Cardiovascular
Sex differences in the multifactorial structural relationship between sugar-sweetened beverage intake and metabolic syndrome during adolescence WU, PEI-WEN* PEI WEN WU Yu-Ting Chin Sharon Tsai Wei-Ting Lin Chien-Hung Lee
Sugar-sweetened beverages (SSBs) are the primary source of dietary fructose intake. The metabolism of fructose involves an increase in uric acid (UA) and insulin resistance (IR), both of which are endogenous factors associated with metabolic disorders. Studies indicated that sex may modify the effect of endogenous factors on the aggregation of cardiometabolic abnormalities during adolescence. This study examined sex heterogeneity in the structural associations between SSB intake, UA, IR, and adolescent metabolic syndrome (MetS). A community-based cohort of 703 boys and 751 girls underwent assessments for dietary intake, physical activity, and clinical cardiometabolic outcomes. We applied structural equation modeling to evaluate sex differences in the multifactorial structural relationship across SSB intake, UA, homeostatic model assessment-based insulin resistance (HOMA-IR), and confirmatory factor analysis-derived MetS score (cMSs). The factor loadings for waist circumference and log-transformed triglyceride on the MetS construct were higher in boys (11.67 cm and 0.21 mg/dL) compared to girls (7.55 cm and 0.12 mg/dL). Adjusted for covariates, SSB intake had UA- and HOMA-IR-mediated effects on cMSs in both sexes. In boys, the two endogenous markers showed significant mediated effects on the association between consuming >500 mL/day of fructose-rich tea drinks (FTD) and cMSs. However, in girls, the indirect effect was only observed on the path of >500 mL/day FTD->HOMA-IR->cMSs. Our study helps to elucidate the effects of sex and endogenous markers on the structural relationship between SSB intake and the clustering of metabolic dysfunctions during adolescence.