# Metabolic Syndrome Severity in All of Us: Relationship with Social Determinants of Health and with Long-Term Risk for Cardiovascular Disease

> **NIH NIH R03** · UNIVERSITY OF VIRGINIA · 2024 · $154,751

## Abstract

PROJECT SUMMARY
In this project we aim to validate tools that researchers (including other All of Us researchers) can utilize to
assess and follow the severity of metabolic syndrome (MetS) among study participants, and we will also
evaluate characteristics of MetS among minoritized groups for use in personalized medicine in clinical
practice. MetS is a cluster of cardiovascular disease (CVD) risk factors that occur together more frequently
than would be expected by chance, as though they are driven by a common underlying process that is related
to risk for future Type 2 diabetes (T2D) and CVD. We previously formulated MetS severity z-scores (MetS-Z)
specific to sex and to three different race/ethnicities (individuals who are non-Hispanic white, non-Hispanic
black or Hispanic), but we did not previously have statistical power to assess for—and if necessary derive—
unique MetS-Z scores for other racial/ethnic and sexual/gender groups. In particular Asian American
individuals have been noted to manifest insulin resistance at a lower BMI (suggesting unique manifestation of
MetS), and many sexual/gender sub-groups have been noted to have high levels of chronic stress from
discrimination, which could also affect MetS severity.
We propose to use confirmatory factor analysis to assess MetS severity among multiple minoritized
race/ethnicity and sexual/gender groups in All of Us. If the loading factors for the individual MetS components
differ for a specific population sub-group, we will derive a unique MetS severity z-score for that group (e.g.
among individuals who are Asian American); if the MetS loading factors are similar to other groups, we will
utilize the corresponding MetS-Z score for that group’s set of loading factors. We will then assess how these
MetS-Z scores relate to social determinants of health (SDOH), including perceived discrimination and
depressive symptoms— the physiological stress from which can exacerbate MetS. This may help in
highlighting the importance of assessing and considering SDOH in clinical care.
Finally, we will evaluate how baseline MetS-Z is related to longitudinal risk for T2D and CVD, including
assessing for whether this differs by racial/ethnic and sexual gender sub-groups. Our overall goal is to
provide support for personalized medicine considerations for all individuals, including minoritized groups.
These data will help validate specific MetS-Z scores that can be used to assess relationships with metabolic
health for other topics of interest to multiple investigator teams in All of Us.

## Key facts

- **NIH application ID:** 10925423
- **Project number:** 5R03HL172130-03
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** MARK DANIEL DEBOER
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $154,751
- **Award type:** 5
- **Project period:** 2023-09-10 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10925423

## Citation

> US National Institutes of Health, RePORTER application 10925423, Metabolic Syndrome Severity in All of Us: Relationship with Social Determinants of Health and with Long-Term Risk for Cardiovascular Disease (5R03HL172130-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10925423. Licensed CC0.

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