Comparison of adiponectin, leptin and leptin to adiponectin ratio as diagnostic marker for metabolic syndrome in older adults of Chinese major cities.

The aim of this study was to compare the strength of association between metabolic syndrome (MetS) and adiponectin, leptin and leptin to adiponectin ratio (L/A) in older Chinese. This study included 950 males (220 with MetS) and 1096 females (452 with MetS), aged 60-96 years from 18 major cities of the 2002 China National Nutrition and Health Survey. The associations of adiponectin, leptin and L/A with components of MetS and MetS were examined using logistic regression and the receiver operating characteristic (ROC) curves. The correlation coefficients of MetS components except fasting glucose with leptin were similar to those with L/A and higher than those with adiponectin. After adjusting for age and BMI, the odds ratio for MetS corresponding to 1 SD change in L/A was higher than those for leptin and adiponectin. L/A had highest area under the curve (AUC) for MetS. However, there was no statistically significant difference in AUC between leptin and L/A, and both indices produced a significantly higher AUC than adiponectin. In conclusion, L/A and leptin may be better diagnostic markers for MetS than adiponectin. After adjusting for BMI, L/A has better ability for correctly classifying subjects with and without MetS than adiponectin or leptin alone.