The metabolic syndrome (MetS) is a cluster of cardiovascular indices that appear to be linked by poorly- understood insidious processes that increases risk for coronary heart disease (CHD), stroke, Type 2 diabetes (T2DM) and chronic kidney disease (CKD)-diseases that are highly prevalent among African Americans. The individual components of MetS include abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure (BP), and high fasting glucose. A classification of MetS in a given individual has traditionally been based on a combination of cut-off points for these different components. However, the use of cut-offs is liable to miss classifying individuals with moderate elevations that are just below the cut-off level. Additionally, MetS criteria have been shown to exhibit racial/ethnic differences in their association with disease. We have designed a sex- and race/ethnicity-specific continuous MetS severity score that takes into account how the individual components of MetS (elevated BP, low HDL, etc.) cluster and correlate differentially by sex and racial/ethnic group. Thus, based on these differences the score assigns different weights to each component by sex and race/ethnicity. A given individual's score can be calculated from standard clinical measures using an equation specific to his/her sex and racial/ethnic group. This novel score has excellent potential for clinical application for risk assessment. Not only is the score able to take into account unique features of MetS seen in African Americans but the score expresses MetS severity in a way that can be compared between individuals and followed over time within an individual. We propose to use this MetS severity score to evaluate participants in the Jackson Heart Study to gain information critical to using this tool in clinical application. Our plan is three-fold. 1) We will assess baseline and longitudinal epidemiologic and lifestyle factors that are likely to affect MetS severity;2) we wil assess baseline MetS severity between individuals who do and do not progress to develop CHD, stroke, T2DM and CKD;and 3) we will evaluate intra-individual changes in MetS severity leading up to diagnosis of the above CVD- associated diseases. We have gathered a team with multiple areas of expertise and will use our findings to provide guidance to clinicians regarding the use of MetS severity as an ominous indicator of future disease- with an ultimate goal of CVD prevention among African American patients.
Our diverse and multi-faceted research group proposes to evaluate risk related to the metabolic syndrome (MetS) among participants of the Jackson Heart Study by using a new tool designed specifically to assess severity of MetS among African Americans. We propose to use this tool to evaluate 1) how baseline MetS severity predicts subsequent CVD-related disease (coronary heart disease, stroke, diabetes, chronic kidney disease), 2) how MetS severity changes prior to disease diagnosis, and 3) the epidemiology of MetS severity. Our vision is that this tool will be able to be used clinically to identify individuls of highest risk for disease for more targeted follow-up or earlier intervention.
|Gurka, Matthew J; Filipp, Stephanie L; DeBoer, Mark D (2018) Geographical variation in the prevalence of obesity, metabolic syndrome, and diabetes among US adults. Nutr Diabetes 8:14|
|DeBoer, Mark D; Filipp, Stephanie L; Gurka, Matthew J (2018) Use of a Metabolic Syndrome Severity Z Score to Track Risk During Treatment of Prediabetes: An Analysis of the Diabetes Prevention Program. Diabetes Care 41:2421-2430|
|Cardel, Michelle I; Min, Yuan-I; Sims, Mario et al. (2018) Association of psychosocial stressors with metabolic syndrome severity among African Americans in the Jackson Heart Study. Psychoneuroendocrinology 90:141-147|
|DeBoer, Mark D; Filipp, Stephanie L; Musani, Solomon K et al. (2018) Metabolic Syndrome Severity and Risk of CKD and Worsened GFR: The Jackson Heart Study. Kidney Blood Press Res 43:555-567|
|Kapral, N; Miller, S E; Scharf, R J et al. (2018) Associations between birthweight and overweight and obesity in school-age children. Pediatr Obes 13:333-341|
|Gurka, Matthew J; Filipp, Stephanie L; Musani, Solomon K et al. (2018) Use of BMI as the marker of adiposity in a metabolic syndrome severity score: Derivation and validation in predicting long-term disease outcomes. Metabolism 83:68-74|
|Cardel, Michelle I; Tong, Suhong; Pavela, Greg et al. (2018) Youth Subjective Social Status (SSS) is Associated with Parent SSS, Income, and Food Insecurity but not Weight Loss Among Low-Income Hispanic Youth. Obesity (Silver Spring) 26:1923-1930|
|Gurka, Matthew J; Guo, Yi; Filipp, Stephanie L et al. (2018) Metabolic syndrome severity is significantly associated with future coronary heart disease in Type 2 diabetes. Cardiovasc Diabetol 17:17|
|DeBoer, Mark D; Gurka, Matthew J; Golden, Sherita Hill et al. (2017) Independent Associations Between Metabolic Syndrome Severity and Future Coronary Heart Disease by Sex and Race. J Am Coll Cardiol 69:1204-1205|
|Musani, Solomon K; Martin, Lisa J; Woo, Jessica G et al. (2017) Heritability of the Severity of the Metabolic Syndrome in Whites and Blacks in 3 Large Cohorts. Circ Cardiovasc Genet 10:|
Showing the most recent 10 out of 24 publications