【摘要】 目的 分析内脏脂肪代谢评分（METS-VF）与老年人群白蛋白尿患病风险之间的关联性。方法 本研究采用横断面研究设计，选取1999—2018年美国国家健康与营养调查中60岁及以上的老年人群7 512例。METS-VF基于胰岛素抵抗代谢评分、腰围身高比、年龄及性别计算得出。白蛋白尿的诊断标准为尿白蛋白/肌酐比值≥30 mg/g。比较白蛋白尿组（1 593例）与非白蛋白尿组（5 919例）的基线特征，另比较按METS-VF四分位数分组的受试者基线特征分布和白蛋白尿患病率趋势。通过多因素逻辑回归、限制性立方样条模型和亚组分析评估METS-VF与老年人群白蛋白尿患病风险的关系。结果 白蛋白尿组METS-VF水平高于非白蛋白尿组，且白蛋白尿患病率随METS-VF升高呈递增趋势。校正混杂因素后，多因素逻辑回归表明METS-VF与老年人白蛋白尿患病风险显著相关，OR(95%CI)为1.721(1.389～2.134)。限制性立方样条分析显示，两者呈J形剂量-反应关系，阈值为6.818。亚组分析发现，METS-VF和白蛋白尿患病风险在超重/肥胖人群中更明显。结论 老年人群中，METS-VF升高与白蛋白尿患病风险增加相关，METS-VF可作为量化内脏脂肪对老年人白蛋白尿患病风险影响的流行病学指标。更多还原

【Abstract】 Objective To analyze the association between metabolic score for visceral fat(METS-VF) and risk of albuminuria in the elderly population. Methods This cross-sectional study included 7,512 elderly adults aged ≥ 60 years from the National Health and Nutrition Examination Survey(1999-2018). METS-VF was calculated based on insulin resistance metabolic score, waist-to-height ratio, age, and sex. Albuminuria was defined as urine albumin-to-creatinine ratio ≥ 30 mg/g. Baseline characteristics were compared between albuminuria(n=1,593) and non-albuminuria groups(n=5, 919). Subjects were also stratified by METS-VF quartiles to analyze baseline characteristic distributions and albuminuria prevalence trends. Multivariate Logistic regression, restricted cubic spline models, and subgroup analyses were performed to assess the relationship between METS-VF and albuminuria risk in elderly population. Results METS-VF levels were higher in the albuminuria group than in the non-albuminuria group, and albuminuria prevalence increased progressively with rising METS-VF quartiles. After adjusting for confounding factors, multivariate Logistic regression revealed a significant association between METS-VF and albuminuria risk with an OR(95% CI) of 1. 721(1. 389-2. 134). Restricted cubic spline analysis demonstrated a J-shaped dose-response relationship with a threshold value of 6. 818. Subgroup analysis indicated that the association between METS-VF and albuminuria risk was more pronounced in overweight/obese individuals. Conclusions Elevated METS-VF is significantly associated with increased albuminuria risk in elderly population. METS-VF may serve as a valuable epidemiological indicator for quantifying the impact of visceral fat on albuminuria risk in elderly adults.更多还原