腰围身高比对代谢综合征的筛检能力分析及界值确定

Power and the cutoff value of waist-to-height ratio predicting metabolism syndrome

目的分析腰围身高比(WHtR)对代谢综合征(MS)的筛检能力并确定界值,以期获得简单、准确、经济、家庭化的MS筛检方法。方法采用随机整群抽样的方法,以河南省某县为研究现场对成年常住居民进行问卷调查、体格检查和生化检查。进而通过MedCalc软件对WHtR与腰围预测MS各代谢异常组分的ROC曲线下面积进行比较;计算WHtR筛检MS的界值并分析假阳性和假阴性人群的特征。结果WHtR与WC相比,除对MS少数组分预测能力无统计学差异外;对其余各组分的预测能力均较强;WHtR筛检MS的界值为男性0.51,女性0.52,不考虑性别差异的界值为0.52。对假阳性和假阴性人群进行特征分析显示:假阳性组人群的体重、BMI、腰围等指标高于假阴性组,其余指标低于假阴性组。假阳性组中存在任意一个组分异常者的人数占80.78%;存在任意两个组分异常者人数占8.59%。结论WHtR对MS单组分及复合组分异常的预测效力均较强,适合作为MS的筛检指标,其诊断界值可定为0.52。

Objective In order to gain a simple,accurate,economical and familyused predictor for metabolism syndrome（MS）,the predictive power and the cutoff value of waist-to-height ratio（WHtR） were explored.Methods A random cluster sampling was carried out in a county of Henan Province.Questionnaire,physical examination and biochemical tests were admitted to the adult inhabitants.Statistics software MedCalc was used to compare the areas under curve of ROC（AUC） between WHtR and WC on predicting metabolism abnormal components.The cutoff value of WHtR predicting MS was calculated.The characters of false positive and false negative population were analyzed.Results The AUC of WHtR were larger than WC in most of the metabolism abnormal components,though there was no statistical significance in some metabolic abnormality components.The cutoff value of WHtR was 0.51 in male,0.52 in female and 0.52 in total.The means of components such as weight,BMI,WC in false positive group were higher than that in false negative group.However,the means of other components were lower.There were 80.78% people who had one metabolic abnormality component.There were 8.59% people who had two components.Conclusion The power of WHtR predicting one or more metabolic abnormality components was strong.It is a good predictor for MS.The cutoff value was 0.52.