High blood sugar, obesity, and increasing body mass index over time contributed to the likelihood that women would be at risk for metabolic syndrome, but physical activity reduced that risk, according to a recent study. Neither smoking nor alcohol consumption contributed to becoming at-risk for metabolic syndrome.
"Women who remained metabolically benign were more physically active than their peers, and the protective effect of physical activity ... persisted, even after adjusting for known cardiometabolic risk factors," reported Unab I. Khan of Albert Einstein College of Medicine, New York (J. Clin. Endocrinol. Metab. 2014 May 20 [doi:10.1210/jc.2013-3259]).
Dr. Khan and his associates tracked 482 overweight (BMI 25-29.9) and 384 obese (BMI higher than 30) women regarded as metabolically benign overweight/obese because they had fewer than two of the following metabolic syndrome abnormalities:
• Systolic/diastolic blood pressure of 130/85 mm Hg or greater, or antihypertensive medication use.
• Fasting triglycerides of 150 mg/dL or greater.
• Fasting HDL cholesterol levels of 50 mg/dL or less, or lipid-lowering medication use.
• Fasting glucose of 100 mg/dL or greater, or self-reported use of antidiabetic medications.
"At risk" was defined as having two or more metabolic syndrome abnormalities.
During the 7-year follow-up, 43% of the women progressed from metabolically benign to being at risk. These women had a higher baseline BMI and greater abnormalities in blood glucose, triglycerides, blood pressure and low HDL cholesterol measurements.
After the researchers accounted for age, race/ethnicity, education status, menopausal status, geographical site, smoking, alcohol use, and a family history of cardiovascular disease, the strongest contributor to progression to being at risk was abnormal fasting glucose (hazard ratio, 3.24, P less than .001), followed by high blood pressure (HR 3.00), triglycerides (HR 2.91) and HDL (HR 2.85). Baseline physical activity significantly reduced that risk (HR 0.86). All differences were statistically significant.
"Controlling these [cardiometabolic] factors could potentially allay the elevated risk of cardiovascular morbidity and mortality unanimously associated with the at-risk phenotype," the authors wrote.
The study was supported by the National Institutes of Health, the National Institute on Aging, the National Institute of Nursing Research, and the Office of Research on Women’s Health. The authors reported no disclosures.