LIAN-YU LINKuo H.-K.HUNG-YUAN LIHWANG, JUEY-JENJUEY-JENHWANGJOU-WEI LIN2020-06-012020-06-0120081930-7381https://www.scopus.com/inward/record.uri?eid=2-s2.0-58149277472&doi=10.1038%2foby.2008.429&partnerID=40&md5=6550f05ef06492501462a763e5e57a23https://scholars.lib.ntu.edu.tw/handle/123456789/495938The objective of this study was to examine the role of obesity in the development of the metabolic syndrome (MS). A total of 3,596 whites aged 19 years and above, who participated in the National Health and Nutrition Examination Survey (NHANES) 1999-2002, were included for analysis. Anthropometric measurements, biochemical profiles, and high-sensitivity C-reactive protein (CRP) were measured. A structural equation model (SEM) was constructed to elucidate a pathway in which obesity initiated the cascade leading to full MS. The results of SEM demonstrated that obesity was positively associated with elevated CRP level (B = 0.05, P < 0.001). This higher inflammatory state directed to insulin resistance (B = 0.32, P < 0.001), which in turn was positively associated with dyslipidemia (B = 0.06, P < 0.001). Obesity could also directly and positively affect blood pressure (B = 0.51, P < 0.001), without the mediation of insulin resistance and/or inflammation. The results of the cross-sectional analysis in the white subjects have shown that obesity has a strong influence on hypertension that obtains little additional influence from inflammation or insulin resistance. The metabolic profile in the NHANES group has been confirmatory with the statement that there is a sequential effect from obesity to inflammation, insulin resistance, and dyslipidemia. This approach has allowed to inferring important biological insights about the nature of the relationships among the components of MS.[SDGs]SDG3C reactive protein; adult; aged; article; biological model; Caucasian; cross-sectional study; dyslipidemia; female; human; hypertension; inflammation; insulin resistance; male; metabolic syndrome X; metabolism; middle aged; nutrition; obesity; pathophysiology; Adult; Aged; C-Reactive Protein; Cross-Sectional Studies; Dyslipidemias; European Continental Ancestry Group; Female; Humans; Hypertension; Inflammation; Insulin Resistance; Male; Metabolic Syndrome X; Middle Aged; Models, Biological; Nutrition Surveys; Obesity; Young Adultjournal article10.1038/oby.2008.429188460462-s2.0-58149277472