Department of Diabetology and Metabolic Medicine, S.K. Soni Hospital, Jaipur, India.
Metab Syndr Relat Disord. 2009 Dec;7(6):525-7. doi: 10.1089/met.2008.0102.
The International Diabetes Federation (IDF) global definition of metabolic syndrome suggests using race- and gender-specific waist circumference (WC) cutoffs. Previously, we have hypothesized that need for gender- and race-specific cutoffs could be obviated by supplanting WC with index of central obesity (ICO). The aim of this study was to test the utility of ICO in defining metabolic syndrome.
Data were collected from National Health and Nutrition Examination Survey (NHANES) database for year 2005-2006. Subjects were analyzed for presence of metabolic syndrome using National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. The IDF definition was modified by replacing WC with ICO. Sensitivity and specificity of the IDF definition and modified definition were compared against the NCEP ATP III definition.
Using a modified IDF definition, a common cutoff of 0.53 could be obtained for both males and females. The modified IDF definition improved sensitivity from 0.85 to 0.98 and 0.98 to 0.99 among males and females, respectively. This was at the cost of compromised specificity, which reduced from 1.0 to 0.89 and 0.98 for males and females, respectively.
ICO appears better than WC in defining metabolic syndrome in terms of better sensitivity and potential to be used with single cutoff for both genders.
国际糖尿病联合会（IDF）的代谢综合征全球定义建议使用种族和性别特异性腰围（WC）切点。此前，我们假设通过用中心性肥胖指数（ICO）替代 WC，可以避免性别和种族特异性切点的需要。本研究旨在检验 ICO 在定义代谢综合征中的应用。
数据来自 2005-2006 年国家健康和营养调查（NHANES）数据库。采用国家胆固醇教育计划成人治疗专家组 III（NCEP ATP III）标准对受试者进行代谢综合征的存在情况进行分析。用 ICO 替代 WC，对 IDF 定义进行修改。比较 IDF 定义和改良定义与 NCEP ATP III 定义的敏感性和特异性。
使用改良的 IDF 定义，男性和女性均可以采用 0.53 的共同切点。改良的 IDF 定义提高了男性和女性的敏感性，分别从 0.85 提高到 0.98 和 0.98 提高到 0.99。这是以牺牲特异性为代价的，分别从 1.0 降低到 0.89 和 0.98。
ICO 在定义代谢综合征方面似乎优于 WC，因为它具有更好的敏感性和潜力，可以使用单一切点用于两性。
