Sevil KARAHAN YILMAZ, Fatih ÖZÇİÇEK, Cuma MERTOĞLU

Yetişkin bireylerde metabolik sendromun belirlenmesinde obeziteyle ilişkili geleneksel ve yeni indekslerin karşılaştırılması

Amaç: Yetişkin bireylerde metabolik sendromun belirlenmesinde obeziteyle ilişkili geleneksel ve yeni indekslerin değerlendirilmesi ve hangi belirtecin daha iyi öngördürücü olduğunu belirleme amacı ile planlanmıştır. Gereç ve Yöntem: Bu çalışmaya 18-65 yaş arası toplam 419 yetişkin birey dahil edildi. Vücut ağırlığı, boy uzunluğu, bel ve kalça çevresi ile kan basıncı ölçüldü; açlık kan şekeri, total kolesterol, trigliserit, düşük dansiteli lipoprotein kolesterol ve yüksek dansiteli lipoprotein kolesterol değerleri analiz edildi. Metabolik sendrom (MetS) Uluslararası Diabet Federasyonu kriterleri kullanılarak tanımlanmıştır. Obeziteyle ilişkili 23 indeksin değeri hesaplandı. Bulgular: Metabolik sendrom prevalansı % 58,7 (erkek % 41,2; kadın % 67,7)’dir. Trigliserit-glikoz (TyG) indeksi hem erkeklerde (eğri altında kalan alan (AUC)= 0,894, kesme değeri = 9,3) hemde kadınlar da (AUC = 0,901, kesme değeri = 8,3) en büyük AUC'ye sahiptir. Erkeklerde lipit birikim ürünü (LAP), MetS için ikinci en yüksek belirlemeye sahip iken (AUC = 0,880, kesme değeri = 51,1), ardından TyG-bel/kalça (AUC = 0,876, kesme değeri = 3,7) gelmektedir. Kadınlarda kardiyometabolik indeks (CMI) (AUC = 0,872, kesme değeri = 1,3) ve viseral adipozite indeksi (VAI) (AUC = 0,868, kesme değeri = 4,1) sırasıyla ikinci ve üçüncü en büyük AUC'lere sahiptir. Sonuç: TyG indeksi MetS belirlemede en iyi öngördürüdür. Bel çevresi kullanışlılığı ve uygun maliyetiyle büyük ölçekli epidemiyolojik çalışmalarda alternatif bir indeks olabilir.

Anahtar Kelimeler:

Metabolik sendrom, trigliserit-glikoz indeksi, viseral adipozite indeksi, lipit birikim ürünü, kardiyometabolik indeks.

Comparison of traditional and novel obesity-related indices for identification of metabolic syndrome in adults

Purpose: The aim of this study was to evaluate the traditional and novel obesity-related indices in the determination of metabolic syndrome in adults and to determine which marker is the better predictor. Materials and Methods: A total of 419 adults between the ages of 18-65 were included in this study. Body weight, height, waist, hip and waist circumference, and blood pressure were measured; fasting blood glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol values were analyzed. Metabolic syndrome (MetS) was defined using the International Diabetes Federation criteria. The values of 23 obesity-related indices were calculated. Results: The prevalence of metabolic syndrome is 58.7% (male 41.2%; female 67.7%). The triglyceride glucose (TyG) index has the largest area under the curve (AUC) in both men (AUC = 0.894, cutoff = 3.9) and women (AUC = 0.901, cutoff = 3.9). In men, lipid accumulation product (LAP) had the second highest determination for MetS (AUC = 0.880, cut-off = 51.1), followed by TyG-waist/hip (AUC = 0.876, cut-off = 3.7). Cardiometabolic index (CMI) (AUC = 0.872, cut-off value = 1.3) and visceral adiposity index VAI (AUC = 0.868, cut-off value = 4.1) had the second and third largest AUCs, respectively, in women. Conclusion: TyG index is the best predictor of MetS. Waist circumference could be an alternative index in large epidemiology survey due to its convenient and cost-efective characteristics.

Keywords:

Metabolic syndrome, triglyceride-glucose index, visceral adiposity index, lipid accumulation product, cardiometabolic index.,

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