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Metabolic Syndrome/Insulin Resistance Syndrome/Pre-Diabetes

The Metabolic Syndrome in Uygur and Kazak Populations

  1. Weili Yan, PHD1,
  2. Xiaoyan Yang, MD1,
  3. Yujian Zheng, PHD1,
  4. Dongliang Ge, PHD2,
  5. Yuanming Zhang, MD3,
  6. Zimei Shan, BS3,
  7. Ha Simu, MD4,
  8. Musilin Sukerobai, MD5 and
  9. Ren Wang, MD5
  1. 1Division of Occupational and Environmental Health, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
  2. 2Georgia Prevention Institute, Medical College of Georgia, Augusta, Georgia
  3. 3Department of Hypertension, First Affiliate Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
  4. 4Cele County Hospital, Hetian, Xinjiang Uygur Autonomous Region, China
  5. 5Kazak Hospital, Aletai, Xinjiang Uygur Autonomous Region, China
  1. Address correspondence and reprint requests to Weili Yan, PhD, School of Public Health, Xinjiang Medical University, 8 Xinyi Rd., Urumqi 830054, Xinjiang Uygur Autonomous Region, China. E-mail: yanweili01{at}yahoo.com.cn
Diabetes Care 2005 Oct; 28(10): 2554-2555. https://doi.org/10.2337/diacare.28.10.2554
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  • WHR, waist-to-hip ratio

The metabolic syndrome, which has been defined as a clustering of insulin resistance, hypertension, and dyslipidemia (1–4), has become a major public health issue worldwide. Previous studies have shown that the prevalence of hypertension and diabetes was significantly different between the Uygur and Kazak populations, the two major minorities in Xinjiang (5,6). The current study aims to evaluate and compare the epidemiological and clinical features of the metabolic syndrome in the Uygur and Kazak ethnic populations.

RESEARCH DESIGN AND METHODS

In total, 3,015 Uygur subjects (1,301 males and 1,714 females) from rural south Xinjiang and 1,281 Kazak subjects (499 males and 719 females) from suburban north Xinjiang were randomly enrolled by multistage cluster sampling. A set of questionnaires was completed, including demographic information; details of medical history; family history of hypertension, obesity, type 2 diabetes, and stroke; medication use; and lifestyle information. Three blood pressure measurements and anthropometric measurements including height, weight, and waistline and hip circumference were obtained from each participant by trained and certified observers with standard protocols. Blood glucose was determined after an overnight fast by using a one-touch glucose autoanalyzer (Accu-Chek Advantage II Test Strips; Roche Diagnostics, Mannheim, Germany). Written informed consents were obtained from all study subjects before any data collection and measurements. The International Diabetes Federation definition (4) was adopted to define the metabolic syndrome or its components. All statistical analyses were performed using SAS software (SAS Institute, Cary, NC). Power calculation for generalized linear models was computed using a SAS macro program (available at http://www.sas.com/service/techsup/tnote/tnote_stat.html). P < 0.05 was considered statistically significant.

RESULTS

The metabolic syndrome, which was defined by central obesity, raised blood pressure, and pre-diabetes, was more prevalent in the Uygur than the Kazak population (8.6 vs. 4.8%, P = 0.001). The age-adjusted prevalence of hyperglycemia in the Uygur population was >18 times higher than that in the Kazak population (86.2 vs. 4.7%, P = 0.001). However, the prevalence of raised blood pressure and central obesity in the Kazak population was significantly higher than that in the Uygur population (58.1 vs. 25.2%, P = 0.001 and 48.0 vs. 30.6%, P = 0.001, respectively). To evaluate the effect of obesity on hypertension and diabetes in the Uygur and Kazak populations, the prevalence of hypertension and diabetes was compared by three BMI categories. For BMI <24, 24–28, and ≥28 kg/m2, the prevalence of hypertension was 11.39, 29.39, and 51.36% for Uygurs and 27.03, 42.34, and 70.02% for Kazaks. The prevalence of diabetes was 5.19, 6.14, and 12.27% for Uygurs and 0.54, 1.56, and 3.75% for Kazaks, with the P value being 0.0001 for all comparisons of prevalence between the two ethnic groups at the same BMI levels. It showed that with the same BMI level, more Kazak people developed hypertension, whereas more Uygur people developed diabetes. Further comparisons of the abdominal fat between the two populations showed that even with the same BMI levels, Uygur subjects had significantly greater WHR than Kazak subjects for both sexes (0.87 vs. 0.80, 0.93 vs. 0.84, and 0.95 vs. 0.93 for males and 0.85 vs. 0.78, 0.92 vs. 0.82, and 0.94 vs. 0.87 for females, P < 0.05).

