Zhang Xianghui, Ding Yusong, Shao Yinbao, He Jia, Ma Jiaolong, Guo Heng, Keerman Mulatibieke, Liu Jiaming, Si Huili, Guo Shuxia, Ma Rulin
Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, People's Republic of China.
Department of Neurology, Shihezi People's Hospital, Shihezi, Xinjiang, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Apr 12;14:1609-1620. doi: 10.2147/DMSO.S306908. eCollection 2021.
Few studies have focused on the predictive ability of visceral obesity-related indices for metabolic syndrome (MetS), especially in different ethnic groups. This study aimed to evaluate the applicability of visceral obesity-related indices for MetS screening among three major ethnic groups living in remote rural areas of Xinjiang.
Based on multistage stratified cluster random sampling method, 3,192 Uyghurs, 3,054 Kazakhs, and 3,658 Hans were recruited from Xinjiang, China. The Joint Interim Statement (JIS) criteria were used to define MetS. The receiver operating characteristic curve (ROC), area under the ROC curve (AUC), and predictive value of each visceral obesity-related index were used to evaluate the predictive ability of MetS.
After adjusting for potential confounding factors, the lipid accumulation product (LAP), Chinese visceral adiposity index (CVAI), waist-to-height ratio (WHtR), and atherogenic index of plasma (AIP) were significantly correlated with MetS for each ethnic group, and the odds ratios (ORs) for MetS increased across quartiles. LAP was best able to identify MetS status in Kazakhs (AUC=0.853) and Uyghurs (AUC=0.851), with optimal cut-offs being 36.3 and 28.2, respectively. Both LAP (AUC=0.798) and CVAI (AUC=0.791) most accurately identified MetS status in Hans, with the optimal cut-offs being 27.3 and 85.0, respectively. Moreover, the AUC of the combination of these visceral obesity-related indices is higher for each ethnic group. However, compared with LAP, the improved value of combined screening was not significant.
LAP had the best discriminative capability for the screening of MetS among Kazakhs, Uyghurs, and Hans. The screening ability of CVAI for MetS was similar to that of LAP in Hans. Thus, LAP may be a complementary indicator for assessing MetS in various ethnic groups.
很少有研究关注内脏肥胖相关指标对代谢综合征(MetS)的预测能力,尤其是在不同种族群体中。本研究旨在评估内脏肥胖相关指标在新疆偏远农村地区居住的三个主要民族中用于MetS筛查的适用性。
基于多阶段分层整群随机抽样方法,从中国新疆招募了3192名维吾尔族、3054名哈萨克族和3658名汉族。采用联合临时声明(JIS)标准定义MetS。使用受试者工作特征曲线(ROC)、ROC曲线下面积(AUC)以及每个内脏肥胖相关指标的预测值来评估MetS的预测能力。
在调整潜在混杂因素后,脂质蓄积产物(LAP)、中国内脏脂肪指数(CVAI)、腰高比(WHtR)和血浆致动脉粥样硬化指数(AIP)在每个民族中均与MetS显著相关,且MetS的比值比(OR)随四分位数增加。LAP在哈萨克族(AUC = 0.853)和维吾尔族(AUC = 0.851)中最能识别MetS状态,最佳截断值分别为36.3和28.2。LAP(AUC = 0.798)和CVAI(AUC = 0.791)在汉族中最准确地识别MetS状态,最佳截断值分别为27.3和85.0。此外,这些内脏肥胖相关指标组合的AUC在每个民族中更高。然而,与LAP相比,联合筛查的改善值并不显著。
LAP在哈萨克族、维吾尔族和汉族中对MetS筛查具有最佳判别能力。CVAI对汉族MetS的筛查能力与LAP相似。因此,LAP可能是评估不同民族MetS的补充指标。