Assessing the Risk of Cardiovascular Diseases: Metabolic Syndrome Versus Quantitative Metabolic Syndrome Severity Score

 To overcome the limitations of the definition of metabolic syndrome (MetS) in clinical use, a health index named quantitative Metabolic Syndrome Severity Score (cMetS-S), has been recently introduced and validated in the Tehran Lipid and Glucose Study. This study investigated the association between the severity of MetS based on age and gender (cMetS- score), and cardiovascular diseases (CVD) beyond the components of MetS.

 At the beginning of the study, participants aged 20-60 years were enrolled. Those with cardiovascular disease, cancer, use of corticosteroid, estimated glomerular filtration rate <30 ml/min/1.73m², or pregnancy were excluded. The association between cMetS-S and cardiovascular diseases was evaluated continuously for 18 years follow-up among 8,500 participants using Cox proportional hazards regression models and its performance in predicting cardiovascular disease events was compared with the MetS criteria.

 Participants with higher cMetS-S showed a significant increase in the risk of cardiovascular disease (CVD), coronary heart disease (CHD), and non-coronary heart disease (non-CHD). Independent of the confounding factors of metabolic syndrome components, each 1-SD unit increase in cMetS-S was associated with risk ratios of 1.67, 1.60 and 1.88 for cardiovascular diseases, coronary and non-coronary cardiac events, respectively. Model fit analysis showed better CVD prediction value for cMetS-S independent of (MetS) components, compared with metabolic syndrome (p<0.0001).

 The cMetS-S predicts cardiovascular diseases more accurately than the MetS and its components. The standardized cMetS-S, which considers the weighted contribution of MetS components and their variations by age and gender, may serve as a health metric for determining the severity of metabolic syndrome.