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目的评价各种肥胖指标诊断代谢综合征(MS)的效果,确定最佳切点。方法对辽宁省沈阳市某高校1 907名在职及退休职工进行人体测量、检测生理及血液指标;MS标准采用国际糖尿病联盟标准(IDF标准)和中华医学会糖尿病学分会建议标准(CDS标准);应用受试者工作特征曲线(ROC曲线)筛选腰围、体重指数(BMI)、腰围身高比(WSR)、腰臀比(WHR)中诊断MS效果最好的肥胖指标,以最大约登指数确定切点。结果 WSR最佳切点为男性53,女性为51;IDF标准下,腰围最佳切点男性为90 cm,女性为80 cm;CDS标准下,BMI最佳切点男性为24.6,女性为25.6;WSR在ROC曲线下面积最大,诊断MS的效果显著优于BMI(均P<0.05);WSR最佳切点以上者与正常者比较,MS危险因素聚集的危险度明显升高(P<0.05)。将WSR控制在切点以下,可能防止人群中41.3%～44.6%的MS危险因素聚集。结论 WSR是诊断MS最简单有效的肥胖指标。
Objective To evaluate the effect of various obesity indicators on the diagnosis of metabolic syndrome (MS) and determine the optimal cut point. Methods A total of 1 907 serving and retired workers in a certain university in Shenyang City of Liaoning Province were measured for anthropometry and blood and physiological indexes. MS criteria were based on the International Diabetes Federation Standard (IDF) and the Chinese Association of Diabetes Mellitus Recommended Standards (CDS) The receiver operating characteristic curve (ROC curve) was used to screen the obesity index with the best MS in waist circumference, body mass index (BMI), waist circumference to body height ratio (WHR) and waist to hip ratio (WHR) point. Results The optimal cut-point of WSR was 53 for males and 51 for females. The optimal cut-point for waist circumference was 90 cm for males and 80 cm for females under IDF criteria. The optimal cut-point for BMI was 24.6 for males and 25.6 for females under CDS criteria. The area under the ROC curve of WSR was the largest, and the diagnostic value of MS was significantly better than that of BMI (all P <0.05). Compared with the normal WSR, the risk of MS was significantly increased (P <0.05) . Controlling the WSR below the cutoff point may prevent 41.3% to 44.6% of MS risk factors from accumulating in the population. Conclusion WSR is the most simple and effective indicator of obesity to diagnose MS.