Frequency of metabolic syndrome and associated factors in institutionalized elderly individuals

Figures & data

Figure 1 Flowchart of study participant selection.

Abbreviations: NH, nursing home; MS, metabolic syndrome.

Table 1 Factorial analysis model of the dietary components for institutionalized elderly individuals (n=178)

Variables	Values of communalities	Factor load values	Factor score quartiles
			Group 1 (up to −0.681)	Group 2 (−0.680–0.109)	Group 3 (0.110–0.670)	Group 4 (>0.671)
Energy	0.814	0.902	Low	Moderate	High	Very high
Total fat	0.764	−0.874	High	Moderate	Low	Very low
Dietary fiber	0.327	0.572	Very low	Low	Moderate	High

Note: Data were missing for 24 elderly individuals.

Table 2 Frequency of MS and MS components, and sociodemographic, clinical, and lifestyle factors among institutionalized elderly individuals (n=202)

Characteristic	n (%)
MS
Yes	59 (29.2)
No	143 (70.8)
MS components
Abdominal obesity	82 (42.7)
Hyperglycemia and/or use of oral hypoglycemic drugs	52 (25.7)
Arterial hypertension and/or use of antihypertensive drugs	80 (40.2)
Hypertriglyceridemia	38 (18.8)
Low HDL-c	129 (63.9)
Sex
Male	50 (24.8)
Female	152 (75.2)
Age (years)
<75	48 (23.8)
≥75	154 (76.2)
Type of nursing home
Nonprofit	141 (69.8)
For profit	61 (30.2)
Main reason for institutionalization
Lack of caregiver	69 (35.8)
Disease	38 (19.7)
Living alone	29 (15.0)
Lack of housing	20 (10.4)
Own option	13 (6.7)
Other options	24 (12.4)
Age-adjusted institutionalization time (%)
<25	115 (56.9)
25–50	48 (23.8)
>50	39 (19.3)
Physical activity
Yes	51 (26.7)
No	140 (73.3)
Smoking
Yes	18 (9.2)
No	178 (90.8)
Former smoking
Yes	40 (25.6)
No	116 (74.4)
Alcoholic beverage intake
Yes	6 (3.0)
No	191 (97.0)
Carbohydrate intake (% total energy)
Below recommended	11 (6.2)
Recommended	79 (44.4)
Above recommended	88 (49.4)
Protein intake (% total energy)
Below recommended	4 (2.2)
Above recommended	174 (97.8)
Energy, total fat, and dietary fiber intakea
Group 1	44 (24.7)
Group 2	46 (25.8)
Group 3	44 (24.7)
Group 4	44 (24.7)
hs-CRP (mg/dL)
≥10.0	201 (99.5)
<10.0	1 (0.5)
IL-6 (pg/mL)
≥3.4	96 (47.5)
<3.4	106 (52.5)
TNF-α (pg/mL)
≥8.1	90 (44.6)
<8.1	112 (55.4)

Notes: Data are expressed as n (%). Data were missing for abdominal obesity (n=10); arterial hypertension and/or use of antihypertensive drugs (n=3); main reason for institutionalization (n=9); physical activity (n=11); smoking (n=6); former smoking (n=46); alcoholic beverage intake (n=5); energy, total fat, and dietary fiber intake (n=24); carbohydrate intake (% total) (n=24); and protein intake (% total) (n=24).

a Group 1: low energy, high fat, and very low dietary fiber intake; Group 2: moderate energy, moderate fat, and low dietary fiber intake; Group 3: high energy, low fat, and moderate dietary fiber intake; Group 4: very high energy, very low fat, and high dietary fiber intake.

Abbreviations: HDL-c, high-density lipoprotein cholesterol; hs-CRP, high- sensitivity C-reactive protein; IL, interleukin; TNF, tumor necrosis factor; MS, metabolic syndrome.

Table 3 Association between MS in institutionalized elderly individuals, and sociodemographic, lifestyle, and clinical variables with n percent values >10 (n=202)

	Individuals with MS, n (%)	PR (95% CI)	P-valuea
Sex
Male (n=50)	8 (16.0)	1.00	0.016
Female (n=152)	51 (33.6)	2.35 (1.14–4.83)
Age (years)
≤75 (n=48)	18 (37.5)	1.43 (0.91–2.25)	0.183
>75 (n=154)	41 (26.6)	1.00
Type of nursing home
Nonprofit (n=141)	40 (28.4)	1.00	0.761
Profit (n=61)	19 (31.1)	1.12 (0.71–1.77)
Age-adjusted institutionalization time (%)
<25 (n=115)	29 (50.0)	1.32 (0.68–2.56)	0.533
25–50 (n=48)	9 (15.5)	1.00	–
>50 (n=39)	20 (34.5)	2.68 (1.38–5.19)	0.004
Physical activity, n=191
Yes (n=51)	15 (29.4)	1.00 (0.59–1.61)	1.000
No (n=140)	41 (29.3)	1.00
Former smoking, n=156
Yes (n=40)	13 (32.5)	1.11 (0.65–1.88)	0.858
No (n=116)	34 (29.3)	1.00
Energy, total fat, and dietary fiber intake,b n=178
Group 1 (n=44)	13 (29.5)	1.28 (0.62–2.66)	0.669
Group 2 (n=46)	10 (21.7)	1.00	–
Group 3 (n=44)	12 (27.3)	1.25 (0.60–2.60)	0.715
Group 4 (n=44)	18 (40.9)	1.88 (0.98–3.62)	0.083
IL-6 (pg/mL)
≥3.4 (n=96)	39 (40.6)	2.25 (1.40–3.60)	0.001
<3.4 (n=106)	20 (18.9)	1.00
TNF-α (pg/mL)
≥8.1 (n=90)	34 (37.8)	1.75 (1.12–2.72)	0.018
<8.1 (n=112)	25 (22.3)	1.00

Notes: Data are expressed as n (%).

a Chi-squared test.

b Group 1: low energy, high fat, and very low dietary fiber intake; Group 2: moderate energy, moderate fat, and low dietary fiber intake; Group 3: high energy, low fat, and moderate dietary fiber intake; Group 4: very high energy, very low fat, and high dietary fiber intake.

