关键词: 尿酸, 代谢综合征X, 肥胖症, 儿童

Abstract: Objective　To evaluate the value of serum uric acid （SUA） in predicting metabolic syndrome （MS） in obese male children.Methods　We enrolled 256 obese male children from Department of Endocrinology，The Children's Hospital，Zhejiang University School of Medicine，Department of Pediatrics，The First Affiliated Hospital of Huzhou University，Department of Pediatrics，Huzhou Maternal & Child Care Hospital between June 2008 and October 2015，including 118 with MS and 138 without.We collected and compared their data about physical examination and laboratory findings.Performance analysis of different combinations of markers for the prediction of MS was conducted using area under the ROC curve （AUC），sensitivity，specificity and Cohen's Kappa coefficient（κ）．Results　For the prediction of MS，the AUC of SUA 〔0.631，95%CI（0.562，0.970）〕was significantly different from that of triglycerol（TG）〔0.878，95%CI（0.833，0.932），Z=5.898，P<0.001〕and high-density lipoprotein cholesterol （HDL-C）〔0.787，95%CI（0.730，0.844），Z=3.432，P<0.001〕，but similar to that of systolic blood pressure （SBP）〔0.688，95%CI（0.621，0.754），Z= 1.168，P= 0.243〕，diastolic blood pressure （DBP）〔0.592，95%CI（0.251，0.667），Z=0.777，P=0.437〕，low-density lipoprotein cholesterol（LDL-C）〔0.664，95%CI（0.598，0.731），Z=0.676，P= 0.449〕，fasting plasma glucose（FPG） 〔0.642，95%CI（0.571，0.713），Z=0.219，P=0.827〕，2 h-postprandial plasma glucose（2 h PG）〔0.647，95%CI（0.576，0.718），Z=0.319，P=0.750〕.The sensitivity of TG in serial combination with SUA was significantly different from that of TG in serial combination with FPG or 2 h PG，TG in serial combination with HDL-C or LDL-C and TG in serial combination with hypertension（P<0.001）；TG in serial combination with SUA showed obviously different specificity compared with TG in serial combination with FPG or 2 h PG（P=0.001） as well as TG in serial combination with hypertension（P<0.001），but was similar to that of TG in serial combination with HDL-C or LDL-C（P=0.324）．The κ of TG in serial combination with SUA did not significantly differ from that of TG in serial combination with FPG or 2 h PG，TG in serial combination with HDL-C or LDL-C，TG in serial combination with hypertension（Z=1.913，0.389，1.057；P=0.056，0.697，0.291）．The κ for measuring the extent of agreement was 0.357 between TG in serial combination with SUA and TG in serial combination with FPG or 2 h PG，0.554 between TG in serial combination with SUA and TG in serial combination with HDL-C or LDL-C，0.459 between TG in serial combination with SUA and TG in serial combination with hypertension.Conclusion　SUA can be used as a predictor of MS，and the prediction effect will be better if it is used in combination with TG.

Key words: Uric acid, Metabolic syndrome X, Obesity, Child