Predictor of Metabolic Syndrome: A community study from Urban Delhi, India

Authors

  • Astha Bansal Department of Anthropology, University of Delhi
  • P.C. Joshi Department of Anthropology, University of Delhi, India

Keywords:

Sunni Muslims, Urban Population, Metabolic Syndrome

Abstract

The aim of the present study is to assess and compare the presence of metabolic syndrome using IDF and Modified NCEP ATPIII criteria among Sunni Muslim of Delhi and to determine the optimal cut off values of different parameters for the detection of metabolic syndrome. A total of, 406 individuals (125 men, 281women) aged 35-65 years were recruited. Anthropometric, blood pressure and laboratory investigations were performed following the standard protocols. Receiver operating characteristics (ROC) curves of waist circumference, serum triglycerides, High density lipoprotein cholesterol, systolic and diastolic blood pressure and fasting blood glucose were created for the determination of the metabolic syndrome and the area under curve (AUC) was evaluated to determine the predictive efficiency of each variable of metabolic syndrome. The cut off values of each parameter with corresponding sensitivity, specificity, Youden index and likelihood ratios were estimated.  

The overall metabolic syndrome assessed through Modified NCEP ATP III was 75.12% while through IDF criterion it was 75.36%. Majority of the participants were equally identified by both definitions. The metabolic syndrome was higher in women as compare to men using both the criteria. The area under curve (AUC) shows that serum triglycerides have highest predictive ability for metabolic syndrome in modified NCEP ATP III and IDF. The population specific cut off values of different variable to detect metabolic syndrome was formed. Although these result may not apply to rest of Indian population due to multi ethnicity but similar studies with large sample size to find the cut off values of parameter for metabolic syndrome is needed for better detection and prevention. 

 

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Author Biographies

Astha Bansal, Department of Anthropology, University of Delhi

Department of Anthropology 

University of Delhi 

Senior Research Scholar

P.C. Joshi, Department of Anthropology, University of Delhi, India

Department of Anthropology, University of Delhi, India

Professor

References

American Heart Association.(1981).Report of subcommittee of post graduate education committee recommendation for human blood pressure determination of sphygmomanometer. Circulation , 64: 510-599

Anjana, R.M., Ali, M.K., Pradeepa, R., Deepa, M., Datta, M., Unnikrishnan, R., et al. (2011) The need for obtaining accurate nationwide estimates of diabetes prevalence in India-Rationale for a national study on diabetes. Indian J Med Res 133,369-80.

Alberti, K.(1996) Impaired glucose tolerance — fact or fiction. Diabet Med 13, 6–8.

Bohning, D., Bohning, W., Holling, H. (2008) Revisiting Youden’s index as a useful measure of the misclassification error in meta analysis of diagnostic studies. Statistical Methods in Medical Research 3, 1–12

Bewick, V., Cheek, L., Ball, J. (2004) Statistics review 13: receiver operating characteristics curves. Critical Care 8, 508–512

Balkau, B., Shipley, M., Jarrett, R.J., Pyorala, K., Pyorala, M., Forhan, A. et al.(1998) High blood glucose concentration is a risk factor for mortality in middle-aged non-diabetic men. 20-year follow-up in the Whitehall Study, the Paris Prospective Study, and the Helsinki Policemen Study.Diabetes Care 21, 360–367.

Chiba, Y., Saitoh, S., Takagi, S., Ohnishi, H., Katoh, N., Ohato, J., et al(2007)Relationship between visceral fat and cardiovascular disease risk factor: The Tanno and Sobetsu Study. Hypertens Res 30, 229–36.

Charles, M., Fontbonne, A., Thibult, N., Warnet, J.M., Rosselin, G., Eschwege, E. (1991) Risk factors for NIDDM in white population. Paris Prospective Study. Diabetes 40, 796–799

Després, J.P., Lemieux, I., Bergeron, J., Pibarot, P., Mathieu, P., Larose, E., et al.(2008) Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arterioscler Thromb Vasc Biol 28, 1039–49.

Edelstein, S., Knowler, W., Bain, R., Andres, R., Barrett-Connor, E., Dowse, G et al(1997) Predictors of progression from impaired glucose tolerance to NIDDM. An analysis of six prospective studies. Diabetes 46, 701–710.

Gupta, R., Deedwania, P.C., Gupta, A., Rastogi, S., Panwar, R.B., Kothari, K. (2004) Prevalence of metabolic syndrome in an Indian urban population. Int J Cardiol 97, 257-61.

