Study On The Prevalence Of Metabolic Syndrome Under Four Different Diagnostic Criteria And Its Association With Alkaline Phosphatase

Background and ObjectiveMetabolic syndrome(Met S)is a set of clinical syndromes including obesity,hypertension,dyslipidemia,sugar metabolic abnormalities.So far,the diagnostic criteria of Met S is not entirely unification,the study was aimed to analyze the prevalence of Met S based on the four standard(CDS2013,JIS,IDF,and ATPIII),and investigate the consistency of the four criteria for Met S.Considering the possible role of liver enzymes in Met S occurrence and the contradictions in previous studies,this study explored the correlation between ALP and Met S occurrence risk.MethodsData were collected on healthy check-up in a hospital physical examination centre,including physical examination data and laboratory examination data.Kappa test was used to compare the consistency of the four diagnostic criteria.Quartile method was used to divide the ALP index into four groups,namely Q1,Q2,Q3 and Q4.With Q1 as the reference group,the dichotomous logistic regression model with unadjusted covariates and adjusted covariates was fitted,respectively,and to analyze the influence of different levels of ALP on metabolic syndrome and its components.ROC curve was used to analyze the diagnostic value of ALP to Met S.Restricted cubic spline was used to analyze the nonlinear relationship between ALP and metabolic syndrome.ResultsA total of 1561 respondents were included in this study,with an average age of45.7±14.67 years.The highest prevalence rate was 26.6%for JIS standard,followed by ATP III standard(25.8%),IDF standard(20.3%)and CDS standard(19.3%).The consistency between JIS and ATP III was the highest.The ALP level of Met S in the total population was 81.87±24.23mmol/L and 74.09±22.48 mmol/L in the non-Mets group,with statistically significant difference(t=5.084,P<0.001).Spearman correlation analysis showed that ALP level was positively correlated with the number of abnormal metabolic components,especially in women(r_s=0.360,P<0.001).In the total population,in the unadjusted model,the risk of metabolic syndrome in the Q3 and Q4groups was 1.827-fold and 2.506-fold,respectively,with Q1 as the reference group.After adjusting for covariates such as age,smoking,and alcohol consumption,the risk of metabolic syndrome in ALP Q4 groups was 1.903 times higher than that in Group Q1.When analyzed by gender stratification,the correlation of female population is significant.In the total population,the area under the ROC curve of the diagnostic value of ALP level for metabolic syndrome was 0.607(95%CI:0.583-0.632),which was higher in the female population(0.729(95%CI:0.692-0.763).Restricted cubic spline analysis showed that the relationship between ALP and metabolic syndrome was nonlinear.Conclusion(1)The four diagnostic criteria have a high consistency in the diagnosis of metabolic syndrome.(2)Increased serum ALP level is associated with Met S risk,especially in female population.(3)Serum ALP level has diagnostic value for metabolic syndrome,especially in female population.(4)The relationship between serum ALP level and metabolic syndrome is nonlinear.