Diabetes Metab J.  2021 Jul;45(4):569-577. 10.4093/dmj.2020.0103.

Metabolic Syndrome Severity Score for Predicting Cardiovascular Events: A Nationwide Population-Based Study from Korea

• Jang YN
• Lee JH
• Moon JS
• Kang DR
• Park SY
• Cho J
• Kim JY
• Huh JH

• KMID: 2518899
• DOI: http://doi.org/10.4093/dmj.2020.0103

Abstract

Background
Recently, a metabolic syndrome severity score (MS score) using a dataset of the Korea National Health and Nutrition Examination Surveys has been developed. We aimed to determine whether the newly developed score is a significant predictor of cardiovascular (CV) events among the Korean population.
Methods
From the Korean National Health Insurance System, 2,541,364 (aged 40 to 59 years) subjects with no history of CV events (ischemic stroke or myocardial infarction [MI]), who underwent health examinations from 2009 to 2011 and were followed up until 2014 to 2017, were identified. Cox proportional hazard model was employed to investigate the association between MS score and CV events. Model performance of MS score for predicting CV events was compared to that of conventional metabolic syndrome diagnostic criteria (Adult Treatment Program III [ATP-III]) using the Akaike information criterion and the area under the receiver operating characteristic curve.
Results
Over a median follow-up of 6 years, 15,762 cases of CV events were reported. MS score at baseline showed a linear association with incident CV events. In the multivariable-adjusted model, the hazard ratios (95% confidence intervals) comparing the highest versus lowest quartiles of MS score were 1.48 (1.36 to 1.60) for MI and 1.89 (1.74 to 2.05) for stroke. Model fitness and performance of the MS score in predicting CV events were superior to those of ATP-III.
Conclusion
The newly developed age- and sex-specific continuous MS score for the Korean population is an independent predictor of ischemic stroke and MI in Korean middle-aged adults even after adjusting for confounding factors.

Keyword

Cardiovascular diseases; Metabolic syndrome; Myocardial infarction; Stroke

Figure

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  Fig. 1. Incidence rates, hazard ratios (HRs), and 95% confidence intervals (CIs) of (A) cardiovascular (CV) events (myocardial infarction or ischemic stroke), (B) myocardial infarction, and (C) ischemic stroke by deciles of age, sex-specific metabolic syndrome (MS) severity score. Adjusted for age, body mass index, current smoking, heavy alcohol consumption, regular exercise, income, presence of hypertension, diabetes, medication for dyslipidemia, and total cholesterol.

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