{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:02:29Z","timestamp":1760148149956,"version":"3.40.5"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T00:00:00Z","timestamp":1680825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Predicting metabolic syndrome (MetS) is important for identifying high-risk cardiovascular disease individuals and providing preventive interventions. We aimed to develop and validate an equation and a simple MetS score according to the Japanese MetS criteria.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>In total, 54,198 participants (age, 54.5\u00b110.1 years; men, 46.0%), with baseline and 5-year follow-up data were randomly assigned to \u2018Derivation\u2019 and \u2018Validation\u2019 cohorts (ratio: 2:1). Multivariate logistic regression analysis was performed in derivation cohort and scores were assigned to factors corresponding to \u03b2-coefficients. We evaluated predictive ability of the scores using area under the curve (AUC), then applied them to validation cohort to assess reproducibility.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The primary model ranged 0\u201327 points had an AUC of 0.81 (sensitivity: 0.81, specificity: 0.81, cut-off score: 14), and consisted of age, sex, blood pressure (BP), body mass index (BMI), serum lipids, glucose measurements, tobacco smoking, and alcohol consumption. The simplified model (excluding blood tests) ranged 0\u201317 points with an AUC of 0.78 (sensitivity: 0.83, specificity: 0.77, cut-off score: 15) and included: age, sex, systolic BP, diastolic BP, BMI, tobacco smoking, and alcohol consumption. We classified individuals with a score &lt;15 and \u226515 points as low- and high-risk MetS, respectively. Furthermore, the equation model generated an AUC of 0.85 (sensitivity: 0.86, specificity: 0.55). Analysis of the validation and derivation cohorts yielded similar results.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>We developed a primary score, an equation model, and a simple score. The simple score is convenient, well-validated with acceptable discrimination, and could be used for early detection of MetS in high-risk individuals.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0284139","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T17:38:06Z","timestamp":1680889086000},"page":"e0284139","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Development of predictive equation and score for 5-year metabolic syndrome incidence in Japanese adults"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4630-6596","authenticated-orcid":true,"given":"Anwar Ahmed","family":"Salim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin","family":"Kawasoe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6055-1259","authenticated-orcid":true,"given":"Takuro","family":"Kubozono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoko","family":"Ojima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeko","family":"Kawabata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Hashiguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiyuki","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaaki","family":"Miyata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hironori","family":"Miyahara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Tokushige","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiko","family":"Nishio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuru","family":"Ohishi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,4,7]]},"reference":[{"key":"pone.0284139.ref001","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.2337\/diabetes.37.12.1595","article-title":"Banting lecture 1988. Role of insulin resistance in human disease","volume":"37","author":"GM Reaven","year":"1988","journal-title":"Diabetes"},{"key":"pone.0284139.ref002","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.tcm.2015.10.004","article-title":"Metabolic syndrome update.","volume":"26","author":"SM Grundy","year":"2016","journal-title":"Trends Cardiovasc Med"},{"key":"pone.0284139.ref003","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1016\/j.jacc.2010.05.034","article-title":"The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis","volume":"56","author":"S Mottillo","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"pone.0284139.ref004","doi-asserted-by":"crossref","first-page":"149","DOI":"10.2147\/VHRM.S245829","article-title":"Metabolic Syndrome for Cardiovascular Disease Morbidity and Mortality Among General Japanese People: A Mini Review.","volume":"16","author":"J Watanabe","year":"2020","journal-title":"Vasc Health Risk Manag."