MetSyn Risk Research Articles

Adolescent BMI trajectory and associations with adult metabolic syndrome and offspring obesity.

This study examinedthe association of adolescent BMI trajectory with adult metabolic syndrome (MetSyn) and with intergenerational obesity. This study used data from the National Heart, Lung, and Blood Institute (NHLBI) Growth and Health Study (1987-1997). Data from the 20-year follow-up (2016-2019) study were included from the original participants (N = 624) and their children (N = 645). Adolescent BMI trajectories were identified using latent trajectory modeling. Mediation analysis using logistic regression models was performed to estimate confounder-adjusted odds ratios (OR) and 95% CI between adolescent BMI trajectory and adult MetSyn. Using similar methods, the association between BMI trajectory and offspring obesity was examined. Latent trajectory modeling identified four patterns: "weight loss then gain" (N = 62); "persistently normal" (N = 374); "persistently high BMI" (N = 127); and "weight gain then loss" (N = 61). Women who had a persistently high BMI trajectoryhad twice the odds of having children who met the definition for obesity compared with the persistently normal group, adjusting for adult BMI (OR: 2.76; 95% CI: 1.39-5.46). None of the trajectory groups was associated with adult MetSyn compared with the persistently normal group. Intermittent adolescent obesity may not confer MetSyn risk during adulthood. However, maternal adolescent BMI trajectories that are persistently highmay increase the odds of intergenerational obesity among offspring.

Dietary Tryptophan and the Risk of Metabolic Syndrome: Total Effect and Mediation Effect of Sleep Duration.

PurposeTryptophan affects energy homeostasis, glucose metabolism, blood pressure, and sleep. However, studies investigating the association between tryptophan and metabolic syndrome (MetSyn) are rare. We aimed to investigate the associations of dietary tryptophan with MetSyn incidence and potential mediation via sleep duration.MethodsData of 7890 participants were obtained from the China Health and Nutrition Survey (1997–2011) (male: 49.9%; mean age=43.43 years;median follow-up=129.76 months; MetSyn incidence: 16.3%). A combination of individual 24-hour recall and household survey was used to assess dietary intake. In total, 6720 and 4474 participants who reported sleep duration and had blood samples taken, respectively, were incorporated into subgroup analyses. MetSyn was defined according to National Cholesterol Education Program Adult Treatment Panel (NCEP ATP) III criteria (2004), and tryptophan consumption and sleep duration were assessed by self-report in each survey. Multivariate Cox regression models were used to assess the associations between tertiles of tryptophan intake and MetSyn. Generalized linear regression models were used to evaluate the effect of tryptophan on sleep duration and plasma biomarkers.ResultsDietary tryptophan showed a protective effect on the risk of MetSyn. The hazard ratio (95% CI) of MetSyn was 0.77 (0.65–0.90) for individuals with a high tertile of tryptophan. Sleep duration was significantly higher, and HbA1c, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (APO-B) were lower in the high tertile of tryptophan compared to the low tertile (P<0.05). In addition, mediation effects on the association between tryptophan intake and MetSyn risk were observed for sleep duration (estimated mediation percentage: 26.5%).ConclusionOur study demonstrated a negative association between dietary tryptophan and MetSyn incidence, and the mediation effect of sleep duration on this association, after adjusting for numerous confounders such as nutrients and food patterns. These findings may have important public health implications for the improvement of cardiometabolic health.

Higher Incidence of Metabolic Syndrome in Black Women With Polycystic Ovary Syndrome: A Longitudinal Study.

Cross-sectional studies have identified an increased risk of metabolic syndrome (MetSyn) in women with polycystic ovary syndrome (PCOS), but longitudinal data are limited and primarily include White and European cohorts. To compare the longitudinal risk of MetSyn in Black and White women with PCOS and to identify potential factors mediating the risk of MetSyn. Longitudinal cohort study with a follow-up of 5.3 years at an academic medical center. 247 adult women with hyperandrogenic PCOS phenotype with 2 or more visits at least 3 years apart. The main outcome measure was incidence of MetSyn in Black and White women with PCOS. Using a mixed-effects model over time, the incidence of MetSyn was higher in Black women (45.9 ± 4.74 per 100 person-years) than in White women (31.3 ± 3.03 per 100 person-years) (P < .01) after adjusting for age and medication status. This difference persisted among women under age 30. Among Black women who did not have MetSyn at their prior visit, 28.0% had MetSyn at the next visit, compared with 12.1% of White women after adjusting for age and medication status (P < .01). In both races, the model-based estimated rates of MetSyn increased significantly with increase in body mass index and free testosterone. We describe a persistent higher incidence of MetSyn in Black than in White women with PCOS. In addition to early cardiometabolic screening at the time of diagnosis, our findings highlight the need for ongoing and frequent screening in this population.

