Quantifying cardiometabolic risk using modifiable non-self-reported risk factors.

Journal Article

BACKGROUND: Sensitive general cardiometabolic risk assessment tools of modifiable risk factors would be helpful and practical in a range of primary prevention interventions or for preventive health maintenance. PURPOSE: To develop and validate a cumulative general cardiometabolic risk score that focuses on non-self-reported modifiable risk factors such as glycosylated hemoglobin (HbA1c) and BMI so as to be sensitive to small changes across a span of major modifiable risk factors, which may not individually cross clinical cut-off points for risk categories. METHODS: We prospectively followed 2,359 cardiovascular disease (CVD)-free subjects from the Framingham offspring cohort over a 14-year follow-up. Baseline (fifth offspring examination cycle) included HbA1c and cholesterol measurements. Gender-specific Cox proportional hazards models were considered to evaluate the effects of non-self-reported modifiable risk factors (blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking, BMI, and HbA1c) on general CVD risk. We constructed 10-year general cardiometabolic risk score functions and evaluated its predictive performance in 2012-2013. RESULTS: HbA1c was significantly related to general CVD risk. The proposed cardiometabolic general CVD risk model showed good predictive performance as determined by cross-validated discrimination (male C-index=0.703, 95% CI=0.668, 0.734; female C-index=0.762, 95% CI=0.726, 0.801) and calibration (lack-of-fit chi-square=9.05 [p=0.338] and 12.54 [p=0.128] for men and women, respectively). CONCLUSIONS: This study presents a risk factor algorithm that provides a convenient and informative way to quantify cardiometabolic risk on the basis of modifiable risk factors that can motivate an individual's commitment to prevention and intervention.

Full Text

Duke Authors

Cited Authors

  • Marino, M; Li, Y; Pencina, MJ; D'Agostino, RB; Berkman, LF; Buxton, OM

Published Date

  • August 2014

Published In

Volume / Issue

  • 47 / 2

Start / End Page

  • 131 - 140

PubMed ID

  • 24951039

Pubmed Central ID

  • 24951039

Electronic International Standard Serial Number (EISSN)

  • 1873-2607

Digital Object Identifier (DOI)

  • 10.1016/j.amepre.2014.03.006


  • eng

Conference Location

  • Netherlands