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应用人体生物刺激反馈仪筛查代谢综合征的效果评价

Evaluation of the effect of human biological stimulation feedback instrument for screening of metabolic syndrome

摘要:

目的:评价人体生物刺激反馈仪筛查代谢综合征(MS)的效果。方法按照入选标准连续纳入2012年1—12月在浙江大学医学院附属第二医院进行健康体检,既往无糖尿病的体检者5674名(男3437名,女2237名)。进行问卷调查,测量MS组分(身高、体重、血压、血糖、血脂),人体生物刺激反馈仪检测,以2004中华医学会糖尿病分会(CDS)关于MS的诊断为金标准,评估人体生物刺激反馈仪对MS的诊断效能。结果5674名体检者按照CDS标准确诊MS 1096名,经人体生物刺激反馈仪检测的代谢异常体检者2798名,经ROC曲线检验,曲线下面积(AUC):0.674(95%CI:0.658~0.691,P<0.0001);对应的人体生物刺激反馈仪风险评分最佳切点值为25.00%,对MS敏感度77.80%,特异度56.00%,阳性预测值30.20%,阴性预测值91.30%。对其中409名无MS且无糖尿病的体检者随访2年,再次经ROC曲线检验,AUC:0.719(95%CI 0.644~0.794,P=0.000),对应的风险评分最佳切点值亦为25.00%,对MS的敏感度78.00%,特异度59.80%,且人体生物刺激反馈仪测量值与2年后MS检出率呈正相关。结论人体生物刺激反馈仪检测对MS的诊断效能虽然不够高,但阴性预测值较高,操作简便、无创,可作为体检人群中MS的早期筛查工具,并对MS进展有一定的预警作用。

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abstracts:

Objective To assess the effect of a noninvasive equipment (the human biological stimulation feedback instrument) for the screening of metabolic syndrome (MS). Methods The samples were selected from the International Health Care Center of the Second Affiliated Hospital of Zhejiang University College of Medicine. From January to December 2012, according to the inclusion criteria, a total of 5674 consecutive participants (3 437 men, 2 237 women) without medical history of diabetes mellitus underwent general health screening in this hospital, which included questionnaire investigation, all MS components and the risk assessment of the human biological stimulation feedback instrument. MS was defined according to 2004 the Chinese Diabetes Society (CDS) criteria. Results The 5 674 subjects were divided into three groups in accordance with the human biological stimulation feedback instrument risk score: the normal group, metabolic abnormalities low risk group, metabolic abnormalities high risk group. The detection rate of MS corresponding to the three groups was 8.73% (251/2 876), 29.32% (612/2 087), 32.77% (233/711), respectively (trend χ2=372.14,P<0.001). With the increase of risk score, the detection rate of MS increased. A total of 1 096 (male 879, female 217) were diagnosed MS by CDS criteria. The area under the curve (AUC) of the test was 0.674 (95%CI 0.658-0.691, P<0.000 1)for predicting MS. The corresponding cutoff value was 25.00%, the sensitivity, specificity, positive predictive value and negative predictive value of diagnosis of MS was 77.80%, 56.00%, 30.20%and 91.30%, respectively;409 subjects who had no history of MS and diabetes mellitus follow up for two years, the AUC of the test was 0.719 (95%CI 0.644-0.794)for predicting MS. The corresponding cutoff value was 25.00%, too. And the sensitivity and specificity of diagnosis of MS was 78.00%and 59.80%, respectively. The detection rate of MS was positively correlated with the risk score. Conclusion We found that the human biological stimulation feedback instrument is a potential screening approach for early predicting MS in health checkup with simple and noninvasive procedure and high negative predictive value, although its diagnostic efficiency is not so good. And it might have a warning effect on the progress of MS.

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作者: 尹俊华 [1] 沈晓如 [1] 沈国丽 [1] 余馨妍 [1] 宋震亚 [1]
期刊: 《中华健康管理学杂志》2016年10卷3期 223-227页 ISTICCSCD
栏目名称: 论著
DOI: 10.3760/cma.j.issn.1674-0815.2016.03.013
发布时间: 2016-07-20
基金项目:
浙江省教育厅科研项目(Y201330062) 浙江省医药卫生科研项目(201469465)Fund program:The Department of Education of Zhejiang Province Scientific Research Project Medical and Health of Zhejiang Province Scientific Research Project
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