中国全科医学 ›› 2025, Vol. 28 ›› Issue (21): 2595-2603.DOI: 10.12114/j.issn.1007-9572.2024.0559
收稿日期:
2025-01-10
修回日期:
2025-04-15
出版日期:
2025-07-20
发布日期:
2025-06-05
通讯作者:
刘安诺
作者贡献:
李春贤负责文章的构思与设计、数据收集与整理、统计学处理、论文撰写;李春贤、刘安诺负责研究的实施与可行性分析、结果的分析与解释、论文的修订;刘安诺负责文章的质量控制及审校,并对文章整体负责,监督管理。
基金资助:
LI Chunxian1,2, LIU Annuo1,*()
Received:
2025-01-10
Revised:
2025-04-15
Published:
2025-07-20
Online:
2025-06-05
Contact:
LIU Annuo
摘要: 背景 代谢综合征(MetS)是心血管并发症和肾损害的重要危险因素。肥胖和脂质相关指标与MetS密切相关,目前不同指标对MetS的预测价值尚有争议。 目的 本研究旨在评估脂质积累指数、BMI、内脏脂肪指数、中国内脏脂肪指数(CVAI)、腹容积指数(AVI)、体脂肪指数、体圆度指数、体型指数(ABSI)、三酰甘油葡萄糖指数(TyG)及其联合指数TyG-BMI、TyG-腰围(TyG-WC)、TyG-腰高比(TyG-WHtR)12项肥胖和脂质相关指标对MetS筛查和预测的最佳截断值,并确定最合适的预测因子。 方法 选取2023年安徽省某国企成年人健康体检资料,采用二元Logistic回归分析12项肥胖和脂质相关指标与MetS的相关性。绘制不同肥胖和脂质相关指标评估MetS的受试者工作特征(ROC)曲线,计算ROC曲线下面积(AUC)并比较其预测价值。 结果 本研究共纳入4 028名某国企成年人健康体检者的数据,研究人群MetS总体患病率为23.43%(944/4 028),男性MetS患病率为26.53%(816/3 075),女性MetS患病率为13.43%(128/953)。二元Logistic回归分析结果显示,TyG-WHtR与总人群[OR(95%CI)=7.170(5.411~9.500)]、性别亚组[男性OR(95%CI)=16.277(11.554~22.930);女性OR(95%CI)=13.422(5.388~33.435)]、年龄亚组[>50岁男性,OR(95%CI)=31.411(18.868~52.292)与36~50岁女性,OR(95%CI)=95.154(22.610~400.465)]MetS患病风险相关(P<0.05)。CVAI预测总人群、男性及年龄亚组男性≤35岁组和36~50岁组发生MetS的AUC分别为0.926(95%CI=0.917~0.936,P<0.001)、0.941(95%CI=0.933~0.949,P<0.001)、0.931(95%CI=0.917~0.946,P<0.001)、0.947(95%CI=0.934~0.961,P<0.001);AVI预测女性及年龄亚组女性≤35岁和>50岁、男性>50岁组发生MetS的AUC分别为0.951(95%CI=0.938~0.963,P<0.001)、0.961(95%CI=0.943~0.978,P<0.001)、0.909(95%CI=0.857~0.961,P<0.001)、0.962(95%CI=0.951~0.974,P<0.001);TyG-WC预测年龄亚组女性36~50岁组发生MetS的AUC为0.949(95%CI=0.925~0.972,P<0.001)。 结论 TyG-WHtR与成年人MetS关联性最强。除ABSI对MetS预测能力欠佳外,CVAI在总人群、男性及年龄亚组男性≤35岁组和36~50岁组对MetS预测能力均较佳,AVI对女性及年龄亚组女性≤35岁和>50岁、男性>50岁组对MetS均具有较高预测价值,TyG-WC对年龄亚组女性36~50岁组MetS的预测能力表现更优。
变量 | 总人群 | 男性 | 女性 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
非MetS (n=3 084) | MetS (n=944) | 检验统计量值 | P值 | 非MetS (n=2 259) | MetS (n=816) | 检验统计量值 | P值 | 非MetS (n=825) | MetS (n=128) | 检验统计量值 | P值 | |
年龄(岁) | 40±10 | 43±11 | -7.88a | <0.05 | 41±11 | 43±11 | -4.26a | <0.05 | 38±8 | 46±12 | -7.55a | <0.05 |
年龄分层[例(%)] | 60.25b | <0.05 | 14.57b | <0.05 | 94.95b | <0.05 | ||||||
≤35岁 | 1 327(43.0) | 305(32.3) | 912(76.9) | 274(33.6) | 415(50.3) | 31(24.2) | ||||||
36~50岁 | 1 040(33.7) | 307(32.5) | 703(73.0) | 260(31.8) | 337(40.8) | 47(36.7) | ||||||
≥51岁 | 717(23.3) | 332(35.2) | 644(70.0) | 282(34.6) | 73(8.9) | 50(39.1) | ||||||
身高(cm) | 169.77±7.50 | 170.54±7.45 | -2.77a | <0.05 | 170.88±7.01 | 171.12±7.12 | -0.82a | 0.41 | 166.72±7.96 | 166.81±8.42 | -0.13a | 0.89 |
体质量(kg) | 70.59±11.47 | 85.63±12.06 | -34.83a | <0.05 | 74.44±10.07 | 87.69±11.10 | -31.33a | <0.05 | 60.02±7.86 | 72.48±9.33 | -16.22a | <0.05 |
WC(cm) | 81.88±7.89 | 94.79±6.91 | -48.50a | <0.05 | 84.66±6.68 | 96.24±5.87 | -43.71a | <0.05 | 74.26±5.58 | 85.56±5.81 | -21.19a | <0.05 |
HC(cm) | 94.54±6.01 | 102.76±4.92 | -42.51a | <0.05 | 95.46±5.91 | 103.29±4.63 | -38.30a | <0.05 | 92.02±5.53 | 99.42±5.44 | -14.11a | <0.05 |
SBP(mmHg) | 127±16 | 143±15 | -27.96a | <0.05 | 130±15 | 143±15 | -21.40a | <0.05 | 118±15 | 143±18 | -14.70a | <0.05 |
DBP(mmHg) | 79±11 | 91±10 | -30.88a | <0.05 | 81±11 | 92±11 | -24.55a | <0.05 | 72±10 | 88±11 | -16.04a | <0.05 |
TG[M(P25,P75),mmol/L] | 1.2(0.8,1.7) | 2.0(1.3,2.8) | -21.75c | <0.05 | 1.3(0.9,20) | 2.1(1.4,3.0) | -17.22c | <0.05 | 0.9(0.6,1.2) | 1.5(1.1,2.2) | -10.85c | <0.05 |
TC(mmol/L) | 4.98±0.97 | 5.32±1.07 | -8.77a | <0.05 | 5.05±0.98 | 5.32±1.08 | -6.20a | <0.05 | 4.79±0.90 | 5.35±1.03 | -5.84a | <0.05 |
HDL-C(mmol/L) | 1.38±0.28 | 1.26±0.29 | 11.13a | <0.05 | 1.33±0.27 | 1.24±0.29 | 7.77a | <0.05 | 1.51±0.26 | 1.37±0.28 | 5.43a | <0.05 |
FPG | 5.12±1.05 | 5.72±1.63 | -10.67a | <0.05 | 5.20±1.15 | 5.76±1.68 | -8.83a | <0.05 | 4.91±0.68 | 5.49±1.24 | -5.12a | <0.05 |
LAP[M(P25,P75)] | 21.8(12.9,35.7) | 60.1(40.3,92.4) | -32.90c | <0.05 | 25.6(15.8,41.2) | 63.2(42.7,99.4) | -28.38c | <0.05 | 13.6(9.0,21.1) | 41.4(28.3,57.8) | -14.84c | <0.05 |
