Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index
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Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index. / Huang, Benjamin; Huang, Weiting; Allen, John Carson; Sun, Lijuan; Goh, Hui Jen; Kong, Siew Ching; Lee, Dewaine; Ding, Cherlyn; Bosco, Nabil; Egli, Leonie; Actis-Goretta, Lucas; Magkos, Faidon; Arigoni, Fabrizio; Leow, Melvin Khee Shing; Tan, Swee Yaw; Yeo, Khung Keong.
In: Frontiers in Nutrition, Vol. 9, 979208, 2022.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index
AU - Huang, Benjamin
AU - Huang, Weiting
AU - Allen, John Carson
AU - Sun, Lijuan
AU - Goh, Hui Jen
AU - Kong, Siew Ching
AU - Lee, Dewaine
AU - Ding, Cherlyn
AU - Bosco, Nabil
AU - Egli, Leonie
AU - Actis-Goretta, Lucas
AU - Magkos, Faidon
AU - Arigoni, Fabrizio
AU - Leow, Melvin Khee Shing
AU - Tan, Swee Yaw
AU - Yeo, Khung Keong
N1 - Publisher Copyright: Copyright © 2022 Huang, Huang, Allen, Sun, Goh, Kong, Lee, Ding, Bosco, Egli, Actis-Goretta, Magkos, Arigoni, Leow, Tan and Yeo.
PY - 2022
Y1 - 2022
N2 - Background: Subclinical atherosclerosis can be present in individuals with an optimal cardiovascular risk factor profile. Traditional risk scores such as the Framingham risk score do not adequately capture risk stratification in low-risk individuals. The aim of this study was to determine if markers of metabolic syndrome and insulin resistance can better stratify low-risk individuals.Methods: A cross-sectional study of 101 healthy participants with a low Framingham risk score and no prior morbidities was performed to assess prevalence of subclinical atherosclerosis using computed tomography (CT) and ultrasound. Participants were compared between groups based on Metabolic Syndrome (MetS) and Insulin-Sensitivity Index (ISI-cal) scores. Results: Twenty three individuals (23%) had subclinical atherosclerosis with elevated CT Agatston score ≥1. Presence of both insulin resistance (ISI-cal <9.23) and fulfillment of at least one metabolic syndrome criterion denoted high risk, resulting in significantly improved AUC (0.706 95%CI 0.588–0.822) over the Framingham risk score in predicting elevated CT Agatston score ≥1, with net reclassification index of 50.9 ± 23.7%. High-risk patients by the new classification also exhibited significantly increased carotid intima thickness. Conclusions: The overlap of insulin resistance and presence of ≥1 criterion for metabolic syndrome may play an instrumental role in identifying traditionally low-risk individuals predisposed to future risk of atherosclerosis and its sequelae.
AB - Background: Subclinical atherosclerosis can be present in individuals with an optimal cardiovascular risk factor profile. Traditional risk scores such as the Framingham risk score do not adequately capture risk stratification in low-risk individuals. The aim of this study was to determine if markers of metabolic syndrome and insulin resistance can better stratify low-risk individuals.Methods: A cross-sectional study of 101 healthy participants with a low Framingham risk score and no prior morbidities was performed to assess prevalence of subclinical atherosclerosis using computed tomography (CT) and ultrasound. Participants were compared between groups based on Metabolic Syndrome (MetS) and Insulin-Sensitivity Index (ISI-cal) scores. Results: Twenty three individuals (23%) had subclinical atherosclerosis with elevated CT Agatston score ≥1. Presence of both insulin resistance (ISI-cal <9.23) and fulfillment of at least one metabolic syndrome criterion denoted high risk, resulting in significantly improved AUC (0.706 95%CI 0.588–0.822) over the Framingham risk score in predicting elevated CT Agatston score ≥1, with net reclassification index of 50.9 ± 23.7%. High-risk patients by the new classification also exhibited significantly increased carotid intima thickness. Conclusions: The overlap of insulin resistance and presence of ≥1 criterion for metabolic syndrome may play an instrumental role in identifying traditionally low-risk individuals predisposed to future risk of atherosclerosis and its sequelae.
KW - Computed tomography
KW - Framingham risk
KW - Insulin sensitivity
KW - Metabolic syndrome and Type II diabetes
KW - Subclinical atherosclerosis
U2 - 10.3389/fnut.2022.979208
DO - 10.3389/fnut.2022.979208
M3 - Journal article
C2 - 36352897
AN - SCOPUS:85141405798
VL - 9
JO - Frontiers in Nutrition
JF - Frontiers in Nutrition
SN - 2296-861X
M1 - 979208
ER -
ID: 326458479