哈萨克族代谢综合征适宜腰围切点的研究

采用分层整群随机抽样的方法,对新疆部分地区常住哈萨克族居民进行问卷调查、体格检查和血生化检测,共收集完整资料2 760例,分析其不同腰围水平和代谢综合征(MS)组分聚集的关系.按照国际糖尿病联盟(IDF)标准,随着腰围升高,哈萨克族≥1和≥2个MS组分检出率呈增加趋势,比值比(OR)明显增高.当男性腰围≥91 cm,女性≥88 cm,受试者工作特征(ROC)曲线距离最短.以此标准哈萨克族MS粗患病率为22.1%,男性为22.4%,女性为21.9%.

Abstract：

Questionnaire-based survey, physical examination, and blood testing were conducted according to cluster random samplings in Kazakh residents in Xinjiang.2 760 samples were collected to analyze the association of different strata of waist circumference and clustering of metabolic syndrome (MS) components.Accoding to International Diabetes Federation standard, the prevalence of ≥1and ≥2 components of MS showed increasing trend with the increase of waist circunference, and odds ratio of clustering of MS components also increased significantly.The distance of receiver operating characteristic curve was the shortest and the prevalence of MS was 22.1% ;22.4% in men, and 21.9% in women;when the waist circumference was ≥91 cm for men, and ≥88 cm for women.     

上海市奉城社区30岁以上人群代谢综合征及其相关疾病的流行病学调查

目的：调查上海市奉城社区代谢综合征（MS）及其相关疾病的患病情况。方法：随机整群抽取奉城镇灯民村及洪南村30岁以上村民1041人列入本次分析。MS的诊断以国际糖尿病联盟（IDF）2005年4月制定的工作定义及诊断标准为依据。结果：①上海奉城社区30岁以上人群中常见代谢病患病率较高,超重、肥胖、中心性肥胖、糖调节异常（IGR）、糖尿病（DM）、高血压、高三酰甘油（TG）血症以及MS患病率分别为38.14%、11.24%、49.09%、15.05%、4.71%、58.69%、17.77%、26.51%;②上述疾病发病率随年龄增长而增加,其中50岁以上人群超重、中心性肥胖、IGR、DM、高血压、高TG血症及MS发病率是50岁以下人群的1.07～3.55倍;③高血压前期发病率为14.41%,随年龄增长高血压患病率的增多呈下降趋势;④社区中2/3以上人群患有不同程度代谢异常,1/3以上人群患有2种以上代谢异常。结论：上海农村社区人群具有较高的MS及相关疾病患病率。     

中国哈萨克族成人代谢综合征腰围适宜切点研究

探讨哈萨克族成人代谢综合征(MS)诊断的腰围适宜切点.选取2 052例哈萨克族成人,依据国际糖尿病联盟标准,检出两个以上MS组分的假阳性和假阴性率均较低的腰围切点为男性≥99 cm,女性≥88 cm.建议哈萨克族成人以此切点作为MS的检出标准.     

蒙古族农牧民代谢综合征诊断的腰围切点观察

目的研究我国蒙古族农牧民代谢综合征（MS）诊断的腰围（WC）适宜切点。方法以内蒙古自治区通辽市科左后旗朝鲁吐苏木和奈曼旗固日班花苏木32个自然村2589名年龄大于20岁的蒙古族农牧民为研究对象,以国际糖尿病联盟（IDF）MS全球共识诊断标准为基础,分析蒙古族男女不同WC水平与MS其他组分聚集的关联,检出至少两个组分存在时灵敏度和特异度均较高的WC界限,作为诊断蒙古族农牧民MS的WC切点,并以此计算不同年龄组MS的检出率。结果随WC增大,MS组分聚集的OR值显著增高。当男性WC≥84cm、女性WC≥81cm时,ROC曲线下面积最大。结论IDF标准在蒙古族农牧民男性中WC切点偏高,宜降至男性≥85cm、女性≥80cm。     

