Adapting a Prediction Rule for Metabolic Syndrome Risk Assessment Suitable for Developing Countries

Abstract

Background: Metabolic syndrome (MetS) is a cluster of cardiometabolic disturbances that increases the risk of cardiovascular diseases (CVD) and type 2 diabetes mellitus (DM). The early identification of high-risk individuals is the key for halting these conditions. The world is facing a growing epidemic MetS although the magnitude in Egypt is unknown. Objectives: To describe MetS and its determinants among apparently healthy individuals residing in urban and rural communities in Egypt and to establish a model for MetS prediction. Methods: A cross-sectional study was conducted with 270 adults from rural and urban districts in Alexandria, Egypt. Participants were clinically evaluated and interviewed for sociodemographic and lifestyle factors and dietary habits. MetS was defined according to the harmonized criteria set by the AHA/NHLBI. The risk of ischemic heart diseases (IHDs), DM and fatty liver were assessed using validated risk prediction charts. A multiple risk model for predicting MetS was developed, and its performance was compared. Results: In total, 57.8% of the study population met the criteria for MetS and were at high risk for developing IHD, DM, and fatty liver. Silent CVD risk factors were identified in 20.4% of the participants. In our proposed multivariate logistic regression model, the predictors of MetS were obesity [OR (95% CI) = 16.3 (6.03-44.0)], morbid obesity [OR (95% CI) = 21.7 (5.3-88.0)], not working [OR (95% CI) = 2.05 (1.1-3.8)], and having a family history of chronic diseases [OR (95% CI) = 4.38 (2.23-8.61)]. Consumption of caffeine once per week protected against MetS by 27.8-fold. The derived prediction rule was accurate in predicting MetS, fatty liver, high risk of DM, and, to a lesser extent, a 10-year lifetime risk of IHD. Conclusion: Central obesity and sedentary lifestyles are accountable for the rising rates of MetS in our society. Interventions are needed to minimize the potential predisposition of the Egyptian population to cardiometabolic diseases.

Cardiometabolic risk prediction algorithms for young people with psychosis: a systematic review and exploratory analysis

“…The literature search returned 7744 results after removing duplicates. We reviewed 362 full texts, of which 110 studies met inclusion criteria (28‐30, 33‐138). See Fig.…”

Risk models and scores for metabolic syndrome: a systematic review

“…Furthermore, out of the 27 included papers, 25 report about the development of one or more risk model or score [19][20][21][22][23][24][25][26][27][28][29][30]32,33,[35][36][37][38][39][40][41][42][43][44][45], and 2 studies report about the development and validation of one or more risk model or scores on an external population [31,34]. Overall, the 27 studies reported 43 models, out of which 27 models were selected for full data extraction.…”

“…Surprisingly, the observed incidence/prevalence of MetS at the end of the study is not reported in over fourty-one percent of the studies [19,20,26,32,36,37]. For those that reported it, the prevalence/ incidence of MetS ranged from as little as 7.9% [31] to as high as 57.8% [45]. In all the 17 risk scores targeting adults, various combinations of risk factors (predictors) were considered signi cant in the respective nal model.…”

“…Regarding the target population, more risk scores were reported in adults than in children or adolescents. Of the 27 included models, 17 focused on adult subjects [19,20,24,[26][27][28][29][30][31][32][33][36][37][38][39]42,45], while 10 targets children and adolescents [21][22][23]25,34,35,40,41,43,44].…”

“…Both diagnostic and prognostic MetS models exist for adults. But, majority (70.6%) are diagnostic developed using data from cross-sectional studies [19,20,24,26,27,[31][32][33]37,39,45]. Surprisingly, the observed incidence/prevalence of MetS at the end of the study is not reported in over fourty-one percent of the studies [19,20,26,32,36,37].…”