Dynamic Metabolic Risk Profiling of World Trade Center Lung Disease: A Longitudinal Cohort Study.

Rationale: Metabolic syndrome (MetSyn) increases the risk of World Trade Center (WTC) lung injury (LI). However, the temporal relationship of MetSyn, exposure intensity, and lung dysfunction is not well understood. Objective: To model the association of longitudinal MetSyn characteristics with WTC lung disease to define modifiable risk. Methods: Firefighters, for whom consent was obtained (N = 5,738), were active duty on September 11, 2001 (9/11). WTC-LI (n = 1,475; FEV1% predicted <lower limit of normal [LLN]) and non-WTC-LI (n = 4,263; FEV1% predicted ⩾LLN at all exams) was the primary outcome, and FVC% predicted <LLN and FEV1/FVC <0.70 were secondary outcomes. We assessed 1) the effect of concurrent MetSyn on longitudinal lung function by linear mixed models, 2) the temporal effect of MetSyn and exposure by Weibull proportional hazards, 3) the effects of MetSyn's rate of change by two-stage models, and 4) the nonlinear joint effect of longitudinal MetSyn components by a partially linear single-index model (PLSI). Measurements and Main Results: WTC-LI cases were more often ever-smokers, arrived in the morning (9/11), and had MetSyn. Body mass index ⩾30 kg/m2 and high-density lipoprotein <40 mg/dl were most contributory to concurrent loss of FEV1% predicted and FVC% predicted while conserving FEV1/FVC. Body mass index ⩾30 kg/m2 and dyslipidemia significantly predicted WTC-LI, FVC% predicted <LLN in a Weibull proportional hazards model. Dynamic risk assessment of WTC-LI on the basis of MetSyn and exposure showed how reduction of MetSyn factors further reduces WTC-LI likelihood in susceptible populations. PLSI demonstrates that MetSyn has a nonlinear relationship with WTC lung disease, and increases in cumulative MetSyn risk factors exponentially increase WTC-LI risk. An interactive metabolic-risk modeling application was developed to simplify PLSI interpretation. Conclusions: MetSyn and WTC exposure contribute to the development of lung disease. Dynamic risk assessment may be used to encourage treatment of MetSyn in susceptible populations. Future studies will focus on dietary intervention as a disease modifier.

Body Composition Change, Unhealthy Lifestyles and Steroid Treatment as Predictor of Metabolic Risk in Non-Hodgkin's Lymphoma Survivors.

Unhealthy lifestyle, as sedentary, unbalanced diet, smoking, and body composition change are often observed in non-Hodgkin’s lymphoma (NHL) survivors, and could be determinant for the onset of cancer treatment-induced metabolic syndrome (CTIMetS), including abdominal obesity, sarcopenia, and insulin resistance. The aim of this study was to assess whether changes in body composition, unhealthy lifestyles and types of anti-cancer treatment could increase the risk of metabolic syndrome (MetSyn) and sarcopenia in long-term NHL survivors. We enrolled 60 consecutive NHL patients in continuous remission for at least 3 years. Nutritional status was assessed by anthropometry-plicometry, and a questionnaire concerning lifestyles and eating habits was administered. More than 60% of survivors exhibited weight gain and a change in body composition, with an increased risk of MetSyn. Univariate analysis showed a significantly higher risk of metabolic disorder in patients treated with steroids, and in patients with unhealthy lifestyles. These data suggest that a nutritional intervention, associated with adequate physical activity and a healthier lifestyle, should be indicated early during the follow-up of lymphoma patients, in order to decrease the risk of MetSyn’s onset and correlated diseases in the long term.

