METABOLIC SYNDROME - University of Pittsburgh

Dr. I. Selvaraj Indian Railways Medical Service B.Sc., M.B.B.S., M.D.,D.P.H., D.I.H., PGCHFW ( NIHFW,New Delhi)., Life member of Indian Association of Preventive & Social Medicine Life member of Indian Public Health Association Life member of Indian Medical Association

As I am one of the strong supporter of super course, I am dedicating this presentation to the public health students (Post graduate Diploma in Public Health, M.D Community Medicine) METABOLIC SYNDROME Metabolic syndrome is a cluster of risk factors

which is responsible for excess of cardiovascular disease morbidity among overweight and Obese patients and those persons with type 2 diabetes mellitus. The National Cholesterol Education ProgramAdult Treatment Panel (NCEP-ATP III) identified metabolic syndrome as an independent risk factor for cardiovascular

disease and considered it an indication for intensive lifestyle modification. W.H.O DEFINITION OF MEATBOLIC SYNDROME INSULIN RESISTANCE+ TWO OF THE FOLLOWING: 1.Abdominal/central obesity:

Waist to hip ratio: > 0.90 (men), > 0.85 (women), or BMI > 30 2. Hypertriglyceridemia: 150 mg per dL 3. Low HDL cholesterol: < 35 mg perdl for men, < 39 mg per dL for women 4. High blood pressure: 140/90 mm Hg or documented use of antihypertensive therapy 5. High fasting glucose: Impaired glucose tolerance, impaired fasting

glucose, insulin resistance, or diabetes 6. Microalbuminuria Urinary albumin to creatinine ratio: 30 mg per g, or albumin excretion rate: 20 mcg per minute Review of literature A CROSS SECTIONAL STUDY ON

METABOLIC SYNDROME JUSTIFICATION OF THE STUDY As there is an epidemiological transition from communicable to non-communicable diseases The prevalence of Metabolic syndrome is reported to be very high in developing countries.

The components of the metabolic syndrome are important risk factors for the development of Coronary Heart Diseases and for Type 2 diabetes. Hence this study will be ideal to estimate the prevalence of Metabolic syndrome in the developing countries OBJECTIVE

1. To determine the prevalence of metabolic syndrome using NCEP adult treatment panel-3 (ATP-3) guidelines 2. To determine the role of lifestyle risk factors in the development of metabolic syndrome with particular reference to physical activity, smoking, diet and alcohol consumption.

CASE DEFINITION: Metabolic syndrome is defined in accordance with NCEP - ATP III as the presence of 3 or more of the following characteristics: 1. Waist circumference > 102 cm in men and > 88 cm in women

2. Triglyceride levels > or = 150 mg/dl, 3. High density lipoprotein cholesterol < 40 mg/dl in men and < 50 mg/dl in women 4. Blood pressure > or = 130/85 mm hg 5. and Fasting serum glucose > or = 110 mg/dl. METHODS

STUDY DESIGN: Cross sectional study SAMPLE SIZE CALCULATION Sample Size (N) = (Zpq)/ppq)/q)/L Z=1.96 Ordinate value for =5%

p = Prevalence of Metabolic Syndrome q = 100-p L = Precision APPROVAL 1.ETHICS COMMITTEE

2.COMPETENT AUTHORITY PILOT STUDY It will be done to pre- test & pre design the questionnaire and other procedures

DATA COLLECTION A structured questionnaire comprising information on social demographic, behavioral and clinical characteristics. Anthropometrics measurement Blood pressure( JNC VII) Fasting blood sample of glucose and Lipid

Profile ANALYSIS Data analysis by using appropriate available software package Prevalence of Metabolic syndrome as point estimate and 95% C.I for precision

Odds Ratio for the risk factors of Metabolic syndrome Logistic regression to find out the adjusted Odds Ratio & 95% C.I

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