Development of a metabolic syndrome severity score and its association with incident diabetes in an Asian population-results from a longitudinal cohort in Singapore

Sex difference in the relationship between 24-h sodium-potassium ratio and prevalence of metabolic syndromes: a cross-sectional study

Maintaining a balanced ratio between sodium and potassium intake is one of the most important dietary and lifestyle factors in the development of metabolic syndrome (MetS), but available evidence is still limited, particularly when using urine samples to estimate this ratio. We aim to evaluate the associations between the 24-h urinary sodium-potassium ratio (24hUNa/KE) and MetS risk through a large health check-up program in China. This cross-sectional study analyzed health check-up data from 59,292 participants at the Third Xiangya Hospital's Department of Health Management in Changsha, China, from 2018 to 2021. Each participant gave one fasting urine sample to analyze sodium, potassium, and creatinine levels during the check-up. The Kawasaki formula estimated 24-h urinary sodium (24hUNaE) and potassium excretion (24hUKE), with the 24hUNa/KE ratio calculated by dividing 24hUNaE by 24hUKE. The prevalence of MetS was found to be 19.27%. Notably, the overall MetS prevalence was higher in men (28.08%) than in women (7.83%). In women, MetS prevalence increased from 6.35 to 10.30% across the lowest to highest 24hUNa/KE quartiles. A significant increase in MetS prevalence was associated with each standard deviation increase in 24hUNa/KE (adjusted odds ratio [AOR], 1.03; 95% confidence interval [CI] 1.01-1.06), particularly for central obesity (AOR, 1.04; 95% CI 1.02-1.06) and elevated blood pressure (AOR, 1.20; 95% CI 1.17-1.22). In women, a one standard deviation increase in the 24hUNa/KE ratio raised the risk of MetS by 9% (AOR, 1.09; 95% CI 1.05-1.14), but no significant link was found in men. A strong positive link exists between 24hUNa/KE and MetS and its components, especially central obesity and high blood pressure, with a more significant effect in women.

Metabolic syndrome severity score and long-term cardiovascular outcomes in patients with myocardial infarction with nonobstructive coronary arteries

BACKGROUND AND AIM

Metabolic syndrome (MetS) is a cluster of metabolic disorders that promotes the risk of cardiovascular diseases. Beyond the dichotomous criteria of MetS, a continuous MetS scoring model enables the quantification of MetS severity and performs well in risk prediction. However, the impact of MetS score in myocardial infarction with nonobstructive coronary arteries (MINOCA) remains unclear. We aim to clarify the implications of MetS and its severity in a Chinese cohort of MINOCA.

METHODS AND RESULTS

A total of 1179 MINOCA patients were enrolled with a median follow-up of 41.7 months. An age-sex-ethnicity-specific MetS scoring model tailored to the Chinese adults was used to assess the MetS severity. The primary endpoint was a composite of major adverse cardiovascular events (MACE) including all-cause death, nonfatal MI, stroke, revascularization, and hospitalization for unstable angina or heart failure. Nearly a quarter of patients had MetS and they had worse outcomes after MINOCA. At multivariate Cox model, a higher MetS score was significantly associated with an increased risk of MACE (adjusted HR 2.00, 95 % CI: 1.47-2.74, p < 0.001). Restricted cubic splines analysis showed a non-linear relationship between the MetS score and event risk. At receiver-operating characteristic curves, the MetS score outperformed the binary defined MetS in predicting MACE and yielded a more accurate prognostic value in MINOCA.

CONCLUSIONS

The MetS severity score was an independent predictor of adverse events after MINOCA and thus may serve as a valuable tool for risk stratification, providing a rationale for the MetS score-guided interventions in MINOCA population.

Association between Metabolic Syndrome Score and Subclinical Atherosclerosis

Background

Previous studies have presented conflicting results on the correlation between metabolic syndrome (MetS) and subclinical atherosclerosis. However, the binary MetS definition cannot reflect the severity of metabolic disorders continuously and dynamically. The present study calculated the MetS score and explored the association between MetS score and subclinical atherosclerosis.

