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Pathophysiology

Intra-Abdominal Fat Is a Major Determinant of the National Cholesterol Education Program Adult Treatment Panel III Criteria for the Metabolic Syndrome

  1. Darcy B. Carr1,
  2. Kristina M. Utzschneider2,
  3. Rebecca L. Hull2,
  4. Keiichi Kodama2,
  5. Barbara M. Retzlaff2,
  6. John D. Brunzell2,
  7. Jane B. Shofer3,
  8. Brian E. Fish2,
  9. Robert H. Knopp2 and
  10. Steven E. Kahn2
  1. 1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington
  2. 2Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, Veterans Affairs Puget Sound Health Care System and Harborview Medical Center, University of Washington, Seattle, Washington
  3. 3Department of Rehabilitation Research and Development, University of Washington, Seattle, Washington
  1. Address correspondence and reprint requests to Darcy B. Carr, MD, Assistant Professor, Box 356460, Dept. OB/GYN, University of Washington, Seattle, WA 98195-6460. E-mail: darcarr{at}u.washington.edu
Diabetes 2004 Aug; 53(8): 2087-2094. https://doi.org/10.2337/diabetes.53.8.2087
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    FIG. 1.

    The frequency of the number of NCEP ATP III metabolic syndrome criteria in the whole study population (n = 218; □), the male subjects (n = 89; □), and the female subjects (n = 129; ▪)

  • FIG. 2.
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    FIG. 2.

    Frequency of the individual NCEP ATP III criteria in the whole study population (n = 218; □), the male subjects (n = 89; □), and the female subjects (n = 129; ▪)

  • FIG. 3.
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    FIG. 3.

    Si and IAF and SCF areas (mean ± SE) versus the number of NCEP ATP III criteria

Tables

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  • TABLE 1

    Characteristics of the study population

    TotalMaleFemale
    n21889129
    Age (years)52.5 ± 0.752.8 ± 1.152.4 ± 0.9
    BMI (kg/m2)26.2 ± 0.326.7 ± 0.425.9 ± 0.4
    Systolic BP (mmHg)117.4 ± 0.9119.5 ± 1.2116.0 ± 1.2
    Diastolic BP (mmHg)72.3 ± 0.674.2 ± 0.871.0 ± 0.*
    Waist circumference (cm)87.1 ± 1.094.7 ± 1.281.9 ± 1.1†
    HDL (mmol/l)1.34 ± 0.031.13 ± 0.031.48 ± 0.03†
    TG (mmol/l)1.38 ± 0.061.47 ± 0.111.32 ± 0.07
    FPG (mmol/l)5.4 ± 0.035.6 ± 0.055.3 ± 0.04†
    • Data are means ± SE.

    • *

      * P < 0.01 and

    • †

      † P < 0.001 for male vs. female subjects, determined by independent samples t or Wilcoxon’s rank-sum test.

  • TABLE 2

    Simple linear regression analyses of the association of Si, IAF area, or SCF area and the individual NCEP ATP III criteria as continuous dependent variables

    Systolic BP (mmHg)
    Diastolic BP (mmHg)
    Waist circumference (cm)
    HDL (mmol/l)
    log(TG [mmol/l])
    FPG (mmol/l)
    SlopePSlopePSlopePSlopePSlopePSlopeP
    Si [×10−5 min−1/(pmol/l)]−1.0 ± 0.2<0.001−0.55 ± 0.13<0.001−1.6 ± 0.18<0.0010.028 ± 0.006<0.001−0.022 ± 0.004<0.001−0.04 ± 0.007<0.001
    IAF (cm2)0.08 ± 0.01<0.0010.045 ± 0.007<0.0010.15 ± 0.008<0.001−0.086 ± 0.013<0.0010.0014 ± 0.0002<0.0010.039 ± 0.008<0.001
    SCF (cm2)0.025 ± 0.0070.0010.018 ± 0.004<0.0010.064 ± 0.006<0.001−0.019 ± 0.0080.010.0006 ± 0.0001<0.0010.015 ± 0.0040.001
    • Data are means ± SE, unless otherwise noted.

