Abstract 13535: Investigating Subtypes of the Metabolic Syndrome among US Hispanics/Latinos in Relation to Coronary Heart Disease Prevalence: Preliminary Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Abstract

The validity and clinical utility of metabolic syndrome (MetS) diagnosis has been debated. MetS component cut-off scores may be viewed as arbitrary, and whether meaningful subtypes of MetS exist remains unclear. Data on Hispanics/Latinos (H/Ls) are particularly lacking. In 10970 US H/L participants from HCHS/SOL, latent class analysis was used to investigate 1) whether distinct subtypes of MetS could be identified, 2) how identified subtypes related to demographic characteristics and prevalent CHD, and 3) how MetS component levels differed among identified subtypes. Incorporating continuous measures of MetS components (waist circumference, systolic and diastolic blood pressure, HDL cholesterol, triglycerides, and glucose) and medication use data (antihypertensive, lipid- and glucose-lowering) into analyses, two latent clusters were identified among the entire sample, as well as among men (n = 4429) and women (n = 6541) separately. One cluster was characterized by individuals exhibiting relatively healthy mean levels across most MetS components (Non-MetS cluster, 73.9% of entire sample), while the other cluster was characterized by individuals exhibiting clinically elevated mean levels across most MetS components (MetS cluster, 26.1% of entire sample). The presence of additional, meaningful subtypes of MetS was not confirmed. Individuals who were older and had a positive family history of CHD exhibited greater odds of being classified into the MetS cluster (OR = 1.13 and 1.5, respectively; p’s < .001), and those classified into the MetS cluster demonstrated greater odds of having prevalent CHD (OR = 1.12, p < .001). Results also suggest that 1) compared to other components, HDL cholesterol may poorly differentiate between US H/Ls with and without MetS (mean = 47.6 and 48.6 mg/dL for the MetS and Non-MetS clusters, respectively) and 2) the NCEP-ATP III waist circumference cutoff of 88 cm for US females might not be optimal for diagnosing MetS among US H/L women (mean waist circumference among women classified into the MetS cluster = 102.6 cm). Conducting comparable comparative analyses in non-H/L samples may help clarify racial/ethnic differences in MetS presentation and inform current diagnostic criteria.