Frontiers in Endocrinology (Sep 2022)
Morbid liver manifestations are intrinsically bound to metabolic syndrome and nutrient intake based on a machine-learning cluster analysis
- Víctor Micó,
- Rodrigo San-Cristobal,
- Roberto Martín,
- Miguel Ángel Martínez-González,
- Miguel Ángel Martínez-González,
- Miguel Ángel Martínez-González,
- Jordi Salas-Salvadó,
- Jordi Salas-Salvadó,
- Dolores Corella,
- Dolores Corella,
- Montserrat Fitó,
- Montserrat Fitó,
- Ángel M. Alonso-Gómez,
- Ángel M. Alonso-Gómez,
- Julia Wärnberg,
- Julia Wärnberg,
- Jesús Vioque,
- Jesús Vioque,
- Dora Romaguera,
- Dora Romaguera,
- José López-Miranda,
- José López-Miranda,
- Ramon Estruch,
- Ramon Estruch,
- Francisco J. Tinahones,
- Francisco J. Tinahones,
- José Lapetra,
- José Lapetra,
- J. Luís Serra-Majem,
- J. Luís Serra-Majem,
- Aurora Bueno-Cavanillas,
- Aurora Bueno-Cavanillas,
- Josep A. Tur,
- Josep A. Tur,
- Josep A. Tur,
- Vicente Martín Sánchez,
- Vicente Martín Sánchez,
- Xavier Pintó,
- Xavier Pintó,
- Miguel Delgado-Rodríguez,
- Pilar Matía-Martín,
- Josep Vidal,
- Josep Vidal,
- Clotilde Vázquez,
- Clotilde Vázquez,
- Ana García-Arellano,
- Salvador Pertusa-Martinez,
- Alice Chaplin,
- Alice Chaplin,
- Antonio Garcia-Rios,
- Antonio Garcia-Rios,
- Carlos Muñoz Bravo,
- Carlos Muñoz Bravo,
- Helmut Schröder,
- Nancy Babio,
- Nancy Babio,
- Jose V. Sorli,
- Jose V. Sorli,
- Jose I. Gonzalez,
- Jose I. Gonzalez,
- Diego Martinez-Urbistondo,
- Estefania Toledo,
- Estefania Toledo,
- Vanessa Bullón,
- Miguel Ruiz-Canela,
- María Puy- Portillo,
- María Puy- Portillo,
- María Puy- Portillo,
- Manuel Macías-González,
- Manuel Macías-González,
- Nuria Perez-Diaz-del-Campo,
- Jesús García-Gavilán,
- Jesús García-Gavilán,
- Lidia Daimiel,
- J. Alfredo Martínez,
- J. Alfredo Martínez,
- J. Alfredo Martínez
Affiliations
- Víctor Micó
- Cardiometabolic Nutrition Group, Madrid Institute for Advanced Studies (IMDEA) Food, Excellence International Campus Autónoma Madrid University (CEI UAM) + CSIC, Madrid, Spain
- Rodrigo San-Cristobal
- Cardiometabolic Nutrition Group, Madrid Institute for Advanced Studies (IMDEA) Food, Excellence International Campus Autónoma Madrid University (CEI UAM) + CSIC, Madrid, Spain
- Roberto Martín
- Biostatistics and Bioinformatics Unit, Madrid Institute for Advanced Studies (IMDEA) Food, Excellence International Campus Autónoma Madrid University (CEI UAM) + CSIC, Madrid, Spain
- Miguel Ángel Martínez-González
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, IdiSNA-Navarra Institute for Health Research, University of Navarra, Pamplona, Spain
- Miguel Ángel Martínez-González
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
- Jordi Salas-Salvadó
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Jordi Salas-Salvadó
- Biochemistry and Biotechnology Department, Nutrition Unit, Institut d’Investigació Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Universitat Rovira i Virgili, Reus, Spain
- Dolores Corella
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Dolores Corella
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
- Montserrat Fitó
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Montserrat Fitó
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Ángel M. Alonso-Gómez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Ángel M. Alonso-Gómez
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country (UPV/EHU) , Vitoria-Gasteiz, Spain
- Julia Wärnberg
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Julia Wärnberg
- 0Department of Nursing, School of Health Sciences, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
- Jesús Vioque
- 1CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Jesús Vioque
- 2Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain
- Dora Romaguera
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Dora Romaguera
- 3Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR). Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain
- José López-Miranda
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- José López-Miranda
- 4Lipids and Atherosclerosis Unit, Department of Internal Medicine, Lipids and Atherosclerosis Hospital Reina Sofía, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain
- Ramon Estruch
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Ramon Estruch
- 5Department of Internal Medicine, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
- Francisco J. Tinahones
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Francisco J. Tinahones
- 6Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, Málaga, Spain
- José Lapetra
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- José Lapetra
- 7Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
- J. Luís Serra-Majem
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- J. Luís Serra-Majem
- 8Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain
- Aurora Bueno-Cavanillas
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Aurora Bueno-Cavanillas
- 9Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Josep A. Tur
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Josep A. Tur
- 3Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR). Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain
- Josep A. Tur
- 0Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
- Vicente Martín Sánchez
- 1CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Vicente Martín Sánchez
- 1Institute of Biomedicine (IBIOMED), University of León, León, Spain
- Xavier Pintó
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Xavier Pintó
- 2Lipids and Vascular Risk Unit, Internal Medicine, Hospitalet de Llobregat, Hospital Universitario de Bellvitge, Barcelona, Spain
- Miguel Delgado-Rodríguez
- 3Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
- Pilar Matía-Martín
- 4Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Josep Vidal
