关键词: 脂质蓄积指数, 中老年人群, 代谢综合征X

Abstract: Objective  To explore the value of lipid accumulation product in the screening of metabolic syndrome(MS) in middleaged and old people. Methods  Selected Dalian community residents aged over 40 years who participated in the REACTION study initiated by Chinese Medical Association from July to December 2011. According to the lipid accumulation product quartile level，male and female subjects were respectively divided into q1,  q2,  q3 and q4 and Q1,  Q2,  Q3 and Q4 groups and compared the prevalence of metabolic syndrome between groups. The optimal lipid accumulation product cut points for metabolic syndrome screening in males and females in Dalian area were determined by the analysis of working characteristic curve of the subjects.Results  ①Male and female subjects with the metabolic syndrome,  a total of 825 and 1 834 cases, at a prevalence rate of 30.02% and 25.12%,  the metabolic syndrome prevalence rates of lipid accumulation productquartile q1 and q2,  q3 and q4 groups of metabolic syndrome  respectively were 5.1%,  14.8%,  30.3% and 69.9%. Q1 and Q2,  Q3 and Q4 groups of metabolic syndromerespectively were 2.4%,  8.6%,  25.5% and 64.0%,  the differences between the groups were statistically significant (P<0.001). ②The Spearman correlation analysis showed that in the male subjects,  lipid accumulation product and DBP (r=0.145),  SBP (r=0.102),  TG(r=0.931),  fasting blood glucose (r=0.169),  postprandial 2 hours blood glucose (r=0.155) and BMI (r=0.395) were positively correlated,  and HDLc (r=0.299) was  negative correlation. In female subjects, lipid accumulation product and DBP (r=0.196),  SBP (r=0.248),  TG (r=0.908),  fasting blood glucose (r=0.269),  postprandial 2 hours blood glucose (r=0.299) and BMI (r=0.427) were positively correlated,  and HDLc (r=0.376)  was negative correlation,  P values were all less than 0.01. ③ROC curve analysis showed that among male subjects,  the area under the curve of lipid accumulation product,  BMI and waist circumference diagnosis metabolic syndrome was 0.830,  0.769 and 0.701,  respectively. Among female subjects,  the area under the curve of lipid accumulation product,  BMI and waist circumference diagnosis metabolic syndrome was 0.860,  0.791 and 0.718 respectively. Among males,  lipid accumulation product=47.45 was the optimal cut point for metabolic syndrome,  with sensitivity of  0.743   and specificity of  0.793. Among females,  lipid accumulation product=48.08 was the optimal cut point for metabolic syndrome,  with sensitivity of 0.803 and specificity of  0.762.Conclusion  Lipid accumulation product can be a reliable indicator for metabolic syndrome screening of middleaged and elderly people in Dalian area.

Key words: lipid accumulation product, middleaged and elderly people;metabolic syndrome X