The Association and Diagnostic Value of Lipid Ratios to Metabolic Syndrome： A Multistage Cross-sectional Study inGuizhou Province

Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-04-03 Cooperative journals: 《中国全科医学》

周诗宇 谌绍林 邓仁丽 代米 刘涛 田坤明

Abstract： Background With the growing incidence of metabolic diseases，there has been increasing attention given to the prevention and control of metabolic syndrome（MS）. As important screening markers of MS，the relationship between lipid ratios and metabolic syndrome has become a hot research topic. Objective To analyse the association and diagnostic value of triglyceride/high-density lipoprotein cholesterol（TG/HDL-C）ratio，total cholesterol/HDL-C（TC/HDL-C）ratio，lowdensity lipoprotein cholesterol/ HDL-C（LDL-C/HDL-C）ratio and non-HDL-C to the risk of MS in populations included in a multistage cross-sectional study in Guizhou Province. Methods This study retrospectively selected natural populations（totally 21 727 cases）from Guizhou who attended the National Survey of Chronic Diseases and Risk Factors in Surveillance Regions 2010，China Chronic Disease and Risk Factor Surveillance 2013，and two waves of China Adult Chronic Disease and Nutrition Surveillance （2015 and 2018）. Baseline data were collected，and according to MS prevalence included in which，subjects were divided into MS group（ n=4 981）and non-MS group（ n=16 746）. The receiver operating characteristic（ROC）curve analysis was used to evaluate the diagnostic value of TG/HDL-C ratio，TC/HDL-C ratio，LDL-C/HDL-C ratio and non-HDL-C for MS in males and females，respectively. The Delong test was used to compare the values of area under the ROC curve（AUC） of lipid ratios in predicting MS. Multivariate Logistic regression was used to analyze the association of lipid ratios with MS measured using odds ratio（OR）with 95% confidence interval（CI），and to identify factors associated with MS among subjects stratified by survey time，age，sex，body mass index（BMI），smoking and alcohol consumption. Results There were statistically significant differences in mean age，sex ratio，distribution of ethnicities，education level and marital status，prevalence of smoking and alcohol consumption，and mean BMI，TG/HDL-C ratio，TC/HDL-C ratio，LDL-C/HDL-C ratio and non-HDL-C between MS group and non-MS group（ P<0.05）. TG/HDL-C ratio had a higher AUC value than TC/HDL-C ratio（ Z=17.822， P<0.001），LDL-C/HDL-C ratio（ Z=23.813， P<0.001）and non-HDL-C（ Z=27.608， P<0.001）. The value of AUC of TG/HDL-C ratio was higher in males than that in females（ Z=4.299， P<0.001）. And the value of AUC of LDL-C/HDL-C ratio in males was lower than that in females（ Z=2.061， P=0.039）. Multivariate Logistic regression analysis showed that in <60 years old， ≥ 60 years old，male，female，BMI<24.0 kg/m2，BMI ≥ 24.0 kg/m2，smoking，non-smoking，drinking and non-drinking groups，TG/HDL-C ratio，TC/HDL-C ratio，LDL-C/HDL-C ratio and non-HDL-C were associated with the prevalence of MS and the associations were stronger in females，individuals with BMI<24 kg/m2，non-smokers or nondrinkers（ P<0.05）. Conclusion TG/HDL-C ratio has a good diagnostic value for MS. TG/HDL-C ratio，TC/HDL-C ratio，LDL-C/HDL-C ratio and non-HDL-C are associated factors of MS，which should be paid more attention clinically in females，individuals with BMI<24 kg/m2，non-smokers or non-drinkers.

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