Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 191, Issue 5, Pages 886-899Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwab298
Keywords
added value; development; external validation; metabolomics; prediction; visceral adipose tissue
Categories
Funding
- Netherlands Cardiovascular Research Initiative
- Dutch Heart Foundation [CVON2014-02 ENERGIZE]
- Board of Directors of the Leiden University Medical Centre
- Leiden University, Research Profile Area Vascular and Regenerative Medicine
- National Heart, Lung and Blood Institute [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, N01-HC-95169]
- National Center for Advancing Translational Sciences [UL1-TR-000040, UL1-TR-001079, UL1-TR-001420]
- National Heart, Lung, and Blood Institute [R01-HL088451]
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This study showed that estimation of visceral adipose tissue (VAT) can be improved by incorporating waist circumference but not by metabolite measurements. Adding waist circumference and other anthropometric measurements to prediction models increased the accuracy of VAT estimation.
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 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 R-2 from 0.50 to 0.58 with a decrease in the root-mean-square error (RMSE) from 45.6 to 41.5 cm(2) and with overall good calibration. Further addition of predominantly lipoprotein-related metabolites from the Nightingale platform did not improve the optimism-corrected R-2 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 (R-2 = 0.63, RMSE = 42.4 cm(2), calibration slope = 0.94) but lower in MESA (R-2 = 0.44, RMSE = 60.7 cm(2), 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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