EVALUATION OF LIPID PROFILE STATUS IN METABOLIC SYNDROME (MetS)Type of manuscript: Research article.Running title: Lipid profile status in metabolic syndrome.A.Shamaa AnjumGraduate Student,Saveetha Dental College,Saveetha University,Chennai, India.

Mrs.Gayatri Devi.RAssistant Professor, Department of physiology,Saveetha Dental College,Saveetha University,Chennai, India.Corresponding authorMrs.Gayatri Devi.

RAssistant Professor, Department of physiology,Saveetha Dental College, Saveetha University,162, Poonamallee High RoadChennai 600077Tamil Nadu, IndiaEmail: [email protected] number: +918248016505Total number of words: 1424Abstract Introduction: Metabolic syndrome (MetS) is known as a group of cardiovascular risk factors associated with insulin resistance, hypertension, glucose intolerance, hypertriglyceridemia and low levels of high-density lipoprotein cholesterol (HDL-C). It is a major worldwide public health problem.The aim of this study is to analyse the lipid profile status in metabolic syndrome.Materials and methods: Healthy individuals and individuals with metabolic syndrome underwent serum analysed for fasting blood sugar (FBS) by GOD-POD method, serum cholesterol by Cholesterol esterase-Oxidase method, Serum triglycerides by colorimetric enzymatic method, HDL-c by Phosphotungtic acid method, LDL-c and VLDL-c were calculated by Friedwald’s formula and lipid profile status was compared between the two groups.Results: All the data were analysed by using SPSS package.

The mean value of FBS, TGL, T.Chols, HDL-c, LDL-c and VLDL-c in individuals with metabolic syndrome was found to be 10531.22, 151.

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138.80, 191.15 35.12, 20.76.

31, 140.335.37, 30.

426.76 respectively.Conclusion: From this study, it is evident that individuals with MetS have most of the risk factors that increases the person’s risk of heart attack and stroke. Aside from the increase in waist circumference, most of the disorders associated with MetS have no symptoms.Key Words : Metabolic syndrome, lipid profile, heart diseases, obesity, diabetes.Introduction: Metabolic syndrome (MetS) is known as a group of cardiovascular risk factors associated with insulin resistance, hypertension, glucose intolerance, hypertriglyceridemia and low levels of high-density lipoprotein cholesterol (HDL-C). It is a major worldwide public health problem 1.

MetS is considered a major threat for public health in the 21st century 5 and is associated with an increased risk of cardiovascular disease (CVD) and pathophysiologic states such as heart failure 2, type 2 diabetes mellitus 3, and erectile dysfunction (ED) 4. Dyslipidemia is a risk factor for CVD and is a component of MetS; the role of HDL-C, triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) have already been established as  predictors of CVD17. Serum adiponectin secreted by the adipose tissue, contains four differentiable domains which regulate the lipid metabolism, glucose metabolism and insulin sensitivity 19.  Low circulating levels of serum adiponectin has been reported as a risk factor for the development of metabolic syndrome 20 and CVD 21 .In 1989, Kaplan 13 renamed MetS as “The Deadly Quartet” for the combination of upper body obesity, glucose intolerance, hypertriglyceridemia, and hypertension ; however, in 1992, it was again renamed as “The Insulin Resistance Syndrome” 14.The prevalence of MetS increases with increase in glucose intolerance 6 and with the increasing world-wide prevalence of diabetes mellitus (DM). The prevalence of MetS in Chennai was found to be 46.316 .

The expected increase in the frequency of occurrence of the MetS will be in geometric proportions.The prevalence of MetS in the general population is estimated to be between 17-25% 7,8 and in people with DM prevalence rates range from 59% to 61% 9.The  metabolic  syndrome  study,  however,  has  not  been adequately  explored  in  the  60-year  old population or people above 60 years of age. The  understanding  of  the  extension  of  these kind of disorder  in  this population segment is  necessary for the national distribution of  resources  for  medical  care  and  research,  as  well  as  for the  adequate  management.  It  is  also  emphasized  that  the prevalence  of  MetS  in  elderly  people  has  not  been  defined; partly  because  they  have  been  traditionally  under – represented in large epidemiologic studies 10,11.

Therefore in this study we aimed to analyse the lipid profile status in metabolic syndrome.Materials and methods: Patients were selected from the outpatient department of Saveetha Dental College, and hospitals and divided into two groups. Each group consists of 25 individuals.Group I: Normal healthy individuals  Group II: Patients with metabolic syndromeInclusion Criteria• Individuals with the age group of 35 to 55 years• Individuals with type 2 diabetes mellitus (FBS ?100mg/dl)• Individual with normal BMI (18.9 – 24.9) and Obese BMI (?30)• Serum Triglycerides levels more than 150mg/dlExclusion Criteria• Individuals with other systemic illness like cardio vascular disease, Renal failure, Stroke, endocrine illness.

