Early Identification of Metabolic Syndrome in Adults of Jiaxing, China: Utilizing a Multifactor Logistic Regression Model.

Shiyu Hu, Wenyu Chen, Xiaoli Tan, Ye Zhang, Jiaye Wang, Lifang Huang, Jianwen Duan
Author Information
  1. Shiyu Hu: Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.
  2. Wenyu Chen: Department of Respiratory Medicine, The Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, People's Republic of China.
  3. Xiaoli Tan: Department of Respiratory Medicine, The Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, People's Republic of China.
  4. Ye Zhang: Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.
  5. Jiaye Wang: Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.
  6. Lifang Huang: Health Management Center, The Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, People's Republic of China.
  7. Jianwen Duan: Department of Hepatobiliary Surgery, Quzhou People's Hospital, Quzhou, Zhejiang, People's Republic of China.

Abstract

Purpose: The purpose of this study is to develop and validate a clinical prediction model for diagnosing Metabolic Syndrome (MetS) based on indicators associated with its occurrence.
Patients and Methods: This study included a total of 26,637 individuals who underwent health examinations at the Jiaxing First Hospital Health Examination Center from January 19, 2022, to December 31, 2022. They were randomly divided into training (n = 18645) and validation (n = 7992) sets in a 7:3 ratio. Firstly, the Least Absolute Shrinkage and Selection Operator (LASSO) regression algorithm was employed for variable selection. Subsequently, a multifactor Logistic regression analysis was conducted to establish the predictive model, accompanied by nomograms. Thirdly, model validation was performed using Receiver Operating Characteristic (ROC) curves, Harrell's concordance index (C-index), calibration plots, and Decision Curve Analysis (DCA), followed by internal validation.
Results: In this study, six predictive indicators were selected, including Body Mass Index, Triglycerides, Blood Pressure, High-Density Lipoprotein Cholesterol, Low-Density Lipoprotein Cholesterol, and Fasting Blood Glucose. The model demonstrated excellent predictive performance, with an AUC of 0.978 (0.976-0.980) for the training set and 0.977 (0.974-0.980) for the validation set in the nomogram. Calibration curves indicated that the model possessed good calibration ability (Training set: Emax 0.081, Eavg 0.005, = 0.580; Validation set: Emax 0.062, Eavg 0.007, = 0.829). Furthermore, decision curve analysis suggested that applying the nomogram for diagnosis is more beneficial when the threshold probability of MetS is less than 89%, compared to either treating-all or treating-none at all.
Conclusion: We developed and validated a nomogram based on MetS risk factors, which can effectively predict the occurrence of MetS. The proposed nomogram demonstrates significant discriminative ability and clinical applicability. It can be utilized to identify variables and risk factors for diagnosing MetS at an early stage.