HIGHER RISK OF PERSISTENT METABOLIC SYNDROME (METSYN) IN BLACK WOMEN WITH POLYCYSTIC OVARY SYNDROME (PCOS): A LONGITUDINAL STUDY

To evaluate the impact of race on the longitudinal risk of MetSyn among women with PCOS Prospective cohort study Women with PCOS based on Rotterdam criteria with ≥2 visits over at least one year seen between 2008- 2019 were included. MetSyn was defined as at least three of the five criteria shown in Table. Presence or absence of MetSyn was determined at each visit. Data were collected on demographics, PCOS work-up, medical history, use of PCOS-specific medications (oral contraceptives, metformin, spironolactone). Two-tailed t-tests or rank sum tests were used for continuous variables and chi-square tests for categorical variables. Mixed-effects models were used for longitudinal data to accommodate repeated measures per person, the varying of amount of data and spacing between assessments per person and examine the impact of race and medication. 269 women with well-defined PCOS (94.8% with hyperandrogenic phenotype) were followed for a mean 5.8±2.7 visits over 5.4±2.6 years with 1.3±0.7 years between visits. During the study period, the overall prevalence of MetSyn was 31.8% in White women (n=188) and 49.4% in Black women (n=81, p < 0.01) and increased with time. This difference in MetSyn remained significant when including only women < 30 years (23.0% in White, 48.5% in Blacks, p < 0.01). Use of medications did not significantly interact with race: prevalence of MetSyn was 33.1% in White women compared to 51.2% in Black women not taking medications for PCOS (p < 0.01). Among women taking medications, 29.4% of White women and 43.2% of Black women had MetSyn (p = 0.01). Absence of Metsyn at a prior visit was associated with a higher prevalence of MetSyn at the next visit in Black woman when compared to White women (31.6% versus 13.5%, p < 0.01), even when restricting to women <30years (30.5% versus 11.6%, p < 0.01). In contrast, both Black and White women with MetSyn at the prior visit had a similar rate of persistent MetSyn at the next visit (72.5% versus 69.8%, p = 0.62). This is the first longitudinal study in prospectively identified women with PCOS demonstrating a higher persistent risk of MetSyn in Black women compared to White women, regardless of age or medication use. Our study highlights the importance of frequent follow-up visits, starting at a young age, in this high risk population to allow for early identification of modifiable cardiovascular disease risk factors.

87-LB: Reduced Risk of Metabolic Syndrome and T2DM after One Year in an Automated No-Coaches Online Behavior Change Program

Adults (n=339) at risk of diabetes, 68.1% with Metabolic Syndrome (MetSyn), were randomized to immediate intervention or to 6-month delayed control. Other than quarterly clinic visits for blood and weight measurement, there was no contact with study staff. The intervention, Alive-PD, was algorithm-driven, low-cost, and had no human coaching. Published 6-month results showed significant (p&amp;lt;0.001) treatment vs. control effects on HbA1c, glucose (FG), and weight. Baseline means (SD) were: age 55 (8.9)y, BMI 31.2 (4.4), FG 109.9 (8.4) mg/dL, HbA1c 5.6 (0.3)%. Most were male (68.7%), college-educated (82%), and white (68%). We calculated change from baseline to 12 months, and MetSyn severity Z-score (MetSynZ), a continuous variable associated with long-term risk for CVD, T2DM and MetSyn. We present data for those who provided 12-month biometric data (n=240), and also an intention-to-treat analysis for all 339 using Last Observation Carried Forward (LOCF). In the 240 with 12-month data, pre-post improvements at 1 year were significant at p&amp;lt;0.001 for HbA1c, weight, waist, HDL, TG/HDL ratio and MetSynZ. The pre-post effect sizes ((12-month - baseline)/SD) were -0.50 for waist (half a SD), -0.43 for HbA1c and -0.36 for MetSynZ. These represent medium to low-medium effects. Changes, effect sizes and significance were similar in the LOCF n=339 analysis. Effect sizes of other analytes were significant but small. Only change in FG failed to maintain significance at 1 year. Prevalence of metabolic syndrome was 68% at baseline, similar to that of the DPP sample (70%). It fell to 42% at 1 year, similar to that of DPP (45%). The MetSyn severity Z-score declined from 0.60 to 0.32, p&amp;lt;0.001. Insulin resistance by TG/HDL fell from 41% to 27% at 12 months. These data indicate that at least for well-educated participants receiving quarterly clinic visits, this automated online coach-free program can help users achieve and maintain significant and non-trivial one-year reductions in risk of MetSyn and T2DM at relatively low cost. Disclosure G. Block: Other Relationship; Self; Turnaround Health (NutritionQuest). T. Block: Other Relationship; Self; Turnaround Health. C.H. Block: None. Funding National Institutes of Health

Plasma Linoleic Acid Is Associated with Less Adiposity and Lower Risk of Metabolic Syndrome: An NHANES Analysis (P08-121-19)

