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Trajectories of metabolic syndrome development in young adults.

ABSTRACT: Metabolic syndrome (MetS) is a constellation of metabolic aberrations that collectively increase the risk for cardiovascular disease and type 2 diabetes. Greater understanding of MetS developments may provide insight into targeted prevention strategies for individuals at greatest risk. The purpose of this study was to i) identify distinct patterns of longitudinal MetS development and; ii) develop a character profile that differentiates groups by level of MetS risk.Data from the Coronary Artery Risk Development in Young Adults (CARDIA) study (n = 3 804; 18-30 y) was obtained by limited access application from the National Heart, Lung, and Blood Institute and used for this analysis. MetS, as defined by the Harmonized criteria, was assessed over a 20 year follow-up period. Group-level trajectory analysis identified 4 distinct groups with varying rates of component development [No (23.8% of sample); Low (33.5%); Moderate (35.3%); and High MetS (7.4%)]. After adjusting for covariates, individuals in the At-Risk groups (Low, Moderate and High MetS) were more likely to be of black ethnicity (1.37, 1.14-1.66), have a family history of cardiovascular disease (1.61, 1.31-1.97) and history of dieting (1.69, 1.20-2.39) when compared to the No Risk trajectory group (No MetS). Conversely, increasing baseline education (0.76, 0.65-0.89) and aerobic fitness (0.55, 0.47-0.64) was inversely associated with At-Risk group membership.Results suggest distinct profiles of MetS development that can be identified by baseline risk factors. Further research is necessary to understand the clinical implication of intermediate MetS development groups with respect to overall cardiometabolic risk.

SUBMITTER: Poon VT

PROVIDER: S-EPMC4219745 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Trajectories of metabolic syndrome development in young adults.

Poon Vivian T W VT Kuk Jennifer L JL Ardern Chris I CI

PloS one 20141104 11

<h4>Background</h4>Metabolic syndrome (MetS) is a constellation of metabolic aberrations that collectively increase the risk for cardiovascular disease and type 2 diabetes. Greater understanding of MetS developments may provide insight into targeted prevention strategies for individuals at greatest risk. The purpose of this study was to i) identify distinct patterns of longitudinal MetS development and; ii) develop a character profile that differentiates groups by level of MetS risk.<h4>Methods ...[more]

PMID: 25368999

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Project description:ImportanceMetabolic syndrome (MetS) is a common health condition that predisposes individuals to cardiovascular disease (CVD) and disproportionately affects Black and other racially and ethnically minoritized people. Concurrently, Black individuals also report more exposure to racial discrimination compared with White individuals; however, the role of discrimination in the development of MetS over time and associated mediators in these pathways remain underexplored.ObjectiveTo evaluate the association between racial discrimination and MetS in rural Black individuals transitioning from late adolescence into early adulthood and to identify potential mediating pathways.Design, setting, and participantsThis longitudinal cohort study included Black adolescents enrolled in the Strong African American Families Healthy Adults (SHAPE) Project between June 2009 and May 2021. Families resided in rural counties of Georgia, where poverty rates are among the highest in the nation. Analyses included 322 of the 500 participants who originally enrolled in SHAPE and who were eligible to participate. Guardians provided information about socioeconomic disadvantage. Analyses were conducted in April 2023.ExposuresYouths reported exposure to racial discrimination annually from ages 19 to 21 years.Main outcomes and measuresMetS was the main health outcome and was measured at ages 25 and 31 years. MetS was diagnosed according to the International Diabetes Federation guidelines, which requires central adiposity (ie, waist circumference ≥94 cm for males and ≥80 cm for females) and at least 2 of the 4 additional components: signs of early hypertension (ie, systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥85 mm Hg); elevated triglyceride levels (ie, >150 mg/dL); elevated fasting glucose level (ie, ≥100 mg/dL); or lowered high-density lipoprotein levels (ie, <40 mg/dL in men and <50 mg/dL in women). At age 25 years, markers of inflammatory activity (ie, soluble urokinase plasminogen activator receptor [suPAR]) and sleep problems were collected to consider as potential mediators.ResultsIn 322 participants (210 [65.2%] female) ages 19 to 21 years, more frequent exposure to racial discrimination was associated with higher suPAR levels (b = 0.006; 95% CI, 0.001-0.011; P = .01) and more sleep problems at age 25 years (b = 0.062; 95% CI, 0.028-0.097; P < .001) as well as a 9.5% higher risk of MetS diagnosis at age 31 years (odds ratio [OR], 1.10; 95% CI, 1.01-1.20; P = .03). Both suPAR (b = 0.015; 95% CI, 0.002-0.037) and sleep problems (b = 0.020; 95% CI, 0.002-0.047) at age 25 years were significant indirect pathways. No significant interactions between sex and discrimination emerged.Conclusions and relevanceThis study suggests that racial discrimination in late adolescence is associated with MetS among Black young adults through biobehavioral pathways. Thus, health interventions for MetS in Black adults will need to contend with sleep behaviors and inflammatory intermediaries as well as address and reduce exposure to racial discrimination to narrow disparities and promote health equity.

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Trajectories of metabolic syndrome development in young adults.

Publications

Trajectories of metabolic syndrome development in young adults.

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