Janssen Ian, Katzmarzyk Peter T, Ross Robert
School of Physical and Health Education, Queen's University, Kingston, Ontario, Canada K7L 3N6.
Arch Intern Med. 2002 Oct 14;162(18):2074-9. doi: 10.1001/archinte.162.18.2074.
No evidence supports the waist circumference (WC) cutoff points recommended by the National Institutes of Health to identify subjects at increased health risk within the various body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) categories.
To examine whether the prevalence of hypertension, type 2 diabetes mellitus, dyslipidemia, and the metabolic syndrome is greater in individuals with high compared with normal WC values within the same BMI category.
The subjects consisted of 14 924 adult participants of the Third National Health and Nutrition Examination Survey, which is a nationally representative cross-sectional survey. Subjects were grouped by BMI and WC in accordance with the National Institutes of Health cutoff points. Within the normal-weight (18.5-24.9), overweight (25.0-29.9), and class I obese (30.0-34.9) BMI categories, we computed odds ratios for hypertension, diabetes, dyslipidemia, and the metabolic syndrome and compared subjects in the high-risk (men, >102 cm; women, >88 cm) and normal-risk (men, <or=102 cm; women, <or=88 cm) WC categories.
With few exceptions, within the 3 BMI categories, those with high WC values were increasingly likely to have hypertension, diabetes, dyslipidemia, and the metabolic syndrome compared with those with normal WC values. Many of these associations remained significant after adjusting for the confounding variables (age, race, poverty-income ratio, physical activity, smoking, and alcohol intake) in normal-weight, overweight, and class I obese women and overweight men.
The National Institutes of Health cutoff points for WC help to identify those at increased health risk within the normal-weight, overweight, and class I obese BMI categories.
尚无证据支持美国国立卫生研究院推荐的腰围（WC）切点可用于在不同体重指数（BMI，计算方法为千克体重除以米身高的平方）类别中识别健康风险增加的个体。
研究在相同BMI类别中，WC值高的个体与正常WC值的个体相比，高血压、2型糖尿病、血脂异常和代谢综合征的患病率是否更高。
研究对象为第三次全国健康与营养检查调查中的14924名成年参与者，这是一项具有全国代表性的横断面调查。根据美国国立卫生研究院的切点，将研究对象按BMI和WC进行分组。在正常体重（18.5 - 24.9）、超重（25.0 - 29.9）和I类肥胖（30.0 - 34.9）的BMI类别中，我们计算了高血压、糖尿病、血脂异常和代谢综合征的比值比，并比较了高风险（男性，>102 cm；女性，>88 cm）和正常风险（男性，≤102 cm；女性，≤88 cm）WC类别中的研究对象。
除少数例外情况外，在这3个BMI类别中，与WC值正常的个体相比，WC值高的个体患高血压、糖尿病、血脂异常和代谢综合征的可能性更大。在对正常体重、超重和I类肥胖女性以及超重男性的混杂变量（年龄、种族、贫困收入比、身体活动、吸烟和饮酒量）进行调整后，许多这些关联仍然显著。
美国国立卫生研究院的WC切点有助于在正常体重、超重和I类肥胖BMI类别中识别健康风险增加的个体。
