A Study Of The Detection Rate Of The Four Criteria Of MetS And Its Correlation With Serum TBIL In A Single-centre Medical Examination Population

Objective:To calculate the detection rate of Metabolic Syndrome(Met S)in the medical check-up population aged 25-65 years at the Affiliated Hospital of Inner Mongolia Medical University in Hohhot under four diagnostic criteria(ATPIII criteria,JIS criteria,IDF criteria and CDS criteria),and to compare the consistency of the four criteria and analyse their applicability;To investigate the correlation between Total Bilirubin(TBIL)and Met S and its diagnostic value for Met S.Methods:By using a simple random sample of 1500 people aged 25-65 years who attended health check-ups at the Medical Examination Centre of the Affiliated Hospital of Inner Mongolia Medical University from January 2022 to December 2022,relevant data of the included subjects were collected and analysed.The collection included general data(age,gender,height,weight,body mass index,waist circumference,blood pressure,history of previous diseases,history of smoking and alcohol consumption,etc.)and laboratory test data(blood cell count,blood lipids,liver function,kidney function,blood glucose,etc.),all of which were performed by professional staff.The data collected were divided into Met S and non-Met S groups using four diagnostic criteria: ATPIII,JIS,IDF and CDS.The SPSS26.0 software was used to analyse the data,in which the Kappa test was used to assess the consistency of the above four diagnostic criteria for Met S;TBIL was divided into three groups using the triple quantile method,and logistic regression was used to analyze the effects of different levels of TBIL on Met S and its components,to clarify the influencing factors of Met S,and the area under the ROC curve was used to explore the diagnostic value of TBIL on Met S.Results:1.For the purpose of this study,a total of 1500 subjects were finally included according to the inclusion and exclusion criteria,of whom 747(49.8%)were male and 753(50.2%)were female.The overall mean age was 42.43±10.46 years;The detection rate of Met S under the four diagnostic criteria was JIS > ATPIII > IDF > CDS,whichever criteria were used,the detection rate of Met S was higher in men than in women,and all showed an increasing trend with age,all differences were statistically significant(P < 0.05);Met S had the highest detection rate of the hyperglycaemic component and the lowest detection rate of the central obesity component under the four diagnostic criteria;the detection rate of the high TG component in Met S was the second highest under the three diagnostic criteria other than the CDS criteria,with all differences being statistically significant(P < 0.001);Consistency in diagnosing Met S was highest in the total and female populations for the JIS and ATP III criteria,and in the male population for the IDF and ATP III;while for the two diagnostic criteria with the lowest consistency,CDS and JIS criteria were at the lowest in the total and male populations,and the lowest consistency in the female population was for the CDS and ATP III criteria.All differences were statistically significant(P < 0.001).2.Based on the results of the first part of the study,the JIS criteria with the highest Met S detection rate were used as the diagnostic criteria for the second part of Met S.The mean levels of BMI,SBP,DBP,TC,TG,LDL,FBG,Scr and UA were higher in the Met S group than in the non-Met S group and all were statistically significant(P < 0.05);The mean levels of BMI,SBP,DBP,TC,TG,LDL,FBG,Scr and UA were all higher in the Met S group than in the non-Met S group,and all were statistically significant(P < 0.05);whereas the mean values of TBIL,DBIL,IBIL and HDL were lower than in the non-Met S group,and all differences were statistically significant(P < 0.001);The range of TBIL values in this study was 6.2umol/L-30.1umol/L.Grouping TBIL levels by tertile,the detection rates of Met S,high TG and low HDL-C showed a decreasing trend with increasing TBIL levels,and the difference was statistically significant(P < 0.05);In the uncorrected Model 1,the risk of Met S was 0.56 and0.45 times higher in groups T2 and T3,respectively,using group T1 as the control group;after correcting for sex and age,the risk of Met S was 0.44 and 0.29 times higher in groups T2 and T3 than in group T1,respectively;After adjusting for multiple factors such as smoking,alcohol consumption,WBC,RBC and NLR on the basis of Model 2,the risk of Met S was 0.38 and 0.23 times higher in the T2 and T3 groups,respectively,and all these differences were statistically significant(P < 0.001).The detection rate of Met S tended to decrease as the TBIL value increased(P < 0.001).It can be seen that low levels of TBIL are an independent risk factor for Met S;In the total population,the area under the ROC curve for the diagnostic value of TBIL levels for Met S was 0.61(95% CI: 0.58-0.64),with a sensitivity of 62.82% and a specificity of 54.39%.In the male population,the area under the ROC curve for the diagnostic value of TBIL levels for Met S was 0.67(95% CI: 0.63-0.71),with a sensitivity of 72.27% and a specificity of 53.23%;in the female population,the area under the ROC curve for the diagnostic value of TBIL levels for Met S was 0.63(95% CI:0.58-0.67),with a sensitivity of69.47% and a specificity of 53.23%.The sensitivity was 69.47% and the specificity was50.96%,all with statistically significant differences(P < 0.001).Conclusion:(1)The detection rate of Met S was highest under the JIS criteria of the four diagnostic criteria,and there was a high level of agreement between these four criteria for the diagnosis of Met S,which differed by gender.(2)Comparing the prevalence of Met S under the four criteria and their consistency,it is known that the JIS criteria may be more suitable for the diagnosis of Met S in the residents of Hohhot.(3)TBIL is shown to be negatively associated with Met S,and low TBIL levels may increase the risk of Met S.(4)TBIL has diagnostic value for Met S regardless of gender.