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在一组成年特纳综合征患者中,人体测量学变量作为心血管疾病风险预测指标的研究

Anthropometric variables as cardiovascular risk predictors in a cohort of adult subjects with Turner syndrome.

作者信息

Álvarez-Nava Francisco, Racines Marcia, Witt Julia, Guarderas Jéssica, Estévez María, Lanes Roberto

机构信息

Biological Sciences School, Faculty of Biological Sciences, Central University of Ecuador, Quito, Ecuador.

Genetic Research Institute, University of Zulia, Maracaibo, Venezuela.

出版信息

Diabetes Metab Syndr Obes. 2019 Sep 9;12:1795-1809. doi: 10.2147/DMSO.S214787. eCollection 2019.

Abstract

BACKGROUND AND PURPOSE

Excessive adiposity is associated with cardiometabolic complications in Turner syndrome (TS) subjects. Reference data for predictive anthropometric indices of overweight/obesity and metabolic syndrome (MetS) are lacking for subjects with TS. The purpose of this study was to identify the best anthropometric predictor of cardiometabolic risk in a Latin-American cohort of TS subjects.

PATIENTS AND METHODS

This was a cross-sectional correlational study conducted in adult TS subjects (n=88) over the past seven years. Anthropometric parameters, body composition and biochemical variables were evaluated in a study and in a reference (n=57) group. Overweight/obesity and MetS were diagnosed using international consensus. The area under the ROC curve (AUC-ROC) was then used to determine the value of each anthropometric variable in predicting MetS or overweight/obesity.

RESULTS

The prevalence of MetS and overweight/obesity in TS subjects was 40% and 48%, respectively. All anthropometric and cardiometabolic variables were significantly increased in TS subjects when compared to the reference group, except for body mass index (BMI) and HDL-c. To detect MetS and overweight/obesity, waist to height ratio (WHtR) was found to have a higher correlation with cardiometabolic variables (TC, LDL-c, HDL-c levels and the LDL-c/HDL-c ratio), and to have a higher AUC-ROC and odds ratio than BMI, waist circumference (WC) and the waist to hip ratio (WHR).

CONCLUSION

The prevalence of MetS and overweight/obesity is elevated in TS subjects. WHtR was the most useful variable in predicting the presence of MetS and overweight and obesity in this TS cohort. A combination of WHtR with BMI or with WC could have the best clinical utility in identifying adult TS subjects with overweight/obesity and MetS, respectively.

摘要

背景与目的

过度肥胖与特纳综合征(TS)患者的心脏代谢并发症相关。目前缺乏TS患者超重/肥胖及代谢综合征(MetS)预测性人体测量指标的参考数据。本研究旨在确定拉丁美洲TS患者队列中最佳的心脏代谢风险人体测量预测指标。

患者与方法

这是一项在过去七年中对成年TS患者(n = 88)进行的横断面相关性研究。对一组研究对象和一组参照对象(n = 57)进行了人体测量参数、身体成分及生化变量评估。采用国际共识诊断超重/肥胖及MetS。然后用ROC曲线下面积(AUC-ROC)来确定各人体测量变量在预测MetS或超重/肥胖方面的价值。

结果

TS患者中MetS和超重/肥胖的患病率分别为40%和48%。与参照组相比,TS患者所有人体测量和心脏代谢变量均显著升高,但体重指数(BMI)和高密度脂蛋白胆固醇(HDL-c)除外。为检测MetS和超重/肥胖,发现腰高比(WHtR)与心脏代谢变量(总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)、HDL-c水平及LDL-c/HDL-c比值)具有更高的相关性,且AUC-ROC和比值比高于BMI、腰围(WC)和腰臀比(WHR)。

结论

TS患者中MetS和超重/肥胖的患病率升高。在该TS队列中,WHtR是预测MetS以及超重和肥胖存在的最有用变量。WHtR与BMI或WC联合使用可能分别在识别超重/肥胖和MetS的成年TS患者方面具有最佳临床效用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f794/6750008/bc41ac6305b9/DMSO-12-1795-g0001.jpg

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