BMI(kg/m2) | 24.65±3.08 | 29.04±3.12 | -38.19a | <0.05 | 25.22±2.97 | 29.18±3.11 | -32.24a | <0.05 | 23.07±2.83 | 28.16±3.08 | -18.63a | <0.05 |
VAI[M(P25,P75)] | 1.16(0.79,1.78) | 2.18(1.45,3.31) | -23.35c | <0.05 | 1.24(0.82,1.92) | 2.19(1.47,3.36) | -19.22c | <0.05 | 1.00(0.72,1.47) | 2.02(1.33,3.21) | -11.64c | <0.05 |
CVAI[M(P25,P75)] | 73.60(44.94,93.3) | 125.8(113.2,143.2) | -39.68c | <0.05 | 83.5(63.4,97.7) | 129.4(116.4,145.2) | -37.41c | <0.05 | 38.5(19.7,57.5) | 97.9(79.8,118.8) | -15.41c | <0.05 |
BAI | 24.94±4.12 | 28.56±6.15 | -20.82a | <0.05 | 24.94±4.13 | 28.60±6.40 | -18.46a | <0.05 | 24.93±4.06 | 28.36±4.25 | -8.80a | <0.05 |
AVI | 13.72±3.13 | 18.50±7.33 | -19.47a | <0.05 | 14.60±3.10 | 19.08±7.69 | -16.14a | <0.05 | 11.32±1.62 | 14.86±2.08 | -21.95a | <0.05 |
BRI | 3.11±1.06 | 4.65±2.60 | -17.81a | <0.05 | 3.35±1.07 | 4.81±2.74 | -14.77a | <0.05 | 2.44±0.68 | 3.67±0.89 | -14.76a | <0.05 |
ABSI[M(P25,P75)] | 7.5(7.1,7.8) | 7.7(7.4,8.0) | -13.47c | 0.59 | 7.6(7.3,7.9) | 7.7(7.5,8.0) | -10.88c | <0.05 | 7.1(6.8,7.4) | 7.2(6.9,7.5) | -1.54c | 0.12 |
TyG | 6.91±0.62 | 7.51±0.68 | -23.02a | <0.05 | 7.04±0.62 | 7.56±0.68 | -18.79a | <0.05 | 6.55±0.47 | 7.20±0.56 | -12.47a | <0.05 |
TyG-BMI | 171.13±30.08 | 218.49±32.18 | -41.62a | <0.05 | 178.20±28.73 | 220.88±31.96 | -33.56a | <0.05 | 151.76±24.73 | 203.25±29.33 | -18.85a | <0.05 |
TyG-WC | 568.03±85.69 | 713.08±88.04 | -45.21a | <0.05 | 597.37±74.90 | 728.13±81.06 | -40.28a | <0.05 | 487.69±57.24 | 617.15±68.22 | -23.17a | <0.05 |
TyG-WHtR | 3.34±0.50 | 4.18±0.53 | -43.59a | <0.05 | 3.50±0.46 | 4.26±0.51 | -37.24a | <0.05 | 2.93±0.38 | 3.71±0.45 | -18.16a | <0.05 |
表1 研究对象的临床资料比较
Table 1 Basic characteristics of the participants
变量 | 总人群 | 男性 | 女性 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
非MetS (n=3 084) | MetS (n=944) | 检验统计量值 | P值 | 非MetS (n=2 259) | MetS (n=816) | 检验统计量值 | P值 | 非MetS (n=825) | MetS (n=128) | 检验统计量值 | P值 | |
年龄(岁) | 40±10 | 43±11 | -7.88a | <0.05 | 41±11 | 43±11 | -4.26a | <0.05 | 38±8 | 46±12 | -7.55a | <0.05 |
年龄分层[例(%)] | 60.25b | <0.05 | 14.57b | <0.05 | 94.95b | <0.05 | ||||||
≤35岁 | 1 327(43.0) | 305(32.3) | 912(76.9) | 274(33.6) | 415(50.3) | 31(24.2) | ||||||
36~50岁 | 1 040(33.7) | 307(32.5) | 703(73.0) | 260(31.8) | 337(40.8) | 47(36.7) | ||||||
≥51岁 | 717(23.3) | 332(35.2) | 644(70.0) | 282(34.6) | 73(8.9) | 50(39.1) | ||||||
身高(cm) | 169.77±7.50 | 170.54±7.45 | -2.77a | <0.05 | 170.88±7.01 | 171.12±7.12 | -0.82a | 0.41 | 166.72±7.96 | 166.81±8.42 | -0.13a | 0.89 |
体质量(kg) | 70.59±11.47 | 85.63±12.06 | -34.83a | <0.05 | 74.44±10.07 | 87.69±11.10 | -31.33a | <0.05 | 60.02±7.86 | 72.48±9.33 | -16.22a | <0.05 |
WC(cm) | 81.88±7.89 | 94.79±6.91 | -48.50a | <0.05 | 84.66±6.68 | 96.24±5.87 | -43.71a | <0.05 | 74.26±5.58 | 85.56±5.81 | -21.19a | <0.05 |
HC(cm) | 94.54±6.01 | 102.76±4.92 | -42.51a | <0.05 | 95.46±5.91 | 103.29±4.63 | -38.30a | <0.05 | 92.02±5.53 | 99.42±5.44 | -14.11a | <0.05 |
SBP(mmHg) | 127±16 | 143±15 | -27.96a | <0.05 | 130±15 | 143±15 | -21.40a | <0.05 | 118±15 | 143±18 | -14.70a | <0.05 |
DBP(mmHg) | 79±11 | 91±10 | -30.88a | <0.05 | 81±11 | 92±11 | -24.55a | <0.05 | 72±10 | 88±11 | -16.04a | <0.05 |
TG[M(P25,P75),mmol/L] | 1.2(0.8,1.7) | 2.0(1.3,2.8) | -21.75c | <0.05 | 1.3(0.9,20) | 2.1(1.4,3.0) | -17.22c | <0.05 | 0.9(0.6,1.2) | 1.5(1.1,2.2) | -10.85c | <0.05 |
TC(mmol/L) | 4.98±0.97 | 5.32±1.07 | -8.77a | <0.05 | 5.05±0.98 | 5.32±1.08 | -6.20a | <0.05 | 4.79±0.90 | 5.35±1.03 | -5.84a | <0.05 |
HDL-C(mmol/L) | 1.38±0.28 | 1.26±0.29 | 11.13a | <0.05 | 1.33±0.27 | 1.24±0.29 | 7.77a | <0.05 | 1.51±0.26 | 1.37±0.28 | 5.43a | <0.05 |
FPG | 5.12±1.05 | 5.72±1.63 | -10.67a | <0.05 | 5.20±1.15 | 5.76±1.68 | -8.83a | <0.05 | 4.91±0.68 | 5.49±1.24 | -5.12a | <0.05 |
