Xu Tao, Liu Junting, Liu Junxiu, Zhu Guangjin, Han Shaomei
Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China.
Department of Epidemiology, Capital Institute of Pediatrics, Beijing, 100020, China.
BMC Public Health. 2017 Apr 20;17(1):337. doi: 10.1186/s12889-017-4238-3.
Few nationally representative surveys regarding body composition and metabolic syndrome (MetS) have been done in a large-scale representative Chinese population to explore the prediction of body composition indicators for MetS. The objective of this study was to examine the relation of body composition and MetS and to determine the optimal cut-off values of body composition indicators that predict MetS in a large representative Chinese sample based on multiple provinces and ethnicities, covering a broad age range from 10 to 80 years old.
The subjects came from a large-scale population survey on Chinese physiological constants and health conditions conducted in six provinces. 32,036 subjects completed all blood biochemical testing and body composition measure. Subjects meeting at least 3 of the following 5 criteria qualify as having MetS: elevated blood pressure, lower high density lipoprotein cholesterol level, higher triglyceride level, higher fasting glucose level and abdominal obesity.
The total prevalence rate of MetS for males (9.29%) was lower than for females (11.58%). The prevalence rates were 12.03% for male adults and 15.57% for female adults respectively. The risk of MetS increased 44.6% (OR = 1.446, 95%CI: 1.414-1.521) for males and 53.4% (OR = 1.534, 95%CI: 1.472-1.598) for females with each 5% increase of percentage of body fat. The risk of MetS increased two-fold (OR = 2.020, 95%CI: 1.920-2.125 for males; OR = 2.047, 95%CI: 1.954-2.144 for females respectively) with each 5% increase of waist-hip ratio. The risk of MetS increased three-fold (OR = 2.915, 95%CI: 2.742-3.099 for males; OR = 2.950, 95%CI: 2.784-3.127 for females respectively) with each 5% increase of Waist-to-Height Ratio (WHtR). Areas under the receiver operating curve (AUC) of most body composition indicators were larger than 0.70 and the sensitivities and the specificities of most cut-off values were larger than 0.65. AUCs of WHR and WHtR were the largest. The optimal cut-off values of WHtR were 0.51 for males and 0.53 for females.
MetS has become a serious public health challenge in China. Body composition variables were closely related to MetS and they were reliable indicators in the screening of the presence of MetS.
在中国大规模代表性人群中，很少有关于身体成分与代谢综合征（MetS）的全国性代表性调查来探索身体成分指标对MetS的预测作用。本研究的目的是探讨身体成分与MetS的关系，并基于来自多个省份和不同民族、年龄范围从10岁到80岁的大型代表性中国样本，确定预测MetS的身体成分指标的最佳截断值。
研究对象来自于在六个省份开展的关于中国生理常数和健康状况的大规模人群调查。32036名受试者完成了所有血液生化检测和身体成分测量。符合以下5项标准中至少3项的受试者被判定为患有MetS：血压升高、高密度脂蛋白胆固醇水平降低、甘油三酯水平升高、空腹血糖水平升高和腹型肥胖。
男性MetS的总患病率（9.29%）低于女性（11.58%）。男性成年人和女性成年人的患病率分别为12.03%和15.57%。男性和女性的体脂百分比每增加5%，MetS风险分别增加44.6%（OR = 1.446，95%CI：1.414 - 1.521）和53.4%（OR = 1.534，95%CI：1.472 - 1.598）。男性和女性的腰臀比每增加5%，MetS风险分别增加两倍（男性OR = 2.020，95%CI：1.920 - 2.125；女性OR = 2.047，95%CI：1.954 - 2.144）。男性和女性的腰高比（WHtR）每增加5%，MetS风险分别增加三倍（男性OR = 2.915，95%CI：2.742 - 3.099；女性OR = 2.950，95%CI：2.784 - 3.127）。大多数身体成分指标的受试者工作特征曲线下面积（AUC）大于0.70，大多数截断值的敏感性和特异性大于0.65。WHR和WHtR的AUC最大。男性WHtR的最佳截断值为0.51，女性为0.53。
MetS已成为中国严峻的公共卫生挑战。身体成分变量与MetS密切相关，是筛查MetS存在情况的可靠指标。
