代谢综合征患者肥胖和脂质代谢参数的特征及其诊断价值

Characteristics of Obesity and Lipid Metabolism-related Parameters in the Patients with Metabolic Syndrome and Their Diagnostic Value

目的:比较代谢综合征(MetS)患者不同肥胖和脂质代谢参数的特征和其对疾病的诊断价值。方法:回顾性分析2016年1月至2018年12月在我院就诊的MetS患者和健康体检者,比较其体重指数(Body Mass Index, BMI)、腰高比(Waist-to-Height Ratio,WHt R)、甘油三酯/高密度脂蛋白胆固醇(TG/HDL-C)、脂肪蓄积指数(Lipid accumulation product, LAP)和内脏脂肪指数(Visceral adiposity index,VAI)的差异及不同代谢因素分组患者上述参数差异。采用ROC曲线评价不同肥胖和脂质代谢参数对MetS的诊断价值。结果:与健康组相比,MetS组无论男性还是女性患者BMI、WC、WHt R、血压、FPG、TG、TG/HDL-C、LAP和VAI均明显升高,而HDL-C显著降低(P<0.05)。随着MetS特征个数的增加,MetS组患者的BMI、WHt R、TG/HDL-C、LAP和VAI均呈现显著增加趋势(P<0.05)。上述五个诊断MetS的ROC曲线中都是LAP的AUC最大,男性AUC为0.896,敏感度为0.75,特异度为0.84。女性LAP的AUC为0.874,最佳诊断切点为31.05,此时的敏感度为0.74,特异度为0.92。结论:LAP对代谢综合征的诊断效能最高,男性LAP大于26.36、女性LAP大于31.05有助于诊断代谢综合征患者。

Objective: To compare the characteristics of different obesity and lipid metabolism parameters in patients with metabolic syndrome(MetS) and their diagnostic value. Methods: A retrospective analysis was made on the differences of body mass index(BMI), waist-to-height ratio(WHt R), triglyceride/high density lipoprotein cholesterol(TG/HDL-C), fat accumulation index(LAP)and visceral fat index(VAI) between the two groups and the healthy people who were examined in our hospital from January 2016 to December 2018. ROC curve was used to determine the diagnostic value of different obesity and lipid metabolism parameters for MetS.Results: Compared with the healthy group, BMI, WC, WHt R, blood pressure, FPG, TG, TG/HDL-C, LAP and VAI in the MetS group increased significantly, while HDL-C decreased significantly(P<0.05). BMI, WHt R, TG/HDL-C, LAP and VAI in MetS group increased significantly with the increase of the number of MetS characteristics(P<0.05). Among the five ROC curves for diagnosis of MetS, the AUC of LAP was the largest. The male AUC was 0.896, the sensitivity was 0.75, and the specificity was 0.84. The AUC of female LAP was 0.874, and the best diagnostic cut-off point was 31.05. The sensitivity and specificity were 0.74 and 0.92 respectively. Conclusion:LAP is the most effective diagnostic tool for metabolic syndrome among many parameters reflecting obesity and lipid metabolism.