CONCLUSIONS

We reported a difference in distributions of the metabolic syndrome among ethnicities that was similar to previous studies. African Americans had a higher age-adjusted prevalence of hypertension, and Mexican-Americans had a higher age-adjusted prevalence of hyperglycemia (7). It is interesting that the different prevalence of hypertension and diabetes in the two ethnic populations with the same BMI levels does not seem to be associated with obesity. Further analysis suggested that even with the same BMI, both Uygur males and females had a significantly greater waist-to-hip ratio (WHR) than Kazak people, which was consistent with the study of Li et al. (8). Numerous studies found that besides environmental factors, WHR was determined by genetic factors in different degrees among ethnic populations (9,10). In African Americans, 59% of variance of WHR in men and 56% of variance in women was attributed to genetic factors (11). More comprehensive studies are expected to elucidate the determinants of the distribution of the metabolic syndrome in Uygur and Kazak populations.

Acknowledgments

This study was supported by the 10th Five Years Key Programs for Science and Technology Development of China (2002BA711A08-22) and the Key Project for Nature Science of Xinjiang Universities (XJEDU2004I32).

Footnotes

  • A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    • Accepted July 12, 2005.
    • Received July 12, 2005.
  • DIABETES CARE

References

  1. ↵
    World Health Organization: Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications: Report of a WHO Consultation. Part 1: Diagnosis and Classification of Diabetes Mellitus. Geneva, World Health Org., 1999 (publ. no. WHO/NCD/NCS/99.2)
  2. Balkau B, Charles MA: Comment on the provisional report from the WHO consultation: European Group for the Study of Insulin Resistance (EGIR). Diabet Med 16:442–443, 1999
    OpenUrlCrossRefPubMedWeb of Science
  3. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive summary of the third report of the National Cholesterol Education Program (NECP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285:2486–2497, 2001
    OpenUrlCrossRefPubMedWeb of Science
  4. ↵
    International Diabetes Federation: The IDF consensus worldwide definition of the metabolic syndrome [article online]. Available from http://www.metabolicsyndromeinstitute.com/medical_information/literature_review/2005/document.2005-05-19.5770709184/document_view. Accessed 15 April 2005
  5. ↵
    Gu D, Reynolds K, Wu X, Chen J, Duan X, Reynolds RF, Whelton PK, He J, InterASIA Collaborative Group: Prevalence of the metabolic syndrome and overweight among adults in China. Lancet 365:1398–1405, 2005
    OpenUrlCrossRefPubMedWeb of Science
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    The Chinese Task Force of National Survey of Hypertension: The prevalence, awareness, treatment and control of hypertension in China: the report of national sampling survey of hypertension 1991. Chin J Hypertens 3 (Suppl.):14–18, 1993
  7. ↵
    Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 287:356–359, 2002
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    Li LL, Zhang YM, Du JY, Mao XM, Wu XH, Ran XJ, Wang SG, Bai L, Alimu, Li ND, Sun XF: Analysis of metabolic features and food composition related with pathogenesis of type 2 diabetes mellitus in population of Uigurs and Kazaks in Xinjiang. Chin J Endocrinol Metab 21:141–142, 2005
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    Nelson TL, Brandon DT, Wiggins SA, Whitfield KE: Genetic and environmental influences on body-fat measures among African-American twins. Obes Res 10:733–739, 2002
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    Nelson TL, Vogler GP, Pedersen NL, Miles TP: Genetic and environmental influences on waist-to-hip ratio and waist circumference in an older Swedish twin population. Int J Obes Relat Metab Disord 23:449–455, 1999
    OpenUrlCrossRefPubMedWeb of Science
  11. ↵
    Cardon L, Carmelli D, Fabsitz R, Reed T: Genetic and environmental correlations between obesity and body fat distribution in adult male twins. Hum Biol 66:465–479, 1994
    OpenUrlPubMed
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The Metabolic Syndrome in Uygur and Kazak Populations
Weili Yan, Xiaoyan Yang, Yujian Zheng, Dongliang Ge, Yuanming Zhang, Zimei Shan, Ha Simu, Musilin Sukerobai, Ren Wang
Diabetes Care Oct 2005, 28 (10) 2554-2555; DOI: 10.2337/diacare.28.10.2554

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The Metabolic Syndrome in Uygur and Kazak Populations
Weili Yan, Xiaoyan Yang, Yujian Zheng, Dongliang Ge, Yuanming Zhang, Zimei Shan, Ha Simu, Musilin Sukerobai, Ren Wang
Diabetes Care Oct 2005, 28 (10) 2554-2555; DOI: 10.2337/diacare.28.10.2554
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