Kato Masayuki, Takahashi Yoshihiko, Inoue Manami, Tsugane Shoichiro, Kadowaki Takashi, Noda Mitsuhiko
Japan Foundation for the Promotion of International Medical Research Cooperation, Tokyo, Japan.
Asia Pac J Clin Nutr. 2008;17(2):223-8.
Most definitions of the metabolic syndrome (MS) employ waist circumference as an indicator of central obesity. However, several reports, mainly from Asia, argue that other indices, for example the waist/height ratio, are superior to waist circumference for identifying subjects with cardiovascular risk factors. We therefore investigated correlations between the predictive power of several anthropometric indices and risk factor accumulation (RFA) defined by the existence of two or more disorders among hypertension, dyslipidemia (high triglycerides and/or low levels of high density lipoprotein cholesterol) and fasting hyperglycemia; each of which is a component of MS.
We conducted a cross-sectional analysis using data from a part of the Japan Public Health Center-based Cohort. A total of 315 men and 314 women, 51 to 70 years of age were examined for variables including waist and hip circumferences, blood pressure, fasting plasma glucose and lipids at an annual health check-up.
The prevalence of RFA increased almost linearly in parallel with increasing waist circumference up to 95 cm. Receiver operating characteristic analysis demonstrated that waist circumference was better than waist/ height ratio, waist/hip ratio and BMI at predicting RFA; but the differences were not statistically significant. However, even in the case of waist circumference, no clear cut-off point yields sufficiently high sensitivity and specificity simultaneously.
The predictive power of waist circumference was not inferior to those of other indices. Therefore, waist circumference is practically the most convenient measure for predicting MS because of its simplicity.
代谢综合征(MS)的大多数定义采用腰围作为中心性肥胖的指标。然而,一些主要来自亚洲的报告认为,其他指标,如腰高比,在识别有心血管危险因素的受试者方面优于腰围。因此,我们研究了几种人体测量指标的预测能力与危险因素聚集(RFA)之间的相关性,RFA由高血压、血脂异常(高甘油三酯和/或低水平高密度脂蛋白胆固醇)和空腹血糖升高这两种或更多种疾病的存在来定义;这些都是MS的组成部分。
我们使用基于日本公共卫生中心队列的一部分数据进行了横断面分析。在年度健康检查中,对315名男性和314名年龄在51至70岁之间的女性进行了包括腰围和臀围、血压、空腹血糖和血脂等变量的检查。
在腰围达到95厘米之前,RFA的患病率几乎与腰围增加呈线性平行上升。受试者工作特征分析表明,腰围在预测RFA方面优于腰高比、腰臀比和BMI;但差异无统计学意义。然而,即使是腰围,也没有一个明确的切点能同时产生足够高的敏感性和特异性。
腰围的预测能力并不低于其他指标。因此,由于其简单性,腰围实际上是预测MS最方便的指标。