腰围是代谢综合征最主要的危险成分

目的在代谢综合征(MS)多种成分中,试图发现其中最主要的成分,验证腰围预测中华医学会糖尿病学分会(CDS)建议的MS标准的临床价值。方法收集163例研究对象,以CDS建议的MS为标准,MS患者80例,非MS患者83例,比较MS及非MS患者年龄、腰围、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBG)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C),Logistic回归分析预测腰围对MS的危险性,分别建立男性及女性腰围对MS的ROC曲线评价系统,计算ROC曲线下面积,确定腰围最佳诊断界定值,得出灵敏度及特异度。结果MS患者的年龄、腰围、BMI、SBP、DBP、FBG、TG、1/HDL-C均大于非MS患者;控制年龄、吸烟、糖尿病家族史、高血压家族史后,Logistic回归分析示腰围是MS最主要危险因素;男性ROC曲线下面积0.92,腰围界定值为89.5cm时,灵敏度为0.84,特异度为0.93。女性ROC曲线下面积0.93,腰围界定值为80.8cm时,灵敏度为0.97,特异度为0.81;研究发现,吸烟也是MS的危险成分,现仍吸烟者MS的风险是从未吸烟者的6.88倍,曾吸烟者是从未吸烟者的3.96倍。结论证实高腰围是MS最主要危险因素,是预测CDS建议MS标准的可靠指标.吸烟也是MS的危险成分。

Waist Circumference is The Most Important Components of Metabolic Syndrome

Objective Among the various components of metabolic syndrome(MS),this investigation attempt to find the most important one.Furthermore,to verify the feasibility of using waist circumference(WC)for assessing the diagnostic criteria for MS proposed by the CDS in 2004.Methods Among 163 cases recruited,80 patients met the criteria of MS and 83 cases were diagnosed as non-metabolic syndrome group(non-MS).Age,WC,body mass index(BMI),fasting plasma glucose,lipid profile,blood pressure were compared between patients of MS and non-MS.Logistic regression analysis and area under curve(AUC)of receiver-operating characteristic(ROC)were used to study the predictive value of WC.Results Patients with CDS-defined MS showed a significantly higher age,WC,SBP,DBP,fasting plasma glucose,triglycerides(TG),1/HDL-C when compared with non-MS group.After adjusting for age,the family history of diabetes and hypertension,smoke,multiple logistic regression analysis revealed WC was the most important predictive factor for MS group.ROC analysis showed that the AUC of WC was 0.92 in the males,the cut-off value is 89.5 cm,the sensitivity was 0.84,the specificity was 0.93;the AUC of WC was 0.93 in the females,the sensitivity was 0.97,the specificity was 0.81 when cut-off value is 80.8 cm.This investigation has shown that smoking was also a component of MS.The relative risk of MS in current smokers and sustained smoker was higher than that of abstinence(6.88 vs 1.00 and 3.96 vs 1.00).Conclusion Central obesity is the riskest indicator for the diagnostic criteria for MS proposed by the CDS,WC is verified to be the accuracy and satisfactory predictive indicators for MS.Smoking may be a novel component of MS.