Evaluating CMR

Metabolic Syndrome and Type 2 Diabetes/CVD Risk

Comparison of Screening Tools

The Hoorn Study

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The Hoorn Study is a population-based cohort study of diabetes that included 615 asymptomatic men and 749 asymptomatic women 50 to 75 years of age (4). The study investigated the incidence of fatal and nonfatal CVD associated with metabolic syndrome clinical criteria proposed by NCEP-ATP III, WHO, EGIR, and a modified version of AACE. The results of the Hoorn Study were published at the same time as the proposed IDF criteria, and therefore the authors could not compare IDF criteria to the others. In men, metabolic syndrome prevalence was 19%, 32%, 19%, and 41%, respectively, when NCEP-ATP III, WHO, EGIR, and AACE criteria were used. In women, the respective prevalence of the metabolic syndrome was 26%, 26%, 17%, and 35%. The Hoorn Study was the first study to compare metabolic syndrome prevalence between criteria using Cohen’s agreement test (κ). In men, the best coefficient of concordance was found between WHO and EGIR criteria (both criteria relying mostly on insulin resistance) with κ=0.66 (95% CI, 0.59-0.72). The poorest coefficient of concordance was found between WHO and NCEP-ATP III criteria with κ=0.37 (95% CI, 0.29-0.45). In women, the strongest coefficient of concordance was between NCEP-ATP III and AACE criteria with κ=0.78 (95% CI, 0.73-0.82), while the poorest coefficient of concordance was between EGIR and AACE criteria with κ=0.36 (95% CI, 0.29-0.43).


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4. Dekker JM, Girman C, Rhodes T, et al. Metabolic syndrome and 10-year cardiovascular disease risk in the Hoorn Study. Circulation 2005; 112: 666-73.