Harokopio University, Department of Nutrition Science-Dietetics, Athens, Greece.
Hellenic J Cardiol. 2011 Sep-Oct;52(5):391-8.
The optimal performance of cardiovascular disease (CVD) risk models in various populations (such as the Framingham Heart Sheet or the ESC SCORE) is of major interest in risk prediction modeling nowadays. We evaluated whether the inclusion of socioeconomic status (SES) in the HellenicSCORE would increase the accuracy of prediction, irrespectively of dietary information and the classical CVD risk factors.
Data from 1514 men and 1528 women (age >18 years), who were free of known CVD on enrolment in 2001-02, were studied (the ATTICA study). Five years later a follow up was performed and the development of CVD was defined (WHO-ICD-10 criteria). As SES indicators, education status and mean annual income were recorded, and a special SES 3-class index was calculated (low, moderate and high). The MedDietScore, which incorporates the inherent characteristics of the Mediterranean diet, was used as a dietary assessment tool, while the HellenicSCORE, which reflects the level of CVD risk factors, was also calculated. Additive logistic regression models were used to test the additive effect of SES and dietary assessment on the predictive ability of the HellenicSCORE.
SES assessment did not improve the predictive ability of the estimated risk model compared to the model that included the HellenicSCORE, physical activity status, waist-to-hip ratio, diabetes and family history of CVD. Additionally, SES did not improve the predictive ability of the estimated risk model even when dietary assessment was added to the above model.
Socioeconomic status does not improve the predictive ability of a CVD risk model, even when dietary information is also taken into account.
心血管疾病 (CVD) 风险模型在不同人群（如弗雷明汉心脏表或 ESC SCORE）中的最佳性能是当今风险预测建模的主要关注点。我们评估了在 HellenicSCORE 中纳入社会经济地位 (SES) 是否会提高预测的准确性，而与饮食信息和经典 CVD 风险因素无关。
研究了 1514 名男性和 1528 名年龄>18 岁的女性（在 2001-02 年登记时无已知 CVD）的数据（ATTICA 研究）。五年后进行了随访，并定义了 CVD 的发展（WHO-ICD-10 标准）。SES 指标记录了教育程度和平均年收入，并计算了特殊 SES 3 级指数（低、中、高）。MedDietScore 被用作饮食评估工具，其中包含地中海饮食的固有特征，而 HellenicSCORE 则反映了 CVD 风险因素的水平。使用加性逻辑回归模型来检验 SES 和饮食评估对 HellenicSCORE 预测能力的加性影响。
SES 评估与包括 HellenicSCORE、身体活动状况、腰臀比、糖尿病和 CVD 家族史在内的风险模型相比，并未改善估计风险模型的预测能力。此外，即使在将饮食评估添加到上述模型中后，SES 也不能改善估计风险模型的预测能力。
即使考虑到饮食信息，社会经济地位也不能提高 CVD 风险模型的预测能力。
