (P=0.006 for TC, 0.025 for LDL-C, respectively). CONCLUSION: The observed differences in allele-driven, diet-induced changes in blood lipids may be the result of a recent environmentally driven selection on the rs12449157 minor allele. Variation in the GFOD2 gene contributes to the genetic basis for a differential response to a cholesterol- or lipid-lowering diet.

Applicability of the National Cholesterol Education Program III (NCEP-III) Guidelines for treatment of dyslipidemia in a non-Caucasian population: A Mexican Nation-Wide Survey / Aplicabilidad del III Programa Nacional de Educación en Colesterol (NCEP-III). Guías para el tratamiento de la dislipidemia en una población no caucásica: Un estudio en toda la nación mexicana

We assessed the impact of the NCEP-III recommendations in a population-based, nation-wide Mexican survey. Information was obtained from 15,607 subjects aged 20 to 69 years. In this report, only samples obtained after a 9 to 12 hours fast are included (2,201 cases). A cardiovascular risk equivalent was found in 10.5% and > 2 risk factors were present in 41.7% of the population. In 10% of cases, the LDL-C concentration was high enough to be an indication for a lipid-lowering drug (> 160 mg/dL), independent of the presence of risk factors. A quarter of the population was eligible for some form of treatment (lifestyle modifications in 15.9%, drug therapy in an additional 11.7%). Among cases with > 2 risk factors, a small percentage (1.8%) were identified as having a 10 year-risk > 20% and 86.3% were considered as having alO year-risk < 10%. The majority of the metabolic syndrome cases (84%) were identified as low-risk subjects. As a result, only 17.6% of them qualified for drug-based LDL-C lowering. Our data helps to estimate of the magnitude of the burden imposed on the Mexican health system, of lowering LDL-C for cardiovascular prevention. If we apply our results to the 2,000 Mexican population census more than 5.8 million cases nationwide may require LDL lowering drug therapy following the NCEP-III criteria.

Evaluamos el impacto de las recomendaciones del Programa Nacional de Educación en Colesterol (NCEP-III) en muestra poblacíonal. La información proviene de 2,201 sujetos de 20 a 69 años cuyas muestras se obtuvieron después de un ayuno de 9 a 12 horas. Una condición con riesgo cardiovascular equivalente al de la cardiopatía isquémica se encontró en 10.5%; > 2 factores de riesgo se encontraron en 41.7%. El colesterol LDL (LDL-C) fue suficientemente alto (> 160 mg/dL) para indicarse tratamiento hipolipemiante con medicamentos, en ausencia de otros factores de riesgo en 10% de los participantes. El 25% de la población calificó para recibir tratamiento hipolipemiante (cambios del estilo de vida 15.9% y tratamiento farmacológico en 11.7%). En casos con > 2 factores de riesgo, un pequeño porcentaje (1.8%) fue identificado con riesgo mayor a > 20% de tener un evento cardiovascular a 10 años; 86.3% fue identificado con bajo riesgo (< 10% a 10 años). La mayoría de los casos con síndrome metabólíco (84%) fueron identificados en el grupo de bajo riesgo. Como resultado, sólo 17.6% de ellos calificó para disminuir su LDL-C con medicamentos. Nuestros datos demuestran el reto que representa la prevención de complicaciones cardiovasculares por medio de la reducción de la concentración del LDL-C. Extrapolando nuestros datos al censo 2000, más de 5.8 millones de mexicanos califican para recibir tratamiento farmacológico de acuerdo con los criterios del NCEP-III.