Department of Nursing, Chang Gung Institute of Technology, Chiayi Campus, Chiayi, Taiwan 61363.
BMC Public Health. 2010 Nov 18;10:708. doi: 10.1186/1471-2458-10-708.
Metabolic syndrome (MS) is an important current public health problem faced worldwide. To prevent an "epidemic" of this syndrome, it is important to develop an easy single-parameter screening technique (such as waist circumference (WC) determination recommended by the International Diabetes Federation). Previous studies proved that age is a chief factor corresponding to central obesity. We intended to present a new index based on the linear combination of body mass index, and age, which could enhance the area under the receiver operating characteristic curves (AUCs) for assessing the risk of MS.
The labour law of the Association of Labor Standard Law, Taiwan, states that employers and employees are respectively obligated to offer and receive routine health examination periodically. Secondary data analysis and subject's biomarkers among five high-tech factories were used in this study between 2007 and 2008 in northern Taiwan. The subjects included 4712 males and 4196 females. The first principal component score (FPCS) and equal-weighted average (EWA) were determined by statistical analysis.
Most of the metabolic and clinical characteristics were significantly higher in males than in females, except high-density lipoprotein cholesterol level. The older group (>45 years) had significantly lower values for height and high-density lipoprotein cholesterol level than the younger group. The AUCs of FPCS and EWA were significantly larger than those of WC and waist-to-height ratio. The low specificities of EWA and FPCS were compensated for by their substantially high sensitivities. FPCS ≥ 0.914 (15.4%) and EWA ≥ 8.8 (6.3%) were found to be the most prevalent cut off points in males and females, respectively.
The Bureau of Health Promotion, Department of Health, Taiwan, had recommended the use of WC ≥ 90 cm for males and ≥ 80 cm for females as singular criteria for the determination of central obesity instead of multiple parameters. The present investigation suggests that FPCS or EWA is a good predictor of MS among the Taiwanese. However, the use of FPCS is not computationally feasible in practice. Therefore, we suggest that EWA be used in clinical practice as a simple parameter for the identification of those at risk of MS.
代谢综合征（MS）是当前全球面临的一个重要公共卫生问题。为了预防这种综合征的“流行”，开发一种简单的单参数筛选技术（如国际糖尿病联合会推荐的腰围（WC）测定）非常重要。先前的研究证明，年龄是与中心性肥胖相对应的主要因素。我们旨在提出一种基于体重指数和年龄的线性组合的新指标，该指标可以提高评估 MS 风险的受试者工作特征曲线（AUC）下面积。
台湾劳动基准法规定，雇主和雇员分别有义务定期提供和接受常规健康检查。本研究使用了 2007 年至 2008 年在台湾北部的五家高科技工厂的劳工法中的二次数据分析和受试者的生物标志物。研究对象包括 4712 名男性和 4196 名女性。通过统计分析确定了第一主成分得分（FPCS）和等权重平均（EWA）。
除高密度脂蛋白胆固醇水平外，男性的大多数代谢和临床特征均明显高于女性。年龄较大组（>45 岁）的身高和高密度脂蛋白胆固醇水平明显低于年龄较小组。FPCS 和 EWA 的 AUC 明显大于 WC 和腰高比。EWA 和 FPCS 的低特异性通过其高灵敏度得到补偿。发现 FPCS≥0.914（15.4%）和 EWA≥8.8（6.3%）分别是男性和女性中最常见的截断点。
台湾卫生署健康促进局曾建议使用 WC≥90cm 作为男性和 WC≥80cm 作为女性确定中心性肥胖的单一标准，而不是多个参数。本研究表明，FPCS 或 EWA 是台湾人 MS 的良好预测指标。然而，在实践中使用 FPCS 是不可行的。因此，我们建议在临床实践中使用 EWA 作为识别 MS 风险的简单参数。
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