Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, P.O. Box 13145-784, Tehran, Iran.
Endocrine. 2011 Aug;40(1):117-23. doi: 10.1007/s12020-011-9447-4. Epub 2011 Mar 8.
Leptin is strongly contributed to the clustering of metabolic syndrome (MetS) components and potentially can be regarded as a single predictor of MetS. This population-based study, for the first time, reports the diagnostic accuracy of different leptin cut-points for determining MetS. Further, the current study compares the predictive ability of the appropriate threshold of leptin with insulin resistance. Data of the individuals without history of known diabetes mellitus, aged 25-64 years, from the third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007) were analyzed. MetS was defined due to either adult treatment panel III (ATPIII) or the modified international diabetes federation (IDF) criteria. Receiver-operating characteristic (ROC) curves were depicted to define cut-off of serum leptin, using the maximum Youden index and the shortest distance methods. Further, the values of leptin cut-offs in prediction of MetS were compared with those of insulin resistance (defined as homeostasis model assessment of insulin resistance >1.775). In men, the optimal cut-offs of leptin for IDF- and ATPIII-defined MetS were 3.6 ng/ml (positive predictive value, PPV: 56.5%; negative predictive value, NPV: 72.7%) and 4.1 ng/ml (PPV: 49.6%; NPV: 78.1%), respectively. In women, the optimal threshold was equal to 11.0 ng/ml (PPV: 53.8%; NPV: 73.0% for IDF criteria and PPV: 60.1%; NPV: 64.9% for ATPIII criteria). The diagnostic accuracy of these values in identifying MetS was similar to that of insulin resistance. Therefore, leptin is comparable to insulin resistance in identifying MetS and can be used as single predictor of MetS.
瘦素强烈促成代谢综合征（MetS）成分的聚类，并且可能被视为 MetS 的单一预测因子。这项基于人群的研究首次报告了不同瘦素切点用于确定 MetS 的诊断准确性。此外，本研究比较了适当的瘦素阈值与胰岛素抵抗的预测能力。分析了来自第三次全国非传染性疾病危险因素监测（SuRFNCD-2007）的无已知糖尿病史、年龄在 25-64 岁的个体数据。MetS 根据成人治疗小组 III（ATPIII）或改良的国际糖尿病联合会（IDF）标准定义。使用最大 Youden 指数和最短距离方法描绘血清瘦素的截断值的接收者操作特征（ROC）曲线。此外，将瘦素截断值在预测 MetS 中的值与胰岛素抵抗（定义为稳态模型评估的胰岛素抵抗>1.775）进行比较。在男性中，IDF 和 ATPIII 定义的 MetS 的瘦素最佳截断值分别为 3.6ng/ml（阳性预测值，PPV：56.5%；阴性预测值，NPV：72.7%）和 4.1ng/ml（PPV：49.6%；NPV：78.1%）。在女性中，最佳阈值等于 11.0ng/ml（IDF 标准的 PPV：53.8%；NPV：73.0%和 ATPIII 标准的 PPV：60.1%；NPV：64.9%）。这些值在识别 MetS 中的诊断准确性与胰岛素抵抗相似。因此，瘦素在识别 MetS 方面与胰岛素抵抗相当，可以用作 MetS 的单一预测因子。
