What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Metabolic syndrome risk (n=178). Intervention: Elevated metabolic syndrome risk (ER) classification vs. Healthy controls. Primary outcome: Cardiovagal baroreflex sensitivity (cBRSall) (p=≥0.395).

March 4, 2025Open Access

Examining the use of a continuous marker of metabolic syndrome severity for detecting resting autonomic dysfunction in a multiracial sample of young adults

Key Result

Young adults at an elevated risk of metabolic syndrome based on a continuous severity score did not demonstrate significantly lower cardiovagal baroreflex sensitivity compared to healthy controls.

Study Design

Type

Cross-Sectional (n=178)

Multicenter

Structured PICO

Does a continuous marker of metabolic syndrome severity (MetS index) detect early-onset autonomic dysfunction in young adults at elevated risk?

Population

178 young adults (ages 18-39, mean age 22 ± 4 years, 59.1% female), multiracial (42.1% White, 35.1% Black or African American, 22.2% Asian), free of known cardiovascular, metabolic, pulmonary, renal, or neurological diseases (including diagnosed type 2 diabetes, and excluded the hypertensive component of MetS).

Intervention

Assessment of metabolic syndrome severity using a continuous marker (MetS index and MetSz).

Comparator

Healthy controls (negative MetS index, no MetS criteria) vs Elevated Risk (positive MetS index, no MetS criteria) vs MetS group (positive MetS index, meets MetS criteria).

Outcome

Cardiovagal baroreflex sensitivity (cBRS) and heart rate variability (HRV) indices (SDNN, RMSSD, LF/HF ratio) measured during 10 minutes of supine rest.surrogate

The continuous metabolic syndrome severity score (MetS index) is weakly associated with autonomic function but lacks the sensitivity to detect early-onset autonomic dysfunction in young adults at elevated risk before formal MetS diagnosis.

Main Result

Absolute Event Rate: 23.1% vs 25.7%

p-value: p=≥0.395

Limitations

Only evaluated resting closed-loop (spontaneous) assessments of baroreflex function and HRV and did not collect muscle sympathetic nerve activity (MSNA).
Study sample was determined via convenience sampling as part of two larger ongoing projects.

Abstract

Aims To determine if a continuous marker of metabolic syndrome (MetS) severity (MetS index ) could identify early-onset autonomic dysfunction in young adults at an elevated risk (ER) of MetS. Methods Blood biomarkers and anthropometrics were collected from 178 individuals. Cardiovagal baroreflex sensitivity (cBRS) and heart rate variability (HRV) were evaluated during 10-min of rest. Linear regressions examined the associations between the MetS index and cBRS, as well as select indices of HRV. These variables were also compared between individuals meeting the criteria for MetS (MetS group), individuals not meeting the criteria for MetS but having a positive MetS index (ER), and healthy controls (Con) matched for sex, race, and ethnicity ( n = 20 per group). Results All indices of cBRS (all p ≤ 0.007) and the standard deviation of normal-to-normal r-r intervals (SDNN; p = 0.001) were attenuated in the MetS group compared to the Con group. However, no differences were observed between the Con and ER groups ( p ≥ 0.395). The MetS index did demonstrate a significant, albeit small (R 2 ≤ 0.038, β ≤ −0.168, p ≤ 0.028) association with all indices of cBRS and SDNN. Conclusions The MetS index is associated with indices of cBRS and HRV, but is not currently able to detect early-onset autonomic dysfunction in young adults with an elevated risk of MetS.

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