代谢心血管指数：一种新的筛选代谢肥胖正常体重表型的工具。
Cardiometabolic index: a new tool for screening the metabolically obese normal weight phenotype.
机构信息
Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tong-Zi-Po Road, Changsha, 410013, Hunan, China.
Department of Health Examination Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
出版信息
J Endocrinol Invest. 2021 Jun;44(6):1253-1261. doi: 10.1007/s40618-020-01417-z. Epub 2020 Sep 9.
PURPOSE
People with the metabolically obese normal weight (MONW) phenotype are considered as an extremely high-risk group for unfavorable health consequences, but they are frequently undetected due to deceptive body mass index (BMI) and complex assessment. This study aimed to explore the clinical usefulness of cardiometabolic index (CMI) in identifying MONW individuals.
METHODS
This cross-sectional study involved a total of 47,683 normal-weight subjects aged ≥ 18 years. Participants underwent anthropometrics, routine biochemical tests, and questionnaires for a full evaluation of the metabolic profile. The odds ratio (OR) of CMI and MONW phenotype was determined by the Logistic regression models and the diagnostic accuracy of CMI was evaluated by the receiver operating characteristic (ROC) curve analysis.
RESULTS
The prevalence of MONW phenotype was 11.0%. After multivariate adjustment, the ORs for MONW in the highest compared with the lowest quartile of CMI was 71.20 (95% CI 55.19-91.86), and 1-SD increment of CMI brought a 54% additional risk. In ROC analysis, compared with BMI and waist circumference, CMI showed superior performance for identifying MONW individuals with an AUC of 0.853 (95% CI 0.847-0.860) in men and 0.912 (95% CI 0.906-0.918) in women, respectively. Moreover, CMI exhibited the highest diagnostic accuracy in younger age groups (aged 18-34 for men; aged 18-34 and 35-44 for women), in which AUCs surpassed 0.9 in both sexes.
CONCLUSIONS
CMI could be served as a valuable indicator to identify MONW phenotype of Chinese adults, particularly for young people.
目的
代谢正常体重肥胖（MONW）表型的人被认为是健康状况不佳的极高风险群体，但由于欺骗性的体重指数（BMI）和复杂的评估，他们经常被漏诊。本研究旨在探讨代谢指数（CMI）在识别 MONW 个体中的临床应用价值。
方法
本横断面研究共纳入 47683 名年龄≥18 岁的正常体重受试者。参与者接受了人体测量学、常规生化检查和问卷，以全面评估代谢状况。通过 Logistic 回归模型确定 CMI 和 MONW 表型的比值比（OR），并通过接收者操作特征（ROC）曲线分析评估 CMI 的诊断准确性。
结果
MONW 表型的患病率为 11.0%。经过多变量调整后，CMI 最高四分位与最低四分位相比，MONW 的 OR 为 71.20（95%CI 55.19-91.86），CMI 增加 1 个标准差会增加 54%的风险。在 ROC 分析中，与 BMI 和腰围相比，CMI 在男性中的 AUC 为 0.853（95%CI 0.847-0.860），在女性中的 AUC 为 0.912（95%CI 0.906-0.918），CMI 用于识别 MONW 个体的性能更优。此外，CMI 在年龄较小的年龄组（男性为 18-34 岁；女性为 18-34 岁和 35-44 岁）中具有最高的诊断准确性，在两性中 AUC 均超过 0.9。
结论
CMI 可以作为识别中国成年人 MONW 表型的有价值指标，特别是对于年轻人。
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