Melka Melkaye G, Abrahamowicz Michal, Leonard Gabriel T, Perron Michel, Richer Louis, Veillette Suzanne, Gaudet Daniel, Paus Tomáš, Pausova Zdenka
The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
PLoS One. 2013 Dec 20;8(12):e82368. doi: 10.1371/journal.pone.0082368. eCollection 2013.
Visceral fat (VF) promotes the development of metabolic syndrome (MetS), which emerges as early as in adolescence. The clustering of MetS components suggests shared etiologies, but these are largely unknown and may vary between males and females. Here, we investigated the latent structure of pre-clinical MetS in a community-based sample of 286 male and 312 female adolescents, assessing their abdominal adiposity (VF) directly with magnetic resonance imaging. Principal component analysis of the five MetS-defining variables (VF, blood pressure [BP], fasting serum triglycerides, HDL-cholesterol and glucose) identified two independent components in both males and females. The first component was sex-similar; it explained >30% of variance and was loaded by all but BP variables. The second component explained >20% of variance; it was loaded by BP similarly in both sexes but additional loading by metabolic variables was sex-specific. This sex-specificity was not detected in analyses that used waist circumference instead of VF. In adolescence, MetS-defining variables cluster into at least two sub-syndromes: (1) sex-similar metabolic abnormalities of obesity-induced insulin resistance and (2) sex-specific metabolic abnormalities associated with BP elevation. These results suggest that the etiology of MetS may involve more than one pathway and that some of the pathways may differ between males and females. Further, the sex-specific metabolic abnormalities associated with BP elevation suggest the need for sex-specific prevention and treatment strategies of MetS.
内脏脂肪（VF）会促进代谢综合征（MetS）的发展，这种综合征在青春期就已出现。代谢综合征各组成部分的聚集表明存在共同病因，但这些病因大多不明，且可能因性别而异。在此，我们在一个包含286名男性和312名女性青少年的社区样本中，研究了临床前期代谢综合征的潜在结构，并通过磁共振成像直接评估他们的腹部肥胖情况（VF）。对五个定义代谢综合征的变量（VF、血压[BP]、空腹血清甘油三酯、高密度脂蛋白胆固醇和血糖）进行主成分分析，结果显示男性和女性均存在两个独立成分。第一个成分在性别上相似；它解释了超过30%的方差，除血压变量外的所有变量均对其有负荷。第二个成分解释了超过20%的方差；两性的血压均对其有负荷，但代谢变量的额外负荷具有性别特异性。在使用腰围而非VF的分析中未检测到这种性别特异性。在青春期，定义代谢综合征的变量至少聚集成两种亚综合征：（1）由肥胖诱导的胰岛素抵抗引起的性别相似的代谢异常，以及（2）与血压升高相关的性别特异性代谢异常。这些结果表明，代谢综合征的病因可能涉及不止一条途径，且其中一些途径可能因性别而异。此外，与血压升高相关的性别特异性代谢异常表明需要针对代谢综合征采取性别特异性的预防和治疗策略。
