Ashwell Associates Ltd, Ashwell Street, Ashwell, Hertfordshire SG7 5PZ, UK.
Nutr Res Rev. 2010 Dec;23(2):247-69. doi: 10.1017/S0954422410000144. Epub 2010 Sep 7.
This systematic review collated seventy-eight studies exploring waist-to-height ratio (WHtR) and waist circumference (WC) or BMI as predictors of diabetes and CVD, published in English between 1950 and 2008. Twenty-two prospective analyses showed that WHtR and WC were significant predictors of these cardiometabolic outcomes more often than BMI, with similar OR, sometimes being significant predictors after adjustment for BMI. Observations from cross-sectional analyses, forty-four in adults, thirteen in children, supported these predictions. Receiver operator characteristic (ROC) analysis revealed mean area under ROC (AUROC) values of 0·704, 0·693 and 0·671 for WHtR, WC and BMI, respectively. Mean boundary values for WHtR, covering all cardiometabolic outcomes, from studies in fourteen different countries and including Caucasian, Asian and Central American subjects, were 0·50 for men and 0·50 for women. WHtR and WC are therefore similar predictors of diabetes and CVD, both being stronger than, and independent of, BMI. To make firmer statistical comparison, a meta-analysis is required. The AUROC analyses indicate that WHtR may be a more useful global clinical screening tool than WC, with a weighted mean boundary value of 0·5, supporting the simple public health message 'keep your waist circumference to less than half your height'.
这篇系统综述共汇集了 78 项研究，旨在探讨腰高比（WHtR）和腰围（WC）或 BMI 作为糖尿病和心血管疾病预测因子的作用，这些研究均发表于 1950 年至 2008 年期间的英文文献。22 项前瞻性分析显示，WHtR 和 WC 作为这些代谢性心血管疾病的预测因子，比 BMI 更为显著，有时在调整 BMI 后，其 OR 仍具有统计学意义。44 项成人横断面研究和 13 项儿童横断面研究的结果支持了上述预测。接受者操作特征（ROC）分析显示，WHtR、WC 和 BMI 的 ROC 曲线下面积（AUROC）平均值分别为 0.704、0.693 和 0.671。在来自 14 个不同国家的研究中，涵盖所有代谢性心血管疾病的终点，WHtR 的平均界值范围为男性 0.50 和女性 0.50。因此，WHtR 和 WC 是糖尿病和心血管疾病的相似预测因子，其预测作用均强于 BMI，且与 BMI 独立。为了进行更可靠的统计学比较，需要进行荟萃分析。ROC 分析表明，WHtR 可能是一种比 WC 更有用的全身性临床筛查工具，其加权平均界值为 0.5，这一结果支持了“将腰围控制在身高一半以下”这一简单的公共健康信息。
