Misra Kiran B, Endemann Sarah W, Ayer Mandeep
Department of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.
Ethn Dis. 2006 Spring;16(2):331-7.
In populations predisposed to cardiovascular disease, type 2 diabetes and visceral obesity, use of additional measurements of waist girth and waist/hip ratio (WHR) can help define risk levels associated with body mass index (BMI) for screening and clinical purposes.
To investigate measures of obesity associated with presence of metabolic syndrome and its risk factors in asymptomatic American adults of Asian Indian origin between 29 and 59 years of age.
Fifty-six apparently healthy men (43.7 years +/- 7.1, BMI 21-34 kg/m2) and women (43.1 years +/- 6.9, BMI 21-36 kg/m2) were recruited for participation in this cross-sectional study. Height, weight, hip girth, waist girth, and blood pressure were recorded by using standard procedures. Blood samples were taken after an overnight fast and analyzed for measures defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria for the metabolic syndrome.
Prevalence of the metabolic syndrome was 33.9% (29-59 years, average BMI 26.1 +/- 3.7 kg/m2). Risk factors most prevalent were low high-density lipoprotein cholesterol (HDL-C) (55%), hypertriglyceridemia (61%), and high blood pressure (50%) in men and low HDL-C (56%), high waist circumference (44%), and high blood pressure (32%) in women. Waist girth of 90.8 +/- 6.8 cm (men) and 75 +/- 3 cm (women), waist/hip ratios (WHRs) of .89 +/- .06 (men) and .76 +/- .03 (women), and BMI values of 24.8 +/- 2.5 kg/m2 (men) and 23.7 +/- 1 kg/m2 (women) were associated with absence of all risk factors associated with metabolic syndrome. Average waist girth (men: 99.6 +/- 8.1 cm, P < .05; women: 95.5 +/- 5.2 cm, P < .001) of those positive was significantly higher than those negative for the metabolic syndrome. Waist girth in women was significantly associated with fasting glucose (r = .40, P < .05), two-hour glucose (r = .57, P < .05), triglyceride (r = .42, P < 05), and HDL-C (r = -.47, P < .05). Waist/ hip ratio (WHR) for women with the metabolic syndrome was significantly higher (.87 +/- .07, P < .05) compared to those without (.79 +/- .05) and most significantly correlated with two-hour glucose (r = .51, P < .05). Body mass index (BMI) in the overweight range for men (28.3 +/- 3 kg/m2, P < .05) and women (30.0 +/- 3.5 kg/m2, P < .05) was associated with metabolic syndrome and significantly correlated with low HDL-C levels in men (r = -.49,
Prevalence of the metabolic syndrome in Indian Americans aged 29- 59 years using the NCEP ATP III criteria was similar to rates reported in urban populations in India. Low HDL-C, hypertriglyceridemia, high waist circumference, and high blood pressure were most prevalent risk factors in this study. Among obesity measures, waist girth was significantly associated with most risk factors for the syndrome; WHR was most significant for two-hour glucose in women, whereas BMI mostly correlated with HDL-C for men. While BMI < or = 24.9 was associated with absence of all risk factors, BMI in overweight range was associated with presence of metabolic syndrome. These results point to clinical significance of using additional measures of obesity in addition to BMI to determine health risk in this population, particularly in premenopausal Asian Indian women.
在易患心血管疾病、2型糖尿病和内脏肥胖的人群中，使用腰围和腰臀比（WHR）的额外测量值有助于确定与体重指数（BMI）相关的风险水平，用于筛查和临床目的。
调查29至59岁无症状的亚裔印度裔美国成年人中与代谢综合征及其危险因素存在相关的肥胖测量指标。
招募了56名表面健康的男性（43.7岁±7.1岁，BMI 21 - 34 kg/m²）和女性（43.1岁±6.9岁，BMI 21 - 36 kg/m²）参与这项横断面研究。使用标准程序记录身高、体重、臀围、腰围和血压。在过夜禁食后采集血样，并根据美国国家胆固醇教育计划成人治疗小组第三次报告（NCEP ATP III）代谢综合征标准进行分析测量。
代谢综合征的患病率为33.9%（29 - 59岁，平均BMI 26.1±3.7 kg/m²）。最普遍的危险因素在男性中是低高密度脂蛋白胆固醇（HDL - C）（55%）、高甘油三酯血症（61%）和高血压（50%），在女性中是低HDL - C（56%）、高腰围（44%）和高血压（32%）。腰围90.8±6.8 cm（男性）和75±3 cm（女性）、腰臀比（WHR）0.89±0.06（男性）和0.76±0.03（女性）以及BMI值24.8±2.5 kg/m²（男性）和23.7±1 kg/m²（女性）与代谢综合征所有危险因素的不存在相关。代谢综合征阳性者的平均腰围（男性：99.6±8.1 cm，P < 0.05；女性：95.5±5.2 cm，P < 0.001）显著高于阴性者。女性腰围与空腹血糖（r = 0.40, P < 0.05）、两小时血糖（r = 0.57, P < 0.05）、甘油三酯（r = 0.42, P < 0.05）和HDL - C（r = -0.47, P < 0.05）显著相关。患有代谢综合征的女性腰臀比（WHR）（0.87±0.07，P < 0.05）显著高于未患代谢综合征的女性（0.79±0.05），并且与两小时血糖相关性最强（r = 0.51, P < 0.05）。超重范围男性（BMI 28.3±3 kg/m²，P < 0.05）和女性（BMI 30.0±3.5 kg/m²，P < 0.05）的体重指数与代谢综合征相关，并且与男性低HDL - C水平显著相关（r = -0.49）。
使用NCEP ATP III标准，29至59岁印度裔美国人中代谢综合征的患病率与印度城市人群报告的患病率相似。低HDL - C、高甘油三酯血症、高腰围和高血压是本研究中最普遍的危险因素。在肥胖测量指标中，腰围与该综合征的大多数危险因素显著相关；腰臀比对女性两小时血糖影响最大，而体重指数对男性HDL - C影响最大。虽然BMI≤24.9与所有危险因素不存在相关，但超重范围的BMI与代谢综合征的存在相关。这些结果表明，除BMI外，使用额外的肥胖测量指标来确定该人群的健康风险具有临床意义，特别是对于绝经前的亚裔印度女性。
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