The effect of smoking on latent hazard classes of metabolic syndrome using latent class causal analysis method in the Iranian population
Abstract Background The prevalence of metabolic syndrome is increasing worldwide. Clinical guidelines consider metabolic syndrome as an all or none medical condition. One proposed method for classifying metabolic syndrome is latent class analysis (LCA). One approach to causal inference in LCA is usi...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-16863-6 |
| _version_ | 1797451166038097920 |
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| author | Farzad Khodamoradi Maryam Nazemipour Nasrin Mansournia Kamran Yazdani Davood khalili Maedeh Arshadi Mahyar Etminan Mohammad Ali Mansournia |
| author_facet | Farzad Khodamoradi Maryam Nazemipour Nasrin Mansournia Kamran Yazdani Davood khalili Maedeh Arshadi Mahyar Etminan Mohammad Ali Mansournia |
| author_sort | Farzad Khodamoradi |
| collection | DOAJ |
| description | Abstract Background The prevalence of metabolic syndrome is increasing worldwide. Clinical guidelines consider metabolic syndrome as an all or none medical condition. One proposed method for classifying metabolic syndrome is latent class analysis (LCA). One approach to causal inference in LCA is using propensity score (PS) methods. The aim of this study was to investigate the causal effect of smoking on latent hazard classes of metabolic syndrome using the method of latent class causal analysis. Methods In this study, we used data from the Tehran Lipid and Glucose Cohort Study (TLGS). 4857 participants aged over 20 years with complete information on exposure (smoking) and confounders in the third phase (2005–2008) were included. Metabolic syndrome was evaluated as outcome and latent variable in LCA in the data of the fifth phase (2014–2015). The step-by-step procedure for conducting causal inference in LCA included: (1) PS estimation and evaluation of overlap, (2) calculation of inverse probability-of-treatment weighting (IPTW), (3) PS matching, (4) evaluating balance of confounding variables between exposure groups, and (5) conducting LCA using the weighted or matched data set. Results Based on the results of IPTW which compared the low, medium and high risk classes of metabolic syndrome (compared to a class without metabolic syndrome), no association was found between smoking and the metabolic syndrome latent classes. PS matching which compared low and moderate risk classes compared to class without metabolic syndrome, showed that smoking increases the probability of being in the low-risk class of metabolic syndrome (OR: 2.19; 95% CI: 1.32, 3.63). In the unadjusted analysis, smoking increased the chances of being in the low-risk (OR: 1.45; 95% CI: 1.01, 2.08) and moderate-risk (OR: 1.68; 95% CI: 1.18, 2.40) classes of metabolic syndrome compared to the class without metabolic syndrome. Conclusions Based on the results, the causal effect of smoking on latent hazard classes of metabolic syndrome can be different based on the type of PS method. In adjusted analysis, no relationship was observed between smoking and moderate-risk and high-risk classes of metabolic syndrome. |
| first_indexed | 2024-03-09T14:49:55Z |
| format | Article |
| id | doaj.art-026a040168ec46f48c6acc6b15562f9e |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-09T14:49:55Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
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| series | BMC Public Health |
| spelling | doaj.art-026a040168ec46f48c6acc6b15562f9e2023-11-26T14:29:22ZengBMCBMC Public Health1471-24582023-10-0123111110.1186/s12889-023-16863-6The effect of smoking on latent hazard classes of metabolic syndrome using latent class causal analysis method in the Iranian populationFarzad Khodamoradi0Maryam Nazemipour1Nasrin Mansournia2Kamran Yazdani3Davood khalili4Maedeh Arshadi5Mahyar Etminan6Mohammad Ali Mansournia7Department of Social Medicine, Faculty of Medicine, Ahvaz Jundishapur University of Medical SciencesDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical SciencesDepartment of Endocrinology, AJA University of Medical SciencesDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical SciencesPrevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesDepartment of Epidemiology and Biostatistics, School of Public Health, Shahid Sadoughi University of Medical SciencesDepartments of Ophthalmology and Visual Sciences, Medicine and Pharmacology, University of British ColumbiaDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical SciencesAbstract Background The prevalence of metabolic syndrome is increasing worldwide. Clinical guidelines consider metabolic syndrome as an all or none medical condition. One proposed method for classifying metabolic syndrome is latent class analysis (LCA). One approach to causal inference in LCA is using propensity score (PS) methods. The aim of this study was to investigate the causal effect of smoking on latent hazard classes of metabolic syndrome using the method of latent class causal analysis. Methods In this study, we used data from the Tehran Lipid and Glucose Cohort Study (TLGS). 4857 participants aged over 20 years with complete information on exposure (smoking) and confounders in the third phase (2005–2008) were included. Metabolic syndrome was evaluated as outcome and latent variable in LCA in the data of the fifth phase (2014–2015). The step-by-step procedure for conducting causal inference in LCA included: (1) PS estimation and evaluation of overlap, (2) calculation of inverse probability-of-treatment weighting (IPTW), (3) PS matching, (4) evaluating balance of confounding variables between exposure groups, and (5) conducting LCA using the weighted or matched data set. Results Based on the results of IPTW which compared the low, medium and high risk classes of metabolic syndrome (compared to a class without metabolic syndrome), no association was found between smoking and the metabolic syndrome latent classes. PS matching which compared low and moderate risk classes compared to class without metabolic syndrome, showed that smoking increases the probability of being in the low-risk class of metabolic syndrome (OR: 2.19; 95% CI: 1.32, 3.63). In the unadjusted analysis, smoking increased the chances of being in the low-risk (OR: 1.45; 95% CI: 1.01, 2.08) and moderate-risk (OR: 1.68; 95% CI: 1.18, 2.40) classes of metabolic syndrome compared to the class without metabolic syndrome. Conclusions Based on the results, the causal effect of smoking on latent hazard classes of metabolic syndrome can be different based on the type of PS method. In adjusted analysis, no relationship was observed between smoking and moderate-risk and high-risk classes of metabolic syndrome.https://doi.org/10.1186/s12889-023-16863-6Cohort studiesSmokingMetabolic syndromeCausal analysisLatent class analysisPropensity score |
| spellingShingle | Farzad Khodamoradi Maryam Nazemipour Nasrin Mansournia Kamran Yazdani Davood khalili Maedeh Arshadi Mahyar Etminan Mohammad Ali Mansournia The effect of smoking on latent hazard classes of metabolic syndrome using latent class causal analysis method in the Iranian population BMC Public Health Cohort studies Smoking Metabolic syndrome Causal analysis Latent class analysis Propensity score |
| title | The effect of smoking on latent hazard classes of metabolic syndrome using latent class causal analysis method in the Iranian population |
| title_full | The effect of smoking on latent hazard classes of metabolic syndrome using latent class causal analysis method in the Iranian population |
| title_fullStr | The effect of smoking on latent hazard classes of metabolic syndrome using latent class causal analysis method in the Iranian population |
| title_full_unstemmed | The effect of smoking on latent hazard classes of metabolic syndrome using latent class causal analysis method in the Iranian population |
| title_short | The effect of smoking on latent hazard classes of metabolic syndrome using latent class causal analysis method in the Iranian population |
| title_sort | effect of smoking on latent hazard classes of metabolic syndrome using latent class causal analysis method in the iranian population |
| topic | Cohort studies Smoking Metabolic syndrome Causal analysis Latent class analysis Propensity score |
| url | https://doi.org/10.1186/s12889-023-16863-6 |
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