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[基于腰围和体重指数定义的肥胖对心血管危险因素的比值比]

[Odds ratio on cardiovascular risk factors of obesity defined by waist and body mass index].

作者信息

Du Song-ming, Li Yan-ping, Fang Hong-yun, Hu Xiao-qi, Yang Xiao-guang, Ma Guan-sheng, Hu Yong-hua

机构信息

School of Public Health, Peking University Health Science Center, Beijing 100191, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2010 Jun;31(6):626-32.

Abstract

OBJECTIVE

To compare the odds ratio of waist circumference (WC) and/or body mass index (BMI) on cardiovascular risk factors.

METHODS

Data on a cross-sectional study involving 41 087 adults (19 567 male, 21 520 female) from the 2002 China National Nutrition and Health Survey were examined. According to the obesity definition of the Chinese Working Group on Obesity for Children (WGOC) (BMI, 24 and 28 kg/m(2); WC, male 85 cm, female 80 cm), the study population were divided into 9 groups. The prevalence and odds ratio (OR) of cardiovascular disease (CVD) risk factors were compared among these 9 groups. Variation and standard β were indexes being used to compare the likelihood of BMI and/or WC on CVD risk factors.

RESULTS

Within each of the BMI categories, with few exceptions, indices levels on CVD risk factors were significantly increased (decreased for HDL-C levels) with the increase of WC, and vice versa. After adjusting the effects of age, sex, income, education, sedentary activity and dietary factors, the ORs of hypertension in adults with higher WC within each of the BMI categories were higher than adults with lower WC, and the ORs of hypertension in adults with higher BMI within each of the WC categories were higher than adults with lower BMI. Similar trends were found for high fast plasma glucose (FPG) and dyslipidemia. The variation in CVD risk factors explained only by WC and BMI were quite similar, but slightly larger when combined WC with BMI. Standard β was higher on BMI when predicting systolic BP and was higher on WC when predicting TG, TC and HDL-C.

CONCLUSION

BMI and WC were independently associated with the risk factors on CVD. To combine the BMI and WC, the results could accurately evaluate the risk of CVD, thus to provide substantive evidence that the WGOC cutoff points for the WC might help in identifying those population under increased risk.

摘要

目的

比较腰围(WC)和/或体重指数(BMI)对心血管危险因素的比值比。

方法

对2002年中国居民营养与健康状况调查中41087名成年人(19567名男性,21520名女性)的横断面研究数据进行分析。根据中国肥胖问题工作组(WGOC)的肥胖定义(BMI,24和28kg/m²;WC,男性85cm,女性80cm),将研究人群分为9组。比较这9组中心血管疾病(CVD)危险因素的患病率和比值比(OR)。采用变异系数和标准化β系数来比较BMI和/或WC对CVD危险因素的影响程度。

结果

在每个BMI类别中,除少数情况外,随着WC的增加,CVD危险因素的指标水平显著升高(HDL-C水平降低),反之亦然。在调整年龄、性别、收入、教育程度、久坐活动和饮食因素的影响后,各BMI类别中WC较高的成年人患高血压的OR高于WC较低的成年人,各WC类别中BMI较高的成年人患高血压的OR高于BMI较低的成年人。高空腹血糖(FPG)和血脂异常也呈现类似趋势。仅由WC和BMI解释的CVD危险因素变异相当相似,但WC与BMI联合时变异略大。预测收缩压时BMI的标准化β系数较高,预测甘油三酯(TG)、总胆固醇(TC)和高密度脂蛋白胆固醇(HDL-C)时WC的标准化β系数较高。

结论

BMI和WC均与CVD危险因素独立相关。将BMI和WC结合起来,结果能够准确评估CVD风险,从而提供实质性证据表明WGOC的WC切点可能有助于识别风险增加的人群。

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