中国成人代谢综合征腰围切点的研究

目的　根据中国成人较近期的调查数据 ,分析代谢综合征中腰围的适宜切点。方法　利用国家“九五”科技攻关课题 1998年在 15组人群进行心血管病危险因素调查 13732例 35～ 5 9岁成人的数据库 ,分析男性和女性不同腰围水平和代谢综合征其他成分聚集的关系 ,并寻找检出两个及以上危险成分假阳性和假阴性率均较低的腰围切点 ,作为成人腰围切点的建议。据此计算各性别年龄组代谢综合征的患病率 ,以及成分组合特点。结果　随腰围增大 ,代谢综合征成分聚集的OR值显著增高 ,以男性腰围≥ 85cm ,女性腰围≥ 80cm ,ROC曲线距离最短。以此为腰围切点中年男性人群代谢综合征患病率为 19 3% ,女性为 13 9% ,其中以腰围超标 ,血压升高和高甘油三酯三项的组合为最多。结论　建议男性腰围≥ 85cm ,女性腰围≥ 80cm ,收缩压≥ 130mmHg(1mmHg =0 133kPa)和 (或 )舒张压≥ 85mmHg ,血清甘油三酯≥ 1 6 9mmol/L ,高密度脂蛋白胆固醇 <1 0 3mmol/L ,空腹血糖≥ 6 1mmol/L ,5项中具备 3项及以上作为中国成人代谢综合征的临床检出标准。以上初步结果需要在有全国代表性的样本中进一步验证。     

国际糖尿病联盟代谢综合征诊断标准中的腰围切点分析

目的分析国际糖尿病联盟（IDF）关于代谢综合征（MS）的诊断标准中适用于我国城市中老年人群的诊断中心性肥胖的腰围切点。方法对北京地区中老年人群流行病学调查，无糖尿病者行口服75g葡萄糖耐量试验，同时进行问卷调查和体检。对1870例完整资料进行统计，通过对腰围预测各代谢异常危险因素的分析，讨论适用于该人群的诊断中心性肥胖的腰围切点。结果（1）无论男性还是女性，甘油三酯（TG）、收缩压、舒张压和空腹血糖（FBG）的中位数均随腰围的增加而呈线形增加趋势，高密度脂蛋白胆固醇（HDL-C）呈线形下降趋势；（2）高TG、高血压、高FBG、低HDL-C及≥2个危险因素的患病率随腰围的增加而增加；（3）腰围预测各代谢异常因素的敏感度和特异度、ROC曲线，以及Youden指数均显示男性腰围90cm，女性腰围80cm时预测各代谢异常因素的真实性较好；（4）预测≥2个代谢异常危险因素的OR值在男性腰围≥90cm，女性≥80cm时增加最为显著。结论北京城市中老年人群中男性腰围90cm，女性80cm是IDF诊断MS的标准中诊断中心性肥胖的合适切点。     

青少年代谢综合征腰围身高比切点的初步探讨

目的 探讨预测青少年代谢综合征的最佳腰嗣身高比(WHtR)切点.方法 在秦皇岛地区进行一项4 507名13～18岁青少年的横断面调查.采用受试者工作特征(ROC)曲线分析确定代谢综合征 的最佳WHtR切点.结果 无论男性还是女性,代谢综合征的百分比均随着WHtR的增加而增加.WHtR>/0.45后发生代谢综合征的OR值显著增加,分别为13.85(4.08～46.97)和12.42(2.62～58.96,P<0.01).ROC曲线分析显示以上相应WHtR切点具有最佳的敏感性和特异性.结论 WHtR与青少年代谢综合征密切相关.预测青少年代谢综合征的WHtR切点为0.45.     

我国维吾尔族成人代谢综合征腰围适宜切点研究

目的研究我国维吾尔族成人代谢综合征（MS）诊断中腰围的适宜切点。方法以乌鲁木齐市和喀什地区2526例25-90岁维吾尔族成人为研究对象，以国际糖尿病联盟（IDF）MS全球共识诊断标准为基础，分析维吾尔族男女不同腰围水平与MS其他组分聚集的关系，检出至少两个组分存在时假阳性率和假阴性率均较低的腰围界限，作为诊断维吾尔族成人MS腰围切点，并以此计算不同年龄组MS的检出率及成分组合特点。结果随腰围增大，MS组分聚集的OR值显著增高。在我们所划分的切点中，当男性腰围≥93cm、女性腰围≥89cm时，ROC曲线距离最短。以此腰围切点计算维吾尔族成人的MS检出率，男性为26．0％，女性为27．7％。结论建议维吾尔族以男性腰围≥93cm、女性腰围≥89cm为切点，结合IDF诊断标准中其他组分定义，作为维吾尔族成人MS的临床检出标准。以上结果有待在更大样本量的维吾尔族人群中进一步验证。     

