应用腰围身高比、腰臀比预测儿童青少年代谢综合征的最佳切点值的研究  

Cutoff Waist-to-height and Waist-to-hip Ratios for Metabolic Syndrome in Chinese Children and Adolescents

作　　者：刘冰阳[1] 姜冉华 厉平[1] 刘聪[1] 李玲[1] 

机构地区：[1]中国医科大学附属盛京医院内分泌科,沈阳110004 [2]辽阳市糖尿病医院,辽宁辽阳111000

出　　处：《中国医科大学学报》2017年第5期434-438,443,共6页Journal of China Medical University

基　　金：辽宁省科学技术计划(2008225009-21)

摘　　要：目的应用不同的肥胖测量指标及胰岛素抵抗(IR)指标预测11~16岁儿童青少年代谢综合征(MS)的有效性及切点值。方法采用整群分层随机抽样的方法,于2010年12月至2011年1月选取辽阳市933名学生(11~16岁)作为调查对象,进行问卷调查,采集体格测量(身高、腰围、臀围)、血压、空腹血糖、血脂、血清尿酸(SUA)、空腹胰岛素等指标,绘制腰围身高比(WHt R)、腰臀比(WHR)、稳态模型胰岛素抵抗指数(HOMA-IR)、甘油三酯血糖指数(Ty G指数)预测IR的受试者工作曲线(ROC曲线),分析后得到各指标诊断的切点值。结果 ROC曲线的曲线下面积(AUC)数值从最高到最低依次为WHt R(女0.92,男0.90),WHR(女0.84,男0.83),Ty G指数(0.76),HOMA-IR(0.74),SUA(0.68);AUC数值均>0.5,且差异具有统计学意义(P<0.01)。WHt R预测MS的最佳切点值为男生0.48、女生0.46,灵敏度、特异度分别为87.0%、84.1%和95.1%、81.8%。WHR预测MS的最佳切点值为男生0.84、女生0.80,灵敏度、特异度分别为83.3%、70.3%和90.5%、71.8%。结论 WHt R和WHR可用于儿童青少年MS的预测,不推荐应用HOMA-IR、Ty G指数、SUA水平预测MS。Objective This study aimed to identify high-risk groups for metabolic syndrome （MS） among Chinese children and adolescents by calculating the cutoff values of adiposity measures and insulin resistance （IR）. Methods From December 2010 to January 2011, data from 933 Chinese subjects （492 boys and 436 girls, aged 11-16 years） from Liaoyang City, China, were included. Questionnaires were administered, and data such as anthropometric parameters （height, waist circumference, and hip cireumference）, blood pressure, fasting blood glucose level, blood lipid level, serum uric acid level, and fasting insulin level were collected. Receiver-operating characteristic （ROC） curve aualysis was used to deter- mine the optimal cutoff waist-to-height ratio （WHtR）, waist-to-hip ratio （WHR）, homeostasis model assessment-insulin resistance （HOMA-IR） index, triglyceride level, glucose index （TyG index）, and serum uric acid （SUA） level for identification of children and adolescents with MS. Re- sults The AUC of WHtR, WHR, TyG index, HOMA-IR index, and SUA level were larger than 0.5, with P values of 〈0.01. The optimal eutoff WHtR and WHR derived from the ROC analysis were respectively 0.48 （87.0%, 84.1% ） and 0.84 （83.3%, 70.3% ） for boys and 0.46 （95.1%, 81.8% ） and 0.80 （90.5%, 71.8% ） for girls. Conclusion This study demonstrated that WHtR and WHR are useful predictive markers of MS, while HOMA-IR, TyG index, and SUA level are not. The usefulness of these criteria needs to be verified by further evaluation.

关 键 词：代谢综合征 儿童青少年 肥胖 胰岛素抵抗 

分 类 号：R725.8[医药卫生—儿科]