Chen Xiaojie, Zhao Yifan, Sun Jihong, Jiang Yaohui, Tang Yi
Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Nutr Metab (Lond). 2024 Nov 20;21(1):96. doi: 10.1186/s12986-024-00864-2.
Numerous studies indicate that visceral adipose tissue (VAT) significantly contribute to metabolic syndrome (MetS) development. This study aims to assess the distinguishing value of novel obesity markers, specifically lipid accumulation products (LAP) and cardiometabolic index (CMI), in relation to MetS. Considering the gender disparity in MetS prevalence, it is essential to explore whether LAP and CMI exhibit differential distinguishing capabilities by gender.
The investigation included a total of 11,687 qualified individuals who participated in the NHANES survey spanning a 14-year period from 2005 to 2018. Biochemical analysis of blood and body measurements were utilized to determine LAP and CMI values for each participant. Inclusion of gender as a variable was a key factor in the examination of all data. Restricted cube plots (RCS) were utilized to analyze the strength of the relationship between LAP, CMI, and MetS. The study delved into potential connections between LAP and CMI with MetS, all-cause and cardiovascular mortality using various statistical models such as multivariate logistic regression and Cox regression.
The findings revealed a significant nonlinear association between CMI, LAP, and MetS (P-non-linear < 0.001), irrespective of gender, with all models exhibiting a J-shaped trend. The multivariable logistic regression analysis considered both LAP and CMI as continuous variables or tertiles, revealing significant associations with MetS in male, female, and general populations (All the P < 0.001). Although males displayed a higher risk of MetS, no gender differences were observed in the area under the curve (AUC) values of LAP and CMI for distinguishing (P > 0.005) MetS. Impressively, LAP and CMI were identified as the primary predictors of MetS in both genders from AUC (P < 0.005). More specifically, the cutoff points for distinguishing MetS in females were LAP = 49.87 or CMI = 0.56, while for males, they were LAP = 52.76 or CMI = 0.70. Additionally, the Cox regression analysis revealed that LAP and CMI were correlated with all-cause mortality in both general population and females (P < 0.005), but not in males.
In comparison to other measures of obesity, LAP and CMI demonstrated superior diagnostic accuracy for MetS in both males and females. Additionally, LAP and CMI were found to be predictive of all-cause mortality in both general population and females. These markers are cost-effective, easily accessible, and widely applicable for the early identification and screening of MetS in clinical settings.
大量研究表明，内脏脂肪组织（VAT）对代谢综合征（MetS）的发展有显著影响。本研究旨在评估新型肥胖标志物，特别是脂质积聚产物（LAP）和心脏代谢指数（CMI）与MetS相关的鉴别价值。考虑到MetS患病率的性别差异，探索LAP和CMI是否因性别而具有不同的鉴别能力至关重要。
该调查共纳入11687名符合条件的个体，他们参与了2005年至2018年为期14年的美国国家健康和营养检查调查（NHANES）。利用血液生化分析和身体测量来确定每位参与者的LAP和CMI值。将性别作为变量纳入所有数据分析是一个关键因素。使用受限立方图（RCS）分析LAP、CMI与MetS之间关系的强度。该研究使用多元逻辑回归和Cox回归等各种统计模型，深入探讨LAP和CMI与MetS、全因死亡率和心血管死亡率之间的潜在联系。
研究结果显示，无论性别如何，CMI、LAP与MetS之间均存在显著的非线性关联（P-非线性<0.001），所有模型均呈现J形趋势。多变量逻辑回归分析将LAP和CMI视为连续变量或三分位数，结果显示在男性、女性和总体人群中与MetS均存在显著关联（所有P<0.001）。尽管男性患MetS的风险较高，但在区分MetS的LAP和CMI曲线下面积（AUC）值方面未观察到性别差异（P>0.005）。令人印象深刻的是，从AUC来看，LAP和CMI被确定为男女MetS的主要预测指标（P<0.005）。更具体地说，女性区分MetS的截断点为LAP = 49.87或CMI = 0.56，而男性为LAP = 52.76或CMI = 0.70。此外，Cox回归分析显示，LAP和CMI与总体人群和女性的全因死亡率相关（P<0.005），但与男性无关。
与其他肥胖测量指标相比，LAP和CMI在男性和女性中对MetS均显示出更高的诊断准确性。此外，发现LAP和CMI在总体人群和女性中可预测全因死亡率。这些标志物具有成本效益、易于获取，并且广泛适用于临床环境中MetS的早期识别和筛查。
