Abstract
Most previous studies on metabolic syndrome (MetS) examined urban and high income settings. We thus investigated the prevalence of MetS among a multi-ethnic population living in a low income rural area and explored the use of visceral adiposity and anthropometric indicators to identify men and women with MetS. We recruited 10,029 individuals of nomadic Kazakhs, rural Uyghur and Han residents in Xinjiang, China. MetS was defined by the Joint Interim Statement criteria. The receiver operating characteristic curve (ROC) was used to compare the area under the ROC curve (AUC) of each index. The age-adjusted prevalence of MetS was 21.8%. The visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index (BAI) and the waist-to-height ratio (WHtR) were significantly associated with MetS, independent of ethnic, age, and other covariates. The AUC of VAI, LAP and WHtR were all greater than 0.7, and the LAP was the index that most accurately identified MetS status in men (AUC = 0.853) and women (AUC = 0.817), with the optimal cut-offs of 34.7 and 27.3, respectively. In conclusion, the prevalence of MetS in low income rural adults of Xinjiang was high and the LAP was an effective indicator for the screening of MetS.
Highlights
Imaging techniques, such as magnetic resonance imaging and computed tomography, are considered the gold standard for quantitative evaluation of visceral adiposity, but the costs and radiation exposure associated with these two methods represent major barriers to their widespread use in clinical practice
The visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index (BAI) and waist-to-height ratio (WHtR) were strongly associated with the odds of having metabolic syndrome (MetS) in both men and women, after adjustment for potential confounders (p for trend < 0.001) (Table 2)
The area under the ROC curve (AUC) of AVI, confidence intervals (CIs) and WHR were 0.775, 0.681 and 0.737 for men, and 0.769, 0.685 and 0.713 for women, respectively (Supplementary Fig. S1 and Supplementary Table S2). In this large community-based and multi-ethnic population living in a low income rural area in the remote northwest region of China, we found that 21.8% of participants had MetS, based on the JIS criteria
Summary
Imaging techniques, such as magnetic resonance imaging and computed tomography, are considered the gold standard for quantitative evaluation of visceral adiposity, but the costs and radiation exposure associated with these two methods represent major barriers to their widespread use in clinical practice In this context, it would be of interest to consider other visceral adiposity indicators which are feasible in general practice. Few studies have examined whether the visceral adiposity indicators (VAI and LAP) and BAI perform better than WHtR for the screening of MetS, especially in a multi-ethnic population. We conducted this study to examine the prevalence of MetS among a multi-ethnic population (Uyghurs, Kazakhs and Hans) living in Xinjiang rural area and explore the feasibility of visceral adiposity and anthropometric indicators (i.e., VAI, LAP, BAI and WHtR) for the screening of MetS. Our observations may have important implications for the screening of MetS in other multi-ethnic populations, and provide basic data and theoretical evidence for the improvement of MetS criteria
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