Chung-Huang Tsai

To assess the clustering of modifiable cardiovascular risk factors among Taiwanese adults, we evaluated 579 healthy participants who underwent health examinations between May and December 2007. Exploratory factor analysis was used to examine risk factor clustering. Smoking, alcohol intake, exercise habits, body mass index, waist circumference, total cholesterol, triglycerides, high- and low-density lipoprotein cholesterol, fasting glucose, uric acid, serum hepatic enzymes, and mean arterial pressure were assessed. Separate factor analyses assessed total and low-density lipoprotein cholesterol. Principal components analysis identified five factors for a model without low-density lipoprotein cholesterol and four factors for a model without total cholesterol. Four common factors in both models explained between 51.1 and 51.8% of variance in the original 14 factors. Metabolic factors, hematological factors (white blood cells and platelets), lifestyle factors (smoking and alcohol consumption), and exercise habits and fasting blood glucose explained about 20, 11, 10, 10% of total variance, respectively. In the model without low-density lipoprotein cholesterol, total cholesterol factor explained 8.83% of variance. This study confirmed clustering of established metabolic syndrome components and revealed additional associated cardiovascular disease risk factors, including lifestyle factors, exercise and total cholesterol, which should be targeted in prevention efforts.

Studies of outpatient department patients indicate that somatic discomforts such as headache, neck pain, chest pain, low back pain, and gastrointestinal discomfort are commonly found in patients with multiple complaints. Clustering of some symptoms has been found in common somatic symptom analyses. Because of the complexity involved in the diagnosis of patients with multiple complaints, the aim of this study is to identify and classify patterns of somatic symptoms in individuals assessed during a health examination.

Not only the obese, but also the non-obese adults have the high prevalence of metabolic syndrome in the upper normal weight. The aim of this study was to assess the prevalence rates of metabolic syndrome and its individual components in non-obese adult Taiwanese (body mass index (BMI) <or= 26.9 kg/m(2)). A cross-sectional study was conducted from January 2006 to December 2007. One thousand six hundred and fifty-nine subjects (aged 47.5 +/- 12.4 years), 60.8% of which were men, were enrolled. The prevalence and odds ratios of metabolic syndrome, defined by the American Heart Association/National Heart, Lung and Blood Institute (2005), were analyzed in the BMI category according to 2.0 unit increments, in individuals seeking a health examination. The higher the BMI categories, the more prevalent the metabolic syndrome was in women and in men (P < 0.001). Compared with those women with a BMI <or= 20.9 kg/m(2), the odds ratios for metabolic syndrome in women were 1.3 (95%CI: 0.5 - 3.2) with BMI 21.0 - 22.9 kg/m(2), 3.0 (1.3 - 7.1) with BMI 23.0 - 24.9 kg/m(2), and 8.6 (3.6 - 20.8) for women with BMI 25.0 - 26.9 kg/m(2), after controlling for age, smoking status, alcohol consumption, betel nut chewing, blood routine, biochemical data, hepatitis B virus surface antigen and anti-hepatitis C virus. The corresponding odds ratios in men were 1.6 (0.6 - 4.2), 3.7 (1.6 - 8.8), and 9.9 (4.2 - 23.2). Individuals in the upper normal weight and slightly overweight BMI range have relatively high prevalence and increased risk of having metabolic syndrome. Therefore, physicians should screen metabolic syndrome in not only obese but also non-obese individuals for the prevention of cardiovascular disease.