Abstract
Visceral fat (VF) promotes the development of metabolic syndrome (MetS), which emerges as early as in adolescence. The clustering of MetS components suggests shared etiologies, but these are largely unknown and may vary between males and females. Here, we investigated the latent structure of pre-clinical MetS in a community-based sample of 286 male and 312 female adolescents, assessing their abdominal adiposity (VF) directly with magnetic resonance imaging. Principal component analysis of the five MetS-defining variables (VF, blood pressure [BP], fasting serum triglycerides, HDL-cholesterol and glucose) identified two independent components in both males and females. The first component was sex-similar; it explained >30% of variance and was loaded by all but BP variables. The second component explained >20% of variance; it was loaded by BP similarly in both sexes but additional loading by metabolic variables was sex-specific. This sex-specificity was not detected in analyses that used waist circumference instead of VF. In adolescence, MetS-defining variables cluster into at least two sub-syndromes: (1) sex-similar metabolic abnormalities of obesity-induced insulin resistance and (2) sex-specific metabolic abnormalities associated with BP elevation. These results suggest that the etiology of MetS may involve more than one pathway and that some of the pathways may differ between males and females. Further, the sex-specific metabolic abnormalities associated with BP elevation suggest the need for sex-specific prevention and treatment strategies of MetS.
Highlights
IntroductionMetabolic syndrome (MetS) is defined as a cluster of risk factors for cardiovascular disease (CVD) and type-2 diabetes mellitus (T2DM) occurring in the same individual; it includes elevated blood pressure (BP), atherogenic dyslipidemia (raised triglycerides [TG] and lowered high-density lipoproteins (HDL)-cholesterol [HDL-chol]), raised fasting glucose (Glu) and abdominal obesity
Metabolic syndrome (MetS) is defined as a cluster of risk factors for cardiovascular disease (CVD) and type-2 diabetes mellitus (T2DM) occurring in the same individual; it includes elevated blood pressure (BP), atherogenic dyslipidemia, raised fasting glucose (Glu) and abdominal obesity
The first component, capturing the variance related to obesity-related insulin resistance, is similar in males and females, whereas the second component, capturing the variance associated with metabolic correlates of BP, is different in the two sexes
Summary
Metabolic syndrome (MetS) is defined as a cluster of risk factors for cardiovascular disease (CVD) and type-2 diabetes mellitus (T2DM) occurring in the same individual; it includes elevated blood pressure (BP), atherogenic dyslipidemia (raised triglycerides [TG] and lowered HDL-cholesterol [HDL-chol]), raised fasting glucose (Glu) and abdominal obesity. MetS, typically regarded as a middle- to lateadulthood disorder, is emerging in adolescence [6] with close to 10% of all 12–19-year olds being affected [7,8]. This emergence of MetS in adolescence has been in part attributed to obesity; it is one of the components as well as the main risk factor for MetS, and its prevalence has tripled during the last 30 year in this age group [9,10]
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