Low sensitivity for the metabolic syndrome to detect uric acid elevations in females and non-Hispanic-black male adolescents: An analysis of NHANES 1999-2006
Low sensitivity for the metabolic syndrome to detect uric acid elevations in females and non-Hispanic-black male adolescents: An analysis of NHANES 1999-2006
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DOI：
10.1016/j.atherosclerosis.2011.11.033
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发表时间：
2012-02-01
期刊：
影响因子：
5.3
通讯作者：
Gurka, Matthew J.
中科院分区：
文献类型：
--
作者：
DeBoer, Mark D.;Gurka, Matthew J.
背景：尿酸与代谢综合征（MetS）密切相关，在成年人中，较高的尿酸水平与未来患糖尿病、心血管疾病、高血压和肾脏疾病的风险相关。目的：评估MetS在种族/民族和性别基础上识别尿酸水平升高的青少年的敏感性。方法：我们评估了3296名参加1999-06年全国健康与营养评价调查的12-19岁青少年，其中67.6%为非西班牙裔白人，15.1%为非西班牙裔黑人，17.3%为西班牙裔。我们使用了针对青少年修订的MetS定义，并评估了MetS诊断的敏感性，以识别尿酸升高的个体（正常体重的青少年中按性别划分的尿酸大约为95%）。结果：当用于鉴别尿酸升高个体的筛查试验时，met在女性中的表现（18.0%）比男性（37.0%）更差（p < 0.001）。在男性中，MetS在非西班牙裔黑人中的敏感性（17.8%）低于西班牙裔（45.9%）（p < 0.01）和非西班牙裔白人（37.4%）（p < 0.05）。在检测女性尿酸水平升高方面，没有种族/民族差异（非西班牙裔白人15.5%，非西班牙裔黑人19.4%，西班牙裔26.5%,p < 0.05）。结论：目前的met诊断标准在识别尿酸水平升高的青少年方面表现出种族/民族和性别差异，在非西班牙裔黑人男性和女性中表现不佳。鉴于有关尿酸升高预测未来疾病能力的新数据，这些数据可能对使用MetS作为所有性别和种族/民族群体的风险标记具有启示意义。2011爱思唯尔爱尔兰有限公司版权所有。
Background: Uric acid is tightly linked to the metabolic syndrome (MetS) and among adults higher uric acid levels are associated with future risk for diabetes, cardiovascular disease, hypertension and renal disease.Objective: Evaluate the sensitivity of MetS to identify adolescents with elevated uric acid levels on a race/ethnicity and gender-specific basis.Methods: We evaluated 3296 male and female adolescents 12-19 y participating in the National Health and Nutrition Evaluation Survey 1999-06, comprised of 67.6% non-Hispanic whites, 15.1% non-Hispanic blacks, and 17.3% Hispanics. We used a definition of MetS modified for use in adolescents and evaluated the sensitivity of a diagnosis of MetS to identify individuals with uric acid elevations (approximately the 95th percentile of uric acid by gender among normal-weight adolescents).Results: When used as a screening test to identify individuals with uric acid elevations MetS performed more poorly among females (18.0%) than among males (37.0%) (p < 0.001). Among males, MetS exhibited a lower sensitivity among non-Hispanic blacks (17.8%) compared to Hispanics (45.9%) (p < 0.01) and non-Hispanic whites (37.4%) (p < 0.05). There were no race/ethnicity differences in detecting elevated uric acid levels among females (non-Hispanic-white 15.5%, non-Hispanic-black 19.4%, Hispanic 26.5%, p > 0.05).Conclusion: Current criteria to diagnose MetS exhibit racial/ethnic and gender differences in the ability to identify adolescents with elevated uric acid levels, performing poorly among non-Hispanic-black males and among females. Given emerging data regarding the ability of uric acid elevations for predicting future disease, these data may have implications regarding the use of MetS as a marker of risk among all gender and racial/ethnic groups. (C) 2011 Elsevier Ireland Ltd. All rights reserved.