The metabolic syndrome and coronary artery disease: A structural equation modeling approach suggestive of a common underlying pathophysiology

Stevenson, Jennifer E.; Wright, Bruce R.; Boydstun, Alan S.

doi:10.1016/j.metabol.2012.04.010

Cited by 20 publications

(18 citation statements)

References 34 publications

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“…A commonality among studies in Caucasian samples and the results of our examination of Andean Hispanics, however, is that all studies support the presence of a single underlying metabolic syndrome construct. 7,9 In line with previous results and theoretical considerations, 7,9 our study reports evidence of the significant contribution of WC, SBP and DBP, TGs, and glucose levels on the metabolic syndrome latent factor.…”

supporting

confidence: 89%

“…Stevenson and colleagues recently tested a more parsimonious model with five components-BMI, SBP, HDL-C, TGs, and glucose. 9 It differs from our model in that Stevenson et al used BMI and not WC as a proxy for abdominal obesity. A commonality among studies in Caucasian samples and the results of our examination of Andean Hispanics, however, is that all studies support the presence of a single underlying metabolic syndrome construct.…”

mentioning

confidence: 77%

“…7,8 These studies have identified a metabolic syndrome factor model with glucose dysregulation [measured by both fasting blood glucose (FBG) and insulin level], obesity [measured by body mass index (BMI) and waist circumference (WC)], dyslipidemia (measured by TGs and HDL-C), and systolic blood pressure (SBP) and diastolic blood pressure (DBP) as central components. 7,8 More recently, Stevenson and colleagues 9 developed a more parsimonious metabolic syndrome model with five components commonly used in clinical practice-adiposity, SBP, HDL-C, TGs, and glucose. Possible gender differences and the examination of a metabolic syndrome latent factor model in Hispanics, however, have yet to be investigated and are of high importance.…”

Section: Introductionmentioning

confidence: 99%

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Metabolic Syndrome As an Underlying Disease Entity and Its Relationship to Subclinical Atherosclerosis in Andean Hispanics

Chirinos

Medina‐Lezama

Argüelles

et al. 2014

Metabolic Syndrome and Related Disorders

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Background: The question of whether the metabolic syndrome truly reflects a single disease entity with a common underlying pathology remains unclear. In this study, we assess whether metabolic syndrome represents an underlying disease construct in a large population-based sample of Andean Hispanic adults and examine its relationship to subclinical atherosclerosis. Methods: The study sample was comprised of 2513 participants. Confirmatory factor analysis (CFA) was used to identify a metabolic syndrome latent factor using waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), and glucose levels as indicators. The relationship with subclinical atherosclerosis, measured by carotid intima media thickness (cIMT), was assessed using structural equation modeling. Results: Results supported the proposed structure of the metabolic syndrome latent factor evidenced by adequate fit indexes. HDL-C did not significantly load on the metabolic syndrome latent factor (standardized factor loading = 0.01, P = 0.88). The metabolic syndrome latent factor was significantly associated with cIMT in women (B = 0.007, P < 0.001) and men (B = 0.008, P < 0.001) after controlling for age, low-density lipoprotein cholesterol and smoking. Conclusions: Our findings suggest that metabolic syndrome components, such as waist circumference, blood pressure, TGs, and glucose levels, but not HDL-C, share a common underlying pathophysiology that may contribute to the progression of atherosclerosis in Andean Hispanics. Its longitudinal association with cardiovascular disease should be the focus of future research.