LAP[M(P25,P75)] | 21.8(12.9,35.7) | 60.1(40.3,92.4) | -32.90c | <0.05 | 25.6(15.8,41.2) | 63.2(42.7,99.4) | -28.38c | <0.05 | 13.6(9.0,21.1) | 41.4(28.3,57.8) | -14.84c | <0.05 |
BMI(kg/m2) | 24.65±3.08 | 29.04±3.12 | -38.19a | <0.05 | 25.22±2.97 | 29.18±3.11 | -32.24a | <0.05 | 23.07±2.83 | 28.16±3.08 | -18.63a | <0.05 |
VAI[M(P25,P75)] | 1.16(0.79,1.78) | 2.18(1.45,3.31) | -23.35c | <0.05 | 1.24(0.82,1.92) | 2.19(1.47,3.36) | -19.22c | <0.05 | 1.00(0.72,1.47) | 2.02(1.33,3.21) | -11.64c | <0.05 |
CVAI[M(P25,P75)] | 73.60(44.94,93.3) | 125.8(113.2,143.2) | -39.68c | <0.05 | 83.5(63.4,97.7) | 129.4(116.4,145.2) | -37.41c | <0.05 | 38.5(19.7,57.5) | 97.9(79.8,118.8) | -15.41c | <0.05 |
BAI | 24.94±4.12 | 28.56±6.15 | -20.82a | <0.05 | 24.94±4.13 | 28.60±6.40 | -18.46a | <0.05 | 24.93±4.06 | 28.36±4.25 | -8.80a | <0.05 |
AVI | 13.72±3.13 | 18.50±7.33 | -19.47a | <0.05 | 14.60±3.10 | 19.08±7.69 | -16.14a | <0.05 | 11.32±1.62 | 14.86±2.08 | -21.95a | <0.05 |
BRI | 3.11±1.06 | 4.65±2.60 | -17.81a | <0.05 | 3.35±1.07 | 4.81±2.74 | -14.77a | <0.05 | 2.44±0.68 | 3.67±0.89 | -14.76a | <0.05 |
ABSI[M(P25,P75)] | 7.5(7.1,7.8) | 7.7(7.4,8.0) | -13.47c | 0.59 | 7.6(7.3,7.9) | 7.7(7.5,8.0) | -10.88c | <0.05 | 7.1(6.8,7.4) | 7.2(6.9,7.5) | -1.54c | 0.12 |
TyG | 6.91±0.62 | 7.51±0.68 | -23.02a | <0.05 | 7.04±0.62 | 7.56±0.68 | -18.79a | <0.05 | 6.55±0.47 | 7.20±0.56 | -12.47a | <0.05 |
TyG-BMI | 171.13±30.08 | 218.49±32.18 | -41.62a | <0.05 | 178.20±28.73 | 220.88±31.96 | -33.56a | <0.05 | 151.76±24.73 | 203.25±29.33 | -18.85a | <0.05 |
TyG-WC | 568.03±85.69 | 713.08±88.04 | -45.21a | <0.05 | 597.37±74.90 | 728.13±81.06 | -40.28a | <0.05 | 487.69±57.24 | 617.15±68.22 | -23.17a | <0.05 |
TyG-WHtR | 3.34±0.50 | 4.18±0.53 | -43.59a | <0.05 | 3.50±0.46 | 4.26±0.51 | -37.24a | <0.05 | 2.93±0.38 | 3.71±0.45 | -18.16a | <0.05 |
变量 | 总人群 | 男性 | 女性 | |||
---|---|---|---|---|---|---|
OR(95%CI) | P值 | OR(95%CI) | P值 | OR(95%CI) | P值 | |
LAP | 1.016(1.013~1.020) | <0.001 | 1.017(1.014~1.020) | <0.001 | 1.055(1.034~1.076) | <0.001 |
BMI | 1.117(1.067~1.170) | <0.001 | 1.094(1.023~1.170) | 0.008 | 1.008(0.878~1.158) | 0.905 |
VAI | 1.281(1.210~1.357) | <0.001 | 1.137(1.065~1.213) | <0.001 | 2.188(1.653~2.895) | <0.001 |
CVAI | 1.049(1.042~1.056) | <0.001 | 1.073(1.065~1.082) | <0.001 | 1.044(1.032~1.057) | <0.001 |
BAI | 1.023(0.998~1.048) | 0.073 | 0.984(0.959~1.009) | 0.205 | 0.984(0.905~1.070) | 0.711 |
AVI | 1.012(0.983~1.042) | 0.415 | 1.716(1.602~1.838) | <0.001 | 3.251(2.413~4.379) | <0.001 |
BRI | 1.565(1.361~1.801) | <0.001 | 1.682(1.437~1.969) | <0.001 | 2.713(1.638~4.493) | <0.001 |
ABSI | 1.095(1.012~1.185) | 0.024 | 1.879(1.472~2.399) | <0.001 | 1.067(0.963~1.183) | 0.216 |
TyG | 2.203(1.816~2.672) | <0.001 | 2.494(2.032~3.062) | <0.001 | 3.451(1.708~6.975) | <0.001 |
TyG-BMI | 1.021(1.016~1.026) | <0.001 | 1.026(1.020~1.032) | <0.001 | 1.017(1.003~1.032) | 0.019 |
TyG-WC | 1.009(1.007~1.011) | <0.001 | 1.018(1.016~1.021) | <0.001 | 1.026(1.018~1.034) | <0.001 |
TyG-WHtR | 7.170(5.411~9.500) | <0.001 | 16.277(11.554~22.930) | <0.001 | 13.422(5.388~33.435) | <0.001 |
表2 12项肥胖和脂质相关指标与MetS关系的二元Logistic回归分析
Table 2 Binary Logistic regression analysis of the relationship between 12 obesity and lipid-related indicators and MetS
变量 | 总人群 | 男性 | 女性 | |||
---|---|---|---|---|---|---|
OR(95%CI) | P值 | OR(95%CI) | P值 | OR(95%CI) | P值 | |
LAP | 1.016(1.013~1.020) | <0.001 | 1.017(1.014~1.020) | <0.001 | 1.055(1.034~1.076) | <0.001 |
BMI | 1.117(1.067~1.170) | <0.001 | 1.094(1.023~1.170) | 0.008 | 1.008(0.878~1.158) | 0.905 |
VAI | 1.281(1.210~1.357) | <0.001 | 1.137(1.065~1.213) | <0.001 | 2.188(1.653~2.895) | <0.001 |
CVAI | 1.049(1.042~1.056) | <0.001 | 1.073(1.065~1.082) | <0.001 | 1.044(1.032~1.057) | <0.001 |
BAI | 1.023(0.998~1.048) | 0.073 | 0.984(0.959~1.009) | 0.205 | 0.984(0.905~1.070) | 0.711 |
AVI | 1.012(0.983~1.042) | 0.415 | 1.716(1.602~1.838) | <0.001 | 3.251(2.413~4.379) | <0.001 |
