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目的探寻北京市大屯地区65岁以上老年人群代谢综合征(metabolic syndrome,MS)相关肥胖程度的腰围身高比(waist to height ratio,WHt R)的切点,以期获得简单、经济、家庭化的筛检方法。方法对2015年1—12月北京市大屯地区65岁以上参加体检的居民979人进行调查,其中:男性404人,女性575人。以中华医学会糖尿病学分会(Chinese diabetes society,CDS)提出的诊断标准(2007年修订)诊断代谢综合征,分析男性和女性不同腰围身高比与MS其他因素的关系,用受试者工作特征(receiver operating characteristic,ROC)曲线分析以获得敏感性和特异性均较好的切点。计数资料进行χ~2检验,计量资料采用t检验,P<0.05为差异有统计学意义。用ROC曲线分析WHt R预测MS的敏感性、特异性,曲线下面积越大表示预测的价值越大,曲线下面积为0.5时代表此指标没有预测价值,曲线上敏感性和特异性之和最大的点为最佳切点。结果 979名老年人中,代谢综合征患者286人,患病率为29.21%,女性患病率高于男性(31.83%、25.20%),对比差异有统计学意义(P<0.05)。本地区老年人WHt R预测MS的最佳切点是0.545,敏感度为75.2%,特异度为25.4%,其中:男性为0.535,女性为0.545。结论本地区65岁以上的老年人群具有MS患病率高、女性患者多的特点,用此方法可初步判断老年人MS高危人群,尽早开展筛查和干预。
Objective To explore the cut-off point of waist to height ratio (WHt R) of obesity related to metabolic syndrome (MS) in the population over 65 years old in Datun, Beijing, with a view to obtaining a simple, economical and family-oriented Screening method. Methods Nine hundred and seventy-nine residents aged 65 and above who participated in the physical examination from January to December 2015 in Datun, Beijing were investigated, including 404 males and 575 females. The diagnostic criteria (revised in 2007) proposed by Chinese Diabetes Society (CDS) were used to diagnose metabolic syndrome and to analyze the relationship between the height-to-height ratio of MS and other MS patients and other factors of MS, using the working characteristics of the subjects receiver operating characteristic (ROC) curve analysis to obtain good cutoff points with good sensitivity and specificity. Count data for χ ~ 2 test, measurement data using t test, P <0.05 for the difference was statistically significant. The sensitivity and specificity of WH-R for predicting MS using ROC curve analysis showed that the larger the area under the curve, the greater the value of the prediction. The area under the curve of 0.5 means that this index has no predictive value and the sum of the sensitivity and the specificity of the curve is the largest The point for the best cut point. Results Among 979 elderly people, 286 were metabolic syndrome patients, with a prevalence of 29.21%. The prevalence rate of females was higher than that of males (31.83%, 25.20%). The difference was statistically significant (P <0.05). The best cut-point for prediction of MS in elderly WHt R in this area is 0.545, with a sensitivity of 75.2% and a specificity of 25.4%, of which 0.535 for men and 0.545 for women. Conclusion The elderly population over 65 years old in this area have the characteristics of high prevalence of MS and many female patients. This method can be used to determine the high risk population of MS in the elderly and carry out screening and intervention as soon as possible.