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The severity of the metabolic syndrome increases over time within individuals, independent of baseline metabolic syndrome status and medication use: The Atherosclerosis Risk in Communities Study.

ABSTRACT: The severity of the metabolic syndrome (MetS) is linked to future cardiovascular disease. However, it is unclear whether MetS severity increases among individuals followed over time.We assessed changes in a sex- and race/ethnicity-specific MetS severity Z-score over a 10-year period (visits 1-4) among 9291 participants of the Atherosclerosis Risk in Communities study cohort. We compared sex- and racial/ethnic subgroups for the rate of change in the MetS severity score and MetS prevalence as assessed using traditional ATP-III MetS criteria. We further examined effects of use of medications for hypertension, diabetes and dyslipidemia.Over the 10 years of follow-up, MetS severity Z-scores increased in 76% of participants from an overall mean of 0.08 ± 0.77 at baseline to 0.48 ± 0.96 at visit 4 with the greatest progression in scores observed among African-American women. Baseline MetS severity scores predicted the time until ATP-III MetS diagnosis, with a model-predicted 77.5% of individuals with a visit 1 MetS severity score of 0.75 progressing to ATP-III MetS within 10 years. The rate of increase in MetS severity score was higher among those younger at baseline but was independent of baseline MetS status or the use of medications to treat blood pressure, lipids and diabetes.The severity of metabolic derangements as measured using this MetS severity score increases over time within individuals and predicts diagnosis of ATP-III MetS. These data may have implications for tracking MetS related risk within individuals over time.

SUBMITTER: Vishnu A

PROVIDER: S-EPMC4734118 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature

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The severity of the metabolic syndrome increases over time within individuals, independent of baseline metabolic syndrome status and medication use: The Atherosclerosis Risk in Communities Study.

Vishnu Abhishek A Gurka Matthew J MJ DeBoer Mark D MD

Atherosclerosis 20150921 1

<h4>Background and aims</h4>The severity of the metabolic syndrome (MetS) is linked to future cardiovascular disease. However, it is unclear whether MetS severity increases among individuals followed over time.<h4>Methods</h4>We assessed changes in a sex- and race/ethnicity-specific MetS severity Z-score over a 10-year period (visits 1-4) among 9291 participants of the Atherosclerosis Risk in Communities study cohort. We compared sex- and racial/ethnic subgroups for the rate of change in the Met ...[more]

PMID: 26409627

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Project description:Aims/hypothesisThe study aimed to assess for an association between the degree of severity of the metabolic syndrome and risk of type 2 diabetes beyond that conferred by the individual components of the metabolic syndrome.MethodsWe assessed HRs for an Adult Treatment Panel III (ATP-III) metabolic syndrome score (ATP-III MetS) and a sex- and race-specific continuous metabolic syndrome severity z score related to incident diabetes over a median of 7.8 years of follow-up among participants of two observational cohorts, the Atherosclerosis Risk in Communities study (n = 10,957) and the Jackson Heart Study (n = 2137).ResultsThe ATP-III MetS had an HR for incident diabetes of 4.36 (95% CI 3.83, 4.97), which was attenuated in models that included the individual metabolic syndrome components. By contrast, participants in the fourth quartile of metabolic syndrome severity (compared with the first quartile) had an HR of 17.4 (95% CI 12.6, 24.1) for future diabetes; in models that also included the individual metabolic syndrome components, this remained significant, with an HR of 3.69 (95% CI 2.42, 5.64). There was a race × metabolic syndrome interaction in these models such that HR was greater for black participants (5.30) than white participants (2.24). When the change in metabolic syndrome severity score was included in the hazard models, this conferred a further association, with changes in metabolic syndrome severity score of ≥0.5 having a HR of 2.66 compared with changes in metabolic syndrome severity score of ≤0.Conclusions/interpretationUse of a continuous sex- and race-specific metabolic syndrome severity z score provided an additional prediction of risk of diabetes beyond that of the individual metabolic syndrome components, suggesting an added risk conferred by the processes underlying the metabolic syndrome. Increases in this score over time were associated with further risk, supporting the potential clinical utility of following metabolic syndrome severity over time.

Dataset Information

The severity of the metabolic syndrome increases over time within individuals, independent of baseline metabolic syndrome status and medication use: The Atherosclerosis Risk in Communities Study.

Publications

The severity of the metabolic syndrome increases over time within individuals, independent of baseline metabolic syndrome status and medication use: The Atherosclerosis Risk in Communities Study.

Similar Datasets

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