School of Public Health, Peking University Health Science Center Beijing 100083, China.
Biomed Environ Sci. 2010 Apr;23(2):92-101. doi: 10.1016/S0895-3988(10)60037-2.
To compare the relative risk of waist circumference (WC) and/or BMI on cardiovascular risk factors.
A cross-sectional data of 41 087 adults (19 567 male and 21 520 female) from the 2002 China National Nutrition and Health Survey were examined. According to the obesity definition of WGOC (BMI, 24 kg/m2 and 28 kg/m2; WC, male 85 cm and 95 cm for male, 80 cm and 90 cm for female), the study population were divided into 9 groups. The prevalence and odds ratio (ORs) of cardiovascular disease (CVD) risk factors (hypertension, high fasting plasma glucose and dyslipidemia) were compared among these 9 groups. Stepwise linear regression analyses were used to compare the likelihood of BMI and/or WC on CVD risk factors. RESULTS Both the indexes levels and the odds ratios of CVD risk factors were significantly increased (decreased for HDL-C levels) along with the increase of WC and/or BMI, even when the effect of age, sex, income, education, sedentary activity and dietary factors were adjusted. The variances (R2) in CVD risk factors explained by WC only and BMI only were quite similar, but a little bit larger when WC and BMI were combined. The standard beta was higher of BMI when predicting systolic BP and was higher of WC when predicting TG TC and HDL.
BMI and WC had independent effects on CVD risk factors and combination of BMI and WC would be more predictive. Findings from the present study provided substantive evidence for the WGOC recommendation of a combined use of BMI and WC classifications.
比较腰围（WC）和/或体重指数（BMI）与心血管危险因素的相对风险。
对 2002 年中国营养与健康调查的 41087 名成年人（男性 19567 名，女性 21520 名）进行横断面数据分析。根据 WGOC（BMI，24kg/m2 和 28kg/m2；WC，男性 85cm 和 95cm，女性 80cm 和 90cm）的肥胖定义，将研究人群分为 9 组。比较 9 组人群中心血管疾病（CVD）危险因素（高血压、高空腹血糖和血脂异常）的患病率和比值比（ORs）。采用逐步线性回归分析比较 BMI 和/或 WC 对 CVD 危险因素的影响。
随着 WC 和/或 BMI 的增加，CVD 危险因素的指标水平和 ORs 均显著升高（HDL-C 水平降低），即使调整了年龄、性别、收入、教育、久坐活动和饮食因素的影响。仅用 WC 和仅用 BMI 解释 CVD 危险因素的方差（R2）非常相似，但当 WC 和 BMI 结合使用时，方差略大。预测收缩压时，BMI 的标准β更高，预测 TG、TC 和 HDL 时，WC 的标准β更高。
BMI 和 WC 对 CVD 危险因素有独立影响，BMI 和 WC 的组合预测效果更好。本研究结果为 WGOC 联合使用 BMI 和 WC 分类的建议提供了实质性证据。
