Authors

  • M. Badritdinova
    Bukhara State Medical Institute

DOI:

https://doi.org/10.71337/inlibrary.uz.ijms.114381

Abstract

The prevalence of the components of metabolic syndrome in the studied population is significantly higher, and both the overall prevalence of metabolic syndrome and its individual components increase with age. The most pronounced rise in metabolic syndrome and its components is observed after the age of 40, while the distribution dynamics of individual components remain unclear. In addition to cholesterol and beta-lipoprotein levels, a correlation is observed between body mass parameters and the investigated risk factors.

 

 

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AGE-RELATED TRENDS AND RISK FACTOR INTERRE-LATIONS IN

METABOLIC SYNDROME

Badritdinova M.N.

Bukhara State Medical Institute

email: matluba_badritdinova@bsmi.uz

https://orcid.org/0000-0002-7814-4106

Abstract:

The prevalence of the components of metabolic syndrome in the studied

population is significantly higher, and both the overall prevalence of metabolic syndrome

and its individual components increase with age. The most pronounced rise in metabolic

syndrome and its components is observed after the age of 40, while the distribution

dynamics of individual components remain unclear. In addition to cholesterol and beta-

lipoprotein levels, a correlation is observed between div mass parameters and the

investigated risk factors.

Key words:

Arterial hypertension, obesity, hyperlipidemia, diabetes mellitus.

Relevance

A substantial div of international research highlights the multifactorial nature of metabolic

syndrome (MS) and its key role in the development and progression of cardiovascular

diseases (CVD), including ischemic heart disease (IHD). MS is recognized as one of the

major contributors to morbidity and is strongly associated with a heightened risk of

comorbid conditions. According to the literature, individuals with MS are more prone to

developing CVDs, which tend to present more severely and are more frequently complicated

by myocardial infarction and stroke than in individuals without MS. Furthermore, MS has

been identified as a risk factor for numerous other diseases [1,2].

In addition to the known impact of hypercholesterolemia (HC) on IHD development,

increasing attention is being paid to the so-called lipid triad: hypertriglyceridemia (HTG),

hyper-beta-lipoproteinemia (HβLP), and reduced alpha-cholesterol levels. The pivotal role

of diabetes mellitus (DM) in IHD pathogenesis is also well-established [1,3,5], with DM

often developing in individuals with prior impaired glucose tolerance (IGT). Notably, IGT is

closely linked with insulin resistance and can be considered a pre-diabetic state [4,7,8]. This

underlines the importance of early detection of hyperglycemia as a potential avenue for

understanding the pathogenesis and improving the prevention of IHD.

Recent global discussions have increasingly focused on the pathophysiological connections

between insulin resistance and the major risk factors for chronic non-communicable diseases.

Insulin resistance is now considered the central mechanism of MS, significantly contributing

to the development and outcomes of IHD when combined with other risk factors. Given the

considerable increase in CVD mortality associated with MS, it has been referred to as the

“deadly quartet” (Kaplan J., 1989) and later as the “deadly sextet” (Enzi G., 1994). Despite

the wide range of conditions proposed by researchers as components of MS, international


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guidelines generally define its core elements as hypertension, elevated BMI or obesity,

hyperlipidemia, and diabetes or impaired glucose tolerance [11,12,15].

Aim of the study:

To assess the dynamics of risk factor prevalence in individuals with

metabolic syndrome.

Materials and methods:

A total of 110 patients were enrolled to study the progression of risk factors associated with

metabolic syndrome by monitoring its primary components. The cohort included 60 men

and 50 women. Gender distribution is shown in Table 1.

Table 1.

Distribution of patients by sex and age

Group

Age Range

Men

Women

Total

I

20–80 yrs

30

25

55

II

20–80 yrs

30

25

55

Total

60 (54.5%)

50 (45.5%)

110

Within this study, we analyzed the dynamics of average values of key risk factors. The

results revealed varying trends across different parameters (Table 2). In addition to a decline

in blood pressure levels, reductions were also noted in postprandial glucose levels measured

2 hours after a glucose challenge, as well as in glucose levels measured at the 1-hour mark.

Notably, both systolic and diastolic blood pressure levels showed significant reductions.

However, no marked differences were found between the rates of change in systolic and

diastolic pressures.

A slight increase in fasting glucose levels and a decrease in the Quetelet Index (QI) were

observed, though these changes were not statistically significant. Glucose levels 2 hours

post-challenge increased by 14.42 mg%, whereas a reduction of 17.52 mg% was noted 1

hour after the glucose challenge. Although the frequency of elevated BMI decreased, this

did not correspond to a significant reduction in the Quetelet Index. To better understand this

discrepancy, we examined the dynamics of QI across normal and overweight groups. The

average QI decreased from 0.259 to 0.241 (p<0.05) with increasing div mass.

Table 2.

