2018—2020年成都体检人群身体测量指标对代谢综合征的筛检价值及相关性

Screening value and correlation of body measurement indices for metabolic syndrome in the population undergoing physical examinations in Chengdu during 2018-2020

目的研究身体测量指标对代谢综合征(metabolic syndrome,MS)的筛检价值及相关性。方法回顾2018—2020年在四川省人民医院健康管理中心北区参加健康体检的全部18岁及以上人群资料,共获取了73411例有效的健康体检资料,收集了身高、体重、腰围、臀围、收缩压、舒张压、空腹血浆葡萄糖、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、吸烟史及饮酒史的资料,计算身体形态指数(a body shape index,ABSI)、身体圆度指数(body roundness index,BRI)、身体脂肪指数(body adiposity index,BAI)、腹部容积指数(abdominal volume index,AVI)、相对脂肪质量指数(relative fat mass index,RFM)和体质指数(body mass index,BMI),将其分为MS组及非MS组,使用ROC曲线评估身体测量指标对MS筛检价值,利用回归分析探讨身体测量指标与MS的相关性。结果调查对象中男性44426人,女性28985人,18~44岁、44~59岁和≥60岁分别为42572人(58%)、20257人(28%)和10582人(14%)。MS 10849人(15%),非MS 62562人(85%)。男性MS组9181人(占男性21%),女性MS组1668人(占女性6%)。MS组与非MS组ABSI[(0.08±0.00)vs.(0.08±0.00)]、BRI[(4.95±0.67)vs.(4.17±0.68)]、BAI[(28.08±3.52)vs.(26.39±3.39)]、AVI[(17.51±2.77)vs.(12.85±2.91)]、BMI[(27.15±2.99)vs.(23.00±3.04)]、RFM[(29.77±5.35)vs.(27.13±6.39)]水平差异有统计学意义(P<0.05)。单因素Logistic回归分析显示,ABSI(OR=2.303,95%CI 1.190~4.457)、BRI(OR=4.596,95%CI 4.446~4.752)、BAI(OR=1.144,95%CI 1.137~1.151)、AVI(OR=1.668,95%CI 1.652~1.684)、RFM(OR=1.067,95%CI 1.064~1.071)、BMI(OR=1.516,95%CI 1.503~1.528)与MS相关(P<0.05)。调整性别、年龄、吸烟、饮酒的多因素Logstic回归分析显示,ABSI(OR=1.767,95%CI 4.237~7.371),BRI(OR=5.441,95%CI 5.228~5.663),BAI(OR=1.269,95%CI 1.260~1.279),AVI(OR=1.648,95%CI 1.631~1.665),RFM(OR=1.504,95%CI 1.491~1.517),BMI(OR=1.508,95%CI 1.495~1.522)与MS有关(P<0.05)。男性AVI的ROC曲线下面积最大(AUC=0.855,最佳截断值=16.18),其次为RFM(AUC=0.844,最佳截断值=25.71)、BMI(AUC=0.811,最佳截断值=25.21)、BRI(AUC=0.793,最佳截断值=4.39)、BAI(AUC=0.709,最佳截断值=25.88)和ABSI(AUC=0.671,最佳截断值=0.08)。女性RFM的ROC曲线下面积最大(AUC=0.918,最佳截断值=37.01),其次为AVI(AUC=0.911,最佳截断值=13.43)、BRI(AUC=0.901,最佳截断值=4.71)、BMI(AUC=0.860,最佳截断值=23.94)、ABSI(AUC=0.804,最佳截断值=0.08)和BAI(AUC=0.797,最佳截断值=29.92)。结论ABSI、BRI、BAI、AVI、BMI和RFM均能筛检MS。男性AVI对MS的筛检价值最高,其次为RFM、BMI、BRI、BAI和ABSI。女性RFM的对MS的筛检价值最高,其次为AVI、BRI、BMI、ABSI和BAI。ABSI、BRI、BAI、AVI、RFM、BMI与MS呈正相关。

OBJECTIVE To investigate the screening value and correlation of body measurement indicators for metabolic syndrome(MS)and to provide evidence for MS screening.METHODS Through a cross-sectional research approach,data from individuals aged 18 and above who participated in health examinations at the North Health Management Center of Sichuan Provincial People's Hospital from 2018 to 2020 were reviewed.Data including height,weight,waist circumference,hip circumference,systolic blood pressure,diastolic blood pressure,fasting plasma glucose,triglycerides,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,smoking history,and alcohol consumption history were collected.Subsequently,a body shape index(ABSI),body roundness index(BRI),body adiposity index(BAI),abdominal volume index(AVI),relative fat mass index(RFM),and body mass index(BMI)were computed.The individuals were then divided into MS and non-MS groups.The value of body measurement indices in screening for MS in the population aged 18 and above was assessed using ROC curves.Regression analysis was employed to explore the correlation between body measurement indices and MS.RESULTSSA total of 73411 valid health examination data were obtained,including 44426 males and 28985 females.The MS group comprised 9181 males(21%)and 1668 females(6%).In the comparison between the MS and non-MS groups,there were statistically significant differences in ABSI((0.08±0.00)vs.(0.08±0.00)),BRI((4.95±0.67)vs.(4.17±0.68)),BAI((28.08±3.52)vs.(26.39±3.39)),AVI((17.51±2.77)vs.(12.85±2.91)),BMI((27.15±2.99)us.(23.00±3.04))and RFM((29.77±5.35)us.(27.13±6.39))(P<0.05).Univariate Logistic regression analysis showed that ABSI(OR=2.303,95%CI 1.190-4.457),BRI(OR=4.596,95%CI 4.446-4.752),BAI(0R=1.144,95%CI 1.137-1.151),AVI(0R=1.668,95%CI 1.652-1.684),RFM(OR=1.067,95%CI 1.064-1.071)and BMI(0R=1.516,95%CI 1.503-1.528)were associated with MS(P<0.05).Multifactorial Logistic regression analysis corrected for sex,age,smoking and alcohol consumption showed that ABSI(OR=1.767,95%CI 4.237-7.371),BRI(OR=5.441,95%CI5.228-5.663),BAI(OR=1.269,95%CI 1.260-1.279),AVI(OR=1.648,95%CI 1.631-1.665),RFM(OR=1.504,95%CI 1.491-1.517)and BMI(0R=1.508,95%CI 1.495-1.522)were associated with MS(P<0.05).The ROC curve analysis showed that in adults,the AVI had the highest screening value for MS in males(AUC=0.855,optimal cutoff value=16.18),followed by RFM(AUC=0.844,optimal cutoff value=25.71),BMI(AUC=0.811,optimal cutoff value=25.21),BRI(AUC=0.793,optimal cutoff value=4.39),BAI(AUC=0.709,optimal cutoff value=25.88),and ABSI(AUC=0.671,optimal cutoff value=0.08).In adult females,the RFM had the highest screening value for MS(AUC=0.918,optimal cutoff value=37.01),followed by AVI(AUC=0.911,optimal cutoff value=13.43),BRI(AUC=0.901,optimal cutoff value=4.71),BMI(AUC=0.860,optimal cutoff value=23.94),ABSI(AUC=0.804,optimal cutoff value=0.08),and BAI(AUC=0.797,optimal cutoff value=29.92).CONCLUSION ABSI,BRI,BAI,AVI,BMI and RFM are all capable of screening for MS.Among males,AVI has the highest screening value for MS,followed by RFM,BMI,BRI,BAI and ABSI.Among females,RFM has the highest screening value for MS,followed by AVI,BRI,BMI,ABSI and BAI.ABSI,BRI,BAI,AVI,RFM and BMI are positively correlated with MS.