Path analysis of metabolic syndrome components in black versus white children, adolescents, and adults: The bogalusa heart study

PURPOSE: Examine the complex relationships among metabolic syndrome components in black and white individuals by growth periods. METHODS: Path analyses of metabolic syndrome components were performed on 8203 black and white healthy subjects (64.3% white and 47.9% male) comprising children (4-11 years), adolescents (12-18 years), and adults (19-44 years). RESULTS: The direct effect of body mass index (BMI) on fasting insulin levels was greatest among all the paths for each age group in both races. In general, path coefficients were greater in whites than in blacks except for the age-mean arterial pressure (MAP) path and greater in children and adults than in adolescents. The direct age effect on MAP was greater in black versus white adults (p = 0.010 for race difference). Whites showed greater direct effects of BMI on MAP in children (p = 0.007), adolescents (p = 0.090), and adults (p = 0.022); BMI on insulin in adolescents (p < 0.001); BMI on triglycerides in children (p = 0.003); and insulin on triglycerides in adults (p < 0.001). A race difference in the effect of BMI on fasting glucose was noted among adolescents (p = 0.048). CONCLUSIONS: The black-white differences in the relationships of obesity and insulin resistance measures to other components may account for the lower prevalence of metabolic syndrome in the black population.