机构：[1]Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China[2]Municipal Key Laboratory of Clinical Epidemiology, Beijing, China[3]Department of Preventive Medicine, Yanjing Medical College, Capital Medical University, Beijing, China[4]Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, China首都医科大学宣武医院[5]School of Public Health, Taishan Medical University, Tai’an, China[6]School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia
Background Chronic stress is associated with suboptimal health status (SHS) which is a new public health challenge in China and worldwide. Plasma stress hormones may act as potential objective biomarlcers for SHS measure. This study was aimed to evaluate the diagnostic performance of plasma cortisol, catecholamine adrenaline/noradrenaline, and SHS questionnaires (SHSQ) for SHS using latent class analysis (LCA) in the absence of a gold standard. Methods A cross-sectional study was conducted among 868 employees in Beijing. The SHS questionnaires-25 (SHSQ-25) was distributed, and plasma cortisol, adrenaline, and noradrenaline were measured in the survey. LCA was used to assess the performance of both subjective and objective measures for SHS recognition. Results Akaike information criterion (AIC) and consistent AIC (LAIC) was 14.11 and 54.48 respectively, indicating that the model was well fitted. The sensitivity and specificity of plasma cortisol were 0.836 (95% CI 0.811-0.861) and 0.840 (95% CI 0.816-0.864), respectively. The area under curve (AUC) of receiver operating characteristic (ROC) of SHSQ-25 was 0.743 (95% CI 0.709-777), while the AUC of plasma adrenaline was 0.688 (95% CI 0.651-0.725). The prevalence of SHS in the investigated population was 34.78%. Conclusion Plasma cortisol is a valuable biomarker for SHS detection, whereas SHSQ-25 is more suitable for SHS screening in the population-based health survey. The accuracy and applicability of plasma adrenaline are inferior to cortisol and SHSQ-25, respectively. LCA has merit to evaluate performance of plasma cortisol, catecholamines, and SHSQ-25 for recognition of SHS in the absence of a gold standard test.
基金：
This study was supported by the National Natural
Science Foundation (81102208, 81573214), the Beijing Municipal
Natural Science Foundation (7162020), and the Scientific Research
Project of BeijingMunicipal Educational Committee (KM201510025006)
第一作者机构：[1]Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China[2]Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China[2]Municipal Key Laboratory of Clinical Epidemiology, Beijing, China[5]School of Public Health, Taishan Medical University, Tai’an, China[6]School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia
推荐引用方式(GB/T 7714)：
Yu-Xiang Yan,Li-Juan Wu,Huan-Bo Xiao,et al.Latent class analysis to evaluate performance of plasma cortisol, plasma catecholamines, and SHSQ-25 for early recognition of suboptimal health status[J].EPMA JOURNAL.2018,9(3):299-305.doi:10.1007/s13167-018-0144-8.
APA：
Yu-Xiang Yan,Li-Juan Wu,Huan-Bo Xiao,Shuo Wang,Jing Dong&Wei Wang.(2018).Latent class analysis to evaluate performance of plasma cortisol, plasma catecholamines, and SHSQ-25 for early recognition of suboptimal health status.EPMA JOURNAL,9,(3)
MLA：
Yu-Xiang Yan,et al."Latent class analysis to evaluate performance of plasma cortisol, plasma catecholamines, and SHSQ-25 for early recognition of suboptimal health status".EPMA JOURNAL 9..3(2018):299-305
