Clustering of metabolic syndrome factors in Malaysian population: Asian criteria revisited

Introduction: Metabolic syndrome (MetS) had been known as clustering of risk factors for cardiovascular disease and diabetes. Over the years, clinical criteria had been revised to highlight importance of various risk factors in defining MetS. Studies had reported different clustering of factors based on different population characteristics. Objective: Our study aimed to identify the clustering factors among our Malaysian population based on sexes and 4 major ethnic groups namely Malay, Chinese, Indian and other minor ethnic Methods: A national cross sectional study was done covering both Peninsular and East Malaysia. Subjects� sociodemographic, body mass index (BMI), waist, hip and neck circumference, blood pressure, fasting triglycerides (TG) and HDL-cholesterol and glucose, urine microalbumin and serum insulin were taken. Principal component factor analysis with Varimax rotation was done to identify the clustering based on sex and ethnic groups. Results: One thousand two hundred and sixty eight male and 2355 female subjects were recruited. Majority of subjects were Malays (63.0) followed by Chinese (13.3), Indian (7.4) and other ethnic groups (13.8) which followed the population composition in Malaysia. Four factors were identified for both men and women. The factors were anthropometry, glycemia, blood pressure and dyslipidemia given the cumulative percent of variance of 69.4 and 65.9 respectively. There are 4 factors identified for Malay, Chinese and Aborigines but 5 factors for Indian ethnic groups given cumulative percent of variance explained ranged from 65.1 to 77.7. Discussion and Conclusion: BMI, neck circumference, blood pressure, Fasting TG and HDL had a high factor loading in both sexes suggesting that for field screening, diagnostic criteria would be adequate criteria. These factors also showed a similar pattern of loading by different ethnic groups. In conclusion,in Malaysian population, at least one measurement from each components namely anthropometric, blood pressure, glycemia and dyslipidemia is adequate to diagnose MetS

Predictors of ischaemic heart disease in a Malaysian population with the metabolic syndrome

Aims Cardiovascular disease is the foremost cause of mortality in Malaysia but little is known about the prevalence of the metabolic syndrome and its associations with other known cardiovascular risk markers. We undertook a population-based study to examine these. Methods For the study, 4341 subjects were selected using a multistage stratified sampling method. Subjects were interviewed for personal and past medical history. Biomedical markers and anthropometric indices were measured. The metabolic syndrome was defined using the harmonized criteria. The associations between the metabolic syndrome and cardiovascular risk markers, including high-sensitivity C-reactive protein, microalbuminuria and HbA1c were examined. Results The prevalence of the metabolic syndrome was 42.5. Subjects with the metabolic syndrome are significantly more likely to have higher BMI (> 25 kg/m2), HbA1c = 42 mmol/mol (6.0%), LDL (= 2.6 mmol/l), elevated albumin:creatinine ratio (> 2.5 mu g/mmol creatinine for men, 3.5 mu g/mmol creatinine for women) and high-sensitivity C-reactive protein (> 3 mg/l); odds ratio 5.48, 6.14, 1.44, 3.68 and 1.84, respectively, P 48 mmol/mol (6.5%) is associated with increased relative risk of elevated albumin:creatinine ratio, high-sensitivity C-reactive protein and LDL (relative risk 3.10, 2.46 and 1.65 respectively, P < 0.001). Conclusions We confirmed the high prevalence of the metabolic syndrome in Malaysia. Our study revealed a strong relationship between risk markers of elevated BMI, HbA1c, LDL, albumin:creatinine ratio and high-sensitivity C-reactive protein with the presence of the metabolic syndrome, putting them at a statistically high risk for cardiovascular mortality