Abstract P185: Metabolic Syndrome and Cardiovascular Risk - A Comparative Analysis of Waist-Cricumference and Waist-Height-Ratio for Predictive Accuracy

Autor: Sandip K Zalawadiya, Vikas Veeranna, Ashutosh Niraj, Jyotiranjan Pradhan, Sony Jacob, Luis Afonso
Rok vydání: 2011
Předmět:
Zdroj: Circulation: Cardiovascular Quality and Outcomes. 4
ISSN: 1941-7705
1941-7713
DOI: 10.1161/circoutcomes.4.suppl_1.ap185
Popis: Introduction: Metabolic syndrome (MS) is an adverse predictor of cardiovascular outcomes. Recently, waist height ratio (WHtR) is shown to correlate better with future cardiovascular risk factors than other anthropometric measures. We sought to determine whether replacing waist circumference (WC) with WHtR in metabolic syndrome diagnostic criteria per National Cholesterol Education Program (NCEP) guidelines improves predictive accuracy for future cardiovascular disease (CVD) events. Methods: The study cohort consisted of prospectively evaluated 6,702 healthy adults aged 45-84 years enrolled in the Multi-Ethnic Study of Atherosclerosis [MESA] study [Age-: 62±10 years, 47% males, 1473 Hispanics, 2575 Caucasians, 799 Chinese and 1855 African Americans]. Metabolic syndrome (MSwc), at baseline, was defined by NCEP guidelines (n=2,208). Metabolic syndrome (MSwhtr) was redefined using WHtR (≥ 0.5 in both male and females) in place of WC, keeping rest of the components constant as recommended by NCEP (n=2,590). CVD events were defined as All CVD (CVDa) per MESA protocol (See Table ). Unadjusted and adjusted Cox-proportional hazard analysis was performed. Harrell's C-statistics were calculated for the most adjusted models. Results: Total of 319 CVDa events [n=171 (7.44%) in MSwc group and n=190 (7.34%) in MSwhtr group] were identified during a mean follow up of 4.6 years. Results are displayed in the table . Conclusion: Predictive accuracy of MS re-defined with WHtR and MS defined with WC per NCEP criteria is comparable. Risk of CVDa and Metabolic Syndrome Metabolic Syndrome per NCEP guideline [MSwc] Re-defined Metabolic Syndrome with WHtR [MSwhtr] Models HR (95% CI) p-value Models HR (95% CI) p-value 2.45 (1.97-3.06) 0.000 2.43 (1.95-3.05) 0.000 MSwc + X 2.39 (1.91-2.99) 0.000 MSwhtr + X 2.28 (1.82-2.85) 0.000 MSwc + Y 1.97 (1.56-2.49) 0.000 MSwhtr + Y 1.93 (1.53-2.43) 0.000 MSwc + Z 1.89 (1.47-2.44) 0.000 MSwhtr + Z 1.83 (1.43-2.35) 0.000 Harrell's C (MSwc + Z) -: 0.7517 Harrell's C (MSwhtr + Z) -: 0.7531 Abbreviations: HR - Hazard Ratio; CI - Confidence Interval; CVDa - All Cardiovascular Disease events X = Age, Sex, Race Y = X + Hypertension, Use of Hypertension Medications, Total intentional exercise, Total cholesterol, Use of Statins, Smoking [>100 cigarettes ever in life] Z = Y + C-reactive Protein + Serum Insulin level CVDa includes - Myocardial infarction(MI), Resuscitated Cardiac Arrest (RCA), Definite Angina, Probable Angina (if followed by Revascularization), Stroke, Stroke Death, coronary heart disease (CHD) Death, Other Atherosclerotic Death, Other CVD Death.
Databáze: OpenAIRE
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