Yonsei University Wonju College of Medicine, Wonju, Korea.
Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea.
Diabetes Metab J. 2021 Jul;45(4):569-577. doi: 10.4093/dmj.2020.0103. Epub 2021 Jan 30.
Recently, a metabolic syndrome severity score (MS score) using a dataset of the Korea National Health and Nutrition Examination Surveys has been developed. We aimed to determine whether the newly developed score is a significant predictor of cardiovascular (CV) events among the Korean population.
From the Korean National Health Insurance System, 2,541,364 (aged 40 to 59 years) subjects with no history of CV events (ischemic stroke or myocardial infarction [MI]), who underwent health examinations from 2009 to 2011 and were followed up until 2014 to 2017, were identified. Cox proportional hazard model was employed to investigate the association between MS score and CV events. Model performance of MS score for predicting CV events was compared to that of conventional metabolic syndrome diagnostic criteria (Adult Treatment Program III [ATP-III]) using the Akaike information criterion and the area under the receiver operating characteristic curve.
Over a median follow-up of 6 years, 15,762 cases of CV events were reported. MS score at baseline showed a linear association with incident CV events. In the multivariable-adjusted model, the hazard ratios (95% confidence intervals) comparing the highest versus lowest quartiles of MS score were 1.48 (1.36 to 1.60) for MI and 1.89 (1.74 to 2.05) for stroke. Model fitness and performance of the MS score in predicting CV events were superior to those of ATP-III.
The newly developed age- and sex-specific continuous MS score for the Korean population is an independent predictor of ischemic stroke and MI in Korean middle-aged adults even after adjusting for confounding factors.
最近，基于韩国国民健康营养调查（Korea National Health and Nutrition Examination Surveys）数据集开发了一种代谢综合征严重程度评分（MS score）。我们旨在确定该新评分是否可作为韩国人群心血管（CV）事件的重要预测指标。
从韩国国民健康保险系统中，选取了 2541364 名（年龄 40 至 59 岁）无 CV 事件（缺血性卒中或心肌梗死 [MI]）病史的受试者，他们在 2009 年至 2011 年期间接受了健康检查，并随访至 2014 年至 2017 年。采用 Cox 比例风险模型研究 MS 评分与 CV 事件之间的关系。使用赤池信息量准则和接受者操作特征曲线下面积比较 MS 评分和传统代谢综合征诊断标准（成人治疗方案 III [ATP-III]）预测 CV 事件的模型性能。
在中位随访 6 年期间，报告了 15762 例 CV 事件。基线时的 MS 评分与 CV 事件呈线性关联。在多变量调整模型中，MS 评分最高四分位数与最低四分位数相比，MI 的危险比（95%置信区间）为 1.48（1.36 至 1.60），卒中为 1.89（1.74 至 2.05）。MS 评分预测 CV 事件的模型拟合度和性能优于 ATP-III。
为韩国人群开发的新的年龄和性别特异性连续 MS 评分是韩国中年成年人缺血性卒中和 MI 的独立预测指标，即使在调整混杂因素后也是如此。
