Confirmatory factor analysis to assess the measure of adiposity that best fits the diagnosis of metabolic syndrome and relationship to physical activity in adults.

PURPOSE: The objective of the study is to assess the goodness of fit for the diagnosis of metabolic syndrome in adults of four models with different measures of adiposity using confirmatory factor analysis, to develop a cardio metabolic risk index and to analyze its relationship to physical activity. METHODS: Cross-sectional descriptive multicenter study including 636 patients from the EVIDENT study. Considering as fixed variables, triglycerides/HDL-C ratio, HOMA-IR index and mean arterial pressure, we will compare which single-factor model of metabolic syndrome shows better goodness of fit. The models only differ by the measure of adiposity used: waist circumference, waist circumference/height, body mass index or adiposity index. With the factorial weights obtained, we created a quantitative metabolic index and analyzed its relationship to physical activity, quantified with the accelerometer for 1 week and measured at counts/min. RESULTS: The single-factor model including waist circumference in women and body mass index in men were those that were better indicators of goodness of fit. The estimated quantitative metabolic index shows a mean value in men of -0.022 ± 1.29 with a range of values between -3.36 and 4.57 and in women of 0.0001 ± 1.53 with a range of values between -3.17 and 5.55. The quantitative index shows an inverse relationship to physical activity. CONCLUSIONS: Waist circumference in women and body mass index in men are the measures of adiposity that were better indicators goodness of fit. This quantitative index may be useful to quantify the risk of metabolic syndrome in clinical practice.

Comparison of two measuring instruments, B-pro and SphygmoCor system as reference, to evaluate central systolic blood pressure and radial augmentation index.

A comparison is made of central aortic systolic pressure (CASP) and the radial augmentation index (rAIx) estimated with the B-Pro device and SphygmoCor (as reference) in 104 healthy Caucasians without drug treatment, together with an analysis of the relationship between CASP and rAIx, and arterial stiffness. Peripheral and central blood pressure, and the rAIx were measured with B-pro and SphygmoCor, with determination of the central augmentation index (CAIx), pulse wave velocity (PWV), carotid intima-media thickness (IMT) and the ankle-brachial index (ABI). rAIx as determined with B-Pro was greater than measured with SphygmoCor (5.85; 95%CI: 1.75-9.96), in the same way as CASP, estimated from the transfer function (1.47; 95%CI: 0.47-2.47 mm Hg) and with the second peak of the radial wave (4.46; 95%CI: 2.80-6.12 mm Hg). The Pearson correlation coefficient for CASP with B-Pro and SphygmoCor was r = 0.937 (P < 0.01), with an intraclass correlation of 0.972 (95%CI: 0.959-0.981). In the case of rAIx, the correlation coefficient was r = 0.436 (P < 0.01), with an intraclass correlation of 0.599 (95% CI: 0.409-0.728). The correlation of CASP (B-pro) with PWV was r = 0.558 (P < 0.01), with CAIx r = 0.253 (P < 0.01) and with carotid IMT r = 0.442 (P < 0.01). The correlation of rAIx (B-Pro) with age was r = 0.369 (r < 0.01), and with CAIx r = 0.463 (P < 0.001). Central arterial pressure estimated with B-Pro in healthy Caucasians without drug treatment offers adequate validity vs. the reference standard (SphygmoCor). However, in the estimation of rAIx, some differences with respect to the reference standard have been detected, probably related to measurement of the second peak of the radial wave.

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Physical exercise, fitness and dietary pattern and their relationship with circadian blood pressure pattern, augmentation index and endothelial dysfunction biological markers: EVIDENT study protocol.

BACKGROUND: Healthy lifestyles may help to delay arterial aging. The purpose of this study is to analyze the relationship of physical activity and dietary pattern to the circadian pattern of blood pressure, central and peripheral blood pressure, pulse wave velocity, carotid intima-media thickness and biological markers of endothelial dysfunction in active and sedentary individuals without arteriosclerotic disease. DESIGN: A cross-sectional multicenter study with six research groups. SUBJECTS: From subjects of the PEPAF project cohort, in which 1,163 who were sedentary became active, 1,942 were sedentary and 2,346 were active. By stratified random sampling, 1,500 subjects will be included, 250 in each group. PRIMARY MEASUREMENTS: We will evaluate height, weight, abdominal circumference, clinical and ambulatory blood pressure with the Radial Pulse Wave Acquisition Device (BPro), central blood pressure and augmentation index with Pulse Wave Application Software (A-Pulse) and SphymgoCor System Px (Pulse Wave Analysis), pulse wave velocity (PWV) with SphymgoCor System Px (Pulse Wave Velocity), nutritional pattern with a food intake frequency questionnaire, physical activity with the 7-day PAR questionnaire and accelerometer (Actigraph GT3X), physical fitness with the cycle ergometer (PWC-170), carotid intima-media thickness by ultrasound (Micromax), and endothelial dysfunction biological markers (endoglin and osteoprotegerin). DISCUSSION: Determining that sustained physical activity and the change from sedentary to active as well as a healthy diet improve circadian pattern, arterial elasticity and carotid intima-media thickness may help to propose lifestyle intervention programs. These interventions could improve the cardiovascular risk profile in some parameters not routinely assessed with traditional risk scales. From the results of this study, interventional approaches could be obtained to delay vascular aging that combine physical exercise and diet. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01083082.