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Empirical derivation to improve the definition of the metabolic syndrome in the evaluation of cardiovascular disease risk.
Pubmed ID: 21285391
Pubmed Central ID: PMC3041220
Journal: Diabetes care
Publication Date: March 1, 2011
Affiliation: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA. rachel.wildman@einstein.yu.edu
MeSH Terms: Humans, Cardiovascular Diseases, Risk Factors, Metabolic Syndrome
Grants: R21 HL089625
Authors: Wildman RP, McGinn AP, Wang D, Muntner P, Cohen HW, Reynolds K, Fonseca V, Kim M, Ogorodnikova AD
Cite As: Wildman RP, McGinn AP, Kim M, Muntner P, Wang D, Cohen HW, Ogorodnikova AD, Reynolds K, Fonseca V. Empirical derivation to improve the definition of the metabolic syndrome in the evaluation of cardiovascular disease risk. Diabetes Care 2011 Mar;34(3):746-8. Epub 2011 Feb 1.
Studies:
Abstract
OBJECTIVE: To examine whether a quantitatively derived metabolic syndrome definition predicts incident cardiovascular disease (CVD) events better than do existing definitions. RESEARCH DESIGN AND METHODS: Data were pooled from the Atherosclerosis Risk in Communities, Cardiovascular Health, and Framingham Offspring studies (n = 20,581). Incident coronary heart disease and stroke events were ascertained over 9 years. RESULTS: The sensitivity for incident CVD events was higher and the specificity lower for the empirically derived versus the Adult Treatment Panel (ATP) III, International Diabetes Federation (IDF), or Harmonized metabolic syndrome definitions (sensitivity/specificity 0.65/0.53 vs. 0.53/0.63, 0.51/0.66, and 0.64/0.56, respectively), resulting in no overall improvement in discrimination. Multivariable-adjusted hazard ratios for incident CVD events were similar across definitions and were 1.7 (95% CI 1.6-1.9) for ATP III, 1.8 (1.6-2.0) for IDF, 1.9 (1.7-2.0) for Harmonized, and 1.7 (1.6-1.9) for the empirically derived definition. CONCLUSIONS: Empirical derivation of the metabolic syndrome definition did not improve CVD discrimination or risk prediction.