An Ethnicity-Specific MetS Severity Score to Assess Risk: The Jackson Heart Study

描述(申请人提供)：代谢综合征(METS)是一组心血管指标，似乎与人们知之甚少的潜伏过程有关，这些过程增加了非裔美国人中高度流行的冠心病(CHD)、中风、2型糖尿病(T2 DM)和慢性肾脏病(CKD)的风险。蛋氨酸的个体成分包括腹型肥胖、高甘油三酯、低高密度脂蛋白胆固醇、高血压和高空腹血糖。传统上，对特定个体的MET分类是基于这些不同成分的截止点的组合。然而，使用界限很容易错过将略低于界限水平的中等海拔的个人归类。此外，METS标准已被证明在其与疾病的关联中显示出种族/民族差异。我们设计了一个性别和种族/民族特定的持续性METS严重程度评分，该评分考虑了METS的各个组成部分(高血压、低高密度脂蛋白等)如何。按性别和种族/民族不同地分类和相互关联。因此，根据这些差异，分数按性别和种族/民族为每个组成部分分配不同的权重。一个人的得分可以根据标准的临床测量方法，使用特定于他/她的性别和种族/民族的方程式来计算。这一新的评分在风险评估的临床应用中具有很好的潜力。该分数不仅能够考虑到非裔美国人患上METS的独特特征，而且以一种可以在个人之间进行比较并在个人内部随着时间的推移进行跟踪的方式来表达METS的严重性。我们建议使用Mets的严重程度评分来评估杰克逊心脏研究的参与者，以获得对在临床应用中使用这一工具至关重要的信息。我们的计划有三个方面。1)我们将评估可能影响METS严重程度的基线和纵向流行病学和生活方式因素；2)我们将评估进展为冠心病、中风、T2 DM和CKD的个人与未进展的个体之间的基线METS严重程度；以及3)我们将评估在诊断上述心血管疾病相关疾病之前METS严重程度的个体内部变化。我们聚集了一个拥有多个专业领域的团队，并将利用我们的发现为临床医生提供指导，指导他们将甲硫氨酸的严重程度作为未来疾病的不祥指标-最终目标是在非裔美国患者中预防心血管疾病。

DESCRIPTION (provided by applicant): The metabolic syndrome (MetS) is a cluster of cardiovascular indices that appear to be linked by poorly- understood insidious processes that increases risk for coronary heart disease (CHD), stroke, Type 2 diabetes (T2DM) and chronic kidney disease (CKD)-diseases that are highly prevalent among African Americans. The individual components of MetS include abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure (BP), and high fasting glucose. A classification of MetS in a given individual has traditionally been based on a combination of cut-off points for these different components. However, the use of cut-offs is liable to miss classifying individuals with moderate elevations that are just below the cut-off level. Additionally, MetS criteria have been shown to exhibit racial/ethnic differences in their association with disease. We have designed a sex- and race/ethnicity-specific continuous MetS severity score that takes into account how the individual components of MetS (elevated BP, low HDL, etc.) cluster and correlate differentially by sex and racial/ethnic group. Thus, based on these differences the score assigns different weights to each component by sex and race/ethnicity. A given individual's score can be calculated from standard clinical measures using an equation specific to his/her sex and racial/ethnic group. This novel score has excellent potential for clinical application for risk assessment. Not only is the score able to take into account unique features of MetS seen in African Americans but the score expresses MetS severity in a way that can be compared between individuals and followed over time within an individual. We propose to use this MetS severity score to evaluate participants in the Jackson Heart Study to gain information critical to using this tool in clinical application. Our plan is three-fold. 1) We will assess baseline and longitudinal epidemiologic and lifestyle factors that are likely to affect MetS severity; 2) we wil assess baseline MetS severity between individuals who do and do not progress to develop CHD, stroke, T2DM and CKD; and 3) we will evaluate intra-individual changes in MetS severity leading up to diagnosis of the above CVD- associated diseases. We have gathered a team with multiple areas of expertise and will use our findings to provide guidance to clinicians regarding the use of MetS severity as an ominous indicator of future disease- with an ultimate goal of CVD prevention among African American patients.