在美国青少年中，腰围比体重指数更能预测胰岛素抵抗吗？
Is waist circumference a better predictor of insulin resistance than body mass index in U.S. adolescents?
机构信息
New Hanover Regional Medical Center, Wilmington, North Carolina, USA.
出版信息
J Adolesc Health. 2011 Sep;49(3):330-3. doi: 10.1016/j.jadohealth.2010.12.008. Epub 2011 May 4.
PURPOSE
To determine whether waist circumference (WC) is a better predictor of insulin resistance (IR) than body mass index (BMI) in U.S. adolescents aged 12-18 years.
METHODS
Using data from the National Health and Nutrition Examination Survey 1999-2002, we evaluated an ethnically diverse sample of 1,571 adolescents with regard to BMI, WC, and fasting glucose and insulin levels. Children were classified as having IR if they had a homeostasis model assessment of insulin resistance (insulin [U/mL] × glucose [mmol/L]/22.5) of greater than 4.39.We created receiver operating characteristic curves predicting IR across various thresholds of WC and BMI, and area under the curve was compared.
RESULTS
The prevalence rate of IR in the study population was 11.8%. Measures of test performance (sensitivity and specificity) for predicting IR were similar for abnormal BMI and WC thresholds; that is, thresholds of BMI 85th% and WC 75th% and thresholds of BMI 95th% and WC 90th% were quite similar. There were no significant differences in area under the curve for WC versus BMI (.85; 95% CI, .83-.88; p = .84) either for the overall population or for specific racial groups.
CONCLUSIONS
WC does not seem to provide a distinct advantage over BMI for identifying adolescents with IR.
目的
确定腰围（WC）是否比身体质量指数（BMI）更能预测美国 12-18 岁青少年的胰岛素抵抗（IR）。
方法
利用 1999-2002 年全国健康和营养调查的数据，我们评估了 1571 名具有不同种族背景的青少年的 BMI、WC、空腹血糖和胰岛素水平。如果孩子的稳态模型评估的胰岛素抵抗（胰岛素[U/mL]×血糖[mmol/L]/22.5）大于 4.39，则将其归类为患有 IR。我们创建了预测 WC 和 BMI 不同阈值下 IR 的受试者工作特征曲线，并比较了曲线下面积。
结果
研究人群中 IR 的患病率为 11.8%。用于预测 IR 的测试性能（敏感性和特异性）对于异常 BMI 和 WC 阈值是相似的；也就是说，BMI 第 85%百分位和 WC 第 75%百分位以及 BMI 第 95%百分位和 WC 第 90%百分位的阈值非常相似。WC 与 BMI 的曲线下面积（0.85；95%CI，0.83-0.88；p=0.84）在总体人群或特定种族群体中均无显著差异。
结论
WC 在识别有 IR 的青少年方面似乎并没有比 BMI 提供明显的优势。
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