体脂肪率在代谢综合征诊断中的应用

Application of body fat percent in diagnosis of metabolic syndrome

目的：探讨不同性别个体体脂肪率（BF％）与代谢综合征（MS）之间的关系，阐明BF％是不同性别体检者MS的判定因素之一。方法：选择健康体检者904人，其中男性554人，女性350人。检测其BF％、体质量指数（BMI）、腰臀比（WHR）、收缩压（SBP）、舒张压（DBP）、空腹血糖（FBG）和血脂（BL）等指标，分析不同性别体检者各代谢指标差异；采用Spearman相关分析方法分析不同性别体检者各代谢指标与BF％的相关性；采用Logistic回归分析方法分析不同性别体检者BF％与MS的发病风险；采用受试者工作特征（ROC）曲线分析不同性别体检者BF％判定MS的可靠性和适宜切点。结果：男性体检者SBP、DBP、FPG、BMI和WHR水平高于女性（P〈0．05）。男性体检者BF％低于女性（P〈O．05）；男性和女性BF％分别与SBP（r=0．27，r=0．41）、DBD（r=0．27，r=0．34）、FBG（r=0．18，r=0．37）、总胆固醇（TC）（r=0．19，r=0．31）、甘油三酯（TG）（r=0．42，r=0．47）和低密度脂蛋白-胆固醇（LDL—C）（r=0．17，r=0．33）水平均呈显著正相关关系，与高密度脂蛋白-胆固醇（HDL-C）水平呈显著负相关关系（r=0．28，r=0．30）。在调整MS相关因素后，BF％仍为MS的独立危险因素（OR=1．090，95％CI 1．044～1.137），男性BF％异常升高发生MS的风险是BF％正常者的1．086倍（95％CI：1．0301．144），女性BF％异常升高发生MS的风险是BF％正常者的1．107倍（95％CI 1．027～1．192）。男性BF％诊断MS的ROC曲线下面积为0．710（95％C10．665～0．754），BF％在29．050％为最佳切点值；女性BF％诊断MS的ROC曲线下面积为0．811（95％CI：0．749～0．873），BF％在38．550％为最佳切点值。结论：不同性别个体的BF％是MS的危险因素，对MS的发生具有预测价值。

Objective To determine the relationship between body fat percent （BF~） and metabolic syndrome （MS） in healthy examinees with different gender, and to clarify that BF~ was one of the main risk factors to judge MS. Methods 904 persons （554 male and 350 female） for health examination were recruited, the BF~, body mass index （BMI）, waist-to-hip ratio （WHR）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, fasting blood glucose （FBG）, and blood lipid （BL） were compared between male and female; the correlation between metabolic indexes and BF% in examinees with different gender was detected by Spearman correlation analysis; the correlationship between BF% and the risk of MS in examinees with different gender was analyzed by Logistic regression; the optimal cut-point and reliability of BF% in judging MS were calcuated by receive operating characteristic （ROC） curve in the examinees with different gender. Results The levels of SBP, DBP, FBG, BMI, and WHR in the male examinees were higher than those in the female （P〈0.05）. The levels of BF% in the male examinees were lower than that in the female （P〈0.05）. The BF% was positively correlated with the levels of SBP （r=0.27, r=0.41）, DBP （r=0.27, r=0.34）, FBG （r=0.18, r=0.37）, total cholesterol （TC） （r=0.19, r=0.31）, triglycerides （TG） （r=0.42, r=0.47）, low density lipoprotein cholesterol （LDL-C） （r= 0.17, r= 0.33） and negatively correlated with the level of high density lipoprotein cholesterol （HDL-C） （r= -0.28, r=-0.30） in both women and men. After adjustment for all components of MS, BF% was still the independant risk factor of MS （OR=1. 090, 95%CI 1. 044-1. 137）. The risk of MS in the men and women with abnormal increasing of BF% was 1. 086 （95% CI 1. 030 - 1. 144） and 1. 107 （95% CI 1. 027 - 1. 192） times the people with normal BF%. In ROC analysis on BF% and MS, the areas under ROC curve were 0. 710 （95% CI 0. 665-0.754） and 0. 811 （95%CI 0. 749-0. 873） in the male and female, respectively. The optimal cut-points of BF% for MS were 29. 05% in the male and 38. 550% in the different female. Conclusion BF% is a risk factor and indicator for MS in the people with gender.