Trajectories of Metabolic Syndrome Development in Young Adults

Background: Metabolic syndrome (MetS) is a constellation of metabolic aberrations that collectively increase the risk for cardiovascular disease and type 2 diabetes. Greater understanding of MetS developments may provide insight into targeted prevention strategies for individuals at greatest risk. The purpose of this study was to i) identify distinct patterns of longitudinal MetS development and; ii) develop a character profile that differentiates groups by level of MetS risk. Methods and Results: Data from the Coronary Artery Risk Development in Young Adults (CARDIA) study (n = 3 804; 18-30 y) was obtained by limited access application from the National Heart, Lung, and Blood Institute and used for this analysis. MetS, as defined by the Harmonized criteria, was assessed over a 20 year follow-up period. Group-level trajectory analysis identified 4 distinct groups with varying rates of component development [No (23.8% of sample); Low (33.5%); Moderate (35.3%); and High MetS (7.4%)]. After adjusting for covariates, individuals in the At-Risk groups (Low, Moderate and High MetS) were more likely to be of black ethnicity (1.37, 1.14-1.66), have a family history of cardiovascular disease (1.61, 1.31-1.97) and history of dieting (1.69, 1.20-2.39) when compared to the No Risk trajectory group (No MetS). Conversely, increasing baseline education (0.76, 0.65-0.89) and aerobic fitness (0.55, 0.47-0.64) was inversely associated with At-Risk group membership. Conclusions: Results suggest distinct profiles of MetS development that can be identified by baseline risk factors. Further research is necessary to understand the clinical implication of intermediate MetS development groups with respect to overall cardiometabolic risk.