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目的研究并比较低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C/high density lipoprotein-cholesterol,HDL-C)、载脂蛋白B/载脂蛋白AI(apolipoprotein B,Apo B/Apo AI)、三酰甘油/高密度脂蛋白胆固醇(triglyceride,TG/HDL-C)、总胆固醇/高密度脂蛋白胆固醇(total cholesterol,TC/HDL-C)4种血清脂蛋白比值对多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者发生代谢综合征(metabolic syndrome,MS)的诊断预测价值。方法选取2014年1月至2015年5月在首都医科大学附属北京妇产医院内分泌科就诊的PCOS患者441例,年龄15~44岁,空腹抽血查性激素、血糖、血脂、胰岛素等,按2005年国际糖尿病联盟的MS诊断标准比较MS组与非MS组在年龄、血压、体质量指数(body mass index,BMI)、腰围、腰臀比等指标的差异。分析LDL-C/HDL-C、Apo B/Apo AI、TG/HDL-C、TC/HDL-C比值与MS各组分的相关性。再根据MS诊断标准中的5个组分将441例患者分为0~5项异常组,分析各组4个比值的均值差异有无统计学意义。ROC曲线确定4者诊断MS的临界值(cutoff),并比较4者对PCOS患者发生MS的诊断预测效果。结果 LDL-C/HDL-C、Apo B/Apo AI、TG/HDL-C、TC/HDL-C均值总体上随代谢综合征异常指标项数的增加而升高,且与代谢综合征各组分均明显相关。4个比值中以TG/HDL-C的ROC曲线下面积最大为0.941。其cutoff值定为1.089时,诊断代谢综合征的灵敏度为0.864,特异度0.891,此时诊断代谢综合征的价值最大。结论 LDL-C/HDL-C、Apo B/Apo AI、TG/HDL-C、TC/HDL-C均值均随代谢综合征异常组分项数的增多而增加,且与MS各诊断指标相关,以TG/HDL-C对MS的诊断预测价值最大。临床上当TG/HDL-C≥1.089时,应警惕患者已经发生或即将发生MS,及时进行药物和生活方式的干预,避免或延缓MS的发生。
Objective To study and compare the effects of low density lipoprotein cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), apolipoprotein B Apo B / Apo AI), triglyceride / TG / HDL-C and total cholesterol (TC / HDL-C) To predict the metabolic syndrome (MS) in patients with polycystic ovary syndrome (PCOS). Methods From January 2014 to May 2015, 441 PCOS patients, aged 15-44 years old, who were admitted to the Department of Endocrinology, Beijing Maternity and Child Hospital, Capital Medical University, were recruited. The sex hormone, blood glucose, blood lipids, MS diagnostic criteria of the International Diabetes Federation were compared between MS group and non-MS group in terms of age, blood pressure, body mass index (BMI), waist circumference and waist-to-hip ratio. The correlation between LDL-C / HDL-C, Apo B / Apo AI, TG / HDL-C, TC / HDL- According to the 5 diagnostic criteria of MS, 441 patients were divided into 0 to 5 abnormal groups, and the mean differences of 4 ratios in each group were analyzed statistically. ROC curves were used to determine the cutoffs of 4 MS patients and to compare the predictive value of 4 for the diagnosis of MS in PCOS patients. Results The mean values of LDL-C / HDL-C, Apo B / Apo AI, TG / HDL-C and TC / HDL-C increased as the number of abnormal indexes of metabolic syndrome increased, Points were significantly related. The area under the ROC curve of TG / HDL-C in the 4 ratios was 0.941. The cutoff value of 1.089, the sensitivity of the diagnosis of metabolic syndrome was 0.864, the specificity of 0.891, the diagnosis of metabolic syndrome at this time the value of the largest. Conclusions The means of LDL-C / HDL-C, Apo B / Apo AI, TG / HDL-C and TC / HDL-C all increase with the increase of the number of abnormal components of the metabolic syndrome, The diagnostic value of TG / HDL-C for MS is the most valuable. Clinically, when TG / HDL-C≥1.089, we should be wary of the occurrence of patients with MS or imminent, timely drug and lifestyle intervention to prevent or delay the occurrence of MS.