Luo Wenshu, Guo Zhirong, Wu Ming, Hao Chao, Zhou Zhengyuan, Yao Xingjuan
aChangzhou Center for Disease Control and Prevention, Changzhou bDepartment of Public Health, Soochow University, Suzhou cCenter for Disease Control of Jiangsu Province, Nanjing dCenter for Disease Control of Changshu, Suzhou, Jiangsu, China.
J Cardiovasc Med (Hagerstown). 2014 Oct;15(10):738-44. doi: 10.2459/JCM.0000000000000039.
To compare the suitability of metabolic syndrome definitions in predicting cardiovascular disease (CVD) risk.
We analyzed data from a population-based prospective cohort of 3598 participants from Jiangsu, China. Waist circumference was replaced with central obesity [index of central obesity (ICO), a ratio of waist circumference and height] in Cholesterol Education Program Adult Treatment Panel III (ICO-replaced ATPIII) and International Diabetes Federation (ICO-replaced IDF), respectively. Cox proportional-hazards regression model and the receiver operating characteristic curve (ROC curve) was used to evaluate the suitability of ATPIII, IDF, ICO-replaced IDF and ICO-replaced ATPIII in predicting CVD risk.
ICO was a better parameter in predicting CVD risk by ROC curve analysis. The ROC curve analysis also showed that although ICO-replaced IDF and IDF had the higher degree of specificity, lower sensitivity, longer ROC curve distance, less area under the curve to identify CVD than ATPIII and ICO-replaced ATPIII, therefore ICO-replaced IDF and IDF seemed to be undesirable. However, there was no significant difference in area under the curve between ATPIII and ICO-replaced ATPIII in predicting CVD risk. But it seems that odds ratios for abnormal triglyceride and high-density lipoprotein levels increase slightly when using ICO, but decrease for hyperglycemia and hypertension when using ICO.
ICO was a better predictor of abnormal triglyceride and high-density lipoprotein levels than waist circumference, but waist circumference was a better predictor of hyperglycemia and hypertension than ICO. However, we failed to support ICO as a better parameter for metabolic syndrome definition in predicting CVD risk compared with waist circumference.
比较代谢综合征定义在预测心血管疾病（CVD）风险方面的适用性。
我们分析了来自中国江苏的3598名参与者的基于人群的前瞻性队列数据。在胆固醇教育计划成人治疗小组第三次报告（ICO替代的ATPIII）和国际糖尿病联盟（ICO替代的IDF）中，分别用中心性肥胖[中心性肥胖指数（ICO），腰围与身高之比]替代腰围。采用Cox比例风险回归模型和受试者工作特征曲线（ROC曲线）来评估ATPIII、IDF、ICO替代的IDF和ICO替代的ATPIII在预测CVD风险方面的适用性。
通过ROC曲线分析，ICO在预测CVD风险方面是一个更好的参数。ROC曲线分析还表明，尽管ICO替代的IDF和IDF具有较高的特异性、较低的敏感性、较长的ROC曲线距离、识别CVD的曲线下面积比ATPIII和ICO替代的ATPIII小，因此ICO替代的IDF和IDF似乎不太理想。然而，在预测CVD风险方面，ATPIII和ICO替代的ATPIII之间的曲线下面积没有显著差异。但使用ICO时，甘油三酯异常和高密度脂蛋白水平的优势比似乎略有增加，而使用ICO时，高血糖和高血压的优势比则降低。
与腰围相比，ICO是甘油三酯异常和高密度脂蛋白水平更好的预测指标，但腰围是高血糖和高血压比ICO更好的预测指标。然而，与腰围相比，我们未能支持将ICO作为代谢综合征定义中预测CVD风险的更好参数。
