Distinct Component Profiles and High Risk Among African Americans With Metabolic Syndrome

Abstract

OBJECTIVE -Health of African Americans is seriously threatened by unremitting epidemics of diabetes and cardiovascular disease (CVD). However, the role of metabolic syndrome in the African-American population has not been investigated widely. This study examined the prevalence of metabolic syndrome and assessed its cross-sectional relationship to CVD in the Jackson Heart Study (JHS) cohort.RESEARCH DESIGN AND METHODS -A total of 5,302 participants aged Ն21 years who were recruited at baseline during 2000 -2004 were analyzed for this study. Adjusted odds ratios (ORs) were estimated in a logistic regression analysis for coronary heart disease (CHD) and cerebrovascular disease (CBD) in those with and without coexisting metabolic syndrome. Diabetic participants were excluded.RESULTS -Among those aged 35-84 years, metabolic syndrome prevalence was 43.3% in women and 32.7% in men. Elevated blood pressure (70.4%), abdominal obesity (64.6%), and low HDL cholesterol (37.2%) were highly prevalent among those with metabolic syndrome. Prevalence rates for CVD, CHD, and CBD were 12.8, 8.7, and 5.8%, respectively. After adjustment for age and sex, metabolic syndrome was associated with increased age-and sex-adjusted ORs for CVD (OR 1.7 [95% CI 1.4 -2.1]), CHD (1.7 [1.4 -2.2]), and CBD (1.7 [1.3-2.3]) compared with those without CVD, CHD, or CBD.CONCLUSION -Metabolic syndrome prevalence in the JHS is among the highest reported for population-based cohorts worldwide and is significantly associated with increased ORs for CVD, CHD, and CBD. Abdominal obesity, increased blood pressure, and low HDL cholesterol (without triglyceride elevation) are surprisingly prominent. A high prevalence of low HDL emerges as a leading contributor to metabolic syndrome among African Americans in this large African-American cohort.

Metabolic Syndrome in Blacks: Are the Criteria Right?

“…We [12,13,35,37] and others [4, 5•, 6-17, 19-23, 47] have reported a weaker association between insulin resistance and triglycerides in African Americans. Furthermore, Sumner et al [22,23] and Haffner et al [4,49] showed that the increasing serum triglycerides are not associated with changes in serum total cholesterol and LDL cholesterol levels in African American women.…”

“…Apart from body mass index (BMI), WC is reported to be greater predictor of MetS in several populations, although the cut off points vary according to the IDF criteria [31,[33][34][35]. In blacks, WC is the most common component of MetS [11, 14-16••, 18].…”

“…Globally, obesity is a major health problem and on the rise in blacks residing in urban areas in diverse regions including the United States, South Africa, the United Kingdom, Africa, and West Indies [30,31,[33][34][35][41][42][43][44][45]. Apart from body mass index (BMI), WC is reported to be greater predictor of MetS in several populations, although the cut off points vary according to the IDF criteria [31,[33][34][35].…”

Ethnic Disparities in Metabolic Syndrome in Malaysia: An Analysis by Risk Factors

“…Thus, ''Other-Bumiputera'' refers to other native ethnic groups, not including the Malays). [14][15][16][17] Ethnic-based disparities in metabolic syndrome prevalence have been noted in previous studies for developed countries, [18][19][20] and reducing inequality among citizens of different ethnic groups has been a long-standing goal of policy makers in Malaysia. Therefore, this study uses data from a nationally representative sample of Malaysians to study differences in metabolic syndrome prevalence, as well as differences in the underlying conditions that comprise metabolic syndrome.…”

Effect of Obesity on the Traditional and Emerging Cardiovascular Disease Risk Factors in African American Women

“…The Framingham Heart Study has been helpful in identifying traditional cardiovascular risk factors; studies such as the Jackson Heart Study (JHS) have confirmed its utility in African Americans also (Taylor et al, 2008). The JHS found that 40% of African American women, as opposed to 29% of African American men, had the traditional cardiovascular risk factors (Association of American Medical Colleges [AAMC], 2008).…”