The effect of the COVID-19 pandemic on the increase of hyperlipidemia and metabolic syndrome in the Turkish population: a retrospective study

Yıl 2022, , 607 - 613, 15.03.2022

Alpaslan Karabulut , Mustafa Şahin

https://doi.org/10.32322/jhsm.1062633

Öz

Aim: With the Coronavirus Disease 2019 (COVID-19) pandemic starting in late 2019 and continuing into 2020, permanent or periodic quarantine processes and curfews have been implemented. The objective of the study was to investigate the impact of extended quarantine processes during the pandemic on the development of metabolic syndrome (MET-S) due to physical inactivity.
Material and Method: This retrospective study consists of two groups. The first group consists of patients who applied to our hospital in the 12 months preceding the pandemic. The second group consists of the same patients who applied to the same hospital within 12 months of the onset of the pandemic. A total of 44,024 participants who had lab data prior to and during the pandemic were included in the study. Fasting plasma glucose (FPG), Triglyceride (TRIG), Total Cholesterol (T-Chol), High Density Lipoprotein-Cholesterol (HDL-C), Low Density Lipoprotein-Cholesterol (LDL-C) levels and demographic characteristics of the patients were recorded. The test averages were compared between the two groups and their effects on the development of MET-S were subjected to statistical analysis.
Results: When we compared our patients' HDL-C, FPG and TRIG levels measured during the pandemic and the pre-pandemic period, we found a statistically significant increase (p<0.001 for all three). We examined whether the COVID-19 pandemic affected the diagnosis criteria for MET-S (TRIG, HDL-C, FPG). The proportion of patients with FPG>100 mg/dL and TRIG>150 mg/dL during the pandemic was statistically significantly higher than during the pre-pandemic period (51.7% vs 45.8%, p<0.001; 45.7% vs 42.7%, p<0.001).We found that the proportion of patients with HDL-C<50 mg/dL in women and HDL-C<40 mg/dL in men during the pandemic was statistically significantly lower than during the pre-pandemic period (43.7% vs 46.9%, p<0.001; 32.4% vs 36.7 p<0.001, respectively).
Conclusions: The influence of sedentary living on the development of MET-S, insulin resistance, diabetes mellitus and cardiovascular diseases is known. The levels of FPG, TRIG and HDL-C constitute three of the five diagnostic criteria of MET-S, and abnormal changes in these tests are effective in the formation of MET-S. We have detected a significant increase in FPG and TRIG levels in patients due to the COVID-19 pandemic. Thus, we have established that patients became more susceptible to MET-S on the pandemic due to quarantine. On the other hand, there is a need for further research, including waist circumference and blood pressure data, which are included in the diagnostic criteria for MET-S.

