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Title: Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index
Authors: Huang, Benjamin
Huang, Weiting
Allen, John Carson
Sun, Lijuan
Goh, Hui Jen
Kong, Siew Ching
Lee, Dewaine
Ding, Cherlyn
Bosco, Nabil
Egli, Leonie
Actis-Goretta, Lucas
Magkos, Faidon
Arigoni, Fabrizio
Leow, Melvin Khee-Shing
Tan, Swee Yaw
Yeo, Khung Keong
Keywords: Science::Medicine
Issue Date: 2022
Source: Huang, B., Huang, W., Allen, J. C., Sun, L., Goh, H. J., Kong, S. C., Lee, D., Ding, C., Bosco, N., Egli, L., Actis-Goretta, L., Magkos, F., Arigoni, F., Leow, M. K., Tan, S. Y. & Yeo, K. K. (2022). Prediction of subclinical atherosclerosis in low Framingham risk score individuals by using the metabolic syndrome criteria and insulin sensitivity index. Frontiers in Nutrition, 9, 979208-.
Project: I-1701E0B15 
Journal: Frontiers in Nutrition 
Abstract: Background: Subclinical atherosclerosis can be present in individuals with an optimal cardiovascular risk factor profile. Traditional risk scores such as the Framingham risk score do not adequately capture risk stratification in low-risk individuals. The aim of this study was to determine if markers of metabolic syndrome and insulin resistance can better stratify low-risk individuals. Methods: A cross-sectional study of 101 healthy participants with a low Framingham risk score and no prior morbidities was performed to assess prevalence of subclinical atherosclerosis using computed tomography (CT) and ultrasound. Participants were compared between groups based on Metabolic Syndrome (MetS) and Insulin-Sensitivity Index (ISI-cal) scores. Results: Twenty three individuals (23%) had subclinical atherosclerosis with elevated CT Agatston score ≥1. Presence of both insulin resistance (ISI-cal <9.23) and fulfillment of at least one metabolic syndrome criterion denoted high risk, resulting in significantly improved AUC (0.706 95%CI 0.588–0.822) over the Framingham risk score in predicting elevated CT Agatston score ≥1, with net reclassification index of 50.9 ± 23.7%. High-risk patients by the new classification also exhibited significantly increased carotid intima thickness. Conclusions: The overlap of insulin resistance and presence of ≥1 criterion for metabolic syndrome may play an instrumental role in identifying traditionally low-risk individuals predisposed to future risk of atherosclerosis and its sequelae.
ISSN: 2296-861X
DOI: 10.3389/fnut.2022.979208
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Organisations: Duke-NUS Medical School
Singapore Institute for Clinical Sciences
Tan Tock Seng Hospital
Rights: © 2022 Huang, Huang, Allen, Sun, Goh, Kong, Lee, Ding, Bosco, Egli, Actis-Goretta, Magkos, Arigoni, Leow, Tan and Yeo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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