Anthropometric indices and their relationship with cardiometabolic risk factors in a sample of Turkish adults

PubMed ID: 18489811Objective: To identify the best anthropometric index that predicts cardiometabolic risk factors. Design and setting: Cross-sectional study in Turkey, in 2003. Subjects: Turkish men and women aged 18 years and over (n 1692) were examined. Body weight, height, waist and hip circumferences, blood pressure, total cholesterol, HDL cholesterol, TAG, glucose and insulin were measured. Metabolic syndrome score was calculated as the sum of modified National Cholesterol Education Program Adult Treatment Panel III criteria, excluding waist circumference. Insulin resistance was estimated by homeostasis model assessment (HOMA-IR). Results: BMI, waist:hip ratio (WHpR), waist:height ratio (WHtR), waist circumference (WC) and hip circumference (HC) were significantly correlated with each other. Partial correlation coefficients between systolic blood pressure, HDL cholesterol, TAG levels or HOMA-IR and BMI, WC or WHtR were similar and higher than correlation coefficients of WHpR and HC. The association of anthropometric indices with metabolic syndrome score and Framingham risk score was highest for WHtR. Areas under the receiver-operating characteristic curves showed that WHtR was the best anthropometric index that discriminated between the presence and absence of hypertension, diabetes and metabolic syndrome, whereas WHpR was better for dyslipidaemia. Conclusions: WHtR was the best anthropometric index for predicting most cardiometabolic risk factors. WC and BMI ranked second for their predictive capability of cardiometabolic risk, followed by WHpR and HC. © The Authors 2008

Comparison between Turkish Cardiovascular Risk Platform and United States National Cholesterol Education Program Adult Treatment Panel III definitions of the metabolic syndrome in Turkish adults

PubMed ID: 19245513The Turkish Cardiovascular Risk Platform (TCRP) calls for the diagnosis of the metabolic syndrome (MS) if insulin resistance, impaired fasting glucose, impaired glucose tolerance, or diabetes mellitus and ? 2 other established criteria are present. TCRP defines insulin resistance as a homeostasis model assessment > 2.7. The aim of this cross-sectional study was to compare TCRP guidelines with the United States National Cholesterol Education Program Adult Treatment Panel III (NCEP) definition of MS in Turkish adults (N = 1690). The age- and sex-adjusted prevalence of MS was 25% with the TCRP and 40% for the NCEP definition. Patients with MS identified by the NCEP definition but not by the TCRP definition had lower body mass index and less insulin resistance, but had a similarly adverse cardiovascular risk factor profile to those with TCRP-identified MS, with high blood pressure, waist circumference, triglycerides, and total cholesterol/high-density lipoprotein cholesterol ratio. Other national health organizations should avoid using homeostasis model assessment as a prerequisite for diagnosing MS. Modification of the NCEP definition would be more appropriate for ethnic groups with different body sizes. © 2009 Wiley Periodicals, Inc

Apolipoprotein A-IMilano. Detection of normal A-I in affected subjects and evidence for a cysteine for arginine substitution in the variant A-I

The A-I(Milano) contains a variant form of apolipoprotein A-I, which unlike normal A-I, has cysteine. We have characterized the A-I(Milano) isoforms in two affected subjects, D.M. and D.G. In these subjects, the two most prominent A-I(Milano) isoforms were displaced from the corresponding normal A-I isoforms by a single charge unit toward the anode, as determined by isoelectric focusing. The amino acid compositions of the purified isoforms, which were separated by either preparative isoelectric focusing or thiopropyl-Sepharose 6B chromatography, indicated that the A-I(Milano) from these subjects contained both a normal A-I (A-I(N)) and a cysteine-containing variant A-I (A-I(Cys)). Furthermore, amino acid analyses suggested that the A-I(Cys) differed from normal A-I by a single cysteine for arginine substitution, which was sufficient to account for the charge difference between the two proteins. Partial sequence analysis revealed that an arginine in normal A-I was replaced by cysteine in the variant A-I at residue 173. Consistent with the amino acid analyses, the cysteine-containing isoforms shifted one charge unit toward the cathode after modification of the cysteine residue with cysteamine. Quantitation of the relative amounts of the A-I(N) and A-I(Cys) in D.M. and D.G. by thiopropyl-Sepharose 6B chromatography revealed that the relative levels were different in each subject. The percentage of the total A-I represented by the A-I(N) in D.M. and D.G. was 16.1 and 25.7%, respectively. The demonstration of variable amounts of normal A-I in A-I(Milano) subjects raises some interesting questions regarding the genetics, regulation, and metabolism of apolipoprotein A-I

