Metabolic syndrome severity score: range and associations with cardiovascular risk factors

Introduction: Metabolic Syndrome Severity Score (MSSS) is a new clinical prediction rule (CPR) for diagnostic and therapeutic decisions and employs available components (sex, age, race, systolic blood pressure, waistline circumference, high-density lipoprotein, triglycerides and fasting blood glucose). The aim of our work was to perform cross-sectional pilot trial on middle-aged healthy volunteers and patients with metabolic syndrome (MetS) with and without type 2 diabetes mellitus (T2DM) for studying feasibility and implementation of MSSS and its associations with cardiovascular risk factors.

Material and methods: We approached 64 eligible participants from Bulgaria. The MSSS values, together with demographic, anthropometric, medical history, laboratory findings, CVD risk factors, QRISK2 score for 10-year cardiovascular risk and predicted heart age, were analysed. Descriptive statistics with tests for comparison (e.g., t-test, χ²) between groups as well as ANOVA and logistic regression were applied.

Results: We analysed data from 56 participants (aged 50.11 ±3.43 years). The MSSS was higher in MetS patients (including 6 T2DM patients) than in controls (n = 29; 51.8%) presented as percentiles (69.97% and 34.41%, respectively) and z-scores (0.60 and –0.45, respectively) (p < 0.05). The logistic regression model of MSSS indicated a positive association with MetS/T2DM cases (correctness > 85%, p < 0.01). For further validation purposes, positive correlations of MSSS with CVD risk factor as diastolic blood pressure (Rho = 0.399; p < 0.003) and QRISK2 score (Rho = 0.524; p < 0.001) or predicted heart age (Rho = 0.368; p < 0.007) were also found.

Conclusions: The pilot study of MSSS in Bulgaria indicated feasibility and consistency of its implementation among patients with metabolic syndrome and/or T2DM and healthy volunteers.