National Centre for Epidemiology and Public Health, Mills Road, Australian National University, Acton ACT 0200, Australia.
Nutr Metab Cardiovasc Dis. 2012 Jan;22(1):42-9. doi: 10.1016/j.numecd.2010.04.003. Epub 2010 Jul 31.
Waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-stature ratio (WSR), being common proxy measures of abdominal obesity, are useful tools in epidemiologic studies, but little is known about their validity when the indices are derived from self-reported measurements. We determine and compare the validity of self-reported WC, WHR and WSR in order to identify the optimal index for use in epidemiologic surveys.
Technician- and self-reported measurements of height, waist and hip circumference were obtained from 613 Thai adults (mean age 35 years). Regarding technician-reported measurements as reference, diagnostic test properties were derived and performances of the indices compared using receiver-operator-characteristic curves and the area-under-the-curve (AUC) analyses. There was good agreement between technician- and self-reported measurements for WC and WSR (concordance correlation coefficients ranged from 0.84 to 0.90) but not for WHR (0.50 in men, 0.45 in women). The sensitivity and specificity of self-reported WC and self-reported WSR as measures of abdominal obesity were superior to those of self-reported WHR in both sexes. AUCs for WC and WSR were comparable (0.93 and 0.92, respectively, in men; 0.88 and 0.87 in women) and significantly higher than for WHR (0.80 in men; 0.76 in women; p<0.0001).
WC and WSR derived from self-reported waist and height measurements are valid methods for determining abdominal obesity. Self-reported measurements should not be used to derive the WHR. In Asian populations, WSR may be the optimal index of abdominal obesity when measurements are derived from self-reports in epidemiologic surveys.
腰围（WC）、腰臀比（WHR）和腰高比（WSR）作为腹部肥胖的常见替代测量指标，在流行病学研究中是有用的工具，但对于这些指标来自自我报告测量时的有效性知之甚少。我们确定并比较了自我报告的 WC、WHR 和 WSR 的有效性，以确定在流行病学调查中使用的最佳指标。
从 613 名泰国成年人（平均年龄 35 岁）中获得了技术人员和自我报告的身高、腰围和臀围测量值。将技术人员报告的测量值作为参考，得出诊断测试特性，并使用接收者操作特征曲线和曲线下面积（AUC）分析比较指标的性能。WC 和 WSR 的技术人员报告和自我报告测量值之间存在良好的一致性（一致性相关系数范围为 0.84 至 0.90），但 WHR 则不然（男性为 0.50，女性为 0.45）。WC 和 WSR 作为腹部肥胖的自我报告测量值的敏感性和特异性均优于男性和女性的自我报告 WHR。WC 和 WSR 的 AUC 相当（男性分别为 0.93 和 0.92，女性分别为 0.88 和 0.87），且显著高于 WHR（男性为 0.80，女性为 0.76；p<0.0001）。
自我报告的腰围和身高测量值得出的 WC 和 WSR 是确定腹部肥胖的有效方法。不应该使用自我报告测量值来推导 WHR。在亚洲人群中，当自我报告的测量值用于流行病学调查时，WSR 可能是腹部肥胖的最佳指标。