Methods

A total of 840 participants were included in this observational, cross-sectional study; 66.55% of participants were men, and the median age was 61.00 years (53.00, 67.00). Brachial-ankle pulse wave velocity (baPWV) and brachial flow-mediated dilation (bFMD) values were measured from October 2016 to January 2020. Spearman's correlation and multiple linear regression analyses were conducted to explore the correlation between the MetS score and baPWV and bFMD. Arterial stiffness was defined as baPWV ≥1400 cm/s, while endothelial dysfunction was described as bFMD >6%. Multiple logistic regression was performed to explore the effects of MetS and MetS score on arterial stiffness and endothelial dysfunction.

Results

The MetS score was significantly associated with baPWV (β = 73.59, 95% CI (42.70, 104.48); p < 0.001) and bFMD (β = -0.43, 95% CI (-0.75, -0.10); p = 0.010) after adjusting for covariates. Compared with the binary definition of MetS, the MetS score was a more significant predictor for arterial stiffness (odds ratio, OR = 2.63, 95% CI (1.85, 3.74); p < 0.001) and endothelial dysfunction (OR = 1.33, 95% CI (1.01, 1.76); p = 0.040). Leukocyte count (r = 0.32; p < 0.001) and high-sensitivity C-reactive protein (hs-CRP) (r = 0.17; p < 0.001) values were related to the MetS score.

Conclusions

The MetS score is a clinically accessible assessment of metabolic status that can identify individuals at higher risk of subclinical atherosclerosis.

Independent association of metabolic syndrome severity score and risk of diabetes: findings from 18 years of follow-up in the Tehran Lipid and Glucose Study

OBJECTIVES

This study aimed to investigate the association between age-specific and sex-specific continuous metabolic syndrome severity score (cMetS-S) and the risk of developing type 2 diabetes mellitus (T2DM). Additionally, the study aimed to assess the added value of cMetS-S in predicting T2DM compared with traditional MetS criteria.

DESIGN

The study used a longitudinal cohort design, following participants for 18 years.

SETTING

The research was conducted within the Tehran Lipid and Glucose Study, a community-based study in Tehran, Iran.

PARTICIPANTS

A total of 6957 participants aged 20-60 years were included in the study.

INTERVENTIONS/EXPOSURES

The cMetS-S of each participant was determined using age-specific and sex-specific equations and Cox proportional hazard regression models were used to analyse the association between cMetS-S and T2DM using continuous and quantile approaches.

PRIMARY AND SECONDARY OUTCOME MEASURES

The outcome measure was the association between cMetS-S and the development of T2DM during the 18-year follow-up.

RESULTS

A total of 1124 T2DM cases were recorded over 18 years of follow-up. In the fully adjusted model, a 1-SD increase in the cMetS-S was associated with future T2DM (HR 1.72; 95% CI 1.54 to 1.91). Men and women had HRs of 1.65 (95% CI 1.40 to 1.95) and 1.83 (95% CI 1.59 to 2.10) for T2DM per 1-SD increase in cMetS-S, respectively. Higher cMetS-S was associated with increased risk of diabetes in both prediabetic (HR 1.42;95% CI 1.23 to 1.64) and normoglycaemic individuals (HR 2.11;95% CI 1.76 to 2.54); this association was more significant in normoglycaemic individuals. Unlike the traditional-based MetS definitions, the cMetS-S improved diabetes prediction (p<0.001).

CONCLUSIONS

The cMetS-S is strongly associated with future diabetes in prediabetic and normoglycaemic individuals independent of MetS components during a long term. As the relationship between cMetS-S and T2DM is more pronounced in normoglycaemic individuals than in those with pre-diabetes, implementing the evaluation of cMetS-S can serve as an early identification tool for individuals at risk of T2DM prior to the onset of pre-diabetes.

Association of metabolic syndrome severity with frailty progression among Chinese middle and old-aged adults: a longitudinal study

BACKGROUND

The binary diagnosis of Metabolic Syndrome(MetS) fails to accurately evaluate its severity, and the association between MetS severity and frailty progression remains inadequately elucidated. This study aims to clarify the relationship between the severity of MetS and the progression of frailty among the middle-aged and elderly population in China.

METHOD

Participants from the 2011-2018 China Health and Retirement Longitudinal Study(CHARLS) were included for a longitudinal analysis. The study employs a frailty index(FI) based on 32 health deficits to diagnose frailty and to assess FI trajectories. An age-sex-ethnicity-specific MetS scoring model (MetS score) was used to assess metabolic syndrome severity in Chinese adults. The Cumulative MetS score from 2012 to 2015 was calculated using the formula: (MetS score in wave 1 + MetS score in wave 3) / 2 × time(2015 - 2012). The association between MetS score, Cumulative MetS score, and the risk and trajectory of frailty were evaluated using Cox regression/logistic regression, and linear mixed models. Restricted Cubic Splines(RCS) models were utilized to detect potential non-linear associations.

