OBJECTIVES: To study the relationship between skeletal muscle mass index (SMI) and metabolic phenotypes of obesity in adolescents, and to provide a basis for the prevention and control of adolescent obesity and related metabolic diseases. METHODS: A total of 1 352 adolescents aged 12 to 18 years were randomly selected by stratified cluster sampling in Yinchuan City from October 2017 to September 2020, and they were surveyed using questionnaires, physical measurements, body composition measurements, and laboratory tests. According to the diagnostic criteria for metabolic abnormalities and the definition of obesity based on the body mass index, the subjects were divided into four metabolic phenotypes: metabolically healthy normal weight, metabolically healthy obesity, metabolically unhealthy normal weight, and metabolically unhealthy obesity. The association between SMI and the metabolic phenotypes was analyzed using multivariate logistic regression. RESULTS: The SMI level in the metabolically unhealthy normal weight, metabolically healthy obesity, and metabolically unhealthy obesity groups was lower than that in the metabolically healthy normal weight group (P<0.001). Multivariate logistic regression analysis showed that after adjusting for gender and age, a higher SMI level was a protective factors for adolescents to develop metabolic unhealthy normal weight, metabolically healthy obesity, and metabolically unhealthy obesity phenotypes (OR=0.74, 0.60, and 0.54, respectively; P<0.001). CONCLUSIONS Increasing SMI can reduce the risk of the development of metabolic unhealthy/obesity.
Adolescent ; Humans ; Body Mass Index ; Metabolic Syndrome/metabolism* ; Muscle, Skeletal/metabolism* ; Obesity, Metabolically Benign/diagnosis* ; Pediatric Obesity ; Phenotype ; Risk Factors ; Child

Objective: To evaluate the predictive performance of anthropometric indices for metabolic syndrome (MetS) among Chinese adolescents with different nutritional status. Methods: We recruited 9,513 adolescents aged 10-18 years from seven provinces in China during September 2014. Anthropometric indices and blood pressure were measured at recruitment, and blood samples were collected for determining fasting plasma glucose and lipid profile. Receiver operating characteristic (ROC) analyses were used to assess the predictive performance of anthropometric indices, including body mass index (BMI) percentile, waist circumference percentile, waist-height ratio, and waist-hip ratio. Results: Overall, the four anthropometric indices showed good accuracy for predicting MetS with areas under ROC curves (AUCs) ranging from 0.86 to 0.94; similar AUCs ranging from 0.73 to 0.99 were observed for participants with normal weight. The performance of all four indices was poor in overweight and obese participants, with AUCs ranging from 0.66 to 0.77 and from 0.60 to 0.67, respectively. Waist circumference showed relatively better performance in all the subgroup analyses. Conclusions We suggest using anthropometric indices with the cutoff values presented here for predicting MetS in the overall and normal-weight adolescent population, but not in the overweight and obese adolescent population where more specific screening tests are required.
Adolescent ; Asians ; Body Weights and Measures ; Child ; China ; Cross-Sectional Studies ; Female ; Humans ; Male ; Metabolic Syndrome/diagnosis* ; Nutritional Status ; Randomized Controlled Trials as Topic

