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Critical assessment of the metabolic syndrome definitions in the adult general population of the United States - the Multi-Ethnic Study of Atherosclerosis (MESA)

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Abstract

Background

Metabolic syndrome (MetS) consists of a cluster of cardiometabolic risk factors and is an important determining factor for cardiovascular diseases (CVDs). We intended to use latent class analysis to classify the study population into several clusters.

Methods

The baseline information of 6,814 participants of the Multi-Ethnic Study of Atherosclerosis (MESA) aged 45–84 years in 2000–2002 was used. The latent class analysis was conducted to extract different patterns of components. SAS 9.2 and Stata 12 software were used for analysis.

Results

The components of MetS tend to accumulate, hence it would be feasible to categorize the population into three classes: [1] Non-Metabolic Syndrome Latent Class (NonMetS-LC), [2] Low Risk Latent Class (LowR-LC), and [3] Metabolic Syndrome Latent Class (MetS-LC). In women, adding high-density lipoprotein (HDL) component to the two-component combinations of NonMetS-LC will transfer the individual to MetS-LC, and it was found in 100% of combinations of MetS-LC. However, in men, blood pressure (BP) played such a similar role, which was found in 97.36% of combinations of MetS-LC.

Conclusion

Results showed that clinical value of each MetS component is different by gender. The main component in men was elevated BP; while low HDL and elevated fasting blood sugar (FBS) were in next ranks. However, the main component in women was low HDL; while elevated BP and FBS were in next ranks. Special attention should be paid to BP and HDL components, because these can be useful for clinicians and health policy-makers in diagnosis and screening. In conclusion, this study showed that revisions might be needed for the MetS definitions.

Graphical abstract

Highlights

  • We used latent class analysis to classify the study population to several clusters.

  • The main component for identifying metabolic syndrome in men was elevated BP.

  • In men, low HDL and elevated fasting blood sugar (FBS) were in next ranks.

  • The main component in women was low HDL; elevated BP and FBS were in next ranks.

  • This study showed a revision for metabolic syndrome definitions might be needed.

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Abbreviations

CVDs:

Cardiovascular Diseases

MetS:

Metabolic Syndrome

BP:

Blood Pressure

FBS:

Fasting Blood Sugar

HDL:

High-density Lipoprotein

TG:

Triglycerides

WC:

Waist Circumference

NonMetS-LC:

Non-Metabolic Syndrome Latent Class

LowR-LC:

Low Risk Latent Class

MetS-LC:

Metabolic Syndrome Latent Class

IDF:

International Diabetes Federation

NCEP-ATPIII:

National Cholesterol Education Program – Adult Treatment Panel III

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Acknowledgements

Dr. SS. Hashemi-Nazari and Dr. SM. Riahi had full access to all data and take responsibility for the integrity and accuracy of the data and analyses. We thank researchers, staff, and participants of MESA study for their valuable contributions. A full list of participating MESA investigators and institutions is at http://www.mesa-nhlbi.org.

Author information

Authors and Affiliations

  1. Department of Community Medicine, School of Medicine, Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran

    Seyed Mohammad Riahi

  2. Student Research Committee, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran

    Ali Fanoodi

  3. Department Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore, A Constituent Unit of MAHE, Manipal, India

    Sameep Shetty

  4. Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Seyed Saeed Hashemi-Nazari

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Contributions

Conception and design: Seyed Mohammad Riahi, Seyed Saeed Hashemi-Nazari.

Cleaning of data: Seyed Mohammad Riahi.

Data analysis and interpretation: Seyed Mohammad Riahi, Seyed Saeed Hashemi-Nazari.

Manuscript writing: Seyed Mohammad Riahi, Ali Fanoodi, Sameep Shetty.

Final approval of manuscript: All authors.

Corresponding authors

Correspondence to Seyed Mohammad Riahi or Seyed Saeed Hashemi-Nazari.

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Ethics approval

For this study, ethical approval was not needed because the data were acquired under the National Heart, Lung, and Blood Institute (NHLBI)—Research Materials Distribution Agreement (RMDA) V021d20120806.

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Conflicts of interest/Competing interests

The authors declare no conflicts of interest and are responsible for the content and writing of the paper. The authors did not have any relationship with industry.

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Riahi, S.M., Fanoodi, A., Shetty, S. et al. Critical assessment of the metabolic syndrome definitions in the adult general population of the United States - the Multi-Ethnic Study of Atherosclerosis (MESA). J Diabetes Metab Disord 22, 851–859 (2023). https://doi.org/10.1007/s40200-023-01213-5

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  • DOI: https://doi.org/10.1007/s40200-023-01213-5

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