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Revised method in calculating CHD, diabetes risk may lead to increased accuracy
An updated method in calculating risk for the development of CHD and diabetes may aid in more accurate predictions, according to findings published in the Journal of the American College of Cardiology.
“The hope is that a scoring system like this could be incorporated in the electronic medical record to calculate someone’s risk and that information could be provided both to the physician, who then realizes there is an elevated risk, and to the patient, who hopefully can start taking some preventive steps,” Mark D. DeBoer, MD, MSc, MCR, associate professor of pediatrics at the University of Virginia School of Medicine’s Center for Diabetes Technology in Charlottesville, said in a press release.
The online metabolic syndrome calculator added sex, race and ethnicity data to the traditional metabolic syndrome components, including BP, waist circumference, low HDL, fasting triglycerides and fasting glucose. It also confronted statistical limitations that were seen in Adult Treatment Panel III. The metabolic syndrome severity score that is produced using the new calculator allows physicians to follow their patients’ metabolic syndrome severity progressively.
Researchers analyzed CHD outcomes from patients in two different studies: black and white patients from the Atherosclerosis Risk in Communities study (n = 11,004; mean age, 54 years; maximum follow-up, 24 years) and black patients from the Jackson Heart Study (n = 2,137; mean age, 49 years; maximum follow-up, 11 years). The risk for CHD and diabetes was calculated using the Adult Treatment Panel III criteria and the metabolic syndrome severity calculator.
Adult Treatment Panel III metabolic classification was significantly associated with patients with future CHD (HR = 1.64; 95% CI, 1.49-1.8). Researchers noted an interaction between men (HR = 1.37) and women (HR = 2.09) and Adult Treatment Panel III metabolic classification.
Once adjusted for each metabolic syndrome component, there was no evidence of a link between Adult Treatment Panel III and future CHD (HR = 0.87; 95% CI, 0.73-1.05). The metabolic syndrome severity z score was associated with future CHD both with and without adjustments (P < .01).
Those within the 75th percentile or higher for baseline metabolic syndrome had a 25-year CHD rate of 24.9% using the metabolic syndrome severity score vs. 6.5% in the lowest percentiles, according to the researchers. Significant race or sex interactions were not seen.
“Although [metabolic syndrome] has been criticized as not being worth more than the sum of its individual parts, these data demonstrate that a continuous estimate of [metabolic syndrome] severity provided additional predictive ability for future CHD beyond the individual [metabolic syndrome] components,” DeBoer and colleagues wrote. – by Darlene Dobkowski
Disclosure: The researchers report no relevant financial disclosures.