Use of anthropometric indices as simple predictors of deranged lipid profile and at risk population for future cardiovascular events

Abstract

Introduction: The uninsured population presents unique challenges to the application of an integrated approach to population health. Our objective is to compare and test population risk indices for identifying a cohort of uninsured patients at high-risk for avoidable healthcare utilization and costs. Methods: Patients who had a least one visit at a safety-net clinic, had a primary address in Mecklenburg County, were aged 18-74, and had the most recent healthcare visit coded as 'uninsured' were identified in the baseline period. The five risk indices used were: the HHS Hierarchical Conditions Category (HCC), the Charlson Comorbidity Index (CCI), Total Cost Index, Total Inpatient Visits Index, and Total Emergency Department Visits Index. First, agreement across the five indices was analyzed. Then, the accuracy of the five risk indices was tested in predicting future utilization and costs for the subsequent 12-month follow-up period. Results: Kappa statistics and percent overlap values showed below average to poor agreement between indices when comparing scorers. The strongest predictors of being in the 90 th percentile of total cost during the 12 months follow-up period were the Total Cost Index at baseline (C statistic=0.75) and the HCC (C-statistic=0.73). The CCI and Total Inpatient Visit Index's demonstrated the lowest accuracy for predicting an unnecessary ED visit (C-statistic=0.51, for both) Discussion/Conclusion: Prior cost and ED utilization were key in predicting their corresponding 12-month metrics. In contrast, the Total Inpatient Visit Index had the worst predictive performance for future hospitalization rates. Some indices were similarly predictive as compared to insured cohorts but others showed contrasting results.

Apolipoprotein B Is a Good Tool for Screening Dyslipidaemia in Apparently Healthy Population

“…Further, some studies indicate that LDL-C/HDL-C ratio or TC/HDL-C ratio acts as better indicators than lipoprotein itself in predicting CVD [17]. Even though ATP III of NCEP has recommended LDL-C as a primary target and non-HDL-C as the secondary target for the treatment of dyslipidaemia in order to prevent CVD [7] while being widely used in the practice as well, most of the recent studies have proven that apoB is the better marker for dyslipidaemia and a better predictor for the risk of CVD.…”

Correlation between Anthropometric Measurement and Lipid Profile among Rural Community at Cangkringan Village, District Sleman, Yogyakarta Province

“…10 Penelitian di Cina dan India menunjukkan bahwa antropometri abdominal merupakan suatu parameter yang sensitif dan mudah diaplikasikan untuk memprediksi risiko kardiovaskular terkait dengan abnormalitas profil lipid. 11,12 Terdapat penelitian yang menyebutkan rasio lingkar pinggang-panggul dapat digunakan untuk mengidentifikasi abnormalitas kardiometabolik. Lingkar pinggang merupakan prediktor yang paling baik untuk melihat abnormalitas profil lipid dan paling mudah diaplikasikan.…”