Messiah Sarah E, Arheart Kristopher L, Lipshultz Steven E, Miller Tracie L
Department of Pediatrics, Division of Pediatric Clinical Research, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
J Pediatr. 2008 Dec;153(6):845-50. doi: 10.1016/j.jpeds.2008.06.013.
To determine optimal threshold values for body mass index (BMI) and waist circumference (WC) for detecting cardiovascular disease (CVD) risk (as defined with >/=3 CVD risk factors [RFs]) in adolescents.
The 1999-2004 National Health and Nutrition Examination Surveys (NHANES) cross-sectional data for 12- to 19-year-old adolescents (n = 2581) was analyzed. Main outcome measures were >/=3 age-adjusted CVD RFs (high- and low-density lipoprotein cholesterol level, triglyceride level, glucose level, insulin level, and systolic and diastolic blood pressure). The presence of >/=3 RFs was predicted from age- and sex-adjusted BMI and WC values with receiver operating characteristics analyses.
The proportion of adolescents at risk for >/=3 RFs ranged from 17% to 19%. Both BMI and WC had good diagnostic accuracy, ranging from 0.73 to 0.83, and good sensitivity and specificity, ranging from 0.68 to 0.77. The BMI cutoff points ranged from 19.5 to 25.0 kg/m(2) for boys and from 19.4 to 27.0 kg/m(2) for girls, and WC cutoff points ranged from 66.8 to 87.5 cm for boys and from 71.5 to 87.2 cm for girls.
Age-, sex-, and ethnicity/race-specific threshold values for BMI and WC may have significant clinical usefulness in identifying adolescents and teenagers at risk for later CVD onset.
确定青少年中用于检测心血管疾病（CVD）风险（定义为≥3个CVD风险因素[RFs]）的体重指数（BMI）和腰围（WC）的最佳阈值。
分析了1999 - 2004年全国健康与营养检查调查（NHANES）中12至19岁青少年（n = 2581）的横断面数据。主要结局指标为≥3个年龄校正的CVD RFs（高密度和低密度脂蛋白胆固醇水平、甘油三酯水平、血糖水平、胰岛素水平以及收缩压和舒张压）。通过受试者操作特征分析，根据年龄和性别校正的BMI和WC值预测≥3个RFs的存在情况。
有≥3个RFs风险的青少年比例在17%至19%之间。BMI和WC均具有良好的诊断准确性，范围为0.73至0.83，以及良好的敏感性和特异性，范围为0.68至0.77。男孩的BMI切点范围为19.5至25.0 kg/m²，女孩为19.4至27.0 kg/m²；男孩的WC切点范围为66.8至87.5 cm，女孩为71.5至87.2 cm。
BMI和WC的年龄、性别及种族/民族特异性阈值在识别有后期CVD发病风险的青少年方面可能具有显著的临床实用性。
