A clinically practicable diagnostic score for metabolic syndrome improves its predictivity of diabetes mellitus: The Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico (GISSI)-Prevenzione scoring

Alejandro Macchia, Giacomo Levantesi, Giovanna Borrelli, Maria Grazia Franzosi, Aldo Pietro Maggioni, Rosamaria Marfisi, Marco Scarano, Luigi Tavazzi, Gianni Tognoni, Franco Valagussa, Roberto Marchioli

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Abstract

Background: Metabolic syndrome (MS) is associated with late-onset diabetes. However, diagnostic criteria for individual components of MS are based on categorical/arbitrary cut points and, therefore, do not exploit the information yield of each factor. We aimed to generate a diagnostic score for MS (MS-Score), aimed at predicting diabetes by giving appropriate weight to the individual components of MS. Methods: Of 11 323 patients with prior myocardial infarction and followed up for 3.5 years in the GISSI-Prevenzione study, 3855 subjects with diabetes at baseline or missing information for relevant variables were excluded. A Cox proportional hazards model including age, sex, glycemia, high-density lipoprotein cholesterol, triglycerides, hypertension, and body mass index was fitted to create a diagnostic score. A cutoff point of 28 of the score was the best compromise between sensitivity and specificity for MS diagnosis (MS-Score). The prognostic performance of the MS-Score was compared with that of the diagnostic criteria of MS, as defined by National Cholesterol Education Program Adult Treatment Panel III (MS-ATP). Results: Of 7468 patients, 940 developed diabetes. The risk of getting diabetes significantly and progressively increased in the quintiles of the score reaching >6-fold higher risk in the last one. The predictive capability of MS-Score was significantly higher than that of the MS-ATP (AUC = 0.650 vs 0.587, sensitivity 67% vs 52%, specificity 63% vs 66%, P = .0002). The MS-Score, but not the MS-ATP, was significantly associated with mortality. Conclusion: MS-Score improves the prediction of diabetes development by using the full informative content of individual components for diagnosis of MS.

Original languageEnglish
JournalAmerican Heart Journal
Volume151
Issue number3
DOIs
Publication statusPublished - Mar 2006

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Diabetes Mellitus
Adenosine Triphosphate
Proportional Hazards Models
HDL Cholesterol
Area Under Curve
Triglycerides
Body Mass Index
Myocardial Infarction
Cholesterol
Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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A clinically practicable diagnostic score for metabolic syndrome improves its predictivity of diabetes mellitus : The Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico (GISSI)-Prevenzione scoring. / Macchia, Alejandro; Levantesi, Giacomo; Borrelli, Giovanna; Franzosi, Maria Grazia; Maggioni, Aldo Pietro; Marfisi, Rosamaria; Scarano, Marco; Tavazzi, Luigi; Tognoni, Gianni; Valagussa, Franco; Marchioli, Roberto.

In: American Heart Journal, Vol. 151, No. 3, 03.2006.

Research output: Contribution to journalArticle

Macchia, Alejandro ; Levantesi, Giacomo ; Borrelli, Giovanna ; Franzosi, Maria Grazia ; Maggioni, Aldo Pietro ; Marfisi, Rosamaria ; Scarano, Marco ; Tavazzi, Luigi ; Tognoni, Gianni ; Valagussa, Franco ; Marchioli, Roberto. / A clinically practicable diagnostic score for metabolic syndrome improves its predictivity of diabetes mellitus : The Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico (GISSI)-Prevenzione scoring. In: American Heart Journal. 2006 ; Vol. 151, No. 3.
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abstract = "Background: Metabolic syndrome (MS) is associated with late-onset diabetes. However, diagnostic criteria for individual components of MS are based on categorical/arbitrary cut points and, therefore, do not exploit the information yield of each factor. We aimed to generate a diagnostic score for MS (MS-Score), aimed at predicting diabetes by giving appropriate weight to the individual components of MS. Methods: Of 11 323 patients with prior myocardial infarction and followed up for 3.5 years in the GISSI-Prevenzione study, 3855 subjects with diabetes at baseline or missing information for relevant variables were excluded. A Cox proportional hazards model including age, sex, glycemia, high-density lipoprotein cholesterol, triglycerides, hypertension, and body mass index was fitted to create a diagnostic score. A cutoff point of 28 of the score was the best compromise between sensitivity and specificity for MS diagnosis (MS-Score). The prognostic performance of the MS-Score was compared with that of the diagnostic criteria of MS, as defined by National Cholesterol Education Program Adult Treatment Panel III (MS-ATP). Results: Of 7468 patients, 940 developed diabetes. The risk of getting diabetes significantly and progressively increased in the quintiles of the score reaching >6-fold higher risk in the last one. The predictive capability of MS-Score was significantly higher than that of the MS-ATP (AUC = 0.650 vs 0.587, sensitivity 67{\%} vs 52{\%}, specificity 63{\%} vs 66{\%}, P = .0002). The MS-Score, but not the MS-ATP, was significantly associated with mortality. Conclusion: MS-Score improves the prediction of diabetes development by using the full informative content of individual components for diagnosis of MS.",
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AU - Levantesi, Giacomo