ObjectivesTo examine relationships between plasma fatty acids, dietary intake of fatty acids, adiposity and risk of metabolic syndrome (MetSyn) in the National Health and Nutrition Examination Survey (NHANES) dataset. MethodsPlasma fatty acids levels (n = 24) measured in NHANES 2001–2003 (n = 1674) and dietary intake of fatty acids (n = 19) from NHANES 2001–2014 (n = 9108) were used for these analyses. The association between plasma fatty acid levels, intake of fatty acids and body weight, BMI, waist circumference, and number of criteria for MetSyn was assessed. Backwards stepwise multiple regression analyses adjusted for age, sex, ethnicity, prescription of anti-hypertensive, lipid-lowering of anti-diabetic medication, modified Health Eating Index-2015 score, physical activity, poverty to income ratio, smoking, and calorie intake were conducted to identify fatty acids that were predictive of the outcomes of interest. Logistic regression analysis, adjusted for the aforementioned covariates, was used to assess the odds of MetSyn, and overweight/obesity associated with each fatty acid. ResultsHigher levels of the plasma saturated fatty acids myristic acid (14:0), stearic acid (18:0), and docosanoic acid (22:0) were associated with greater BMI, waist circumference, and number of MetSyn criteria (P < 0.01). Arachidic acid (20:0) and lignoceric acid (24:0) were inversely associated with BMI, waist circumference, and number of MetSyn criteria. Plasma linoleic acid (18:2) was the only PUFA inversely associated with BMI (β = −0.002), waist circumference (β = −0.005), and number of MetSyn criteria (β −0.0003) (all P < 0.01). Plasma linoleic acid was also correlated with lower risk of being overweight or obese (odds ratio (OR) 0.9995; P < 0.03) and having an elevated waist circumference (OR 0.9992; P < 0.01). These results were not supported by the dietary fatty acid intake data. ConclusionsThese data from a representative U.S. cohort indicate that plasma medium and longer chain saturated fats were generally associated with greater adiposity and more criteria for MetSyn, whereas these relationships were not detected for MUFA. Linoleic acid was the only PUFA associated with less adiposity and lower risk of MetSyn and, thus also lower risk of cardiometabolic disease. Funding SourcesACH Food Companies, Inc.

1340-P: Higher Morning Serum Cortisol (MSC) Associates with Prediabetes and Other Metabolic Syndrome (MetSyn) Components in Predominantly Latino Adolescents

Chronic life stress and “allostatic load” may increase risk for MetSyn. This study examines the associations between MSC, prediabetes, and MetSyn components in adolescents with body mass index (BMI) ranging from underweight to obese. Fasting blood was drawn ∼8AM from 191 healthy adolescents (126F/65M; 16.4±0.6 years; 95% Latino) to measure MSC, glucose, HbA1C, and lipids; triplicate measurements of BMI, waist circumference, and systolic/diastolic blood pressure (BP). All analyses were adjusted for a priori covariates of age, sex, BMI, and ethnicity. MSC was higher in adolescents with prediabetes (fasting glucose 100-125 mg/dL, n=20) vs. normoglycemia (Figure). This relationship was not seen when applying the prediabetes definition of HbA1C 5.7-6.4%. Higher MSC was associated with higher fasting glucose (β=0.02±0.005, p&amp;lt;0.001) and triglycerides (β=0.06±0.02, p=0.003). MSC was not associated with waist circumference, HDL cholesterol, HbA1c, or systolic/diastolic BP in linear modeling. However, adolescents with borderline/high BP (n=27) exhibited higher MSC compared to those with normal BP (516±32 vs. 392±12 nnol/L, p&amp;lt;0.001). The significant relationships between MSC, prediabetes and other MetSyn components suggest further study of the link between allostatic load and diabetes/cardiometabolic risk in adolescents is warranted. Disclosure C.M. Toledo-Corral: None. C.J. Lane: None. M. Weigensberg: None. Funding National Institutes of Health (R01AT008330)

Psychosocial Factors in the Relationship between Socioeconomic Status and Cardiometabolic Risk: the HCHS/SOL Sociocultural Ancillary Study.