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supporting

confidence: 89%

mentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Metabolic Syndrome As an Underlying Disease Entity and Its Relationship to Subclinical Atherosclerosis in Andean Hispanics

Chirinos

Medina‐Lezama

Argüelles

et al. 2014

Metabolic Syndrome and Related Disorders

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“…Shen et al (2003) and Shen, Goldberg, Llabre, and Schneiderman (2006) used a hierarchical four-factor model in two studies that provided an empirical foundation for conceptualizing and measuring the metabolic syndrome. Similarly, a recent study using three preclinical adult cohorts concluded that a one-factor metabolic syndrome model adequately fit each data set (Stevenson, Wright, & Boydstun, 2012). Taken together, results from these studies suggest that metabolic syndrome represents related domains, with obesity and insulin resistance as integral components.…”

Section: Introductionmentioning

confidence: 96%

Modeling Metabolic Syndrome and Its Association with Cognition: The Northern Manhattan Study

Levin

Llabre

Dong

et al. 2014

J Int Neuropsychol Soc

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Metabolic syndrome (MetS) is a clustering of vascular risk factors and is associated with increased risk of cardiovascular disease. Less is known about the relationship between MetS and cognition. We examined component vascular risk factors of MetS as correlates of different cognitive domains. The Northern Manhattan Study (NOMAS) includes 1290 stroke-free participants from a largely Hispanic multi-ethnic urban community. We used structural equation modeling (SEM) to model latent variables of MetS, assessed at baseline and an average of 10 years later, at which time participants also underwent a full cognitive battery. The two four-factor models, of the metabolic syndrome (blood pressure, lipid levels, obesity, and fasting glucose) and of cognition (language, executive function, psychomotor, and memory), were each well supported (CFI = 0.97 and CFI = 0.95, respectively). When the two models were combined, the correlation between metabolic syndrome and cognition was −.31. Among the metabolic syndrome components, only blood pressure uniquely predicted all four cognitive domains. After adjusting for age, gender, race/ethnicity, education, smoking, alcohol, and risk factor treatment variables, blood pressure remained a significant correlate of all domains except memory. In this stroke-free race/ethnically diverse community-based cohort, MetS was associated with cognitive function suggesting that MetS and its components may be important predictors of cognitive outcomes. After adjusting for sociodemographic and vascular risk factors, blood pressure was the strongest correlate of cognitive performance. Findings suggest MetS, and in particular blood pressure, may represent markers of vascular or neurodegenerative damage in aging populations.

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“…In the present study, we added CRP to the five established MetS components to determine MetS using CFA. The CFA approach, instead of simply applying a cutoff score for MetS, was used in previous study without considering CRP (Stevenson, et al 2012). …”

Section: Methodsmentioning

confidence: 99%

Linking cognition and frailty in middle and old age: metabolic syndrome matters

Lin

Roiland

Chen

et al. 2014

Int J Geriat Psychiatry

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Objectives This study examined whether metabolic syndrome (MetS) would moderate the association of cognition with frailty in middle and old age. Methods A cross-sectional design was used. Six hundred and ninety participants (age ≥ 50 years) from an on-going national survey were included in the study. Confirmatory factor analysis was applied to determine latent variables of executive function (EF), episodic memory (EM), and MetS based on relevant measurements. Frailty was defined using a modified form of Fried’s criteria. Results Applying structural equation modeling, having MetS significantly increased the likelihood of being frail. Better performance on EM tasks, but not EF, was significantly associated with lower likelihood of MetS. Worse performance on EF, but not EM, significantly increased the likelihood of being frail. There was a significant interacting effect between MetS and EF, but not EM, on frailty. Further contrast analysis indicated that having MetS strengthened the negative association between EF and frailty. Conclusion MetS moderates the relationship between EF and frailty. A prospecitve study is needed to validate such relationships before developing interventions targeting the prevention or treatment of EF and frailty in individuals with MetS.

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The metabolic syndrome and coronary artery disease: A structural equation modeling approach suggestive of a common underlying pathophysiology

Cited by 20 publications

References 34 publications

Metabolic Syndrome As an Underlying Disease Entity and Its Relationship to Subclinical Atherosclerosis in Andean Hispanics

Metabolic Syndrome As an Underlying Disease Entity and Its Relationship to Subclinical Atherosclerosis in Andean Hispanics

Modeling Metabolic Syndrome and Its Association with Cognition: The Northern Manhattan Study

Linking cognition and frailty in middle and old age: metabolic syndrome matters

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