Deihim Tina, Amiri Parisa, Taherian Reza, Tohidi Maryam, Ghasemi Asghar, Cheraghi Leila, Azizi Fereidoun
Research Center for Social Determinants of Endocrine Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Students' Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Health Qual Life Outcomes. 2015 Dec 9;13:194. doi: 10.1186/s12955-015-0391-5.
The superiority of the diagnostic power of different definitions of metabolic syndrome (MetS) in detecting objective and subjective cardiovascular outcomes is under debate. We sought to compare diagnostic values of different insulin resistance (IR)-based definitions of MetS in detecting poor health-related quality of life (HRQoL) in a large sample of Tehranian adults.
This cross-sectional study conducted within the framework of the Tehran Lipid and Glucose Study on a total sample of 742 individuals, aged ≥ 20 years. Metabolic syndrome was defined according to the World Health Organization (WHO), the European Group for the study of Insulin Resistance (EGIR), and the American Association of Clinical Endocrinology (AACE). Health-related quality of life was assessed using the Short Form Health Survey (SF-36). Logistic regression analysis and Receiver Operating Characteristic (ROC) curve were used to investigate the impact of the three IR-based definitions of MetS on HRQoL and compare their discriminative powers in predicting poor HRQoL.
Compared with other definitions, the WHO definition identified more participants with MetS (41.8 %). Although the AACE definition had higher adjusted odds ratios for reporting poor physical HRQoL (OR: 1.95; CI: 0.84-4.53 and OR: 1.01; CI: 0.55-1.85 in men and women respectively) and mental HRQoL (OR: 0.97; CI: 0.41-2.28 and OR: 1.00; CI: 0.56-1.79 in men and women respectively), none of the three studied definitions were significantly associated with poor physical or mental HRQoL in either gender; nor did ROC curves show any significant difference in the discriminative powers of IR-based definitions in detecting poor HRQoL in either gender.
None of the three studied IR-based definitions of MetS could significantly detect poor HRQoL in the physical or mental domains, indicating no significant superior diagnostic value for any of these definitions.
不同代谢综合征（MetS）定义在检测客观和主观心血管结局方面的诊断效能优势存在争议。我们试图比较基于不同胰岛素抵抗（IR）的MetS定义在一大群德黑兰成年人中检测健康相关生活质量（HRQoL）较差情况时的诊断价值。
这项横断面研究是在德黑兰脂质与葡萄糖研究框架内对742名年龄≥20岁的个体进行的。代谢综合征根据世界卫生组织（WHO）、欧洲胰岛素抵抗研究组（EGIR）和美国临床内分泌学会（AACE）的标准进行定义。使用简短健康调查问卷（SF - 36）评估健康相关生活质量。采用逻辑回归分析和受试者工作特征（ROC）曲线来研究基于IR的三种MetS定义对HRQoL的影响，并比较它们在预测HRQoL较差情况时的判别能力。
与其他定义相比，WHO定义识别出更多患有MetS的参与者（41.8%）。尽管AACE定义在报告身体HRQoL较差（男性和女性的OR分别为：1.95；CI：0.84 - 4.53和OR：1.01；CI：0.55 - 1.85）和心理HRQoL较差（男性和女性的OR分别为：0.97；CI：0.41 - 2.28和OR：1.00；CI：0.56 - 1.79）方面具有更高的调整优势比，但所研究的三种定义在任何性别中均与身体或心理HRQoL较差无显著关联；ROC曲线也未显示基于IR的定义在检测任何性别的HRQoL较差情况时的判别能力有任何显著差异。
所研究的基于IR的三种MetS定义均不能显著检测出身体或心理领域的HRQoL较差情况，表明这些定义中没有任何一个具有显著的优越诊断价值。
