Estimation of the proportion of metabolic syndrome-free subjects on high cardiometabolic risk using two continuous cardiometabolic risk scores: a cross-sectional study in 16- to 20-year-old individuals

In contrast to the dichotomous classification of metabolic syndrome, continuous metabolic syndrome scores enable to assess cardiometabolic burden in metabolic syndrome-free individuals. Using receiver operating characteristics analysis, discrimination power of continuous metabolic syndrome score calculated from population-based Z-scores or individual measures corrected to the accepted international standards for presence/absence of metabolic syndrome was assessed. Calculated cutoff values were used to estimate the proportions of metabolic syndrome-free subjects presenting high cardiometabolic risk. Clinical data were collected from 2331 (52% females) 16- to 20-year-old subjects. Receiver operating characteristics analyses showed an acceptable performance of both scores to classify metabolic syndrome presence: area under the curve (97–98%), sensitivity (95–100%), and specificity (86–96%). Compared with the prevalence of metabolic syndrome, proportions of metabolic syndrome-free subjects on high cardiometabolic risk, e.g., presenting continuous scores ≥ cutoff points, were about 3-fold higher in males, and 4-fold higher in females. Both scores correlated significantly with markers of cardiometabolic risk.

Conclusion: Continuous cardiometabolic syndrome scores are practical tools to evaluate cardiometabolic risk in subjects not presenting metabolic syndrome. Accuracy, simplicity, and ability to classify metabolic syndrome-free subjects on high cardiometabolic risk make continuous metabolic syndrome score derived from international standards convenient for use in research and clinical practice.