Effect of birthplace on cardiometabolic risk among blacks in the Metabolic Syndrome Outcome Study (MetSO)
Ravenell et al. Diabetol Metab Syndr
Effect of birthplace on cardiometabolic risk among blacks in the Metabolic Syndrome Outcome Study (MetSO)
Joseph Ravenell 1
Azizi Seixas 1
Diana Margot Rosenthal 1
Olajide Williams 3
Chinwe Ogedegbe 2
Mary Ann Sevick 1
Valerie Newsome 1
Girardin Jean‑Louis 1
0 6‐629D , New York, NY 10016 , USA
1 Department of Population Health, Center for Healthful Behavior Change (CHBC), New York University Medical Center , 227 East 30th Street (between 2nd and 3rd Ave), Floor
2 Department of Emergency Medicine , Hackensack UMC, Hackensack, NJ , USA
3 Department of Neurology, Columbia University Medical Center , New York, NY , USA
4 6‐629D , New York, NY 10016 , USA
Background: Metabolic syndrome poses an increased global burden of disease and causes immense financial burden, warranting heightened public health attention. The present study assessed the prevalence and severity of cardiometabolic risk among foreign‑ born versus US‑ born blacks, while exploring potential gender‑ based effects. Methods: A total of 1035 patients from the Metabolic Syndrome Outcome Study (Trial registration: NCT01946659) provided sociodemographic, medical history, and clinical data. General Linear Model (GLM) was used to assess the effects of birthplace and gender on cardiometabolic parameters, adjusting for age differences in the sample. Results: Of the sample, 61.6 % were foreign‑ born blacks (FBB) and 38.4 % were US‑ born blacks (USB). FBB had significantly lower BMI compared with USB (32.76 ± 0.35 vs. 35.41 ± 0.44, F = 22.57), but had significantly higher systolic blood pressure (136.70 ± 0.77 vs. 132.83 ± 0.98; F = 9.60) and fasting glucose levels than did USB (146.46 ± 3.37 vs. 135.02 ± 4.27; F = 4.40). Men had higher diastolic BP (76.67 ± 0.65 vs. 75.05 ± 0.45; F = 4.20), glucose (146.53 ± 4.48 vs. 134.95 ± 3.07; F = 4.55) and triglyceride levels (148.10 ± 4.51 vs. 130.60 ± 3.09; F = 10.25) compared with women, but women had higher LDL‑ cholesterol (109.24 ± 1.49 vs. 98.49 ± 2.18; F = 16.60) and HDL‑ cholesterol levels (50.71 ± 0.66 vs. 42.77 ± 0.97; F = 46.01) than did men. Conclusions: Results showed that birthplace has a significant influence on cardiometabolic profiles of blacks with metabolic syndrome. Patients' gender also had an independent influence on cardiometabolic profile.
Place of birth; Cardiometabolic profile; Metabolic syndrome
Background
Metabolic syndrome (MetS), a constellation of
medical conditions that predispose individuals to increased
risk of cardiovascular disease (CVD), Type 2 diabetes
mellitus (T2DM) and all-cause mortality [
1
], increases
global burden of disease and causes immense financial
burden, warranting heightened public health attention
[
2–7
]. MetS components include hyperglycemia
(fasting glucose ≥100 mg/dL), central or abdominal obesity
(measured by waist circumference ≥40 inches for men
and ≥35 inches for women), elevated blood pressure
(systolic/diastolic blood pressure ≥130/85 mmHG), and
atherogenic dyslipidemia (triglyceride levels ≥150 mg/
dL of blood and HDL cholesterol <40 mg/dL in men
and <50 mg/dL in women). MetS risk is greater among
older adults and seems more prevalent among blacks
relative to whites, although this may be gender dependent
[8].
Among blacks, sociodemographic and
environmental factors appear to be associated with the presence of
MetS or its components. Using the Jackson Heart Study,
researchers found that metabolic syndrome was
positively correlated with neighborhood socioeconomic
disadvantage, and lack of perceived safety was associated
with elevated glucose and waist circumference [
9
]. An
intriguing hypothesis has emerged suggesting that place
of birth or geographic residence could influence
prevalence and severity of metabolic syndrome as well as its
associated costs [
10
]. Evidence suggests an increase in
metabolic syndrome related hospitalizations may be
attributed in part to places of residence replete with
persistent environmental and organic pollutants that induce
insulin resistance. Furthermore, since a
disproportionate number of blacks are born and/or reside in zip codes
characterized by persistent environmental and organic
pollutants relative to whites, it is likely that place of birth
and residence contribute to poor cardiometabolic health
[
10
].
We previously examined cardiometabolic risk
profiles of US-born blacks (USB) versus foreign-born blacks
(FBB), finding that higher rates of dyslipidemia and
diabetes exist among USB relative to FBB [
11
]. However,
detailed analyses of potential effects of place of birth on
metabolic syndrome and its components could not be
performed because of limited sample size, lack of
clinical metabolic syndrome data, and restricted age range
in that study. The current study builds on our previous
work, examining effects of place of birth on
cardiometabolic risks among blacks in the Metabolic Syndrome
Outcome Study (MetSO). Specifically, we assessed the
preva (...truncated)