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      Smoking, Habitual Tea Drinking and Metabolic Syndrome in Elderly Men Living in Rural Community: The Tianliao Old People (TOP) Study 02

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          Abstract

          The literature shows an inconsistent relationship between lifestyle behaviors and metabolic syndrome (MetS), especially in the elderly. We designed this study to investigate the interrelationships among cigarette smoking, tea drinking and MetS, and to verify the factors associated with MetS in elderly males dwelling in rural community. In July 2010, with a whole community sampling method, 414 male subjects aged over 65 dwelling in Tianliao township were randomly sampled. The response rate was 60.8%. Each subject completed the structured questionnaires including sociodemographic characteristics, habitual behaviors (including cigarette smoking and tea drinking habits) and medical history. After an overnight fast, the laboratory and anthropometric data were obtained. MetS was confirmed according to the criteria defined by the modified NCEP ATP III for the male Chinese population. Subjects were split into either non-MetS or MetS groups for further analysis. Of the 361 subjects with complete data, 132 (36.6%) elderly men were classified as having MetS. Using binary logistic regression, body mass index, serum uric acid, high sensitivity C-reactive protein, HOMA index, current smokers (OR = 2.72, 95%CI: 1.03 ∼ 7.19), total smoking amount > = 30 (OR = 2.78, 95%CI: 1.31 ∼ 5.90) and more than 20 cigarettes daily (OR = 2.54, 95%CI: 1.24 ∼ 5.18) were positively associated with MetS. Current un- or partial fermented tea drinker (OR = 0.42, 95%CI: 0.22 ∼ 0.84), tea drinking habit for 1–9 years (OR = 0.36, 95%CI: 0.15 ∼ 0.90) and more than 240cc daily (OR = 0.35, 95%CI: 0.17 ∼ 0.72) were negatively associated with MetS. In conclusion, this study suggests that smoking habit was positively associated with MetS, but tea drinking habit was negatively associated with MetS in elderly men dwelling in rural community.

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          Cardiovascular morbidity and mortality associated with the metabolic syndrome.

          To estimate the prevalence of and the cardiovascular risk associated with the metabolic syndrome using the new definition proposed by the World Health Organization A total of 4,483 subjects aged 35-70 years participating in a large family study of type 2 diabetes in Finland and Sweden (the Botnia study) were included in the analysis of cardiovascular risk associated with the metabolic syndrome. In subjects who had type 2 diabetes (n = 1,697), impaired fasting glucose (IFG)/impaired glucose tolerance (IGT) (n = 798) or insulin-resistance with normal glucose tolerance (NGT) (n = 1,988), the metabolic syndrome was defined as presence of at least two of the following risk factors: obesity, hypertension, dyslipidemia, or microalbuminuria. Cardiovascular mortality was assessed in 3,606 subjects with a median follow-up of 6.9 years. In women and men, respectively, the metabolic syndrome was seen in 10 and 15% of subjects with NGT, 42 and 64% of those with IFG/IGT, and 78 and 84% of those with type 2 diabetes. The risk for coronary heart disease and stroke was increased threefold in subjects with the syndrome (P < 0.001). Cardiovascular mortality was markedly increased in subjects with the metabolic syndrome (12.0 vs. 2.2%, P < 0.001). Of the individual components of the metabolic syndrome, microalbuminuria conferred the strongest risk of cardiovascular death (RR 2.80; P = 0.002). The WHO definition of the metabolic syndrome identifies subjects with increased cardiovascular morbidity and mortality and offers a tool for comparison of results from diferent studies.
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            Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men.