BRI | 1.565(1.361~1.801) | <0.001 | 1.682(1.437~1.969) | <0.001 | 2.713(1.638~4.493) | <0.001 |
ABSI | 1.095(1.012~1.185) | 0.024 | 1.879(1.472~2.399) | <0.001 | 1.067(0.963~1.183) | 0.216 |
TyG | 2.203(1.816~2.672) | <0.001 | 2.494(2.032~3.062) | <0.001 | 3.451(1.708~6.975) | <0.001 |
TyG-BMI | 1.021(1.016~1.026) | <0.001 | 1.026(1.020~1.032) | <0.001 | 1.017(1.003~1.032) | 0.019 |
TyG-WC | 1.009(1.007~1.011) | <0.001 | 1.018(1.016~1.021) | <0.001 | 1.026(1.018~1.034) | <0.001 |
TyG-WHtR | 7.170(5.411~9.500) | <0.001 | 16.277(11.554~22.930) | <0.001 | 13.422(5.388~33.435) | <0.001 |
变量 | 总人群 | 男性 | 女性 | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | |
LAP | 0.853(0.841~0.866) | 39.58 | 76.3 | 79.1 | 55.4 | 0.835(0.820~0.850) | 39.54 | 79.8 | 73.1 | 52.9 | 0.907(0.883~0.931) | 24.46 | 85.9 | 81.9 | 67.8 |
BMI | 0.856(0.844~0.869) | 26.51 | 81.4 | 75.1 | 56.5 | 0.841(0.826~0.856) | 27.15 | 76.2 | 78.0 | 54.2 | 0.893(0.868~0.918) | 24.55 | 84.4 | 82.3 | 66.7 |
VAI | 0.751(0.734~0.768) | 1.68 | 67.8 | 71.9 | 39.7 | 0.727(0.707~0.746) | 1.48 | 75.0 | 61.6 | 36.6 | 0.819(0.780~0.858) | 1.26 | 84.4 | 66.5 | 50.9 |
CVAI | 0.926(0.917~0.936) | 101.97 | 89.9 | 84.9 | 74.8 | 0.941(0.933~0.949) | 105.45 | 92.9 | 84.7 | 77.6 | 0.923(0.903~0.943) | 63.40 | 92.2 | 79.8 | 72 |
BAI | 0.750(0.733~0.767) | 25.83 | 75.4 | 62.1 | 37.5 | 0.761(0.743~0.779) | 25.96 | 74.0 | 65.8 | 39.8 | 0.720(0.672~0.767) | 27.45 | 63.0 | 72.7 | 35.7 |
AVI | 0.909(0.899~0.920) | 15.97 | 88.5 | 89.8 | 78.3 | 0.938(0.930~0.946) | 16.07 | 100.0 | 86.8 | 86.8 | 0.951(0.938~0.963) | 12.88 | 100 | 87.0 | 87.0 |
BRI | 0.885(0.874~0.896) | 3.63 | 87.5 | 76.5 | 64.0 | 0.891(0.880~0.902) | 3.78 | 88.7 | 75.9 | 64.6 | 0.887(0.861~0.914) | 3.04 | 81.1 | 82.2 | 63.3 |
ABSI | 0.645(0.626~0.664) | 7.58 | 62.2 | 60.0 | 22.2 | 0.628(0.607~0.649) | 7.58 | 68.7 | 51.2 | 19.9 | 0.542(0.487~0.597) | 7.05 | 65.6 | 43.9 | 9.5 |
TyG | 0.750(0.733~0.767) | 7.12 | 72.7 | 66.6 | 39.3 | 0.720(0.700~0.740) | 7.18 | 72.8 | 62.3 | 35.1 | 0.819(0.780~0.858) | 6.93 | 72.7 | 81.1 | 53.8 |
TyG-BMI | 0.866(0.854~0.878) | 186.34 | 86.1 | 70.6 | 56.7 | 0.850(0.835~0.864) | 199.06 | 74.8 | 78.8 | 53.6 | 0.915(0.893~0.936) | 170.18 | 93.0 | 78.7 | 71.7 |
TyG-WC | 0.886(0.875~0.897) | 643.05 | 79.2 | 81.4 | 60.6 | 0.893(0.881~0.905) | 660.68 | 81.4 | 81.9 | 63.3 | 0.941(0.924~0.959) | 544.03 | 91.4 | 83.5 | 74.9 |
TyG-WHtR | 0.878(0.866~0.890) | 3.78 | 79.0 | 80.3 | 59.3 | 0.875(0.862~0.888) | 3.88 | 80.0 | 79.5 | 59.5 | 0.910(0.885~0.934) | 3.25 | 85.8 | 80.3 | 66.1 |
表3 不同肥胖和脂质相关指标预测MetS的AUC、最佳截断值、灵敏度、特异度和约登指数
Table 3 AUC,optimal threshold,sensitivity,specificity,and Jordon's index for the prediction of MetS by different obesity and lipid-related indices
变量 | 总人群 | 男性 | 女性 | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | |
LAP | 0.853(0.841~0.866) | 39.58 | 76.3 | 79.1 | 55.4 | 0.835(0.820~0.850) | 39.54 | 79.8 | 73.1 | 52.9 | 0.907(0.883~0.931) | 24.46 | 85.9 | 81.9 | 67.8 |
BMI | 0.856(0.844~0.869) | 26.51 | 81.4 | 75.1 | 56.5 | 0.841(0.826~0.856) | 27.15 | 76.2 | 78.0 | 54.2 | 0.893(0.868~0.918) | 24.55 | 84.4 | 82.3 | 66.7 |
VAI | 0.751(0.734~0.768) | 1.68 | 67.8 | 71.9 | 39.7 | 0.727(0.707~0.746) | 1.48 | 75.0 | 61.6 | 36.6 | 0.819(0.780~0.858) | 1.26 | 84.4 | 66.5 | 50.9 |
CVAI | 0.926(0.917~0.936) | 101.97 | 89.9 | 84.9 | 74.8 | 0.941(0.933~0.949) | 105.45 | 92.9 | 84.7 | 77.6 | 0.923(0.903~0.943) | 63.40 | 92.2 | 79.8 | 72 |
BAI | 0.750(0.733~0.767) | 25.83 | 75.4 | 62.1 | 37.5 | 0.761(0.743~0.779) | 25.96 | 74.0 | 65.8 | 39.8 | 0.720(0.672~0.767) | 27.45 | 63.0 | 72.7 | 35.7 |
AVI | 0.909(0.899~0.920) | 15.97 | 88.5 | 89.8 | 78.3 | 0.938(0.930~0.946) | 16.07 | 100.0 | 86.8 | 86.8 | 0.951(0.938~0.963) | 12.88 | 100 | 87.0 | 87.0 |
BRI | 0.885(0.874~0.896) | 3.63 | 87.5 | 76.5 | 64.0 | 0.891(0.880~0.902) | 3.78 | 88.7 | 75.9 | 64.6 | 0.887(0.861~0.914) | 3.04 | 81.1 | 82.2 | 63.3 |
