American Heart Journal
Volume 151, Issue 3 , Pages 754.e7-754.e17 , March 2006

A clinically practicable diagnostic score for metabolic syndrome improves its predictivity of diabetes mellitus: The Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico (GISSI)–Prevenzione scoring

  • Alejandro Macchia, MD

      Affiliations

    • Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy
  • ,
  • Giacomo Levantesi, MD

      Affiliations

    • Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy
  • ,
  • Giovanna Borrelli, MSc

      Affiliations

    • Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy
  • ,
  • Maria Grazia Franzosi, MSc

      Affiliations

    • Department of Cardiovascular Disease, Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
  • ,
  • Aldo Pietro Maggioni, MD

      Affiliations

    • Centro Studi ANMCO, Firenze, Italy
  • ,
  • RosaMaria Marfisi, MS

      Affiliations

    • Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy
  • ,
  • Marco Scarano, MSc

      Affiliations

    • Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy
  • ,
  • Luigi Tavazzi, MD

      Affiliations

    • IRCCS Policlinico San Matteo, Pavia, Italy
  • ,
  • Gianni Tognoni, MD

      Affiliations

    • Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy
  • ,
  • Franco Valagussa, MD

      Affiliations

    • Ospedale San Gerardo, Monza, Italy
  • ,
  • Roberto Marchioli, MD

      Affiliations

    • Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy
    • Corresponding Author InformationReprint requests: Roberto Marchioli, MD, Department of Clinical Pharmacology and Epidemiology, Laboratory of Clinical Epidemiology of Cardiovascular Disease, Consorzio Mario Negri Sud, Santa Maria Imbaro, Italy.
  • on behalf of Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico (GISSI)–Prevenzione Investigators

      Affiliations

    • The names of GISSI-Prevenzione Investigators are reported in reference.21

Received 6 April 2005 ,Accepted 13 October 2005.

  • Image Result

    Observed, predicted risk of diabetes, and distribution of patients according to the score for diagnosis of MS. Solid circles (•) and the gray line indicate the distribution of patients according to pr

    Observed, predicted risk of diabetes, and distribution of patients according to the score for diagnosis of MS. Solid circles (•) and the gray line indicate the distribution of patients according to progressively increasing values of the score. Solid (♦) diamonds indicate the observed proportion of patients with diagnosis of diabetes during follow-up. The black line indicates the expected incidence of diabetes using the score points.

  • Image Result
    Receiver-operating characteristic curves showing the performance of the various diagnostic tools in predicting diabetes. Separate plots were used to compare the final model with the original variables

    Receiver-operating characteristic curves showing the performance of the various diagnostic tools in predicting diabetes. Separate plots were used to compare the final model with the original variables to the global risk assessment score used as a continuous variable, the MS-Score and the MS-ATP diagnostic criteria. □ = final model; ▴ = global risk assessment score; ♦ = MS-ATP; • = MS-Score.

  • Image Result
    Diabetes-free survival of patients attributed to MS-ATP and MS-Score risk groups predicted by a multivariate model. As compared with 3523 patients without MS according to both MS-ATP and MS-Score crit

    Diabetes-free survival of patients attributed to MS-ATP and MS-Score risk groups predicted by a multivariate model. As compared with 3523 patients without MS according to both MS-ATP and MS-Score criteria (incidence of diabetes 6.8%, RR 1.00), 896 were diagnosed as having MS according to ATP-III criteria but not with the MS-Score (incidence of diabetes 8.0%, RR 1.20, 95% CI 0.92-1.56, P = .18), 1214 were diagnosed as having MS according to MS-Score but not with the ATP III criteria (incidence of diabetes 17.8%, RR 2.84, 95% CI 2.36-3.42, P < .0001), and 1835 had an MS diagnosis according to both diagnostic criteria (incidence of diabetes 22.6%, RR 3.68, 95% CI 3.14-4.32, P < .0001).

  • Image Result
    Incidence, relative risk, and 95% CI for risk of diabetes, death, and death plus diabetes according to the MS-Score and the MS-ATP diagnostic criteria.

    Incidence, relative risk, and 95% CI for risk of diabetes, death, and death plus diabetes according to the MS-Score and the MS-ATP diagnostic criteria.

PII: S0002-8703(05)01007-0

doi: 10.1016/j.ahj.2005.10.023

American Heart Journal
Volume 151, Issue 3 , Pages 754.e7-754.e17 , March 2006