Ashwell Associates, Ashwell, Herts, UK.
Obes Rev. 2012 Mar;13(3):275-86. doi: 10.1111/j.1467-789X.2011.00952.x. Epub 2011 Nov 23.
Our aim was to differentiate the screening potential of waist-to-height ratio (WHtR) and waist circumference (WC) for adult cardiometabolic risk in people of different nationalities and to compare both with body mass index (BMI). We undertook a systematic review and meta-analysis of studies that used receiver operating characteristics (ROC) curves for assessing the discriminatory power of anthropometric indices in distinguishing adults with hypertension, type-2 diabetes, dyslipidaemia, metabolic syndrome and general cardiovascular outcomes (CVD). Thirty one papers met the inclusion criteria. Using data on all outcomes, averaged within study group, WHtR had significantly greater discriminatory power compared with BMI. Compared with BMI, WC improved discrimination of adverse outcomes by 3% (P < 0.05) and WHtR improved discrimination by 4-5% over BMI (P < 0.01). Most importantly, statistical analysis of the within-study difference in AUC showed WHtR to be significantly better than WC for diabetes, hypertension, CVD and all outcomes (P < 0.005) in men and women. For the first time, robust statistical evidence from studies involving more than 300 000 adults in several ethnic groups, shows the superiority of WHtR over WC and BMI for detecting cardiometabolic risk factors in both sexes. Waist-to-height ratio should therefore be considered as a screening tool.
我们的目的是区分腰高比（WHtR）和腰围（WC）在不同民族成年人心血管代谢风险筛查中的潜力，并将两者与体重指数（BMI）进行比较。我们对使用接受者操作特征（ROC）曲线评估人体测量指数在区分高血压、2 型糖尿病、血脂异常、代谢综合征和一般心血管结局（CVD）的成年人方面的鉴别能力的研究进行了系统回顾和荟萃分析。符合纳入标准的有 31 篇论文。使用在研究组内平均的所有结局数据，WHtR 与 BMI 相比具有显著更高的鉴别能力。与 BMI 相比，WC 提高了不良结局的鉴别能力 3%（P<0.05），而 WHtR 比 BMI 提高了 4-5%的鉴别能力（P<0.01）。最重要的是，对 AUC 内研究差异的统计分析表明，WHtR 在男性和女性中对糖尿病、高血压、CVD 和所有结局的诊断均优于 WC（P<0.005）。首次从涉及多个种族群体的 30 多万名成年人的研究中获得了强有力的统计学证据，表明 WHtR 优于 WC 和 BMI，可用于检测两性的心血管代谢危险因素。因此，腰高比应被视为一种筛查工具。
