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      Association of dietary patterns, anthropometric measurements, and metabolic parameters with C-reactive protein and neutrophil-to-lymphocyte ratio in middle-aged and older adults with metabolic syndrome in Taiwan: a cross-sectional study

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          Abstract

          Background

          Metabolic syndrome is commonly associated with inflammation. The underlying factors of inflammation in metabolic syndrome are not fully understood. The objective of the study was to determine the association of dietary patterns, anthropometric measurements, and metabolic parameters with inflammatory markers in middle-aged and older adults with metabolic syndrome in Taiwan.

          Methods

          A total of 26,016 subjects aged ≥35 y with metabolic syndrome were recruited from Mei Jau institution between 2004 and 2013 for a cross sectional study. Metabolic syndrome was defined by the International Diabetes Federation. Multivariate logistic regression was performed to evaluate the association of dietary patterns, anthropometric measurements, and metabolic parameters with C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) in men and women with metabolic syndrome. Crude and adjusted models were analyzed by gender.

          Results

          The western dietary pattern, obesity, high body fat, high waist or hip circumference, and high waist-to-hip ratio were significantly associated with increased odds ratios of high CRP and NLR in both genders. High systolic or diastolic blood pressure (BP), low high-density lipoprotein-cholesterol (HDL-C), high low-density lipoprotein-cholesterol (LDL-C), high total cholesterol (TC), high serum triglycerides (TG), and high fasting blood glucose (FBG) were significantly correlated with increased odds ratios of high CRP in both genders. Low HDL-C, high LDL-C, high serum TG, and high FBG were significantly associated with increased odds ratios of high NLR in both genders. However, high systolic (OR = 1.124, 95% CI 1.047–1.206, P < 0.01) or diastolic BP (OR = 1.176, 95% CI 1.087–1.273, P < 0.001) and high TC (OR = 1.138, 95% CI 1.062–1.220, P < 0.001) were significantly correlated with increased odds ratios of high NLR only in men.

          Conclusions

          The western dietary pattern, obese-related anthropometric parameters, and most components of metabolic syndrome are positively associated with CRP levels and NLR in men and women with metabolic syndrome.

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          Most cited references42

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          C-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events: An 8-Year Follow-Up of 14 719 Initially Healthy American Women

          The metabolic syndrome describes a high-risk population having 3 or more of the following clinical characteristics: upper-body obesity, hypertriglyceridemia, low HDL, hypertension, and abnormal glucose. All of these attributes, however, are associated with increased levels of C-reactive protein (CRP). We evaluated interrelationships between CRP, the metabolic syndrome, and incident cardiovascular events among 14 719 apparently healthy women who were followed up for an 8-year period for myocardial infarction, stroke, coronary revascularization, or cardiovascular death; 24% of the cohort had the metabolic syndrome at study entry. At baseline, median CRP levels for those with 0, 1, 2, 3, 4, or 5 characteristics of the metabolic syndrome were 0.68, 1.09, 1.93, 3.01, 3.88, and 5.75 mg/L, respectively (P(trend) <0.0001). Over the 8-year follow-up, cardiovascular event-free survival rates based on CRP levels above or below 3.0 mg/L were similar to survival rates based on having 3 or more characteristics of the metabolic syndrome. At all levels of severity of the metabolic syndrome, however, CRP added prognostic information on subsequent risk. For example, among those with the metabolic syndrome at study entry, age-adjusted incidence rates of future cardiovascular events were 3.4 and 5.9 per 1000 person-years of exposure for those with baseline CRP levels less than or greater than 3.0 mg/L, respectively. Additive effects for CRP were also observed for those with 4 or 5 characteristics of the metabolic syndrome. The use of different definitions of the metabolic syndrome had minimal impact on these findings. These prospective data suggest that measurement of CRP adds clinically important prognostic information to the metabolic syndrome.
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            Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome.