ABSI | 0.645(0.626~0.664) | 7.58 | 62.2 | 60.0 | 22.2 | 0.628(0.607~0.649) | 7.58 | 68.7 | 51.2 | 19.9 | 0.542(0.487~0.597) | 7.05 | 65.6 | 43.9 | 9.5 |
TyG | 0.750(0.733~0.767) | 7.12 | 72.7 | 66.6 | 39.3 | 0.720(0.700~0.740) | 7.18 | 72.8 | 62.3 | 35.1 | 0.819(0.780~0.858) | 6.93 | 72.7 | 81.1 | 53.8 |
TyG-BMI | 0.866(0.854~0.878) | 186.34 | 86.1 | 70.6 | 56.7 | 0.850(0.835~0.864) | 199.06 | 74.8 | 78.8 | 53.6 | 0.915(0.893~0.936) | 170.18 | 93.0 | 78.7 | 71.7 |
TyG-WC | 0.886(0.875~0.897) | 643.05 | 79.2 | 81.4 | 60.6 | 0.893(0.881~0.905) | 660.68 | 81.4 | 81.9 | 63.3 | 0.941(0.924~0.959) | 544.03 | 91.4 | 83.5 | 74.9 |
TyG-WHtR | 0.878(0.866~0.890) | 3.78 | 79.0 | 80.3 | 59.3 | 0.875(0.862~0.888) | 3.88 | 80.0 | 79.5 | 59.5 | 0.910(0.885~0.934) | 3.25 | 85.8 | 80.3 | 66.1 |
图1 不同肥胖和血脂相关指数对的MetS预测价值注:A为总人群,B为男性,C为女性;LAP=脂质积累指数,VAI=内脏脂肪指数,CVAI=中国内脏脂肪指数,BAI=体脂肪指数,AVI=内脏脂肪指数,BRI=体圆度指数,TyG=三酰甘油葡萄糖指数,TyG-BMI=三酰甘油葡萄糖指数-体质指数,TyG-WC=三酰甘油葡萄糖指数-腰围,TyG-WHtR=三酰甘油葡萄糖指数-腰高比。
Figure 1 The predictive value of different obesity and lipid-related indices for MetS
变量 | ≤35岁 | 36~50岁 | >50岁 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
男性 | 女性 | 男性 | 女性 | 男性 | 女性 | |||||||
OR(95%CI) | P值 | OR(95%CI) | P值 | OR(95%CI) | P值 | OR(95%CI) | P值 | OR(95%CI) | P值 | OR(95%CI) | P值 | |
LAP | 1.017 (1.012~1.022) | <0.001 | 1.092 (1.059~1.126) | <0.001 | 1.025 (1.019~1.032) | <0.001 | 1.102 (1.068~1.137) | <0.001 | 1.020 (1.013~1.027) | <0.001 | 1.049 (1.022~1.076) | <0.001 |
BMI | 1.067 (0.992~1.147) | 0.083 | 1.421 (1.243~1.623) | 0.083 | 1.598 (1.480~1.725) | <0.001 | 1.585 (1.364~1.841) | <0.001 | 1.620 (1.499~1.751) | <0.001 | 1.682 (1.341~2.111) | <0.001 |
VAI | 1.204 (1.108~1.308) | <0.001 | 2.969 (1.996~4.416) | <0.001 | 1.372 (1.233~1.527) | <0.001 | 2.958 (1.776~4.929) | <0.001 | 1.213 (1.088~1.352) | <0.001 | 1.485 (1.093~2.018) | <0.001 |
CVAI | 1.061 (1.048~1.074) | <0.001 | 1.075 (1.050~1.101) | <0.001 | 1.102 (1.086~1.117) | <0.001 | 1.080 (1.054~1.107) | <0.001 | 1.135 (1.113~1.156) | <0.001 | 1.087 (1.052~1.124) | <0.001 |
BAI | 1.215 (1.163~1.269) | <0.001 | 1.383 (1.219~1.568) | <0.001 | 1.243 (1.183~1.306) | <0.001 | 1.207 (1.095~1.331) | <0.001 | 1.256 (1.198~1.318) | <0.001 | 1.089 (0.990~1.199) | <0.001 |
AVI | 1.668 (1.543~1.802) | <0.001 | 2.705 (1.932~3.788) | <0.001 | 1.277 (1.108~1.473) | <0.001 | 3.628 (2.412~5.457) | <0.001 | 3.045 (2.587~3.584) | <0.001 | 3.829 (2.344~6.254) | <0.001 |
BRI | 1.568 (1.250~1.967) | <0.001 | 9.891 (4.541~21.546) | <0.001 | 1.618 (1.187-2.205) | 0.002 | 7.898 (3.833~16.274) | 0.002 | 5.663 (4.116~7.792) | 0.002 | 3.888 (2.041~7.407) | 0.002 |
ABSI | 2.203 (1.622~2.993) | <0.001 | 2.918 (1.417~6.010) | 0.004 | 3.230 (2.254~4.628) | <0.001 | 1.111 (0.422~2.929) | <0.001 | 2.094 (1.388~3.157) | <0.001 | 1.652 (0.687~3.973) | <0.001 |
TyG | 3.936 (3.109~4.982) | <0.001 | 7.541 (3.144~18.087) | <0.001 | 3.363 (2.366~4.779) | <0.001 | 7.796 (3.277~18.545) | <0.001 | 2.531 (1.855~3.454) | <0.001 | 2.987 (1.357~6.576) | <0.001 |
TyG-BMI | 1.031 (1.023~1.039) | <0.001 | 1.052 (1.033~1.070) | <0.001 | 1.048 (1.040~1.056) | <0.001 | 1.065 (1.044~1.086) | <0.001 | 1.046 (1.039~1.054) | <0.001 | 1.053 (1.030~1.077) | <0.001 |
TyG-WC | 1.017 (1.014~1.021) | <0.001 | 1.038 (1.025~1.050) | <0.001 | 1.026 (1.022~1.030) | <0.001 | 1.039 (1.026~1.051) | <0.001 | 1.024 (1.021~1.028) | <0.001 | 1.027 (1.016~1.039) | <0.001 |
TyG-WHtR | 9.692 (5.874~15.989) | <0.001 | 94.460 (22.298~400.156) | <0.001 | 16.189 (8.913~29.405) | <0.001 | 95.154 (22.610~400.465) | <0.001 | 31.411 (18.868~52.292) | <0.001 | 20.454 (5.581~74.961) | <0.001 |
表4 年龄亚组不同肥胖和脂质相关指标与MetS关系的二元Logistic回归模型
Table 4 Binary Logistic regression modeling of the relationship between different obesity and lipid-related indicators and mets in age subgroups
