腰围身高比对代谢综合征诊断的预测价值研究

Predictive value of waist-to-height ratio for the diagnosis of metabolic syndrome

目的：调查重庆市54 634例体检人群代谢综合征的患病率,评价腰围身高比对代谢综合征诊断的预测价值。方法：以中华医学会糖尿病学分会建议的标准诊断代谢综合征,描述体检人群代谢综合征的检出情况,并对人体测量学指标进行受试者工作特征曲线评价。结果：54 634例研究对象中,代谢综合征患者6 730例（患病率12.32%）,男性患病率高于女性（P=0.000）,代谢综合征患病率随着年龄增长而增高（P=0.000）。采用ROC曲线观察WHt R对MS的预测价值,全体受检者的AUC为0.857（95%CI=0.853～0.861）,男性组和女性组的AUC分别为0.827（95%CI=0.821～0.832）和0.892（95%CI=0.886～0.899）,≤44岁组、45～64岁组和≥65岁组的AUC分别为0.886（95%CI=0.880～0.892）,0.812（95%CI=0.805～0.820）和0.798（95%CI=0.785～0.810）。各组的WHt R最佳切点在0.51左右（敏感度和特异度分别为：全体受检者：85.1%和72.4%,男性：82.5%和68.9%,女性：85.0%和79.3%,≤44岁组：87.8%和76.6%,45～64岁组：77.6%和71.6%,≥65岁组：77.5%和69.3%）。结论：腰围身高比对代谢综合征诊断的预测价值较高,最佳切点为0.51。

Objective：To investigate the prevalence rate of metabolic syndrome（MS）of 54 634 medical examination cohort in Chongqing,and to evaluate predictive value of waist-to-height ratio WHt R in the diagnosis of metabolic syndrome. Methods：The diagnosis of MS was made based on the criteria recommended by the Chinese Diabetes Society. The prevalence rate of MS was described by dividing the subjects into different groups. The predictive value of the anthropometry indices for the diagnosis of MS was evaluated by the receiver operating characteristic（ROC）curves. Results：Totally 6 730 out of the 54 634 subjects were diagnosed as MS. The prevalence rate was 12.32%. The prevalence rate of MS was higher in males than in females（P=0.000）. The prevalence rate of MS increased with age（P=0.000）. The predictive value of WHt R in the diagnosis of MS was assessed in the ROC curves. The area under the curve of whole population was 0.857（95%CI=0.853 to 0.861）. The area under the curve of the males and the females were separately 0.827（95%CI=0.821 to 0.832）and 0.892（95%CI=0.886 to 0.899）. The area under the curve of the groups of under 45 years,45-64 years and above 65 years were separately 0.886（95% CI =0.880 to 0.892）,0.812（95% CI =0.805 to 0.820） and（95% CI =0.785 to0.810）. WHt R in each group had nearly the same optimal cutoff value of 0.51（sensitivity and specificity were respectively： the whole group：85.1% and 72.4%,the male group：82.5% and 68.9%,the female group：85.0% and 79.3%,under 44 years group：87.8% and76.6%,45-64 years group：77. 6 % and 71. 6 %,above 65 years group ：77. 5 % and 69.3%）. Conclusion：WHt R has a high value in predicting the diagnosis of MS,with the optimal cutoff value of 0.51.