},{"key":"pone.0284139.ref005","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1186\/s12889-017-4041-1","article-title":"Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review.","volume":"17","author":"P Ranasinghe","year":"2017","journal-title":"BMC Public Health"},{"key":"pone.0284139.ref006","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.ijcard.2018.01.139","article-title":"Trends in the prevalence of metabolic syndrome and its components in the United States 2007\u20132014.","volume":"259","author":"D Shin","year":"2018","journal-title":"Int J Cardiol."},{"key":"pone.0284139.ref007","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.amjcard.2013.08.042","article-title":"Impact of metabolic syndrome on the risk of cardiovascular disease mortality in the United States and in Japan","volume":"113","author":"L Liu","year":"2014","journal-title":"Am J Cardiol"},{"key":"pone.0284139.ref008","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/j.1464-5491.2006.01858.x","article-title":"Metabolic syndrome\u2014a new world-wide definition. A Consensus Statement from the International Diabetes Federation","volume":"23","author":"KGMM Alberti","year":"2006","journal-title":"Diabet Med J Br Diabet Assoc"},{"key":"pone.0284139.ref009","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1038\/hr.2009.14","article-title":"The impact of the metabolic syndrome and its components on the incidence of ischemic heart disease and stroke: the Japan public health center-based study","volume":"32","author":"H Noda","year":"2009","journal-title":"Hypertens Res Off J Jpn Soc Hypertens"},{"key":"pone.0284139.ref010","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1001\/jama.287.3.356","article-title":"Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey","volume":"287","author":"ES Ford","year":"2002","journal-title":"JAMA"},{"key":"pone.0284139.ref011","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity.","volume":"120","author":"Eckel RH Alberti KGMM","year":"2009","journal-title":"Circulation."},{"key":"pone.0284139.ref012","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1161\/CIRCULATIONAHA.105.169404","article-title":"Diagnosis and management of the metabolic syndrome: an American Heart Association\/National Heart, Lung, and Blood Institute Scientific Statement.","volume":"112","author":"SM Grundy","year":"2005","journal-title":"Circulation."},{"key":"pone.0284139.ref013","doi-asserted-by":"crossref","first-page":"e2017003","DOI":"10.4178\/epih.e2017003","article-title":"The criteria for metabolic syndrome and the national health screening and education system in Japan","volume":"39","author":"K Yamagishi","year":"2017","journal-title":"Epidemiol Health"},{"key":"pone.0284139.ref014","first-page":"987","article-title":"Examination Committee of Criteria for \u201cObesity Disease\u201d in Japan, Japan Society for the Study of Obesity. New criteria for \u201cobesity disease\u201d in Japan","volume":"66","year":"2002","journal-title":"Circ J Off J Jpn Circ Soc"},{"key":"pone.0284139.ref015","doi-asserted-by":"crossref","first-page":"409","DOI":"10.4329\/wjr.v6.i7.409","article-title":"Clinical significance of visceral adiposity assessed by computed tomography: A Japanese perspective.","volume":"6","author":"M Ryo","year":"2014","journal-title":"World J Radiol"},{"key":"pone.0284139.ref016","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1536\/ihj.49.193","article-title":"The Japanese national health screening and intervention program aimed at preventing worsening of the metabolic syndrome","volume":"49","author":"T Kohro","year":"2008","journal-title":"Int Heart J"},{"volume-title":"Lipid Modification: Cardiovascular Risk Assessment and the Modification of Blood Lipids for the Primary and Secondary Prevention of Cardiovascular Disease","year":"2014","author":"National Clinical Guideline Centre (UK).","key":"pone.0284139.ref017"},{"key":"pone.0284139.ref018","doi-asserted-by":"crossref","first-page":"e0222809","DOI":"10.1371\/journal.pone.0222809","article-title":"Development and verification of prediction models for preventing cardiovascular diseases","volume":"14","author":"JM Sung","year":"2019","journal-title":"PloS One"},{"key":"pone.0284139.ref019","doi-asserted-by":"crossref","first-page":"345","DOI":"10.5551\/jat.61960","article-title":"Development