Pua Yong-Hao, Ong Peck-Hoon
Physiotherapy Department, Rehabilitative Services, Alexandra Hospital, Singapore.
Asia Pac J Clin Nutr. 2005;14(1):74-9.
Previous studies have suggested the need to revise the World Health Organization (WHO) cut-off values for the various indices of obesity and fat distribution in Singapore. The purpose of this study was to delineate cut-off points of body mass index (BMI), waist-hip ratio (WHR), waist circumference (WC), and waist-stature ratio (WSR) as screening tools for cardiovascular risk factors in Singaporean women. Anthropometric indices were measured in a cross sectional survey of 566 subjects (60% Chinese individuals, 28% Malay individuals and 12% Indian individuals). Cardiovascular risk factors were determined by measuring blood pressure, serum lipids, and fasting blood glucose levels. Receiver Operating Characteristic (ROC) curves were constructed to determine cut-off points. Forward logistic regression and area under curves (AUC) were used to determine the best anthropometric index. For at least one cardiovascular risk factor (hypertension, dyslipidaemia and diabetes mellitus), the cut-off points for BMI, WHR, WC and WSR were around 23.6 kg/m(2), 0.80, 77.8 cm and 0.48 for Singaporean females. The AUC of WSR was the highest for all three risk factors in females (0.79 for hypertension, 0.70 for dyslipidaemia, 0.88 for diabetes mellitus). Regression analyses revealed that WSR was independently associated with all risk factors. For Singaporean female adults, the cut-off points were lower than the criteria suggested by the WHO, but were in agreement with those reported for Asians. BMI, WHR, WC and WSR may be used as screening tools for cardiovascular risk factors, of which WSR may be the best anthropometric index.
先前的研究表明,有必要修订世界卫生组织(WHO)针对新加坡肥胖及脂肪分布各项指标所设定的临界值。本研究的目的是确定体重指数(BMI)、腰臀比(WHR)、腰围(WC)和腰高比(WSR)的临界值,作为筛查新加坡女性心血管危险因素的工具。在一项对566名受试者(其中60%为华人、28%为马来人、12%为印度人)的横断面调查中测量了人体测量指标。通过测量血压、血脂和空腹血糖水平来确定心血管危险因素。构建受试者工作特征(ROC)曲线以确定临界值。采用向前逻辑回归和曲线下面积(AUC)来确定最佳人体测量指标。对于至少一种心血管危险因素(高血压、血脂异常和糖尿病),新加坡女性的BMI、WHR、WC和WSR临界值分别约为23.kg/m²、0.80、77.8cm和0.48。女性中,WSR的AUC在所有三种危险因素中最高(高血压为0.79,血脂异常为0.70,糖尿病为0.88)。回归分析显示,WSR与所有危险因素独立相关。对于新加坡成年女性,临界值低于WHO建议的标准,但与亚洲人报告的标准一致。BMI、WHR、WC和WSR可作为心血管危险因素的筛查工具,其中WSR可能是最佳人体测量指标。