Central obesity shown to precede other metabolic syndrome components
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Longitudinal surveys were conducted in Mauritius in 1987, 1992, and 1998, and in Australia in 2000 and 2005 (AusDiab program). Men and women aged ≥25 years were classified in three cohorts: AusDiab 2000-2005 (n=5039), Mauritius 1987-1992 (n=2849), and Mauritius 1987-1998 (n=1999). Metabolic syndrome components included into the model were waist circumference, systolic blood pressure, fasting and 2-h postload plasma glucose, HDL cholesterol, triglycerides, and HOMA-S (insulin sensitivity). Linear regression analysis was used to determine which baseline component predicted deterioration in the other metabolic syndrome components over 5 years in AusDiab and 5 and 11 years in the Mauritius registers, after adjusting for age, gender, and ethnicity. This analysis revealed that baseline waist circumference significantly predicted deterioration in four of the other six metabolic syndrome variables tested in AusDiab, five of six in Mauritius 1987-1992, and four of six in Mauritius 1987-1998. However, an increase in waist circumference between baseline and follow-up was only predicted by HOMA-S, and only in one of the three cohorts. Central obesity appears to play a central role in the natural history of metabolic syndrome, preceding the appearance of other metabolic syndrome phenotypic components.
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