变量 | ≤35岁 | 36~50岁 | >50岁 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
男性 | 女性 | 男性 | 女性 | 男性 | 女性 | |||||||
OR(95%CI) | P值 | OR(95%CI) | P值 | OR(95%CI) | P值 | OR(95%CI) | P值 | OR(95%CI) | P值 | OR(95%CI) | P值 | |
LAP | 1.017 (1.012~1.022) | <0.001 | 1.092 (1.059~1.126) | <0.001 | 1.025 (1.019~1.032) | <0.001 | 1.102 (1.068~1.137) | <0.001 | 1.020 (1.013~1.027) | <0.001 | 1.049 (1.022~1.076) | <0.001 |
BMI | 1.067 (0.992~1.147) | 0.083 | 1.421 (1.243~1.623) | 0.083 | 1.598 (1.480~1.725) | <0.001 | 1.585 (1.364~1.841) | <0.001 | 1.620 (1.499~1.751) | <0.001 | 1.682 (1.341~2.111) | <0.001 |
VAI | 1.204 (1.108~1.308) | <0.001 | 2.969 (1.996~4.416) | <0.001 | 1.372 (1.233~1.527) | <0.001 | 2.958 (1.776~4.929) | <0.001 | 1.213 (1.088~1.352) | <0.001 | 1.485 (1.093~2.018) | <0.001 |
CVAI | 1.061 (1.048~1.074) | <0.001 | 1.075 (1.050~1.101) | <0.001 | 1.102 (1.086~1.117) | <0.001 | 1.080 (1.054~1.107) | <0.001 | 1.135 (1.113~1.156) | <0.001 | 1.087 (1.052~1.124) | <0.001 |
BAI | 1.215 (1.163~1.269) | <0.001 | 1.383 (1.219~1.568) | <0.001 | 1.243 (1.183~1.306) | <0.001 | 1.207 (1.095~1.331) | <0.001 | 1.256 (1.198~1.318) | <0.001 | 1.089 (0.990~1.199) | <0.001 |
AVI | 1.668 (1.543~1.802) | <0.001 | 2.705 (1.932~3.788) | <0.001 | 1.277 (1.108~1.473) | <0.001 | 3.628 (2.412~5.457) | <0.001 | 3.045 (2.587~3.584) | <0.001 | 3.829 (2.344~6.254) | <0.001 |
BRI | 1.568 (1.250~1.967) | <0.001 | 9.891 (4.541~21.546) | <0.001 | 1.618 (1.187-2.205) | 0.002 | 7.898 (3.833~16.274) | 0.002 | 5.663 (4.116~7.792) | 0.002 | 3.888 (2.041~7.407) | 0.002 |
ABSI | 2.203 (1.622~2.993) | <0.001 | 2.918 (1.417~6.010) | 0.004 | 3.230 (2.254~4.628) | <0.001 | 1.111 (0.422~2.929) | <0.001 | 2.094 (1.388~3.157) | <0.001 | 1.652 (0.687~3.973) | <0.001 |
TyG | 3.936 (3.109~4.982) | <0.001 | 7.541 (3.144~18.087) | <0.001 | 3.363 (2.366~4.779) | <0.001 | 7.796 (3.277~18.545) | <0.001 | 2.531 (1.855~3.454) | <0.001 | 2.987 (1.357~6.576) | <0.001 |
TyG-BMI | 1.031 (1.023~1.039) | <0.001 | 1.052 (1.033~1.070) | <0.001 | 1.048 (1.040~1.056) | <0.001 | 1.065 (1.044~1.086) | <0.001 | 1.046 (1.039~1.054) | <0.001 | 1.053 (1.030~1.077) | <0.001 |
TyG-WC | 1.017 (1.014~1.021) | <0.001 | 1.038 (1.025~1.050) | <0.001 | 1.026 (1.022~1.030) | <0.001 | 1.039 (1.026~1.051) | <0.001 | 1.024 (1.021~1.028) | <0.001 | 1.027 (1.016~1.039) | <0.001 |
TyG-WHtR | 9.692 (5.874~15.989) | <0.001 | 94.460 (22.298~400.156) | <0.001 | 16.189 (8.913~29.405) | <0.001 | 95.154 (22.610~400.465) | <0.001 | 31.411 (18.868~52.292) | <0.001 | 20.454 (5.581~74.961) | <0.001 |
变量 | ≤35岁 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
男性 | 女性 | |||||||||
AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | |
LAP | 0.864(0.841~0.886) | 41.73 | 81.4 | 76.6 | 58.0 | 0.905(0.856~0.955) | 18.89 | 93.5 | 76.1 | 69.6 |
BMI | 0.853(0.830~0.876) | 27.15 | 80.3 | 77.9 | 58.2 | 0.876(0.818~0.934) | 25.57 | 74.2 | 85.8 | 60.0 |
VAI | 0.760(0.727~0.792) | 2.11 | 62.0 | 79.5 | 41.5 | 0.827(0.738~0.916) | 1.62 | 71.0 | 84.1 | 55.1 |
CVAI | 0.931(0.917~0.946) | 101.75 | 94.2 | 85.0 | 79.2 | 0.935(0.901~0.968) | 48.61 | 90.3 | 85.3 | 75.6 |
BAI | 0.772(0.742~0.801) | 25.97 | 75.5 | 68.7 | 44.2 | 0.841(0.775~0.907) | 27.45 | 83.3 | 77.1 | 60.4 |
AVI | 0.924(0.909~0.938) | 16.13 | 100 | 82.5 | 79.2 | 0.961(0.943~0.978) | 13.02 | 100.0 | 90.4 | 90.4 |
BRI | 0.882(0.863~0.901) | 3.78 | 86.9 | 76.0 | 62.9 | 0.924(0.885~0.964) | 2.91 | 90.0 | 79.7 | 69.7 |
ABSI | 0.590(0.553~0.626) | 7.21 | 91.2 | 23.1 | 14.3 | 0.605(0.493~0.717) | 7.70 | 33.3 | 88.9 | 22.2 |
TyG | 0.753(0.720~0.785) | 7.25 | 70.1 | 71.2 | 41.3 | 0.802(0.710~0.893) | 6.64 | 80.6 | 69.2 | 49.8 |
TyG-BMI | 0.875(0.853~0.896) | 200.44 | 80.7 | 80.6 | 61.3 | 0.907(0.860~0.955) | 169.07 | 87.1 | 83.4 | 70.5 |
TyG-WC | 0.911(0.894~0.929) | 661.98 | 86.1 | 83.1 | 69.2 | 0.945(0.911~0.979) | 531.48 | 93.5 | 84.8 | 78.3 |
