Clustering of Cardiovascular Risk Factors Associated With the Insulin Resistance Syndrome

Zanolin, Maria Elisabetta; Tosi, Flavia; Zoppini, Giacomo; Castello, R.; Spiazzi, Giovanna; Dorizzi, Romolo M.; Muggeo, Michele; Moghetti, Paolo

doi:10.2337/diacare.29.02.06.dc05-1478

Cited by 20 publications

(3 citation statements)

References 69 publications

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“…The findings suggest that two main components can explain roughly 50% of the variability in the data, with adiposity and blood pressure being the dominant indicators. Our results align with those of several adult studies that have used principal component analysis across various cardiovascular risk variables [ 18 , 23 , 24 ]. For example, while those studies included some measures of insulin and glucose, they also revealed separate components related to adiposity, dyslipidemia (but specifically HDL and TG), and BP.…”

Section: Discussionsupporting

confidence: 90%

Determining independence and associations among various cardiovascular disease risk factors in 9-12 years old school-children: a cross sectional study

et al. 2022

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Background Cardiovascular disease (CVD) risk assessment of children typically includes evaluating multiple CVD risk factors some of which tend to correlate each other. However, in older children and young adolescents, there are little data on the level of independence of CVD risk factors. The purpose of this study was to examine the relationships among various CVD risk factors to determine the level of independence of each risk factor in a sample of 5th-grade public school students. Method A cross-sectional analysis of 1525 children (856 girls and 669 boys; age: 9-12 years) who participated in baseline CVD risk assessment for the (S)Partners for Heart Health program from 2010 - 2018. Thirteen CVD risk factor variables were used in the analysis and included blood lipids [low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglycerides], resting systolic and diastolic blood pressure (BP); anthropometrics [height, weight, body mass index (BMI), % body fat, waist circumference (WC)]. Additionally, acanthosis nigricans (a marker insulin resistance and diabetes), and cardiorespiratory fitness (VO2 ml/kg) was estimated using the PACER. Descriptive statistics, bivariate Pearson correlations, and principal component analysis were used to determine the relationships among these variables and the independence. Results Parallel analysis indicated two components should be extracted. Among the two components extracted, WC, % body fat, and BMI loaded highest on component 1, which explained 34% of the total variance. Systolic BP and diastolic BP loaded predominantly on component 2 and accounted for 17% of the variance. Cardiorespiratory fitness, acanthosis nigricans, HDL, and triglycerides loaded highest on the first component (loadings between 0.42 and 0.57) but still suggest some non-shared variance with this component. Low-density lipoprotein had low loadings on each component. Factor loadings were stable across sex. Conclusion Among the various CVD risk indicators, measures of adiposity loaded highest on the component that explained the largest proportion of variability in the data reinforcing the importance of assessing adiposity in CVD risk assessment. In addition, blood pressure loaded highest on the second component, suggesting their relative independence when assessing CVD risk. The data also provide support and rationale for determining what CVD risk factors to include- based on resource needs. For example, researchers or public health programs may choose to assess WC instead of lipid profile for cardiovascular related problems if ease of assessment and cost are considerations.

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Section: Discussionsupporting

confidence: 90%

Determining independence and associations among various cardiovascular disease risk factors in 9-12 years old school-children: a cross sectional study

et al. 2022

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“…Repeatedly, three to four factors were found, which can explain 60-70% of the variability of the individual phenotype (Edwards et al 1994;Zanolin et al 2006). Moreover, factor analysis in children with MS showed indicators of low-grade inflammation and the same endocrine factors (Retnakaran et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Severity of Metabolic Syndrome Unfavorably Influences Oxidative Stress and Fatty Acid Metabolism in Men

Žák

Tvrzická

Vecka

et al. 2007

Tohoku J. Exp. Med.

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Metabolic syndrome (MS) is defined by the clustering of several components (MSC), which include abdominal fat accumulation, impaired glucose homeostasis, hypertriglyceridemia, lowered high-density lipoprotein cholesterol, increased blood pressure, and hyperuricemia. Metabolic syndrome is also accompanied by increased oxidative stress and inflammation as well as by altered composition of esterified fatty acids (FA). Therefore, we have investigated 210 men (categorized into six groups with increasing number of MSC) to find trends in the extent of oxidative stress, FA pattern and frequency of pathological alleles of the selected candidate genes for lipid metabolism. Increasing number of MSC was connected with the raised serum glucose and insulin, increased concentrations of conjugated dienes in low-density lipoprotein (all p < 0.0001), and high frequency of e2 and e4 alleles of the apolipoprotein E gene ( p < 0.005). However, the last significance was lost after the adjustment for age. The incidence of 54Thr allele for intestinal isoform of the fatty acid-binding protein (FABP-2) gene was comparable in all groups. The most important findings were the raised content of saturated FA and the increased activities of Δ 9 and Δ 6 desaturases (all p < 0.0001), and the decreased content of polyunsaturated FA n-6 family and the decreased activity of Δ 5 desaturase (both p < 0.001) in connection with increasing number of MSC. In conclusion, the severity of MS is connected with the progression of oxidative stress and the unfavorable changes in the FA composition. These changes are independent of the studied gene polymorphisms.

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“…Finally, because higher UA levels are correlated with other metabolic abnormalities such as insulin resistance (16,17,26 -31), higher triglyceride levels (16,28,29,31,32), and higher BMI, some have argued that UA is a component of the metabolic syndrome (16,29). Its association with hypertension therefore may be confounded by other metabolic abnormalities (33).…”

Section: Statistical Analysesmentioning

confidence: 99%

Plasma Uric Acid Level and Risk for Incident Hypertension Among Men

Forman¹,

Choi²,

Curhan³

2007

Journal of the American Society of Nephrology

165

114

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Several studies have found that uric acid (UA) level is associated with an increased risk for hypertension, but the association could be confounded by metabolic factors that were not included in these previous studies. UA level and risk for incident hypertension was examined prospectively among men who participated in the Health Professionals' Follow-up Study. From among men without hypertension at the time blood was collected, 750 participants who developed hypertension during the subsequent 8 yr and 750 age-matched controls were selected. In addition to adjustment for standard hypertension risk factors and renal function, adjustments controlled for fasting insulin, triglyceride, and cholesterol levels. The mean age of participants was 61 yr, and mean plasma UA level was 6.0 mg/dl (SD 1.25 mg/dl). The multivariable relative risk (RR) for a 1-SD increase in UA was 1.02 (95% confidence interval [CI]0.87 to 1.18); the RR comparing the highest with lowest quartile of UA was 1.08 (95% CI 0.71 to 1.63). The multivariable RR associated with a 1-SD increase in UA was 1.38 (95% CI 1.05 to 1.81) for men aged <60 yr and 0.90 (95% CI 0.74 to 1.10) for men >or=60 yr (P = 0.04 for interaction). However, further adjustment for fasting insulin, triglyceride, and cholesterol levels attenuated the results (RR for men <60 yr 1.24; 95% CI 0.93 to 1.66). In conclusion, no independent association between UA level and risk for incident hypertension was found among older men.

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Clustering of Cardiovascular Risk Factors Associated With the Insulin Resistance Syndrome

Cited by 20 publications

References 69 publications

Determining independence and associations among various cardiovascular disease risk factors in 9-12 years old school-children: a cross sectional study

Determining independence and associations among various cardiovascular disease risk factors in 9-12 years old school-children: a cross sectional study

Severity of Metabolic Syndrome Unfavorably Influences Oxidative Stress and Fatty Acid Metabolism in Men

Plasma Uric Acid Level and Risk for Incident Hypertension Among Men

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