Metabolic syndrome and lipogenesis both associated with higher death rates

Today, I’m reporting on two new observational studies that show interesting associations between first metabolic syndrome, and then de novo lipogenesis (creating fat from sugar), and increased risk for cardiovascular or all-cause mortality. This may sound a little dry — and it is a little dry — but the results are interesting enough that I want to share them with you! As always, the observational nature of these studies means that they can show interesting associations, but neither suggests a causal relationship.

The first study, published in the journal Annals of Internal Medicine, followed almost 10 million people for 3.5 years. Now that is a huge study! The researchers grouped subjects based on whether they currently have or ever had the diagnosis of metabolic syndrome.

Not surprisingly, they found a higher risk of cardiovascular events in those with metabolic syndrome. However, they also found that those who have recovered from metabolic syndrome had a reduced risk compared to those who still had it (4.5 vs 8.5 per 1000-person-years).

The hazard ratios were small, ranging from 15 to 36%, so we do need to interpret the results with caution. But this study suggests that there is hope. It is never too late to improve your health, reverse your metabolic syndrome, and lower your cardiovascular risk.

The second study, published in the Journal of the American Heart Association, investigated 3,800 adults and correlated their blood concentrations of “de novo lipogenesis-related fatty acids” and risk of death. That is a mouthful, but simply means that levels of fatty acids that likely came from the conversion of dietary sugar and starch were measured and later, investigators assessed whether the levels were statistically related to mortality rates.

The scientists found that the two particular fatty acids that are most closely associated with sugar intake, 16:0 and 18:1n-9, correlated with an increased risk of all-cause mortality. Another fatty acid that is NOT produced through denovo lipogenesis, 18:0, had an inverse correlation with mortality. So, converting sugar and starch to fatty acids was associated with more death, whereas fatty acids from other sources were not linked to higher death rates.

What can we make of all this? Well, we can’t say, “See! This proves that eating sugar and starch can kill you!” But we can say that understanding more about the fatty acid profiles most linked to cardiovascular mortality seems promising, and that designing randomized clinical trials to test some of the ideas suggested by these correlations would be beneficial.

Both of these studies have gotten their fair share of social media publicity. While the results are interesting and encouraging, especially showing that it is never too late to improve your health and reduce your risk, they are not conclusive. Our hope is that this research will eventually serve as a spring board for higher quality studies down the road.

Thanks for reading,
Bret Scher, MD FACC

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