Pratyush Daliparthy Devi, Tiwari Shalbha, Singh Saurabh, Singh Surya Kumar
Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Indian J Endocrinol Metab. 2012 Jan;16(1):112-5. doi: 10.4103/2230-8210.91205.
There is inconsistency in accepting waist circumference (WC) as mandatory and also regarding its significance for diagnosis of metabolic syndrome (MetS) for different populations.
To study the association of individual parameters of MetS with WC cutoffs suitable for South Asian Indians.
From an ongoing hospital-based study on MetS as per the criteria of diagnosis of modified NCEP ATP III, 713 subjects having a minimum three of the four parameters, i.e., dyslipidemia [low high density lipoprotein (HDL), high triglycerides], dysglycemia and hypertension, without regard to cutoffs of WC, were included in the present study.
Receiver operator characteristic curve analysis of WC cut-off points for males was 90 cm with a sensitivity and specificity of 71% and 96%, respectively, and for females was 85 cm with a sensitivity and specificity of 86% and 93%, respectively, associated with the risk factors of MetS. Multiple logistic regression analysis for low density lipoprotein (LDL) cholesterol concentration of ≥3.38 mmol/l showed an odds ratio of 5.03 (95% CI = 1.29-19.5) in males and 3.17 (95% CI = 1.14-8.76) in females which was statistically significant (P < 0.02); in addition to higher WC, higher level of triglyceride (P ≤ 0.0001) and lower level of high density lipoprotein cholesterol (P ≤ 0.02) were observed.
This study suggests that WC of 90 cm in males and 85 cm in females should be a mandatory criterion of MetS in our subset of population. LDL may be considered one of the components of MetS along with the currently defined WC cutoffs.
在将腰围(WC)作为代谢综合征(MetS)诊断的必要指标以及其对不同人群诊断MetS的意义方面,存在不一致的情况。
研究MetS各参数与适合南亚印度人的WC临界值之间的关联。
根据改良的美国国家胆固醇教育计划成人治疗组第三次报告(NCEP ATP III)诊断标准,从一项正在进行的基于医院的MetS研究中,纳入了713名至少具备四项参数中的三项的受试者,这四项参数即血脂异常(低高密度脂蛋白(HDL)、高甘油三酯)、血糖异常和高血压,而不考虑WC的临界值。
男性WC临界值的受试者工作特征曲线分析显示,临界值为90 cm时,敏感性和特异性分别为71%和96%;女性WC临界值为85 cm时,敏感性和特异性分别为86%和93%,这些临界值与MetS的危险因素相关。对低密度脂蛋白(LDL)胆固醇浓度≥3.38 mmol/l进行的多因素logistic回归分析显示,男性的比值比为5.03(95%置信区间=1.29 - 19.5),女性为3.17(95%置信区间=1.14 - 8.76),差异具有统计学意义(P < 0.02);除WC较高外,还观察到甘油三酯水平较高(P≤0.0001)和高密度脂蛋白胆固醇水平较低(P≤0.02)。
本研究表明,在我们的人群亚组中,男性WC为90 cm、女性WC为85 cm应作为MetS的必要诊断标准。LDL可与当前定义的WC临界值一起被视为MetS的组成部分之一。