PURPOSE: An unresolved inflammatory state contributes to the pathogenesis of periodontal disease and metabolic syndrome (MetS). Therefore, the purpose of this study was to evaluate the role of lipoxin A4 (LXA4), a proresolving lipid mediator, in the association between periodontal disease and MetS. METHODS: Sixty-seven patients with MetS and 65 patients without MetS were included in the study. Sociodemographic information was obtained via a questionnaire, and detailed medical diagnoses were made. Periodontal parameters (plaque index [PI], gingival index [GI], probing pocket depth [PD], and clinical attachment level [CAL]) and metabolic parameters were measured, and serum LXA4 levels were determined. The associations among MetS, periodontal parameters, and serum LX levels were evaluated by adjusted multivariate linear regression analyses. RESULTS: Patients with MetS were older and had a higher body mass index than patients without MetS. Periodontal parameters (PI, GI, PD, and CAL) were higher in patients with MetS than in those without MetS. Serum LXA4 levels were higher in patients without MetS. Multivariate linear regression analysis indicated a positive association between MetS and periodontal parameters (PD and CAL). Negative associations were established between MetS and LXA4 levels, and between LXA4 and periodontal parameters (PI, PD, and CAL). CONCLUSIONS: The presence of higher values of periodontal parameters in patients with MetS and the negative relationship of LXA4 with MetS and periodontal disease may support the protective role of proresolving lipid mediators in the association between periodontal disease and MetS.
Body Mass Index ; Diagnosis ; Humans ; Inflammation ; Linear Models ; Lipoxins ; Metabolic Syndrome X ; Periodontal Diseases ; Periodontal Index

OBJECTIVES: This study aimed to identify the sex-based association between depression and the development of metabolic syndrome (Mets) among middle-aged and older Korean adults. METHODS: A cross-sectional design was used for the secondary analysis of the 2010–2014 Korean National Health and Nutrition Examination Survey. Data from 1,938 men and 2,404 women were analyzed. Mets was defined in accordance with the criteria used for clinical diagnosis. Depression was assessed with a question about having clinical depression. The association between depression and the development of Mets with or without adjustment for covariates was identified by conducting logistic regression analysis on weighted data using a complex sample procedure. RESULTS: More women than men had depression. Before covariate adjustment, depression was significantly associated with the development of Mets among women (odds ratio [OR], 1.586; 95% confidence interval [CI], 1.152–2.183) and with a higher triglyceride level among men (OR, 1.679; 95% CI, 1.001–2.818). After covariate adjustment; depression was significantly associated with higher waist circumference among women (adjusted OR [AOR], 1.532; 95% CI, 1.046–2.245) and higher triglyceride level (AOR, 1.511; 95% CI, 1.029–2.219) than was Mets. Conversely, depression did not have significant effects on the development of Mets among men. CONCLUSION: Depression was associated with the development of Mets among middle-aged and older Korean women. Healthcare providers in communities should assess women with depression for the presence of Mets components. Interventions for relieving depressive symptoms should also be provided to women at risk for Mets.
Adult* ; Depression* ; Diagnosis ; Female ; Health Personnel ; Humans ; Logistic Models ; Male ; Metabolic Syndrome X ; Nutrition Surveys ; Sex Characteristics ; Triglycerides ; Waist Circumference

Hepatocellular carcinoma (HCC) is one of the most common life-threatening cancers worldwide. Recently, many patients with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) have progressed to HCC even in the absence of cirrhosis. As the morbidity of metabolic syndrome increases, the proportion of HCC associated with NAFLD is expected to increase gradually. A new mechanism for the development of HCC in NAFLD has been identified; Diabetes mellitus, insulin resistance, obesity, lipotoxicity, gut dysbiosis are risk factors. Inflammatory cytokines such as adipokines, leptin, tumor necrosis factor-α, interlukin-8, nuclear factor-κB constitute dysplasia-carcinoma sequence. At the time of diagnosis, NAFLD/NASH related HCC tend to progress to larger and in advanced tumor-node-metastasis stages compared to viral hepatitis related HCC. But there are no guidelines for early detection of NAFLD-related HCC. So, it is essential to study the screening program for the early detection of NAFLD-related HCC and precise methods for NAFLD.
Adipokines ; Carcinoma, Hepatocellular* ; Cytokines ; Diabetes Mellitus ; Diagnosis ; Dysbiosis ; Fatty Liver ; Fibrosis ; Hepatitis ; Humans ; Insulin Resistance ; Leptin ; Mass Screening ; Metabolic Syndrome X ; Necrosis ; Non-alcoholic Fatty Liver Disease* ; Obesity ; Risk Factors

