Predictors of the Incident Metabolic Syndrome in Adults

Palaniappan, Latha; Carnethon, Mercedes R.; Wang, Yun; Hanley, Anthony J.; Fortmann, Stephen P.; Sm, Haffner; Wagenknecht, Lynne E.

doi:10.2337/diacare.27.3.788

Cited by 278 publications

(227 citation statements)

References 31 publications

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“…In this study, we found that waist gain is associated with most MetS parameters, mainly with high levels of TGs and reduced levels of HDL-C and increased BP, as markedly observed in the literature (Carr et al, 2004;Grievink et al, 2004;Chuang et al, 2006;Menke et al, 2007;Hirani et al, 2008). On the other hand, in this study, entering FBS as a variable into analysis did not show any significant relationship with waist gain in both genders, as observed in some studies (Palaniappan et al, 2004;Stolk et al, 2005), possibly indicating a lower interference of waist gain in increases in FBS; however, some other studies showed inconsistent results (Nyamdorj et al, 2009;Sone et al, 2009).…”

contrasting

confidence: 33%

Effect of changes in waist circumference on metabolic syndrome over a 6.6-year follow-up in Tehran

et al. 2010

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Background/Objectives: This cohort study was conducted to evaluate the effect of waist change on metabolic syndrome (MetS) status and its parameters in 5720 participants, aged X20 years, of the Tehran Lipid and Glucose Study who were followed up for a mean of 6.6 years. Subjects/Methods: We measured waist circumference (WC) and MetS parameters at baseline (phase I: 1999) and at follow-up (phase III: 2008), and assessed this relationship across five groups: waist loss (oÀ2.0 cm); waist stable (À2.0 to 2.9 cm); mild (3.0-5.9 cm); moderate (6.0-8.9 cm) and large (X9.0 cm) waist gain. MetS was defined according to the International Diabetes Federation criteria. Results: In phase I, the mean (s.d.) waist gain was 88.8 cm (11.7). Between phases I and III, the mean (s.d.) waist gain was 5 cm (7.9). There was 16% (95% confidence interval (95% CI): 13.6-18.4) age-adjusted incident MetS and for every centimeter of WC gained over 6.6 years, the risk of MetS increased by 10% (odds ratio (OR) 1.10; 95% CI: 1.09-1.12). Compared with a stable WC in both genders, ORs for MetS for different waist gain groups were as follows: mild (OR 2.3, 95% CI: 1.7-3.2); moderate (OR 3.5, 95% CI: 2.6-4.7) and large (OR 5.8, 95% CI: 4.5-7.6). Waist loss had a protective effect on MetS (OR 0.6, 95% CI: 0.4-0.9). Waist gain showed a detrimental effect on all parameters of MetS in both genders, except for high-density lipoprotein cholesterol and fasting blood sugar in women. Conclusions: Waist gain, even mild, was a risk factor of the development of MetS and its parameters. Intervention for reducing WC could be an effective strategy to decrease incident MetS.

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confidence: 33%

Effect of changes in waist circumference on metabolic syndrome over a 6.6-year follow-up in Tehran

et al. 2010

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“…Since two prospective studies have identified obesity as the central feature of the MSX, 43,44 suggesting that obesity may precede the development of other components of the MSX, it is tempting to speculate that the definition of MSX by the NCEP that weights obesity equal to the other features of MSX might be more valid than the definition of the WHO that assigns IR a presupposition of MSX.…”

Section: Value Of Fm Vs Anthropometric Obesity Indices For Assessmentmentioning

confidence: 99%

Value of body fat mass vs anthropometric obesity indices in the assessment of metabolic risk factors

et al. 2005

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Objective: To compare the value of body fat mass (%FM) to indirect measures of general (body mass index (BMI)) and central adiposity (waist circumference (WC); waist-to-height ratio (WC/ht)) for the prediction of overweight-and obesity-related metabolic risk in a study population with a high prevalence of metabolic syndrome (MSX). Methods: BMI, WC, WC/ht, body composition (by air-displacement plethysmography) and metabolic risk factors: triglycerides, cholesterol, HDL-cholesterol (HDL-C), uric acid, systolic blood pressure (BPsys), insulin resistance by homeostasis model assessment (HOMA-IR) and C-reactive protein (CRP) were measured in 335 adults (191 women, 144 men; mean age 53 713.9 years, prevalence of MSX 30%). Results: When compared with BMI and WC, %FM showed weaker associations with metabolic risk factors, except for CRP and BPsys in men. In women, HDL-C and HOMA-IR showed the closest correlations with BMI. For all other risk factors, WC or WC/ht were the best predictors in both sexes. Differences in the strength of correlations between an obesity index and different risk factors exceeded the differences observed between all obesity indices within one risk factor. In stepwise multiple regression analyses, WC/ht was the main predictor of metabolic risk in both sexes combined. However, analysis of the area under receiver operating characteristic curves for prediction of the prevalence of X2 component traits of the MSX revealed a similar accuracy of all obesity indices. Conclusions: At the population level, measurement of body FM has no advantage over BMI and WC in the prediction of obesityrelated metabolic risk. Although measures of central adiposity (WC, WC/ht) tended to show closer associations with risk factors than measures of general adiposity, the differences were small and depended on the type of risk factor and sex, suggesting an equivalent value of methods.

