Risk indicators of metabolic syndrome in young
adults: A preliminary investigation on the
influence of tobacco smoke exposure and
gender
Elizabeth J. Corwin, PhD, RN,
a
Colleen S. McCoy, MS,
b
Courtney A. Whetzel, MS,
c
Rachel M. Ceballos, PhD,
c
and Laura Cousino Klein, PhD
c
BACKGROUND: Metabolic syndrome is characterized by hypertension, dyslipidemia, insulin resis-
tance, and obesity. Limited investigations have studied early indicators of metabolic syndrome in healthy
young adults before diagnosis of disease.
PURPOSE: The purpose of this investigation is to identify shifts in cardiovascular (CV), metabolic, and
immune variables consistent with metabolic syndrome but occurring before development of the disor-
der, and to determine whether these variables are influenced by gender or cigarette smoking.
METHODS: A pilot study of 41 subjects ages 18 to 39 years, with 20 smokers and 21 nonsmokers, was
undertaken. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured to evaluate
CV status; cholesterol, body mass index, leptin, percent glycated albumin, and homocysteine were
measured to evaluate metabolic status; C-reactive protein, interleukin-1, and interleukin-10 were
measured to evaluate immunologic status. Risk scores were assigned to each indicator, and total risk
score was computed.
RESULTS: Men had higher SBP (P .001), DBP (P = .046), and body mass index (P = .01), whereas
women had higher leptin (P = .002). Total risk scores in men were greater (P = .02). There was no effect
of smoking on risk score, related to the increase in two risks for smokers (SBP, P = .04, DBP; P = .027)
reciprocated by a decrease in another (percentage of glycated albumin; P = .02).
CONCLUSION: Risk factors contributing to metabolic syndrome are present and highest in young men
compared with women, whereas the effects of cigarette smoking on the syndrome are mixed. Early
intervention to reduce modifiable risks may prevent full expression of disease. (Heart Lung® 2006;35:
119 –129.)
M
etabolic syndrome describes a combina-
tion of cardiovascular (CV) and metabolic
characteristics that predispose a person to
the development of type 2 diabetes and macrovas-
cular and microvascular pathology. According to
The World Health Organization guidelines,
1
a diag-
nosis of the disorder is based on a combination of
insulin resistance plus two other factors that may
include hypertension, high plasma triglycerides, low
levels of high-density lipoprotein cholesterol, cen-
tral obesity, microalbuminuria, or high urinary albu-
min-to-creatinine ratio. From the year 2000 census,
it is estimated that 47 million U.S. residents meet
these criteria and have a diagnosis of metabolic
syndrome.
2
The consequences of the syndrome are
severe, and include type 2 diabetes, atherosclerosis,
cerebrovascular disease, myocardial infarction, re-
nal failure, and other disorders related to vascular
impairment.
3,4
From the
a
Ohio State University College of Nursing, Columbus,
Ohio;
b
Intrecollege Physiology Program,
c
Department of Biobe-
havioral Health, Pennsylvania State University, Pennsylvania.
Research support for this work was provided by a grant from the
Pennsylvania State University Life Sciences Consortium. Cytokine
assays were carried out at the Penn State General Clinical Research
Center, funded by National Institutes of Health RR10732.
Reprint requests: Elizabeth J. Corwin, PhD, RN, 1585 Neil Avenue,
Columbus, OH 43210.
0147-9563/$ – see front matter
Copyright © 2006 by Mosby, Inc.
doi:10.1016/j.hrtlng.2005.09.003
ISSUES IN PULMONARY NURSING
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