Vazquez Gabriela, Duval Sue, Jacobs David R, Silventoinen Karri
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Minneapolis, MN 55454, USA.
Epidemiol Rev. 2007;29:115-28. doi: 10.1093/epirev/mxm008. Epub 2007 May 10.
Body mass index, waist circumference, and waist/hip ratio have been shown to be associated with type 2 diabetes. From the clinical perspective, central obesity (approximated by waist circumference or waist/hip ratio) is known to generate diabetogenic substances and should therefore be more informative than general obesity (body mass index). Because of their high correlation, from the statistical perspective, body mass index and waist circumference are unlikely to yield different answers. To compare associations of diabetes incidence with general and central obesity indicators, the authors conducted a meta-analysis based on published studies from 1966 to 2004 retrieved from a PubMed search. The analysis was performed with 32 studies out of 432 publications initially identified. Measures of association were transformed to log relative risks per standard deviation (pooled across all studies) increase in the obesity indicator and pooled using random effects models. The pooled relative risks for incident diabetes were 1.87 (95% confidence interval (CI): 1.67, 2.10), 1.87 (95% CI: 1.58, 2.20), and 1.88 (95% CI: 1.61, 2.19) per standard deviation of body mass index, waist circumference, and waist/hip ratio, respectively, demonstrating that these three obesity indicators have similar associations with incident diabetes. Although the clinical perspective focusing on central obesity is appealing, further research is needed to determine the usefulness of waist circumference or waist/hip ratio over body mass index.
体重指数、腰围和腰臀比已被证明与2型糖尿病有关。从临床角度来看，已知中心性肥胖（以腰围或腰臀比近似）会产生致糖尿病物质，因此应该比一般肥胖（体重指数）更具参考价值。由于它们之间的高度相关性，从统计学角度来看，体重指数和腰围不太可能得出不同的答案。为了比较糖尿病发病率与一般肥胖指标和中心性肥胖指标之间的关联，作者基于从PubMed检索到的1966年至2004年发表的研究进行了一项荟萃分析。该分析使用了最初确定的432篇出版物中的32项研究。关联度量被转换为肥胖指标每增加一个标准差（所有研究汇总）的对数相对风险，并使用随机效应模型进行汇总。体重指数、腰围和腰臀比每增加一个标准差，新发糖尿病的汇总相对风险分别为1.87（95%置信区间（CI）：1.67，2.10）、1.87（95%CI：1.58，2.20）和1.88（95%CI：1.61，2.19），表明这三个肥胖指标与新发糖尿病的关联相似。尽管关注中心性肥胖的临床观点很有吸引力，但仍需要进一步研究以确定腰围或腰臀比相对于体重指数的实用性。
