静息心率、白细胞计数与红细胞比容联合检测对代谢综合征的预测价值研究

Predictive Value of Resting Heart Rate in Combination with White Blood Cell Count and Hematocrit in Matabolic Syndrome

背景代谢综合征(MS)是心脑血管疾病等许多重大非传染性疾病的共同病理基础和早期阶段,只有通过对MS早期预测才能实现一些慢性病的早期预防,然而目前报道的各指标对MS的预测价值尚不明确。目的探讨静息心率(RHR)、白细胞计数(WBC)与红细胞比容(HCT)联合检测对MS的预测价值,为MS早期预防提供参考。方法选取2017年在大连医科大学附属第二医院健康管理中心行健康体检者24 612例,根据2013年版中华医学会糖尿病学分会对MS的诊断标准,评估其合并MS及相关代谢组分情况。比较是否合并MS及合并0~≥3项MS代谢组分者的RHR、WBC、HCT、中性粒细胞和淋巴细胞比值(NLR)、尿酸(UA)水平,采用多元Logistic回归分析RHR、WBC、HCT、NLR、UA对MS的影响,绘制受试者工作特征(ROC)曲线评价RHR、WBC、HCT及三者联合检测对MS的预测价值。结果共检出MS患者5 343例(27.71%),其RHR、WBC、HCT、NLR、UA水平高于未检出者(P<0.001),采用倾向评分匹配法校正性别、年龄后,差异仍有统计学意义(P<0.001)。RHR、WBC、HCT、NLR、UA水平随合并MS代谢组分项数的增加而升高(P<0.001)。多元Logistic回归分析结果显示,高RHR、WBC、HCT、UA水平是MS发生的危险因素(OR值分别为1.032 0、1.234 5、1.028 4、1.006 7,P<0.001)。RHR、WBC、HCT单独预测MS时的ROC曲线下面积分别为0.572、0.654、0.682,三者联合预测时的ROC曲线下面积为0.716。结论 RHR、WBC及HCT联合检测可提高MS早期预测的准确性,且简便易得,可为MS的前期预防提供参考。

Background Metabolic syndrome(MS) is the common pathological basis and early stage of many noncommunicable diseases,such as cardiovascular and cerebrovascular diseases.Although early identifying MS can prevent some chronic illnesses early,predictive values of indicators for MS in reports are still unclear.Objective To explore the predictive value of resting heart rate(RHR) combined with white blood cell(WBC) count and hematocrit(HCT) for MS,to provide a reference for early MS prevention.Methods From Health Management Center,the Second Affiliated Hospital of Dalian Medical University,24 612 physical examinees were enrolled in 2017.MS prevalence and components were evaluated in accordance with 2013 diagnostic criteria for MS by the Chinese Diabetes Society.The levels of RHR,WBC count,HCT,neutrophil-to-lymphocyte ratio(NLR) and uric acid(UA) were compared among MS patients by prevalence of MS and number of MS components(0 to 3 and more).Impacts of RHR,WBC count,HCT,NLR and UA on MS were analyzed by multiple Logistic regression.ROC analysis was conducted to evaluate the values of RHR,WBC count,HCT and combination of the three in predicting MS.Results The prevalence of MS was 27.71%(5 343/24 612).MS group showed higher mean levels of RHR,WBC count,HCT,NLR and UA than non-MS group(P<0.001).After adjusting for sex and age by propensity score matching,the above-mentioned intergroup differences were still significant(P<0.001).Levels of RHR,WBC count,HCT,NLR and UA elevated with the increase of combined MS components(P<0.001).Multiple Logistic regression analysis showed that increased RHR,WBC count,HCT and UA were risk factors for MS(OR=1.032 0,1.234 5,1.028 4, 1.006 7,P<0.001).For predicting MS,AUCs of RHR,WBC count,HCT,and the combination of the three were 0.572,0.654,0.682,and 0.716,respectively.Conclusion Joint detection of RHR,WBC count and HCT is simple and convenient,and can improve the accuracy of MS early prediction,which may be used as a reference for prophase prevention of MS.