Blood pressure, Quetelet Index, and glycemia

Parameter

Group I

Group II


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SBP (mmHg)

121.63

114.37

DBP (mmHg)

92.13

77.87

Quetelet Index (QI)

0.259

0.241

Fasting glucose (mg%)

6.28

56.72

1h post-load glucose

8.86

7.14

2h post-load glucose

7.04

61.96

Cholesterol (mg%)

77.14

32.86

Triglycerides (mg%)

82.36

27.64

Beta-lipoproteins (mg%)

85.51

24.49

The average dynamics of lipid levels largely paralleled the prevalence of hyperlipidemia.

While increases in triglycerides and beta-lipoproteins were noted, cholesterol levels showed

a decreasing trend. With age, increases in both systolic and diastolic blood pressure were

observed. Additionally, the prevalence of hyperglycemic conditions rose with advancing age.

It was found that the incidence of diabetes mellitus (DM) and second-phase abnormalities in

glucose curves rose with age, whereas the frequency of first-phase abnormalities declined.

The observed decrease in BMI prevalence with age did not adequately reflect changes in

div composition, which warranted further analysis of the Quetelet Index in normal and

overweight groups.

The frequency and intensity of risk factors (RFs) increased with age, justifying the need for

targeted early detection and preventive measures. Notably, the combination of RFs increased

most significantly between the 30–39 and 40–49 age groups. However, in older groups, this

increase plateaued. Interestingly, no metabolic syndrome cases were observed in the 20–29

age range. As the number of unidentified RFs decreased with age, there was a shift in the

profile of existing RFs, indicating a correlation between age and the number or combination

of RFs.

Additionally, the interrelationships between various RFs were explored (Table 3). While a

significant correlation existed for most variables, QI showed no clear association with

cholesterol or beta-lipoprotein levels.

Table

3.

Correlation coefficients between blood pressure, Quetelet Index, and glycemia

SBP

DBP

QI

Cholest

erol

TG

Beta-

LP

Fasting

Glu

1h Glu 2h

Glu

DBP

0.77 *

Quetelet

Index

(QI)

0.35 ** 0.45 *

Cholester

0.1 *

0.03

0.01


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ol

Triglyceri

des (TG)

0.2 *

0.09

0.11 *

0.45 *

Beta-

lipoprotei

ns

0.12 *

0.06

0.08

0.61 *

0.34

*

Fasting

glucose

0.13 *

0.12 *

0.21 *

0.2 *

0.35

*

0.18 *

1h post-

load

glucose

0.18 *

0.14 *

0.22 *

0.05

0.22

*

0.1 *

0.41 *

2h post-

load

glucose

0.25 *

0.21 *

0.29 *

0.16 *

0.52

*

0.11 * 0.43 *

0.42 *

Conclusion.

The prevalence of metabolic syndrome components in the studied population is significantly

elevated, and this prevalence increases with age. The most substantial growth in MS and its

elements occurs after age 40. The dynamic distribution of individual components remains

ambiguous. A significant correlation exists between div mass parameters and most RFs,

excluding cholesterol and beta-lipoproteins.

References:

1. Abdukhakimova N.A. Features of the clinical course of gout in metabolic syndrome.

diss. Tashkent, 2011. P. 152.

2. Akbarova M., Mamasoliev N.S. Epidemiological, clinical, biorhythmological and

preventive aspects of chronic heart failure in the conditions of the sharply continental

climate of the Fergana Valley/V-Congress of Cardiologists of the CIS countries in the

journal Cardiology of the CIS. 2005, vol.-3, No 2, art. 17.

3. Tursunov Kh.Kh., Babich S.M. Features of the Coronary Heart Disease Flow in the

Conditions of the Sharply Continental Climate of the Fergana Valley of Uzbekistan. – 2008.

– No 3 – P. 31-34

4. Kamilova U.K., Rasulova Z.D. Study of the comparative efficacy of losartan and

lisinopril on glomerulo-tubular markers of renal dysfunction in patients with chronic heart

failure.

Cardiovascular

therapy

and

prevention.

2015;

14(2):41-45.

https://doi.org/10.15829/1728-8800-2015-2-41-45

5. Shagazatova B.Kh., Assessment of the quality of outpatient and polyclinic observation

of patients with diabetes mellitus // Vrachebnoye delo, 2013.

1. American Diabetes Association. Prevention or delay of type 2 diabetes. Diabetes Care.

2017;40 (Suppl 1): S44–S47.

2. Aspry KE, Van Horn L, Carson JAS, et al.: Medical Nutrition Education, Training, and

Competencies to Advance Guideline-Based Diet Counseling by Physicians: A Science

Advisory from the American Heart Association. Circulation. 2018;137(23): e821–e841.

10.1161/CIR.0000000000000563.


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Ju

ne

,2

02

5

,

M

ED

IC

AL

SC

IE

N

CE

S.

IM

PA

CT

FA

CT

OR

:7

,8

9

3. Barrett-Connor E, Khaw KT. Diabetes mellitus: an independent risk factor for stroke?

Am J Epidemiol 1988; 128:116–23. 10.1093/oxfordjournals.aje.a114934

4. Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of

pathogenesis and therapy. Lancet. 2005;365(9467):1333–46.

