National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, 100050 China.
Biomed Environ Sci. 2010 Feb;23(1):21-31. doi: 10.1016/s0895-3988(10)60027-x.
To explore the optimal threshold values of waist circumference (WC) for detecting cardiovascular (CV) risk factors among Chinese children and adolescents.
Association of WC with CV risk factors was studied among 65,898 children aged 7-18 years whose data were pooled from nine previous studies in China. CV risk factors in this study included hypertension (blood pressure above 95 percentile levels), dyslipidemia (with one or more of the following three indexes: TG > or = 1.7 mmol/L, TC > or = 5.18 mmol/L, and HDL-C < or = 1.04 mmol/L) and elevated glucose level (fasting plasma glucose > or = 5.6 mmol/L). Receive-operating characteristic analysis (ROC) and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting CV risk factors.
A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, which was at the 90th percentiles for detecting at least two of the above three CV risk factors. In comparison with children with waist circumference below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between the 75th and the 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing with waist circumference remained significant after having been stratified by BMI category.
The 75th and the 90th percentiles of WC are the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents, respectively.
探讨腰围（WC）用于检测中国儿童青少年心血管（CV）危险因素的最佳临界值。
本研究汇总了中国 9 项既往研究中 65898 名 7-18 岁儿童的数据，研究 WC 与 CV 危险因素之间的相关性。本研究中的 CV 危险因素包括高血压（血压高于 95 百分位数水平）、血脂异常（有以下三个指标之一或更多：TG≥1.7mmol/L、TC≥5.18mmol/L 和 HDL-C<1.04mmol/L）和高血糖水平（空腹血糖≥5.6mmol/L）。采用接收者操作特征分析（ROC）和逻辑回归得出最佳的年龄和性别特异性腰围参考值，用于预测 CV 危险因素。
研究人群中，CV 危险因素从第 75 百分位的 WC 开始呈轻微上升趋势，而从第 90 百分位开始则呈显著上升趋势。预测高血压的最佳 WC 临界值在男孩和女孩中均为第 75 百分位，而检测上述三种 CV 危险因素中至少两种的最佳 WC 临界值为第 90 百分位。与 WC 低于第 75 百分位的儿童相比，WC 在第 75-90 百分位之间的儿童发生两种 CV 危险因素的比值比增加了一倍，而 WC 高于第 90 百分位的儿童则增加了 6 倍。在按 BMI 类别分层后，WC 升高与高血压之间的趋势仍然显著。
WC 的第 75 百分位和第 90 百分位分别是预测中国儿童青少年 CV 因素风险增加和显著增加的最佳截断点。