RESULTS

A higher MetS score was significantly associated with an increased risk of frailty(HR per 1 SD increase = 1.205; 95%CI: 1.14 to 1.273) and an accelerated FI trajectory(β per 1 SD increase = 0.113 per year; 95%CI: 0.075 to 0.15 per year). Evaluating changes in MetS score using a Cumulative MetS score indicated that each 1 SD increase in the Cumulative MetS score increased the risk of frailty by 22.2%(OR = 1.222; 95%CI: 1.133 to 1.319) and accelerated the rate of increase in FI(β = 0.098 per year; 95%CI: 0.058 to 0.138 per year). RCS model results demonstrated a dose-response curve relationship between MetS score and Cumulative MetS score with frailty risk. Stratified analysis showed consistency across subgroups. The interaction results indicate that in males and individuals under aged 60, MetS score may accelerate the increase in FI, a finding consistent across both models.

CONCLUSIONS

Our findings underscore the positive correlation between the severity of MetS and frailty progression in the middle-aged and elderly, highlighting the urgent need for early identification of MetS and targeted interventions to reduce the risk of frailty.

[Study of the metabolic syndrome severity index as a predictive factor of a major cardiovascular event in premenopausal women with systemic lupus erythematosus]

BACKGROUND

Patients with systemic lupus erythematosus (SLE) have an increased risk of metabolic syndrome (MS) and cardiovascular (CV) disease. MS is evaluated binary, limiting the understanding of each component's severity individually. Therefore, severity scores for MS that evaluate them separately have been developed. This study aims to determine the prognosis between MS severity and the occurrence of major adverse cardiovascular events (MACE) in SLE patients.

METHODS

Ten-year follow-up cohort study. Premenopausal>18-year-old women with a previous diagnosis of SLE were included. Patients with recent CV events, pregnancy, thyroid disease, and liposuction were excluded. The variables of interest were CV events; the confounding variables, and the MS severity indexes were examined. Hazard ratios and Kaplan-Meier survival curves were estimated through Cox regression.

RESULTS

A total of 238 women were analyzed: 22 presented MACE, and 216 did not. MS prevalence, measured according to consensus and ATP-III criteria, was higher in MACE patients (50 and 40,95%, respectively). The MetSx-IMC severity index was higher within the MACE group. Cox analysis showed an increase in the MetSx-IMC associated with the risk of suffering MACE in a 1.107 ratio.

CONCLUSIONS

The MetSx-IMC severity index, contrary to the binary approaches, is recommended to evaluate MS as a predictor of MACE in SLE patients. Offering improved and more accurate prognosis in patients at risk of developing MCE.

Association between metabolic syndrome severity score and cardiovascular disease: results from a longitudinal cohort study on Chinese adults

Objective

This study aimed to quantify the severity of metabolic syndrome(MetS) and investigate its association with cardiovascular disease(CVD) risk on Chinese adults.

Methods

13,500 participants from the Zhejiang Adult Chronic Disease Study were followed up between 2010 and 2021. A continuous MetS severity score derived from the five components of MetS was used to quantify MetS severity, and the association between MetS severity and the risk of incident CVD was assessed using Cox proportional hazard and restricted cubic spline regression.

Results

Both the presence and severity of MetS were strongly associated with CVD risk. MetS was related to an increased risk of CVD (hazard ratio(HR):1.700, 95% confidence interval(CI): 1.380-2.094). Compared with the hazard ratio for CVD in the lowest quartile of the MetS severity score, that in the second, third, and highest quartiles were 1.812 (1.329-2.470), 1.746 (1.265-2.410), and 2.817 (2.015-3.938), respectively. A linear and positive dose-response relationship was observed between the MetS severity and CVD risk (P for non-linearity = 0.437). Similar results were found in various sensitivity analyses.

Conclusion

The MetS severity score was significantly associated with CVD risk. Assessing MetS severity and further ensuring intervention measures according to the different severities of MetS may be more useful in preventing CVD.

