The Influence Of Metabolic Syndrome Score On Prediction To Cardiovascular Disease And Type 2 Diabetes Mellitus

Objective: This study was used to compare the abilities with three kinds of metabolic syndromes (MS) diagnostic criteria to forecast Cardiovascular Disease (CVD) and the Type 2 Diabetes Mellitus (T2DM). And it was used to generate a practicable diagnosis score for MS, aimed at predicting CVD and T2DM by giving appropriate weight to the individual components of MS. It also compared MS score with MS'diagnostic criteria and Framingham risk score (FRS) as predictors of CVD and T2DM.Method:1. Participants (male 1451, female 2147) were recruited from the Prevention of multiple metabolic disorders and MS in JiangSu province, which have been followed-up for at least five years. The criteria proposed by Adult Treatment Panel III of National Cholesterol Education Program (NECP-ATPâ…¢), International Diabetes Foundation(IDF) and Chinese Diabetes Suggestion(CDS) were used to define the MS. The COX regression and Receiver Operation Characteristic (ROC) curve were conducted to compare the predictive ability of MS'diagnostic criteria for CVD and T2DM.2. MS and its components were stratified and entered into COX proportional hazard model. The percentage of each components'regression coefficient were carried on the weight of MS score.3. We used Receiver Operation Curve(ROC) and COX regression to analysis the MS score vs NECP-ATPâ…¢and the MS score vs FRS as predictors of CVD and T2DM.Result:1.After adjusted general risk factors, compared the predictive ability of three MS criteria, diagnosis of CDS to forecast CVD (aRR=3.26,95%CI:2.02~5.25) and T2DM (aRR=4.03,95%CI:2.77~5.84) was more superior. However, the Youden index(CVD:0.25,T2DM:0.26) and AUC(CVD:0.63,T2DM:0.63) of NECP-ATPIII for predicting CVD and T2DM were beyond diagnosis of CDS and IDF.2.With the increase of MS score, the incidence of CVD and T2DM also increased.3.Using analysis of ROC to find the best reasonable cut-off point of MS score for CVD and T2DM, We found that the best diagnostic of the individual point of diagnosis of CVD and the incidence of T2DM was significantly higher than NECP-ATPâ…¢diagnostic criteria. (CVD: 4.83% vs 0.28%, p<0.05;T2DM:7.68% vs 1.69%, p<0.05).4.Compared the predictive ability of MS score with NECP-ATPâ…¢criteria, MS score was a better predictor for CVD and T2DM(the AUC for CVD:0.80 vs 0.60,p <0.05, the AUC for T2DM: 0.74 vs 0.63,p <0.05).5.Using ROC to compare MS score with FRS score for predicting CVD and T2DM, for CVD, there was no difference of AUC between MS score and FRS score (0.80 vs 0.79,p>0.05).Nevertheless, for T2DM, the AUC of MS score was larger than FRS score (0.74 vs 0.61,p <0.05).Conclusion: The relationships between MS'components with CVD and T2DM were different. Diagnosis of ATPIII was more suitable for Chinese people diagnosed MS than IDF and CDS. After applied the MS score in place of MS, with the increase of individual MS score, the incidences of CVD and T2DM were increased obviously. The ability of MS score for predicting CVD was closed to FRS score, however, MS score was more superior than FRS scoe in predicting T2DM.