A CROSS SECTIONAL STUDY OF METABOLIC SYNDROME AMONG RAILWAY EMPLOYEE

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METABOLIC SYNDROME
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Dr. I. Selvaraj
Indian Railways Medical Service
B.Sc., M.B.B.S., M.D.,D.P.H., D.I.H., PGCHFW (
NIHFW,New Delhi)., Life member of
Indian Association of Preventive Social
Medicine Life member of Indian Public
Health Association Life member of
Indian Medical Association
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• As I am one of the strong supporter of
  super course, I am dedicating this presentation
  to the public health students (Post graduate
  Diploma in Public Health, M.D Community Medicine)

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METABOLIC SYNDROME

• Metabolic syndrome is a cluster of risk factors
  which is responsible for excess of cardiovascular
  disease morbidity among overweight and Obese
  patients and those persons with type 2 diabetes
  mellitus.
• The National Cholesterol Education Program- Adult
  Treatment Panel (NCEP-ATP III) identified
  metabolic syndrome as an independent risk factor
  for cardiovascular disease and considered it an
  indication for intensive lifestyle modification.

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W.H.O DEFINITION OF MEATBOLIC SYNDROME   INSULIN
RESISTANCE TWO OF THE FOLLOWING  1.Abdominal/cen
tral obesity Waist to hip ratio gt 0.90
(men), gt 0.85 (women), or BMI gt 30  2.
Hypertriglyceridemia 150 mg per dL   3. Low
HDL cholesterol lt 35 mg perdl for men, lt 39 mg
per dL for women  4. High blood pressure
140/90 mm Hg or documented use of
antihypertensive therapy   5. High fasting
glucose Impaired glucose tolerance, impaired
fasting glucose, insulin resistance, or
diabetes  6. Microalbuminuria Urinary albumin to
creatinine ratio 30 mg per g, or albumin
excretion rate 20 mcg per minute
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Review of literature
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A CROSS SECTIONAL STUDY ON METABOLIC SYNDROME
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JUSTIFICATION OF THE STUDY

• As there is an epidemiological transition from
  communicable to non-communicable diseases
• The prevalence of Metabolic syndrome is reported
  to be very high in developing countries.
• The components of the metabolic syndrome are
  important risk factors for the development of
  Coronary Heart Diseases and for Type 2 diabetes.
• Hence this study will be ideal to estimate the
  prevalence of Metabolic syndrome in the
  developing countries

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OBJECTIVE 1. To determine the
prevalence of metabolic syndrome using NCEP adult
treatment panel-3 (ATP-3) guidelines   2. To
determine the role of lifestyle risk factors in
the development of metabolic syndrome with
particular reference to physical activity,
smoking, diet and alcohol consumption.
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• CASE DEFINITION
• Metabolic syndrome is defined in
  accordance with NCEP - ATP III as the presence of
  3 or more of the following characteristics
• Waist circumference gt 102 cm in men and gt 88 cm
  in women
• Triglyceride levels gt or 150 mg/dl,
• High density lipoprotein cholesterol lt 40 mg/dl
  in men and lt 50 mg/dl in women
• Blood pressure gt or 130/85 mm hg
• and Fasting serum glucose gt or 110 mg/dl.

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STUDY DESIGN Cross sectional study
METHODS
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SAMPLE SIZE CALCULATION
Sample Size (N) (Z?²pq)/L² Z?1.96 Ordinate
value for ?5 p Prevalence of Metabolic
Syndrome q 100-p L Precision
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APPROVAL 1.ETHICS COMMITTEE 2.COMPETENT
AUTHORITY
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PILOT STUDY
It will be done to pre- test pre design the
questionnaire and other procedures
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DATA COLLECTION

• A structured questionnaire comprising information
  on social demographic, behavioral and clinical
  characteristics.
• Anthropometrics measurement
• Blood pressure( JNC VII)
• Fasting blood sample of glucose and Lipid Profile

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ANALYSIS

• Data analysis by using appropriate available
  software package
• Prevalence of Metabolic syndrome as point
  estimate and 95 C.I for precision
• Odds Ratio for the risk factors of Metabolic
  syndrome
• Logistic regression to find out the adjusted
  Odds Ratio 95 C.I

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THANK YOU