BACKGROUND/AIMS: This study evaluated the relationship between thyroid nodules and metabolic syndrome (MS) and its components in apparently healthy Koreans. METHODS: We reviewed the records of 3,298 subjects with no noticeable symptoms who underwent thyroid ultrasound imaging as part of a routine check-up between July 2009 and June 2010; of these, 1,308 were excluded based upon predefined criteria. Among the remaining 1,990 patients, we examined the association between MS and its components and the incidence of thyroid nodules. RESULTS: Of the 1,990 subjects included in this study, 38.4% (n = 764) had thyroid nodules and 12.7% (n = 253) had MS. Female sex, older age, higher body mass index, larger waist circumference, higher glycated hemoglobin level, lower thyroid stimulating hormone level, and presence of MS were all closely related with the presence of thyroid nodules (all p < 0.05). Furthermore, the relevant number of MS components showed a positive linear correlation with the occurrence of thyroid nodules (p < 0.001). Evidence of MS alone was not independently associated with thyroid nodules after adjusting for sex and age in a multivariate binary logistic regression analysis; however, glycated hemoglobin for females and waist circumference for males, as well as both age and thyroid stimulating hormone for all patients, were identified as independent predictors for the existence of thyroid nodules (all p < 0.05). CONCLUSIONS: This study suggests a positive relationship between the components of MS and thyroid nodules in an ostensibly healthy Korean population. Our data support the idea that the recent increase in thyroid nodules is partly due to increases in both MS and obesity.
Adult ; Biomarkers/blood ; Body Mass Index ; Chi-Square Distribution ; Cross-Sectional Studies ; Diabetes Mellitus/diagnosis/epidemiology ; Female ; Hemoglobin A, Glycosylated/analysis ; Humans ; Incidence ; Linear Models ; Logistic Models ; Male ; Metabolic Syndrome X/blood/diagnosis/*epidemiology ; Middle Aged ; Multivariate Analysis ; Obesity/diagnosis/epidemiology ; Odds Ratio ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Thyroid Nodule/blood/diagnostic imaging/*epidemiology ; Thyrotropin/blood ; Waist Circumference

OBJECTIVEThis study explored the correlation of longitudinal changes in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels with the incidence of metabolic syndrome (Mets) based on a dynamic health examination cohort.

METHODSA Mets-free dynamic cohort involving 4541 participants who underwent at least three health examinations from 2006 to 2011 was included in the study. Mets was defined according to the Chinese Medical Association Diabetes Branch definition that included hypertension, obesity, hyperlipidemia, and hyperglycemia. Generalized estimating equation (GEE) model was used to analyze multivariate relative risk (RR) of repeated observations of ALT and AST in quartiles for Mets or its components according to gender.

RESULTSIn all, 826 Mets cases were reported. Adjustment of relevant parameters indicated that time-varying changes in ALT and AST levels were positively associated with the incidence of Mets in a dose-response manner. Positive association between high ALT levels and fatty liver was much stronger than that between high AST levels and fatty liver, particularly in male participants. These associations were consistently observed in the following subgroups: participants with ALT and AST levels of <40 U/L, participants with of <25 kg/m2, and participants with non-fatty liver. Furthermore, participants with 2 Mets components at baseline showed lower multivariate adjusted RRs of ALT and AST for Mets than participants with 0-1 Mets component.

CONCLUSIONThese results suggested that elevated serum ALT and AST levels were early biomarkers of Mets or its components.

