REV.CHIM.(Bucharest)♦69♦No.11♦2018 http://www.revistadechimie.ro 3329 *email: lucretiu.radu@gmail.com All authors had equal contribution to this manuscript. An Easy Way to Detect Cardiovascular Risk IONELA MIHAELA VLADU 1 , LUCRETIU RADU 2* , SIGINA RODICA GIRGAVU 3 , VLAD BALEANU 4 , DIANA CLENCIU 5 , CRISTINA GABRIELA ENE 6 , BOGDAN SOCEA 7 , ELFARRA MAZEN 8 , OANA MARIANA CRISTEA 9 , MARIA MOTA 1 , TIBERIU STEFNITA TENEA COJAN 9 1 Department of Metabolism and Nutrition Diseases, University of Medicine and Pharmacy Craiova, Filantropia Clinical Hospital of Craiova, 1 st Filantropiei Str., 200143, Craiova, Romania 2 Department of Hygiene, University of Medicine and Pharmacy Craiova, CFR Hospital of Craiova, 6 th Stirbei-Voda Blvd., 200374, Craiova, Romania 3 Department of Diabetes, Nutrition and Metabolic Diseases, Emergency Clinical Hospital of Craiova, 1 st Tabaci Str., 200642, Craiova, Romania 4 Department of Surgery, University of Medicine and Pharmacy Craiova, Bucharest University Emergency Hospital, 2 nd Petru Rares Str., 200349, Craiova, Romania 5 Filantropia Clinical Hospital of Craiova, 1 st Filantropiei Str., 200143, Craiova, Romania 6 Department of Pharmacology, University of Medicine and Pharmacy Craiova, County Hospital of Craiova, 2 nd Petru Rares Str., 200349, Craiova, Romania 7 St. Pantelimon Emergency Clinical Hospital, Department of Surgery, 340-342 nd Pantelimon Road, 021661, Bucharest, Romania 8 St. John Emergency Clinical Hospital, Department of Vascular Surgery, 13 th Vitan-Barzesti Road, 042122, Bucharest, Romania 9 Department of Microbiology, University of Medicine and Pharmacy Craiova, CFR Hospital of Craiova, 6 th Stirbei-Voda Blvd., 200374, Craiova, Romania Cardiovascular risk means the degree of risk for atherosclerotic cardiovascular pathology, predictable by quantifying the risk factors (RF) existing in each individual. Global cardio-metabolic risk is the overall risk of developing type 2 diabetes mellitus (T2DM) and/or CVD, including myocardial infarction (MI) and stroke, which is due to a bundle of risk factors. The cardio-metabolic risk is based on the concept of continuous risk. The importance of cardiovascular / cardio-metabolic risk is particular because controlling its components may affect atherogenesis and its clinical consequences: chronic ischemic heart disease, cerebrovascular disease and peripheral arteriopathy, but also diabetes mellitus (DM). Currently there is no method to use all the known risk cardio-metabolic factors to quantify cardiovascular risk or diabetes risk. Key words: visceral adiposity index, diabetes, prediabetes, cardiovascular risk The cardiovascular risk quantitation is a golden desideratum for clinical management, as the possibility of accurately assigning the patient to a risk class allows for appropriate conduct targeted at the respective risk class [1-3]. It is also important for patients with cardiovascular risk, which will undergo different types of surgeries [4,5]. The quantification of cardiovascular risk in people with DM and CV disease is not relevant, because the risk is very high, however [6-9]. Several methods accepted by international clinical guidelines for cardiovascular risk calculation are available: Framingham score, SCORE diagram, UKPDS score, and Archimedes model. The original Framingham Risk Score [10,11] had been published in 1998 [12] and provided predictive morbidity for 10 years only for coronary territory. The first Framingham Risk Score included age, sex, LDL cholesterol, HDL cholesterol, blood pressure (and whether the patient is treated or not for his/her hypertension), diabetes, and smoking. It estimated the 10-year risk for coronary heart disease (CHD). It performed well and correctly predicted 10-year risk for CHD in American men and women of European and African descent. The current version of the Framingham Risk Score was published in 2008 and help us to identify the cardio-vascular and cerebrovascular risk, the risk of heart failure or peripheral vascular diseases [13-15]. The publishing body is the ATP III, i.e. the Adult Treatment Panel III , an expert panel of the National Heart, Lung and Blood Institute, which is part of the National Institutes of Health (NIH), USA. The updated version in 2008 was modified to include dyslipidemia, age range, hypertension treatment, smoking, and total cholesterol, and it excluded diabetes, because Type 2 diabetes meanwhile was considered a CHD Risk Equivalent, having the same 10-year risk as individuals with prior CHD. Patients with Type 1 diabetes were considered separately with slightly less aggressive goals; while at increased risk, no study had shown them to be at equivalent risk for CHD as those with previously diagnosed coronary disease or Type 2 diabetes [16,17]. Primary prevention is based on the modifiable risk factors control in the general population, but especially in the population at risk of developing T2DM [18]. In the general population, prevention in any type of disease cannot be achieved quickly or by only one method, achieving this goal by requiring a methodical and sustained approach over a long period of time [19,20]. In the daily practice, it is necessary to introduce an easy instrument, namely visceral adiposity index (VAI), to assess the value of cardiovascular risk and to be useful in initiating early management measures to reduce cardiovascular morbidity and mortality and, implicitly, the costs [21-23]. This study aims is to establish the relationship between the visceral adiposity index (VAI) and the cardiovascular risk calculated by the Framingham score and to observe if VAI could be used in daily clinical practice to assess cardio- metabolic risk in patients with visceral obesity. Experimental part Materials and method The study was conducted over 3 years (2011-2014) and included patients with diabetes mellitus, prediabetes and subjects without diabetes or prediabetes. The study,