U.S. Hispanics/Latinos display a high prevalence of metabolic syndrome (MetSyn), a group of co-occurring cardiometabolic risk factors (abdominal obesity, impaired fasting glucose, dyslipidemia, elevated blood pressure) associated with higher cardiovascular disease and mortality risk. Low socioeconomic status (SES) is associated with higher risk for MetSyn in Hispanics/Latinos, and psychosocial factors may play a role in this relationship. This cross-sectional study examined psychosocial factors in the association of SES and MetSyn components in 4,996 Hispanic/Latino adults from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. MetSyn components were measured at the baseline examination. Participants completed interviews to determine psychosocial risks (e.g., depression) and resources (e.g., social support) within 9 months of baseline (< 4 months in 72.6% of participants). Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to identify latent constructs and examine associations. Participant mean age was 41.7 years (SE = 0.4) and 62.7% were female. CFA identified single latent factors for SES and psychosocial indicators, and three factors for MetSyn [blood pressure, lipids, metabolic factors]. SEMs showed that lower SES was related to MetSyn factors indirectly through higher psychosocial risk/lower resources (Y-Bχ2 (df = 420) = 4412.90, p < .05, RMSEA = .042, SRMR = .051). A statistically significant effect consistent with mediation was found from lower SES to higher metabolic risk (glucose/waist circumference) via psychosocial risk/resource variables (Mackinnon's 95% asymmetric CI = -0.13 to -0.02). SES is related to metabolic variables indirectly through psychosocial factors in U.S. Hispanics/Latinos of diverse ancestries.

Antimüllerian hormone levels and cardiometabolic risk in young women with polycystic ovary syndrome

To determine the association between antimüllerian hormone (AMH) levels and metabolic syndrome (MetSyn) in young women with polycystic ovary syndrome (PCOS). Cross-sectional study. Academic PCOS center. A total of 252 women aged 18-46years with PCOS. None. Association of AMH with markers of cardiometabolic risk and MetSyn. The median AMH level was 5.1ng/mL (interquartile range [IQR] 3.0-8.1), and prevalence of MetSyn was 23.8%. AMH levels positively correlated with total T, high-density lipoprotein (HDL) cholesterol, and SHBG and negatively correlated with fasting glucose, homeostasis-model assessment of insulin resistance, body mass index (BMI), and systolic and diastolic blood pressure. A single-unit decrease in AMH was associated with an 11% increase in odds of MetSyn (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.03-1.20); the strength of this association was maintained in the multivariate model (OR 1.09, 95% CI 1.01-1.18) adjusting for age and race. Subjects with AMH values in the lowest tertile were twice as likely as those in the highest tertile to have MetSyn (adjusted OR 2.1, 95% CI 1.01-4.3). Total T was not associated with MetSyn or its individual components. Our findings indicate that in young women with PCOS, low AMH levels predict a greater risk of MetSyn. The role of AMH, an established biomarker of ovarian reserve, in risk stratification of cardiometabolic risk in obese women with PCOS needs to be clarified in longitudinal studies and in the perimenopausal population.

The Association Between Metabolic Syndrome, Obesity-Related Outcomes, and ADHD in Adults With Comorbid Affective Disorders

Objective: ADHD may predispose to obesity, a metabolic syndrome component. Affective disorders are also associated with MetSyn and ADHD. This study examined whether ADHD confers any added risk of MetSyn and obesity-related associations in a large sample with varying stages of affective disorders. Method: Participants included 2,303 adults from the Netherlands Study of Depression and Anxiety. Three groups were compared (controls, those with depressive/anxiety disorders without ADHD; and those with depressive/anxiety disorders and ADHD) for presence of MetSyn risk factors, body mass index, and waist–hip ratio. ADHD symptoms were identified by using a T-score > 65 (Conners Adult ADHD Rating Scale). Results: Multivariable analyses were additionally adjusted for sociodemographic, lifestyle, health factors, and affective disorders. Analyses showed no significant association between MetSyn, obesity-related variables, and comorbid ADHD. High Inattention and Hyperactivity/Impulsivity symptoms were not associated with MetSyn. Conclusion: This study did not confirm that MetSyn and obesity-related parameters are increased in comorbid ADHD.

Association between the dietary inflammatory index, waist-to-hip ratio and metabolic syndrome

Inflammation due to poor diet may contribute to the development of metabolic syndrome (MetSyn). The Dietary Inflammatory Index (DII) was created to characterize diet on a scale from anti- to pro-inflammatory. Our hypothesis was that higher (i.e., more pro-inflammatory) DII scores are associated with an increased prevalence of MetSyn compared to those with lower (i.e., more anti-inflammatory) DII scores. Data from the Polish-Norwegian (PONS) Study were analyzed using logistic and linear regression procedures in SAS (version 9.4). Comparisons of interest were between the first and fourth DII quartiles; analyses were stratified by sex. Mean waist-to-hip ratio (WHR) and diastolic blood pressure were greater among those in DII quartile 4 compared to 1. No statistically significantly increased MetSyn risks were observed for DII quartile 4 among men or women. Men in DII quartile 4 had elevated odds of fulfilling the waist component of MetSyn (odds ratio=1.65, 95% confidence interval=1.01-2.69). Although this study benefited from the DII and large sample sizes for both men and women, its cross-sectional nature and use of self-reported data may limit interpretation of results. Further work must be done in longitudinal studies to understand whether pro-inflammatory diets are associated with an increased risk of MetSyn, its components or other metabolic-related conditions. Additionally, further examination of the DII in relation to body habitus will be needed to understand the role of pro-inflammatory diets on anthropometrics, as observed in this study.