女性绝经前后腰围身高比预测代谢综合征的筛选切点

目的分析女性绝经前后腰围身高比(WHtR)与代谢综合征(MS)的关系,寻找WHtR预测MS的筛选切点。方法选择女性体检者1 964例,其中绝经前1 091例,绝经期873例。通过计算ROC曲线下面积评估WHtR,预测MS、各亚指标的敏感性、特异性及其筛选切点,用Logistic回归分析WHtR比值预测MS发病的风险值。结果WHtR与MS及各亚指标密切相关,以WHtR筛查MS及各亚指标的ROC曲线下面积,其预测MS发生危险增加的筛选切点界值为绝经前0.48、绝经期0.51;高于此切点时,绝经前和绝经期MS的发病风险明显增加。结论绝经前、绝经期女性WHtR是预测MS的重要指标,其WHtR比值0.48、0.51的各自切点是MS的警戒线,高于此切点预示MS的发病风险明显增加。     

贵阳市城区某社区20岁及以上成人代谢综合征患病率调查

目的了解贵阳市城区成人代谢综合征（MS）的患病情况,并分析其影响因素。方法2009年11月至2010年2月,采用分层整群抽样方法调查贵阳市城区宅吉社区20岁及以上常住居民共1512人（男634人,女878人）,分为6个年龄组（≥20—30、≥30～40、≥40～50、≥50—60、≥60～70、≥170岁）,对其进行问卷调查、体格检查及相关代谢指标的测定。MS采用2005国际糖尿病联盟（IDF）全球共识定义。组间率的比较用χ2检验,均数的比较用t检验。结果调查人群中Ms的粗患病率为29．7％（男性26．5％,女性32．0％）,女性高于男性（χ2=5．346,P〈0．05）,标化患病率为29．1％（男性26．6％,女性31．6％）。MS的患病率随年龄的增长而显著升高,女性在≥60～70岁达到高峰,男性在≥140～50岁达到高峰。调查人群中中心性肥胖、甘油三酯升高、高密度脂蛋白胆固醇降低、血压升高及空腹血糖升高的粗患病率分别为39．5％、38．0％、49．1％、35．9％、55．2％,标化患病率分别为38．3％、39．4％、47．6％、36．1％、56．0％。调查人群中,1335名（88．3％）有一项以上代谢组分异常。MS患者中,有3、4及5项代谢组分异常者分别占43．2％、39．9％及16．9％。结论贵阳市城区宅吉社区成人MS的患病率较高,MS的防治工作应进一步加强。     

Optimal cut‐off point of waist circumference for the diagnosis of metabolic syndrome in Japanese subjects

Metabolic syndrome (MetS) has been redefined by a new criterion in Japan, in which waist circumference cut‐off points, that is 85 cm for men and 90 cm for women, are used; however, objections are rising against this criterion. The present study examined the criterion for waist circumference to predict the accumulation of the components of MetS. In the present study, we used data for 5972 Japanese people who received annual health examinations, and 621 men (16.3%) and 51 women (2.4%) were diagnosed as having MetS. A cut‐off point as a predictor for two or more components of MetS was evaluated by the sensitivity/specificity and a receiver operating characteristic analysis. The optimal point of waist circumference was estimated as being approximately 84 cm for men and 80 cm for women. We therefore recommend revising the cut‐off value for the criterion of MetS in women according to our results and studies from other investigators. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2010.00020.x, 2010)     

Determination of most suitable cut off point of waist circumference for diagnosis of metabolic syndrome in Kerman

ObjectivesMetabolic syndrome is a determining indicator of cardiovascular diseases and diabetes. Abdominal obesity, determined by measuring waist circumference, is one of the most important criteria for diagnosing this syndrome. This criterion varies between men and women and among different races. The present study aims at the assessment of the sensitivity and specificity of the commonly used cut off point of waist circumference, and the estimation of the most suitable cut off point of waist circumference for the diagnosis of metabolic syndrome in the urban society of Kerman.Methods5332 subjects consisting of 2966 women and 2366 men, 20 years old and above were studied in a population based, cross sectional study. Waist circumference, blood pressure, blood sugar, and blood lipids were measured. People with at least two of the NCEP ATP III criteria – high blood pressure (BP > 130/80), high triglycerides (TG > 150), high glucose (FBG > 100) and low HDL (HDL < 40 in men and <50 in women) – were taken as population at risk. ROC analysis was used for determining the most suitable cut off point of waist circumference. The prevalence of metabolic syndrome was then assessed based on IDF, NCEP criteria and the proposed criterion, and agreement among the three methods in diagnosing people suffering from metabolic syndrome was examined.ResultsThe average ± standard deviation of waist circumference in women and in men was 83.90 ± 12.55 and 87.99 ± 11.94 cm respectively. The most suitable cut off point of waist circumference for metabolic syndrome diagnosis was 86 in women and 89 in men. These circumferences had the highest specificity and sensitivity. The prevalence of metabolic syndrome in IDF, NCPE, and the proposed criterion was 30.4%, 27.7%, and 35.2% respectively. The new criterion and the NCEP criterion achieved the highest agreement (kappa factor = 83%).ConclusionThe cuts off point of waist circumference in men and women are close. It is possible, then, to determine a common cut off point of waist circumference for both in Iran. Therefore, the cut point of 90-cm of waist circumference proposed by the National Obesity Committee seems to be appropriate for the Iranian society. These clinical findings should nevertheless be verified by simulation.     

