绝经年限对代谢综合征筛选切点的研究

Clinical Discriminability of the Number of Years since Menopause in Assessment of Metabolic Syndrome in Women with Menopause

目的:评估女性绝经年限与代谢综合征的相关性,探讨其对代谢综合征以及各项亚指标的筛选切点。方法:选择河北省衡水市哈励逊国际和平医院女性体检者共4 200名,包括绝经前女性和绝经期女性。通过计算受试者工作曲线(ROC)下面积评估绝经年限检测代谢综合征以及各项亚指标的敏感度和特异度及其筛选切点,并通过Logistic回归分析绝经年限检测代谢综合征发病的风险值。结果:最终有2 868例体检者符合条件纳入研究,包括绝经前女性1 655例,绝经期女性1 213例。绝经年限与代谢综合征以及各亚指标关系密切。以绝经年限作为筛查指标,其代谢综合征发病率的ROC曲线下面积0.66(即ROC曲线下面积>0.5即为有显著统计学意义),检测代谢综合征发生危险增加的筛选切点界值为绝经8年,高于此切点代谢综合征的发病风险相对增加2.7倍。结论:绝经期女性代谢综合征发病与其绝经年限密切相关,绝经年限8年是代谢综合征发病的警戒线,高于此切点预示着代谢综合征的风险明显增加。

Objective： To evaluate clinical discriminability of the number of years since menopause in assessment of metabolic syndrome and to calculate the cut point above which there was seen elevations in onset risk of metabolic syndrome in women with menopause. Methods： Using data from 4 200 women enrolled in the health screening centre at Harrison International Peace Hospital attached to HEBEI Medical university in 2008 and 2009, we studied sensitivity and specificity of the number of years since menopause in assessment of metabolic syndrome and the best cut point,above which subjects were an upward shift in onset risk of metabolism and subgroup risk factors, was calculated by ROC curve. Logistic regression analysis was to show the onset relative risk in metabolism and subgroups risk factors above the cut point of the number of years since menopause. Results： 2 868 participants aged 19.0-81.0 y, including 1 655 pre-menopausal women and 1 213 women with menopause,were enrolled in this study according to the standard criterium.The number of years since menopause was significantly associated with the onset risk of metabolic syndrome and its subgroup risk factors in females with menopauses, the areas under the ROC curve was 0.66 （〉0.5 in the areas under the ROC curve show statisticsly significant） in the number of years since menopause as screening tool in indentifying the onset risk of metabolic syndrome in women with menopause, the best cut point above which point there was to elevate the related risk of metabolic syndrome was 8 years since menopauses in females with intact uterus. At the aforementioned cut point, compared with women with menopause of 〈 8 years,an increased likelihood of the onset rate of metabolic syndrome had a significant odds ratio：2.7.Conelusion：the number of years since menopause, a practical and convenient tool that had a high discriminant ability in identifying female with menopause with or without metabolic syndrome and other subgroup risk factors, appears as a valid screening tool .the elevated thresholds of 〉8years since menopauses were specific maker in indentifying metabolic syndrome and subgroups risk factors in apparently healthy women with intact uterus.