Metabolic and Body Composition Risk Factors Associated with Metabolic Syndrome in a Cohort of Women with a High Prevalence of Cardiometabolic Disease

Abstract

BackgroundThe aetiology of the metabolic syndrome and the inter-relationship between risk factors for this syndrome are poorly understood. The purpose of this investigation was to determine the risk factors for metabolic syndrome and their interactions in a cohort of women with a high prevalence of metabolic syndrome.Materials and MethodsAbdominal and whole body composition (ultrasound and dual-energy X-ray absorptiometry), blood pressure, and cardiometabolic and demographic factors were measured in a cross-sectional study of 702 black African women from Soweto, Johannesburg. Data was analysed using multivariate logistic regression.ResultsMetabolic syndrome was present in 49.6% of the study cohort. Logistic regression analysis demonstrated that adiponectin (odds ratio [95% CIs]: 0.84 [0.77, 0.92], p<0.0005) and abdominal subcutaneous fat (0.56 [0.39, 0.79], p = 0.001) reduced metabolic syndrome risk whilst insulin resistance (1.31 [1.16, 1.48], p<0.0005) and trunk fat-free soft-tissue mass (1.34 [1.10, 1.61], p = 0.002) increased risk. Within this group of risk factors, the relationship of adiponectin with metabolic syndrome risk, when analysed across adiponectin hexiles, was the least affected by adjustment for the other risk factors.ConclusionsAdiponectin has a significant protective role against metabolic syndrome and is independent of other risk factors. The protective and possible augmentive effects of abdominal subcutaneous fat and lean trunk mass, respectively on metabolic syndrome risk demonstrate the existence of novel interactions between body composition and cardiometabolic disease.

Factors associated with obesity and metabolic syndrome in ageing black South African women

“…A questionnaire was used to determine consumption of high-fat foods (‘fatty cuts of red meat, chicken with skin, full-cream milk, processed meats, crisps, and fried food items’), alcohol intake, and smoking status (including snuff/smokeless tobacco consumption) [11,12]. Data on high-fat foods and alcohol consumption were collected at baseline in 2002/03, while smoking was collected at both time-points.…”

“…Fasting blood samples were collected and analysed for fasting glucose, fasting insulin, insulin resistance [measured by homeostasis model assessment (HOMA)], serum triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, total cholesterol, adiponectin, and leptin [10,12]. Biochemical data were collected at both time-points.…”

“…systolic blood pressure ≥ 130 mmHg, diastolic blood pressure ≥ 85 mmHg, fasting blood glucose ≥ 5.6 mmol/l, triglycerides ≥ 1.7 mmol/l, HDL cholesterol < 1.3 mmol/l, LDL cholesterol ≥ 3 mmol/l, and total cholesterol ≥ 5 mmol/l [29]. MetS was defined as three or more out of four components, without waist circumference, to uncover the association of anthropometric compartments with the syndrome and its components [12]. …”

“…Backward, stepwise removal of non-significant variables ( p  > 0.05) was used to determine which of these variables remained as independent variables in the logistic regression models. Significant odds ratios with accompanying 95% confidence intervals are reported in Table 2 [12]. …”

“…Therefore, the purpose of this paper is to improve our understanding of the interrelationship of the determinants of obesity and MetS in black South African women. The results presented here originate from cross-sectional and longitudinal studies linked to the doctoral research, and are organised by theme: (1) patterns and correlates of self-reported physical activity; (2) the role of selected lifestyle behavioural and body-size perception factors in determining changes in anthropometry; and (3) metabolic and anthropometric risk factors associated with MetS [10–12]. …”