Nutrition/Obesity
Endogenous Biomarkers in Adolescent Metabolic Syndrome: A Longitudinal Study on Incidence and Persistence Pei-Tung Lin* Pei-Tung Lin Pei-Wen Wu Yu-Ting Chin Sharon Tsai Wei-Ting Lin Chien-Hung Lee
Background: Insulin resistance-related pathophysiological mechanisms drive the excessive accumulation of cardiometabolic risk factors that trigger metabolic syndrome (MetS). This process is associated with endogenous biomarkers reflecting inflammatory responses and metabolic disturbances that contribute to the development and progression of MetS. This study aimed to investigate the roles of various endogenous biomarkers in the incidence and transition of adolescent MetS over a 2.3-year longitudinal follow-up period.
Methods: Participants were drawn from a community-based, randomly selected cohort of 1,075 adolescents conducted in southern Taiwan. We used two series of case-cohort samples—one sub-cohort for the incidence of MetS (n=357) and another for its persistence (n=374)—to evaluate the effects of endogenous biomarkers on the development of adolescent MetS. The biomarkers measured included high-sensitivity C-reactive protein (hs-CRP), interleukins, chemokines, tumor necrosis factor, as well as glucose, lipid, liver, and renal endogenous markers. We applied the Cox proportional hazards model and inverse probability weighting to assess the effects, adjusting for covariates.
Results: Higher baseline uric acid (UA) levels were associated with an increased hazard risk (HR) of incident MetS (adjusted HR=1.50 per 1 mg/dL increase). Adolescents with elevated total cholesterol and homeostasis model assessment-insulin resistance (HOMA-IR) had a higher HR for persistent MetS after 2.3 years. Additionally, serum hs-CRP levels significantly predicted both incident and persistent MetS and modified the HRs for UA on incident MetS and HOMA-IR on persistent MetS (p for interaction: 0.028 and 0.001, respectively). No mediation effects among the studied biomarkers were observed.
Conclusion: This study highlights the significant roles of endogenous biomarkers, particularly uric acid and hs-CRP, in the incidence and persistence of MetS among adolescents.