| Objective:1.To investigated the prevalence of MS among a multi-ethnic population living in a low income rural area of Xinjiang and to analysis the association between visceral adiposity(VAI,LAP)as well as anthropometric indicators(BAI,WHtR)and MS.2.To explored the use of VAI,LAP,BAI and WHtR to identify men and women with MS.Then present the optimal cut-offs of the indices which mentioned above for the screening of MS,and to evaluate the validity of suitable parameters in combination for the screening of MetS.Methods:1.National support program have interviewed local inhabitants aged ? 18 years who had resided in the village for at least 6 months and in Kashi(Uyghur),Yili(Kazakh)and Shihezi(Han)prefectures,respectively by Multistage(prefecture-county-township-village)stratified cluster random sampling method.In the present study,we chose the individuals mentioned above as study object.Finally,we successfully interviewed a total of 10,029(3,122 Uyghurs,3,694 Kazakhs and 3,213 Hans,respectively)individuals(who were interviewed to complete questionnaires,anthropometric measurements and blood tests).MS was defined by the JIS,IDF and ATP III criteria,respectively.2.Data were analyzed using SPSS version 17.0.Mainly using t-test,Chi-square test,and logistic regression analysis was used to calculate odds ratios(ORs)and 95% confidence intervals(CIs)of visceral adiposity and anthropometric indicators for MS.3.The screening ability of each index to identify individuals with MS was explored using ROC analysis.The optimal cut-off point to identify individuals with MS was defined by the maximum value of Youden's index.And the comparisons of ROC curves were performed using Empower Stats statistical software.The AUC of 0.5,0.6 ? AUC < 7,7 ? AUC < 0.8,0.8 ? AUC < 0.9,and ? 0.9 corresponded to no discrimination,poor,acceptable,excellent,and outstanding discrimination,respectively.The validity of screening test was evaluated by sensitivity,specificity,false negative rate,false positive rate and Youden's index.Results:1.According to the JIS,IDF and ATP III criteria,the overall crude prevalence of MS was 25.6%(24.6% for men,26.4% for women),20.7%(16.2% for men,24.3% for women)and 12.9%(9.60% for men,15.5%for women),respectively.The age standardized prevalence was 21.8%(21.1% for men,22.8% for women),17.2%(13.3% for men,20.8% for women)and 10.7%(8.20% for men,13.0% for women),respectively.According to the three criteria mentioned above,the prevalences of MS in women were all significantly higher than that in men.2.The level of VAI,LAP,BAI and WHtR were all raised with the increasing of the number of MS components.After adjustment for ethnic,age,smoking habits,alcohol consumption,education,marriage status and BMI,in men,compared with Q1,the ORs of VAI in Q2,Q3 and Q4 were 1.34(p>0.05),3.19 and 20.7,respectively.The ORs of LAP were 3.09,6.50 and 39.7,respectively.The ORs of BAI were 1.28,1.55 and 1.65,respectively.And the ORs of WHtR were 4.36,11.3 and 15.6,respectively.In women,compared with Q1,the ORs of VAI in Q2,Q3 and Q4 were 1.63,4.09 and 17.0,respectively.The ORs of LAP were 3.08,6.46 and 23.0,respectively.The ORs of BAI were 1.21,1.34 and 1.90,respectively.And the ORs of WHtR were 4.21,9.11 and 13.9,respectively.3.According to the JIS,IDF and ATP III criteria,The AUC of VAI,LAP and WHtR were all greater than0.7,and the LAP was the index that most accurately identified MS status in men and women.The AUC of LAP were all greater than 0.8 based on all the criterion mentioned above.Based on Hosmer and Lemeshow's criteria,the LAP was an excellent indicator for the screening of MS according to the JIS criteria.When according to the IDF and ATP III criteria,both LAP and WHtR were excellent indicators for the screening of MS.After divided by ethnic,the results were similar.4.According to the JIS criteria,the optimal cut-offs of LAP for the screening of MS were 34.7 for men and27.3 for women,respectively,the WHtR were 0.51?0.52,respectively.According to the IDF criteria,the optimal cut-offs of LAP for the screening of MS were 36.3 for men and 27.3 for women,respectively,the WHtR were 0.53?0.52,respectively.According to the ATP III criteria,the optimal cut-offs of LAP for the screening of MS were 36.4 for men and 30.3 for women,respectively,the WHtR were 0.55?0.55,respectively.5.On the basis of the IDF standard,the sensitivity,specificity,false negative rate,false positive rate and Youden's index of WHtR and LAP serial tests for the screening of MetS were 66.0%,86.0%,34.0%,13.4%,0.526 in men and 65.1%,78.1%,34.9%,21.9%,0.432 in women,respectively,and those of WHtR and LAP parallel tests were91.1%,61.8%,8.9%,38.2%,0.529 in men and 92.7%,58.7%,7.3%,41.3%,0.514 in women,accordingly.Conclusion:1.According to the JIS,IDF and ATP III criteria,the prevalences of MS in low income rural adults of Xinjiang were higher than the national level of China.And the prevalences of MS in women were higher than that in men.2.After independent of ethnic,age,and other covariates,all the VAI,LAP,BAI and WHtR were risk factors for MS both in men and women.3.The LAP was an excellent indicator for the screening of MS according to the JIS criteria.When according to the IDF and ATP III criteria,both LAP and WHtR were excellent indicators for the screening of MS,and no matter what criteria,the LAP was the index that most accurately identified MS status in men and women4.According to the JIS criteria,the optimal cut-offs of LAP for the screening of MS were 34.7 for men and27.3 for women,respectively,the WHtR were 0.51 ? 0.52,respectively.Different criteria had different cut-offs,so we suggested choosing the appropriate cut-offs when chose different criteria.5.On the basis of the IDF standard,the WHtR and LAP parallel test was the most accurate. |
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