title: Sex-Specific Predictors of Metabolic Syndrome Independent of Its Components.
abstract: To what extent is the metabolic syndrome (MetS) determined beyond its recognized components? In 1702, middle-aged men and women without MetS at baseline, MetS development was identified in 546 participants at a mean of 10.1-year follow-up. Participants subsequently developing MetS had, beyond higher values of MetS traits, significantly higher total and low-density lipoprotein cholesterol, apolipoprotein B, C-reactive protein (CRP), γ-glutamyl transferase (GGT), and lower high-density lipoprotein cholesterol. Females were significantly more frequent never smokers and males had lower values of total testosterone. In logistic regression analyses, adjusted for sex, age, and smoking status, MetS was predicted disparately in the sexes, whereas males exhibited, beyond abdominal obesity, CRP, GGT, and sex hormone-binding globulin (SHBG) as independent predictors, abdominal obesity was not an independent predictor in females in whom other than age, CRP conferred MetS risk, whereas SHBG was and current smoking tended to be protective. A surrogate of hepatic steatosis proved a major mediator of abdominal obesity in determining incident MetS (relative risk, 5.6 [95% confidence interval, 3.4-9.3]) in each sex. We confirm that GGT and SHBG are novel independent MetS determinants. Hepatic steatosis is the major predictor of MetS mediating adiposity in each sex. Abdominal obesity is not an independent determinant in Turkish women in whom autoimmune activation seems to prevail before MetS development.
authors.affiliation: From the Departments of *Cardiology and †Public Health, Cerrahpaşa Medical Faculty Istanbul University, Istanbul; ‡Department of Medicine, Darıca Training and Research Hospital, Kocaeli; §Department of Cardiology, Balıklıgöl State Hospital; ∥Department of Internal Medicine, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa; ¶Siyami Ersek Center for Cardiovascular Surgery, Cardiovascular Division; and #Biochemistry Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Altan
authors.initials: A
authors.lastname: Onat
authors.forename: Günay
authors.initials: G
authors.lastname: Can
authors.forename: Hakan
authors.initials: H
authors.lastname: Çakr
authors.forename: Fatma
authors.initials: F
authors.lastname: Özpamuk-Karadeniz
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Karadeniz
authors.forename: Hüsniye
authors.initials: H
authors.lastname: Yüksel
authors.forename: Barş
authors.initials: B
authors.lastname: Şimşek
authors.forename: Evin
authors.initials: E
authors.lastname: Ademoğlu
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D005234:Fatty Liver / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000150:complications / Q000473:pathology; D019746:Intramolecular Oxidoreductases / Q000378:metabolism; D016015:Logistic Models; D008263:Macrophage Migration-Inhibitory Factors / Q000378:metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications / Q000473:pathology; D012307:Risk Factors; D012727:Sex Characteristics; D012907:Smoking / Q000009:adverse effects
chemical_list: D008263:Macrophage Migration-Inhibitory Factors; D002097:C-Reactive Protein; D002784:Cholesterol; D019746:Intramolecular Oxidoreductases; C515598:MIF protein, human