Gupta, R., Misra, A. (2007) Type 2 diabetes in India: Regional disparities. Br J Diabetes Vasc Dis 7, 12-6.

Gandhi, B.M. (1982) Lipoprotein composition of normal healthy subjects in northern India; India J Med. Res 75,393-401

Gupta, R., Prakash, H.(1997) Assessment of dietary ghee intake with coronary heart disease and risk factor prevalence in rural male. J. Indian. Med Association 95, 67-69

Goswami, K., Bandopadhyaya, A.(2003) Lipid profile in middle class Bengali population of Kolkata. Indian journal of clinical biochemistry 18, 127-130

Hydrie, M.Z., Shera, A.S., Fawwad, A., Basit, A., Hussain, A. (2009) Prevalence of metabolic syndrome in urban Pakistan (Karachi): comparison of newly proposed International Diabetes Federation and modified Adult Treatment Panel III criteria. Metab Syndr Relat Disord 7,119-24.

Heng, D., Ma, S., Lee, J.J.M., Tai, B.C., Mak, K.H., Hughes, K., et al.(2006) Modification of the NCEP ATP III definitions of the metabolic syndrome for use in Asians identifies individuals at risk of ischemic heart disease. Atherosclerosis 186, 367-73.

Hanley, J.A., M.c.Neil, B.J. (1982) The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 143, 29-36.

Isles, C.G., Hole, D.J., Hawthorne, V.M., Lever, A.F. (1992) Relation between coronary risk and coronary mortality in women of the Renfrew and Paisley survey: comparison with men. The Lancet 339,702-6.

Jesmin, S., Islam, R., Islam, S., Mia, S., Sultana, S.N., Zaedi, S. et al. (2012) Comprehensive assessment of metabolic syndrome among Rural Bangladeshi Women. BMC Public Health 12,49.

Jhala, C.I., shaha, TK, Naik, B.K., Dalfda, J.D.(1998) A study of serum lipid profile part 1 establishment of normal reference value of serum lipid level in healthy vegetarian population of Gujarat. Ind J, clin biochem, 13, 1-7

Khanam, M.A., Qiu, C., Lindeboom, W., Streatfield, P.K., Kabir, Z.N., Wahlin, A.(2011)The Metabolic Syndrome: Prevalence, Associated Factors, and Impact on Survival among Older Persons in Rural Bangladesh. PLoS ONE 6, 20259

Lohman, T., Roche, A. F. & Martorell, R. (1988) Anthropometric Standardization Reference Manual. Human Kinetics Publication, Chicago.

Laakso, M., Lehto , S.(1998) Epidemiology of risk factors for cardiovascular disease in diabetes and impaired glucose tolerance. Atherosclerosis, 137,65–73.

Misra, A., Misra, R. (2003) Asian Indians and insulin resistance syndrome: Global perspective. Met Syndr Relat Disord 1, 277-85.

Misra A., Khurana, L. (2009) The Metabolic Syndrome in South Asians: Epidemiology, Determinants, and Prevention. Metab Syndr Relat Disord 7, 497-514.

Misra, A., Khurana, L. (2009) The metabolic syndrome in South Asians: Epidemiology, clinical correlates and possible solutions. International Diabetes Monitor 21, 92-101.

Mohan, V., Rao, G.H.R. (2007) Type 2 Diabetes in South Asians. 1st ed. New Delhi: South Asian Society on Atherosclerosis and Thrombosis

Misra, A., & Vikram, N., K. (2008) Factor, definitions, predictive value & Asian Indian ethnicity: Complexities of the metabolic syndrome. Indian J Med Res 127,293-296

Mabry, R.M., Reeves, M.M., Eakin, E.G., Owen, N.(2010) Gender differences in prevalence of the metabolic syndrome in Gulf Cooperation Council Countries: a systematic review. Diabet Med 27, 593-7.

Mohan, V., Deepa, R.(2006) Obesity and abdominal obesity in Asian Indians. Indian J Med Res 123 , 593-6

Prasad, D.S., Kabir, Z., Dash, A.K., Das, B.C. (2011) Abdominal obesity, an independent cardiovascular risk factor in Indian subcontinent: A clinico epidemiological evidence summary. J Cardiovasc Dis Res. 2,199-205.

