FACTORS OF THE METABOLIC SYNDROME - BASE-LINE INTERRELATIONSHIPS IN THE FIRST FOLLOW-UP COHORT OF THE HDDRISC STUDY (HDDRISC-1)

Syndromes of risk factor disturbance may contribute to the development of coronary heart disease and non-insulin-dependent diabetes mellitus , but their definition and quantification remain problematic, Using fa ctor analysis, constellations of risk factor variables that could indi cate distinct syndromes of metabolic disturbance were explored in the baseline data of the first follow-up cohort of 742 men from the Heart Disease and Diabetes Risk Indicators in a Screened Cohort (HDDRISC) st udy. The primary analysis considered 16 intercorrelated variables meas ured in more than 90% of cohort participants. A missing-values estimat ion routine was used to ensure inclusion of all participants in the an alysis. Subanalyses were undertaken, including a repeat of the primary analysis on the 522 individuals who had received measurement of HDL c holesterol, an oblique rather than orthogonal factor rotation procedur e performed on primary and HDL subset analyses, a repeat of the two pr imary and HDL subset analyses using only those participants with compl ete measurements cs, and a repeat of these site analyses including onl y thr seven variables conventionally associated with the metabolic syn drome. The principal factor that emerged in all analyses undertaken co mprised oral glucose tolerance test insulin and glucose response, seru m uric acid, and body mass index. Fasting serum triglyceride concentra tion was included in this factor in 11 of the the 12 analyses undertak en, fasting plasma insulin in 8, fasting plasma glucose in 5, and mean arterial pressure in 3. HDL cholesterol factored in isolation 6 om in sulin in all analyses undertaken. These findings preside strong suppor t for a core metabolic cluster, which is unlikely to include blood pre ssure and does not include HDL. The factor scores relating to this clu ster will provide a means of assessing its quantitative importance in prospective analysis of the development of CHD and diabetes in this co hort.