Vitamin D Status Is Associated with Metabolic Syndrome in a Clinic-Based Sample of Hispanic Adults.

Vitamin D status has been associated with metabolic syndrome (MetSyn) and its components in different populations, but few studies have assessed this among Hispanics. The objective of this analysis was to assess such association in a clinic-based sample of Hispanic adults. Medical records were reviewed retrospectively for the years 2005-2013. MetSyn was assessed using the revised NCEP-ATP III criteria. Vitamin D status was evaluated from reported serum 25(OH)D levels. A multivariable logistic regression model was used to assess the association between MetSyn risk and vitamin D status, controlling for important confounders. From 1379 medical records evaluated, 712 met the inclusion criteria. Most were females (62.6%), with a mean age of 53.8 ± 14.1 years, mean body mass index (BMI) of 30.1 ± 6.4 kg/m(2), and mean serum 25(OH)D levels of 24.4 ± 8.3 ng/mL. MetSyn was identified in 40.5% of the participants. Serum 25(OH)D levels in those with MetSyn (22.7 ± 8.0 ng/mL) were significantly lower compared to those without MetSyn (25.5 ± 8.4 ng/mL; P < 0.001). Serum 25(OH)D levels were inversely correlated to triglycerides, waist circumference, and fasting blood glucose (P < 0.05). In the multivariable logistic regression model, decreased serum 25(OH)D levels were associated with higher odds of MetSyn, even after adjusting for age, gender, BMI, and seasonality. In this clinic-based sample, the odds of MetSyn increased as serum 25(OH)D levels decreased. These results have important public health implications for developing recommendations directed to increase vitamin D status in this sample.

Anti Mullerian hormone (AMH) levels predict cardiovascular risk assessment in young women with PCOS

Serum levels of anti-mullerian hormone (AMH), a member of the TGFb family, are elevated in women with PCOS. There is conflicting information in women with and without PCOS regarding the association between low AMH levels and increased cardiometabolic risk. Young women with PCOS have an increased risk of metabolic syndrome and we hypothesized that serum AMH levels would predict risk of metabolic syndrome in this population. Retrospective cohort study. Women seen at the Penn PCOS center from 2010-2014 with complete metabolic work up were included in this study (n=469). Metabolic syndrome (Met Syn) was defined by modified NCEP-ATP III criteria (BMI≥30, sBP/dBP≥135/85mmHg or taking anti-hypertensives medications, fasting glucose ≥100mg/ml or taking medications for diabetes, TG≥150mg/ml, HDL-C ≤50mg/ml). AMH was measured using the Gen II ELISA, lipids were measured by standard enzymatic methods and total testosterone was measured by radioimmunoassay. Spearman correlation coefficients were used to determine relationships between continuous variables. Linear regression was used to model associations between AMH and lipids adjusting for confounders. AMH was dichotomized based on tertiles and univariate tests and logistic regression modeling were used to evaluate associations of selected variables with tertiles of AMH. The median AMH level in the entire cohort was 5.06ng/ml (IQR 3.08-7.97) . The mean age of the group was 27.6±6years, 42.1% were non-white and 8.1% were smokers. The overall prevalence of Met Syn was 19%. AMH levels positively correlated with total testosterone (p<0.008). On examination of individual components of Met Syn, AMH levels positively correlated with HDL-C (p<0.001) and negatively correlated with fasting glucose (p<0.004), total insulin (p<0.001), BMI (p<0.001), systolic and diastolic BP (p<0.003, p<0.005 respectively). AMH did not have a significant correlation with smoking, LDL-C, TG, CRP, DHEAS and SHBG. Total testosterone did not correlate with individual components of Met Syn. For every unit increase in AMH the odds of Met Syn decreased by 10% (OR 0.9 (0.83-0.97) in the univariate model (p=0.01) and in the multivariate model (p<0.02). The OR for Met Syn for women in the lowest AMH tertile compared to those in the highest AMH tertile was 2.3 (95% CI 1.1-4.6, p=0.02). Adjusted for age, race and testosterone the OR for Met Syn in the lowest AMH tertile was 2.1 (95% CI 1.01-4.3, p=0.04). Total testosterone did not predict risk of Met Syn (p=0.5). Our findings indicate that AMH levels, independent of age, race and testosterone are a strong predictor of Met Syn risk in young women with PCOS. Although the causal or temporal relationship for our findings is unclear, our study suggests that metabolic risk in young women with PCOS is influenced by the ovarian hormone AMH but not testosterone.