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“…The observed prevalence of the metabolic syndrome in NHANES III was 5% among the subjects of normal weight, 22% among the overweight, and 60% among the obese (7). A Framingham Heart Study report indicated that a weight increase of Ն2.25 kg over a period of 16 yr was associated with an up to 45% increased risk for developing the metabolic syndrome (8), and it was shown recently that each 11-cm increase in waist circumference is associated with an adjusted 80% increased risk for developing the syndrome within 5 yr (9). The rapidly increasing prevalence of obesity in the adult US population (10) suggests that the current number of individuals who have the metabolic syndrome very probably is much higher than that estimated on the basis of the NHANES III analysis.…”

Section: Metabolic Syndrome and Ckd: Two Major Public Health Problemsmentioning

confidence: 99%

Renal Manifestations in the Metabolic Syndrome

Locatelli

Pozzoni²,

Vecchio³

2006

Journal of the American Society of Nephrology

140

112

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The metabolic syndrome, which is characterized by obesity, serum lipid profile alterations, hypertension, and fasting hyperglycemia, is very common in developed countries, and its prevalence is likely to increase. Chronic kidney disease (CKD) also has become a significant public health problem because it affects a considerable proportion of the adult population and is a major risk factor for cardiovascular disease and premature death. Although it is widely known that the metabolic syndrome is a major risk factor for the development of type 2 diabetes and cardiovascular disease, its precise relationship with the risk for renal impairment only recently has been clarified: Patients with the metabolic syndrome are at significantly higher risk for microalbuminuria and/or CKD, and the level of risk is related to the number of components of the syndrome itself. Although it is difficult to discriminate the detrimental renal effects of the metabolic syndrome from those of hypertension and impaired glucose metabolism, its other aspects (particularly obesity) may favor independently the development of renal abnormalities and may be considered new modifiable risk factors for CKD. These observations provide a rationale for intervention studies that aim to verify whether treating the many components of the metabolic syndrome can effectively prevent the development and progression of renal damage. T he metabolic syndrome (also known as syndrome X or the insulin resistance syndrome) is a complex pattern of disorders that were described for the first time by Reaven in 1988 (1) and whose main features consist of abdominal obesity, hypertriglyceridemia, low HDL cholesterol levels, high BP, and high fasting blood glucose levels. Although somewhat different definitions of the syndrome have been proposed since its first description, the guidelines of the 2001 National Cholesterol Education Program-Adult Treatment Panel III (2) now are widely used to identify it (Table 1), although a recent report from the National Heart, Lung, and Blood Institute and the American Heart Association (NHLBI/AHA) (3) recommended lowering the cutoff point for fasting blood glucose levels and abdominal obesity in men and proposed diagnosing the syndrome in the presence of only two of the defined criteria (Table 1). However, it cannot be excluded that the identification of additional risk factors, such as high C-reactive protein levels (4), soon will lead to a broader definition of the syndrome. Pathogenetically, it is thought that insulin resistance plays a key role in its development, as is suggested by a number of observations linking insulin resistance (clinically defined by the detection of abnormally high plasma insulin concentrations) with each of the syndrome's components (5). J Am Soc NephrolThe metabolic syndrome is very common in developed countries, and its prevalence is expected to become even higher in the near future, together with the rapidly increasing prevalence of obesity. For many years, there were few data concerning the relationship be...

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Predictors of the Incident Metabolic Syndrome in Adults

Cited by 278 publications

References 31 publications

Effect of changes in waist circumference on metabolic syndrome over a 6.6-year follow-up in Tehran

Effect of changes in waist circumference on metabolic syndrome over a 6.6-year follow-up in Tehran

Value of body fat mass vs anthropometric obesity indices in the assessment of metabolic risk factors

Renal Manifestations in the Metabolic Syndrome

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