Zhou Beifan
Department of Epidemiology, Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2002 Feb;23(1):5-10.
For prevention of obesity in Chinese population, it is necessary to define the optimal range of healthy weight and the appropriate cut-off points of body mass index (BMI) and waist circumference for Chinese adults. The Working Group on Obesity in China (WGOC) under the support of International Life Sciences Institute Focal point in China organized a meta-analysis on the relation between BMI, waist circumference and risk factors of related chronic diseases.
All together 13 population studies met the criteria for enrollment, with data of 239 972 adults (20 - 70 year) surveyed in the 1990s. Data on waist circumference was available for 111 411 persons and data on serum lipids and glucose were available for more than 80 000. The study populations located in 21 provinces, municipalities and autonomous regions in mainland China as well as in Taiwan. Each enrolled study group provided data according to a common protocol and uniform format. The center for data management in the Department of Epidemiology, Fu Wai Hospital was responsible for statistical analysis.
The prevalence of hypertension, diabetes, dyslipidemia and clustering of risk factors all increased with increasing levels of BMI or waist circumference. BMI at 24 with best sensitivity and specificity for identification of the risk factors, was recommended as the cut-off point for overweight since and BMI at 28 which might identify the risk factors with specificity around 90% to be recommended as the cut-off point for obesity. Waist circumference beyond 85 cm for men and beyond 80 cm for women were recommended as the cut-off points for central obesity.
Analysis of population attributable risk percent illustrated that reducing BMI to normal range (< 24) could prevent 45% - 50% clustering of risk factors. Treatment of obese persons (BMI >/= 28) with drugs could prevent 15% - 17% clustering of risk factors. Control the waist circumference under 85 cm for men and under 80 cm for women, could prevent 47% - 58% clustering of risk factors.
为预防中国人群肥胖,有必要确定中国成年人健康体重的最佳范围以及体重指数(BMI)和腰围的合适切点。中国肥胖问题工作组(WGOC)在中国国际生命科学研究所联络处的支持下,组织了一项关于BMI、腰围与相关慢性病危险因素之间关系的荟萃分析。
共有13项人群研究符合纳入标准,数据来自20世纪90年代对239972名成年人(20 - 70岁)的调查。111411人有腰围数据,80000多人有血脂和血糖数据。研究人群分布在中国大陆以及台湾的21个省、直辖市和自治区。每个纳入研究组按照共同方案和统一格式提供数据。中国医学科学院阜外医院流行病学系数据管理中心负责统计分析。
高血压、糖尿病、血脂异常和危险因素聚集的患病率均随BMI或腰围水平升高而增加。BMI为24时识别危险因素的灵敏度和特异度最佳,建议作为超重切点;BMI为28时识别危险因素的特异度约为90%,建议作为肥胖切点。男性腰围超过85 cm、女性腰围超过80 cm,建议作为中心性肥胖的切点。
人群归因危险度百分比分析表明,将BMI降至正常范围(< 24)可预防45% - 50%的危险因素聚集。对肥胖者(BMI≥28)进行药物治疗可预防15% - 17%的危险因素聚集。将男性腰围控制在85 cm以下、女性腰围控制在80 cm以下,可预防47% - 58%的危险因素聚集。