Age-related changes in basal substrate oxidation and visceral adiposity and their association with metabolic syndrome.

Ageing is directly associated with visceral fat (VAT) deposition and decline of metabolically active cellular mass, which may determine age-related shifts in substrate oxidation and increased cardiometabolic risk. We tested whether VAT and fasting respiratory quotient (RQ, an index of macronutrient oxidation) changed with age and if they were associated with increased risk of metabolic syndrome (MetSyn). A total of 2819 adult participants (age range: 18-81 years; men/women: 894/1925) were included; we collected history, anthropometric measures, biochemistry, smoking habits, and physical activity. The body mass index range was 18.5-60.2kg/m(2). Gas exchanges (VO2 and VCO2) were measured by indirect calorimetry in fasting conditions, and RQ was calculated. Body composition was measured by bioelectrical impedance. Abdominal subcutaneous fat and VAT were measured by ultrasonography. MetSyn was diagnosed using harmonised international criteria. Multivariate linear and logistic regression models were utilised. VAT increased with age in both men (r=0.31, p<0.001) and women (r=0.37, p<0.001). Basal RQ was not significantly associated with age (p=0.49) and VAT (p=0.20); in addition, basal RQ was not a significant predictor of MetSyn (OR 3.31, 0.57-19.08, p=0.27). VAT was the primary predictor of MetSyn risk in a fully adjusted logistic model (OR 4.25, 3.01-5.99, p<0.001). Visceral adiposity remains one of the most important risk factors for cardiometabolic risk and is a significant predictor of MetSyn. Post-absorptive substrate oxidation does not appear to play a significant role in age-related changes in body composition and cardiometabolic risk, except for a correlation with triglyceride concentration.

Psychological well-being and metabolic syndrome: findings from the midlife in the United States national sample.

Psychological well-being predicts favorable cardiovascular outcomes, but less evidence addresses biological mediators underlying these effects. Therefore, associations among well-being and metabolic syndrome (MetSyn) were examined in a national sample. Survey of Midlife in the US participants (MIDUS; n = 1205) provided survey assessments of hedonic (positive affect, life satisfaction) and eudaimonic well-being (e.g., personal growth and purpose in life) at two waves 9 to 10 years apart. MetSyn components were measured during an overnight clinic visit at Time 2 only. Outcomes included the number of MetSyn risk factors and a binary outcome reflective of MetSyn status. The unadjusted prevalence of MetSyn was 36.6%. Life satisfaction (B [standard error {SE}] = -0.12 [0.04], p = .005), positive affect (B [SE] = -0.10 [0.04], p = .009), and personal growth (B [SE] = -0.10 [0.04], p = .012) predicted fewer MetSyn components and lower risk of meeting diagnostic criteria in fully adjusted models. Results were unchanged by adjustments for depressive symptoms, and were not moderated by age, sex, race, or socioeconomic status. Life satisfaction (B [SE] = -0.11 [0.05], p = .023) and a eudaimonic well-being composite (B [SE] = -0.11 [0.05], p = .045) also predicted fewer components and lower risk of meeting diagnostic criteria in longitudinal models. Psychosocial resources, including positive affect, life satisfaction, and personal growth, predicted reduced risk for MetSyn both cross sectionally and longitudinally. Further work should examine consequences of these linkages for cardiovascular outcomes in intervention contexts.

Lifestyle and metabolic syndrome in adult survivors of childhood cancer: a report from the St. Jude Lifetime Cohort Study.

