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Updated: Sep 22, 2025
Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Assessment of Comorbidity in Bariatric Patients through a Biomarker-Based Model-A Multicenter Validation of the
Carmen Gensen1,2, Saskia L M van Loon1,3, Natal A van Riel2
1Expert Center Clinical Chemistry Eindhoven, collaboration initiative between Catharina Hospital, Maxima Medical Center, and Eindhoven University of Technology, Eindhoven, the Netherlands.
Background:
The metabolic health index (MHI) is a biomarker-based model that objectively assesses the cumulative impact of comorbidities type 2 diabetes mellitus, hypertension and dyslipidemia on the health state of bariatric patients. The MHI was developed on a single-center cohort using a fully laboratory data-driven approach, resulting in a MHI score on a range from 1 to 6. To show universal applicability in clinical care, the MHI was validated externally and potential laboratory-related shortcomings were evaluated.
Methods:
Retrospective laboratory and national bariatric quality registry data were collected from five Dutch renowned bariatric centers (n = 11 501). MHI imprecision was derived from the cumulative effect of biological and analytical variance of the individual input variables of the MHI model. The performance of the MHI (model) was assessed in terms of discrimination and calibration.
Results:
The cumulative imprecision in MHI was 0.25 MHI points. Calibration of the MHI model diverged over the different centers but was accounted for by misregistration of comorbidity after cross-checking the data. Discriminative performance of the MHI model was consistent across the different centers.
Conclusions:
The MHI model can be applied in clinical practice of bariatric centers, regardless of patient mix and analytical platform. Because the MHI is based on objective parameters, it is insensitive to diverging clinical definitions of comorbidities. Therefore, the MHI can be used to objectify severity of metabolic comorbidities in bariatric patients. The MHI can support the patient-selection process for surgery and objectively assessing the effect of surgery on the metabolic health state.
