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目的探讨联合腰围、身高、体重指标对代谢综合征(MS)的风险预测价值,为MS的防治工作提供依据。方法于2014年5月1日至6月1日,以天津市第四中心医院体检的552名天津地区常住居民为研究对象,每个研究对象均填写一般情况调查表,内容包括一般人口学资料和行为生活方式,并进行血压、身高、体重和腰围测量,血脂、空腹血糖水平测定,计算腰围身高比(WHt R)、体质指数(BMI)、体重/(身高-腰围)2、体重/(身高2-腰围2)和腰围2/(体重×身高)。使用国际糖尿病联盟(IDF)2005年的标准中涉及的4个非肥胖的条件,出现2个或更多的非肥胖条件被认为是MS,判别不同肥胖指标诊断MS的价值。采用SPSS 15.0软件进行统计学分析,两组计量资料的比较用t检验,计数资料的比较用χ2检验。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)及最佳诊断点。结果 ROC曲线分析结果显示,体重/(身高-腰围)2预测MS的AUC,男性和女性分别为0.709和0.799,预测效力高于BMI、WC、WHt R、体重/(身高2-腰围2)和腰围2/(身高×体重);体重/(身高-腰围)2的最佳临界值:男性为0.010 010,女性为0.008 257;灵敏度和特异度:男性分别为0.86和0.47,女性分别为0.93和0.55,灵敏度高于其他各肥胖指标;男性和女性的约登指数分别为0.33和0.48。以体重/(身高-腰围)2代替WC筛查MS,进行一致性检验,Kappa值为0.794,表明一致性较好。结论体重/(身高-腰围)2对MS的预测价值较高,其突出的灵敏度有利于对MS进行有效的筛查。
Objective To explore the value of predicting the risk of metabolic syndrome (MS) combined with waist circumference, body height and body mass index to provide the basis for the prevention and treatment of MS. Methods From May 1 to June 1, 2014, 552 residents in Tianjin area from the Fourth Central Hospital of Tianjin were enrolled in this study. Each subject completed a general survey, which included general demographic data Body weight / (waist-height), body weight / (waist-height), and body weight / (waist circumference) Height 2 - waist circumference 2) and waist circumference 2 / (weight × height). Using four non-obese conditions referred to in the International Diabetes Federation (IDF) 2005 criteria, two or more non-obesity conditions were considered as MS to determine the value of different obesity indicators in the diagnosis of MS. SPSS15.0 software was used for statistical analysis, t test was used to compare the measurement data of two groups, the count data were compared with χ2 test. The receiver operating characteristic (ROC) curve was plotted to calculate the area under the curve (AUC) and the best diagnostic point. Results The ROC curve analysis showed that the predicted AUC of body weight / (height-waist circumference) 2 was 0.709 and 0.799 for males and females, respectively. The predicted predictive power was higher than that of BMI, WC, WHt R, body weight / Waist 2 / (height × weight); Body weight / (height - waist circumference) 2 The best cutoffs were 0.010 010 for males and 0.008 257 for females; Sensitivity and specificity were 0.86 and 0.47 for males and 0.93 for females and 0.93 for females respectively 0.55, higher sensitivity than other obesity indicators; Men and women’s Youden index were 0.33 and 0.48. Body weight / (height - waist circumference) 2 instead of WC screening MS, consistency test, Kappa value of 0.794, indicating good consistency. Conclusion Body weight / (height - waist circumference) 2 has a high predictive value for MS, and its outstanding sensitivity is helpful for effective MS screening.