School of Medicine, Trinity College Dublin, Ireland.
Department of Biochemistry, St James's Hospital, Dublin, Ireland.
Arch Phys Med Rehabil. 2014 Aug;95(8):1540-6. doi: 10.1016/j.apmr.2014.03.029. Epub 2014 Apr 15.
To report the prevalence of cardiometabolic risk factors in a cohort of adults with cerebral palsy (CP) and to investigate the ability of anthropometric measures to predict these factors.
Cross-sectional study.
Testing took place in a laboratory setting.
Adults with CP (N=55; mean age, 37.5±13.3 y; Gross Motor Function Classification System levels, I-V) participated in this study.
Not applicable.
Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, insulin, and C-reactive protein levels were measured from a fasting venous blood sample. Insulin resistance was calculated using the Homeostasis Model Assessment (HOMA-IR) index. Blood pressure, body mass index (BMI), waist circumference (WC), waist-hip ratio, and waist-height ratio were also measured. The metabolic syndrome (MetS) was defined according to the 2009 Joint Interim Statement.
The prevalence of the MetS was 20.5% in ambulatory adults and 28.6% in nonambulatory adults. BMI was associated with HOMA-IR only (β=.451; P<.01). WC was associated with HOMA-IR (β=.480; P<.01), triglycerides (β=.450; P<.01), and systolic blood pressure (β=.352; P<.05). Receiver operating characteristic curve analysis revealed that WC provided the best indication of hypertensive blood pressure, dyslipidemia, HOMA-IR, and the presence of multiple risk factors (area under the curve, .713-.763).
A high prevalence of the MetS was observed in this relatively young sample of adults with CP. WC was a better indicator of a number of risk factors than was BMI and presents as a clinically useful method of screening for cardiometabolic risk among adults with CP.
报告脑性瘫痪（CP）成人队列中心血管代谢危险因素的流行情况，并探讨人体测量指标预测这些因素的能力。
横断面研究。
测试在实验室环境中进行。
本研究纳入了 55 名 CP 成人（平均年龄 37.5±13.3 岁；Gross Motor Function Classification System 分级，I-V）。
无。
从空腹静脉血样中测量总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、葡萄糖、胰岛素和 C 反应蛋白水平。使用稳态模型评估（HOMA-IR）指数计算胰岛素抵抗。还测量血压、体重指数（BMI）、腰围（WC）、腰臀比和腰高比。根据 2009 年联合临时声明定义代谢综合征（MetS）。
在有活动能力的成年人中，MetS 的患病率为 20.5%，在无活动能力的成年人中为 28.6%。BMI 仅与 HOMA-IR 相关（β=.451；P<.01）。WC 与 HOMA-IR（β=.480；P<.01）、甘油三酯（β=.450；P<.01）和收缩压（β=.352；P<.05）相关。受试者工作特征曲线分析显示，WC 对高血压血压、血脂异常、HOMA-IR 和多种危险因素的存在提供了最佳指示（曲线下面积，.713-.763）。
在这个相对年轻的 CP 成人样本中，观察到 MetS 的高患病率。WC 是比 BMI 更好的多个危险因素指标，是 CP 成人心血管代谢风险筛查的一种临床有用方法。