            Limited data on the relation between the risk of the metabolic syndrome and fruit and vegetable intakes and inflammatory marker concentrations are available. We evaluated the relation between fruit and vegetable intakes and C-reactive protein (CRP) concentrations and the prevalence of the metabolic syndrome. Fruit and vegetable intakes were assessed with the use of a validated semiquantitative food-frequency questionnaire in a cross-sectional study of 486 Tehrani female teachers aged 40-60 y. Anthropometric measurements were made and blood pressure was assessed according to standard methods. Fasting blood samples were taken for biochemical measurements. The metabolic syndrome was defined on the basis of the National Cholesterol Education Program Adult Treatment Panel III guidelines. The reported mean daily fruit and vegetable intakes were 228 +/- 79 and 186 +/- 88 g/d, respectively. Both fruit and vegetable intakes were inversely associated with plasma CRP concentrations. After statistical control for age, body mass index, and waist circumference, mean plasma CRP concentrations across increasing quintile categories of fruit intakes were 1.94, 1.79, 1.65, 1.61, and 1.56 mg/L and of vegetable intakes were 2.03, 1.82, 1.58, 1.52, and 1.47 mg/L (P for trend < 0.01 for both). These inverse associations remained significant after additional control for other potential confounding variables and dietary factors. After control for potential confounders, persons in the highest quintile of fruit intake had a 34% (95% CI: 20%, 46%) lower and those in the highest quintile of vegetables intake had a 30% (95% CI: 16%, 39%) lower chance of having the metabolic syndrome than did those in the lowest quintiles. Higher intakes of fruit and vegetables are associated with a lower risk of the metabolic syndrome; the lower risk may be the result of lower CRP concentrations. These findings support current dietary recommendations to increase daily intakes of fruit and vegetables as a primary preventive measure against cardiovascular disease.
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              Metabolic syndrome across Europe: different clusters of risk factors.

              Metabolic syndrome (MetS) remains a controversial entity. Specific clusters of MetS components - rather than MetS per se - are associated with accelerated arterial ageing and with cardiovascular (CV) events. To investigate whether the distribution of clusters of MetS components differed cross-culturally, we studied 34,821 subjects from 12 cohorts from 10 European countries and one cohort from the USA in the MARE (Metabolic syndrome and Arteries REsearch) Consortium.
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                Author and article information

                Contributors
                syauqy@fk.undip.ac.id
                cyhsu@ntunhs.edu.tw
                rauhhh@gmail.com
                +886-2-2736-1661 , chenjui@tmu.edu.tw
                Journal
                Nutr J
                Nutr J
                Nutrition Journal
                BioMed Central (London )
                1475-2891
                19 November 2018
                19 November 2018
                2018
                : 17
                : 106
                Affiliations
                [1 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, ; 250 Wu-Hsing Street, Taipei, 110 Taiwan
                [2 ]ISNI 0000 0001 0744 0787, GRID grid.412032.6, Department of Nutrition Science, Faculty of Medicine, , Diponegoro University, ; Semarang, Indonesia
                [3 ]ISNI 0000 0004 0573 0416, GRID grid.412146.4, Department of Information Management, National Taipei University of Nursing and Health Sciences, ; Taipei, Taiwan
                [4 ]ISNI 0000 0000 9337 0481, GRID grid.412896.0, Master Program in Global Health and Development, College of Public Health, Taipei Medical University, ; Taipei, Taiwan
                [5 ]Joint Commission of Taiwan, New Taipei City, Taiwan
                [6 ]ISNI 0000 0004 0639 0994, GRID grid.412897.1, Nutrition Research Center, Taipei Medical University Hospital, ; Taipei, Taiwan
                Author information
                http://orcid.org/0000-0002-3610-9580
                Article
                417
                10.1186/s12937-018-0417-z
                6240947
                30454030
                5ed49a32-aec1-46c8-af3e-e76acf6a9afd
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 25 July 2018
                : 29 October 2018
                Funding
                Funded by: the Ministry of Finance and the Ministry of Research Technology Higher Education, Republic of Indonesia
                Award ID: LPDP-BUDI LN
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2018

                Nutrition & Dietetics
                dietary patterns,anthropometric measurements,metabolic parameters,c-reactive protein,neutrophil-to-lymphocyte ratio,inflammation,metabolic syndrome

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