Department of Epidemiology, Vietnam Military Medical University, 104 Phung Hung, Ha Dong, Hanoi, Vietnam.
Military Institute of Preventive Medicine, 21 Trung Liet, Dong Da, Hanoi, Vietnam.
Endocrine. 2022 Jan;75(1):108-118. doi: 10.1007/s12020-021-02836-5. Epub 2021 Aug 2.
We aimed to determine the incidence and prediction nomogram for new-onset metabolic syndrome (MetS) in a middle-aged Vietnamese population.
A population-based prospective study was conducted in 1150 participants aged 40-64 years without MetS at baseline and followed-up for 5 years. Data on lifestyle factors, socioeconomic status, family diabetes history, and anthropometric measures were collected. MetS incidence was estimated in general population and subgroup of age, gender, and MetS components. A Cox proportional hazards regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for MetS. A prediction nomogram was developed and checked for discrimination and calibration.
During median follow-up of 5.14 years, the accumulate MetS incidence rate was 23.4% (95% CI: 22.2-24.7). The annual incidence rate (95% CI) was 52.9 (46.7-60.1) per 1000 person-years in general population and higher in women [56.6 (48.7-65.9)] than men [46.5 (36.9-59.3)]. The HRs (95% CI) for developing MetS were gender [females vs males: 2.04 (1.26-3.29)], advanced age [1.02 (1.01-1.04) per one year], waist circumference [1.08 (1.06-1.10) per one cm] and other obesity-related traits, and systolic blood pressure [1.02 (1.01-1.03) per one mmHg]. The prediction nomogram for MetS had a good discrimination (C-statistics = 0.742) and fit calibration (mean absolute error = 0.009) with a positive net benefit in the predicted probability thresholds between 0.13 and 0.70.
The study is the first to indicate an alarmingly high incidence of MetS in a middle-aged population in Vietnam. The nomogram with simply applicable variables would be useful to qualify individual risk of developing MetS.
本研究旨在确定越南中年人群中新发代谢综合征（MetS）的发病率和预测列线图。
本研究为一项基于人群的前瞻性研究，共纳入了 1150 名基线时无 MetS 的 40-64 岁人群，并随访 5 年。收集了生活方式因素、社会经济地位、家族糖尿病史和人体测量学指标的数据。估计了一般人群以及年龄、性别和 MetS 成分亚组中新发 MetS 的发病率。使用 Cox 比例风险回归估计 MetS 的风险比（HR）及其 95%置信区间（CI）。开发了预测列线图，并对其进行了区分度和校准度检验。
在中位随访 5.14 年期间，累积 MetS 发病率为 23.4%（95%CI：22.2-24.7）。一般人群的年发病率（95%CI）为 52.9（46.7-60.1）/1000 人年，女性[56.6（48.7-65.9）]高于男性[46.5（36.9-59.3）]。发生 MetS 的 HR（95%CI）为性别[女性比男性：2.04（1.26-3.29）]、年龄较大[1 岁时 1.02（1.01-1.04）]、腰围[1 厘米时 1.08（1.06-1.10）]和其他肥胖相关特征，以及收缩压[1 毫米汞柱时 1.02（1.01-1.03）]。MetS 预测列线图具有较好的区分度（C 统计量=0.742）和校准度（平均绝对误差=0.009），在 0.13 至 0.70 的预测概率阈值之间具有阳性净获益。
本研究首次表明，越南中年人群中 MetS 的发病率高得惊人。该列线图具有简单适用的变量，可用于确定个体发生 MetS 的风险。