AU - Borrelli, Giovanna

AU - Franzosi, Maria Grazia

AU - Maggioni, Aldo Pietro

AU - Marfisi, Rosamaria

AU - Scarano, Marco

AU - Tavazzi, Luigi

AU - Tognoni, Gianni

AU - Valagussa, Franco

AU - Marchioli, Roberto

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N2 - Background: Metabolic syndrome (MS) is associated with late-onset diabetes. However, diagnostic criteria for individual components of MS are based on categorical/arbitrary cut points and, therefore, do not exploit the information yield of each factor. We aimed to generate a diagnostic score for MS (MS-Score), aimed at predicting diabetes by giving appropriate weight to the individual components of MS. Methods: Of 11 323 patients with prior myocardial infarction and followed up for 3.5 years in the GISSI-Prevenzione study, 3855 subjects with diabetes at baseline or missing information for relevant variables were excluded. A Cox proportional hazards model including age, sex, glycemia, high-density lipoprotein cholesterol, triglycerides, hypertension, and body mass index was fitted to create a diagnostic score. A cutoff point of 28 of the score was the best compromise between sensitivity and specificity for MS diagnosis (MS-Score). The prognostic performance of the MS-Score was compared with that of the diagnostic criteria of MS, as defined by National Cholesterol Education Program Adult Treatment Panel III (MS-ATP). Results: Of 7468 patients, 940 developed diabetes. The risk of getting diabetes significantly and progressively increased in the quintiles of the score reaching >6-fold higher risk in the last one. The predictive capability of MS-Score was significantly higher than that of the MS-ATP (AUC = 0.650 vs 0.587, sensitivity 67% vs 52%, specificity 63% vs 66%, P = .0002). The MS-Score, but not the MS-ATP, was significantly associated with mortality. Conclusion: MS-Score improves the prediction of diabetes development by using the full informative content of individual components for diagnosis of MS.

AB - Background: Metabolic syndrome (MS) is associated with late-onset diabetes. However, diagnostic criteria for individual components of MS are based on categorical/arbitrary cut points and, therefore, do not exploit the information yield of each factor. We aimed to generate a diagnostic score for MS (MS-Score), aimed at predicting diabetes by giving appropriate weight to the individual components of MS. Methods: Of 11 323 patients with prior myocardial infarction and followed up for 3.5 years in the GISSI-Prevenzione study, 3855 subjects with diabetes at baseline or missing information for relevant variables were excluded. A Cox proportional hazards model including age, sex, glycemia, high-density lipoprotein cholesterol, triglycerides, hypertension, and body mass index was fitted to create a diagnostic score. A cutoff point of 28 of the score was the best compromise between sensitivity and specificity for MS diagnosis (MS-Score). The prognostic performance of the MS-Score was compared with that of the diagnostic criteria of MS, as defined by National Cholesterol Education Program Adult Treatment Panel III (MS-ATP). Results: Of 7468 patients, 940 developed diabetes. The risk of getting diabetes significantly and progressively increased in the quintiles of the score reaching >6-fold higher risk in the last one. The predictive capability of MS-Score was significantly higher than that of the MS-ATP (AUC = 0.650 vs 0.587, sensitivity 67% vs 52%, specificity 63% vs 66%, P = .0002). The MS-Score, but not the MS-ATP, was significantly associated with mortality. Conclusion: MS-Score improves the prediction of diabetes development by using the full informative content of individual components for diagnosis of MS.

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