目的 比较不同肥胖相关指标对四川地区汉族与彝族成人代谢综合征（metabolic syndrome，MetS）的预测价值。方法 以3 492名四川地区汉族及彝族成年人为研究对象，进行代谢综合征横断面调查，记录性别、年龄，测量身高、体质量、腰围（waist circumference，WC）及臀围，留取血清样本，检测空腹及餐后血糖、血脂水平等相关代谢指标。采用Spearman 相关分析探讨不同肥胖测量指标与MetS的关系，且采用受试者工作特征（receiver operating characteristic，ROC）曲线评估和比较体质量指数（body mass index，BMI）、WC、腰臀比（waist-to-hip ratio，WHR）、腰围身高比（waist-to-height ratio，WHtR）、脂质蓄积指数(lipid accumulation product，LAP)和内脏脂肪指数(visceral adiposity index，VAI)在预测彝族与汉族人群MetS中的价值。结果 Spearman相关分析显示，MetS与BMI、WC、WHtR、LAP及VAI均明显相关。ROC结果提示, LAP对彝族和汉族男性人群MetS的预测价值最高，ROC曲线下面积(area under the curve，AUC）>0.90，而WHR预测价值相对最低。在两个民族的女性人群中WHtR对MetS预测价值均高（AUC >0.88），而VAI最低。结论 无论汉族或彝族居民，预测MetS发生风险的肥胖相关指标相似，即男性以LAP、女性以WHtR为最佳，但仍需依据内脏脂肪容积测定及前瞻性研究进一步证实。
英文摘要:
Objective To compare the predictive value of different measures of obesity for metabolic syndrome (MetS) in adult Yi and Han nationality population. Methods A total of 3 492 urban and rural residents in Chengdu and Liangshan Yi Autonomous Prefecture participated in this study. Demographic and laboratory data were collected. Spearman correlation analysis was used to investigate the relationship between different obesity measurement indexes and MetS. Receiver operating characteristic (ROC) curve was used to compare the predictive value between different obesity measurement indexes. Results Spearman correlation analysis showed that MetS was related to body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), lipid accumulation index (LAP) and visceral adiposity index (VAI). The ROC curve showed that the LAP had the highest predictive value for MetS in both Yi and Han male adults， area under the curves (AUCs) >0.90； whereas WHR had the lowest predictive value. WHtR had high predictive value for MetS in both Yi and Han female adults (AUCs >0.88), VAI had the worst predictive value. Conclusion Among different measures of obesity, LAP may have the optimal predictive value for MetS in male adults as do WHtR in female adults either in Yi or Han nationality. These findings should be confirmed through the measure of visceral fat volume and prospective study.
