2021年康定市45岁及以上中老年人人体成分指标对糖、脂代谢异常的诊断效能分析  

Analysis of the diagnostic efficacy of body composition indicators for abnormal glucose and lipid metabolism in middle-aged people aged 45 years and above in Kangding City in 2021

作　　者：何夏梦 林嘉玲 蒲芳芳 魏瑶瑶 曾献春[3] 石磊[1] 柳园[1] 胡雯[1] HE Xiameng;LIN Jialing;PU Fangfang;WEI Yaoyao;ZENG Xianchun;SHI Lei;LIU Yuan;HU Wen(Clinical Nutrition Department of West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China;Sichuan Tianfu New Area People’s Hospital,Chengdu 610213,Sichuan Province,China;School of Laboratory Medicine,Chengdu Medical College,Chengdu 610500,Sichuan Province,China;West China School of Public Health,Sichuan University,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川大学华西医院临床营养科,成都610041 [2]四川天府新区人民医院,成都610213 [3]成都医学院检验医学院,成都610500 [4]四川大学华西公共卫生学院,成都610041

出　　处：《预防医学情报杂志》2024年第2期117-123,131,共8页Journal of Preventive Medicine Information

基　　金：国家重点研发计划(项目编号:2018YFC2001804)。

摘　　要：目的分析四川省康定地区中老年人群体成分和糖、脂代谢的现况,研究人体成分指标对糖、脂代谢异常的诊断效能,为中老年人群慢病防控提供参考依据。方法于2021年9至10月,采用方便抽样的方法对四川省康定市中老年居民进行问卷调查、人体成分检测及实验室检测,运用t检验比较糖、脂代谢异常人群和正常人群体成分的差异,采用Spearman相关性分析糖、脂代谢指标与人体成分指标间的相关性,运用ROC曲线研究人体成分指标对糖、脂代谢异常的诊断效能,以P<0.05为差异有统计学意义。结果共纳入1056例调查对象,其中男性722人,女性334人,平均年龄(56.42±6.85)岁,检出血糖调节受损占14.0%,血脂代谢异常占51.3%,糖、脂代谢均异常占10.0%。血糖调节受损组的骨骼肌质量指数(SMI)、体质指数(BMI)、体脂百分比(PBF)、内脏脂肪面积(VFA)和腰臀比(WHR)均高于其正常组(P均<0.05);血脂代谢异常组及糖、脂代谢均异常组的SMI、骨骼肌质量(SMM)、瘦组织质量(SLM)、BMI、PBF、VFA和WHR均分别高于其正常组(P均<0.05)。BMI、PBF、VFA、WHR与空腹血糖呈正相关(P均<0.05);PBF、VFA、WHR与总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)呈正相关(P均<0.05);SMI、SLM、SMM与TC、高密度脂蛋白胆固醇(HDL-C)呈负相关(P均<0.05)。选取与血糖、血脂具有相关性的体成分指标,进行ROC曲线分析,BMI、PBF、VFA与WHR可预测血糖调节受损,其中WHR的诊断效能最高,理想界值点为0.88(P<0.05);SMI、SLM、SMM、BMI、PBF、VFA与WHR可预测血脂代谢异常和糖、脂代谢均异常风险,两者BMI的诊断效能均最高,理想界值点分别为24.65 kg/m^(2)和24.45 kg/m^(2)(P均<0.05)。结论四川省康定地区中老年人群存在糖、脂代谢异常,其中血脂代谢异常率最高,人体成分中WHR和BMI是预测糖、脂代谢异常的良好指标。Objective To analyze the current situation of composition and glucose and lipid metabolism in the middle-aged and elderly population in Kangding City,Sichuan Province,to study the diagnostic efficacy of human composition indicators on glucose and lipid metabolism abnormalities,and to provide reference basis for the prevention and control of chronic diseases in the middle-aged and elderly population.Methods From September to October 2021,the convenient sampling method was used to select middle-aged and elderly residents in Kangding City of Sichuan Province for a questionnaire survey,body composition tests and laboratory tests.T-test was applied to compare the differences in group composition between people with abnormal glucose and lipid metabolism and normal people.Spearman correlation analysis was used to analyze the correlation between glucose and lipid metabolism indexes and body composition indexes.The receiver operating characteristic(ROC) curve was used to study the diagnostic efficacy of body composition indexes for abnormal glucose and lipid metabolism.And the difference was considered statistically significant with P<0.05.Results A total of 1 056 cases were included in the survey,including 722 males and 334females,with an average age of(56.42 ± 6.85) years.Impaired glucose regulation accounted for14.0%,abnormal lipid metabolism accounted for 51.3%,and abnormal metabolism of both glucose and lipid accounted for 10.0%.The skeletal muscle mass index(SMI),body mass index(BMI),percentage of body fat(PBF),visceral fat area(VFA) and waist-to-hip ratio(WHR) in impaired blood glucose regulation group were higher than those in normal group(all P<0.05).SMI,skeletal muscle mass(SMM),lean tissue mass(SLM),BMI,PBF,VFA and WHR were higher in the abnormal lipid metabolism group and in the group with both abnormal glucose and lipid metabolism than those of normal group(P<0.05).BMI,PBF,VFA and WHR were positively correlated with fasting glucose(all P<0.05).PBF,VFA and WHR were positively correlated with total cholesterol

关 键 词：高原地区 中老年人 人体成分分析 血糖 血脂 

分 类 号：R181.2[医药卫生—流行病学]