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Updated: Sep 27, 2025
Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Scoring systems of metabolic syndrome and prediction of cardiovascular events: A population based cohort study
Nima Motamed1, Hossein Ajdarkosh2, Mohammad Hadi Karbalaie Niya2
1Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Insights
Continuous scoring systems for metabolic syndrome (MetS) better predict cardiovascular events than traditional definitions. SEM-based scoring systems show promise for predicting cardiovascular events in women.
Area of Science:
- Cardiology
- Metabolic Health
- Epidemiology
Background:
- Traditional dichotomous definitions of metabolic syndrome (MetS) lack predictive power for cardiovascular events.
- Continuous scoring systems offer a nuanced approach to defining MetS.
- Evaluating novel scoring systems for cardiovascular risk prediction is crucial.
Purpose of the Study:
- To assess the efficacy of continuous scoring systems versus traditional definitions in predicting cardiovascular events.
- To compare the predictive abilities of different MetS scoring systems, including SEM-based and siMS methods.
- To determine the utility of these systems in diverse populations, stratified by sex.
Main Methods:
- Analysis of a population-based cohort study with 5147 participants aged 18+.
- Follow-up period of 7 years to ascertain atherosclerotic cardiovascular disease (ASCVD) events.
- Comparison of the Joint Interim Statement (JIS) definition of MetS with two scoring systems: SEM-based and siMS.
Main Results:
- SEM-based scoring systems demonstrated a significant association with composite cardiovascular events in both men and women.
- The traditional JIS definition of MetS showed no significant association with cardiovascular events.
- Scoring systems exhibited acceptable predictive ability for cardiovascular events in women, but not in men.
Conclusions:
- Continuous MetS scoring systems, particularly SEM-based ones, are independently associated with cardiovascular events.
- These scoring systems offer improved cardiovascular risk prediction compared to dichotomous definitions.
- SEM-based scoring systems show potential for predicting cardiovascular events in women.
Background And Aims:
Continuous scoring systems were developed versus traditional dichotomous approaches to define metabolic syndrome. The current study was carried out to evaluate the ability of scoring systems to predict fatal and nonfatal cardiovascular events.
Materials And Methods:
The data of 5147 individuals aged 18 years or more obtained from a population-based cohort study were analyzed. The occurrence of atherosclerotic cardiovascular disease (ASCVD) in the period of 7 years follow-up was considered as the associated outcome. Joint Interim Statement (JIS) definition, as a traditional definition of metabolic syndrome (MetS), and two versions of MetS scoring systems, based on standardized regression weights from structural equation modeling (SEM) and simple method for quantifying metabolic syndrome (siMS) were considered as potential predictors.
Results:
The scoring systems, particularly, based on SEM, were observed to have a significant association with composite cardiovascular events (HR = 1.388 [95% CI = 1.153-1.670], p = .001 in men and HR = 1.307 [0.95% CI = 1.120-1.526] in women) in multiple Cox proportional hazard regression analyses, whereas the traditional definition of MetS did not show any significant association. While both two scoring systems showed acceptable predictive abilities for cardiovascular events in women (MetS score based on SEM: area of under curve [AUC] = 0.7438 [95% CI = 0.6195-0.7903] and siMS: AUC = 0.7207 [95% CI = 0.6676-0.7738]), the two systems were not acceptable for identifying risk in men.
Conclusion:
Unlike the dichotomous definition of MetS, the scoring systems showed an independent association with cardiovascular events. Scoring systems, particularly those based on SEM, may be useful for the prediction of cardiovascular events in women.
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