Positive Additive and Multiplicative Interactions among Clustered Components of Metabolic Syndrome with Type 2 Diabetes Mellitus among Brazilian Adolescent Students

• Published in: Nutrients Vol. 14; no. 21; p. 4640
• Main Authors: Deusdará, Rodolfo, de Moura Souza, Amanda, Szklo, Moyses
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.11.2022; MDPI
• Subjects: Adolescent; Adolescents; Analysis; Behavior; biomarkers; Blood Glucose; Blood pressure; Brazil - epidemiology; Cardiovascular diseases; Cholesterol; Complications and side effects; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - epidemiology; Glucose; Health aspects; Health risks; High density; High density lipoprotein; Humans; Hypertension; Insulin; Lipoproteins, HDL; Medical research; Medicine, Experimental; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - epidemiology; Metabolic syndrome X; Obesity; Pediatric research; Prevalence; Public health; Risk analysis; Risk Factors; Sedentary behavior; Socioeconomics; Students; Surveys; synergism; Teenagers; Triglycerides; Type 2 diabetes; Waist Circumference; Youth; Brazil; Colombia; United States > US; metabolic syndrome; synergism; adolescent; diabetes mellitus; biomarkers
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14214640

Background: It is still controversial whether the joint effect of Metabolic syndrome (MetS) components is greater than that expected based on their independent effects, regarding type 2 diabetes mellitus in adolescents. We evaluated additive and multiplicative interactions between pair-wise combinations of metabolic syndrome components regarding type 2 diabetes mellitus. Methods: We studied 37,815 Brazilian adolescents from a national school-based survey, The Study of Cardiovascular Risk Factors in Adolescents (Portuguese acronym, ERICA). A Poisson regression model was used to calculate sex-, age-, obesity-, smoking status-, sedentary behavior-, physical inactivity-, alcoholic consumption- and socioeconomic status-adjusted prevalence ratios to evaluate both additive and multiplicative interactions. Results: In the comparison of observed and expected joint effects, relative excess risk due to additive interaction (RERI) for high triglycerides and low high-density lipoprotein-cholesterol, high triglycerides and elevated waist circumference, elevated waist circumference and low high-density lipoprotein-cholesterol and elevated waist circumference and high blood pressure were 2.53 (−0.41, 5.46), 2.86 (−2.89, 8.61), 1.71 (−1.05, 4.46) and 0.97 (0.15, 1.79), respectively, thus suggesting additive interactions. Multiplicative interactions for those pairs of components were also observed, as expressed by interaction ratios > 1.0. Conclusions: The joint presence of some of the components of MetS showed a greater association with the prevalence of type 2 diabetes mellitus in adolescents than expected from the sum of their isolated effects. From a public health perspective, preventing one of the components of the pairs that interact may result in a greater reduction in the prevalence of T2DM than focusing on an individual component that does not interact with another component.