痰湿证多囊卵巢综合征患者合并代谢综合征预测指标分析

Analysis on predictors of polycystic ovary syndrome with phlegm-dampness syndrome combined with metabolic syndrome

目的:研究和比较肥胖和血清脂蛋白比值指标(TG/HDL、TC/HDL、APOB/A、LDL/HDL、TyG、TyGBMI、VAI、LAP)检测对于痰湿证多囊卵巢综合征(PCOS)患者合并代谢综合征(MS)的诊断预测意义。方法:通过对422例痰湿证PCOS患者合并MS的患病率、各组分的发生率、肥胖和血清脂蛋白比值指标的相关性和ROC曲线进行分析,并比较这些比值对痰湿证PCOS患者发生MS的诊断预测价值。结果:痰湿证PCOS患者中MS各指标的发生率从高到低依次为向心性肥胖、低HDL、高TG、高血糖、高血压。TG/HDL、TC/HDL、APOB/A、LDL/HDL、TyG、TyG-BMI、VAI、LAP与体重、BMI、臀围、WC、WHR、FINS、FBG、FAI、TG、TC、APOB、APOA、APOB/A、HOMA-IR、ALT呈正相关(P<0.05),与LH、SHBG、HDL呈负相关(P<0.05)。TG/HDL、TC/HDL、APOB/A、LDL/HDL、TyG、TyG-BMI、VAI、LAP均对痰湿证PCOS患者发生MS具有较高的诊断预测价值,其中VAI的ROC曲线下面积最大(0.873),约登指数最高,提示VAI对MS的诊断预测价值最高。结论:VAI对于痰湿证PCOS患者合并MS的诊断预测价值最大,尤其当截断值≥2.745时,发生MS的风险越大,需要及时干预,避免MS发生。

Objective:To investigate and compare predictive diagnostic value of obesity and serum lipoprotein ratio indexes(TG/HDL,TC/HDL,APOB/A,LHL/HDL,TyG,TyG-BMI,VAI,LAP)of polycystic ovary syndrome(PCOS)patients with phlegm dampness syndrome complicated with metabolic syndrome(MS).Methods:The prevalence of MS,the incidence of each component,the correlation between obesity and serum lipoprotein ratio and ROC curve were analyzed in 422 patients with phlegm-dampness syndrome of PCOS,and the predictive diagnostic value of these ratios of MS in patients with phlegm-dampness syndrome PCOS was compared.Results:The incidence rate of MS components in PCOS patients with phlegm-dampness syndrome from high to low was centriotropic obesity,low HDL,high TG,hyperglycaemia and hypertension.TG/HDL,TC/HDL,APOB/A,LHL/HDL,TyG,TyG BMI,VAI,LAP were positively correlated with weight,BMI,hip,WC,WHR,FINS,FBG,FAI,TG,TC,APOB,APOA,APOB/A,HOMA-IR and ALT(P<0.05),with a negative correlation with LH,SHBG and HDL(P<0.05).TG/HDL,TC/HDL,APOB/A,LHL/HDL,TyG,TyG-BMI,VAI,LAP had high diagnostic and predictive value for the occurrence of MS in PCOS patients with phlegm dampness syndrome.Among them,the area under the ROC curve of VAI was the largest(AUC=0.873),and the Youden index was the highest,suggesting that VAI had the highest diagnosic value for MS.Conclusion:VAI has the highest predictive value for the occurrence of MS in patients with phlegm-dampness syndrome,especially when the cut-off value is≥2.745,the risk of MS is greater,and timely intervention is needed to avoid the occurrence of MS.