基线非结合胆红素对肥胖人群早期生活方式减重达标的切点预测

Cut-off value of baseline unconjugated bilirubin for early lifestyle weight loss in obese people

目的探究基线非结合胆红素(unconjugated bilirubin,UBiL)对肥胖人群生活方式减重3个月后减重达标的切点预测。方法选取进行体重管理的单纯性肥胖人群314例,采用生活方式减重,通过记录基线及3个月后体重,计算体重减轻百分比,将体重减轻百分比超过10%定义为减重成功,从而分为达标组和未达标组。采用二元logistic回归分析减重达标的影响因素,采用受试者工作特征(ROC)曲线分析UBiL预测减重达标的敏感度和特异度。结果UBiL为女性减重是否达标的影响因素。ROC曲线下面积为0.747(95%CI 0.622,0.871),在最适切点UBiL为9.50μmol/L时,约登指数为0.416,敏感度和特异度分别为52.4%、89.2%。结论UBiL对于预测女性生活方式减重3个月后是否达标具有较高的特异性。当UBiL小于9.50μmol/L时,我们建议尽早在生活方式减重的基础上加用药物、减重手术等其他减重方式。

Objective To explore the identification of baseline unconjugated bilirubin(UBiL)cutoffs for whether the early lifestyle weight loss is up to standard in obese people.Methods 314 simple obese people who underwent weight management were included for weight loss by recording the weight of baseline and after 3 months.The percentage of weight loss greater than 10%was defined as successful weight loss,which was divided into standard group and non-standard group.Binary logistic regression analysis were used to study the influencing factors for whether the weight loss was up to standard.The sensitivity and specificity of baseline unconjugated bilirubin were evaluated for predicting weight loss by using receiver operating characteristic curve.Results UBiL was the influencing factor of weight loss among women.ROC curve analysis showed that the area under the ROC curve of UBiL in women was 0.747(95%CI 0.622,0.871),cut-off value was 9.50μmol/L,and Yoden index was 0.416.Sensitivity and specificity were 52.4%and 89.2%,respectively.Conclusion Baseline unconjugated bilirubin has a high specificity for predicting whether women's lifestyle weight loss is up to standard.We recommend adding drugs,weight loss surgery and other weight loss methods as soon as possible based on lifestyle weight loss,when the baseline unconjugated bilirubin is less than 9.50μmol/L.