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Objective: Assessment of the prevalence of the metabolic syndrome (MetS) and its components in Italian obese individuals., Methods: Cross-sectional estimate of MetS prevalence using the IDF definition in 635 obese (BMI ≥ 35 kg/m(2)) individuals (286 men, 349 women) aged 19-78 years hospitalised for mass excess treatment., Results: MetS prevalence was significantly (p < 0.001) higher in males (75.9%) than in females (61.9%), due to the increased prevalence of 4/5 involved abnormalities. A multivariate binary logistic regression analysis disclosed a contributory independent effect of ageing (p < 0.01-0.001), but not of BMI, whereas large waist circumference (p < 0.01) and high waist-to-hip ratio (p < 0.01) contributed to MetS prevalence only in women. Affected individuals were significantly older (males p = 0.022; females p < 0.001), affected men being younger than affected women (p < 0.01). The prevailing clinical picture included all abnormalities (21.2% in men, 22.2% in women); in minimal trait MetS (3/5 abnormalities), the prevailing combination was, beside central obesity, hypertension-hyperglycaemia in men (12.4%), and hypertension-dyslipidemia in women (19.4%)., Conclusions: MetS is a highly prevalent condition among Italian obese individuals. Prevalence and combinations of involved abnormalities differ considerably between genders and suggest a different pathophysiology of the MetS in men and women, with possible relevance for prevention and treatment of the condition., (Copyright © 2012 S. Karger AG, Basel.)

Juvenile metabolic syndrome (MetS) is a growing major medical problem in industrialised countries. We estimated its prevalence among two similar clinic-based sequentially recruited cohorts of extremely obese adolescents (age: 12-18 years) from Italy (N=665, males=271, females=394) and Germany (N=661, males=261, females=400) using the recent IDF paediatric criteria. The prevalence of the MetS was 23.3% among the Italians and 40.4% among the Germans. A multivariate logistic regression revealed an increased risk related to age (adjusted odd ratio (AOR): 2.24; 95% confidence interval (CI): 1.59-3.16; p<0.001), BMI SDS (AOR: 3.61; 95% CI: 2.33-5.60; p<0.001), male gender (AOR: 2.36; 95% CI: 1.80-3.10; p<0.001), and in German adolescents (AOR: 2.56; 95% CI: 1.98-3.31; p<0.001). Among Italian adolescents having the MetS, 83% had 3 abnormalities, 16% had 4 abnormalities while less than 1% had all the 5 abnormalities. In the German cohort, 67%, 28% and 5% of affected individuals had 3, 4 and 5 abnormalities, respectively. These results indicate that MetS is highly prevalent among extremely obese adolescents, and suggest that (besides age, obesity and gender) national sociocultural factors, as alimentary trends, could be important. Further tools should be developed to understand international epidemiological differences concerning obesity and its comorbidities in relation to lifestyles in the countries of European Union.

Aims and Methods: Factor analysis is a multivariate correlation technique frequently employed to characterise the aggregation of abnormalities underlying the metabolic syndrome (MS), but scarcely used in obese adolescents. Aim of the study was to investigate the clustering of anthropometric and metabolic variables related to the MS in 487 obese pubertal adolescents (140 boys, 347 girls) in the range of age 11-18 yr employing the factor analysis with exploratory approach., Results: Principal component analysis reduced 11 correlated physiological variables to 4 uncorrelated factors that explained 68.7% of the variance in the original parameters in boys, and 68.4% in girls. In boys, these factors were: obesity/ hypertension, insulin resistance, dyslipidemia, and hyperglycemia, with elements related to obesity and fat distribution loaded also in dyslipidemia and insulin resistance. In girls no commonalities were detected, but elements of dyslipidemia and insulin resistance were loaded in a single factor, whereas elements of obesity and hypertension were loaded in separate factors., Conclusions: The identification of 4 independent factors suggests a multiple physiological origin of the MS also in youngsters. The measures of adiposity were correlated with development of hypertension, insulin resistance, and dyslipidemic phenomena in boys only, whereas in girls anthropometric measures were not correlated with any tested component of the MS, possibly disclosing the protective effect of female sex hormones in the juvenile age span.

Background and Aim: Factor analysis is a multivariate correlation technique that is frequently employed to characterise the clustering of intercorrelated abnormalities, which underlie the metabolic syndrome in cohorts of individuals with different characteristics. To our knowledge, it has never been used to identify the components of this syndrome in obese subjects. The purpose of this study was to use factor analysis to investigate the clustering of features, which characterise the metabolic syndrome, in a cohort of 552 obese women aged 18-83 years (mean body mass index: 43.0 kg/m(2)+/-5.7 SD)., Methods and Results: Principal component analysis reduced ten correlated physiological variables, to four uncorrelated factors that explained 72.2% of the variance in the original parameters. These factors were interpreted as: (1) an insulin resistance factor, with positive loading of fasting serum insulin and homeostatic model assessment of insulin resistance; (2) a metabolic glucose/lipid factor, with positive loading of fasting plasma glucose, triglycerides, waist-to-hip ratio, and inverse loading of high density lipoprotein cholesterol; (3) a body mass factor, with positive loading of body mass and waist circumference; and (4) a blood pressure factor, with positive loading of systolic and diastolic blood pressure., Conclusion: The identification of four independent factors is consistent with previous findings among samples of different populations and may also support, in obese women, the hypothesis that multiple physiological determinants are responsible for the abnormalities underlying the metabolic syndrome. Nonetheless, findings in this cohort of obese women suggest that the absolute degree of adiposity is not correlated with any tested component of the metabolic syndrome, but that the relative fat distribution is highly correlated with the development of hyperglycaemic and dyslipidaemic phenomena. Furthermore, insulin resistance appears to be a major factor in obese individuals, independent of other metabolic and anthropometic abnormalities.

The classification system based on five factors with cut-offs defined by the recent International Diabetes Federation consensus was used to estimate the prevalence of the metabolic syndrome in a cohort of 570 obese Italian women (age: 18-83 years; body mass index (BMI): 30.2-66.7kg/m2). A binary logistic regression analysis model assessed the combined impact of age, BMI, waist circumference (WC) and waist-to-hip ratio (WHR) on such prevalence. The overall prevalence of the syndrome among these obese women was 58.6%. The multivariate binary logistic regression analysis revealed that the prevalence progressively increased with age (p<0.001) attaining an adjusted odd ratio (AOR) of 3.77 in the oldest group, in reference to the younger group, and was significantly higher in women with larger WC (AOR=2.03; p<0.001), and in those with higher WHR (AOR=1.72; p=0.017). In contrast, BMI had no significant effect on the prevalence (AOR=0.84; p=0.441). Among women having the metabolic syndrome, 54.5% had three abnormalities, the prevalent combination (38.5%) being abdominal obesity, low HDL-cholesterol and high blood pressure; four abnormalities were found in 32.0%, displaying in the major part (34.6%) the same above factors plus raised triglycerides, while the remaining 13.5% of affected women had all the five abnormalities. These results indicate a high prevalence of the metabolic syndrome among obese Italian women, although the degree of obesity does not appear to have a significant contributory role per se, unlike the absolute and relative amount of abdominal adiposity, which proved to be independent determinants of the metabolic syndrome, along with advancing age. Considerable variations in number and combinations of abnormalities entailed in the metabolic syndrome indicate that further investigation may possibly identify groups of obese patients at higher risk for targeted intervention.