Multimarker approach to evaluate the incidence of the metabolic syndrome and longitudinal changes in metabolic risk factors: the Framingham Offspring Study.

Description

The relative contributions of circulating biomarkers of inflammation, hemostasis, neurohormonal activity, and endothelial dysfunction to metabolic syndrome incidence and longitudinal changes in its constituent risk factors were examined in 2,292 participants of the Framingham Offspring Study. Over the 2.9 year follow-up, 19.1% developed the metabolic syndrome according to modified NCEP-ATP III clinical criteria published in 2005. After adjusting for confounding variables, the cluster of biomarkers was associated with incident metabolic syndrome (p=0.008). Additional analyses revealed that plasminogen activator inhibitor-1 (hemostasis) and aldosterone (neurohormonal activity) were also tied to incident metabolic syndrome. Moreover, in multivariate analyses of longitudinal changes in components of the metabolic syndrome, plasminogen activator inhibitor-1 was linked to changes in fasting glucose, systolic blood pressure, and triglyceride concentrations, while aldosterone was linked to changes in systolic blood pressure and HDL cholesterol. These results suggest that these biomarkers may enhance prediction of the metabolic syndrome and help identify new biological mechanisms involved in the metabolic syndrome. However, the clinical utility of these markers has yet to be established.