• Individuals with acute illness like fever.• Immunocompromised individuals.Sample collection            Informed consents were obtained from the patients before sample collection. 5ml of venous blood was collected and distributed in plain collection tubes and centrifuged in 3000rpm for serum. Then serum was separated and then it is analysed for fasting blood sugar (FBS) by GOD-POD method, serum cholesterol by Cholesterol esterase-Oxidase method, Serum triglycerides by colorimetric enzymatic method, HDL-c by Phosphotungtic acid method, LDL-c and VLDL-c were calculated by Friedwald’s formula.Results: All the data were analysed by using SPSS package. Student t-test analysis was done to find out significant differences between the two groups. All the tests were considered significant at p < 0.

05 level. Table 1: Comparison of FBS and Lipid profile status between 2 groupsParametersGroupNMeanStd. DeviationP-ValueFBS(mg/dl)Control2584.5611.802 0.



24 0.000MetS25191.1535.12HDL(mg/dl)Control2538.858.110.000MetS2520.


60.000MetS2530.426.76Graph 1: FBS level in control and MetSGraph 2: TGL, Total Cholesterol levels in control and MetSGraph 3: HDL, LDL, VLDL levels in control and MetSDiscussion: The control FBS (fasting blood sugar) mean value is 84.5611.

80 The FBS value in individuals with MetS was measured to be 105.5631.22 and p value was higly significant (p<0.05). There is an increase in FBS level in individuals with MetS (Graph 1).  In this study the TGL mean value is less in individuals with MetS when compared to the control mean value.

The control TGL (triglyceride level) mean is 188.3542.59. The TGL mean value in individual with MetS was found to be 151.138.80(Graph2).

P value was also found to be more significant ie. p=0.00 (p<0.

05). A contradiction is seen in other article 13. The National Cholesterol Education Program suggested that total blood cholesterol level should be < 200 mg/dL (normal level).

The control mean value of T.chol (Total cholesterol) is 110.526.24. This T.

Chol mean value in individuals with MetS was found to be 191.15 35.12 and p value was more significant (p<0.05). This study reveals that the total Chol in case of individuals with MetS is significantly increased(Graph2).

The control mean value of HDL-c (high density lipoprotein cholesterol) is 38.858.11. The mean value of HDL-c in individuals with MetS was found to be 20.76.31 and the p value was found to be highly significant. Higher the value of HDL lesser is the risks of diseases. There is a decrease in HDL-c mean value in individuals with MetS(graph3).

Similar results were seen in another article 14. LDL which is the bad cholesterol unfortunately makes most of our body’s cholesterol. LDL is responsible for the formation of plaques that may block the arteries, making heart diseases more likely. The LDL-c (low density lipoprotein cholesterol) control mean value was found to be 53.3224.47 and in individuals with MetS it was found to be 140.

335.37. The p value was also more significant p=0.00 (p<0.

05). Individuals with MetS have significantly increased level of LDL (Graph3) making themselves vulnerable to acquire heart diseases. Similar results were found in another article 14. VLDL carries fat from liver to the other parts of the body. VLDL becomes LDL after it unloads fat. The mean control value of VLDL-c (very low density lipoprotein cholesterol) was found to be 17.608.

6 and and in individuals with MetS it was 30.426.76.

P value was highly significant p=0.00 (p<0.05). In individuals with MetS the level of VLDL exceeds the control value(Graph3). All the values are mentioned in table 1.Metabolic syndrome is linked with type 2 diabetes mellitus and cardiovascular disease. 20%–25% of the population affected with metabolic syndrome and increases in frequency with age.

FBS is calculated by taking venous blood after 8 hours of fasting. In 2013, American diabetes Association made a standard of FBS < 100 mg/dl (5.6 mmol/l) is considered as normal fasting blood sugar . In diabetic patients the glucose level tends to be high in after over - night fasting due to lack of insulin. MetS comprises the risk factors for diseases such as diabetes and fatty liver which are actually causes for increase in total cholesterol . The treatment of MetS involves invasive, costly and time consuming procedures15. The normal value of HDL, which is good cholesterol, is 30-60mg/dl. The parameters considered in this study are , FBS, TGL, T.

Chol, HDL, LDL and VLDL.In this study, the LDL mean value was found be significantly increased than the control mean value. Similar results were observed in another article 14. A contradiction was observed in this article regarding the mean value of TG 13. Kimm et al. 18 demonstrated that lipid ratios of TC/HDL-C, LDL-C/HDL-C and TG/HDL-C, as well as TG and HDL-C, were each consistently associated with the number of metabolic syndrome components.Conclusion: Metabolic Syndrome is not exclusive to adults.

In fact, the prevalence of the MetS in younger populations is increasing in parallel with childhood obesity.  MetS is associated with an approximate doubling risk of cardiovascular disorder and the risk for incident type 2 Diabetes is more than five times higher in individuals with MetS when compared to those without the syndrome.        Reference :            1 Kawamoto, Tabara, Kohara, Miki, Kusunoki, Takayama, Abe, Katohand Ohtsuka; Relationships between lipid profiles and metabolic syndrome, insulin resistance and serum high molecular adiponectin in Japanese community-dwelling adults; Lipids in Health and Disease2011 10:792 Ingelsson E., Arnlov J., Lind L., Sundstrom J..

