Gasevic Danijela, Frohlich Jiri, Mancini Gb John, Lear Scott A
Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 2600-515 West Hastings, Vancouver, British Columbia V6B 5K3, Canada.
Lipids Health Dis. 2014 Oct 10;13:159. doi: 10.1186/1476-511X-13-159.
Waist circumference, a metabolic syndrome (MetSy) criterion, is not routinely measured in clinical practice making early identification of individuals with MetSy challenging. It has been argued that ratios of commonly measured parameters such as lipids and lipoproteins may be an acceptable alternative for identifying individuals with MetSy. The objective of our study was to explore clinical utility of lipid ratios to identify men and women with MetSy; and to explore the association between lipid ratios and the number of MetSy components.
Men and women (N = 797) of Aboriginal, Chinese, European, and South Asian origin (35-60 years), recruited across ranges of body mass index (BMI), with no diagnosed cardiovascular disease (CVD) or on medications to treat CVD risk factors were assessed for anthropometrics, family history of CVD, MetSy components (waist circumference, blood pressure, glucose, triglycerides (TG), high-density-lipoprotein-cholesterol (HDL-C)), low-density-lipoprotein-cholesterol (LDL-C), nonHDL-C, and health-related behaviours.
Mean levels of lipid ratios significantly increased with increasing number of MetSy components in men and women (p < 0.05). After adjustment for age, ethnicity, smoking, alcohol consumption, physical activity, family history of CVD and BMI, (and menopausal status in women), all lipid ratios were associated with the number of MetSy components in men and women (Poisson regression, p < 0.001). Compared to the rest of the lipid ratios (ROC curve analysis), TG/HDL-C was best able to discriminate between individuals with and without MetSy (AUC = 0.869 (95% CI: 0.830, 0.908) men; AUC = 0.872 (95% CI: 0.832, 0.912) women). The discriminatory power of TC/HDL-C and nonHDL-C/HDL-C to identify individuals with MetSY was the same (for both ratios, AUC = 0.793 (95% CI: 0.744, 0.842) men; 0.818 (95% CI: 0.772, 0.864) women). Additionally, LDL-C/HDL-C was a good marker for women (AUC = 0.759 (95% CI: 0.706, 0.812)), but not for men (AUC = 0.689 (95% CI: 0.631, 0.748)). Based on a multiethnic sample, we identified TG/HDL-C cut-off values of 1.62 in men and 1.18 in women that were best able to discriminate between men and women with and without MetSY.
Our results indicate that TG/HDL-C is a superior marker to identify men and women with MetSy compared to TC/HDL-C, LDL-C/HDL-C, and nonHDL-C/HDL-C.
腰围作为代谢综合征（MetSy）的一项标准，在临床实践中并非常规测量项目，这使得早期识别患有MetSy的个体具有挑战性。有人认为，常用测量参数如脂质和脂蛋白的比值可能是识别患有MetSy个体的可接受替代指标。我们研究的目的是探讨脂质比值在识别患有MetSy的男性和女性方面的临床效用；并探讨脂质比值与MetSy组分数量之间的关联。
招募了年龄在35 - 60岁之间、体重指数（BMI）范围各异、未诊断出心血管疾病（CVD）或未服用治疗CVD危险因素药物的原住民、华裔、欧洲裔和南亚裔男性和女性（N = 797），对其进行人体测量学、CVD家族史、MetSy组分（腰围、血压、血糖、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C））、低密度脂蛋白胆固醇（LDL-C）、非HDL-C以及健康相关行为的评估。
男性和女性的脂质比值平均水平随着MetSy组分数量的增加而显著升高（p < 0.05）。在对年龄、种族、吸烟、饮酒、身体活动、CVD家族史和BMI（以及女性的绝经状态）进行调整后，所有脂质比值均与男性和女性的MetSy组分数量相关（泊松回归，p < 0.001）。与其他脂质比值相比（ROC曲线分析），TG/HDL-C最能区分患有和未患有MetSy的个体（男性AUC = 0.869（95%CI：0.830，0.908）；女性AUC = 0.872（95%CI：0.832，0.912））。TC/HDL-C和非HDL-C/HDL-C识别患有MetSY个体的鉴别能力相同（对于这两个比值，男性AUC = 0.793（95%CI：0.744，0.842）；女性AUC = 0.818（95%CI：0.772，0.864））。此外，LDL-C/HDL-C对女性是一个良好的标志物（AUC = 0.759（95%CI：0.706，0.812）），但对男性不是（AUC = 0.689（95%CI：0.631，0.748））。基于一个多民族样本，我们确定男性TG/HDL-C的截断值为1.62，女性为1.18，这最能区分患有和未患有MetSY的男性和女性。
我们的结果表明，与TC/HDL-C、LDL-C/HDL-C和非HDL-C/HDL-C相比，TG/HDL-C是识别患有MetSy的男性和女性的更优标志物。
