超重/肥胖病人VSR对代谢综合征及其组分聚集程度的筛查价值

Value of Visceral-to-Subcutaneous Fat Ratio in Screening of Metabolic Syndrome and the Degree of Aggregation of Its Components in Overweight/Obese Patients

目的:探讨内脏脂肪/皮下脂肪面积比值(VSR)与代谢综合征(MS)及其组分聚集程度的关系,评估VSR筛查MS及其组分聚集程度的能力。方法:选取2020年12月—2022年12月就诊于山西医科大学第一医院内分泌科肥胖门诊符合纳入与排除标准且病例资料完整的超重/肥胖病人180例,根据内脏脂肪面积(VFA)和皮下脂肪面积(SFA)测定结果计算VSR,按照VSR三分位数分为低VSR组、中VSR组和高VSR组。结果:VFA、SFA、VSR水平随MS组分聚集程度增加而明显升高(P<0.05)。随着VSR水平增加,MS及其各组分的发生率逐渐升高(P<0.05)。Logistic回归分析结果显示,高VSR者MS聚集数量≥3个和≥4个的风险分别是低VSR者的2.867倍(P=0.031)和3.415倍(P=0.026)。VSR筛查MS组分聚集数量≥2个、≥3个、≥4个的曲线下面积分别为0.708,0.688和0.707,临界值分别为0.283,0.316,0.330。结论:VSR升高是超重/肥胖者MS组分聚集程度增加的危险因素,对筛查MS及其组分聚集程度具有一定的价值。

Objective:To investigate the relationship between visceral-to-subcutaneous fat ratio(VSR)and metabolic syndrome(MS)and the degree of aggregation of its components,and to assess the ability of VSR to screen for MS and the degree of aggregation of its components.Methods:One hundred and eighty overweight/obese patients who attended the obesity clinic of the Department of Endocrinology,First Hospital of Shanxi Medical University from December 2020 to December 2022 and met the nadir criteria of this study and had complete case data were selected,and VSR was calculated based on the results of visceral fat area(VFA)and subcutaneous fat area(SFA)measurements,and divided into low VSR group,medium VSR group,and high VSR group according to the VSR tri-sectional quantiles.Results:The levels of VFA,SFA,and VSR increased significantly with the increase of MS fraction aggregation(P<0.05).The prevalence of MS and its components gradually increased with increasing VSR levels(P<0.05).Binary Logistic regression analysis showed that the risk of having≥3 and≥4 MS aggregates was 2.867(P=0.031)and 3.415(P=0.026)times higher in those with high VSR than in those with low VSR,respectively.The area under the curve for the number of VSR screening MS component aggregates≥2,≥3,and≥4 was 0.708,0.688,and 0.707,respectively,with critical values of 0.283,0.316,and 0.330,respectively(P<0.05).Conclusion:Elevated VSR is a risk factor for increased MS component aggregation in overweight/obese individuals and has some potential value in screening for MS and its component aggregation.