Qing L, Wei R, Chan L, Xiaoya Z, Xin X
Department of Endocrinology, Chongqing Medical University First Affiliated Hospital, #1 You-Yi Rd., Yu-zhong District, Chongqing, 400016, China.
J Endocrinol Invest. 2017 Jun;40(6):653-661. doi: 10.1007/s40618-017-0621-2. Epub 2017 Feb 23.
Adult growth hormone deficiency (AGHD) refers to decreased secretion of growth hormones in the adults, which is associated with increased clustering of conventional cardiovascular risk factors such as central obesity, insulin resistance and dyslipidemia. Metabolic syndrome (MetS), a recognized risk factor of cardiovascluar diseases, shares some clinical features. Given that the prevalence of MetS is on the rise in patients with AGHD, and that cardiovascular disease (CVD) is an important cause of morbidity and mortality in that population, the alternative, simple, non-invasive methods of assessing MetS among this population are needed. This study aims to determine the sensitivity of five anthropometric indices [Body mass index (BMI), Waist circumference (WC), Waist-to-hip ratio (WHR), Waist-to-height ratio (WHtR) and Visceral adiposity index (VAI)] in predicting metabolic syndrome in Chinese population-based patients with adult growth hormone deficiency.
A total of 96 Chinese patients with adult growth hormone deficiency were included in this study. They were compared with equal number of apparently healthy persons with similar characteristics (matched with age and gender) to the previous group. Anthropometric measurements including weight, height, serum lipids indices, blood pressure (BP), fasting plasma glucose (FPG), WC were measured. BMI, WHR, WHtR, and VAI were calculated.
AGHD patients with MetS had higher WC (91.00 ± 8.28 vs 78.01 ± 7.12), BMI (24.95 ± 2.91 VS 23.30 ± 2.80), WHR (0.92 ± 0.06 VS 0.87 ± 0.07), WHtR (0.53 ± 0.06 VS 0.47 ± 0.05), VAI [(5.59 (4.02, 7.55) VS 1.69 (0.87, 3.05)] levels in comparison to those without MetS. Meantime WC, BMI, WHR, WHtR, VAI was positively correlated to MetS components. ROC curve for participants with AGHD showed that VAI had the highest SS of 92% (BMI 0.812; WHR 0.706; WHtR 0.902; VAI 0.920, respectively) for prediction of MetS in AGHD. The optimal cutoff values for different adiposity markers in predicting MetS were as follows: WC (79.65), BMI (23.46); WHR (0.89); WHtR (0.54); VAI (2.29).
In conclusion, our study showed all adiposity measures of interest present themselves as easy and practical tools for use in population studies and clinical practice for evaluating MetS in AGDH and VAI was identified as the best in Chinese AGHD patients among them.
成人生长激素缺乏症(AGHD)是指成人生长激素分泌减少,这与传统心血管危险因素(如中心性肥胖、胰岛素抵抗和血脂异常)的聚集增加有关。代谢综合征(MetS)是一种公认的心血管疾病危险因素,具有一些临床特征。鉴于AGHD患者中MetS的患病率正在上升,且心血管疾病(CVD)是该人群发病和死亡的重要原因,因此需要在该人群中采用替代的、简单的、非侵入性的方法来评估MetS。本研究旨在确定五项人体测量指标[体重指数(BMI)、腰围(WC)、腰臀比(WHR)、腰高比(WHtR)和内脏脂肪指数(VAI)]在中国成人生长激素缺乏症患者中预测代谢综合征的敏感性。
本研究共纳入96例中国成人生长激素缺乏症患者。将他们与数量相等、特征相似(年龄和性别匹配)的明显健康人群进行比较。测量人体测量指标,包括体重、身高、血脂指标、血压(BP)、空腹血糖(FPG)、WC。计算BMI、WHR、WHtR和VAI。
患有MetS的AGHD患者的WC(91.00±8.28 vs 78.01±7.12)、BMI(24.95±2.91 VS 23.30±2.80)、WHR(0.92±0.06 VS 0.87±0.07)、WHtR(0.53±0.06 VS 0.47±0.05)、VAI[(5.59(4.02,7.55)VS 1.69(0.87,3.05)]水平高于未患MetS的患者。同时,WC、BMI、WHR、WHtR、VAI与MetS各组分呈正相关。AGHD参与者的ROC曲线显示,VAI预测AGHD中MetS的SS最高,为92%(BMI为0.812;WHR为0.706;WHtR为0.902;VAI为0.920)。不同肥胖标志物预测MetS的最佳截断值如下:WC(79.65)、BMI(23.46);WHR(0.89);WHtR(0.54);VAI(2.29)。
总之,我们的研究表明,所有感兴趣的肥胖测量指标都是用于人群研究和临床实践中评估AGDH中MetS的简单实用工具,其中VAI被确定为中国AGHD患者中最佳的指标。