Kahn Henry S, Imperatore Giuseppina, Cheng Yiling J
Division of Diabetes Translation, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA 30341, USA.
J Pediatr. 2005 Apr;146(4):482-8. doi: 10.1016/j.jpeds.2004.12.028.
Determine whether waist-to-height ratio (WHtR) or sex- and age-specific percentiles of body mass index (BMI) better identifies cardiovascular risk.
The third National Health and Nutrition Examination Survey (NHANES III) provided measurements on 7657 participants statistically weighted to represent 50.05 million youth 4 to 17 years of age. We estimated the subpopulations corresponding to BMI strata that were normal (< 85th percentile), at risk for overweight (85th to <95th percentile), and overweight (> or =95th percentile). We chose WHtR cutoff points (0.490 and 0.539) so that subpopulation sizes in the three WHtR strata would equal those in the three BMI strata. For 13 cardiovascular risk factors we compared mean levels among youth discordant for their BMI and WHtR strata.
726 participants (representing 3.69 million youth) were identified as having WHtR stratum >BMI stratum. Compared with the 603 participants (representing 3.70 million youth) who were discordant in the opposite direction, weighted analyses showed they had higher mean levels of heart rate, low-density lipoprotein (LDL) cholesterol, fasting triglycerides, and total cholesterol ( P <.015, adjusted for sex, age, and race-ethnicity). Their mean systolic blood pressure was lower, but this difference was eliminated after adjustment for their shorter stature.
WHtR, a simpler anthropometric index than sex- and age-specific BMI percentiles, better identifies youth with adverse cardiovascular risk factors.
确定腰高比（WHtR）或按性别和年龄划分的体重指数（BMI）百分位数是否能更好地识别心血管疾病风险。
第三次全国健康与营养检查调查（NHANES III）对7657名参与者进行了测量，并进行了统计加权，以代表4至17岁的5005万青少年。我们估计了与BMI分层相对应的亚人群，这些分层分别为正常（<第85百分位数）、超重风险（第85至<第95百分位数）和超重（>或=第95百分位数）。我们选择了WHtR的截断点（0.490和0.539），以使三个WHtR分层中的亚人群规模与三个BMI分层中的亚人群规模相等。对于13种心血管危险因素，我们比较了BMI和WHtR分层不一致的青少年的平均水平。
726名参与者（代表369万青少年）被确定为WHtR分层>BMI分层。与603名（代表370万青少年）方向相反的不一致参与者相比，加权分析显示，他们的心率、低密度脂蛋白（LDL）胆固醇、空腹甘油三酯和总胆固醇的平均水平更高（P<.015，经性别、年龄和种族调整）。他们的平均收缩压较低，但在调整了他们较矮的身高后，这种差异消失了。
与按性别和年龄划分的BMI百分位数相比，WHtR是一种更简单的人体测量指数，能更好地识别具有不良心血管危险因素的青少年。