Prasad, D. S., Kabir, Z., Dash, A. K., Das, B.C. (2010).Cardiovascular risk factors in developing countries: A review of clinico-epidemiological evidence. CVD Prev Control 5 , 115-23.

Perkins, N. J., Schisterman, E.F. (2006) The inconsistency of “optimal” cut points obtained using two criteria based on the receiver operating characteristic curve. The American Journal of Epidemiology 163, 670–675

Rao, G.H.R., Thanickachalam, S. (2005) Coronary Artery Disease: Risk Promoters, Pathophysiology and Prevention. 1st ed. New Delhi: South Asian Society on Atherosclerosis and Thrombosis

Shah, B., Mathur, P. (2010) Surveillance of cardiovascular disease risk factors in India: The need & scope. Indian J Med Res 132 , 634-42

Sone, H., Mizuno, S., Fujii, H., Yoshimura, Y., Yamasaki, Y., Ishibashi S et al. ( 2005) Is the diagnosis of metabolic syndrome useful for predicting cardiovascular disease in Asian diabetic patients? Analysis from the Japan Diabetes Complications Study. Diabetes Care 28, 1463–1471.

Saltiki, K., Cimponeriu, A., Lili, K., Peppa, M., Anastasiou, E., Alevizaki, M (2008) Severity of coronary artery disease in postmenopausal diabetic women. Hormones (Athens)7, 148-55.

Sam, S., Haffner, S., Davidson, MH., D’Agostino, R.B., Feinstein, S., Kondos, G, et al.(2009) Hypertriglyceridemic waist phenotype predicts increased visceral fat in subject with type 2 diabetes. Diabetes Care 32,1916–20.

Shaw, J., Zimmet, P., de Courten, M., Dowse, G., Chitson, P., Gareeboo, Het al.(1999) Impaired fasting glucose or impaired glucose tolerance. What best predicts future diabetes in Mauritius? Diabetes Care 22, 399–402.

Stamler, J., Vaccaro, O., Neaton, J.D., Wentworth, D.(1993) Diabetes, other risk factors, and 12-year cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 16, 434–444.

Tillin, T., Forouhi, N., Johnston, D.G., McKeigue, P.M., Chaturvedi, N., Godsland, IF. (2005) Metabolic syndrome and coronary heart disease in South Asians, African-Caribbeans and white Europeans: a UK population-based cross-sectional study. Diabetologia 48,649–656.

Tan, C.E., Ma, S., Wai, D., Chew, S.K., Tai, E.S. (2004) Can we apply the national cholesterol education program adult treatment panel definition of the metabolic syndrome to asians? Diabetes Care 27,1182–1186.

Takeuchi, H., Saitoh, S., Takagi, S., Ohnishi, H., Ohhata, J., Isobe, T et al. (2005) Metabolic syndrome and cardiac disease in Japanese men: applicability of the concept of metabolic syndrome defined by the National Cholesterol Education Program-Adult Treatment Panel III to Japanese men – the Tanno and Sobetsu Study.Hypertens Res 28, 203–208.

Tunstall-Pedoe, H., Woodward, M., Tavendale, R., A’Brook, R., McCluskey, M.K.(1997) Comparison of the prediction by 27 different factors of coronary heart disease and death in men and women of the Scottish Heart Health Study: Cohort study. BMJ 315, 722-9.

Wasir, J.S., Misra, A., Vikram, N.K., Pandey, R.M., Gupta R. (2008) Comparison of definitions of the metabolic syndrome in adult Asian Indians. J Assoc Physicians India 56 , 158-64.

Wasir, J.S., Misra, A. (2004) The metabolic syndrome in Asian Indians: the impact of nutritional and socio-economic transition in India. Met Syndr Relat Disord 2,14-23.

Wasir, J.S., Misra, A., Vikram, N.K., Pandey, R.M., Gupta, R.(2008) Comparison of definitions of the metabolic syndrome in adult Asian Indians. J Assoc Physicians India. 56,158-64.

Zimmet, P., Magliano, D., Matsuzawa, Y., Alberti, G., Shaw, J. (2005) The metabolic syndrome: a global public health problem and a new definition. J Atheroscler Thromb 12, 295-300.

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Published

2015-06-03

How to Cite

Bansal, A., & Joshi, P. (2015). Predictor of Metabolic Syndrome: A community study from Urban Delhi, India. Journal of Human Sciences, 12(1), 1451–1462. Retrieved from https://j-humansciences.com/ojs/index.php/IJHS/article/view/3289

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Section

Anthropology