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中年越南人群代谢综合征的发病率和预测列线图:一项 5 年随访研究。

Incidence and prediction nomogram for metabolic syndrome in a middle-aged Vietnamese population: a 5-year follow-up study.

机构信息

Department of Epidemiology, Vietnam Military Medical University, 104 Phung Hung, Ha Dong, Hanoi, Vietnam.

Military Institute of Preventive Medicine, 21 Trung Liet, Dong Da, Hanoi, Vietnam.

出版信息

Endocrine. 2022 Jan;75(1):108-118. doi: 10.1007/s12020-021-02836-5. Epub 2021 Aug 2.

Abstract

PURPOSE

We aimed to determine the incidence and prediction nomogram for new-onset metabolic syndrome (MetS) in a middle-aged Vietnamese population.

METHODS

A population-based prospective study was conducted in 1150 participants aged 40-64 years without MetS at baseline and followed-up for 5 years. Data on lifestyle factors, socioeconomic status, family diabetes history, and anthropometric measures were collected. MetS incidence was estimated in general population and subgroup of age, gender, and MetS components. A Cox proportional hazards regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for MetS. A prediction nomogram was developed and checked for discrimination and calibration.

RESULTS

During median follow-up of 5.14 years, the accumulate MetS incidence rate was 23.4% (95% CI: 22.2-24.7). The annual incidence rate (95% CI) was 52.9 (46.7-60.1) per 1000 person-years in general population and higher in women [56.6 (48.7-65.9)] than men [46.5 (36.9-59.3)]. The HRs (95% CI) for developing MetS were gender [females vs males: 2.04 (1.26-3.29)], advanced age [1.02 (1.01-1.04) per one year], waist circumference [1.08 (1.06-1.10) per one cm] and other obesity-related traits, and systolic blood pressure [1.02 (1.01-1.03) per one mmHg]. The prediction nomogram for MetS had a good discrimination (C-statistics = 0.742) and fit calibration (mean absolute error = 0.009) with a positive net benefit in the predicted probability thresholds between 0.13 and 0.70.

CONCLUSIONS

The study is the first to indicate an alarmingly high incidence of MetS in a middle-aged population in Vietnam. The nomogram with simply applicable variables would be useful to qualify individual risk of developing MetS.

摘要

目的

本研究旨在确定越南中年人群中新发代谢综合征(MetS)的发病率和预测列线图。

方法

本研究为一项基于人群的前瞻性研究,共纳入了 1150 名基线时无 MetS 的 40-64 岁人群,并随访 5 年。收集了生活方式因素、社会经济地位、家族糖尿病史和人体测量学指标的数据。估计了一般人群以及年龄、性别和 MetS 成分亚组中新发 MetS 的发病率。使用 Cox 比例风险回归估计 MetS 的风险比(HR)及其 95%置信区间(CI)。开发了预测列线图,并对其进行了区分度和校准度检验。

结果

在中位随访 5.14 年期间,累积 MetS 发病率为 23.4%(95%CI:22.2-24.7)。一般人群的年发病率(95%CI)为 52.9(46.7-60.1)/1000 人年,女性[56.6(48.7-65.9)]高于男性[46.5(36.9-59.3)]。发生 MetS 的 HR(95%CI)为性别[女性比男性:2.04(1.26-3.29)]、年龄较大[1 岁时 1.02(1.01-1.04)]、腰围[1 厘米时 1.08(1.06-1.10)]和其他肥胖相关特征,以及收缩压[1 毫米汞柱时 1.02(1.01-1.03)]。MetS 预测列线图具有较好的区分度(C 统计量=0.742)和校准度(平均绝对误差=0.009),在 0.13 至 0.70 的预测概率阈值之间具有阳性净获益。

结论

本研究首次表明,越南中年人群中 MetS 的发病率高得惊人。该列线图具有简单适用的变量,可用于确定个体发生 MetS 的风险。

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