Development and validation of an age-sex-ethnicity-specific metabolic syndrome score in the Chinese adults

Metabolic syndrome (MetS) is characterized by metabolic dysfunctions and could predict future risk for cardiovascular diseases (CVDs). However, the traditionally defined dichotomous MetS neither reflected MetS severity nor considered demographic variations. Here we develop a continuous, age-sex-ethnicity-specific MetS score based on continuous measures of the five metabolic dysfunctions (waist circumference [WC], triglycerides [TG], high-density lipoprotein cholesterol [HDL-C], mean arterial pressure [MAP], and fasting blood glucose [FBG]). We find that the weights of metabolic dysfunctions in the score vary across age-sex-ethnicity-specific subgroups, with higher weights for TG, HDL-C, and WC. Each unit increase in the score is associated with increased risks for hyperlipidemia, diabetes, and hypertension, and elevated levels of HbA1c, cholesterol, body mass index, and serum uric acid. The score shows high sensitivity and accuracy for detecting CVD-related risk factors and is validated in different geographical regions. Our study would advance early identification of CVD risks and, more broadly, preventive medicine and sustainable development goals.

Trajectory patterns of metabolic syndrome severity score and risk of type 2 diabetes

BACKGROUND

The available evidence indicates that the severity of metabolic syndrome tends to worsen progressively over time. We assessed the trajectory of age and sex-specific continuous MetS severity score (cMetS-S) and its association with the development of diabetes during an 18-year follow-up.

METHODS

In a prospective population-based Tehran Lipid and Glucose Study, 3931 eligible participants free of diabetes, aged 20-60 years, were followed at three-year intervals. We examined the trajectories of cMetS-S over nine years using latent growth mixture modeling (LGMM) and subsequent risks of incident diabetes eight years later. The prospective association of identified trajectories with diabetes was examined using the Cox proportional hazard model adjusting for age, sex, education, and family history of diabetes, physical activity, obesity (BMI ≥ 30 kg/m2), antihypertensive and lipid-lowering medication, and baseline fasting plasma glucose in a stepwise manner.

RESULTS

Among 3931 participants, three cMetS-S trajectory groups of low (24.1%), medium (46.8%), and high (29.1%) were identified during the exposure period. Participants in the medium and high cMetS-S trajectory classes had HRs of 2.44 (95% CI: 1.56-3.81) and 6.81 (95% CI: 4.07-10.01) for future diabetes in fully adjusted models, respectively. Normoglycemic individuals within the high cMetS-S class had an over seven-fold increased risk of diabetes (HR: 7.12; 95% CI: 6.05-12.52).

CONCLUSION

Although most adults exhibit an unhealthy metabolic score, its severity usually remains stable throughout adulthood over ten years of follow-up. The severity score of metabolic syndrome has the potential to be utilized as a comprehensive and easily measurable indicator of cardiometabolic dysfunction. It can be employed in clinical settings to detect and track individuals at a heightened risk of developing T2DM, even if their glucose levels are normal.

Development and validation of a continuous metabolic syndrome severity score in the Tehran Lipid and Glucose Study

Metabolic syndrome (MetS), defined as the coexistence of interrelated cardiometabolic risk factors, is limited by ignoring the severity of the disease and individuals with a pre-metabolic state. We aimed to develop the first age- and sex-specific continuous MetS severity score in the adult population using confirmatory factor analysis (CFA) based on the MetS components in the Middle East. Using data from the population-based Tehran Lipid and Glucose Study (TLGS) I and II datasets, we conducted CFA of the single factor MetS on 8933 adults (20-60 years old) totally, and in age and sex subgroups. We allowed for different factor loadings across the subgroups to formulate age- and sex-specific continuous MetS severity score equations. Thereafter, we validated these equations in the dataset of TLGS III participants. Triglyceride had the highest factor loading across age and sex subgroups, indicating the most correlation with MetS. Except for women aged 40-60 years, waist circumference was the second most significant factor contributing to MetS. Systolic blood pressure was more closely related to MetS in women than in men. Systolic blood pressure and fasting plasma glucose had the weakest correlation with MetS among the 40-60 age group. Moreover, as women age, the contribution of fasting plasma glucose to MetS tended to decline, while it remained relatively constant in men. The resulting MetS severity score was correlated with age and homeostasis model assessment of insulin resistance. Furthermore, the continuous MetS severity score well predicted the traditional MetS according to receiver operating characteristic analysis in the validation dataset. The age- and sex-specific continuous MetS severity score for the West Asian adult population provides a tangible quantitative measure of MetS enabling clinicians to screen and monitor the individuals at risk and assess their metabolic trends.

