上海市35~74岁成人代谢综合征腰围切点的研究
Optimum Cut-Off Points of Waist Circumference for Identifying Metabolic Syndrome in ShanghaiAdults of 35-74 Years of Age
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摘要:
目的 探寻上海市35~74岁人群中代谢综合征(metabolic syndrome,MS)相关肥胖程度的腰围切点。 方法 采用多阶段随机抽样方法,在上海市35~74岁居民中进行横断面调查,共调查7 414名个体。分析男性和女性不同腰围水平与MS其他因素的关系,以获得检出2个及以上危险因素敏感性和特异性均较好的腰围切点。 结果 随腰围增大,MS危险因素聚集的比值比(OR)也随之升高,检出2个及以上MS危险因素的特异度和阳性预测值逐渐增高,而敏感度和阴性预测值逐渐下降。当男性腰围 ≥ 85 cm、女性腰围 ≥ 80 cm,检出2个及以上MS危险因素的敏感度为68.33%(男性)、70.17%(女性),特异度为58.48%(男性)、58.36%(女性),受试者工作特征(ROC)曲线距离最短,分别为男性0.5221、女性0.512 2。 结论 当男性腰围 ≥ 85 cm、女性腰围 ≥ 80 cm时,能较好反映MS危险因素的聚集,为本研究人群代谢综合征肥胖的腰围切点。 Abstract:Objective To determine the optimum cut-off points of waist circumference (WC) for assessing obesityassociated metabolic syndrome in Shanghai adults of 35-74 years old. Methods A cross-sectional study was conducted inShanghai with a representative sample of 7 414 Chinese adults aged 35-74 years using multistage random sampling technique.TheWC levels associated with at least 2 risk factors of metabolic syndrome with proper susceptibility and specificity were identified inthe two gender groups. Results With waist circumference increasing,the odd ratios (OR) of clustering of risk factors increasedsignificantly,the specificity and positive predictive values of association with ≥ 2 risk factors also elevated,but related sensitivityand negative predictive values were lowered.When the WC levels were ≥ 85 cm for male and ≥ 80 cm for female,the sensitivityvalues of association with ≥ 2 risk factors were 68.33%(male) and 70.17%(female),while the specificity values were 58.48%(male) and 58.36%(female) respectively.These points showing the shortest distances (0.522 1 for male and 0.512 2 for female) in thereceiver operating characteristic curves were elected as the cut-off points for the two gender groups in the studied population. Conclusion WC ≥ 85cm for male and ≥ 80cm for female can well reflect the margin of metabolic syndrome associated risk factorscluster,and serve as the optimum cut-off points for identifying obesity-associated metabolic syndrome in the studied residents.
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