Woo J, Ho S C, Yu A L M, Sham A
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Int J Obes Relat Metab Disord. 2002 Oct;26(10):1349-55. doi: 10.1038/sj.ijo.0802080.
To examine the effect of age on the relationship between body mass index (BMI) and waist circumference (WC), and the usefulness of BMI, WC and waist-hip ratio (WHR) in predicting mortality and cardiovascular risk in the elderly population.
Longitudinal observational study of 36 months duration.
A stratified random sample of 2,032 Chinese subjects (990 male, 1,033 female) mean age (s.d.) 80.1 (7.5), interviewed and examined at baseline and after 36 months. Deaths and presence of diabetes mellitus and hypertension were documented. A younger data set of 1,010 subjects (500 male, 510 female), mean age (s.d.) 45.5 (11.6), was used for comparison of the BMI-WC relationship between younger and older subjects. In predicting outcomes using different values of BMI, WC and WHR, receiver operating characteristic curve analysis was used to derive cut-off values with optimal sensitivity and specificity, and the likelihood ratios for mortality, diabetes and hypertension for different anthropometric values were plotted.
The waist circumference values corresponding to BMI values of 25 and 30 kg/m(2) were higher in elderly (92 and 103 cm for men; 88 and 99 cm for women) compared with younger subjects (85 and 97 cm for men; 78 and 88 cm for women). BMI and WC are inversely associated with mortality, in both men and women, positively associated with diabetes in men but not in women. WC was positively associated with hypertension in men and women. WHR was not associated with any outcome measures. The anthropometric measurement at the point of intersection of the likelihood curves for mortality and diabetes may be considered the optimum value, being BMI=21 kg/m(2) for men and 25 kg/m(2) for women, WC between 80 and 85 cm, and WHR 0.88-0.90.
Waist measurement values for predicting health outcomes in elderly people aged 70 y and over are different compared with younger subjects, and have similar predictive accuracy compared with body mass index. Waist-hip ratio is not a useful predictor.
研究年龄对体重指数（BMI）与腰围（WC）之间关系的影响，以及BMI、WC和腰臀比（WHR）在预测老年人群死亡率和心血管风险方面的效用。
为期36个月的纵向观察性研究。
对2032名中国受试者（990名男性，1033名女性）进行分层随机抽样，平均年龄（标准差）为80.1（7.5）岁，在基线时及36个月后进行访谈和检查。记录死亡情况以及糖尿病和高血压的患病情况。使用一组年龄较轻的1010名受试者（500名男性，510名女性）的数据，平均年龄（标准差）为45.5（11.6）岁，用于比较年轻受试者与老年受试者之间的BMI-WC关系。在使用不同的BMI、WC和WHR值预测结果时，采用受试者工作特征曲线分析来得出具有最佳敏感性和特异性的临界值，并绘制不同人体测量值对应的死亡率、糖尿病和高血压的似然比。
与年轻受试者相比，老年男性（BMI值为25和30 kg/m²时对应的腰围值分别为92和103 cm）和老年女性（分别为88和99 cm）的腰围值更高（年轻男性对应的腰围值分别为85和97 cm；年轻女性分别为78和88 cm）。BMI和WC与男性和女性的死亡率均呈负相关，BMI与男性糖尿病呈正相关，但与女性糖尿病无相关性。WC与男性和女性的高血压均呈正相关。WHR与任何结局指标均无相关性。死亡率和糖尿病似然曲线交点处的人体测量值可被视为最佳值，即男性BMI = 21 kg/m²，女性BMI = 25 kg/m²，WC在80至85 cm之间，WHR在0.88至0.90之间。
与年轻受试者相比，70岁及以上老年人用于预测健康结局的腰围测量值有所不同，且与体重指数具有相似的预测准确性。腰臀比不是一个有用的预测指标。
