人体测量指标对代谢综合征心血管风险的预测价值  

Predictive value of anthropometric indicators for cardiovascular risk in metabolic syndrome

作　　者：卢绮韵[1] 李安香 陈本坚[1] 梁庆顺 范冠杰[1] 陶一鸣 张荣华 戴芳芳[3] 胡晓灵 刘昀玮 何英骁 朱樱 刘振杰[1] Lu Qiyun;Li Anxiang;Chen Benjian;Liang Qingshun;Fan Guanjie;Tao Yiming;Zhang Ronghua;Dai Fangfang;Hu Xiaoling;Liu Yunwei;He Yingxiao;Zhu Ying;Liu Zhenjie(Department of Endocrindogy,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,China;Department of TCM,Pharmacy College of Jinan University,Guangzhou 510632,China;Department of Endocrindogy,Jiangsu Province Hospital of TCM,Nanjing 210000,China;Department of Geriatrics,Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University,Urumqi 830000,China;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广东省中医院内分泌科,广州510120 [2]暨南大学药学院中药学教研室,广州510632 [3]江苏省中医院内分泌科,南京210000 [4]新疆维吾尔自治区中医医院老年病科,乌鲁木齐830000 [5]广州中医药大学第二临床医学院,510405

出　　处：《中华内分泌代谢杂志》2023年第1期26-33,共8页Chinese Journal of Endocrinology and Metabolism

基　　金：国家重点研发计划(2018YFC2002500);广州市民政局科技计划项目(2020MZK24);广东省中医院中医药科学技术研究专项(YN2020QN12);广东省中医院朝阳人才项目(ZY2022YL20)。

摘　　要：目的评价各种人体测量指标在代谢综合征(MS)人群中心血管风险的预测价值。方法采用横断面研究方法对MS受试者的人体测量指标与心血管风险进行相关统计学分析,通过心血管代谢风险指数(cardiometabolic risk index,CMRI)评估心血管代谢风险,使用受试者工作特征(ROC)曲线分析评估人体测量指标对心血管代谢风险的预测能力。结果(1)各人体测量指标[体重指数(BMI)、腰臀比、腰围身高比(WtHR)、体脂率、内脏脂肪指数(visceral fat index,VFI)、锥度指数(conicity index,CI)、体形指数(a body shape index,ABSI)、身体圆度指数(body roundness index,BRI)、腹部体积指数(abdominal volume index,AVI)]MS组明显高于非MS(P<0.05),同时2组的CMRI评分及高心血管风险差异均具有统计学意义(P<0.05)。(2)Logistic回归分析表明,无论在总体人群还是在非MS人群或MS人群中,校正混杂因素后,心血管风险随着BMI、VFI、腰臀比、WtHR、CI、BRI、AVI升高而增加(P<0.05)。(3)经ROC曲线分析,BMI、VFI、AVI在总体研究人群AUC值分别为0.767、0.734、0.770,在非MS人群分别为0.844、0.816、0.795,在MS人群分别为0.701、0.666、0.702。对于总体人群、非MS人群,BMI诊断心血管高风险的最佳截断点分别为26.04 kg/m^(2)、24.36 kg/m^(2),VFI的最佳截断点分别为10.25、9.75,AVI的最佳截断点分别为17.3 cm^(2)、15.53 cm^(2)。在MS人群BMI诊断青中年男性心血管高风险的最佳截断点为27.63 kg/m^(2),AVI诊断MS女性心血管高风险的最佳截断点为18.08 cm^(2)。结论BMI、VFI、AVI可用于普通人群早期心血管风险监测,BMI可作为MS青中年男性心血管高风险的预测指标,而AVI可作为女性心血管高风险的预测指标。Objective To evaluate the predictive value of anthropometric indicators in predicting cardiovascular risk in the population with metabolic syndrome(MS).Methods A cross-sectional study was used to analyze the correlation between anthropometric measures and cardiovascular risk in subjects with MS.Cardiometabolic risk was assessed with cardiometabolic risk index(CMRI).Receiver operating characteristic(ROC)curve analysis was used to assess the predictive power of anthropometric measures for cardiometabolic risk.Results(1)The anthropometric measures[body mass index(BMI),waist-hip ratio(WHR),waist-to-height ratio(WtHR),body fat percentage(BFP),visceral fat index(VFI),conicity index(CI),a body shape index(ABSI),body roundness index(BRI),abdominal volume index(AVI)]in the MS group were significantly higher than those in the non-MS group(P<0.05).Moreover,there were significant differences in CMRI score and vascular risk between the two groups(P<0.05).(2)Logistic regression analysis showed that the cardiovascular risk was increased with the increases of BMI,VFI,WHR,WtHR,CI,BRI,and AVI after adjusting for confounding factors in the overall population,the non-MS population,and the MS population(P<0.05).(3)In the ROC analysis,the AUC values of BMI,VFI,and AVI were 0.767,0.734,and 0.770 in the overall population;0.844,0.816,and 0.795 in the non-MS population;0.701,0.666,and 0.702 in the MS population,respectively.For the overall population and non-MS population,the optimal cut points of BMI to diagnose high cardiovascular risk were 26.04 kg/m^(2) and 24.36 kg/m^(2);the optimal cut points of VFI were 10.25 and 9.75;the optimal cut points of AVI were 17.3 cm^(2) and 15.53 cm^(2),respectively.In the MS population,the optimal cut point as a predictor of high cardiovascular risk in young and middle-aged men with MS was 27.63 kg/m^(2),and the optimal cut point of AVI in women was 18.08 cm^(2).Conclusion BMI,VFI,and AVI can be used as predictors of cardiovascular risk in the general population.BMI can be used as a predicator of high

关 键 词：人体测量指标 诊断预测 代谢综合征 心血管风险 

分 类 号：R589[医药卫生—内分泌]