台湾人群用于诊断高血糖、高血压和血脂异常的最佳人体测量学因素切点。
Optimal anthropometric factor cutoffs for hyperglycemia, hypertension and dyslipidemia for the Taiwanese population.
机构信息
National Taiwan University College of Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
出版信息
Atherosclerosis. 2010 Jun;210(2):585-9. doi: 10.1016/j.atherosclerosis.2009.12.015. Epub 2009 Dec 22.
BACKGROUND
Optimal cutoffs for obesity indices are rarely studied in Asians. We evaluated these cutoffs for diabetes, hypertension, dyslipidemia and any risk factor for the Taiwanese general population.
METHODS
Body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHeiR) and other data for 4683 (2280 men and 2403 women) participants of the population-based Taiwanese Survey on Hypertension, Hyperglycemia and Hyperlipidemia were used. Areas under curves (AUCs) were analyzed and optimal cutoffs were estimated by maximizing the sums of sensitivity and specificity. Potential confounders included age, smoking, alcohol, betel nut chewing and exercise.
RESULTS
Optimal cutoffs for men and women, respectively, were 23.7-26.3 and 22.1-23.2 kg/m2 for BMI; 85.0-87.0 and 74.0-83.0 cm for WC; 0.87-0.90 and 0.78-0.83 for WHR; and 0.48-0.52 and 0.48-0.52 for WHeiR. AUCs were not significantly different among the indices for diabetes in men and for hypertension in women. In men, WHR was significantly inferior to the other indices for predicting hypertension, dyslipidemia and any risk factor. In women, BMI was significantly inferior to the others for diabetes. For dyslipidemia and any risk factor in women, WHeiR showed the largest AUCs and significant differences were seen in the following pairs: WHeiR vs. BMI and WHeiR vs. WHR for dyslipidemia and WC vs. WHR and WHeiR vs. WHR for any risk factor.
CONCLUSIONS
WC and WHeiR have similar efficacy and are superior to BMI and WHR. However, WHeiR has the extra benefit of a unisex cutoff within a narrow range.
背景
在亚洲人群中，很少对肥胖指数的最佳切点进行研究。我们评估了这些切点在台湾普通人群中对糖尿病、高血压、血脂异常和任何危险因素的预测价值。
方法
利用基于人群的台湾高血压、高血糖和血脂异常调查中 4683 名参与者（男 2280 名，女 2403 名）的体重指数（BMI）、腰围（WC）、腰臀比（WHR）、腰围身高比（WHeiR）和其他数据。通过最大化灵敏度和特异性的和来分析曲线下面积（AUC）并估计最佳切点。潜在的混杂因素包括年龄、吸烟、饮酒、嚼槟榔和运动。
结果
男性和女性的最佳切点分别为 23.7-26.3 和 22.1-23.2 kg/m2 用于 BMI；85.0-87.0 和 74.0-83.0 cm 用于 WC；0.87-0.90 和 0.78-0.83 用于 WHR；0.48-0.52 和 0.48-0.52 用于 WHeiR。男性的糖尿病和女性的高血压中，各指数的 AUC 无显著差异。在男性中，WHR 在预测高血压、血脂异常和任何危险因素方面明显劣于其他指数。在女性中，BMI 在预测糖尿病方面明显劣于其他指数。对于女性的血脂异常和任何危险因素，WHeiR 的 AUC 最大，且在以下配对中存在显著差异：WHeiR 与 BMI 和 WHeiR 与 WHR 用于血脂异常，WC 与 WHR 和 WHeiR 与 WHR 用于任何危险因素。
结论
WC 和 WHeiR 的疗效相似，优于 BMI 和 WHR。然而，WHeiR 具有在较窄范围内的男女通用切点的额外优势。
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