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载脂蛋白 B/A1 比值在韩国人群代谢综合征诊断中的价值。

The value of apolipoprotein B/A1 ratio in the diagnosis of metabolic syndrome in a Korean population.

机构信息

Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

出版信息

Clin Endocrinol (Oxf). 2012 Nov;77(5):699-706. doi: 10.1111/j.1365-2265.2012.04329.x.

Abstract

OBJECTIVE

The ratio of apolipoprotein B (apoB) to apolipoprotein A1 (apoA1) has been reported to be associated with the metabolic syndrome (MetS). However, the optimal cut-off value of apoB/A1 ratio for detecting subjects with MetS has remained undetermined. In the present study, we aimed to investigate whether apoB/A1 ratio can be an indicator of MetS and to determine the optimal cut-off value of apoB/A1 ratio in detecting subjects with MetS in a Korean population.

DESIGN

This cross-sectional study was conducted at the Asan Medical Center, Seoul, Republic of Korea.

SUBJECTS AND MEASUREMENTS

We collected the data of 10,940 subjects who participated in a routine health screening examination regarding conventional risk factors and serum levels of apoB and apoA1.

RESULTS

The odds for MetS were significantly higher in the highest compared with the lowest apoB/A1 ratio quartiles, after adjustment for confounding variables, in both men [odds ratio (OR) = 4·07, 95% CI = 3·42-4·84] and women (OR = 8·41, 95% CI = 5·85-12·08). The optimal apoB/A1 ratio cut-off value for the detection of MetS was 0·65, which had a sensitivity of 63·5% and a specificity of 61·3% (area under the curve = 0·67, 95% CI = 0·66-0·68, P < 0·001) in men and 0·62, which had a sensitivity of 67·9% and a specificity of 61·9% (area under the curve = 0·70, 95% CI = 0·69-0·71, P < 0·001) in women.

CONCLUSIONS

These results suggest that apoB/A1 ratio is independently associated with MetS and that an apoB/A1 ratio >0·65 in men and 0·62 in women is a marker of MetS independent from conventional risk factors.

摘要

目的

载脂蛋白 B (apoB) 与载脂蛋白 A1 (apoA1) 的比值已被报道与代谢综合征 (MetS) 相关。然而,apoB/A1 比值用于检测 MetS 患者的最佳临界值仍未确定。本研究旨在探讨 apoB/A1 比值是否可作为 MetS 的指标,并确定apoB/A1 比值在韩国人群中检测 MetS 的最佳临界值。

设计

本横断面研究在韩国首尔的 Asan 医疗中心进行。

受试者和测量方法

我们收集了 10940 名参加常规健康筛查的受试者的数据,包括常规危险因素和血清 apoB 和 apoA1 水平。

结果

在调整混杂因素后,apoB/A1 比值最高 quartile 组的 MetS 发生几率明显高于最低 quartile 组,在男性 [比值比 (OR) = 4.07,95%置信区间 (CI) = 3.42-4.84] 和女性 (OR = 8.41,95% CI = 5.85-12.08) 中均如此。apoB/A1 比值检测 MetS 的最佳临界值为 0.65,在男性中具有 63.5%的敏感性和 61.3%的特异性 (曲线下面积 = 0.67,95% CI = 0.66-0.68,P < 0.001),在女性中为 0.62,其敏感性为 67.9%,特异性为 61.9% (曲线下面积 = 0.70,95% CI = 0.69-0.71,P < 0.001)。

结论

这些结果表明,apoB/A1 比值与 MetS 独立相关,男性 apoB/A1 比值 >0.65 和女性 apoB/A1 比值 >0.62 是独立于传统危险因素的 MetS 标志物。

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