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Parallelism among age-incidence curves of metabolic syndrome component disorders

Parallelism among age-incidence curves of metabolic syndrome component disorders. Chen Hsin-Jen. Metabolic syndrome (MS). Definition by Adult Treatment Panel III (USA) Abdominal obesity ( 中廣型肥胖 , AOB) ♂ : waist circumference ≧108cm ♀: waist circumference ≧88cm Hyperglycemia ( 高血糖 , HGlu)

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Parallelism among age-incidence curves of metabolic syndrome component disorders

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  1. Parallelism among age-incidence curves of metabolic syndrome component disorders Chen Hsin-Jen

  2. Metabolic syndrome (MS) • Definition by Adult Treatment Panel III (USA) • Abdominal obesity (中廣型肥胖, AOB) • ♂: waist circumference≧108cm • ♀: waist circumference≧88cm • Hyperglycemia (高血糖, HGlu) • Fasting glucose≧110mg/dL • High triglycerides (高三酸甘油脂, HTG) • Fasting triglycerides≧150mg/dL • Low HDL-C • ♂: <40mg/dL • ♀: <50mg/dL • High blood pressure (血壓偏高, HBP) • Systolic BP 130mm≧Hg or diastolic BP 85≧mmHg • “Component disorders”

  3. Modified definition onsome MS component disorders • Abdominal obesity (中廣型肥胖, AOB) • ♂: waist circumference≧90cm • ♀: waist circumference≧80cm • Low HDL-C • Total cholesterol/HDL-C ratio (THR)≧5 • Isolated systolic hypertension (ISH) • Systolic BP≧130 mmHg and diastolic BP<85 mmHg • Isolated diastolic hypertension (IDH) • Systolic BP<130 mmHg and diastolic BP≧85mmHg

  4. Aims • Explore the similarity among metabolic syndrome component disorders • In terms of incidence • Hypothesized underlying causes • Obesity • Insulin resistance • Compare the age-incidence curves of metabolic syndrome component disorders

  5. Data • A longitudinal follow-up study conducted in Chutung and Putzu • Cycle2: 1991~1993 (baseline examination) • Cycle3: 1993~1997 (follow-up examination) • Subjects • 18 years old + • Subjects who participated both Cycle 2 and Cycle 3

  6. Basic characteristics (adjusted to the level of 45 years old) ‡ p value on the null hypotheses that no difference between the follow-up and the lost of follow-up groups after age and area effects were adjusted * p<0.05 when compared with women in follow-up group, adjusting age and area effects ** p<0.01 when compared with women in lost of follow-up group , adjusting age and area effects

  7. Baseline prevalence (adjusted to the level of 45 years old) ‡ p value on the null hypotheses that no difference between the follow-up and the lost of follow-up groups after age and area effects were adjusted * p<0.05 when compared with women in follow-up group , adjusting age and area effects ** p<0.01 when compared with women in lost of follow-up group , adjusting age and area effects

  8. Discrepancy in Δx and Δ% between genders • Waist circumference (Δx) • ♂ vs. ♀: +7.06 cm • Abdominal obesity (Δ%) • ♂ vs. ♀: -8.23% • TC/HDL-C ratio (THR) (Δx) • ♂ vs. ♀: +0.37 • High THR (≧5) (Δ%) • ♂ vs. ♀: -8.05% (area and age effects adjusted)

  9. Incidence • Incidence: • New case number ÷ sum of follow-up years • Follow-up year • date (follow-up) - date (baseline) • Other metabolic syndrome related disorders • Overweight (BMI) • Insulin resistance (HOMA-IR)

  10. Incidence rates of component disorders *IR: insulin resistance (HOMA-IR) ≥5, the 90th percentile of the baseline population

  11. Incidence rates of component disorders

  12. Smoothing • Moving average of incidence • Sorting by age • Moving window: 150 subjects • Excluding 75 data from both sides of extreme age

  13. Smoothing • Smoothing the curve by generalized additive model • SAS GAM Procedure • Invoke spline model • Specify default degree of freedom, for optimal fitness and concision of the smoothed curves

  14. HTHR AOB HTG HOMA-IR OWT IDH

  15. ISH AOB HGlu HOMA-IR

  16. HTG OWT HGlu HOMA-IR

  17. AOB ISH TC/HDL HOMA-IR IDH

  18. Men Major peak at young ages HTG, OWT, IDH Minor peak at middle ages HGlu, (HOMA-IR) Ageing effects AOB, HTHR, ISH Women Minor peak at young ages HTG, HGlu, OWT Peak at middle ages HTHR, HOMA-IR, IDH Ageing effects ISH, AOB Summary

  19. Men Parallel with HOMA-IR HGlu Parallel with OWT HTG, IDH Parallel with AOB HTHR Women Parallel with HOMA-IR HTHR, IDH, (AOB) Similar to OWT HTG, GLU Summary

  20. Discussion • Categorization between men and women are different • Men: curves of many component disorders parallel with that of overweight • Women: some with overweight, some with insulin resistance • Incidence of ISH mainly affected by age • Analysis at population level • Unsuitable to infer the causal relations between component disorders

  21. Thanks for your attention

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