Evaluation of the Value of Waist Circumference and Metabolomics in the Estimation of Visceral Adipose Tissue
Boone, Sebastiaan C.; Van Smeden, Maarten; Rosendaal, Frits R.; Le Cessie, Saskia; Groenwold, Rolf H.H.; Jukema, J. Wouter; Van Dijk, Ko Willems; Lamb, Hildo J.; Greenland, Philip; Neeland, Ian J.; Allison, Matthew A.; Criqui, Michael H.; Budoff, Matthew J.; Lind, Lars L.; Kullberg, Joel; Ahlström, Hakan; Mook-Kanamori, Dennis O.; De Mutsert, Renée
(2022) American Journal of Epidemiology, volume 191, issue 5, pp. 886 - 899
(Article)
Abstract
Visceral adipose tissue (VAT) is a strong prognostic factor for cardiovascular disease and a potential target for cardiovascular risk stratification. Because VAT is difficult to measure in clinical practice, we estimated prediction models with predictors routinely measured in general practice and VAT as outcome using ridge regression in 2,501 middle-aged
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participants from the Netherlands Epidemiology of Obesity study, 2008-2012. Adding waist circumference and other anthropometric measurements on top of the routinely measured variables improved the optimism-adjusted R2 from 0.50 to 0.58 with a decrease in the root-mean-square error (RMSE) from 45.6 to 41.5 cm2 and with overall good calibration. Further addition of predominantly lipoprotein-related metabolites from the Nightingale platform did not improve the optimism-corrected R2 and RMSE. The models were externally validated in 370 participants from the Prospective Investigation of Vasculature in Uppsala Seniors (PIVUS, 2006-2009) and 1,901 participants from the Multi-Ethnic Study of Atherosclerosis (MESA, 2000-2007). Performance was comparable to the development setting in PIVUS (R2 = 0.63, RMSE = 42.4 cm2, calibration slope = 0.94) but lower in MESA (R2 = 0.44, RMSE = 60.7 cm2, calibration slope = 0.75). Our findings indicate that the estimation of VAT with routine clinical measurements can be substantially improved by incorporating waist circumference but not by metabolite measurements.
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Keywords: added value, development, external validation, metabolomics, prediction, visceral adipose tissue, General Medicine
ISSN: 0002-9262
Publisher: Oxford University Press
Note: Funding Information: This work was supported by the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation (CVON2014-02 ENERGIZE). The Netherlands Epidemiology of Obesity study is supported by the participating Departments, the Division, and the Board of Directors of the Leiden University Medical Centre, and by the Leiden University, Research Profile Area Vascular and Regenerative Medicine. The Multi-Ethnic Study of Atherosclerosis was supported by the National Heart, Lung and Blood Institute (grants HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169) and the National Center for Advancing Translational Sciences (grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420). The MESA Abdominal Body Composition Ancillary study was supported by the National Heart, Lung, and Blood Institute (grant R01-HL088451 to M.A.A.) Publisher Copyright: © 2022 The Author(s) 2021. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.
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