Taylor Sharonda Alston, Hergenroeder Albert C
Baylor College of Medicine, Department of Pediatrics, Adolescent Medicine and Sports Medicine Section, Texas Children's Hospital, Houston, TX, USA.
Int J Pediatr Obes. 2011 Jun;6(2-2):e307-11. doi: 10.3109/17477166.2011.575149. Epub 2011 Jun 7.
The aims of the study were to establish waist circumference (WC) cut-off points that identify clustering of obesity-related conditions and determine if the cut-off points identified an increased risk of disease when used within BMI categories.
This is a secondary analysis of the Centers for Disease Control NHANES III complex, multistage probability weighted data set collected between 1988 and 1994 from multiple locations in the United States. There were 2003 adolescents ages 12-19 years. Main outcome measures were low (<2 risk factors) or high (≥2 risk factors) risk for cardiometabolic disease based on the number of abnormal serum measurements for fasting glucose, high-density lipoprotein (HDL), triglycerides, and blood pressure. Receiver-operating characteristic curve analysis created the WC cut-off points and logistic regression determined if cut-off points predicted of within BMI categories.
Analysis identified cut-off points of ≥80.5 cm for males and ≥81 cm for females. Cut-off points predicted abnormal values for all outcome variables except fasting serum glucose in females, p < 0.05. Males with a normal BMI and elevated waist circumference were more likely to be high risk (OR = 5.23, CI = 1.79, 15.24, p < 0.013) and have increased odds of abnormal serum triglycerides, HDL and blood pressure. Overweight females (BMI ≥ 85-94%) with elevated waist circumference were more likely to have elevated blood pressure (OR = 9.05, 95% CI: 1.44, 56.83).
WC within BMI categories may identify those who have cardiometabolic disease risk factors despite having normal or overweight BMI.
本研究旨在确定能够识别与肥胖相关疾病聚集情况的腰围（WC）切点，并确定这些切点在按体重指数（BMI）分类中使用时是否能识别出疾病风险增加的情况。
这是对疾病控制中心国家健康和营养检查调查（NHANES）III复杂多阶段概率加权数据集的二次分析，该数据集于1988年至1994年在美国多个地点收集。共有2003名12至19岁的青少年。主要结局指标是根据空腹血糖、高密度脂蛋白（HDL）、甘油三酯和血压的血清测量异常数量，将心血管代谢疾病风险分为低（<2个风险因素）或高（≥2个风险因素）。通过受试者工作特征曲线分析确定WC切点，并通过逻辑回归确定切点是否能在BMI分类中进行预测。
分析确定男性的切点为≥80.5厘米，女性为≥81厘米。除女性空腹血清葡萄糖外，切点对所有结局变量的异常值均有预测作用，p<0.05。BMI正常但腰围升高的男性更有可能处于高风险（比值比[OR]=5.23，置信区间[CI]=1.79,15.24，p<0.013），且血清甘油三酯、HDL和血压异常的几率增加。腰围升高的超重女性（BMI≥85-94%）更有可能血压升高（OR=9.05，95%CI：1.44,56.83）。
在BMI分类中，WC可能识别出那些尽管BMI正常或超重但仍有心血管代谢疾病风险因素的人。