Genome-wide linkage and association analyses to identify genes influencing adiponectin levels: the GEMS Study.

Adiponectin has a variety of metabolic effects on obesity, insulin sensitivity, and atherosclerosis. To identify genes influencing variation in plasma adiponectin levels, we performed genome-wide linkage and association scans of adiponectin in two cohorts of subjects recruited in the Genetic Epidemiology of Metabolic Syndrome Study. The genome-wide linkage scan was conducted in families of Turkish and southern European (TSE, n = 789) and Northern and Western European (NWE, N = 2,280) origin. A whole genome association (WGA) analysis (500K Affymetrix platform) was carried out in a set of unrelated NWE subjects consisting of approximately 1,000 subjects with dyslipidemia and 1,000 overweight subjects with normal lipids. Peak evidence for linkage occurred at chromosome 8p23 in NWE subjects (lod = 3.10) and at chromosome 3q28 near ADIPOQ, the adiponectin structural gene, in TSE subjects (lod = 1.70). In the WGA analysis, the single-nucleotide polymorphisms (SNPs) most strongly associated with adiponectin were rs3774261 and rs6773957 (P < 10(-7)). These two SNPs were in high linkage disequilibrium (r(2) = 0.98) and located within ADIPOQ. Interestingly, our fourth strongest region of association (P < 2 x 10(-5)) was to an SNP within CDH13, whose protein product is a newly identified receptor for high-molecular-weight species of adiponectin. Through WGA analysis, we confirmed previous studies showing SNPs within ADIPOQ to be strongly associated with variation in adiponectin levels and further observed these to have the strongest effects on adiponectin levels throughout the genome. We additionally identified a second gene (CDH13) possibly influencing variation in adiponectin levels. The impact of these SNPs on health and disease has yet to be determined

Relation between atherogenic dyslipidemia and the Adult Treatment Program-III definition of metabolic syndrome (Genetic Epidemiology of Metabolic Syndrome Project).

Genetic Epidemiology of Metabolic Syndrome is a multinational, family-based study to explore the genetic basis of the metabolic syndrome. Atherogenic dyslipidemia (defined as low plasma high-density lipoprotein cholesterol with elevated triglycerides (<25th and >75th percentile for age, gender, and country, respectively) identified affected subjects for the metabolic syndrome. This report examines the frequency at which atherogenic dyslipidemia predicts the metabolic syndrome of the National Cholesterol Education Program Adult Treatment Panel III (ATP-III). One thousand four hundred thirty-six (854 men/582 women) affected patients by our criteria were compared with 1,672 (737 men/935 women) unaffected persons. Affected patients had more hypertension, obesity, and hyperglycemia, and they met a higher number of ATP-III criteria (3.2 +/- 1.1 SD vs 1.3 +/- 1.1 SD, p <0.001). Overall, 76% of affected persons also qualified for the ATP-III definition (Cohen's kappa 0.61, 95% confidence interval 0.59 to 0.64), similar to a separate group of 464 sporadic, unrelated cases (75%). Concordance increased from 41% to 82% and 88% for ages < or =35, 36 to 55, and > or =55 years, respectively. Affected status was also independently associated with waist circumference (p <0.001) and fasting glucose (p <0.001) but not systolic blood pressure (p = 0.43). Thus, the lipid-based criteria used to define affection status in this study substantially parallels the ATP-III definition of metabolic syndrome in subjects aged >35 years. In subjects aged <35 years, atherogenic dyslipidemia frequently occurs in the absence of other metabolic syndrome risk factors