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.
Highlights
Coinciding with the significant rise in obesity worldwide, a considerable increase in the prevalence of metabolic syndrome (MS) has been observed in recent times [1]
Our 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, essential for the development of MS, appear later
The components of MS are distributed in the following way: 11.7% with Blood pressure (BP) ! 130/85 mmHg, 14.4% with impaired fasting glucose, 26.5% with dyslipidaemia and 38.6% of the subjects were obese. 51.8% had only one component of MS and 11.8% had two components
Summary
Coinciding with the significant rise in obesity worldwide, a considerable increase in the prevalence of metabolic syndrome (MS) has been observed in recent times [1]. The most commonlyused definition is that of the NCEP ATP III [2,3], in which an individual is considered to have MS when diagnosed with at least three of the following five possible metabolic risk factors: i) abdominal obesity (waist circumference: men >102cm; women > 88cm), ii) impaired tolerance to glucose (fasting glucose levels !110 mg/dL or a diagnosis of type 2 diabetes mellitus, DM2), iii) high blood pressure (!130/85 mmHg); iv) low high density lipoprotein cholesterol (HDL) (in men
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