Chen Lei, Peeters Anna, Magliano Dianna J, Shaw Jonathan E, Welborn Timothy A, Wolfe Rory, Zimmet Paul Z, Tonkin Andrew M
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Eur J Cardiovasc Prev Rehabil. 2007 Dec;14(6):740-5. doi: 10.1097/HJR.0b013e32816f7739.
Framingham risk functions are widely used for prediction of future cardiovascular disease events. They do not, however, include anthropometric measures of overweight or obesity, now considered a major cardiovascular disease risk factor. We aimed to establish the most appropriate anthropometric index and its optimal cutoff point for use as an ancillary measure in clinical practice when identifying people with increased absolute cardiovascular risk estimates.
Analysis of a population-based, cross-sectional survey was carried out.
The 1991 Framingham prediction equations were used to compute 5 and 10-year risks of cardiovascular or coronary heart disease in 7191 participants from the Australian Diabetes, Obesity and Lifestyle Study (1999-2000). Receiver operating characteristic curve analysis was used to compare measures of body mass index (BMI), waist circumference, and waist-to-hip ratio in identifying participants estimated to be at 'high', or at 'intermediate or high' absolute risk.
After adjustment for BMI and age, waist-to-hip ratio showed stronger correlation with absolute risk estimates than waist circumference. The areas under the receiver operating characteristic curve for waist-to-hip ratio (0.67-0.70 in men, 0.64-0.74 in women) were greater than those for waist circumference (0.60-0.65, 0.59-0.71) or BMI (0.52-0.59, 0.53-0.66). The optimal cutoff points of BMI, waist circumference and waist-to-hip ratio to predict people at 'high', or at 'intermediate or high' absolute risk estimates were 26 kg/m2, 95 cm and 0.90 in men, and 25-26 kg/m2, 80-85 cm and 0.80 in women, respectively.
Measurement of waist-to-hip ratio is more useful than BMI or waist circumference in the identification of individuals estimated to be at increased risk for future primary cardiovascular events.
弗雷明汉风险函数被广泛用于预测未来心血管疾病事件。然而，它们并未纳入超重或肥胖的人体测量指标，而超重或肥胖现在被认为是主要的心血管疾病风险因素。我们旨在确定最合适的人体测量指数及其最佳切点，以便在临床实践中作为辅助措施，用于识别心血管疾病绝对风险估计值升高的人群。
开展了一项基于人群的横断面调查分析。
使用1991年的弗雷明汉预测方程计算了澳大利亚糖尿病、肥胖与生活方式研究（1999 - 2000年）中7191名参与者患心血管疾病或冠心病的5年和10年风险。采用受试者工作特征曲线分析，比较体重指数（BMI）、腰围和腰臀比在识别估计处于“高”绝对风险或“中高”绝对风险参与者方面的作用。
在调整BMI和年龄后，腰臀比与绝对风险估计值的相关性比腰围更强。腰臀比的受试者工作特征曲线下面积（男性为0.67 - 0.70，女性为0.64 - 0.74）大于腰围（0.60 - 0.65，0.59 - 0.71）或BMI（0.52 - 0.59，0.53 - 0.66）。预测处于“高”绝对风险或“中高”绝对风险估计值人群的BMI、腰围和腰臀比的最佳切点，男性分别为26 kg/m²、95 cm和0.90，女性分别为25 - 26 kg/m²、80 - 85 cm和0.80。
在识别估计未来发生原发性心血管事件风险增加的个体时，测量腰臀比比BMI或腰围更有用。
