The dynamic behaviour of metabolic syndrome and its components in an eight-year population-based cohort from the Mediterranean

Abstract

BackgroundThe significant rise in the prevalence of obesity coincides with the considerable increase in the prevalence of metabolic syndrome (MS) currently being observed worldwide. The components of MS are not static and their dynamics, such as the order of their occurrence, or the time of exposure to them are, as yet, unknown but could well be clinically relevant. Our objective was to study the dynamic behaviour of MS and its components in a large population-based cohort from a Mediterranean region.Methods and findingsOur study employed a retrospective cohort (between January 1, 2005 and December 31, 2012) made up of individuals from the general population in a region in the northeast of Catalonia, Spain. Given that most of the explicative variables of the risk of having MS were time dependent and, therefore, the risk was not proportional, we used the Andersen-Gill (AG) model to perform a multivariate survival analysis and inferences were performed using a Bayesian framework.Thirty-nine percent of the participants developed MS; 44.6% of them with a single limited episode. Triglycerides and low HDL cholesterol, together with obesity, are components associated with the first occurrence of MS. Components related to the metabolism of glucose are associated with a medium risk of having a first episode of MS, and those related to blood pressure are associated with a lower risk. When the components related to blood pressure and the metabolism of glucose appear first, they determine the appearance of the first episode of MS. The variables concerning the persistence of MS are those that correspond to clinical conditions that do not have well-established drug treatment criteria.ConclusionsOur results suggest that the components related to the metabolism of glucose and to high blood pressure appear early on and act as biomarkers for predicting MS, while the components related to obesity and dyslipidaemia, although essential for the development of MS, appear later. Making lifestyle changes reduces the conditions associated with the persistence of MS.

Dynamic development of metabolic syndrome and its risk prediction in Chinese population: a longitudinal study using Markov model

“…The development of MS is likely a process in which each component appears in succession. We believe that the first component that occurred with the highest incidence is most likely to initiate MS, and it is a beneficial insight to identify the initiating component of MS. To date, controversy still exists regarding this question [ 18 , 24 , 25 ]. It may be a result of the different gender and age groups adopted in studies.…”

Dynamic behavior of metabolic syndrome progression: a comprehensive systematic review on recent discoveries

“…Scientists also believe that in the MetS prediction process, the component that results in the highest incidence of this disorder plays an important role in the development of the MetS [ 19 ]. Of course, this is still a controversial issue today [ 21 , 25 , 26 ]. What is clear is that assessing the dynamics of the MetS progression process has an important role in clarifying the pathways of this disorder.…”

Association of Changes in Metabolic Syndrome Status With the Incidence of Thyroid Nodules: A Prospective Study in Chinese Adults

“…Therefore, this 6-year prospective study aimed to investigate the association of MetS with the incidence of TNs in Chinese adults. Since the MetS status is known to change dynamically (18)(19)(20), we also explored whether the development of or recovery from MetS is associated with an altered risk for TNs.…”