            The purpose of this study was to investigate associations between combinations of body mass index (BMI) categories and metabolic syndrome (MetS) and the risk of cardiovascular disease and death in middle-aged men. At age 50 years, cardiovascular risk factors were assessed in 1758 participants without diabetes in the community-based Uppsala Longitudinal Study of Adult Men (ULSAM). According to BMI-MetS status, they were categorized as normal weight (BMI 30 kg/m(2)) without MetS (n=30), or obese with MetS (n=66). During follow-up (median 30 years), 788 participants died, and 681 developed cardiovascular disease (composite of cardiovascular death or hospitalization for myocardial infarction, stroke, or heart failure). In Cox proportional-hazards models that adjusted for age, smoking, and low-density lipoprotein cholesterol, an increased risk for cardiovascular disease was observed in normal-weight participants with MetS (hazard ratio 1.63, 95% confidence interval 1.11 to 2.37), overweight participants without MetS (hazard ratio 1.52, 95% confidence interval 1.28 to 1.80), overweight participants with MetS (hazard ratio 1.74, 95% confidence interval 1.32 to 2.30), obese participants without MetS (hazard ratio 1.95, 95% confidence interval 1.14 to 3.34), and obese participants with MetS (hazard ratio 2.55, 95% confidence interval 1.81 to 3.58) compared with normal-weight individuals without MetS. These BMI-MetS categories significantly predicted total mortality rate in a similar pattern. Middle-aged men with MetS had increased risk for cardiovascular events and total death regardless of BMI status during more than 30 years of follow-up. In contrast to previous reports, overweight and obese individuals without MetS also had an increased risk. The present data refute the notion that overweight and obesity without MetS are benign conditions.
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              Selection of appropriate Chinese terms to represent intensity and types of physical activity terms for use in the Taiwan version of IPAQ.

              In order to analyze the health risks of insufficient activity by international comparisons, the first author obtained the permission to translate and develop a Taiwan version of the International Physical Activity Questionnaire (IPAQ). The objective was to determine culturally sensitive Chinese translations for the terms "moderate", "vigorous" and "physical activity" as well as to identify representative types of physical activity for Taiwanese. This study used discussions by 12 expert focus groups, 6 expert audits, a scale survey, field study, Cognitive Aspect Survey Methodology (CASM), dual independent translation and back-translation to establish a consensus on physical activity-related concepts, terminologies and types that define the intensity of common activities of Taiwanese by integrating both local and foreign studies. The Chinese terms "fei li", "zhong deng fei li" and "shen ti huo dong", respectively, were identified as suitable and adequate translations for the English terms "vigorous", "moderate" and "physical activity". The common Taiwanese activities were accurately categorized and listed in questionnaires, forming culturally sensitive scales. Taiwan versions of IPAQ's self-administered long version (SL), self-administered short version (SS), and telephone interview short version (TS) were developed. Their content validity indices were .992, .994, and .980, as well as .994, .992, and .994 for language equivalence and meaning similarity between the English and Chinese versions of the IPAQ-LS, IPAQ-SS, and IPAQ-TS, respectively. Consistency values for the English and Chinese versions in terms of intraclass correlation coefficients were .945, .704, and .894, respectively. The IPAQ-Taiwan is not only a sensitive and precise tool, but also shows the effectiveness of the methodology (CASM) used in tool development. Subjects who did not regularly exercise and had an education less than a junior high school level underestimated the moderate-intensity physical activity.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2012
                14 June 2012
                : 7
                : 6
                : e38874
                Affiliations
                [1 ]Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
                [2 ]Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
                [3 ]Tianliao District Public Health Center, Kaohsiung City, Taiwan
                [4 ]Graduate Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
                Tehran University of Medical Sciences, Iran (Islamic Republic of)
                Author notes

                Conceived and designed the experiments: CSC YFC CYC CHW. Performed the experiments: CSC YFC PYL CYC YST CHW. Analyzed the data: CSC YFC CHW. Contributed reagents/materials/analysis tools: CSC YFC PYL CYC YST CHW. Wrote the paper: CSC CHW.

                Article
                PONE-D-12-11945
                10.1371/journal.pone.0038874
                3375307
                22719971
                55884856-5a3d-4f64-9000-c2015561c89a
                Chang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 14 April 2012
                : 14 May 2012
                Page count
                Pages: 8
                Categories
                Research Article
                Medicine
                Endocrinology
                Endocrine Physiology
                Geriatrics
                Primary Care
                Public Health
                Behavioral and Social Aspects of Health
                Preventive Medicine
                Tobacco Control
                Pulmonology
                Smoking Related Disorders

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                Uncategorized

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