and Validation of a Risk Prediction Model for Atherosclerotic Cardiovascular Disease in Japanese Adults: The Hisayama Study","volume":"29","author":"T Honda","year":"2022","journal-title":"J Atheroscler Thromb"},{"key":"pone.0284139.ref020","doi-asserted-by":"crossref","first-page":"e0133884","DOI":"10.1371\/journal.pone.0133884","article-title":"A Risk Score with Additional Four Independent Factors to Predict the Incidence and Recovery from Metabolic Syndrome: Development and Validation in Large Japanese Cohorts","volume":"10","author":"M Obokata","year":"2015","journal-title":"PloS One"},{"key":"pone.0284139.ref021","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.2147\/DMSO.S288881","article-title":"Development and Internal Validation of a Prognostic Model for 4-Year Risk of Metabolic Syndrome in Adults: A Retrospective Cohort Study.","volume":"14","author":"H Zhang","year":"2021","journal-title":"Diabetes Metab Syndr Obes Targets Ther."},{"key":"pone.0284139.ref022","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1055\/a-0677-2720","article-title":"MetS Risk Score: A Clear Scoring Model to Predict a 3-Year Risk for Metabolic Syndrome","volume":"50","author":"T-T Zou","year":"2018","journal-title":"Horm Metab Res Horm Stoffwechselforschung Horm Metab"},{"key":"pone.0284139.ref023","doi-asserted-by":"crossref","first-page":"e0146143","DOI":"10.1371\/journal.pone.0146143","article-title":"siMS Score: Simple Method for Quantifying Metabolic Syndrome.","volume":"11","author":"I Soldatovic","year":"2016","journal-title":"PloS One."},{"key":"pone.0284139.ref024","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.numecd.2015.02.004","article-title":"Probing the factor structure of metabolic syndrome in Sardinian genetic isolates","volume":"25","author":"F Graziano","year":"2015","journal-title":"Nutr Metab Cardiovasc Dis NMCD"},{"key":"pone.0284139.ref025","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.ypmed.2016.04.006","article-title":"A metabolic syndrome severity score: A tool to quantify cardio-metabolic risk factors.","volume":"88","author":"JF Wiley","year":"2016","journal-title":"Prev Med."},{"key":"pone.0284139.ref026","doi-asserted-by":"crossref","first-page":"4981","DOI":"10.2147\/DMSO.S283949","article-title":"Reporting and Methods in Developing Prognostic Prediction Models for Metabolic Syndrome: A Systematic Review and Critical Appraisal","volume":"13","author":"H Zhang","year":"2020","journal-title":"Diabetes Metab Syndr Obes Targets Ther"},{"journal-title":"Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8\u201311 December 2008.","year":"2011","author":"World Health Organization","key":"pone.0284139.ref027"},{"key":"pone.0284139.ref028","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5551\/jat.E580","article-title":"Metabolic syndrome.","volume":"15","author":"T Teramoto","year":"2008","journal-title":"J Atheroscler Thromb"},{"key":"pone.0284139.ref029","doi-asserted-by":"crossref","first-page":"725","DOI":"10.2337\/diacare.26.3.725","article-title":"The diabetes risk score: a practical tool to predict type 2 diabetes risk","volume":"26","author":"J Lindstr\u00f6m","year":"2003","journal-title":"Diabetes Care"},{"key":"pone.0284139.ref030","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1038\/s41440-021-00831-x","article-title":"Development of a risk prediction score for hypertension incidence using Japanese health checkup data","volume":"45","author":"M Kawasoe","year":"2022","journal-title":"Hypertens Res Off J Jpn Soc Hypertens"},{"key":"pone.0284139.ref031","first-page":"878","article-title":"Metabolic syndrome and all-cause and cardiovascular disease mortality: Japan Public Health Center-based Prospective (JPHC) Study","volume":"73","author":"I Saito","year":"2009","journal-title":"Circ J Off J Jpn Circ Soc"},{"key":"pone.0284139.ref032","doi-asserted-by":"crossref","first-page":"2027","DOI":"10.1291\/hypres.31.2027","article-title":"Impact of metabolic syndrome components on the incidence of cardiovascular disease in a general urban Japanese population: the suita study.","volume":"31","author":"Y Kokubo","year":"2008","journal-title":"Hypertens Res Off J Jpn Soc Hypertens"},{"key":"pone.0284139.ref033","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/j.jacc.2006.09.032","article-title":"Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies","volume":"49","author":"AS