中国成人多重心血管危险因素聚集的最佳腰围切割点

目的探讨中国成人多重心血管危险因素聚集的最佳腰围切割点。方法分析1994年全国糖尿病普查的15628例年龄≥25岁的中国成人资料。以腰围〈70cm组（每隔5cm分为一组）作为对照,计算其他各组发生多重心血管危险因素的优势比OR值和95％CI。采用ROC曲线分析计算不同腰围水平对多重心血管危险因素聚集识别的敏感性和特异性,以诊断指数（诊断指数=1-假阳性-假阴性）最大的腰围作为最佳切割点。结果无论男性还是女性。胰岛素抵抗、血脂异常、高血压和高血糖的百分比均随着腰围的增加而增加。男性腰围≥85cm、女性腰围≥80cm后发生代谢综合征的OR值显著增加[分别为2．08（95％CI1．80-2．39）和1．66（95％CI1．41-1．97）1。ROC分析显示以上相应腰围切割点具有最佳的敏感性和特异性。结论反映中国成人多重心血管危险因素聚集的男性最佳腰围切割点为85cm、女性为80cm。     

Optimal waist circumference cutoff values for predicting metabolic syndrome among older adults in Ecuador

AimsTo determine optimal waist circumference cutoff values for predicting metabolic syndrome (MetS) among adults aged 60 years and older in Ecuador.Material and methodsThe National Survey of Health, Wellbeing, and Aging survey was used to describe the prevalence of MetS according to standard definitions. Receiver operating characteristics (ROC) curve analyses and the Younden index J (YI) were performed to examine optimal waist circumference cutoff values for predicting MetS. Moreover, the prevalence of MetS according to country-specific waist circumference cutoff values was compared with those using standard definitions.ResultsAmong 2306 participants with a mean age of 70.6 years, the optimal waist circumference cutoff value for predicting MetS was 90.7 cm in women with a sensitivity of 66.1%, specificity of 65.6% and YI of 0.31. In men, a waist circumference of 91.2 cm with a sensitivity of 73.2%, specificity of 62.8%, and YI of 0.36 was the optimal cutoff point for predicting MetS. In general, applying country-specific cutoff values decreased the prevalence of MetS among older Ecuadorian women. In men, except with the ATP III definition, similar MetS prevalence rates were seen whether the country-specific or standard waist circumference cutoff values were applied.ConclusionsThe optimal waist circumference cutoff values for predicting metabolic syndrome among older Ecuadorians adults were 90.7 cm for women and 91.2 cm for men. Moreover, current standard definitions of abdominal obesity may overestimate the prevalence of MetS, particularly in Latin American women.     

儿童青少年体质指数、腰围预测代谢综合征的意义

目的 研究儿童青少年腰围（WC）、体质指数（BMI）预测胰岛素抵抗（IR）或代谢综合征（MS）的意义。方法 对超重33例、肥胖106例、正常对照（NC）儿童青少年140例进行身高、体重、腰围、Tanner分期、血压及OGTT、血脂、胰岛素的测定。结果 总体人群中，BMI、WC与MS组分存在单因素相关关系（P〈0．01），其中与HOMA-IR相关性最好（r=0.717，0.709）。多元线性回归分析显示，正常对照组WC（β coefficient=2．169）和TG（βcoefficient=0.429）可预测HOMA-IR，而超重肥胖组BMI（βcoefficient=0.356）和TG（βcoefficient=0.886）可预测HOMA—IR。结论 超重、肥胖儿童青少年的BMI可能是确定MS高危人群的指标。