Institute of Public Health, Georgia State University, Atlanta, USA.
Ann Epidemiol. 2010 Nov;20(11):843-51. doi: 10.1016/j.annepidem.2010.08.001.
Although continuous values of metabolic syndrome risk scores (cMetS) has been suggested for modeling the association between potential risk factors and metabolic syndrome (MetS) in young people, the construct validity of cMetS has not been sufficiently examined in a representative sample of youngsters. This study examined: (i) sex and race/ethnic-specific optimal cut-off points of cMetS that are associated with MetS and (ii) the construct validity of cMetS in 12- to 19-year old non-Hispanic white (NHW), non-Hispanic black (NHB), and Mexican-American (MA) subjects.
Data (n = 1239) from the 2003 to 2004 and 2005 to 2006 National Health and Nutrition Examination Surveys were used in this study. cMetS was derived by aggregating age- and sex-standardized residuals of arterial blood pressure, triglycerides, glucose, waist circumference, and high-density lipoprotein cholesterol. Receiver operating characteristics analysis was used to determine the validity and performance of cMetS. The overall performance of the receiver operating characteristics test was quantified with area under the curve (AUC).
A graded relationship between cMetS and increased number of MetS factors was observed, with MetS factors of 3 or greater yielding the greatest cMetS. In male adolescents, the optimal cMetS cut-off points of cMetS that are associated with MetS in NHW, NHB, and MA were 2.01, 2.45, and 2.34, respectively. The corresponding values in female adolescents for NBW, NHB, and MA were 1.93, 2.12, and 2.23, respectively. The construct validity of cMetS for MetS was high (AUC ≥0.885; sensitivity ≥66.7; specificity ≥74.8%).
cMetS appears to be a suitable index for investigating the association between potential risk factors and MetS in adolescents. An understanding of the role of genetic and environmental risk factors in MetS in children may be enhanced with the use of cMetS.
尽管连续的代谢综合征风险评分（cMetS）已被提出用于建模年轻人潜在危险因素与代谢综合征（MetS）之间的关系，但 cMetS 在代表性青少年人群中的结构效度尚未得到充分检验。本研究检验了：（i）与 MetS 相关的 cMetS 的性别和种族/民族特异性最佳截断值，以及（ii）12 至 19 岁非西班牙裔白人（NHW）、非西班牙裔黑人（NHB）和墨西哥裔美国人（MA）受试者中 cMetS 的结构效度。
本研究使用了 2003 年至 2004 年和 2005 年至 2006 年全国健康和营养检查调查的数据（n=1239）。cMetS 通过聚合年龄和性别标准化的动脉血压、甘油三酯、血糖、腰围和高密度脂蛋白胆固醇残差来计算。接受者操作特征分析用于确定 cMetS 的有效性和性能。接受者操作特征测试的整体性能用曲线下面积（AUC）来量化。
在男性青少年中，与 MetS 相关的 cMetS 的最佳截断值在 NHW、NHB 和 MA 中分别为 2.01、2.45 和 2.34。在女性青少年中，NBW、NHB 和 MA 中的相应值分别为 1.93、2.12 和 2.23。cMetS 对 MetS 的结构效度较高（AUC≥0.885；敏感性≥66.7；特异性≥74.8%）。
cMetS 似乎是研究潜在危险因素与青少年 MetS 之间关系的合适指标。了解遗传和环境危险因素在儿童代谢综合征中的作用，可能会随着 cMetS 的使用而增强。