Metabolic syndrome and risk for heart failure in middle-aged men. Heart. 2006;92: 1409–14133 Imam SK, Shahid SK, Hassan A., Alvi Z.. Frequency of the metabolic syndrome in type 2 diabetic subjects attending the diabetes clinic of a tertiary care hospital. J Pak Med Assoc. 2007;57: 239–2424 Bansal TC, Guay AT, Jacobson J.

, Woods BO, Nesto RW. Incidence of metabolic syndrome and insulin resistance in a population with organic erectile dysfunction. J Sex Med. 2005;2: 96–103.5 Taskinen MR. Is metabolic syndrome the main threat to human health in the twenty-first century? Arterioscler Thromb Vasc Biol.

2007;27: 22756 Alexander CM, Landsman PB, Teutsch SM, Haffner SM: NCEP-Defined Metabolic Syndrome, Diabetes, and Prevalence of Coronary Heart Disease Among NHANES III Participants Age 50 Years and Older. Diabetes. 2003, 52 (5): 1210-1214. 10.2337/diabetes.52.

5.12107 AlSaraj F, McDermott JH, Cawood T, McAteer S, Ali M, Tormey W, Cockburn BN: Prevalence of the metabolic syndrome in patients diabetes mellitus. Ir J Med Sc.

2009, 178 (3): 309-313. 10.1007/s11845-009-0302-z8 Wahab KW, Sani M, Gbadamosi M, Yandutse M: Frequency and determinants of the metabolic syndrome in apparently healthy adult Nigerians. Trop Doct. 2008, 38: 224-226. 10.1258/td.

2007.0703359 Isezuo SA, Ezunu E: Demographic and clinical correlates of metabolic syndrome in Native African type 2 diabetic patients. J Natl Med Assoc. 2005, 97 (4): 557-56310 Maggi S,  Noale  M,  Zambon  A,  Limongi  F,  Romanato  G,  Crepaldi  G.  Validity of  the  ATP  III  diagnostic  criteria  for  the  metabolic  syndrome  in  an  elderly Italian  Caucasian  population.  The  Italian  Longitudinal  Study  on  Aging. Atherosclerosis.  2008;  197  (2):  877-82.

11  Marafon  LP,  Cruz  IBM,  Schwanke  CHA,  Moriguchi  EH.  Preditores cardiovasculares  da  mortalidade  em  idosos  longevos.  Cad  Saúde  Pública.

2003;  19  (3):  799-80812 Mihaela Mocan, S?Tefan Vesa, S?oimit?A Suciu, Sorin Nicu Blaga; Systemic Markers Of Oxidative Stress In Relation To Metabolic Syndrome Components. Clujul Medical 2013 Vol. 86 – no.

3, 2013. 1-813 Kaplan NM. The deadly quartet. Upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Archives of Internal Medicine. 1989;149(7):1514–1520. PubMed14 Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysis of the insulin-resistance syndrome (Syndrome X) Diabetes.

1992;41(6):715–722. PubMed15 N.Bhagyashree,Dr.C.

Ramaswamy, H.Manjunath, Dr.Ganesh.M, Study on cardiac anatomical modulation with severity in metabolic syndrome.

Int J Pharma Bio Sci 2017 July;8(3):(B) 665-668.16 P. Padmavathi, E. Sailaja, A. Renuka, E. Gnanadesigan, and K.

Baku Mahendran. Prevalence of metabolic syndrome. Int J Appl Biol Pharm 2012; 2013; 4(3):874-7717 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, : Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II).

JAMA. 1993, 269 (23): 3015-302318 Kimm H, Lee SW, Lee HS, Shim KW, Cho CY, Yun JE, Jee SH: Associations between lipid measures and metabolic syndrome, insulin resistance and adiponectin. – Usefulness of lipid ratios in Korean men and women -. Circ J. 2010, 74 (5): 931-937. 10.

1253/circj.CJ-09-057119 Ziemke F, Mantzoros CS: Adiponectin in insulin resistance: lessons from translational research. Am J Clin Nutr.

2010, 91 (1): 258S-261S. 10.3945/ajcn.2009.28449C20 Seino Y, Hirose H, Saito I, Itoh H: High-molecular-weight adiponectin is a predictor of progression to metabolic syndrome: a population-base 6-year follow-up study in Japanese men. Metabolism. 2009, 58 (3): 355-360.


10.00821 Pischon T, Girman CJ, Hotamisligil GS, Rifai N, Hu FB, Rimm EB: Plasma adiponectin levels and risk of myocardial infarction in men. JAMA. 2004, 291 (14): 1730-1737. 10.1001/jama.291.14.1730