【摘要】：目的研究并比較低密度脂蛋白膽固醇/高密度脂蛋白膽固醇(low density lipoprotein-cholesterol,LDL-C/high density lipoprotein-cholesterol,HDL-C)、載脂蛋白B/載脂蛋白AI(apolipoprotein B,Apo B/Apo AI)、三酰甘油/高密度脂蛋白膽固醇(triglyceride,TG/HDL-C)、總膽固醇/高密度脂蛋白膽固醇(total cholesterol,TC/HDL-C)4種血清脂蛋白比值對(duì)多囊卵巢綜合征(polycystic ovary syndrome,PCOS)患者發(fā)生代謝綜合征(metabolic syndrome,MS)的診斷預(yù)測(cè)價(jià)值。方法選取2014年1月至2015年5月在首都醫(yī)科大學(xué)附屬北京婦產(chǎn)醫(yī)院內(nèi)分泌科就診的PCOS患者441例,年齡15~44歲,空腹抽血查性激素、血糖、血脂、胰島素等,按2005年國(guó)際糖尿病聯(lián)盟的MS診斷標(biāo)準(zhǔn)比較MS組與非MS組在年齡、血壓、體質(zhì)量指數(shù)(body mass index,BMI)、腰圍、腰臀比等指標(biāo)的差異。分析LDL-C/HDL-C、Apo B/Apo AI、TG/HDL-C、TC/HDL-C比值與MS各組分的相關(guān)性。再根據(jù)MS診斷標(biāo)準(zhǔn)中的5個(gè)組分將441例患者分為0~5項(xiàng)異常組,分析各組4個(gè)比值的均值差異有無(wú)統(tǒng)計(jì)學(xué)意義。ROC曲線確定4者診斷MS的臨界值(cutoff),并比較4者對(duì)PCOS患者發(fā)生MS的診斷預(yù)測(cè)效果。結(jié)果 LDL-C/HDL-C、Apo B/Apo AI、TG/HDL-C、TC/HDL-C均值總體上隨代謝綜合征異常指標(biāo)項(xiàng)數(shù)的增加而升高,且與代謝綜合征各組分均明顯相關(guān)。4個(gè)比值中以TG/HDL-C的ROC曲線下面積最大為0.941。其cutoff值定為1.089時(shí),診斷代謝綜合征的靈敏度為0.864,特異度0.891,此時(shí)診斷代謝綜合征的價(jià)值最大。結(jié)論 LDL-C/HDL-C、Apo B/Apo AI、TG/HDL-C、TC/HDL-C均值均隨代謝綜合征異常組分項(xiàng)數(shù)的增多而增加,且與MS各診斷指標(biāo)相關(guān),以TG/HDL-C對(duì)MS的診斷預(yù)測(cè)價(jià)值最大。臨床上當(dāng)TG/HDL-C≥1.089時(shí),應(yīng)警惕患者已經(jīng)發(fā)生或即將發(fā)生MS,及時(shí)進(jìn)行藥物和生活方式的干預(yù),避免或延緩MS的發(fā)生。
[Abstract]:Objective to study and compare LDL-C / high density protein-cholesterol HDL-C (LDL-C / high density protein-cholesterol), apolipoprotein B / apolipoprotein AI (apolipoprotein B/Apo AI), triacylglycerol / high density lipoprotein cholesterol (TG / HDL-C), total cholesterol / high density lipoprotein cholesterol (HDL-C). Prognostic value of four serum lipoprotein ratios of total cholesterol TC / HDL-C in the diagnosis of metabolic syndrome (metabolic syndrome) in patients with polycystic ovary syndrome (polycystic ovary / HDL-C). Methods from January 2014 to May 2015, 441 PCOS patients, aged 1544 years, were selected from the Endocrinology Department of Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University. Fasting blood samples were taken for sex hormones, blood glucose, blood lipids, insulin and so on. The differences of age, blood pressure, body mass index (body mass), waist circumference and waist-to-hip ratio between MS group and non-MS group were compared according to the MS diagnostic criteria of the International Diabetes Federation in 2005. The correlation between the ratio of TG / HDL-C / TC / HDL-C and the components of MS was analyzed. According to the five components of MS diagnostic criteria, 441 patients were divided into 0 or 5 abnormal groups. To analyze the difference of the mean value of the four ratios in each group. The ROC curve was used to determine the critical value of (cutoff), for the diagnosis of MS in 4 patients and to compare the diagnostic and predictive effects of the 4 groups on the occurrence of MS in the patients with PCOS. Results the mean value of TG / HDL-C + TC- / HDL-C increased with the increase of abnormal items of metabolic syndrome, and was significantly related to the components of metabolic syndrome. The area under the ROC curve of TG/HDL-C was 0.941 in all the four ratios. When the cutoff value was 1.089, the sensitivity and specificity of metabolic syndrome were 0.864 and 0.891respectively. Conclusion the mean value of TG / HDL-C + TC-1 / HDL-C + T / HDL-C / C ratio increased with the increase of the number of sub-items in abnormal metabolic syndrome group, and was related to the diagnosis indexes of MS. The diagnostic value of TG/HDL-C was the most important in the diagnosis of MS. When TG/HDL-C 鈮，

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