肥胖相关的人体测量学指标对老年男性和绝经后女性代谢综合征的识别分析  

Identifying MS using obesity-related anthropometric indices in a population of Chinese elderly men and postmenopausal women

作　　者：阴大伟[1] 鲁晓春[1] 惠海鹏[1] 韩学美[2] 孙莹[2] 刘俊[2] 王琴 Yin Dawei;Lu Xiaochun;Hui Haipeng;Han Xuemei;Sun Ying;Liu Jun;Wang Qin(Department of Cardiology,the 2nd Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心心血管内科,北京100853 [2]解放军总医院第二医学中心急诊科,北京100853 [3]解放军总医院第二医学中心国际医学中心,北京100853

出　　处：《中华老年心脑血管病杂志》2021年第1期20-24,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的比较13项肥胖相关的人体测量学指标对老年男性和绝经后女性代谢综合征(MS)的识别能力。方法选取北京万寿路社区居住且资料完整的汉族老年男性和绝经后女性2329例,男性940例,女性1389例。按是否诊断MS,各自分为男性MS组165例和非MS组775例;女性MS组545例和非MS组844例。入选者均测定和计算A型形态指数(ABSI)、腹部容积指数(AVI)、身体肥胖指数(BAI)、身体圆度指数(BRI)、体质量指数(BMI)、锥度指数(CI)、纳瓦拉大学体脂估算公式(CUN-BAE)、腰高比(WHtR)、腰臀比(WHpR)、腰围(WC)、内脏脂肪指数(VAI)、脂质堆积产物指数(LAP)和腰围甘油三酯指数(WTI),分别比较MS组与非MS组的基线特征,采用ROC曲线分析评估13项指标对MS的识别能力。比较各项指标与BMI的ROC曲线下面积(AUC)差异。结果老年男性和绝经后女性MS的患病率分别为17.6%和39.2%。13项指标的AUC均>0.5(P=0.000)。男性BMI与AVI、BRI、CI、CUN-BAE、WC、WHtR和女性BMI与CI、CUN-BAE的AUC均无显著性差异(P>0.05)。男性中,VAI、LAP和WTI的AUC分别为0.874、0.855、0.849,其临界值分别为1.56、44.14和147.66。VAI与LAP的AUC相近(P=0.083),但高于WTI的AUC,有显著差异(P<0.01);女性中,LAP、VAI和WTI的AUC分别为0.887、0.875、0.861,其临界值分别为44.32、2.35和144.43。LAP与VAI的AUC相近(P=0.088),但高于WTI的AUC,有显著差异(P<0.01)。男女性ABSI、BAI及WHpR的AUC均不及BMI(P<0.05,P<0.01)。结论13项肥胖相关指标均可有效识别老年男性和绝经后女性的MS,其中VAI、LAP和WTI识别能力最强,ABSI、BAI及WHpR识别能力较弱。Objective To compared the ability of 13 anthropometric parameters to identify metabolic syndrome(MS)in Chinese elderly men and postmenopausal women.Methods Thirteen anthropometric parameters:body mass index(BMI),A body shape index(ABSI),abdominal volume index(AVI),body adiposity index(BAI),body roundness index(BRI),conicity index(CI),Clínica Universidad de Navarra-body adiposity estimator(CUN-BAE),lipid accumulation product(LAP),visceral adiposity index(VAI),waist circumference(WC),waist-to-hip ratio(WHpR),waist-to-height ratio(WHtR),and waist circumference-triglyceride index(WTI),were measured and calculated in a population of Chinese elderly men and postmenopausal women with and without MS.A receiver operating characteristic(ROC)curve was applied to assess their ability to identify MS.AUC differences between these indices and BMI were analyzed.The Youden index for each index was used to determine the optimal cut-off value.Results Totally 2329 subjects were recruited,in which 17.6%of elderly men and 39.2% of postmenopausal women had MS.All the thirteen anthropometric parameters could identify MS in both men and women with AUC>0.5(all P<0.01).Among these indices,VAI,LAP and WTI had the largest area under the curve(AUC)in both sexes,whereas ABSI,BAI and WhpR showed the lowest AUC value.The AUC of AVI,BRI,CI,CUN-BAE,WC,WHtR did not differ from that of BMI in men(P>0.05),and the AUC of CI,CUN-BAE did not differ from that of BMI in women(P>0.05).The optimal cut-off points in men were 1.56 for VAI,44.14 for LAP and 147.66 for WTI;those in women were 2.35 for VAI,44.32 for LAP and 144.43 for WTI.Conclusion All the thirteen obesity indexes were good discriminators with differences in the diagnosis of the MS in Chinese elderly men and postmenopausal women.VAI,LAP and WTI showed a superior predictive power for MS in both sexes,while ABSI BAI and WHpR were the weakest indicators for the screening of MS in both sexes.

关 键 词：肥胖症 人体质量指数 代谢疾病 糖尿病 2型 

分 类 号：R589[医药卫生—内分泌]