TyG-WHtR | 0.893(0.873~0.912) | 3.83 | 84.3 | 80.0 | 64.3 | 0.926(0.885~0.966) | 3.16 | 86.7 | 80.4 | 67.1 |
变量 | 36~50岁 | |||||||||
男性 | 女性 | |||||||||
AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | |
LAP | 0.840(0.813~0.866) | 44.15 | 79.6 | 75.1 | 54.7 | 0.912(0.878~0.946) | 24.82 | 93.6 | 81.0 | 74.6 |
BMI | 0.840(0.814~0.866) | 26.61 | 81.5 | 70.0 | 51.5 | 0.905(0.870~0.940) | 25.54 | 85.1 | 84.3 | 69.4 |
VAI | 0.743(0.709~0.776) | 1.49 | 83.1 | 59.3 | 42.4 | 0.835(0.778~0.892) | 1.71 | 70.2 | 83.1 | 53.3 |
CVAI | 0.947(0.934~0.961) | 101.02 | 91.9 | 88.9 | 80.8 | 0.937(0.913~0.962) | 67.44 | 97.9 | 81.0 | 78.9 |
BAI | 0.764(0.732~0.795) | 25.83 | 78.5 | 63.4 | 41.9 | 0.729(0.653~0.806) | 26.72 | 76.6 | 63.2 | 39.8 |
AVI | 0.944(0.930~0.958) | 16.10 | 100.0 | 88.3 | 88.3 | 0.945(0.923~0.967) | 12.89 | 100.0 | 86.9 | 86.9 |
BRI | 0.900(0.881~0.919) | 3.65 | 96.9 | 70.7 | 67.6 | 0.869(0.817~0.922) | 3.26 | 70.2 | 91.1 | 61.3 |
ABSI | 0.630(0.593~0.667) | 7.41 | 85.0 | 37.2 | 22.2 | 0.513(0.425~0.600) | 7.11 | 59.6 | 49.0 | 8.6 |
TyG | 0.731(0.696~0.766) | 7.16 | 80.8 | 57.9 | 38.7 | 0.816(0.755~0.876) | 6.83 | 83.0 | 70.0 | 53.0 |
TyG-BMI | 0.851(0.825~0.887) | 191.05 | 85.8 | 67.9 | 53.7 | 0.925(0.895~0.955) | 172.74 | 93.6 | 83.1 | 76.7 |
TyG-WC | 0.894(0.873~0.916) | 652.39 | 86.5 | 78.2 | 64.7 | 0.949(0.925~0.972) | 555.47 | 91.5 | 87.8 | 79.3 |
TyG-WHtR | 0.878(0.855~0.901) | 3.83 | 83.1 | 77.4 | 60.5 | 0.908(0.867~0.949) | 3.25 | 87.2 | 80.4 | 67.6 |
变量 | >50岁 | |||||||||
男性 | 女性 | |||||||||
AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | |
LAP | 0.805(0.777~0.834) | 39.87 | 72.3 | 76.7 | 49.0 | 0.788(0.707~0.869) | 26.12 | 88.0 | 63.0 | 51.0 |
BMI | 0.829(0.800~0.857) | 27.19 | 74.5 | 80.3 | 54.8 | 0.798(0.721~0.875) | 27.40 | 62.0 | 83.6 | 50.3 |
VAI | 0.684(0.648~0.720) | 1.79 | 55.7 | 74.2 | 29.9 | 0.704(0.611~0.797) | 1.26 | 84.0 | 50.7 | 34.7 |
CVAI | 0.956(0.944~0.968) | 111.47 | 92.2 | 88.4 | 80.6 | 0.856(0.792~0.921) | 101.10 | 86.0 | 71.2 | 57.2 |
BAI | 0.742(0.709~0.775) | 25.16 | 81.9 | 52.9 | 34.8 | 0.575(0.474~0.677) | 23.92 | 76.0 | 39.7 | 15.7 |
AVI | 0.962(0.951~0.974) | 15.15 | 100.0 | 91.3 | 91.3 | 0.909(0.857~0.961) | 12.88 | 100.0 | 78.1 | 78.1 |
BRI | 0.899(0.880~0.918) | 3.78 | 89.3 | 76.0 | 65.3 | 0.774(0.693~0.855) | 3.04 | 84.0 | 64.4 | 48.4 |
ABSI | 0.674(0.638~0.710) | 7.64 | 67.6 | 59.6 | 27.2 | 0.547(0.443~0.652) | 7.04 | 64.0 | 46.6 | 10.6 |
TyG | 0.667(0.629~0.704) | 7.21 | 66.0 | 62.0 | 28.0 | 0.677(0.571~0.764) | 6.92 | 82.0 | 53.4 | 35.4 |
TyG-BMI | 0.818(0.789~0.847) | 195.70 | 73.0 | 75.0 | 48.0 | 0.795(0.716~0.874) | 198.83 | 64.0 | 86.3 | 50.3 |
TyG-WC | 0.871(0.848~0.894) | 665.65 | 73.4 | 84.2 | 57.6 | 0.846(0.777~0.915) | 581.27 | 82.0 | 76.7 | 58.7 |
TyG-WHtR | 0.851(0.826~0.876) | 3.85 | 75.4 | 78.5 | 53.9 | 0.780(0.698~0.862) | 3.47 | 74.0 | 72.6 | 46.6 |
表5 年龄亚组12项肥胖和脂质相关指标预测MetS的AUC、最佳截断值、灵敏度、特异度和约登指数
Table 5 AUC,best cutoff value,sensitivity,specificity,and yoden index of 12 obesity and lipid-related indicators predicting mets in age subgroups
变量 | ≤35岁 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
男性 | 女性 | |||||||||
AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | |
LAP | 0.864(0.841~0.886) | 41.73 | 81.4 | 76.6 | 58.0 | 0.905(0.856~0.955) | 18.89 | 93.5 | 76.1 | 69.6 |
BMI | 0.853(0.830~0.876) | 27.15 | 80.3 | 77.9 | 58.2 | 0.876(0.818~0.934) | 25.57 | 74.2 | 85.8 | 60.0 |
VAI | 0.760(0.727~0.792) | 2.11 | 62.0 | 79.5 | 41.5 | 0.827(0.738~0.916) | 1.62 | 71.0 | 84.1 | 55.1 |
CVAI | 0.931(0.917~0.946) | 101.75 | 94.2 | 85.0 | 79.2 | 0.935(0.901~0.968) | 48.61 | 90.3 | 85.3 | 75.6 |
BAI | 0.772(0.742~0.801) | 25.97 | 75.5 | 68.7 | 44.2 | 0.841(0.775~0.907) | 27.45 | 83.3 | 77.1 | 60.4 |
AVI | 0.924(0.909~0.938) | 16.13 | 100 | 82.5 | 79.2 | 0.961(0.943~0.978) | 13.02 | 100.0 | 90.4 | 90.4 |
BRI | 0.882(0.863~0.901) | 3.78 | 86.9 | 76.0 | 62.9 | 0.924(0.885~0.964) | 2.91 | 90.0 | 79.7 | 69.7 |
