Título:	Positive additive and multiplicative interactions among clustered components of metabolic syndrome with type 2 diabetes mellitus among Brazilian adolescent students
Autor(es):	Rodrigues, Rodolfo Rêgo Deusdará Souza, Amanda de Moura Szklo, Moyses
E-mail do autor:	mailto:rodolfodeusdara@gmail.com
ORCID:	https://orcid.org/0000-0002-1343-3265
Assunto:	Síndrome metabólica Diabetes mellitus tipo 2 Biomarcadores Adolescentes - saúde e higiene
Data de publicação:	3-Nov-2022
Editora:	MDPI
Referência:	DEUSDARÁ, Rodolfo; SOUZA, Amanda de Moura; SZKLO, Moyses. Positive additive and multiplicative interactions among clustered components of metabolic syndrome with type 2 diabetes mellitus among Brazilian adolescent students. Nutrients, Basel, v. 14, n. 21, art. 4640, 2022. DOI 10.3390/nu14214640. Disponível em: https://www.mdpi.com/2072-6643/14/21/4640. Acesso em: 29 nov. 2022.
Abstract:	Background: It is still controversial whether the joint effect of Metabolic syndrome (MetS) components is greater than that expected based on their independent effects, regarding type 2 diabetes mellitus in adolescents. We evaluated additive and multiplicative interactions between pair-wise combinations of metabolic syndrome components regarding type 2 diabetes mellitus. Methods: We studied 37,815 Brazilian adolescents from a national school-based survey, The Study of Cardiovascular Risk Factors in Adolescents (Portuguese acronym, ERICA). A Poisson regression model was used to calculate sex-, age-, obesity-, smoking status-, sedentary behavior-, physical inactivity-, alcoholic consumption- and socioeconomic status-adjusted prevalence ratios to evaluate both additive and multiplicative interactions. Results: In the comparison of observed and expected joint effects, relative excess risk due to additive interaction (RERI) for high triglycerides and low high-density lipoprotein-cholesterol, high triglycerides and elevated waist circumference, elevated waist circumference and low high-density lipoprotein-cholesterol and elevated waist circumference and high blood pressure were 2.53 (−0.41, 5.46), 2.86 (−2.89, 8.61), 1.71 (−1.05, 4.46) and 0.97 (0.15, 1.79), respectively, thus suggesting additive interactions. Multiplicative interactions for those pairs of components were also observed, as expressed by interaction ratios > 1.0. Conclusions: The joint presence of some of the components of MetS showed a greater association with the prevalence of type 2 diabetes mellitus in adolescents than expected from the sum of their isolated effects. From a public health perspective, preventing one of the components of the pairs that interact may result in a greater reduction in the prevalence of T2DM than focusing on an individual component that does not interact with another component.
Unidade Acadêmica:	Faculdade de Medicina (FMD)
Licença:	Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).
DOI:	https://doi.org/10.3390/nu14214640
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