Childhood cancer survivors (CCS) are at an increased risk of developing metabolic syndrome (MetSyn), which may be reduced with lifestyle modifications. The purpose of this investigation was to characterize lifestyle habits and associations with MetSyn among CCS. CCS who were ≥ 10 years from diagnosis, aged > 18 years, and participating in the St. Jude Lifetime Cohort Study completed medical and laboratory tests and a food frequency questionnaire. The Third Report of the National Cholesterol Education Program Adult Treatment Panel criteria were used to classify participants with MetSyn. Anthropometric, food frequency questionnaire, and self-reported physical activity data were used to characterize lifestyle habits according to World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations. Those who met ≥ 4 of 7 recommendations were classified as having followed guidelines. Sex-stratified log-binomial regression models were used to evaluate associations between dietary/lifestyle habits and MetSyn, adjusted for age, age at cancer diagnosis, receipt of cranial radiotherapy, education, and household income. Among 1598 CCS (49.2% of whom were male, with a median age of 32.7 years [range, 18.9 years-60.0 years]), 31.8% met criteria for MetSyn and 27.0% followed WCRF/AICR guidelines. Females who did not follow WCRF/AICR guidelines were 2.4 times (95% confidence interval, 1.7-3.3) and males were 2.2 times (95% confidence interval, 1.6-3.0) more likely to have MetSyn than those who followed WCRF/AICR guidelines. Adherence to a heart-healthy lifestyle is associated with a lower risk of MetSyn among CCS. There is a need to determine whether lifestyle interventions prevent or remediate MetSyn in CCS.

Black women with polycystic ovary syndrome (PCOS) have increased risk for metabolic syndrome and cardiovascular disease compared with white women with PCOS

To determine the prevalence of metabolic syndrome (MetSyn) and Framingham cardiovascular disease (CVD) risk in white and black adolescents and adult women with polycystic ovary syndrome (PCOS) compared with controls. Retrospective cohort study. Center for PCOS. Subjects with PCOS with data on race and cardiometabolic risk (n = 519). Controls were age and race matched from the National Health and Nutrition Examination Survey (NHANES) population (1999-2006). None. MetSyn, coronary heart disease risk, and general CVD risk. Black adolescents and young adults with PCOS had an increased prevalence of MetSyn compared with their white counterparts (adolescents relative risk 2.65 [95% confidence interval 1.29-5.4], adults relative risk 1.44 [95% confidence interval 1.21-2.6]). In contrast, there was no difference in risk of MetSyn between black and white adolescents and adult women in the NHANES dataset. After controlling for age and body mass index, black women with PCOS had a significantly increased prevalence of low high-density lipoprotein and high glucose. The general CVD risk was significantly increased in black adults with PCOS. This is the first study to comprehensively demonstrate increased risk of MetSyn in both black adolescents and adult women with PCOS compared with white subjects with PCOS. This racial disparity was not present in the NHANES controls. Longitudinal studies are needed to assess the independent impact of PCOS and race on CVD risk in women.

Black women with polycystic ovary syndrome (PCOS) have increased risk for metabolic syndrome (MET SYN) and cardiovascular disease (CVD) compared to white women with PCOS

Women with PCOS have an increased risk of Met Syn compared to controls. There is limited information on racial differences in cardiometabolic risk in PCOS. Our objective was to determine the prevalence of Met Syn and CVD risk in white and black women with PCOS and compare to controls. Retrospective chart review. Women with well-defined PCOS with information on race and cardiometabolic risk were included. Met Syn was defined as 3 of 5 criteria (Table). Controls were age matched from the NHANES population. Black women with PCOS have a significantly increased prevalence of Met Syn and general CVD risk score compared to white women with PCOS (RR for met syn=1.77 (95% CI 1.2-2.6).Tabled 1Cardiometabolic Risk in PCOSPCOS White (n=280)PCOS Black (n=80)Age±SE27.9±0.328.8±0.6Testosterone±SE ng/dL60.18 ±275.30 ±4.3#TG≥150 mg/dL23.5%10.8%**HDL≤50 mg/dL36.7%77.03%**BMI≥30 kg/m253.2%74.6%§BP≥130/85 mmHg33.5%46.8%Glucose≥100 mg/dL24.4%42.7%**Metabolic Syndrome(≥3 criteria)24.4%42.6%**Framingham 10-yr General CVD Risk 20081.42%2.23%## p<0.01, ** age/BMI adjusted p<0.01, § age adjusted p<0.05. Open table in a new tab # p<0.01, ** age/BMI adjusted p<0.01, § age adjusted p<0.05. There was no difference in risk of Met Syn between white and black women in the NHANES dataset. The RR for Met Syn in white women with PCOS compared to white women from NHANES was 1.52 (95% CI 1.03-2.23), while the same comparison for black women was 2.42 (95% CI 1.52-3.82). After controlling for age and BMI, black women with PCOS had an increased prevalence of low HDL and high glucose. This is the first study to comprehensively demonstrate increased risk of both Met Syn and general CVD in black women with PCOS compared to white women with PCOS. This racial disparity exists in the PCOS population compared to NHANES controls. Our findings highlight the importance of screening and need for longitudinal follow-up for cardiometabolic risk in young black women with PCOS.