ABSI | 0.590(0.553~0.626) | 7.21 | 91.2 | 23.1 | 14.3 | 0.605(0.493~0.717) | 7.70 | 33.3 | 88.9 | 22.2 |
TyG | 0.753(0.720~0.785) | 7.25 | 70.1 | 71.2 | 41.3 | 0.802(0.710~0.893) | 6.64 | 80.6 | 69.2 | 49.8 |
TyG-BMI | 0.875(0.853~0.896) | 200.44 | 80.7 | 80.6 | 61.3 | 0.907(0.860~0.955) | 169.07 | 87.1 | 83.4 | 70.5 |
TyG-WC | 0.911(0.894~0.929) | 661.98 | 86.1 | 83.1 | 69.2 | 0.945(0.911~0.979) | 531.48 | 93.5 | 84.8 | 78.3 |
TyG-WHtR | 0.893(0.873~0.912) | 3.83 | 84.3 | 80.0 | 64.3 | 0.926(0.885~0.966) | 3.16 | 86.7 | 80.4 | 67.1 |
变量 | 36~50岁 | |||||||||
男性 | 女性 | |||||||||
AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | |
LAP | 0.840(0.813~0.866) | 44.15 | 79.6 | 75.1 | 54.7 | 0.912(0.878~0.946) | 24.82 | 93.6 | 81.0 | 74.6 |
BMI | 0.840(0.814~0.866) | 26.61 | 81.5 | 70.0 | 51.5 | 0.905(0.870~0.940) | 25.54 | 85.1 | 84.3 | 69.4 |
VAI | 0.743(0.709~0.776) | 1.49 | 83.1 | 59.3 | 42.4 | 0.835(0.778~0.892) | 1.71 | 70.2 | 83.1 | 53.3 |
CVAI | 0.947(0.934~0.961) | 101.02 | 91.9 | 88.9 | 80.8 | 0.937(0.913~0.962) | 67.44 | 97.9 | 81.0 | 78.9 |
BAI | 0.764(0.732~0.795) | 25.83 | 78.5 | 63.4 | 41.9 | 0.729(0.653~0.806) | 26.72 | 76.6 | 63.2 | 39.8 |
AVI | 0.944(0.930~0.958) | 16.10 | 100.0 | 88.3 | 88.3 | 0.945(0.923~0.967) | 12.89 | 100.0 | 86.9 | 86.9 |
BRI | 0.900(0.881~0.919) | 3.65 | 96.9 | 70.7 | 67.6 | 0.869(0.817~0.922) | 3.26 | 70.2 | 91.1 | 61.3 |
ABSI | 0.630(0.593~0.667) | 7.41 | 85.0 | 37.2 | 22.2 | 0.513(0.425~0.600) | 7.11 | 59.6 | 49.0 | 8.6 |
TyG | 0.731(0.696~0.766) | 7.16 | 80.8 | 57.9 | 38.7 | 0.816(0.755~0.876) | 6.83 | 83.0 | 70.0 | 53.0 |
TyG-BMI | 0.851(0.825~0.887) | 191.05 | 85.8 | 67.9 | 53.7 | 0.925(0.895~0.955) | 172.74 | 93.6 | 83.1 | 76.7 |
TyG-WC | 0.894(0.873~0.916) | 652.39 | 86.5 | 78.2 | 64.7 | 0.949(0.925~0.972) | 555.47 | 91.5 | 87.8 | 79.3 |
TyG-WHtR | 0.878(0.855~0.901) | 3.83 | 83.1 | 77.4 | 60.5 | 0.908(0.867~0.949) | 3.25 | 87.2 | 80.4 | 67.6 |
变量 | >50岁 | |||||||||
男性 | 女性 | |||||||||
AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | AUC(95%CI) | 最佳截断值 | 灵敏度(%) | 特异度(%) | 约登指数(%) | |
LAP | 0.805(0.777~0.834) | 39.87 | 72.3 | 76.7 | 49.0 | 0.788(0.707~0.869) | 26.12 | 88.0 | 63.0 | 51.0 |
BMI | 0.829(0.800~0.857) | 27.19 | 74.5 | 80.3 | 54.8 | 0.798(0.721~0.875) | 27.40 | 62.0 | 83.6 | 50.3 |
VAI | 0.684(0.648~0.720) | 1.79 | 55.7 | 74.2 | 29.9 | 0.704(0.611~0.797) | 1.26 | 84.0 | 50.7 | 34.7 |
CVAI | 0.956(0.944~0.968) | 111.47 | 92.2 | 88.4 | 80.6 | 0.856(0.792~0.921) | 101.10 | 86.0 | 71.2 | 57.2 |
BAI | 0.742(0.709~0.775) | 25.16 | 81.9 | 52.9 | 34.8 | 0.575(0.474~0.677) | 23.92 | 76.0 | 39.7 | 15.7 |
AVI | 0.962(0.951~0.974) | 15.15 | 100.0 | 91.3 | 91.3 | 0.909(0.857~0.961) | 12.88 | 100.0 | 78.1 | 78.1 |
BRI | 0.899(0.880~0.918) | 3.78 | 89.3 | 76.0 | 65.3 | 0.774(0.693~0.855) | 3.04 | 84.0 | 64.4 | 48.4 |
ABSI | 0.674(0.638~0.710) | 7.64 | 67.6 | 59.6 | 27.2 | 0.547(0.443~0.652) | 7.04 | 64.0 | 46.6 | 10.6 |
TyG | 0.667(0.629~0.704) | 7.21 | 66.0 | 62.0 | 28.0 | 0.677(0.571~0.764) | 6.92 | 82.0 | 53.4 | 35.4 |
TyG-BMI | 0.818(0.789~0.847) | 195.70 | 73.0 | 75.0 | 48.0 | 0.795(0.716~0.874) | 198.83 | 64.0 | 86.3 | 50.3 |
TyG-WC | 0.871(0.848~0.894) | 665.65 | 73.4 | 84.2 | 57.6 | 0.846(0.777~0.915) | 581.27 | 82.0 | 76.7 | 58.7 |
TyG-WHtR | 0.851(0.826~0.876) | 3.85 | 75.4 | 78.5 | 53.9 | 0.780(0.698~0.862) | 3.47 | 74.0 | 72.6 | 46.6 |
[1] |
|
[2] |
|
[3] |
|
[4] |
|
[5] |
|
[6] |
|
[7] |
吴瑞鹏,彭成,袁丙坤,等. 我国中老年人群血清尿酸/高密度脂蛋白胆固醇比值与代谢综合征的相关性研究[J]. 中国全科医学,2024,27(3):293-299. DOI:10.12114/j.issn.1007-9572.2023.0290.
|
[8] |
|
[9] |
|
[10] |
|
[11] |
|
[12] |
|
[13] |
|
[14] |
|
[15] |
|
[16] |
|
[17] |
|
[18] |
|
[19] |
|
[20] |
|
[21] |
|
[22] |
|
[23] |
|
[24] |
|
[25] |
|
[26] |
|
[27] |
|
[28] |
|
[29] |
|
[30] |
|
[31] |
|
[32] |
|
[33] |
|
[34] |
|
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