Abbreviations: IL, interleukin; MS, metabolic syndrome; PR, prevalence ratio; TNF, tumor necrosis factor.

Table 4 Association between MS components in institutionalized elderly individuals, and variables that demonstrated significant association with MS in the bivariate analysis model (n=202)

	Abdominal obesity (n=192)a		Hypertriglyceridemia (n=202)		Low HDL-c (n=202)		Arterial hypertension (n=199)b		Hyperglycemia (n=202)
	n (%)	PR (95% CI)	n (%)	PR (95% CI)	n (%)	PR (95% CI)	n (%)	PR (95% CI)	n (%)	PR (95% CI)
Sex
Male (n=50)	11 (23.9)	1.00	6 (12.0)	1.00	24 (48.0)	1.00	20 (40.0)	1.00	11 (22.0)	1.00
Female (n=152)	71 (48.6)	2.19 (1.24–3.87)c	32 (21.1)	2.06 (0.85–5.00)	105 (69.1)	1.41 (1.04–1.91)c	60 (40.3)	1.04 (0.69–1.55)	41 (27.0)	1.20 (0.67–2.15)
Age-adjusted institutionalization time (%)
<25 (n=115)	41 (37.6)	1.00	21 (18.3)	2.15 (0.78–4.60)	73 (63.5)	1.10 (0.83–1.47)	42 (36.5)	1.15 (0.70–1.89)	25 (21.7)	1.00
25–50 (n=48)	20 (44.4)	1.15 (0.76–1.74)	5 (10.4)	1.00	27 (56.3)	1.00	15 (33.3)	1.00	12 (25.0)	1.17 (0.64–2.14)
>50 (n=39)	21 (55.3)	1.47 (1.01–2.14)	12 (30.8)	3.61 (1.27–10.3)c	29 (74.4)	1.29 (0.95–1.76)	23 (59.0)	1.85 (1.11–3.07)c	15 (38.5)	1.77 (1.04–2.10)
IL-6 (pg/mL)
≥3.4 (n=96)	62 (66.7)	3.44 (2.24–5.28)d	19 (19.8)	1.16 (0.65–2.17)	70 (72.9)	1.30 (1.06–1.60)c	42 (44.2)	1.23 (0.87–1.73)	27 (28.1)	1.18 (0.74–1.89)
<3.4 (n=106)	20 (20.2)	1.00	19 (17.9)	1.00	59 (55.7)	1.00	38 (36.5)	1.00	25 (23.6)	1.00
TNF-α (pg/mL)
≥8.1 (n=90)	43 (49.4)	1.35 (0.97–1.88)	26 (28.9)	2.92 (1.53–5.57)d	72 (80.0)	1.56 (1.26–1.91)d	40 (44.9)	1.26 (0.89–1.77)	24 (26.7)	1.06 (0.66–1.70)
<8.1 (n=112)	39 (37.1)	1.00	12 (10.7)	1.00	57 (50.9)	1.00	40 (36.4)	1.00	28 (25.0)	1.00

Notes: Data are expressed as n (%).

a Sex: male (n=46), female (n=146); age-adjusted institutionalization time (%): <25 (n=109), 25–50 (n=45), >50 (n=38); IL-6 ≥3.4 (n=93), IL-6 <3.4 (n=99); and TNF-α ≥8.1 (n=87), TNF-α <8.1 (n=105).

b Sex: male (n=50), female (n=149); age-adjusted institutionalization time (%): <25 (n=115), 25–50 (n=45), >50 (n=39); IL-6 ≥3.4 (n=95), IL-6 <3.4 (n=104); and TNF-α ≥8.1 (n=89), TNF-α <8.1 (n=110). Chi-squared test;

c P<0.05.

d P<0.001.

Abbreviations: IL, interleukin; MS, metabolic syndrome; PR, prevalence ratio; TNF, tumor necrosis factor; HDL-c, high-density lipoprotein cholesterol.

Table 5 Multivariate model including variables associated with MS with P-value <0.20 in the bivariate analysis (n=201)

Variables	Variable category		Adjusted PR (95% CI)	P-valuea
	Reference	Predictive
Sex	Male	Female	2.16 (1.04–4.49)	0.039
Age-adjusted institutionalization time (%)	25%–50%	>50%	2.38 (1.46–3.88)	0.001
Dietary componentsb	Group 2	Group 4	1.85 (1.11–3.10)	0.019
IL-6 (pg/mL)	<3.4	≥3.4	2.01 (1.21–3.32)	0.007
TNF-α (pg/mL)	<8.1	≥8.1	1.70 (1.05–2.77)	0.032

Notes: Data are expressed as n (%).

a Chi-squared test.

b Group 2: moderate energy, moderate fat, and low dietary fiber intake; Group 4: very high energy, very low fat, and high dietary fiber intake.

Abbreviations: IL, interleukin; MS, metabolic syndrome; PR, prevalence ratio; TNF, tumor necrosis factor.