广州地区成年人脂肪组织指数与代谢综合征的相关性及预测价值分析

Analysis of Association between Fat Mass Index and Metabolic Syndrome and Its Predictive Value among Adult Population in Guangzhou

[目的]分析成年人脂肪组织指数（FMI）与代谢综合征（MS）的关系,探讨广州地区不同性别人群FMI筛查MS的切点及其预测效果.[方法]采用横断面研究方法,选择在广东省人民医院参加体检的20岁以上受检者进行调查,内容包括问卷调查、体格、血液生化检查和人体成分分析.体脂肪量采用生物电阻抗法测定,计算FMI,并在男、女亚组中分别按四分位数将FMI水平分为四组.MS的定义参考国际糖尿病联盟（IDF）和中国成人血脂异常防治指南制订联合委员会（JCDCG）的诊断标准.采用单因素分析比较不同FMI水平组的心血管危险因素特征;二分类logistic回归分析不同性别人群FMI与MS的关系;受试者工作特征（ROC）曲线分析男、女亚组FMI筛查MS的切点及其预测效果.[结果]纳入分析890人,其中男502人,女388人;调整相关影响因素后,男、女性MS的患病风险与FMI水平均呈明显的剂量效应关系;根据IDF标准,男、女性FMI预测MS的切点分别为5.50 kg/m2和7.99 kg/m2,相应的ROC曲线下面积为0.865 （0.832 ～ 0.893）和0.869 （0.832～0.901）;根据JCDCG标准,二者的切点分别为5.33 kg/m2和7.99 kg/m2,相应的ROC曲线下面积为0.867 （0.834～0.895）和0.899 （0.864～ 0.927）;无论男性和女性,按照IDF和JCDCG的标准,FMI预测MS的ROC曲线下面积均大于体脂肪率（BF％）.[结论]高FMI水平与MS患病风险密切相关;与BF％相比,在男、女性人群中FMI均可能是评价MS的更好筛查指标.

[Objective] To analyze the association of fat mass index （FMI） and metabolic syndrome （MS）,and investigate the optimal cut-off points and predictive ability of FMI in screening for MS among men and woman in Guangzhou.[Methods] A cross-sectional study was implemented in the examination population aged 20 years and above,who participated in the annual check-ups in Guangdong General Hospital.Questionnaire,anthropometric measurements,blood tests and body composition analysis were performed.Body fat mass was measured by bioelectric impedance analysis.FMI was calculated,and divided into separate quartiles for men and women.The MS was defined both by the diagnostic criteria of the International Diabetes Federation （IDF） and Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults （JCDCG）.The characteristics of cardiovascular risk factors among FMI groups were compared by univariate methods.The association between the sex-specific FMI quartile and MS was examined using binary logistic regression.Receiver operating characteristic （ROC） curve was performed to identify the sex-specific FMI cut-offs and predictive values in screening for MS.[Results] A total of 890 subjects,with 502 men and 388 women were analyzed.After adjustment for relative confounders,the presence of MS and FMI quartiles revealed a dose-response relationship in both sexes.The cut-off point of FMI for MS by IDF criteria was 5.50 kg/m2 for men and 7.99 kg/m2 for women with the corresponding area under the curve （AUC） of 0.865 （0.832 ～ 0.893） and 0.869 （0.832 ～ 0.901）,and 5.33 kg/m2 for men and 7.99 kg/m2 for women by JCDCG criteria with the AUC of 0.867 （0.834 ～ 0.895） and 0.899 （0.864 ～ 0.927）,respectively.The AUCs of FMI for MS were significantly greater than that of body fat percentage （BF％） by both IDF and JCDCG criteria in both sexes.[Conclusion] Higher FMI levels were closely associated with the presence of MS.FMI seems to be a better screening tool for evaluating MS than BF％ in men and women.