TY - JOUR
T1 - Longitudinal paths to the metabolic syndrome
T2 - Can the incidence of the metabolic syndrome be predicted? The Baltimore longitudinal study of aging
AU - Scuteri, Angelo
AU - Morrell, Christopher H.
AU - Najjar, Samer S.
AU - Muller, Denis
AU - Andres, Reubin
AU - Ferrucci, Luigi
AU - Lakatta, Edward G.
PY - 2009/5
Y1 - 2009/5
N2 - Objective. To determine the predictors of incidence of metabolic syndrome (MetS) (Adult Treatment Panel III criteria) and to determine if longitudinal changes in specific MetS components differ by age or gender in participants who developed versus those who did not develop MetS. Methods. A total of 506 men and 461 women (baseline age 52.4 ± 17.5 years) from the Baltimore Longitudinal Study on Aging (BLSA) were followed longitudinally (at least two study visits), and censored when they developed the MetS or reported use of antihypertensive or lipid-lowering medications. Results. After a follow-up period of 6 years, the incidence of the MetS was 25.5% in men and 14.8% in women. As many as 66% of men and 73% of women with one or two altered MetS components at baseline did not develop the MetS. Predictors of developing MetS were higher baseline abdominal obesity or triglycerides and lower high-density lipoprotein cholesterol (area under receiver-operated curve [AUC] = 0.84 in men, 0.88 in women). Addition of the rate of changes in MetS components over time slightly improved predictive accuracy (AUC = 0.94 in men, 0.92 in women). Men were more likely than women to have the MetS without obesity, whereas women were more likely than men to have the MetS without an altered glucose metabolism. Conclusions. The patterns of MetS components and the longitudinal changes that lead to the MetS are different in men and women. Interestingly, components with the highest prevalence prior to MetS development, such as elevated blood pressure, are not necessarily the stronger risk factors.
AB - Objective. To determine the predictors of incidence of metabolic syndrome (MetS) (Adult Treatment Panel III criteria) and to determine if longitudinal changes in specific MetS components differ by age or gender in participants who developed versus those who did not develop MetS. Methods. A total of 506 men and 461 women (baseline age 52.4 ± 17.5 years) from the Baltimore Longitudinal Study on Aging (BLSA) were followed longitudinally (at least two study visits), and censored when they developed the MetS or reported use of antihypertensive or lipid-lowering medications. Results. After a follow-up period of 6 years, the incidence of the MetS was 25.5% in men and 14.8% in women. As many as 66% of men and 73% of women with one or two altered MetS components at baseline did not develop the MetS. Predictors of developing MetS were higher baseline abdominal obesity or triglycerides and lower high-density lipoprotein cholesterol (area under receiver-operated curve [AUC] = 0.84 in men, 0.88 in women). Addition of the rate of changes in MetS components over time slightly improved predictive accuracy (AUC = 0.94 in men, 0.92 in women). Men were more likely than women to have the MetS without obesity, whereas women were more likely than men to have the MetS without an altered glucose metabolism. Conclusions. The patterns of MetS components and the longitudinal changes that lead to the MetS are different in men and women. Interestingly, components with the highest prevalence prior to MetS development, such as elevated blood pressure, are not necessarily the stronger risk factors.
KW - Abdominal obesity
KW - Incidence
KW - Longitudinal studies
KW - Metabolic syndrome
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U2 - 10.1093/gerona/glp004
DO - 10.1093/gerona/glp004
M3 - Article
C2 - 19270183
AN - SCOPUS:65549159948
SN - 1079-5006
VL - 64
SP - 590
EP - 598
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 5
ER -