title: Inter-relationships between the severity of metabolic syndrome, insulin and adiponectin and their relationship to future type 2 diabetes and cardiovascular disease.
abstract: 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.
  
  
  
  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).
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Department of Pediatrics, University of Virginia, Charlottesville, VA, USA.
authors.forename: M D
authors.initials: MD
authors.lastname: DeBoer
authors.affiliation: Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Gurka
authors.affiliation: Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.|Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Morrison
authors.affiliation: Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA.|Division of Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Woo
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D007328:Insulin; D008055:Lipids