Lipid accumulation product: a powerful marker of metabolic syndrome in healthy population
Lipid accumulation product: a powerful marker of metabolic syndrome in healthy population
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DOI：
10.1530/eje-10-1039
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发表时间：
2011-04-01
影响因子：
5.8
通讯作者：
Serrano-Rios, Manuel
中科院分区：
文献类型：
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作者：
Taverna, Mariano J.;Martinez-Larrad, Maria T.;Serrano-Rios, Manuel
目的：代谢综合征（MS）是一组心脏代谢因素，易患糖尿病和心血管疾病（CVD）。使用准确的胰岛素抵抗 (IR) 测量方法及早发现 MS 高危人群可以改善 CVD 和糖尿病的检测和预防。本研究的目的是探讨脂质积累产物 (LAP) 与传统 IR 测量相比识别 MS 的能力。设计：总共招募了 768 名西班牙成年人。 MS 使用国家胆固醇教育计划/成人治疗小组 III (NCEP/ATP III) 和国际糖尿病联合会 (IDF) 的修订标准进行评估。计算IR的测量值，例如IR和LAP的稳态模型评估，LAP是基于腰围和血清甘油三酯的组合的脂质积累指数。进行受试者操作特征分析，以检测对 MS 具有最佳预测能力的参数。结果：MS-NCEP/ATP III 和 MS-IDF 的患病率男性分别为 15.1% 和 20.5%，女性为 15.4% 和 17.5%。 LAP 对 MS-NCEP/ATP III（男性和女性的曲线下面积分别为 0.91 和 0.90）和 MS-IDF（男性和女性的曲线下面积均为 0.88）显示出最高的诊断准确性。使用 20,000 个引导样本的内部验证证实了这一点。在男性和女性中，不同的 LAP 截止值对 MS-NCEP/ATP III 和 MS-IDF 鉴定表现出较高的敏感性 (78-85%) 和特异性 (78-85%)，且效率较高（测试正确分类的阳性和阴性比例 = 78-85%）。当根据寿命对样本进行分层时，LAP 在女性中的表现略低于男性，特别是在 MS-IDF 检测方面。结论：在非糖尿病成人中，LAP 对 MS-IDF 具有很强且可靠的诊断准确性，特别是在女性和西班牙男性中，LAP 对 MS-NCEP/ATP III 具有很强且可靠的诊断准确性。
Objective: The metabolic syndrome (MS) is a cluster of cardiometabolic factors, which predisposes to diabetes and cardiovascular disease (CVD). Early detection of high-risk individuals for MS using accurate measures of insulin resistance (IR) could improve detection and prevention of CVD and diabetes. The aim of this study was to explore the ability of lipid accumulation product (LAP), compared with traditional measures of IR, to identify MS.Design: In total, 768 Spanish adults were recruited. MS was assessed using the revised criteria of National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) and International Diabetes Federation (IDF). Measures of IR such as homeostasis model assessment of IR and LAP, an index of lipid accumulation based on a combination of waist circumference and serum triglycerides, were calculated. Receiver operating characteristic analysis was performed in order to detect the parameter with the best predictive capability for MS.Results: The prevalence of MS-NCEP/ATP III and MS-IDF was 15.1 and 20.5% for men respectively, and 15.4 and 17.5% for women. LAP showed the highest diagnostic accuracy for MS-NCEP/ATP III (area under the curve 0.91 and 0.90 among males and females) and MS-IDF (0.88 for both males and females). This was confirmed by internal validation using 20 000 bootstrap samples. Among males and females, different LAP cut-off values exhibited high sensitivity (78-85%) and specificity (78-85%) for MS-NCEP/ATP III and MS-IDF identification with elevated efficiency (proportion of positives and negatives classified correctly by the test=78-85%). When the sample was stratified according to decades of life, LAP exhibited a slightly lower performance among women than men, especially for MS-IDF detection.Conclusions: In non-diabetic adults LAP has a strong and reliable diagnostic accuracy for MS-IDF and, especially, MS-NCEP/ATP III among females and, in particular, among males from Spain.