Mojiminiyi Olusegun A, Al Mulla Fahd, Abdella Nabila A
Department of Pathology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
Med Princ Pract. 2009;18(2):123-9. doi: 10.1159/000189810. Epub 2009 Feb 10.
The aim of this study was to determine, which of: body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and waist circumference (WC) correlates best with adipokines and is, therefore, the most suitable for the assessment of insulin resistance (IR), metabolic syndrome (MS), type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD) risk.
We studied 248 T2DM patients classified by gender, IR, MS and CHD. Fasting adiponectin, leptin, resistin, high-sensitivity C-reactive protein (CRP), insulin, glucose, IR (HOMA), and lipid profile were measured. Univariate and multivariate regression analyses were used to find the associations of these variables with each other and with IR, MS and CHD. Receiver operating characteristic (ROC) analyses were used to find the best markers of IR, MS and CHD.
There were gender differences in the correlations and associations of BMI, WHR, WHtR and WC with IR, MS and CHD; e.g. in males, WHR showed significant correlation with only resistin (r = 0.30) and leptin (r = 0.39) whereas in females, it showed significant correlations with only adiponectin (r = -0.33). In males and females WHR showed the weakest correlations with CRP and the adipokines and BMI showed the highest correlations. ROC analysis showed that the BMI had the highest diagnostic values for detection of IR, MS and CHD; WHR had the worst diagnostic value.
Anthropometric indices show differences in performance and associations with adipokines, CRP, IR, MS and CHD. In patients with T2DM, BMI should be the preferred marker for risk assessment on account of its association with adipokines and diagnostic performance characteristics.
本研究旨在确定体重指数（BMI）、腰臀比（WHR）、腰高比（WHtR）和腰围（WC）中哪一项与脂肪因子的相关性最佳，因此最适合用于评估胰岛素抵抗（IR）、代谢综合征（MS）、2型糖尿病（T2DM）和冠心病（CHD）风险。
我们研究了248例按性别、IR、MS和CHD分类的T2DM患者。测量了空腹脂联素、瘦素、抵抗素、高敏C反应蛋白（CRP）、胰岛素、血糖、IR（HOMA）和血脂谱。采用单因素和多因素回归分析来找出这些变量之间以及与IR、MS和CHD的关联。采用受试者工作特征（ROC）分析来找出IR、MS和CHD的最佳标志物。
BMI、WHR、WHtR和WC与IR、MS和CHD的相关性及关联存在性别差异；例如，在男性中，WHR仅与抵抗素（r = 0.30）和瘦素（r = 0.39）呈显著相关，而在女性中，它仅与脂联素（r = -0.33）呈显著相关。在男性和女性中，WHR与CRP和脂肪因子的相关性最弱，而BMI的相关性最高。ROC分析表明，BMI对检测IR、MS和CHD具有最高的诊断价值；WHR的诊断价值最差。
人体测量指标在与脂肪因子、CRP、IR、MS和CHD的表现及关联方面存在差异。在T2DM患者中，由于BMI与脂肪因子的关联及其诊断性能特征，它应是风险评估的首选标志物。
