title: Metabolic syndrome as an underlying disease entity and its relationship to subclinical atherosclerosis in Andean Hispanics.
abstract: BACKGROUND
  The question of whether the metabolic syndrome truly reflects a single disease entity with a common underlying pathology remains unclear. In this study, we assess whether metabolic syndrome represents an underlying disease construct in a large population-based sample of Andean Hispanic adults and examine its relationship to subclinical atherosclerosis.
  
  
  METHODS
  The study sample was comprised of 2513 participants. Confirmatory factor analysis (CFA) was used to identify a metabolic syndrome latent factor using waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), and glucose levels as indicators. The relationship with subclinical atherosclerosis, measured by carotid intima media thickness (cIMT), was assessed using structural equation modeling.
  
  
  RESULTS
  Results supported the proposed structure of the metabolic syndrome latent factor evidenced by adequate fit indexes. HDL-C did not significantly load on the metabolic syndrome latent factor (standardized factor loading=0.01, P=0.88). The metabolic syndrome latent factor was significantly associated with cIMT in women (B=0.007, P<0.001) and men (B=0.008, P<0.001) after controlling for age, low-density lipoprotein cholesterol and smoking.
  
  
  CONCLUSIONS
  Our findings suggest that metabolic syndrome components, such as waist circumference, blood pressure, TGs, and glucose levels, but not HDL-C, share a common underlying pathophysiology that may contribute to the progression of atherosclerosis in Andean Hispanics. Its longitudinal association with cardiovascular disease should be the focus of future research.
authors.affiliation: 1 Behavioral Medicine Research Center, University of Miami , Coral Gables, Florida.
authors.forename: Diana A
authors.initials: DA
authors.lastname: Chirinos
authors.forename: Josefina
authors.initials: J
authors.lastname: Medina-Lezama
authors.forename: William
authors.initials: W
authors.lastname: Arguelles
authors.forename: Ronald
authors.initials: R
authors.lastname: Goldberg
authors.forename: Neil
authors.initials: N
authors.lastname: Schneiderman
authors.forename: Zubair
authors.initials: Z
authors.lastname: Khan
authors.forename: Oscar O
authors.initials: OO
authors.lastname: Morey
authors.forename: Muhammad Waheed
authors.initials: MW
authors.lastname: Raja
authors.forename: Roberto
authors.initials: R
authors.lastname: Paz
authors.forename: Julio A
authors.initials: JA
authors.lastname: Chirinos
authors.forename: Maria M
authors.initials: MM
authors.lastname: Llabre
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D059168:Carotid Intima-Media Thickness; D008076:Cholesterol, HDL / Q000378:metabolism; D003971:Diastole; D018450:Disease Progression; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D008875:Middle Aged; D010568:Peru / Q000208:ethnology; D012044:Regression Analysis; D013599:Systole; D014280:Triglycerides / Q000378:metabolism; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides