Background: With modernization, cardiometabolic disease risk has increased in low and middle-income countries. To better understand cardiometabolic disease etiology, we evaluated the patterning risk factors in a susceptible young adult population.
Methods and results: Participants included 1,621 individuals from the 2005 Cebu Longitudinal Health and Nutrition Survey. Using cluster analysis, we grouped individuals by the following biomarkers: triglycerides, HDL and LDL cholesterol, C-reactive protein, blood pressure, homeostasis model assessment of insulin resistance, and fasting glucose. Using multinomial logistic regression models we assessed how diet, adiposity, and environment predicted cardiometabolic clusters. We identified 5 distinct sexspecific clusters: 1) Healthy/High HDL cholesterol (with the addition of high LDL cholesterol in women); 2) Healthy/Low blood pressure; 3) High blood pressure; 4) Insulin resistant/High triglycerides; and 5) High Creactive protein. Low HDL cholesterol was the most prevalent risk factor (63%). In men and women, a higher intake of saturated fat increased the likelihood of being in the healthy clusters. In men, poorer environmental hygiene increased the likelihood of being in the High C-reactive protein cluster, compared to the healthy clusters (OR 0.74 [95% CI 0.60-0.90] and 0.83 [0.70-0.99]). Adiposity most strongly associated with membership to the Insulin resistant/high triglyceride cluster.
Conclusions: Despite the population's youth and leanness, cluster analysis found patterns of cardiometabolic risk. While adiposity measures predicted clustering, diet and environment also independently predicted clustering, emphasizing the importance of screening lean and overweight individuals for cardiometabolic risk. Finding predictors of risk in early adulthood could help inform prevention efforts for future disease.
背景：隨著現代化，在低及中收入國家的心血管代謝疾病風險已增加。為了探 究心血管代謝疾病的病原，評估在易感受性的年輕成人族群的危險因子模式。 方法及結果：納入1621 名來自2005 年宿霧長期健康與營養調查的參與者。使 用集群分析，以下列生化指標分組：三酸甘油酯、高密度脂蛋白及低密度脂蛋 白膽固醇、C 反應蛋白、血壓、恆定模式定量的胰島素阻抗及禁食血糖。使用 多項式邏輯斯回歸模式評估飲食、肥胖及環境如何預測心血管代謝集群。結果 區別出五種有性別差異的集群：1)健康/高HDL 膽固醇(女性並有高LDL 膽固 醇)；2)健康/低血壓；3)高血壓；4)胰島素阻抗/高三酸甘油酯；5)高C 反應蛋 白。低HDL 膽固醇是盛行率最高的危險因子(63%)。在男女性，較高的飽和脂 肪攝取卻提昇進入健康集群的可能性。在男性，比起健康集群，較差的環境衛 生增高成為高C 反應蛋白集群的可能性(OR=0.74 及0.83)。肥胖與胰島素阻抗/ 高三酸甘油酯集群有最強的相關性。結論：儘管這個族群是年輕且瘦的，集群 分析仍發現心血管代謝危險模式。儘管肥胖測量可預測集群，飲食及環境也是 獨立的集群預測因子，因此心血管代謝疾病風險的篩選不論在瘦或是體重過重 的人都很重要。發現年輕成人的預測因子可以協助未來疾病的預防。