Relationship between age and metabolic disorders in the population of Bali

Abstract

a b s t r a c tBackground/Purpose: The purpose of this study is to examine the association between age and metabolic disorders in the population of Bali. Method: A cross-sectional study was conducted on metabolic syndrome (MS) as defined on the basis of recommended parameters for diagnosis of the syndrome in the population of seven villages of Bali comprising six villages and one suburban area. At least three of the five parameters must be present for the diagnosis. Three hundred ten elderly people aged 60 years or more, with a male:female ratio of 168:142, of 1840 subjects were recruited in the study. The criteria for obesity were based on the 2000 World Health Organization recommendations for Asia Pacific population, for prediabetes [impaired fasting glycemia (IFG) and impaired glucose tolerance] and diabetes mellitus (Results: The prevalence of IFG and DM were twofold in the elderly as compared with those in the younger-aged groups (21.4 vs. 11.7; 11.7 vs. 4.8, respectively). Blood pressure and fasting blood sugar levels were higher in the elderly than in the younger-aged group (133/81 mmHg vs. 117/76 mmHg; 102.7 mg/dL vs. 93.0 mg/dL, respectively; p < 0.001). There was no statistically significant difference in triglyceride and high-density lipoprotein cholesterol levels between both groups. Waist circumferences were lower among the elderly than among younger-aged groups (75.8 cm vs. 80.9 cm; p < 0.001). The elderly, with lower waist circumference, revealed significantly higher prevalence of MS as compared with the younger-aged group {22.9% vs. 17.3%; p ¼ 0.026; prevalence risk 1.423 [confidence interval (CI) ¼ 1.043-1.944]}. The subjects who had 1, 2, 3, 4, and 5 components of MS were 34.6%, 23.8%, 13.0%, 4.3%, and 0.9%, respectively. The prevalence risk of each component of MS for the occurrence of MS were: elevated triglyceride [30.2 (CI ¼ 14.5-63.1)], elevated fasting blood sugar )], increased waist circumference [8.1 (CI ¼ 4.3-15.0)], reduced high-density lipoprotein cholesterol [4.4 (CI ¼ 2.4-7.9)], and elevated blood pressure [3.7 (CI ¼ 1.9-7.2)].Conclusions: It could be inferred that in comparison with the younger-age group, the elderly had higher (twice) prevalence of IFG and DM, lower prevalence of central obesity, but higher prevalence of MS. Old age (60 years and more) had 1.4-fold risk for MS as compared with that in the younger-aged group, and elevated triglyceride levels appeared to be the most important risk factor for MS.

Uncoupling protein 2 gene polymorphisms are associated with obesity

“…This study was part of the metabolic disorder study done in Bali, where DNA samples were available [33]. The subjects were recruited by random sampling from either urban (278 subjects) or rural (325 subjects) settlements, and then stratified for large villages and sub-villages.…”

Age is an Important Risk Factor for Type 2 Diabetes Mellitus and Cardiovascular Diseases

“…The peak prevalence of diabetes can be found in the age group of 65-74 years with 15.7% in men and 10.4% in women (Shelton, 2006). The study by Suastika et al (2011) on Bali population showed that the prevalences of IFG and T2DM were higher in the elderly than in the younger age group, i.e. nearly two-fold and more than two fold, respectively (Figure 2).…”

“…The Rotterdam study that enrolled 574 non-diabetic elderly population showed that insulin correlated strongly and significantly with C-reactive protein (CRP), -1-antichymotrypsin, interleukin (IL)-6 and soluble intercellular adhesion molecule-1, indicating that insulin resistance is an integral part of inflammation (Hak et al, 2001). A study by Suastika et al (2011) on the population of Bali, Indonesia, has showed a tendency of increasing frequency of metabolic syndrome and its components with increasing age (Table 1). A study on the elderly by Zambon et al (2009) found that metabolic syndrome was associated with increased mortality by various causes (HR 1:41) and mortality from CVD (HR 1.60).…”

Underweight is an important risk factor for coronary heart disease in the population of Ceningan Island, Bali

“…A study by Suastika et al revealed that the prevalence of MetS and central obesity increased with age, peaking at 50-59 years and decreasing in the older age group. 7 This finding might add fuel to the prevailing controversy about the relationship between age, underweight, and CHD. A study of coronary artery disease (CAD) after prenatal exposure to the Dutch famine revealed an earlier onset of CAD among individuals conceived during the famine, suggesting that maternal nutrition in early gestation may play a role in the onset of CAD.…”