Metabolic syndrome severity score in the middle-aged and elderly Iranian population: A cross-sectional survey of Bandare-Kong Cohort Study (the findings of PERSIAN Cohort Study)

Background

Metabolic syndrome (MetS) is defined as the presence of several metabolic risk factors. The traditional MetS criteria have been considered insufficient for evaluating individuals at risk. MetS has always been categorized using binary criteria, which deny that the risk associated with MetS is likely to exist as a continuum. Also, MetS may present differently depending on age, sex, race, or ethnicity. We aimed to derive age-sex-specific equations for MetS severity scores within a southern Iranian population.

Methods

This study used first-phase data from the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort Study as part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN). After exclusion of the pregnant women, diabetic patients, and individuals taking antihypertensive, antihyperlipidemic, and antidiabetic medications, 2,735 individuals aged 35 to 70 years were selected for analysis. The diagnosis of MetS was based on the National Cholesterol Education Program (NCEP) criteria for the Iranian population. Confirmatory factor analysis (CFA) was performed to formulate MetS severity scores. The receiver operating characteristic (ROC) analysis was performed to validate MetS severity score equations for age-sex-specific categories.

Results

Triglyceride had the highest factor loading range in all age-sex categories for determining the MetS severity score. Conversely, systolic blood pressure and fasting plasma glucose (FPG) exhibited the lowest factor loadings across all age-sex groups. In both sexes, when age was considered, systolic blood pressure and FPG factor loadings were less significant among subjects aged ≥45 and 35-44 years, respectively.

Conclusion

MetS severity scores might be more applicable than the current criteria of MetS. Prospective population-based studies should be conducted to assess the accuracy and validity of the MetS severity score for predicting cardiometabolic diseases.

The bidirectional relationship between metabolic syndrome and hyperuricemia in China: A longitudinal study from CHARLS

OBJECTIVE

It has been reported that metabolic syndrome (MetS) has been associated with hyperuricemia. However, current findings have been inconclusive regarding the direction of this association. The objective of this study was to clarify the possible directional relationship between hyperuricemia and MetS.

DESIGN

This study used two waves of data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015 (N = 6,253, aged ≥40 years). Logistic regression and cross-lagged panel design were performed to evaluate the bidirectional association between uric acid with MetS. MetS score is defined as the number of MetS components present.

RESULTS

New-onset hyperuricemia and MetS were observed in a four-year follow-up study among 719 and 625 participants, respectively. A positive association was observed in the adjusted logistical regression model between baseline MetS score and new-onset hyperuricemia (P for trend <0.001), and also between baseline serum uric acid (SUA) and new-onset MetS (P for trend <0.001). Cross-lagged panel analysis indicated MetS score positively and prospectively predicted SUA, but not vice versa. After stratification by sex, we observed a strong, bidirectional relationship between MetS score and SUA indicating that diagnosis in one illness increased the risk of the other, both men and women. Moreover, this study also found that systolic blood pressure (P < 0.001) and triglycerides (P < 0.001) had a bidirectional relationship with SUA.

CONCLUSIONS

The results of this study indicated a bidirectional relationship between MetS and hyperuricemia.

Mediation role of body fat distribution (FD) on the relationship between CAV1 rs3807992 polymorphism and metabolic syndrome in overweight and obese women

BACKGROUND

Metabolic syndrome (MetS) is associated with an increased risk of morbidity and mortality in almost all chronic diseases. The most frequent methods for the calculation of a continuous MetS (cMetS) score have used the standardized residuals in linear regression (z-score). Recently, emerging data suggest that one of the main genetic targets is the CAV1, which plays a crucial role in regulating body fat distribution. This study is designed to investigate the relationship between CAV1 rs3807992 genotypes and cMetS, and to determine whether body fat distribution plays a mediating role in this regard.

METHODS

The current cross-sectional study was conducted on 386 overweight and obese females. The CAV1 rs3807992 and body composition were measured by the PCR-RFLP method and bioelectrical impedance analysis, respectively. Serum profile of HDL-C, TGs, FPG, and Insulin were measured by standard protocols.

