optimal cut-off points of the standardized continuous metabolic syndrome severity score (cmets-s) for predicting cardiovascular disease (cvd) and cvd mortality in the tehran lipid and glucose study (tlgs)

Background: metabolic syndrome (mets) is a prevalent condition associated with an increased risk of cardiovascular disease (cvd) and cvd mortality. due to the limited clinical applicability of mets, the standardized continuous metabolic syndrome severity score (cmets-s) has the potential to provide continuous assessment of metabolic risk. objectives: this study evaluated the optimal cmets-s cut-off points in the tehran lipid and glucose study (tlgs) for predicting cvd and cvd mortality. methods: the study included 7,776 participants over 30 years old at baseline, followed for 18 years. sex-specific sensitivity (ss) and specificity (sp) of cmets-s measures for predicting cvd and cvd mortality were evaluated using a receiver operating characteristic (roc) curve, along with the area under the curve (auc), employing a naive estimator and considering event failure status and mets variables. results: the cut-off point of cmets-s for cvd was 0.13 (ss: 65.5%, sp: 59.6%) for the total population, 0.44 (ss: 49.6%, sp: 68.1%) for men, and 0.27 (ss: 64.2%, sp: 69.2%) for women. the cut-off point of cmets-s for cvd mortality was 0.53 (ss: 51.3%, sp: 71.9%) for the total population, 0.76 (ss: 35.1%, sp: 76.2%) for men, and 0.28 (ss: 78.8%, sp: 66.4%) for women. the auc (95% ci) of mets based on the international diabetes federation (idf) and joint interim statement (jis) definitions were 60.0 (65.3 - 56.8) and 61.1 (59.6 - 56.8) for cvd, and 59.3 (56.0 - 62.5) and 59.4 (56.3 - 62.6) for cvd mortality. conclusions: the cut-off points of cmets-s for cvd and cvd mortality differ between men and women. the cmets-s could be a better predictive tool for cvd and cvd mortality than mets.