Anahtar Kelimeler

Hyperlipidemia, Metabolic Syndrome, Pandemic, COVID-19

Kaynakça

• Park SE. Epidemiology, virology, and clinical features of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2; Coronavirus Disease-19). Clin Exp Pediatr 2020; 63: 119-24.
• Bourouiba L. Turbulent gas clouds and respiratory pathogen emissions: potential implications for reducing transmission of covid-19. Jama 2020; 323: 1837-8.
• Gençalp DK. Covid-19 salgını döneminde ilk ve acil yardım öğrencilerinin beslenme alışkanlıkları ve fiziksel aktivite durumlarının değerlendirilmesi. Paramedik ve Acil Sağlık Hizmetleri Derg 2020; 1: 1-15.
• Caner ZG. Ünal M, Apaydın Z, et al. Covid-19 hastalığı ve ev egzersizlerinin önemi. J Med Sci 2020; 1: 25-33.
• Kaur J. A comprehensive review on metabolic syndrome. Cardiol Res Pract 2014: 943162.
• Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity. Circulation 2009; 120: 1640-5.
• Alberti KG, Zimmet P, Shaw J. Metabolic Syndrome-a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med 2006: 23: 469-80.
• Grundy SM, Hansen B, Smith SC Jr, et al. American Heart Association; National Heart, Lung, and Blood Institute; American Diabetes Association. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation 2004; 109: 551-6.
• Diabetes Prevention Program (DPP) Research Group. The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care 2002; 25: 2165- 71.
• Sato Y. Diabetes and life-styles: role of physical exercise for primary prevention. Br J Nutr 2000; 84: 187-90.
• Amati F, Dubé JJ, Alvarez-Carnero E, et al. Skeletal muscle triglycerides, diacylglycerols, and ceramides in insulin resistance: another paradox in endurance-trained athletes? Diabetes 2011; 60: 2588-97.
• Koplan JP, Dietz WH. Caloric imbalance and public health policy. JAMA 1999; 282: 1579-81.
• Sato Y, Nagasaki M, Kubota M, Uno T, Nakai N. Clinical aspects of physical exercise for diabetes/metabolic syndrome. Diabetes Res Clin Pract 2007; 77: 87-91.
• Haram PM, Kemi OJ, Lee SJ, et al. Aerobic interval training vs. continuous moderate exercise in the metabolic syndrome of rats artificially selected for low aerobic capacity. Cardiovasc Res 2009; 81: 723-32.
• Gutin B, Owens S. The influence of physical activity on cardiometabolic biomarkers in youths: a review. Pediatr Exerc Sci 2011; 23: 169-85.
• Uyaroğlu OA, Özdede M, Çalık Başaran N, et al. Hyperlipidemia in post-COVID patients; a unique observational followup study on lipid levels in post-COVID patients. J Health Sci Med 2022; 5: 220-6.
• Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID19) outbreak in China: Summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323: 1239-42.
• World Health Organization. Physical activity, https://www.who.int/news-room/fact-sheets/detail/physical-activity(2018, accessed 12 March 2020).
• Bouchard C, Blair SN, Katzmarzyk PT. Less sitting, more physical activity, or higher fitness? Mayo Clin Proc 2015; 90: 1533-40.
• Wilmot EG, Edwardson CL, Achana FA, et al. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia 2012; 55: 2895-905.
• Hamilton MT, Hamilton DG, Zderic TW. Sedentary behavior as a mediator of type 2 diabetes. diabetes and physical activity. Med Sport Sci 2014; 60: 11-26.
• Gennuso KP, Gangnon RE, Thraen-Borowski KM, Colbert LH. Dose–response relationships between sedentary behaviour and the metabolic syndrome and its components. Diabetologia 2015; 58: 485-92.
• van der Berg JD, Stehouwer CDA, Bosma H, et al. Associations of total amount and patterns of sedentary behaviour with type 2 diabetes and the metabolic syndrome: The Maastricht Study. Diabetologia 2016; 59: 709-18.
• Lippi G, Henry BM, Sanchis-Gomar F. Physical inactivity and cardiovascular disease at the time of coronavirus disease 2019 (COVID-19). Eur J Preventive Cardiol 2020; 27: 906–8.
• Hamburg NM, McMackin CJ, Huang AL, et al. Physical inactivity rapidly induces insulin resistance and microvascular dysfunction in healthy volunteers. Arterioscler Thromb Vasc Biol 2007; 27: 2650-6.
• Olsen RH, Krogh-Madsen R, Thomsen C, Booth FW, Pedersen BK. Metabolic responses to reduced daily steps in healthy nonexercising men. JAMA 2008; 299: 1261-3.
• Methnani J, Amor D, Yousf N, Bouslama A, Omezzine A, Bouhlel E. Sedentary behavior, exercise and Covid-19: immune and metabolic implications in obesity and its comorbidities. J Sports Med Phys Fitness 2020; 61: 1538-47.
• Mikus CR, Oberlin DJ, Libla JL, Taylor AM, Booth FW, Thyfault JP. Lowering physical activity impairs glycemic control in healthy volunteers. Med Sci Sports Exerc 2012; 44: 225–31.
• Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc 2009; 41: 998–1005.
• Van der Ploeg H P, Chey T, Korda RJ, Banks E, Bauman A. Sitting time and all-cause mortality risk in 222 497 Australian adults. Arch Intern Med 2012; 172: 494–500.
• Ekelund U, Tarp J, Steene-Johannessen J, et al. Dose response associations between accelerometry measured physical activity and sedentary time and all cause mortality: Systematic review and harmonised meta-analysis. BMJ 2019; 366: l4570
• Mazzucco S, Agostini F, Mangogna A, Cattin L, Biolo G. Prolonged inactivity up-regulates cholesteryl ester transfer protein independently of body fat changes in humans. J Clin Endocrinol Metab 2010; 95: 2508–12.
• Bakrania K, Edwardson CL, Bodicoat DH, et al. Associations of mutually exclusive categories of physical activity and sedentary time with markers of cardiometabolic health in English adults: a cross-sectional analysis of the Health Survey for England. BMC Public Health 2016; 16: 25.
• Dixon NC, Hurst TL, Talbot DCS, Tyrrell RM, Thompson D. Effect of short-term reduced physical activity on cardiovascular risk factors in active lean and overweight middle-aged men. Metabolism 2013; 62: 361–8.
• Bowden Davies KA, Sprung VS, Norman JA, et al. Short-term decreased physical activity with increased sedentary behaviour causes metabolic derangements and altered body composition: effects in individuals with and without a first-degree relative with type 2 diabetes. Diabetologia 2018; 61: 1282–94.
• Winn NC, Pettit-Mee R, Walsh LK, et al. Metabolic implications of diet and energy intake during physical inactivity. Med. Sci. Sports Exerc 2019; 51: 995–1005.