RESULTS

GG allele carriers had significantly lowered Z-MAP (p = 0.02), total cMetS (p = 0.03) and higher Z-HDL (p = 0.001) compared with (A) allele carriers. There was a significant specific indirect effect (standardized coefficient = 0.19; 95% CI 0.01-0.4) of Visceral fat level (VFL). Although, total body fat was significantly associated with CAV1 rs3807992 and cMetS, the specific indirect effect was not significant (standardized coefficient = 0.21; 95% CI - 0.006, 0.44). VFL contributed to significant indirect effects of 35% on the relationship between CAV1 and cMetS.

CONCLUSION

Higher visceral adipose tissue may affect the relationship between CAV1 and cMetS. Although CAV1 rs3807992 is linked to VFL in our study, the influence of this polymorphism on MetS is not via total fat.

Effects of Exercise Intervention on Mitochondrial Stress Biomarkers in Metabolic Syndrome Patients: A Randomized Controlled Trial

Metabolic syndrome (MetS) pathogenesis involves oxidative stress associated with mitochondrial dysfunction, which triggers integrated stress responses via various compensatory metabolic modulators like mitokines and hepatokines. However, the regulatory mechanisms underlying the exercise-derived benefits with respect to mitokines and hepatokines (potential MetS biomarkers) are unknown. Thus, we investigated the effects of exercise training on MetS biomarkers and their associations with clinical parameters. In this single-center trial, 30 women with MetS were randomly assigned to 12-week supervised exercise or control groups (1:1) and compared with 12 age-matched healthy volunteers. All participants completed the study except one subject in the control group. Expectedly, serum levels of the mitokines, fibroblast growth factor-21 (FGF21), growth differentiation factor-15 (GDF15), and the hepatokine, angiopoietin-like 6 (ANGPTL6), were higher in MetS patients than in healthy volunteers. Moreover, their levels were markedly attenuated in the exercise group. Further, exercise-mediated changes in serum FGF21 and GDF15 correlated with changes in the homeostasis model of assessment of insulin resistance (HOMA-IR) and appendicular lean mass (ALM), respectively. Additionally, changes in serum triglycerides and ANGPTL6 were correlated with changes in leptin. Aberrant mitokine and hepatokine levels can be rectified by relieving metabolic stress burden. Therefore, exercise training may reduce the need for the compensatory upregulation of MetS metabolic modulators by improving gluco-lipid metabolism.

Predicting Long-Term Absence of Coronary Artery Calcium in Metabolic Syndrome and Diabetes: The MESA Study

OBJECTIVES

The purpose of this study was to identify predictors of healthy arterial aging (long-term coronary artery calcification [CAC] of 0) among individuals with metabolic syndrome (MetS) or type 2 diabetes (T2D), which may improve primary prevention strategies.

BACKGROUND

Individuals with MetS or T2D have a heterogeneously increased risk of atherosclerotic cardiovascular disease and not all have a high-intermediate risk.

METHODS

We included 574 participants from the MESA (Multi-Ethnic Study of Atherosclerosis) with MetS or T2D who had CAC=0 at baseline and a repeat CAC scan 10 years later. Multivariable logistic regression assessed the association of traditional and novel atherosclerotic cardiovascular disease risk factors and the MetS severity score (based on the 5 MetS criteria) with healthy arterial aging.

RESULTS

The mean age of participants was 58.9 years, 67% were women, 422 participants had MetS, and 152 had T2D. The proportion with long-term CAC=0 was similar for MetS (42%) and T2D (44%). A younger age was the only individual low/normal traditional risk factor associated with an increased likelihood of long-term CAC=0 (odds ratio [OR]: 1.50; 95% confidence interval [CI]: 1.22 to 1.85 per 10-years younger). The strongest associations of nontraditional risk factors were observed for an absence of thoracic calcification (OR: 2.42; 95% CI: 1.24 to 4.72), absence of carotid plaque (OR: 1.81; 95% CI: 1.25 to 2.61), and among persons with a high sensitivity troponin <3 ng/ml (OR: 1.55; 95% CI: 1.01 to 2.38). In addition, persons with the lowest quartile MetS severity score had a substantially higher odds of healthy long-term CAC=0 (OR: 2.71; 95% CI: 1.27 to 5.76).

