Optimizing midlife metabolic syndrome thresholds for dementia: a prospective study of two UK population-based cohorts

Vidil, Sam; Singh-Manoux, Archana; Landré, Benjamin; Fayosse, Aurore; Sabia, Séverine; Machado-Fragua, Marcos D.

doi:10.1186/s13195-025-01732-8

Alzheimer's Research & Therapy

Table 3 Comparison of original and optimal threshold of MetS components in the association with incident dementia in the Whitehall II cohort study^a

From: Optimizing midlife metabolic syndrome thresholds for dementia: a prospective study of two UK population-based cohorts

		N dementia cases/Total		HR (95% CI)		p-value for HR comparison^d	C-statistic (95% CI)	p-value for C-statistic comparison^e
		Reference group	High-risk group	Model 1^b	Model 2^c	p-value for HR comparison^d	C-statistic (95% CI)	p-value for C-statistic comparison^e
Median follow-up 22.6 (IQR 19.1, 27.7) years
Elevated waist circumference
	Original threshold: ≥102 (≥ 88) cm (women)	440/5,068	82/1,069	1.32 (1.04, 1.68)	1.29 (1.01, 1.64)	0.45	0.571 (0.543, 0.599)	0.46
	Optimal threshold (Contal & O’Quigley): ≥96 (≥ 79) cm (women)	347/4,006	175/2,131	1.32 (1.09, 1.59)	1.28 (1.06, 1.54)	0.45	0.575 (0.547, 0.603)	0.46
Elevated blood pressure^f
	Original threshold: ≥130 (≥ 85) mmHg systolic (diastolic)	284/3,437	238/2,700	1.05 (0.88, 1.25)	1.04 (0.87, 1.24)	0.29	0.574 (0.546, 0.602)	0.97
	Optimal threshold (Contal & O’Quigley): ≥129 (≥ 78) mmHg systolic (diastolic)	182/2,517	340/3,620	1.09 (0.91, 1.31)	1.08 (0.90, 1.29)	0.29	0.574 (0.546, 0.602)	0.97
Elevated triglycerides^g
	Original threshold: ≥1.70 mmol/L	369/4,270	153/1,867	1.06 (0.88, 1.28)	1.02 (0.84, 1.24)	0.01	0.573 (0.545, 0.601)	0.95
	Optimal threshold (Contal & O’Quigley): ≥2.13 mmol/L	470/5,555	52/582	1.27 (1.02, 1.58)	1.23 (0.98, 1.53)	0.01	0.573 (0.546, 0.601)	0.95
Low HDL-C^g
	Original threshold: <1.0 (< 1.30) mmol/L (women)	443/5,256	89/881	1.31 (1.04, 1.65)	1.30 (1.03, 1.64)	0.04	0.575 (0.547, 0.603)	0.43
	Optimal threshold (Contal & O’Quigley): <1.46 (< 1.41) mmol/L (women)	252/2,909	270/3,228	1.07 (0.89, 1.29)	1.05 (0.87, 1.27)	0.04	0.571 (0.543, 0.599)	0.43
Elevated fasting glucose^h
	Original threshold: ≥5.60 mmol/L	406/4,726	116/1,411	1.05 (0.86, 1.30)	1.05 (0.85, 1.29)	0.08	0.574 (0.546, 0.602)	0.78
	Optimal threshold (Contal & O’Quigley): ≥5.20 mmol/L	233/2,963	289/3,174	1.20 (1.00, 1.43)	1.20 (1.00, 1.43)	0.08	0.575 (0.546, 0.604)	0.78

MetS: metabolic syndrome; HR: hazard ratio; CI: confidence interval; IQR: interquartile range; HDL-C: high density lipoprotein-cholesterol;
^a The reference group for each component was composed of participants classified as being at low risk on that component
^b Model 1: analysis adjusted for age (as time-scale), sex, education, marital status, and birth cohort (5-year groups)
^c Model 2: model 1 and adjustment for health-related behaviors (smoking, alcohol consumption, consumption of fruits and vegetables, and physical activity)
^d Using original threshold as the reference
^e Using original threshold as the reference
^f Defined with the corresponding threshold for systolic or diastolic blood pressure or use of antihypertensive drugs
^g Defined with the corresponding threshold or use of lipid-modifying drugs
^h Defined with the corresponding threshold or use of glucose-lowering drugs

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ISSN: 1758-9193

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