Adult ; Aged ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Biomarkers ; blood ; China ; epidemiology ; Cohort Studies ; Female ; Hepatitis ; complications ; epidemiology ; etiology ; Humans ; Incidence ; Liver ; enzymology ; physiopathology ; Male ; Metabolic Syndrome ; complications ; diagnosis ; enzymology ; epidemiology ; Middle Aged ; Young Adult

The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing rapidly with the obesity and diabetes mellitus epidemics. It is rapidly becoming the most common cause of liver disease worldwide. NAFLD can progress to serious complications such as cirrhosis, hepatocellular carcinoma and death. Therefore, it is important to recognise this condition so that early intervention can be implemented. Lifestyle modifications and strict control of metabolic risk factors are the mainstay of treatment. As disease progression is slow in the majority of NAFLD patients, most can be managed well by primary care physicians. NAFLD patients with advanced liver fibrosis should be referred to specialist care for further assessment.
Carcinoma, Hepatocellular ; pathology ; Diet ; Disease Progression ; Humans ; Life Style ; Liver ; pathology ; Liver Cirrhosis ; pathology ; Liver Neoplasms ; pathology ; Metabolic Syndrome ; complications ; Non-alcoholic Fatty Liver Disease ; diagnosis ; therapy ; Obesity ; complications ; Prevalence ; Risk Factors ; Treatment Outcome

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease seen in patients with obesity, diabetes, and metabolic syndrome. Metabolic syndrome is an important predictor of the severe form of NAFLD, nonalcoholic steatohepatitis (NASH), and NASH patients with diabetes have an increased risk of liver cirrhosis and hepatocellular carcinoma. With the prevalence of obesity and diabetes around the world, NAFLD has become a global public health problem. NAFLD is not only one of the most important causes of liver-related disability and mortality, but also associated with the increasing incidence of diabetes and cardiovascular disease. The effective prevention and treatment of NAFLD is expected to reduce the burden of liver disease and cardiovascular disease. Therefore, this article overviews the advances in the diagnosis, prevention, and treatment of NAFLD.
Carcinoma, Hepatocellular ; epidemiology ; Cardiovascular Diseases ; epidemiology ; Diabetes Mellitus ; epidemiology ; Humans ; Liver Cirrhosis ; epidemiology ; Liver Neoplasms ; epidemiology ; Metabolic Syndrome ; epidemiology ; Non-alcoholic Fatty Liver Disease ; diagnosis ; epidemiology ; therapy ; Obesity ; epidemiology ; Prevalence

OBJECTIVETo investigate the relationship among serum reproductive hormone levels, serum homocysteine (Hcy) levels, metabolic syndrome (MS), and the components of MS in middle-aged and elderly males.

METHODSUsing the cluster and stratified sampling methods and a unified structured questionnaire, we conducted a survey among 948 men aged 40 - 80 years in the rural community, measured their basic physical parameters, and obtained their reproductive hormone levels, serum Hcy concentrations, and metabolism-related indicators. We collected 868 valid questionnaires along with their serum samples, divided the subjects into an MS and a non-MS control group in a 1:1 ratio, and measured their serum Hcy concentrations.

RESULTSAmong the subjects included, 132 were diagnosed with MS. Nonparametric tests showed statistically significant differences between the MS and non-MS groups in the waist circumference (WC), waist-hip ratio (WHR), body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) (P < 0.05), but not in age (P > 0.05). Significant differences were also observed between the two groups in the levels of serum tT, SHBG, LH, and FTI (P < 0.05) , but not in the concentrations of serum Hcy (P > 0.05). The concentration of serum Hcy exhibited no correlation with BMI, SBP, DBP, FBG, TG, and HDL-C (P > 0.05) and had no influence on MS.

CONCLUSIONThe concentration of serum Hcy is not significantly correlated with MS, nor with its components. The levels of male serum reproductive hormones are associated both with MS and with its components.

Adult ; Aged ; Blood Pressure ; Body Mass Index ; Homocysteine ; blood ; Humans ; Luteinizing Hormone ; blood ; Male ; Metabolic Syndrome ; blood ; diagnosis ; Middle Aged ; Reproduction ; Rural Population ; Sex Hormone-Binding Globulin ; metabolism ; Surveys and Questionnaires ; Testosterone ; blood ; Thyroxine ; blood ; Waist Circumference ; Waist-Hip Ratio