Liu Peng Ju, Lou Hui Ping, Zhu Yan Ning
Department of Clinical Nutrition, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
Department of Medical Examination Center, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Aug 18;13:2899-2907. doi: 10.2147/DMSO.S259770. eCollection 2020.
It has been suggested that hypertriglyceridemic waist (HW) phenotype is strongly associated with metabolic syndrome (MetS); however, there are very limited studies integrating triglyceride (TG) and waist circumference (WC) into a continuous variable to investigate the predictive power of this phenotype. Inspired from the triglyceride glucose index (TyG), we developed an integrated continuous index termed waist-triglyceride index (WTI) which was calculated as Ln [TG (mg/dl) WC (cm)/2].
We aimed to examine the potential of WTI in screening for MetS by comparing this quantitative index with the qualitative HW phenotype and other frequently used indices.
A cross-sectional study was conducted in a total of 3460 non-diabetic adults who participated in an annual health checkup. MetS was defined by the update National Cholesterol Education Program/Adult Treatment Panel ш criteria for Asian Americans. Receiving operating characteristic (ROC) curve and areas under the curve (AUC) were employed to evaluate the performance of the involved indices in screening for MetS. Statistical differences among the AUC values of the indices were compared.
In both genders, the AUC value of WTI, TyG or HW phenotype was markedly larger than that of each anthropometric index alone. In men, there were no statistical differences in the AUC values among WTI, TyG and HW phenotype, whereas in women, the AUC value of WTI was significantly larger than that of HW phenotype [difference between area (DBA): 0.042, 95% CI: 0.0224-0.0617, < 0.0001] and was nominally and significantly smaller than that of TyG (DBA: 0.00646, 95% CI: 0.000903-0.012, = 0.0227).
Our results suggest that there are discriminatory performance between the WTI and HW phenotype in the detection of MetS in women rather than in men. Appropriate markers for screening MetS in population study should be considered according to the genders.
有研究表明，高甘油三酯腰围（HW）表型与代谢综合征（MetS）密切相关；然而，将甘油三酯（TG）和腰围（WC）整合为一个连续变量以研究该表型预测能力的研究非常有限。受甘油三酯葡萄糖指数（TyG）启发，我们开发了一种综合连续指数，称为腰围 - 甘油三酯指数（WTI），其计算方法为Ln [TG（mg/dl）×WC（cm）/2]。
通过将该定量指数与定性的HW表型及其他常用指数进行比较，探讨WTI在筛查MetS中的潜力。
对3460名参加年度健康体检的非糖尿病成年人进行了横断面研究。MetS根据更新后的美国国家胆固醇教育计划/成人治疗小组Ⅲ针对亚裔美国人的标准进行定义。采用受试者工作特征（ROC）曲线和曲线下面积（AUC）来评估所涉及指数在筛查MetS中的表现。比较各指数AUC值之间的统计学差异。
在男性和女性中，WTI、TyG或HW表型的AUC值均明显大于单独的各人体测量指数。在男性中，WTI、TyG和HW表型的AUC值之间无统计学差异；而在女性中，WTI的AUC值显著大于HW表型[面积差异（DBA）：0.042，95%CI：0.0224 - 0.0617，P < 0.0001]，且名义上显著小于TyG（DBA：0.00646，95%CI：0.000903 - 0.012，P = 0.0227）。
我们的结果表明，在检测女性而非男性的MetS时，WTI和HW表型之间存在鉴别性能差异。在人群研究中，应根据性别考虑合适的MetS筛查标志物。