CONCLUSIONS

More than 40% of adults with MetS or T2D and baseline CAC=0 had long-term absence of CAC, which was most strongly associated with an absence of extracoronary atherosclerosis and a low MetS score. An optimal overall cardiovascular profile appears to be more important than an ideal value of any individual risk factor to maintain healthy arterial aging.

Development and internal validation of risk prediction model of metabolic syndrome in oil workers

Background

The prevalence of metabolic syndrome continues to rise sharply worldwide, seriously threatening people’s health. The optimal model can be used to identify people at high risk of metabolic syndrome as early as possible, to predict their risk, and to persuade them to change their adverse lifestyle so as to slow down and reduce the incidence of metabolic syndrome.

Methods

Design existing circumstances research. A total of 1468 workers from an oil company who participated in occupational health physical examination from April 2017 to October 2018 were included in this study. We established the Logistic regression model, the random forest model and the convolutional neural network model, and compared the prediction performance of the models according to the F1 score, sensitivity, accuracy and other indicators of the three models.

Results

The results showed that the accuracy of the three models was 82.49,95.98 and 92.03%, the sensitivity was 87.94,95.52 and 90.59%, the specificity was 74.54, 96.65 and 94.14%, the F1 score was 0.86,0.97 and 0.93, and the area under ROC curve was 0.88,0.96 and 0.92, respectively. The Brier score of the three models was 0.15, 0.08 and 0.12, Observed-expected ratio was 0.83, 0.97 and 1.13, and the Integrated Calibration Index was 0.075,0.073 and 0.074, respectively, and explained how the random forest model was used for individual disease risk score.

Conclusions

The study showed that the prediction performance of random forest model is better than other models, and the model has higher application value, which can better predict the risk of metabolic syndrome in oil workers, and provide corresponding theoretical basis for the health management of oil workers.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-09921-w.

Occupational Assessments of Risk Factors for Cardiovascular Diseases in Labors: An Application of Metabolic Syndrome Scoring Index

Unlike a traditional diagnosis of metabolic syndrome (MS), a numerical MS index can present individual fluctuations of health status over time. This study aimed to explore its value in the application of occupational health. Using a database of physiological and biochemical tests and questionnaires, data were collected from 7232 participants aged 20 to 64 years who received occupational health screenings at a health screening institution in 2018. Using confirmatory factor analysis, five components of MS were used to design an MS severity scoring index, which was then used to evaluate the risks of occupation factors. Waist circumference was the largest loading factor compared with the other MS components. Participants who worked in the traditional industrial, food processing, or electronic technology industries had higher MS severity than those in the logistics industry. Those who worked as a manager or over five years had a relatively high severity. The research showed that assessments based on an MS severity score are applicable when the risk factors of suboptimal health are involved. By monitoring the scores over time, healthcare professionals can propose preventive strategies in time, thus enhancing the effectiveness of occupational health examination services.

An Application of Metabolic Syndrome Severity Scores in the Lifestyle Risk Assessment of Taiwanese Adults

A metabolic syndrome (MS) diagnosis was made when the criteria for three or more of five MS components were met. Due to some limitations in the traditional MS criteria, however, different health care societies have sought to develop applicable MS scoring systems instead. Continuous MS scores can be of meaningful value in the prevention, diagnosis, and treatment of MS at different life stages. Relatedly, this study used a database for 27,748 subjects aged 20 to 64 years who received health checks at a health screening institution in Taiwan from 2010 to 2015 to a similar end. Five components of MS (waist circumference, fasting plasma glucose, blood pressure, fasting triglycerides, and high-density lipoprotein) were used to formulate an MS severity score in different gender and age stratums, which was then used to evaluate the risks of various lifestyle habits. Those estimates were then compared with the results for traditional MS diagnosis. The MS severity scores for some behaviors relating to smoking, drinking, physical activity, and sweetened beverage consumption were found to have changed from 0.03 to 0.2; however, a logistic regression analysis with dichotomous diagnosis did not indicate significant links between these behaviors and MS. The models established by the MS severity scores can identify the risk factors for MS in a more sensitive manner than the traditional MS diagnosis can, especially with respect to specific lifestyle habits. MS severity score can serve as an indicator to explore the potential risk factors for subclinical conditions in the early stages of MS.