What predicts the occurrence of the metabolic syndrome in a population-based cohort of adult healthy subjects?
ABSTRACT Metabolic syndrome (MS), the concurrence of hyperglycaemia, dyslipidaemia, hypertension and visceral obesity, increases cardiovascular risk and mortality. Predictors of MS were previously evaluated in patients without the full syndrome, but with some of its traits. This might confound the resulting associations.
The relationship between baseline variables and MS development was evaluated in healthy middle-aged subjects without any MS component at baseline, over a 4.5-year follow-up.
From a population-based cohort of 1658 subjects, 241 individuals showed no MS components and 201 (83.4%) of them participated in a follow-up screening. At baseline, patients who developed the MS (n = 28/201; 13.9%) showed significantly higher Homeostasis Model Assessment-Insulin Resistance score (HOMA-IR) and C-reactive protein (CRP) values, and lower exercise level than subjects who did not. In a multiple logistic regression analysis, after multiple adjustments, the only baseline variable significantly (p < 0.01) associated with the MS was CRP (OR = 4.05; 95% CI 2.23-7.38; p < 0.001). Results did not change after adjusting for weight gain. The area under the receiver-operating curve was 0.83 for CRP after multiple adjustments. The optimal cut-off point of baseline CRP values was 2.1 mg/L, with 86% (95% CI 81-90) sensitivity and 75% (69-81) specificity in predicting the MS. Baseline CRP resulted associated with after-study glucose values in a multiple regression model (beta = 0.14; 0.08-0.20; p < 0.001).
Higher baseline CRP values confer a significant increased risk of developing the MS in healthy subjects, independently of weight gain.
- [Show abstract] [Hide abstract]
ABSTRACT: A biomarker can be defined as a measurable variable that may be used as an indicator of a given biological state or condition. Biomarkers have been used in health and disease for diagnostic purposes, as tools to assess effectiveness of nutritional or drug intervention, or as risk markers to predict the development of certain diseases. In nutrition studies, selecting appropriate biomarkers is important to assess compliance, or incidence of a particular dietary component in the biochemistry of the organism, and in the diagnosis and prognosis of nutrition-related diseases. Metabolic syndrome is a cluster of cardiovascular risk factors that occur simultaneously in the same individual, and it is associated with systemic alterations that may involve several organs and tissues. Given its close association with obesity and the increasing prevalence of obesity worldwide, identifying obese individuals at risk for metabolic syndrome is a major clinical priority. Biomarkers for metabolic syndrome are therefore potential important tools to maximize the effectiveness of treatment in subjects who would likely benefit the most. Choice of biomarkers may be challenging due to the complexity of the syndrome, and this article will mainly focus on nutrition biomarkers related to the diagnosis and prognosis of the metabolic syndrome.Nutrition in Clinical Practice 12/2013; 29(2). DOI:10.1177/0884533613516168 · 2.06 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Metabolic syndrome (MetS) management programs conventionally focus on the adults having MetS. However, risk assessment for MetS development is also important for many adults potentially at risk but do not yet fulfill MetS criteria at screening. Therefore, we conducted this follow-up study to explore whether initial screening records can be efficiently applied on the prediction of the MetS occurrence in healthy middle-aged employees. Utilizing health examination data, a five-year follow-up observational study was conducted for 1384 middle-aged Taiwanese employees not fulfilling MetS criteria. Data analyzed included: gender, age, MetS components, uric acid, insulin, liver enzymes, sonographic fatty liver, hepatovirus infections and lifestyle factors. Multivariate logistic regression was used to estimate the adjusted odds ratios (OR) and 95% confidence interval (CI) of risk for MetS development. The synergistic index (SI) values and their confidence intervals of risk factor combinations were calculated; and were used to estimate the interacting effects of coupling MetS components on MetS development. Within five years, 13% (175 out of 1384) participants fulfilled MetS criteria. The ORs for MetS development among adults initially having one or two MetS components were 2.8 and 7.3, respectively (both p < 0.01), versus the adults having zero MetS component count at screening. Central obesity carried an OR of 7.5 (p < 0.01), which far exceeded other risk factors (all ORs < 2.7). Synergistic effects on MetS development existed between coupling MetS components: 1. High blood pressure plus low-HDL demonstrated an OR of 11.7 (p < 0.01) for MetS development and an SI of 4.7 (95% CI, 2.1-10.9). 2. High blood pressure plus hyperglycemia had an OR of 7.9 (p < 0.01), and an SI of 2.7 (95% CI, 1.2-6.4). MetS component count and combination can be used in predicting MetS development for participants potentially at risk. Worksite MetS screening programs simultaneously allow for finding out cases and for assessing risk of MetS development.BMC Public Health 12/2010; 10:747. DOI:10.1186/1471-2458-10-747 · 2.32 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Using 24-hour dietary recall data from the National Health and Nutrition Examination Survey 1999 to 2006, the possible link between fruit and vegetable intake and chronic disease risk was assessed. C-reactive protein (CRP), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), fasting plasma glucose (FPG), total cholesterol, and glycosylated hemoglobin were selected as biomarkers for chronic disease risk. It is hypothesized that individuals who consume more fruits and vegetables will have reduced chronic disease risk because of the healthful benefits of these foods. The objective of this study was to examine the relationship between fruit and vegetable consumption on selected biomarkers for chronic disease risk. Although some associations were significant for FPG, HDL-C, and low-density lipoprotein cholesterol in some of the models, no trend was present. After adjusting for demographic factors, socioeconomic factors, lifestyle factors, body mass index, total energy intake, and the presence of at least 1 of our 5 predetermined comorbidities, no associations of reduced or increased risk were observed in any quartiles of combined fruit and vegetable intake. Fruit and vegetable intakes were weakly associated with an increased HDL-C level and decreased FPG, glycosylated hemoglobin, and C-reactive protein levels in some of the models; however, no association was observed in the final model. Because selected biomarkers of future disease risk remained in reference ranges at both high and low intake and no significance was observed in the final model, no protective association was observed between fruit and vegetable intake and biomarkers for chronic disease risk. However, fruit and vegetable consumption is recommended as part of an overall healthy diet and to displace other energy-dense foods for weight maintenance, which can lead to a decrease in future disease risk.Nutrition research 08/2011; 31(8):616-24. DOI:10.1016/j.nutres.2011.07.005 · 2.59 Impact Factor