The metabolic syndrome: prevalence, associated factors, and impact on survival among older persons in rural Bangladesh

Objectives

To describe the prevalence of the metabolic syndrome (MetS) among older persons in rural Bangladesh, to investigate whether the prevalence varies by age, sex, literacy, marital status, nutritional status and socio-economic status, and to assess the impact of MetS on survival.

Methods

The study consisted of 456 persons who were aged ≥60 years living in a rural area of Bangladesh during July 2003–March 2004. Data were collected through interview, clinical examination, and laboratory tests, and their survival status until 30^th June 2009 was ascertained through the Matlab surveillance system. We defined MetS following the NCEP ATP III criteria, with minor modifications, i.e., presence of any three of the following: hypertension (BP ≥130/85 mm Hg); random blood glucose (RBG) level ≥7.0 mmol/L; hyper-triglyceridemia (≥2.28 mmol/L); low level of HDL-cholesterol (<1.04 mmol/L for men and <1.29 mmol/L for women); and BMI ≥25.0 kg/m². Data were analysed with logistic regressions for the influential factors of MetS, and with Cox models for the association of MetS with the survival status.

Findings

The overall prevalence of MetS was 19.5%, 20.8% in women, and 18.0% in men. Asset-index and nutritional status were independently associated with MetS. During 4.93 years of follow-up, 18.2% died. In the presence of high RBG, MetS has a significant negative effect on survival (69.4% vs 95.2%, log rank p = 0.02).

Conclusion

This study highlights the importance of the metabolic syndrome in rural Bangladesh. Our findings suggest that there is a need for screening programmes involving the metabolic syndrome to prevent diabetes and cardiovascular diseases.     

Hybridisation and selective breeding for improvement of low temperature activity of the entomopathogenic nematode Steinernema feltiae

Steinernema feltiae is used to control overwintering larvae of the codling moth Cydia pomonella L. Application is in autumn when efficacy can be limited by low temperature. The objective of this study was to screen for low temperature activity among wild type populations of S. feltiae, hybridise most active strains and further improve low temperature activity by subjection of a hybrid strain to selective breeding. Significant variation was recorded among 22 S. feltiae strains. The temperature at which 50 % (AT₅₀) and 10 % (AT₁₀) of the dauer juveniles (DJs) were active ranged between 2.9 to 5.8 °C and 0.95 to 3.5 °C, respectively. The mean AT₅₀ of 22 S. feltiae strains was 3.83 °C. The five most active strains were crossed. The hybrid strain HYB01 was more active at low temperature than parental and other hybrid strains with an AT₅₀ of 0.52 °C and an AT₁₀ of 0.09 °C. The tolerance was lost after few reproductive cycles in the insect Galleria mellonella, but was recovered after seven selection cycles with exposure to lowering temperatures. The heritability for the low temperature activity was calculated at h ² = 0.45. Negative trade-off effects on virulence against C. pomonella and reproduction on the same insect were not reported. The most virulent strain was a commercial strain with an LD₅₀ of 30.2 at 8 °C and 37.2 DJs per cocooned instar at 15 °C, followed by the selected hybrid with 48.1 and 47.4 DJs, respectively. Offspring production reached 15.000 DJs per instar at 8 °C and was only half at 15 °C. The results well document the potential of a breeding programme for enhancement of the activity of S. feltiae at lower temperature with the objective to improve the control potential of overwintering codling moth C. pomonella.     

Genetic Diversity and Population Structure of Native and Introduced Date Palm (Phoenix dactylifera) Germplasm in the United Arab Emirates

Date palm (Phoenix dactylifera) has been cultivated since ancient times, but little is known about its genetic diversity and population structure. Examination of 80 date palm accessions grown in the United Arab Emirates, including a collection of varieties from around the world, using 21 microsatellite markers, indicated extensive genetic diversity, with many accessions heterozygous for most markers. The average number of alleles per locus (19), expected heterozygosity (0.7), observed heterozygosity (0.25) and fixation indices (Fst?=?0.6, Rst?=?0.72) demonstrated significant population structure. Analysis with a model-based Baysian method, STRUCTURE 2.4.1, indicated that the 80 accessions could be broadly divided into nine groups. Independent samples of genotypes with the same name, collected from different experimental stations, usually clustered together. The study was enriched for germplasm from the United Arab Emirates (UAE), and one STRUCTURE-derived grouping consisted mainly of UAE accessions. In a few other clusters, several genotypes from the UAE, Iraq and Oman grouped together. Two clusters included accessions from both North Africa and the Middle East. Many accessions in the STRUCTURE-derived populations appeared to be genetic admixtures. The results indicated a broad dissemination of related germplasms across date-palm growing regions of the world, with very few alleles that still correlate with particular regional germplasms.     

Parathyroid hormone in urinary stone patients

To evaluate the role of parathyroids in calculus disease, the parathyroid hormone levels were determined in 22 control subjects and 42 stone (14 with bladder stone and 28 with kidney stone) patients. Serum calcium, inorganic phosphate, alkaline phosphatase and parathyroid hormone and urinary excretion of calcium and inorganic phosphate were determined. It was found that normocalcemic and normocalciuric stone patients had slightly higher levelsss of parathyroid hormone (irrespective of the site of the stone) and the difference was not statistically significant as compared with control subjects although some of the patients with calculus disease were hyperparathyroid. Serum alkaline phosphatase was increased while there was an increase in urinary calcium excretion in kidney stone patients and oxalate in all patients as compared with control subjects. The increase in inorganic phosphate was, however, not different from the control subjects. The subclinical hyperparathyroidism and stone formation in these patients are not correlated.     

Pharmacological Emptying of the Stomach with Metoclopramide

This paper evaluates the use of metoclopramide (Maxolon) in emptying human stomach contents into the duodenum and beyond. A method of quantitative assessment of content by barium swallow radiography is used in the study, and the method is recommended as a diagnostic manoeuvre in patients presenting for emergency surgery in whom the stomach content is in doubt. Oral metoclopramide was found effective in emptying stomachs challenged by water load, and the intravenous route has been found effective in emptying semisolid contents in emergency clinical situations. A radiographic scan of the resting stomach was made on patients waiting for routine surgery who had received a variety of common premedication; it was shown that significant residues occur.We believe that metoclopramide deserves further investigation in order to exploit its potential in reducing the hazard of regurgitation and vomiting in patients requiring emergency anaesthesia and surgery.