National Clinical Research Center for Kidney Diseases, State Key Laboratory of Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, Beijing 100853, China.
School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China.
Nutrients. 2022 Mar 23;14(7):1334. doi: 10.3390/nu14071334.
Existing obesity- and lipid-related indices are inconsistent with metabolic syndrome (MetS) in chronic kidney disease (CKD) patients. We compared seven indicators, including waist circumference (WC), body mass index (BMI), visceral fat area (VFA), subcutaneous fat area (SFA), visceral adiposity index (VAI), Chinese VAI and lipid accumulation product (LAP), to evaluate their ability to predict MetS in CKD patients with and without Type 2 diabetes mellitus (T2DM) under various criteria. Multivariate logistic regression analysis was used to investigate the independent associations between the indices and metabolic syndrome among 547 non-dialysis CKD patients, aged ≥18 years. The predictive power of these indices was assessed using receiver operating characteristic (ROC) curve analysis. After adjusting for potential confounders, the correlation between VAI and MetS was strongest based on the optimal cut-off value of 1.51 (sensitivity 86.84%, specificity 91.18%) and 2.35 (sensitivity 83.54%, specificity 86.08%), with OR values of 40.585 (8.683-189.695) and 5.076 (1.247-20.657) for males and females with CKD and T2DM. In CKD patients without T2DM, based on the optimal cut-off values of 1.806 (sensitivity 98.11%, specificity 72.73%) and 3.11 (sensitivity 84.62%, specificity 83.82%), the OR values were 7.514 (3.757-15.027) and 3.008 (1.789-5.056) for males and females, respectively. The area under ROC curve (AUC) and Youden index of VAI were the highest among the seven indexes, indicating its superiority in predicting MetS in both male and female CKD patients, especially those with T2DM.
现有的肥胖和血脂相关指数与慢性肾脏病（CKD）患者的代谢综合征（MetS）不一致。我们比较了七种指标，包括腰围（WC）、体重指数（BMI）、内脏脂肪面积（VFA）、皮下脂肪面积（SFA）、内脏脂肪指数（VAI）、中国 VAI 和脂质堆积产物（LAP），以评估它们在不同标准下预测伴有和不伴有 2 型糖尿病（T2DM）的 CKD 患者 MetS 的能力。使用多变量逻辑回归分析调查了 547 名年龄≥18 岁的非透析 CKD 患者中这些指数与代谢综合征之间的独立关联。使用受试者工作特征（ROC）曲线分析评估这些指数的预测能力。在调整潜在混杂因素后，根据最佳截断值 1.51（敏感性 86.84%，特异性 91.18%）和 2.35（敏感性 83.54%，特异性 86.08%），VAI 与 MetS 的相关性最强，OR 值分别为 40.585（8.683-189.695）和 5.076（1.247-20.657），用于患有 CKD 和 T2DM 的男性和女性。在不伴有 T2DM 的 CKD 患者中，根据最佳截断值 1.806（敏感性 98.11%，特异性 72.73%）和 3.11（敏感性 84.62%，特异性 83.82%），OR 值分别为 7.514（3.757-15.027）和 3.008（1.789-5.056），用于男性和女性。VAI 的 ROC 曲线下面积（AUC）和 Youden 指数在这七个指标中最高，表明其在预测男性和女性 CKD 患者，尤其是伴有 T2DM 的患者的 MetS 方面具有优势。
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