Gami","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"pone.0284139.ref034","doi-asserted-by":"crossref","first-page":"304","DOI":"10.5551\/jat.ED092","article-title":"Specific Health Guidance, the Nationwide Lifestyle Intervention Program Targeting Metabolic Syndrome, Seems to be Successful in Japan","volume":"25","author":"Y. Matsuzawa","year":"2018","journal-title":"J Atheroscler Thromb"},{"key":"pone.0284139.ref035","first-page":"e984","article-title":"Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association","volume":"143","author":"TM Powell-Wiley","year":"2021","journal-title":"Circulation"},{"key":"pone.0284139.ref036","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.jjcc.2020.01.011","article-title":"The serum uric acid level in females may be a better indicator of metabolic syndrome and its components than in males in a Japanese population.","volume":"76","author":"S Tani","year":"2020","journal-title":"J Cardiol"},{"key":"pone.0284139.ref037","doi-asserted-by":"crossref","first-page":"216","DOI":"10.2337\/dc10-0879","article-title":"Persistent increase of prevalence of metabolic syndrome among U.S. adults: NHANES III to NHANES 1999\u20132006","volume":"34","author":"A Mozumdar","year":"2011","journal-title":"Diabetes Care"},{"key":"pone.0284139.ref038","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1038\/s41574-020-00446-1","article-title":"Adiposity measures and mortality in an Asian population.","volume":"17","author":"S Yamashita","year":"2021","journal-title":"Nat Rev Endocrinol"},{"key":"pone.0284139.ref039","first-page":"2253","article-title":"Gender Differences in Lifestyle Factors Associated with Metabolic Syndrome and Preliminary Metabolic Syndrome in the General Population","volume":"56","author":"T Hattori","year":"2017","journal-title":"The Watari Study. Intern Med Tokyo Jpn"},{"key":"pone.0284139.ref040","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/SMJ.0b013e3181836b19","article-title":"Chinese metabolic syndrome risk score.","volume":"102","author":"F-C Hsiao","year":"2009","journal-title":"South Med J"},{"key":"pone.0284139.ref041","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1016\/j.diabres.2010.06.009","article-title":"Identification of metabolic syndrome using decision tree analysis","volume":"90","author":"A Worachartcheewan","year":"2010","journal-title":"Diabetes Res Clin Pract"},{"key":"pone.0284139.ref042","first-page":"146","article-title":"Predicting metabolic syndrome using decision tree and support vector machine methods.","volume":"12","author":"F Karimi-Alavijeh","year":"2016","journal-title":"ARYA Atheroscler"},{"key":"pone.0284139.ref043","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1161\/01.CIR.0000108926.04022.0C","article-title":"Association of the metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey","volume":"109","author":"L Ninomiya JK","year":"2004","journal-title":"Circulation"},{"key":"pone.0284139.ref044","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1016\/S1098-3597(06)80005-0","article-title":"Atherogenic dyslipidemia associated with metabolic syndrome and insulin resistance.","volume":"81","author":"SM Grundy","year":"2006","journal-title":"Clin Cornerstone"},{"issue":"9","key":"pone.0284139.ref045","first-page":"441","article-title":"Prevalence of metabolic syndrome in a 22,892 Japanese population and its associations with life style.","volume":"48","author":"M Urashima","year":"2005","journal-title":"Japan Medical Association Journal"},{"key":"pone.0284139.ref046","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.2169\/internalmedicine.46.0026","article-title":"Risk of metabolic syndrome persists twenty years after the cessation of smoking","volume":"46","author":"T Wada","year":"2007","journal-title":"Intern Med Tokyo Jpn"},{"key":"pone.0284139.ref047","first-page":"1167","article-title":"Population-based metabolic syndrome risk score and its determinants: The Isfahan Healthy Heart Program","volume":"19","author":"M Hosseini","year":"2014","journal-title":"J Res Med Sci Off J Isfahan Univ Med Sci"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0284139","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T17:38:36Z","timestamp":1680889116000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0284139"}},"subtitle":[],"editor":[{"given":"Ozra","family":"Tabatabaei-Malazy","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,4,7]]},"references-count":47,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0284139","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2023,4,7]]}}}