- 5Biomedical Research Centre for Diabetes and Metabolic Diseases Network CIBER Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Josep Vidal
- 6Department of Endocrinology, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
- Clotilde Vázquez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Clotilde Vázquez
- 7Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas Jiménez Díaz Foundation Health Research Institute (IISFJD), University Autónoma, Madrid, Spain
- Ana García-Arellano
- 8Department of Emergency, Complejo Hospitalario de Navarra Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
- Salvador Pertusa-Martinez
- 9Primary Care Center Cabo Huertas, Alicante, Spain
- Alice Chaplin
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Alice Chaplin
- 3Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR). Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma de Mallorca, Spain
- Antonio Garcia-Rios
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Antonio Garcia-Rios
- 4Lipids and Atherosclerosis Unit, Department of Internal Medicine, Lipids and Atherosclerosis Hospital Reina Sofía, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain
- Carlos Muñoz Bravo
- 0Department of Nursing, School of Health Sciences, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
- Carlos Muñoz Bravo
- 0Department of Preventive Medicine and Public Health, School of Medicine, University of Málaga, Málaga, Spain
- Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Nancy Babio
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Nancy Babio
- Biochemistry and Biotechnology Department, Nutrition Unit, Institut d’Investigació Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Universitat Rovira i Virgili, Reus, Spain
- Jose V. Sorli
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Jose V. Sorli
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
- Jose I. Gonzalez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Jose I. Gonzalez
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
- Diego Martinez-Urbistondo
- Department of Preventive Medicine and Public Health, IdiSNA-Navarra Institute for Health Research, University of Navarra, Pamplona, Spain
- Estefania Toledo
- Department of Preventive Medicine and Public Health, IdiSNA-Navarra Institute for Health Research, University of Navarra, Pamplona, Spain
- Estefania Toledo
- 1Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
- Vanessa Bullón
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, IdiSNA-Navarra Institute for Health Research, University of Navarra, Pamplona, Spain
- María Puy- Portillo
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- María Puy- Portillo
- 2Nutrition and Obesity Group, Department of Pharmacy and Food Science, Lucio Lascaray Research Institute, University of the Basque Country (UPV/EHU), Vitoria, Spain
- María Puy- Portillo
- 3Bioaraba Health Research Institute, Alava, Spain
- Manuel Macías-González
- 0Department of Nursing, School of Health Sciences, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
- Manuel Macías-González
- 6Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, Málaga, Spain
- Nuria Perez-Diaz-del-Campo
- 4Department of Medical Sciences, University of Turin, Turin, Italy
- Jesús García-Gavilán
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Jesús García-Gavilán
- Biochemistry and Biotechnology Department, Nutrition Unit, Institut d’Investigació Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Universitat Rovira i Virgili, Reus, Spain
- Lidia Daimiel
- 5Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, Madrid Institute for Advanced Studies (IMDEA) Food, Excellence International Campus Autónoma Madrid University (CEI UAM) + CSIC, Madrid, Spain
- J. Alfredo Martínez
- Cardiometabolic Nutrition Group, Madrid Institute for Advanced Studies (IMDEA) Food, Excellence International Campus Autónoma Madrid University (CEI UAM) + CSIC, Madrid, Spain
- J. Alfredo Martínez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- J. Alfredo Martínez
- 6Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
- DOI
- https://doi.org/10.3389/fendo.2022.936956
- Journal volume & issue
-
Vol. 13
Abstract
Metabolic syndrome (MetS) is one of the most important medical problems around the world. Identification of patient´s singular characteristic could help to reduce the clinical impact and facilitate individualized management. This study aimed to categorize MetS patients using phenotypical and clinical variables habitually collected during health check-ups of individuals considered to have high cardiovascular risk. The selected markers to categorize MetS participants included anthropometric variables as well as clinical data, biochemical parameters and prescribed pharmacological treatment. An exploratory factor analysis was carried out with a subsequent hierarchical cluster analysis using the z-scores from factor analysis. The first step identified three different factors. The first was determined by hypercholesterolemia and associated treatments, the second factor exhibited glycemic disorders and accompanying treatments and the third factor was characterized by hepatic enzymes. Subsequently four clusters of patients were identified, where cluster 1 was characterized by glucose disorders and treatments, cluster 2 presented mild MetS, cluster 3 presented exacerbated levels of hepatic enzymes and cluster 4 highlighted cholesterol and its associated treatments Interestingly, the liver status related cluster was characterized by higher protein consumption and cluster 4 with low polyunsaturated fatty acid intake. This research emphasized the potential clinical relevance of hepatic impairments in addition to MetS traditional characterization for precision and personalized management of MetS patients.
Keywords