Metabolic syndrome severity calculator outperforms traditional methods

An online calculator for metabolic syndrome is able to predict patients’ risk of developing heart disease and diabetes more accurately than traditional assessment methods.

That’s the finding of a new study of more than 13,000 people that concluded that the online tool was a better risk predictor than evaluating individual risk factors alone.

Traditionally, physicians predict risk for cardiovascular disease, type 2 diabetes and stroke through five factors—increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol and triglyceride levels. Using this traditional approach, patients are diagnosed with metabolic syndrome—a cluster of conditions that occur together—if they have at least three of the five abnormalities.

However, according to Mark DeBoer, MD, associate professor of pediatrics at the University of Virginia School of Medicine, the online calculator provides additional risk prediction beyond the typical metabolic syndrome criteria. The metabolic severity scoring system “carries a more accurate predictive ability than did the usual metabolic syndrome criteria” and has been validated in “cross-sectional studies, a smaller cohort, and the current study of more than 13,000 individuals who were followed over time for cardiovascular and diabetes outcomes,” he notes.

DeBoer, who developed the tool with Matthew Gurka, PhD, a professor in the Department of Health Outcomes and Policy at the University of Florida, says the calculator not only weights the traditional risk factors but also takes into account race, gender and ethnicity to produce an easy-to-understand metabolic severity score. He adds that this is significant because African-American men are unlikely to be diagnosed with metabolic syndrome but still have a high risk for cardiovascular disease and type 2 diabetes.

According to DeBoer, the Metabolic Syndrome Severity Calculator was supported by a National Institutes of Health grant and was “predominantly created with physicians in mind.” However, he says the tool is available online for free to anyone who has the health information needed—such as fasting glucose, HDL (good) cholesterol, systolic blood pressure, and triglycerides—to calculate a score.

The scoring system was formulated using a statistical approach called confirmatory factor analysis used to verify the factor structure of a set of observed variables. The approach provided differential weights—the largest being for waist circumference and the smallest being for systolic blood pressure—that are multiplied by an individual’s absolute values for each metabolic syndrome component.

The fact that it’s a weighted score is what differentiates it from other tools, contends DeBoer. Further, he points out that the weight given to the individual components of metabolic syndrome (triglycerides, HDL cholesterol, systolic blood pressure) varies in the score by racial/ethnic group according to how closely the components cluster together in that group.

“The hope is that a scoring system like this could be incorporated in the electronic medical record to calculate someone’s risk and that information could be provided both to the physician, who then realizes there is an elevated risk, and to the patient, who hopefully can start taking some preventative steps,” he says.

In the case of patients, DeBoer adds that by starting medical treatment, an exercise program, or improving diet they could change their score over time. The online calculator could “motivate patients themselves to make the lifestyle changes that are necessary to lower their risk status,” he concludes.

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