【摘要】 目的 对贵阳市某社区40岁以上健康居民进行调查，将血清肌酐按五分数分为5组，探讨各组代谢综合征(MS)患病率是否存在差异，评估能否用肾小球滤过率(eGFR)临界值及时发现MS高危人群。方法 对贵阳市城区某社区40岁以上的10140名居民进行随访，最终7 912人纳入研究，男性2 137人，女性5 775人，按照性别将血清肌酐水平按五分位数分为5组，血清肌酐的临界值男性分别为：第一组<70.5μmol/L,第二组70.5～<76.7μmol/L,第三组76.7～<83.8μmol/L,第四组83.8～<92.1μmol/L;第五组≥92.1μmol/L;女性分别为：第一组<56.6μmol/L,第二组56.6～<61.6μmol/L,第三组61.6～<65.6μmol/L,第四组65.6～<69.8μmol/L,第五组≥69.8μmol/L,卡方检验分析各组MS患病率，受试者工作特征(ROC)曲线求eGFR的最佳临界值。结果 5组男性居民MS的患病率分别为26.0%、26.1%、26.3%、24.2%、31.5%,各组MS患病率差异无统计学意义(P>0.05);5组女性居民MS的患病率分别为44.2%、42.3%、41.4%、45.8%、48.0%,第三组与第五组MS患病率差异有统计学意义(P<0.05)。ROC曲线分析结果显示，eGFR预测MS患病率的ROC曲线下面积(AUC)男性为0.696,女性为0.609,eGFR预测MS的最佳临界值男性为85.30 mL/min,女性为77.86 mL/min。结论 血清肌酐水平在正常范围内时，eGFR与MS患病率是相关的，eGFR有望作为早期发现MS的指标之一。更多还原

【Abstract】 Objective To conduct the survey on healthy residents over 40 years old in a community of Guiyang City, to investigate whether existing difference in the prevalence rate of metabolic syndrome(MS) among 5 groups by quintile grouping according to the serum creatinine value, meanwhile to evaluate whether using the critical value of glomerular filtration rate(eGFR) to timely find the high risk population of MS among the subjects with normal serum creatinine value.Methods A total of 10 140 residents over 40 years old in an urban community of Guiyang City were followed up, and finally 7 912 residents were included in this study, including 2 137 males and 5 775 females.The serum creatinine concentration was divided into 5 groups according to the gender by quintile: the critical values of serum creatinine value for males were the group 1:<70.5 μmol/L,the group 2:70.5-<76.7 μmol/L,the group 3:76.7-<83.8 μmol/L,the group 4:83.8-<92.1 μmol/L and the group 5 ≥92.1 μmol/L;in females: the group 1:≤56.5 μmol/L,the group 2:56.6-61.6 μmol/L,the group 3:61.6-65.6 μmol/L,the group 4:65.6-69.8 μmol/L and the group 5:≥69.8 μmol/L.The Chi-square test was used to analyze the prevalence rate of MS in each group, and receiver operating characteristic(ROC) curve was used to calculate the optimal critical value of eGFR.Results The prevalence rates of MS in 5 groups of males were 26.0%,26.1%,26.3%,24.2% and 31.5%,respectively, and there was no statistical significance among groups(P>0.05).The prevalence rates of MS in the 5 groups of females were 44.2%,42.3%,41.4%,45.8% and 48.0% respectively, and there was statistically significant difference in the MS prevalence rate between the third group and the fifth group(P<0.05).The ROC curve analysis results showed that the area under the ROC curve(AUC) value of eGFR in predicting the prevalence rate of MS was 0.696 for males and 0.609 for females.The optimal cut-off value for eGFR in predicting MS was 85.30 mL/min for males and 77.86 mL/min for females.Conclusion When serum creatinine value is within the normal range, eGFR is correlated with the prevalence rate of MS,and eGFR may be expected to serve one of the indicators for the early detection of MS.更多还原