5. Frd, E. S., Giles, W. H. & Dietz, W. H. Prevalence the metabоlic syndrоme amng US

adults: findings frm the third Natinal Health and Nutritin Examinatin Survey. JAMA 287,

356–359 (2002).

11. Teixeira TF, Alves RD, Moreira AP, Peluzio Mdo C. Main characteristics of

metabolically obese normal weight and metabolically healthy obese phenotypes. Nutr Rev.

2015; 73:175–190.

12.Zinman B, Wanner C, Lachin JM, et al; EMPAREG OUTCOME Investigators.

Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med.

2015; 373:2117–2128.

13.Cusi K, Orsak B, Bril F, et al. Long-term pioglitazone treatment for patients with

nonalcoholic steatohepatitis and prediabetes or type 2 diabetes mellitus: a randomized

trial. Ann Intern Med. 2016; 165:305–315.

14.Kahn R, Buse J, Ferrannini E, Stern M. The metabolic syndrome: time for a critical

appraisal. Joint statement from the American Diabetes Association and the European

Association for the Study of diabetes. Diabetologia. 2005;48(9):1684–99.

15.Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ,

Krauss RM, Savage PJ, Smith SC Jr, et al. Diagnosis and management of the metabolic

syndrome: An American Heart Association/National Heart, Lung, and Blood Institute

scientific statement. Circulation. 2005;112(17):2735–52.

16. Lu Y, Hajifathalian K, Ezzati M, et al. Metabolic mediators of the effects of div-

mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis

of 97 prospective cohorts with 1·8 million participants. Lancet 2014; 383:970–83.

10.1016/S0140-6736(13)61836-X.

References

Abdukhakimova N.A. Features of the clinical course of gout in metabolic syndrome. diss. Tashkent, 2011. P. 152.

Akbarova M., Mamasoliev N.S. Epidemiological, clinical, biorhythmological and preventive aspects of chronic heart failure in the conditions of the sharply continental climate of the Fergana Valley/V-Congress of Cardiologists of the CIS countries in the journal Cardiology of the CIS. 2005, vol.-3, No 2, art. 17.

Tursunov Kh.Kh., Babich S.M. Features of the Coronary Heart Disease Flow in the Conditions of the Sharply Continental Climate of the Fergana Valley of Uzbekistan. – 2008. – No 3 – P. 31-34

Kamilova U.K., Rasulova Z.D. Study of the comparative efficacy of losartan and lisinopril on glomerulo-tubular markers of renal dysfunction in patients with chronic heart failure. Cardiovascular therapy and prevention. 2015; 14(2):41-45. https://doi.org/10.15829/1728-8800-2015-2-41-45

Shagazatova B.Kh., Assessment of the quality of outpatient and polyclinic observation of patients with diabetes mellitus // Vrachebnoye delo, 2013.

American Diabetes Association. Prevention or delay of type 2 diabetes. Diabetes Care. 2017;40 (Suppl 1): S44–S47.

Aspry KE, Van Horn L, Carson JAS, et al.: Medical Nutrition Education, Training, and Competencies to Advance Guideline-Based Diet Counseling by Physicians: A Science Advisory from the American Heart Association. Circulation. 2018;137(23): e821–e841. 10.1161/CIR.0000000000000563.

Barrett-Connor E, Khaw KT. Diabetes mellitus: an independent risk factor for stroke? Am J Epidemiol 1988; 128:116–23. 10.1093/oxfordjournals.aje.a114934

Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet. 2005;365(9467):1333–46.

Frd, E. S., Giles, W. H. & Dietz, W. H. Prevalence the metabоlic syndrоme amng US adults: findings frm the third Natinal Health and Nutritin Examinatin Survey. JAMA 287, 356–359 (2002).

Teixeira TF, Alves RD, Moreira AP, Peluzio Mdo C. Main characteristics of metabolically obese normal weight and metabolically healthy obese phenotypes. Nutr Rev. 2015; 73:175–190.

Zinman B, Wanner C, Lachin JM, et al; EMPAREG OUTCOME Investigators. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015; 373:2117–2128.

Cusi K, Orsak B, Bril F, et al. Long-term pioglitazone treatment for patients with nonalcoholic steatohepatitis and prediabetes or type 2 diabetes mellitus: a randomized trial. Ann Intern Med. 2016; 165:305–315.

Kahn R, Buse J, Ferrannini E, Stern M. The metabolic syndrome: time for a critical appraisal. Joint statement from the American Diabetes Association and the European Association for the Study of diabetes. Diabetologia. 2005;48(9):1684–99.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, et al. Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation. 2005;112(17):2735–52.

Lu Y, Hajifathalian K, Ezzati M, et al. Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1·8 million participants. Lancet 2014; 383:970–83. 10.1016/S0140-6736(13)61836-X.