Assessment of metabolic syndrome predictors in relation to inflammation and visceral fat tissue in older adults

Abstract

The diagnosis of metabolic syndrome (MetS) focuses on the assessment of risk factors such as insulin resistance, dyslipidemia, central adiposity and elevated blood pressure. Evidence suggests that markers of systemic inflammation may also be included in the definition of MetS and play some role in its pathogenesis. The study was designed to evaluate low-grade inflammation status in older adults with MetS in relation to increased body fat tissue and an attempt was made to evaluate new predictors for MetS through the analysis of the ROC Curve. Ninety-six middle-aged (69.2 ± 4.9) individuals from University of Third Age (women n = 75 and men n = 21) were allocated to two groups: without metabolic syndrome (n = 37) and with metabolic syndrome (n = 59) according to International Diabetes Federation criteria in agreement with American Heart Association/National Heart, Lung and Blood Institute 2009. Participants’ current health status was assessed using medical records from a routine follow-up visit to a primary care physician. Statistical analysis was performed using R studio software. Depending on the normal distribution, ANOVA or the Kruskal–Wallis test was used. The optimal threshold value for clinical stratification (cut-off value) was obtained by calculating the Youden index. The AUC was observed to be the highest for a new anthropometric index i.e. lipid accumulation product (0.820). Low-grade inflammation dominated in MetS group (BMI 28.0 ± 4.4 kg/m2, WHR 0.9 ± 0.1, FM 24.7 ± 7.9 kg) where significantly higher values of TNF-α (p = 0.027) and HGMB-1 protein (p = 0.011) were recorded.The optimal threshold values for immunological indices assessed as new predictors of the metabolic syndrome were: 93.4 for TNF-α, 88.2 for HGMB-1 protein and 1992.75 for ghrelin. High AUC values for these indices additionally confirmed their high diagnostic usefulness in MetS.