中国全科医学2025，Vol.28Issue(21)：2595-2603,2610,10.DOI:10.12114/j.issn.1007-9572.2024.0559
成年人肥胖和脂质相关指标对代谢综合征的影响及预测价值研究
Study on the Effect and Predictive Value of Obesity and Lipid-related Indices on Metabolic Syndrome in Adults
摘要
Abstract
Background Metabolic Syndrome(MetS)is an important risk factor for cardiovascular complications and kidney damage.Obesity and lipid-related markers are closely associated with MetS,and the predictive ability of different markers for MetS is still controversial.Objective The aim of this study was to evaluate the effect of 12 obesity and lipid-related indices,including lipid accumulation products,body mass index,visceral adiposity index,Chinese visceral adiposity index(CAVI),abdominal volume index(AVI),body fat index,BMI,body size index(ABSI),triacylglycerol-glucose index(TyG)and its combined index TyG-BMI,TyG-waist circumference(TyG-WC),and TyG-waist-height ratio(TyG-WHtR),on the optimal cutoff values for MetS screening and prediction and to identify the most appropriate predictors.Methods The health checkup data of a state-owned enterprise in Anhui Province in 2023 were selected,and the correlation between 12 obesity and lipid-related indexes and MetS was analyzed by binary logistic regression.The work characteristics(ROC)curves of subjects with different obesity and lipid-related indexes assessing MetS were plotted,and the area under the ROC curve(AUC)was calculated and compared with its predictive value.Results A total of 4 028 employees of a state-owned enterprise were included in this study,and the overall prevalence of MetS in the study population was 23.43%(944/4 028),with a prevalence of MetS of 26.53%(816/3 075)in males and 13.43%(128/953)in females.The results of the logistic model showed that the TyG-WHtR was associated with an OR(95%CI)of the total population=7.170(5.411-9.500),gender subgroup[male OR(95%CI)=16.277(11.554-22.930);female OR(95%CI)=13.422(5.388-33.435)],age subgroup of males>50 years old OR(95%CI)=31.411(18.868-52.292)and 36～50 years old women OR(95%CI)=95.154(22.610-400.465)had the strongest association with the odds of developing MetS.The predictive ability of CVAI for MetS showed the best predictive effect in the total population,males and age subgroups of males≤35 years old group and 36～50 years old group,with AUCs of 0.926(95%CI=0.917-0.936,P<0.001),0.941(95%CI=0.933-0.949,P<0.001),0.931(95%CI=0.917-0.946,P<0.001),0.947(95%CI=0.934-0.961,P<0.001);the predictive ability of AVI for MetS was higher in women and the age subgroups of women≤35 and>50 years old,and in the group of men>50 years old,with a higher discrimination ability,with AUCs of 0.951(95%CI=0.938～0.963,P<0.001),0.961[95%CI=0.943-0.978,P<0.001),0.909(95%CI=0.857-0.961,P<0.001),0.962(95%CI=0.951-0.974,P<0.001);TyG-WC in the age subgroup female 36-50 years group performed better in predicting MetS with an AUC of 0.949(95%CI=0.925～0.972,P<0.001).Conclusion TyG-WHtR had the strongest association with MetS.Except for ABSI,which had poor predictive ability for MetS,CVAI showed better predictive ability for MetS in the total population,males and age subgroups males≤35 years old group and 36～50 years old group,AVI had higher discriminatory ability for MetS in females and age subgroups females≤35 years old and>50 years old,and males>50 years old group,and TyG-WC showed better predictive ability for MetS in the age subgroup females 36-50 years old group.MetS predictive ability performed better.关键词
代谢综合征/成年人/肥胖症/脂质相关指标/ROC曲线Key words
Metabolic syndrome/Adult/Obesity/Lipid-related indexes/ROC curve分类
临床医学引用本文复制引用
李春贤,刘安诺..成年人肥胖和脂质相关指标对代谢综合征的影响及预测价值研究[J].中国全科医学,2025,28(21):2595-2603,2610,10.基金项目
安徽省高校自然科学研究重大项目(2023AH040085) （2023AH040085）
