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Objective: To investigate the prevalence of metabolic syndrome and its associated risk factors in a cohort of university freshmen., Design: A cross-sectional study in a university health center in North Taiwan., Subjects: A total of 8226 students (mean age: 19.2+/-2.3 years) receiving pre-entrance health examinations and lifestyle questionnaires during the 2005-2006 academic year were recruited., Measurements: A fasting plasma glucose, lipids, uric acid and hepatitis B serology were measured for each subject. The prevalence of metabolic syndrome and its individual components were examined using the America Heart Association and National Heart Lung Blood Institute criteria. The risk factors for metabolic syndrome were identified using a multivariate logistic regression analysis., Results: The prevalence of overweight, obesity and metabolic syndrome was 12.7% (17.0% in men and 7.6% in women), 13.0% (18.4% in men and 6.4% in women) and 4.6% (6.4% in men and 2.4% in women). The risk for metabolic syndrome increased with an increase of body mass index and plasma uric acid level, and decreased with the vigorous physical activity and current alcohol drinking. Furthermore, as compared to subjects with seroprotective titers from hepatitis B vaccination (anti-HBs(+) and anti-HBc(-)), those without protective titers of anti-HBs after vaccination or without hepatitis B infection (anti-HBs(-) and anti-HBc(-)) had 34% higher risk for metabolic syndrome, and those with natural infection of hepatitis B (anti-HBc(+)) had 58% higher risk for metabolic syndrome., Conclusions: Overweight, obesity and metabolic syndrome were more common among men than women in university freshmen. Hepatitis B vaccination with anti-HBs(+) was associated with a lower risk of metabolic syndrome as compared to anti-HBs(-). However, hepatitis B infection presented with anti-HBc(+) was associated with a higher risk of metabolic syndrome. The interplay between hepatitis B infection, hepatitis B vaccination and metabolic syndrome needs further investigation.

Obesity is related to increased morbidity and mortality, and prevails worldwide. It has become an important health issue and requires urgent attention. In Taiwan, overweight and obesity are defined as body mass index > or = 24 and 27 kg m(-2), respectively. These cut-offs differ from Caucasian standards, as Asians have higher comorbidities and fat mass at lower BMI levels than Caucasians. The prevalence of obesity and overweight in Taiwan are 19.2% and 30.5% in men, 13.4% and 21.3% in women. This implies that a more profound increase in obesity prevalence is found in men than in women. A high-fat diet, sedentary lifestyle and betel nut chewing may increase substantially this obesity epidemic. Recently, type 2 diabetes mellitus has been found to be the most common type of diabetes, and obesity is significantly related to type 2 diabetes in children. In addition, obesity is associated with cardiovascular diseases risk factors and cannot be neglected in elderly. Therefore, a comprehensive prevention and management programme of obesity is urgently warranted for controlling the growing obesity trend and its related diseases in Taiwan.

Objective: To investigate the relationship between the metabolic syndrome and its related factors among non-diabetic pre- and post-menopausal women in North Taiwan., Design: A cross-sectional study in a medical center in North Taiwan., Subjects: Five hundred and ninety-four, non-diabetic middle-aged women (age range=40-64 years, mean=48.9+/-5.4 years) were recruited., Measurements: The fasting plasma glucose, insulin, lipids levels and anthropometric indices were measured. The homeostasis model assessment was applied to estimate the degree of insulin resistance (HOMA-IR). Metabolic syndrome was defined by using the National Cholesterol Education Panel (NCEP) criteria and modified NCEP criteria (waist circumference >80 cm)., Results: The prevalence of metabolic syndrome was 6.2% using NCEP criteria, and 8.9% using modified NCEP criteria. Post-menopausal women had a higher prevalence of metabolic syndrome and its individual components compared to pre-menopausal women except hyperglycemia and low HDL-C. In multiple logistic regression analysis with adjustment for age and menopausal status, both BMI and HOMA-IR were independently associated with the metabolic syndrome., Conclusion: The prevalence of metabolic syndrome was higher in post-menopausal than pre-menopausal women. Both obesity and insulin resistance may play an important role in the development of metabolic syndrome among the middle-aged women in North Taiwan.

Background: The increased health risks associated with obesity have been found to occur in Asians at lower body mass indices (BMIs). To determine the optimal cut-off values for overweight or obesity in Taiwan, we examined the relationships between four anthropometric indices and cardiovascular risk factors., Methods: The data were collected from four health-screening centers from 1998 to 2000 in Taiwan. Included were 55 563 subjects (26 359 men and 29 204 women, mean age=37.3+/-10.9 and 37.0+/-11.1 y, respectively). None had known major systemic diseases or were taking medication. Individual body weight, height, waist circumference (WC), and a series of tests related to cardiovascular risk (blood pressure, fasting plasma glucose, triglycerides, total cholesterol, low- and high-density lipoprotein cholesterol) were assessed and their relationships were examined. Receiver operating characteristic (ROC) analysis was used to find out the optimal cut-off values of various anthropometric indices to predict hypertension, diabetes mellitus and dyslipidemia., Results: Of the four anthropometric indices we studied, waist-to-height ratio (WHtR) in women was found to have the largest areas under the ROC curve (women=0.755, 95% CI 0.748-0.763) relative to at least one risk factor (ie hypertension or diabetes or dyslipidemia). The optimal cut-off values for overweight or obesity from our study in men and women showed that BMIs of 23.6 and 22.1 kg/m(2), WCs of 80.5 and 71.5 cm, waist-to-hip ratios (WHpR) of 0.85 and 0.76, and WHtR of 0.48 and 0.45, respectively, may be more appropriate in Taiwan., Conclusions: WHtR may be a better indicator for screening overweight- or obesity-related CVD risk factors than the other three indexes (BMI, WC and WHpR) in Taiwan. Our study also supported the hypothesis that the cut-off values using BMI and WC to define obesity should be much lower in Taiwan than in Western countries.

Objective: To examine the relationships between four anthropometric measurements and cardiovascular risk factors in Taiwan., Design: The data was collected from four nationwide health screen centers in Taiwan from 1998 to 1999., Subjects: A total of 38 556 subjects: 18 280 men and 20 276 women, mean age=37.0+/-11.1 y. None had any known major systemic diseases or were currently on medication., Measurements: Individual body weight, height, waist circumference (WC), and cardiovascular risk factors (blood pressure, fasting plasma glucose, triglycerides, total cholesterol level, low-density and high-density-lipoprotein cholesterol level) were assessed and their relationships were examined., Results: In both sexes, with increasing body mass index (BMI), WC, WHpR (waist-to-hip ratio) and WHtR (waist-to-height ratio), there were significantly higher risks of hypertension, impaired fasting glucose, diabetes and dyslipidemia (P<0.001) in almost all age groups. In the age groups older than 65, however, the relationships were statistically inconsistent., Conclusions: In Taiwan, the four anthropometric indexes (BMI, WC, WHpR, WHtR) are closely related to cardiovascular risk factors.