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Clinical Studies and Practice

Inter-relationships between the severity of metabolic syndrome, insulin and adiponectin and their relationship to future type 2 diabetes and cardiovascular disease

International Journal of Obesity volume 40, pages 1353–1359 (2016)Cite this article

Subjects

Abstract

Background:

The severity of the metabolic syndrome (MetS) is related to future incidence of type 2 diabetes (T2DM) and cardiovascular disease (CVD). However, the relationship between MetS severity and levels of fasting insulin and adiponectin—markers of insulin resistance—is unclear.

Methods:

We used linear and logistic regression to analyze data from 711 participants of the Princeton Lipid Research Cohort with information regarding levels of insulin, adiponectin and MetS severity during 1998–2003 (mean age 39.5 years); 595 participants had MetS severity data from childhood (1973–1976, mean age 12.9 years) and 417 had updated disease status from 2010 to 2014 (mean age 50.9 years).

Results:

Childhood MetS Z-scores were positively associated with adult insulin levels (P<0.001) and negatively associated with adiponectin levels (P=0.01). In individual analyses, higher insulin levels and MetS Z-score as adults were related to higher odds of incident diabetes and CVD over the next 11.2 years (all P<0.001), whereas lower adiponectin levels were only related to odds of future T2DM (P<0.0001). In a model including insulin, adiponectin and MetS Z-score, adiponectin was not linked to future disease; both insulin (P=0.027) and MetS Z-score (P=0.002) were related to risk of future T2DM, while only MetS Z-score was related to future CVD (P<0.001).

Conclusions:

The severity of MetS exhibits long-term links to levels of insulin and adiponectin, suggesting potential genetic and environmental influences on insulin resistance over time. As a long-term predictor of T2DM and CVD, the severity of MetS exhibited consistent independent correlations. This supports clinical utility in evaluating MetS severity as a predictor of risk for future disease.

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Acknowledgements

This work was supported by NIH grants 1R21DK085363 (MJG and MDD), 1R01HL120960 (MJG and MDD), 5K08HD060739 (MDD) and NHLBI N01HV22914; a UVa Children’s Hospital Grant-in-Aid (MDD); a CCHMC Heart Institute Research Core grant; a Schmidlapp Women’s Scholar’s Award (JGW); and American Heart Association grant 9750129 (JAM).

Author contributions

MDD, MJG, JGW and JAM designed the study. JGW and JAM oversaw participant recruitment and data collection. MDD and MJG planned the analysis and wrote the manuscript. MJG performed the analysis. MDD is the guarantor of this work and had full access to the data in the study and takes final responsibility for the decision to submit for publication. All authors have read and given final approval of the manuscript.

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Author notes

  1. M D DeBoer and M J Gurka: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Pediatrics, University of Virginia, Charlottesville, VA, USA

    M D DeBoer

  2. Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, USA

    M J Gurka

  3. Division of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    J A Morrison

  4. Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA

    J A Morrison & J G Woo

  5. Division of Epidemiology and Biostatistics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    J G Woo

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  1. M D DeBoer
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Correspondence to M D DeBoer.

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DeBoer, M., Gurka, M., Morrison, J. et al. Inter-relationships between the severity of metabolic syndrome, insulin and adiponectin and their relationship to future type 2 diabetes and cardiovascular disease. Int J Obes 40, 1353–1359 (2016). https://doi.org/10.1038/ijo.2016.81

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