has_metabolic_syndrome_atpiii: Determine presence of metabolic syndrome using updated NCEP...
In LS31/clinicalr: Clinical calculations

Description Usage Arguments Value Caveats References

Determines whether an individual has the metabolic syndrome based on the definition of the NCEP ATPIII criteria, updated in 2005 by Grundy et al.

has_metabolic_syndrome_atpiii(
  is_female,
  waist_circumference = NA,
  sbp = NA,
  dbp = NA,
  triglycerides = NA,
  hdl_cholesterol = NA,
  glucose = NA,
  is_fasting_blood_sample = FALSE,
  has_antihypertensive_drug = FALSE,
  has_lipid_drug = FALSE,
  has_glucose_drug = FALSE
)

`is_female`	`TRUE` if patient is female, `FALSE` if patient is male.
`waist_circumference`	Waist circumference (cm) (`NA` by default).
`sbp`	Systolic blood pressure (mmHg) (`NA` by default).
`dbp`	Systolic blood pressure (mmHg) (`NA` by default).
`triglycerides`	Triglycerides in (mmol/l) (`NA` by default).
`hdl_cholesterol`	HDL cholesterol (mmol/l) (`NA` by default).
`glucose`	Glucose (mmol/l) (`NA` by default).
`is_fasting_blood_sample`	`TRUE` if fasting blood sample, `FALSE` (default) if not or unknown.
`has_antihypertensive_drug`	`TRUE` if patient is on antihypertensive drug treatment, otherwise `FALSE` (default).
`has_lipid_drug`	`TRUE` if patient is on fibrate, nicotinic acid or statin, otherwise `FALSE` (default).
`has_glucose_drug`	`TRUE` if patient is on drug treatment for elevated glucose, otherwise `FALSE` (default).

TRUE if patient has the metabolic syndrome, FALSE is not, NA if indetermined or is_female was NA.

We do include use of a statin as a drug for HDL cholesterol and triglicerides, even though the original statement is unclear about this point (only including niacin and fibrates).

According to the definition, only glucose needs to be from a fasting blood sample (and not triglycerides or HDL cholesterol). The glucose trait is determined in a fail-fast way: if you do not explicitly set is_fasting_blood_sample = TRUE, the glucose measurement is considered to be non-fastening and is ignored.

This function explicitly handles situations of missing data. For example, with blood pressure 120/80 mmHg and antihypertensive medication, a patient is still considered hypertensive. With blood pressure NA/90 mmHg without antihypertensive medication, a patient is still considered hypertensive. A patient with blood pressure NA/NA mmHg and no antihypertensive medication is considered NA for the trait hypertension, but if a patient has NA/NA mmHg but does use antihypertensive medication, the patient is considered to have hypertension (even though measurements are missing).

Grundy, S. M. et al. Diagnosis and Management of the Metabolic Syndrome. Circulation 112, 2735–2752 (2005)..

LS31/clinicalr documentation built on Nov. 16, 2020, 7:58 p.m.