Kim Hye-Ryoung, Kim Hee-Seung
College of Nursing, Shinhan University, Dongducheon-si, South Korea.
College of Nursing, The Catholic University of Korea, Seoul, South Korea.
Asian Nurs Res (Korean Soc Nurs Sci). 2017 Jun;11(2):107-112. doi: 10.1016/j.anr.2017.05.003. Epub 2017 Jun 1.
The purpose of the study was to identify the optimal cutoff values of indices for cardiometabolic risk in postmenopausal Korean women. Specifically, we intended to determine the cutoffs of waist circumference, waist-to-hip ratio (WHR), serum lipid profile, and homeostatic model of assessment-insulin resistance (HOMA-IR) for detecting metabolic syndrome (MetS), and metabolic obesity (MO).
The study participants were 397 postmenopausal women. We defined MetS and MO with the International Diabetes Federation criteria except for waist circumference. A receive operating characteristic curve analysis was used to assess the accuracy of diagnostic indices for identifying MetS and MO. Cutoff values were obtained both from the point on the receive operating characteristic curve which was closest to (0,1) and from the Youden's index.
Among the participants, 34.5% and 73% were classified as having MetS and MO. The optimal cutoff of waist circumference and WHR were 81.9 cm [area under curve (AUC): 0.687, sensitivity: 61.7%, specificity: 68.9%], 0.87 (AUC: 0.660, sensitivity: 64.7%, Specificity: 60.2%) for MetS and 77.4 cm (AUC: 0.655, sensitivity: 65.6%, specificity: 57.8%), 0.86 (AUC: 0.680, sensitivity: 67.0%, specificity: 62.7%) for MO. Triglyceride to high-density lipoprotein ratio for MetS and MO were 2.11 (AUC: 0.838, sensitivity: 71.5%, specificity: 79.6%) and 1.59 (AUC: 0.725, sensitivity: 65.9%, specificity: 68.2%) respectively. The HOMA-IR for MetS was 1.36 (AUC: 0.773, sensitivity: 73%, specificity: 71.9%) and for MO was 1.17 (AUC: 0.713, sensitivity: 64.5%, specificity: 69.2%).
For postmenopausal women, we suggest waist circumference of 81.9 cm and WHR of 0.87 as criteria of MetS. However, women with waist circumference over 77.4 cm and WHR over 0.86 should be monitored for the future development of MetS.
本研究旨在确定绝经后韩国女性心脏代谢风险指标的最佳临界值。具体而言，我们旨在确定腰围、腰臀比（WHR）、血脂谱以及评估胰岛素抵抗的稳态模型（HOMA-IR）用于检测代谢综合征（MetS）和代谢性肥胖（MO）的临界值。
研究参与者为397名绝经后女性。除腰围外，我们采用国际糖尿病联盟标准定义MetS和MO。采用受试者工作特征曲线分析来评估诊断指标识别MetS和MO的准确性。临界值既从受试者工作特征曲线上最接近（0,1）的点获取，也从约登指数获取。
在参与者中，34.5%和73%被归类为患有MetS和MO。MetS的腰围和WHR最佳临界值分别为81.9厘米[曲线下面积（AUC）：0.687，敏感性：61.7%，特异性：68.9%]、0.87（AUC：0.660，敏感性：64.7%，特异性：60.2%），MO的腰围和WHR最佳临界值分别为77.4厘米（AUC：0.655，敏感性：65.6%，特异性：57.8%）、0.86（AUC：0.680，敏感性：67.0%，特异性：62.7%）。MetS和MO的甘油三酯与高密度脂蛋白比值分别为2.11（AUC：0.838，敏感性：71.5%，特异性：79.6%）和1.59（AUC：0.725，敏感性：65.9%，特异性：68.2%）。MetS的HOMA-IR为1.36（AUC：0.773，敏感性：73%，特异性：71.9%），MO的HOMA-IR为1.17（AUC：0.713，敏感性：64.5%，特异性：69.2%）。
对于绝经后女性，我们建议将腰围81.9厘米和WHR 0.87作为MetS的标准。然而，腰围超过77.4厘米且WHR超过0.86的女性应监测MetS的未来发展情况。
