Wang Jin-wen, Hu Da-yi, Sun Yi-hong, Wang Jia-hong, Wang Gui-lian, Xie Jiang, Zhou Zi-qiang
Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Asia Pac J Clin Nutr. 2009;18(1):105-13.
Criteria of obesity in the Chinese population with multiple metabolic risk factors remains unclear. The objective was to determine the best anthropometrical measurements with regard to the metabolic syndrome (MetS) and to propose optimal cut-off values. Between April and August, 2007, 3,704 men and 6,392 women aged 18-85 years were recruited from four community centers. Medical examinations included measurement of weight, height, waist circumference (WC), hip circumference, fasting blood triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), glucose concentrations, and blood pressure (BP). Body mass index (BMI), waist to hip ratio (WHR), WC and waist to stature ratio (WSR) were calculated. Four metabolic risk factors were examined: 1) high BP; 2) high levels of TG; 3) low levels of HDL-C; 4) impaired glucose tolerance. The relationships between studied indices and risk factors were analyzed using partial correlation analyses, analysis of variance (ANOVA), linear regression, and Receiver Operator Characteristic (ROC) curve analysis. The optimal cut-off values of each obesity index were calculated using ROC analysis respectively. All obesity indices were positively associated with metabolic risk factors. Area under curve (AUC) of WC was the largest for >or= 2 risk factors after adjustment for age in both genders. Optimal cut-off points for WC were 89 cm in men, and 80.5cm, 82.5cm, and 89.5cm in < 40-yr, 40-60-yr, and > 60-yr women respectively. Waist circumference is best associated with metabolic risk factors among the studied indices in Chinese adults. Indices of abdominal obesity for older age groups tend to be higher than younger age groups in women.
中国具有多种代谢风险因素人群的肥胖标准仍不明确。目的是确定与代谢综合征(MetS)相关的最佳人体测量指标,并提出最佳截断值。2007年4月至8月,从四个社区中心招募了3704名18 - 85岁男性和6392名18 - 85岁女性。医学检查包括测量体重、身高、腰围(WC)、臀围、空腹血甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、血糖浓度和血压(BP)。计算体重指数(BMI)、腰臀比(WHR)、腰围身高比(WSR)。检查了四个代谢风险因素:1)高血压;2)高甘油三酯水平;3)低高密度脂蛋白胆固醇水平;4)糖耐量受损。使用偏相关分析、方差分析(ANOVA)、线性回归和受试者工作特征(ROC)曲线分析来分析所研究指标与风险因素之间的关系。分别使用ROC分析计算每个肥胖指数的最佳截断值。所有肥胖指数均与代谢风险因素呈正相关。在对年龄进行调整后,无论男女,对于≥2个风险因素,腰围的曲线下面积(AUC)最大。男性腰围的最佳截断点为89厘米,<40岁、40 - 60岁和>60岁女性的腰围最佳截断点分别为80.5厘米、82.5厘米和89.5厘米。在中国成年人中,在所研究的指标中,腰围与代谢风险因素的相关性最佳。女性中,老年组的腹部肥胖指标往往高于年轻组。