人体测量学指标和身体成分分析在筛查和预测老年代谢综合征中的应用

Utility of anthropometric parameters and body composition analysis for the screening and prediction of metabolic syndrome in the elderly

目的 探讨人体测量学指标和身体成分分析对于老年代谢综合征的筛查和预测作用并探索最佳的预测指标。方法 本研究为横断面研究，包括763名参加健康体检的60～88岁老年人（男性406人，女性357人），分别测定其人体测量学指标、身体成分、血脂、空腹血糖、高敏C反应蛋白，采用接受者工作特征曲线（ROC曲线）判定腰围、腰围臀围比、腰围身高比、体脂肪百分率和脂肪指数对老年代谢综合征的筛查作用，并确定其理想切点、敏感度、特异度、曲线下面积。结果 腰围、腰围身高比、腰围臀围比、脂肪百分率和脂肪指数均对老年代谢综合征有预测价值。在男性，腰围87．5cm，腰围臀围比0．89，腰围身高比0．51、脂肪百分率24．1％和脂肪指数5．00kg／m。为预测代谢综合征存在的理想切点，敏感度和特异度分别为：腰围（81-3％，57．7％）、腰围臀围比（78．8％，62．6％）、腰围身高比（87．5％，50％）、脂肪百分率（51．3％，75．5％）和脂肪指数（83．8％，51．8％）；曲线下面积分别为0．728、0．755、0．716、0．671和0．725；在女性，腰围77．5CI／1，腰围臀围比0．87，腰围身高比0．52、脂肪百分率31．7％和脂肪指数7．80kg／m。为预测代谢综合征存在的理想切点，敏感度和特异度分别为：腰围（85．1％，38％）、腰围臀围比（79．8％，53．2％）、腰围身高比（71．3％，55．1％）、脂肪百分率（70．2％，50．6％）和脂肪指数（80．9％，52．5％）；曲线下面积分别为0．652、0．707、O．658、0．619和0．675。在老年男性和女性中，腰围臀嗣比的曲线下面积在所有参数中均最大。结论 人体测量学指标和身体成分分析在老年代谢综合征的筛查和预测中有重要意义，腰围臀围比为最佳的预测指标。

Objective To investigate effectiveness of anthropometric parameters and body composition analysis for the screening and prediction of metabolic syndrome and explore the best indicator for predicting metabolic syndrome in the elderly. Method A cross-sectional study of 763 （406 men and 357 women） elderly people who participated in the annual health check-up was conducted. Clinical data of all participants were obtained including anthropometric parameters, body composition, lipid profiles, fasting blood glucose, and high sensitivity C-reactive protein. Receiver operating characteristic （ROC） curve was used to determine the optimal cutoff points for waist circumference, waist-to-hip ratio, waist-to-height ratio, percent body fat and fat mass index in relation to the area under the curve （AUC）, sensitivity and specificity in the screening and prediction of metabolic syndrome. Result In total subjects, compared with non-metabolic syndrome group,the ROC curve analysis showed that parameters including waist circumference, waist-to-height ratio, waist-to-hip ratio, percent body fat and fat mass index had a significant potential for predicting metabolic syndrome （P〈0.001）. It was determined that waist circumference of 87.5cm and 77.5 era, waist-to-hip ratio of 0.89 and 0.87, waist-to-height ratio of 0.51 and 0.52, percent body fat of 24.1% and 31.7% and fat mass index of 5.00 kg/m2 and 7.80 kg/m^2 were the optimal cutoff points for screening and predicting the presence of metabolic syndrome among men and women with a sensitivity of 81.3%,78.8%,87.5%, 51.3% and 83.8% （in men） and 85.1%,79.8%,71.3%, 70.2% and 80.9% （in women） and a specificity of 57.7%,62.6%,50.0%, 75.5% and 51.8% （in men） and 38.0%,53.2%,55.1%, 50.6% and 52.5% （in women）,respectively. The area under the ROC curve （AUC） was 0.728, 0.755, 0.716, 0.671 and 0.725 in men and 0.652, 0.707, 0.658, 0.619 and 0.675 in women,respectively. Waist-to-hip ratio showed the highest AUC in all the parameters in men and women. Conclusion Anthropometric parameters and body composition analysis play important roles in the screening and prediction of metabolic syndrome, and waist-to-hip ratio seems to be the best parameter in the screening and prediction of metabolic syndrome in the elderly.