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Rigshospitalet - en del af Københavns Universitetshospital

Simple cardiovascular risk stratification by replacing total serum cholesterol with anthropometric measures: The MORGAM prospective cohort project

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


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  • Victoria Rosberg
  • Julie Kk Vishram-Nielsen
  • Anna M Dyrvig Kristensen
  • Manan Pareek
  • Thomas S G Sehested
  • Peter M Nilsson
  • Allan Linneberg
  • Luigi Palmieri
  • Simona Giampaoli
  • Chiara Donfrancesco
  • Frank Kee
  • Giuseppe Mancia
  • Giancarlo Cesana
  • Giovanni Veronesi
  • Guido Grassi
  • Kari Kuulasmaa
  • Veikko Salomaa
  • Tarja Palosaari
  • Susana Sans
  • Jean Ferrieres
  • Jean Dallongeville
  • Stefan Söderberg
  • Marie Moitry
  • Wojciech Drygas
  • Abdonas Tamosiunas
  • Annette Peters
  • Hermann Brenner
  • Ben Schöttker
  • Sameline Grimsgaard
  • Tor Biering-Sørensen
  • Michael H Olsen
Vis graf over relationer

To assess whether anthropometric measures (body mass index [BMI], waist-hip ratio [WHR], and estimated fat mass [EFM]) are independently associated with major adverse cardiovascular events (MACE), and to assess their added prognostic value compared with serum total-cholesterol. The study population comprised 109,509 individuals (53% men) from the MORGAM-Project, aged 19-97 years, without established cardiovascular disease, and not on antihypertensive treatment. While BMI was reported in all, WHR and EFM were reported in ∼52,000 participants. Prognostic importance of anthropometric measurements and total-cholesterol was evaluated using adjusted Cox proportional-hazards regression, logistic regression, area under the receiver-operating-characteristic curve (AUCROC), and net reclassification improvement (NRI). The primary endpoint was MACE, a composite of stroke, myocardial infarction, or death from coronary heart disease. Age interacted significantly with anthropometric measures and total-cholesterol on MACE (P ≤ 0.003), and therefore age-stratified analyses (<50 versus ≥ 50 years) were performed. BMI, WHR, EFM, and total-cholesterol were independently associated with MACE (P ≤ 0.003) and resulted in significantly positive NRI when added to age, sex, smoking status, and systolic blood pressure. Only total-cholesterol increased discrimination ability (AUCROC difference; P < 0.001). In subjects < 50 years, the prediction model with total-cholesterol was superior to the model including BMI, but not superior to models containing WHR or EFM, while in those ≥ 50 years, the model with total-cholesterol was superior to all models containing anthropometric variables, whether assessed individually or combined. We found a potential role for replacing total-cholesterol with anthropometric measures for MACE-prediction among individuals < 50 years when laboratory measurements are unavailable, but not among those ≥ 50 years.

TidsskriftPreventive Medicine Reports
Sider (fra-til)101700
StatusUdgivet - apr. 2022

Bibliografisk note

© 2022 The Author(s).

ID: 74271747