突尼斯成年人群中用于识别腹部肥胖的腰围切点。

Waist circumference cut-off points for identification of abdominal obesity among the tunisian adult population.

作者信息

Bouguerra R, Alberti H, Smida H, Salem L B, Rayana C B, El Atti J, Achour A, Gaigi S, Slama C B, Zouari B, Alberti K G M M

机构信息

Institut National de Nutrition, Tunis, Tunisia.

出版信息

Diabetes Obes Metab. 2007 Nov;9(6):859-68. doi: 10.1111/j.1463-1326.2006.00667.x.

DOI:10.1111/j.1463-1326.2006.00667.x

PMID:17924868

Abstract

AIMS

Waist circumference (WC) is a convenient measure of abdominal adipose tissue. It itself is a cardiovascular disease (CVD) and diabetes-risk factor and is strongly linked to other CVD risk factors. There are, however, ethnic differences in the relationship of WC to the other risk factors. The aim of this study was to determine the optimal cut-off points of WC and body mass index (BMI) at which cardiovascular risk factors can be identified with maximum sensitivity and specificity in a representative sample of the Tunisian adult population and to investigate any correlation between WC and BMI.

METHODS

We used a sample of the Tunisian National Nutrition Survey, a cross-sectional population-based survey, conducted in 1996 on a large nationally representative sample, which included 3435 adults (1244 men and 2191 women) of 20 years or older. WC, BMI, blood pressure and fasting blood measurements (plasma glucose, total cholesterol, triglycerides) were recorded. Receiver operating characteristic (ROC) curve analysis was used to identify optimal cut-off values of WC and BMI to identify with maximum sensitivity and specificity the detection of high blood pressure, hyperglycaemia, high blood cholesterol and hypertriglyceridaemia.

RESULTS

ROC curve analysis suggested WC cut-off points of 85 cm in men and 85 cm in women for the optimum detection of high blood pressure, diabetes and dyslipidaemia. The optimum BMI cut-off points for predicting cardiovascular risk factors were 24 kg/m(2) in men and 27 kg/m(2) in women. The cut-off points recommended for the Caucasian population differ from those appropriate for the Tunisian population. The data show a continuous increase in odds ratios of each cardiovascular risk factor, with increasing level of WC and BMI. WC exceeding 85 cm in men and 79 cm in women correctly identified subjects with a BMI of >/=25 kg/m(2), sensitivity of >90% and specificity of >83%.

CONCLUSIONS

Based on the ROC analysis, we suggest a WC of 85 cm for both men and women as appropriate cut-off points to identify central obesity for the purposes of CVD and diabetes-risk detection among Tunisians. WCs of 85 cm in men and 79 cm in women were the most sensitive and specific to identify most subjects with a BMI >/=25 kg/m(2).

摘要

目的

腰围（WC）是衡量腹部脂肪组织的便捷指标。其本身就是心血管疾病（CVD）和糖尿病的风险因素，且与其他CVD风险因素密切相关。然而，WC与其他风险因素之间的关系存在种族差异。本研究的目的是确定在突尼斯成年人群的代表性样本中，能够以最大敏感性和特异性识别心血管风险因素的WC和体重指数（BMI）的最佳切点，并研究WC与BMI之间的相关性。

方法

我们使用了突尼斯国家营养调查的一个样本，这是一项基于人群的横断面调查，于1996年对一个具有全国代表性的大样本进行，其中包括3435名20岁及以上的成年人（1244名男性和2191名女性）。记录了WC、BMI、血压和空腹血液测量值（血浆葡萄糖、总胆固醇、甘油三酯）。采用受试者操作特征（ROC）曲线分析来确定WC和BMI的最佳切点，以便以最大敏感性和特异性识别高血压、高血糖、高胆固醇血症和高甘油三酯血症。

结果

ROC曲线分析表明，对于高血压、糖尿病和血脂异常的最佳检测，男性WC切点为85厘米，女性为85厘米。预测心血管风险因素的最佳BMI切点，男性为24kg/m²，女性为27kg/m²。为白种人群推荐的切点与突尼斯人群适用的切点不同。数据显示，随着WC和BMI水平的升高，每种心血管风险因素的优势比持续增加。男性WC超过85厘米、女性超过79厘米能够正确识别BMI≥25kg/m²的受试者，敏感性>9%，特异性>83%。