School of Public Health, Capital Medical University, Beijing, 100069, P.R. China.
Suzhou Research Center of Medical School, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China.
BMC Endocr Disord. 2024 Oct 24;24(1):223. doi: 10.1186/s12902-024-01752-9.
This study aimed to compare the diagnostic accuracy of four indicators, including waist-to-height ratio (WHTR), vascular adiposity index (VAI), TG/HDL-C, and BMI/HDL-C for metabolic syndrome (MS) in Chinese adults aged 40 years and above. Additionally, the study aimed to develop an efficient diagnostic model displayed by a nomogram based on individual's BMI and circulating HDL-C level.
A cross-sectional study was conducted on 699 participants aged 40 years and above. Quartiles of BMI/HDL-C, TG/HDL-C, VAI, and WHTR were used as independent variables, and metabolic syndrome was used as the dependent variable. Logistic regression was conducted to explore the impact of each parameter on the risk of MS. The areas under the receiver operating characteristics were compared to determine the accuracy of the indicators in diagnosing MS in the participants. Logistic regression was run to construct the nomograms, and the performance of the nomogram was assessed by a calibration curve.
MS subjects had higher levels of BMI, BFM, PBF, VFA, AMC, WC, SCR, TG, and insulin, but lower LDH and HDL-C levels than the subjects without MS. The BMI/HDL-C ratio was positively correlated with the prevalence of MS and its components. The final diagnostic model included five variables: gender, BFM, WC, TG, and BMI/HDL-C. The model showed good calibration and discrimination power with an AUC of 0.780. The cut-off value for the nomogram was 0.623 for diagnosing MS.
BMI/HDL-C ratio was an independent risk factor for MS in Chinese adults. BMI/HDL-C was significantly correlated with MS and its components. BMI/HDL-C was the most powerful diagnostic indicator compared to other indicators, including TG/HDL-C, VAI and WHTR for diagnosing MS. The nomogram drawn based on the diagnostic model provided a practical tool for diagnosing MS in Chinese adults.
本研究旨在比较腰高比（WHTR）、血管脂肪指数（VAI）、甘油三酯/高密度脂蛋白胆固醇（TG/HDL-C）和体重指数/高密度脂蛋白胆固醇（BMI/HDL-C）等四项指标在诊断中国 40 岁及以上成年人代谢综合征（MS）中的准确性。此外，本研究旨在开发一种基于个体 BMI 和循环 HDL-C 水平的有效诊断模型，通过列线图展示。
对 699 名 40 岁及以上的参与者进行横断面研究。BMI/HDL-C、TG/HDL-C、VAI 和 WHTR 的四分位数作为自变量，代谢综合征作为因变量。采用 Logistic 回归探讨各参数对 MS 发病风险的影响。比较受试者的受试者工作特征曲线下面积，以确定各指标诊断 MS 的准确性。采用 Logistic 回归构建列线图，并通过校准曲线评估列线图的性能。
MS 组的 BMI、BFM、PBF、VFA、AMC、WC、SCR、TG 和胰岛素水平均高于非 MS 组，而 LDH 和 HDL-C 水平则低于非 MS 组。BMI/HDL-C 比值与 MS 及其各组分的患病率呈正相关。最终的诊断模型包括性别、BFM、WC、TG 和 BMI/HDL-C。该模型具有良好的校准度和判别力，AUC 为 0.780。列线图的截断值为 0.623，用于诊断 MS。
BMI/HDL-C 比值是中国成年人 MS 的独立危险因素。BMI/HDL-C 与 MS 及其各组分显著相关。与其他指标（包括 TG/HDL-C、VAI 和 WHTR）相比，BMI/HDL-C 是诊断 MS 最有力的指标。基于诊断模型绘制的列线图为中国成年人 MS 的诊断提供了一种实用工具。
