Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Metabolic syndrome and risk of endometrial carcinoma among asymptomatic, post-menopausal, urban Sri Lankan females: a community cohort follow-up study(Sri Lanka Medical Association, 2017) Dias, T.D.; Niriella, M.A.; de Silva, S.T.; Ediriweera, D.; Motha, C.; Palihawadana, T.; de Silva, H.J.INTRODUCTION & OBJECTIVES: Metabolic syndrome (MetS) has been recognized as a risk factor for malignancies. The aim of this study was to evaluate the association of MetS and risk of endometrial carcinoma (EC), by measuring endometrial thickness (ET). METHODS: The Ragama Health Study (RHS) recruited 35-64-year-old females from the Ragama MOH area by age-stratified random sampling in 2007 and re-evaluated them in 2014, using a structured interview, anthropometric measurements and biochemical tests. Liver ultrasound to detect fatty liver was performed in 2007. Pelvic ultrasound to detect ET was performed in 2014 among consenting participants. MetS was diagnosed on established International Diabetes Federation (IDF 2012) criteria. Increased ET was defined as >5mm. Simple logistic regression was used to screen variables and multiple logistic regression was used to obtain adjusted effects of risk factors for increased ET. RESULTS: Of the original female cohort, 813/1636 (49.7%) attended follow-up; ET was measured in 567 (69.7%). Median (IQR) age of females was 61 (56-66) years. 323 fulfilled criteria for MetS (prevalence 57.1%) in 2007. 57 (10.1%) had increased ET in 2014. Increasing plasma triglycerides [OR=1.004 per mg/dl, 95% CI 1.001-1.007, p<0.05] and being hypertensive [OR=2.16, 95% CI 1.11–4.08, p<0.05] were associated with increased ET, while advancing age [OR=0.93 per year, 95% CI 0.89–0.98, p<0.01] and being diabetic [OR= 0.34, 95% CI 0.10–0.89, p<0.05] were protective. CONCLUSION: Hypertension and increased plasma triglyceride levels, in the pre-menopausal period, were risk factors for future asymptomatic increased ET.Item Metabolic syndrome in the Ragama Health Study: definitions and controversies(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Chackrewarthy, S.Although there is agreement that the Metabolic Syndrome (MetS) is a major public health challenge worldwide and consistent evidence stresses the need for intervention, the definition of the syndrome remains a matter of debate. Currently, several different definitions of MetS exist which share several features but also include important differences and limitations. Prevalence of MetS in the RHS was estimated using the two most widely used definitions of MetS: International Diabetes Federation (IDF) and revised National Cholesterol Education Program Adult Treatment Panel III (revised NCEP ATP III). Age and sex-adjusted prevalences of MetS in the RHS were 46.1% and 38.9% by revised NCEP and IDF definitions, respectively. IDF criteria failed to identify 21% of men and 7% of women identified by the revised NCEP criteria. The discrepant group had more adverse metabolic profiles despite having a lower waist circumference than those diagnosed by both criteria. This discrepancy was mainly caused by waist circumference criterion which is a prerequisite for the diagnosis of MetS based on IDF definition. In contrast, the revised NCEP definition considers abdominal obesity as one of the equally weighted criteria. The discrepant group in our study included a metabolically obese, normal weight (MONW) group of individuals who are predisposed to diabetes and CVD like people with overt obesity. MONW individuals are common in the general population and they probably represent one end of the spectrum with MetS. The study highlights the need for a unified definition of MetS which would identify individuals with an increased risk of diabetes and CVD.