RESUMO
This study aimed to: (1) examine the relationship between depressive symptoms and subclinical atherosclerosis, measured by carotid intima-media thickness (IMT); and, (2) Determine the moderating effect of gender in this relationship among South American Hispanics. We studied 496 adults enrolled in the population-based PREVENCION study. Carotid IMT was measured with high-resolution ultrasonography. Depressive symptoms were assessed using the Hospital Anxiety and Depression Scale. Mean carotid IMT was 0.66 mm. (SD = 0.17) and mean depression score was 5.6 (SD = 3.5). Depressive symptoms were not associated with carotid IMT (ß = 0.04, p = 0.222) in multivariate analyses. A significant moderating effect of gender was found (ß for interaction = 0.10, p = 0.030), resulting from a significant association between depressive symptoms and carotid IMT in men but not women. Depressive symptoms were associated with subclinical atherosclerosis in South American Hispanic men but not women after controlling for demographic characteristics and traditional cardiovascular risk factors.
Assuntos
Espessura Intima-Media Carotídea , Depressão/fisiopatologia , Hispânico ou Latino/psicologia , Aterosclerose/sangue , Aterosclerose/diagnóstico , Aterosclerose/diagnóstico por imagem , Aterosclerose/prevenção & controle , Aterosclerose/psicologia , Glicemia , Pressão Sanguínea/fisiologia , Colesterol/sangue , Depressão/sangue , Depressão/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peru , Sintomas Prodrômicos , Caracteres Sexuais , Triglicerídeos/sangueRESUMO
BACKGROUND: The question of whether the metabolic syndrome truly reflects a single disease entity with a common underlying pathology remains unclear. In this study, we assess whether metabolic syndrome represents an underlying disease construct in a large population-based sample of Andean Hispanic adults and examine its relationship to subclinical atherosclerosis. METHODS: The study sample was comprised of 2513 participants. Confirmatory factor analysis (CFA) was used to identify a metabolic syndrome latent factor using waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), and glucose levels as indicators. The relationship with subclinical atherosclerosis, measured by carotid intima media thickness (cIMT), was assessed using structural equation modeling. RESULTS: Results supported the proposed structure of the metabolic syndrome latent factor evidenced by adequate fit indexes. HDL-C did not significantly load on the metabolic syndrome latent factor (standardized factor loading=0.01, P=0.88). The metabolic syndrome latent factor was significantly associated with cIMT in women (B=0.007, P<0.001) and men (B=0.008, P<0.001) after controlling for age, low-density lipoprotein cholesterol and smoking. CONCLUSIONS: Our findings suggest that metabolic syndrome components, such as waist circumference, blood pressure, TGs, and glucose levels, but not HDL-C, share a common underlying pathophysiology that may contribute to the progression of atherosclerosis in Andean Hispanics. Its longitudinal association with cardiovascular disease should be the focus of future research.
Assuntos
Aterosclerose/complicações , Síndrome Metabólica/complicações , Adulto , Aterosclerose/diagnóstico , Aterosclerose/etnologia , Glicemia/análise , Pressão Sanguínea , Espessura Intima-Media Carotídea , HDL-Colesterol/metabolismo , Diástole , Progressão da Doença , Análise Fatorial , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/etnologia , Pessoa de Meia-Idade , Peru/etnologia , Análise de Regressão , Sístole , Triglicerídeos/metabolismo , Circunferência da CinturaRESUMO
PURPOSE: The metabolic syndrome (MS) is conceived as a cluster of disorders that increase risk for coronary heart disease and type 2 diabetes. Studies examining its structure primarily have used an exploratory factor analytic technique, but yielded discrepant results. There also is a lack of research that investigates whether the clustering pattern is similar across sex and ethnic groups. This study uses confirmatory factor analysis to evaluate the factor structure of the MS and examines its similarity between men and women and across three ethnic groups (Caucasian, African, and Cuban Americans). METHOD: A hierarchical four-factor model with an overarching MS factor uniting insulin resistance, obesity, lipid, and blood pressure factors was tested with 517 individuals from the Miami Community Health Study. RESULTS: Findings show that the proposed structure was well supported (comparative fit index=0.97) and similar between men and women and across ethnic groups. The MS was represented strongly by insulin resistance, followed by obesity, lipid factors, and, to a lesser extent, a blood pressure factor. CONCLUSIONS: This study provides empirical support for identifying and diagnosing the MS by its component factors in a diverse population.