[Screening value and correlation of body measurement indices for metabolic syndrome in the population undergoing physical examinations in Chengdu during 2018-2020].

OBJECTIVE: To investigate the screening value and correlation of body measurement indicators for metabolic syndrome(MS) and to provide evidence for MS screening. METHODS: Through a cross-sectional research approach, data from individuals aged 18 and above who participated in health examinations at the North Health Management Center of Sichuan Provincial People's Hospital from 2018 to 2020 were reviewed. Data including height, weight, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, smoking history, and alcohol consumption history were collected. Subsequently, a body shape index(ABSI), body roundness index(BRI), body adiposity index(BAI), abdominal volume index(AVI), relative fat mass index(RFM), and body mass index(BMI) were computed. The individuals were then divided into MS and non-MS groups. The value of body measurement indices in screening for MS in the population aged 18 and above was assessed using ROC curves. Regression analysis was employed to explore the correlation between body measurement indices and MS. RESULTS: A total of 73 411 valid health examination data were obtained, including 44 426 males and 28 985 females. The MS group comprised 9181 males(21%) and 1668 females(6%). In the comparison between the MS and non-MS groups, there were statistically significant differences in ABSI((0.08±0.00) vs. (0.08±0.00)), BRI((4.95±0.67) vs. (4.17±0.68)), BAI((28.08±3.52) vs. (26.39±3.39)), AVI((17.51±2.77) vs. (12.85±2.91)), BMI((27.15±2.99) vs. (23.00±3.04)) and RFM((29.77±5.35) vs. (27.13±6.39))(P<0.05). Univariate Logistic regression analysis showed that ABSI(OR=2.303, 95%CI 1.190-4.457), BRI(OR=4.596, 95%CI 4.446-4.752), BAI(OR=1.144, 95%CI 1.137-1.151), AVI(OR=1.668, 95%CI 1.652-1.684), RFM(OR=1.067, 95%CI 1.064-1.071) and BMI(OR=1.516, 95%CI 1.503-1.528) were associated with MS(P<0.05). Multifactorial Logistic regression analysis corrected for sex, age, smoking and alcohol consumption showed that ABSI(OR=1.767, 95% CI 4.237-7.371), BRI(OR=5.441, 95% CI 5.228-5.663), BAI(OR=1.269, 95% CI 1.260-1.279), AVI(OR=1.648, 95% CI 1.631-1.665), RFM(OR=1.504, 95% CI 1.491-1.517) and BMI(OR=1.508, 95% CI 1.495-1.522) were associated with MS(P<0.05). The ROC curve analysis showed that in adults, the AVI had the highest screening value for MS in males(AUC=0.855, optimal cutoff value=16.18), followed by RFM(AUC=0.844, optimal cutoff value=25.71), BMI(AUC=0.811, optimal cutoff value=25.21), BRI(AUC=0.793, optimal cutoff value=4.39), BAI(AUC=0.709, optimal cutoff value=25.88), and ABSI(AUC=0.671, optimal cutoff value=0.08). In adult females, the RFM had the highest screening value for MS(AUC=0.918, optimal cutoff value=37.01), followed by AVI(AUC=0.911, optimal cutoff value=13.43), BRI(AUC=0.901, optimal cutoff value=4.71), BMI(AUC=0.860, optimal cutoff value=23.94), ABSI(AUC=0.804, optimal cutoff value=0.08), and BAI(AUC=0.797, optimal cutoff value=29.92). CONCLUSION: ABSI, BRI, BAI, AVI, BMI and RFM are all capable of screening for MS. Among males, AVI has the highest screening value for MS, followed by RFM, BMI, BRI, BAI and ABSI. Among females, RFM has the highest screening value for MS, followed by AVI, BRI, BMI, ABSI and BAI. ABSI, BRI, BAI, AVI, RFM and BMI are positively correlated with MS.

[Double internal fixations of clavicle and scapula and intraoperative reduction of glenopolar angle for treatment of floating shoulder injuries].

OBJECTIVE: To investigate the effectiveness of double internal fixations of clavicle and scapula and intraoperative reduction of glenopolar angle in the treatment of floating shoulder injuries. METHODS: Between January 2010 and June 2019, 13 patients with floating shoulder injury were treated with double internal fixation of clavicle and scapula and intraoperative reduction of glenopolar angle. There were 11 males and 2 females with an average age of 48 years (range, 25-65 years). The causes of injury included falling from height in 2 cases, traffic accident injury in 3 cases, heavy object injury in 2 cases, and other injuries in 6 cases. There were 2 cases of Ⅰ-B-3 type, 1 case of Ⅰ-C-2 type, 1 case of Ⅰ-C-3 type, 3 cases of Ⅱ-B-2 type, 1 case of Ⅱ-B-3 type, 1 case of Ⅱ-B-4 type, 2 cases of Ⅱ-C-2 type, 1 case of Ⅱ-C-4 type, and 1 case of Ⅱ-D-3 type according to the classification of floating shoulder injury. All patients had unilateral clavicle fracture with scapular neck fracture, 1-4 superior shoulder suspensory complex (SSSC) injuries. The time from injury to operation was 7-17 days, with an average of 12 days. The glenopolar angle, subacromail space, anteroposterior inclination angle of scapular glenoid, scapular glenoid up and down angle were measured before and after operation; Constant-Murly score and Herscovici score were used to evaluate the recovery of shoulder joint function. RESULTS: All incisions healed by first intention, and there was no early postoperative complications such as infection. All 13 cases were followed up 12-48 months, with an average of 25.2 months. Both the clavicle and the scapula had bone union, and the average healing time was 6 months and 4 months respectively. There were no complications such as nonunion, shoulder deformity, plate fracture or failure of internal fixation, acromion impingement syndrome, and frozen shoulder. At last follow-up, the glenopolar angle, subacromail space, anteroposterior inclination angle of scapular glenoid, and scapular glenoid up and down angle were all corrected significantly ( P<0.05). The pain, function, activity, muscle strength scores, and total score in Constant-Murly score were significantly improved when compared with preoperative scores ( P<0.05). According to the Herscovici scoring standard, the shoulder joint function was evaluated as excellent in 8 cases, good in 3 cases, and fair in 2 cases. The excellent and good rate was 84.6%. CONCLUSION: Double internal fixation of clavicle and scapula to stabilize SSSC and reduct glenopolar angle during operation is an effective method for treating the floating shoulder injury.