OR48-3 A SEX- AND ETHNICITY-SPECIFIC METABOLIC SYNDROME RISK SCORE: FORMULATION IN NHANES & VALIDATION IN THE JACKSON HEART STUDY

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: OR48-Insulin Resistance & Metabolic Syndrome: From Clinical Physiology to Clinical Care
Translational
Tuesday, June 18, 2013: 9:15 AM-10:45 AM
Presentation Start Time: 9:45 AM
Room 304 (Moscone Center)
Mark Daniel DeBoer*1 and Matthew J. Gurka2
1Univ of Virginia, Charlottesville, VA, 2West Virginia University, Morgantown, WV
Background:
The metabolic syndrome (MetS), which is associated with increase risk for Type 2 diabetes (T2DM) and cardiovascular disease (CVD), has traditionally been classified based on cut-off points for individual components, including waist circumference (WC), triglycerides (TG), HDL cholesterol, blood pressure (BP), and fasting glucose. However, current MetS criteria result in ethnic discrepancies that may limit its usefulness, particularly among non-Hispanic blacks (NHB) relative to non-Hispanic whites (NHW) and Hispanics (Hisp).

Methods:
Using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2010 for NHW, NHB and Hisp. adults age 20-64 years, we designed a continuous MetS risk score that is sex- and ethnicity-specific. We did so by performing confirmatory factor analysis of a single MetS factor, allowing individual components (WC, TG, HDL, BP, glucose) to vary by sex and ethnicity when these components were significantly different by sex/ethnic group in their contribution to the MetS factor.  This provided a MetS score that is unique to each sex/ethnic group in the weighting of each component to the final continuous score. By ethnic group we then assessed ROC area-under-the curve (AUC) of this MetS score predicting traditional ATP III-based MetS (ATP-MetS) in NHANES and assessed correlations of our score for surrogate markers of T2DM and CVD risk (homeostasis model of insulin resistance [HOMA], high sensitivity C-reactive protein [hsCRP], and uric acid) among both NHANES and Jackson Heart Study (JHS) participants.

Results:
We generated sex- and ethnicity-specific equations that differed by ethnicity in the contribution of each component to the final MetS score, as determined by the factor analysis. Among all ethnicities in NHANES this score performed well in predicting ATP-MetS (ROC AUC=0.93 for each ethnicity) and significantly correlated with HOMA, hsCRP and uric acid (all p<0.01).  The score performed similarly among NHB participants of JHS: ROC AUC for ATP MetS =0.91, surrogate correlations all p<0.01.

Discussion:
These new equations for the MetS score produce a clinically accessible and interpretable MetS score that is sex- and ethnicity-specific and that may be able to identify individuals at higher risk for developing chronic diseases related to MetS, who could then be targeted for increased intervention. Additionally, these scores provide a powerful new outcome that can be utilized in obesity and MetS research.

Nothing to Disclose: MDD, MJG

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: NIH: 5K08HD060739-03 (MDD) and 1R21DK085363 (MDD and MJG)