Department of Occupation Medicine, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Maijin Rd., Keelung, 200, Taiwan.
Eur J Nutr. 2013 Feb;52(1):57-65. doi: 10.1007/s00394-011-0286-0. Epub 2011 Dec 11.
We aimed to investigate the association of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with cardiometabolic risk.
In this cross-sectional study, 21,038 men and 15,604 women who participated in a health check-up were included.
In both men and women, the area under the curve (AUC) of WHtR was significantly greater than that of BMI or WC in the prediction of diabetes, hypertension, high total cholesterol, high triglycerides, and low HDL-cholesterol (P < 0.05 for all). The AUC for WHtR in the prediction of metabolic syndrome (MS) was also highest in the women (P < 0.05). After adjustment for potential confounders, the odds ratios and 95% confidence intervals for MS for each standard deviation increase in BMI, WHtR, and WC were 1.47 (1.46-1.49), 1.32 (1.31-1.33), and 1.19 (1.18-1.19), respectively. Finally, patients of either sex with a normal BMI or WC level, but with an elevated WHtR, had higher levels of various cardiometabolic risk factors in comparison with their normal BMI or WC, but low WHtR, counterparts (P < 0.05 for all).
Among Taiwanese adults, a WHtR greater than 0.5 is a simple, yet effective indicator of centralized obesity and associated cardiometabolic risk, even among individuals deemed 'healthy' according to BMI and WC.
本研究旨在探讨体重指数（BMI）、腰围（WC）和腰高比（WHtR）与心血管代谢风险的关系。
本横断面研究纳入了 21038 名男性和 15604 名女性，他们参加了健康检查。
在男性和女性中，WHtR 的曲线下面积（AUC）在预测糖尿病、高血压、高总胆固醇、高三酰甘油和低高密度脂蛋白胆固醇方面均明显大于 BMI 或 WC（P<0.05）。WHtR 在预测女性代谢综合征（MS）方面的 AUC 也最高（P<0.05）。在调整了潜在混杂因素后，BMI、WHtR 和 WC 每增加一个标准差，MS 的比值比（OR）和 95%置信区间（CI）分别为 1.47（1.46-1.49）、1.32（1.31-1.33）和 1.19（1.18-1.19）。最后，无论性别如何，如果 BMI 或 WC 水平正常但 WHtR 升高的患者与 BMI 或 WC 正常但 WHtR 较低的患者相比，其各种心血管代谢危险因素的水平更高（P<0.05）。
在台湾成年人中，WHtR 大于 0.5 是一种简单而有效的中心性肥胖和相关心血管代谢风险的指标，即使是根据 BMI 和 WC 被认为是“健康”的个体也是如此。