  • TABLE 3

    Multiple linear regression analyses of the association of Si, IAF and SCF areas and the individual NCEP ATP III criteria as continuous dependent variables

    Systolic BP (mmHg)
    Diastolic BP (mmHg)
    Waist circumference (cm)
    HDL (mmol/l)
    log(TG [mmol/l])
    FPG (mmol/l)
    SlopePSlopePSlopePSlopePSlopePSlopeP
    Si[×10−5 min−1(pmol/l)]−0.39 ± 0.230.1−0.15 ± 0.150.3−0.06 ± 0.150.70.54 ± 0.260.04−0.011 ± 0.0040.02−0.47 ± 0.150.002
    IAF (cm2)0.06 ± 0.01<0.0010.03 ± 0.009<0.0010.122 ± 0.009<0.001−0.07 ± 0.02<0.0010.0009 ± 0.00030.0010.021 ± 0.0090.02
    SCF (cm2)0.002 ± 0.0080.80.007 ± 0.0050.20.032 ± 0.005<0.0010.009 ± 0.0080.30.0003 ± 0.00010.070.002 ± 0.0050.7
    • Data are means ± SE, unless otherwise noted.

  • TABLE 4

    Multivariate logistic regression determining the independent predictors of the metabolic syndrome

    Independent variablesOR (95% CI)P
    Model 1
        Si [×10−5 min−1/(pmol/l)]0.30 (0.09–0.96)0.04
        IAF (cm2)2.40 (1.41–4.10)0.001
        SCF (cm2)2.12 (1.30–3.46)0.003
    Model 2
        Si [×10−5 min−1/(pmol/l)]0.30 (0.09–0.96)0.04
        IAF (cm2)2.43 (1.33–4.47)0.004
        SCF (cm2)2.09 (1.18–3.70)0.012
        Age (years)1.008 (0.96–1.06)0.7
        Sex1.13 (0.34–3.69)0.8
    • All ORs are presented as the odds of the metabolic syndrome for a 1 SD increase in the independent variable.

  • TABLE 5

    Multiple regression models including all of the NCEP ATP III criteria as independent continuous variables to assess their association to Si and IAF and SCF areas as dependent variables

    log{Si[min−1/(pmol/l)]}
    sqrt(IAF [cm2])
    sqrt(SCF [cm2])
    Independent variablesSlopePSlopePSlopeP
    Systolic BP (mmHg)−0.003 ± 0.0010.020.035 ± 0.0140.02−0.026 ± 0.0240.3
    Diastolic BP (mmHg)−0.001 ± 0.0020.6−0.024 ± 0.0230.30.014 ± 0.0390.7
    Waist circumference (cm)−0.009 ± 0.001<0.0010.179 ± 0.014<0.0010.215 ± 0.023<0.001
    HDL (mmol/l)0.001 ± 0.0010.30.005 ± 0.0110.60.063 ± 0.0190.001
    TG (mmol/l)−0.0007 ± 0.0002<0.0010.007 ± 0.002<0.0010.009 ± 0.0030.003
    FPG (mmol/l)−0.006 ± 0.0020.0040.002 ± 0.0180.9−0.017 ± 0.030.6
    • Data are means ± SE.

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Intra-Abdominal Fat Is a Major Determinant of the National Cholesterol Education Program Adult Treatment Panel III Criteria for the Metabolic Syndrome
Darcy B. Carr, Kristina M. Utzschneider, Rebecca L. Hull, Keiichi Kodama, Barbara M. Retzlaff, John D. Brunzell, Jane B. Shofer, Brian E. Fish, Robert H. Knopp, Steven E. Kahn
Diabetes Aug 2004, 53 (8) 2087-2094; DOI: 10.2337/diabetes.53.8.2087

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Intra-Abdominal Fat Is a Major Determinant of the National Cholesterol Education Program Adult Treatment Panel III Criteria for the Metabolic Syndrome
Darcy B. Carr, Kristina M. Utzschneider, Rebecca L. Hull, Keiichi Kodama, Barbara M. Retzlaff, John D. Brunzell, Jane B. Shofer, Brian E. Fish, Robert H. Knopp, Steven E. Kahn
Diabetes Aug 2004, 53 (8) 2087-2094; DOI: 10.2337/diabetes.53.8.2087
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