Abstract
Understanding the factor weighting in the development of metabolic syndrome (MetS) may help to predict the progression for cardiovascular and metabolic diseases. Thus, the aim of this study was to develop a confirmatory model to describe and explain the direct and indirect effect of each component in MetS status change. A total of 3581 individuals diagnosed with MetS, aged 18–102 years, were selected between January 2019 and December 2020 from a community-representative sample of Portuguese adults in a north-eastern Portuguese region to test the model’s goodness of fit. A structural equation modelling (SEM) approach and a two-way ANOVA (age × body composition) were performed to compare the relative contribution of each MetS component using joint interim statement (JIS). Waist circumference (β = 0.189–0.373, p < 0.001), fasting glucose (β = 0.168–0.199, p < 0.001) and systolic blood pressure (β = 0.140–0.162, p < 0.001) had the highest direct effect on the change in MetS status in the overall population and concerning both sexes. Moreover, diastolic blood pressure (DBP), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-c) had a low or non-significant effect. Additionally, an indirect effect was reported for age and body composition involving the change in MetS status. The findings may suggest that other components with higher specificity and sensitivity should be considered to empirically validate the harmonised definition of MetS. Current research provides the first multivariate model for predicting the relative contribution of each component in the MetS status change, specifically in Portuguese adults.
Highlights
Metabolic syndrome (MetS) is a public health concern defined by a cluster of major risk factors, such as central obesity, dysglycemia, dyslipidemia and hypertension [1]
In each MetS component according to age groups, Body max index (BMI) bands and interaction effect amongst simple or multiple linear regression analysis was computed according to the theoretical model
The current findings were congruent with the differences between age groups, BMI bands and MetS-components, reporting an effect of age and body composition in all MetS components, except for the links between age → HDL in the overall population and men, age → TG in women, and age BMI → SBP in the overall population and women (Table 2)
Summary
Metabolic syndrome (MetS) is a public health concern defined by a cluster of major risk factors, such as central obesity, dysglycemia, dyslipidemia and hypertension [1]. Studies have reported that the combination of these factors increases the risk of atherosclerotic cardiovascular diseases (CVD), type 2 diabetes mellitus (T2DM), neurological disorders and cancers [2–4]. The prevalence of MetS has been increasing worldwide over the last decades due to obesity-related factors, such as a sedentary lifestyle and an unhealthy diet [5,6]. Southern European countries showed a higher prevalence of MetS in comparison to the remaining European countries (i.e., Italy, Spain, and Portugal) [7]. In the Portuguese context, a high prevalence of MetS has been reported among 37.2% to 54.51% of the total population [7–9]. A high prevalence has been described for MetS components
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