Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index
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...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Other Authors: | |
| Format: | Journal Article |
| Language: | English |
| Published: |
2023
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| Online Access: | https://hdl.handle.net/10356/164499 |
| _version_ | 1811681538223374336 |
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| author | 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 |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) 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 |
| author_sort | Huang, Benjamin |
| collection | NTU |
| description | 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. |
| first_indexed | 2024-10-01T03:42:32Z |
| format | Journal Article |
| id | ntu-10356/164499 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T03:42:32Z |
| publishDate | 2023 |
| record_format | dspace |
| spelling | ntu-10356/1644992023-03-05T16:54:16Z 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 Lee Kong Chian School of Medicine (LKCMedicine) Duke-NUS Medical School Singapore Institute for Clinical Sciences Tan Tock Seng Hospital Science::Medicine Subclinical Atherosclerosis Insulin Sensitivity 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. Agency for Science, Technology and Research (A*STAR) National Medical Research Council (NMRC) Published version This work was supported financially by the Agency for Science, Technology and Research (A∗ STAR), Singapore (Grant No. I-1701E0B15), Lee foundation through support of the SingHeart study, and core funding from SingHealth and Duke NUS through their institute of Precision Medicine (PRISM) and a center grant awarded to National Heart Centre Singapore from the National Medical Research Council, Ministry of Health, Republic of Singapore (Grant No. NMRC/CG/M006/2017_NHCS). The funding bodies were not involved in design, conduct, data interpretation, or writing of the manuscript. 2023-01-30T03:11:37Z 2023-01-30T03:11:37Z 2022 Journal Article Huang, B., Huang, W., Allen, J. C., Sun, L., Goh, H. J., Kong, S. C., Lee, D., Ding, C., Bosco, N., Egli, L., Actis-Goretta, L., Magkos, F., Arigoni, F., Leow, M. K., Tan, S. Y. & Yeo, K. K. (2022). Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index. Frontiers in Nutrition, 9, 979208-. https://dx.doi.org/10.3389/fnut.2022.979208 2296-861X https://hdl.handle.net/10356/164499 10.3389/fnut.2022.979208 36352897 2-s2.0-85141405798 9 979208 en I-1701E0B15 NMRC/CG/M006/2017_NHCS Frontiers in Nutrition © 2022 Huang, Huang, Allen, Sun, Goh, Kong, Lee, Ding, Bosco, Egli, Actis-Goretta, Magkos, Arigoni, Leow, Tan and Yeo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. application/pdf |
| spellingShingle | Science::Medicine Subclinical Atherosclerosis Insulin Sensitivity 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 Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index |
| title | Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index |
| title_full | Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index |
| title_fullStr | Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index |
| title_full_unstemmed | Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index |
| title_short | Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index |
| title_sort | prediction of subclinical atherosclerosis in low framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index |
| topic | Science::Medicine Subclinical Atherosclerosis Insulin Sensitivity |
| url | https://hdl.handle.net/10356/164499 |
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