Keywords

References

  1. Lancet. 2023 Jun 24;401(10394):2087 [PMID: 37355279]
  2. Int J Mol Sci. 2022 Jan 12;23(2): [PMID: 35054972]
  3. Endocr Metab Immune Disord Drug Targets. 2023;23(12):1491-1504 [PMID: 36892127]
  4. Diabetol Metab Syndr. 2021 Mar 2;13(1):25 [PMID: 33653388]
  5. Oxid Med Cell Longev. 2021 Jun 26;2021:9987352 [PMID: 34257828]
  6. Arch Gerontol Geriatr. 2008 Jan-Feb;46(1):107-15 [PMID: 17482687]
  7. Nutr Metab (Lond). 2019 Jan 21;16:7 [PMID: 30679939]
  8. J Obes. 2020 Aug 26;2020:5762395 [PMID: 32963827]
  9. Eur J Cardiovasc Nurs. 2016 Dec;15(7):549-558 [PMID: 26743264]
  10. BMC Nutr. 2022 Oct 23;8(1):117 [PMID: 36274164]
  11. JAMA. 2001 May 16;285(19):2486-97 [PMID: 11368702]
  12. Arterioscler Thromb Vasc Biol. 2012 Aug;32(8):1753 [PMID: 22815339]
  13. Curr Opin Urol. 2022 Nov 1;32(6):594-597 [PMID: 36081396]
  14. Antioxidants (Basel). 2021 Dec 29;11(1): [PMID: 35052583]
  15. Exp Ther Med. 2013 Jul;6(1):77-84 [PMID: 23935723]
  16. Int J Obes (Lond). 2021 Jan;45(1):12-24 [PMID: 33208861]
  17. Curr Hypertens Rep. 2018 Feb 26;20(2):12 [PMID: 29480368]
  18. BMC Med. 2011 May 05;9:48 [PMID: 21542944]
  19. Curr Diabetes Rev. 2023;19(4):e290422204258 [PMID: 35507784]
  20. Lancet Oncol. 2015 Apr;16(4):e173-80 [PMID: 25846097]
  21. Eur J Cardiovasc Nurs. 2020 Mar;19(3):223-229 [PMID: 31560220]
  22. J Rural Health. 2013 Spring;29(2):188-97 [PMID: 23551649]
  23. Diabetes Care. 2005 Jul;28(7):1769-78 [PMID: 15983333]
  24. Endocrinol Metab Clin North Am. 2014 Mar;43(1):1-23 [PMID: 24582089]
  25. Comput Math Methods Med. 2014;2014:242717 [PMID: 24817904]
  26. Eur J Surg Oncol. 2021 Aug;47(8):2206 [PMID: 33895026]
  27. Biomed Pharmacother. 2022 Aug;152:113238 [PMID: 35687909]
  28. Diabetes Care. 2007 Apr;30(4):872-7 [PMID: 17392548]
  29. Asia Pac J Clin Nutr. 2019;28(3):621-633 [PMID: 31464410]
  30. Biochem Pharmacol. 2014 Nov 1;92(1):131-41 [PMID: 25175736]
  31. Eur J Public Health. 2008 Dec;18(6):656-60 [PMID: 18603599]
  32. J Cell Physiol. 2020 Nov;235(11):8812-8825 [PMID: 32394436]
  33. Adv Exp Med Biol. 2011;696:191-9 [PMID: 21431559]
  34. Metabolites. 2023 Jan 05;13(1): [PMID: 36677012]
  35. Int J Colorectal Dis. 2021 Oct;36(10):2215-2225 [PMID: 34331119]
  36. Ther Adv Cardiovasc Dis. 2017 Aug;11(8):215-225 [PMID: 28639538]
  37. J Exerc Rehabil. 2020 Apr 28;16(2):183-188 [PMID: 32509704]
  38. BMJ. 2006 Mar 4;332(7540):521-5 [PMID: 16428252]

Word Cloud

Created with Highcharts 10.0.00modelMetSnomogram=validationstudypredictiveriskfactorsclinicalpredictiondiagnosingMetabolicSyndromebasedindicatorsoccurrenceJiaxing2022trainingnregressionLogisticanalysiscurvescalibrationBloodLipoproteinCholesterol980setabilityset:EmaxEavgcanPurpose:purposedevelopvalidateassociatedPatientsMethods:includedtotal26637individualsunderwenthealthexaminationsFirstHospitalHealthExaminationCenterJanuary19December31randomlydivided186457992sets7:3ratioFirstlyLeastAbsoluteShrinkageSelectionOperatorLASSOalgorithmemployedvariableselectionSubsequentlymultifactorconductedestablishaccompaniednomogramsThirdlyperformedusingReceiverOperatingCharacteristicROCHarrell'sconcordanceindexC-indexplotsDecisionCurveAnalysisDCAfollowedinternalResults:sixselectedincludingBodyMassIndexTriglyceridesPressureHigh-DensityLow-DensityFastingGlucosedemonstratedexcellentperformanceAUC978976-0977974-0CalibrationindicatedpossessedgoodTraining081005580Validation062007829Furthermoredecisioncurvesuggestedapplyingdiagnosisbeneficialthresholdprobabilityless89%comparedeithertreating-alltreating-noneallConclusion:developedvalidatedeffectivelypredictproposeddemonstratessignificantdiscriminativeapplicabilityutilizedidentifyvariablesearlystageEarlyIdentificationAdultsChina:UtilizingMultifactorRegressionModelmetabolicsyndrome

Similar Articles

Cited By