Chang Gung University of Science and Technology, Tao Yuan, Taiwan.
Arch Gerontol Geriatr. 2012 Nov-Dec;55(3):718-23. doi: 10.1016/j.archger.2012.02.005. Epub 2012 Mar 3.
While diagnostic criteria for MS may vary depending on ethnicity, obesity remains a key risk factor in its development. In Taiwan, the incidence of obesity and MS among women has been increasing; however cut-off values for defining obesity for the diagnosis of MS among different groups of women have not been clearly established. The goal of this research was to examine the suitability of various anthropometric indicators of obesity in predicting the presence of MS criteria and to determine appropriate cut-off values of these indicators for women of different age and menstrual status. The sample was derived from the 2002 "Taiwan Three High Prevalence Survey" database. Women were divided into three groups based on age and menstrual status. Receiver-operating characteristic (ROC) curves was applied to the anthropometric indicators of obesity including, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), to ascertain its value in predicting MS. 2848 cases were included. It was found that most MS component values were worse with age and following menopause. Obesity indicators showed poor predictability for MS risks in post-menopausal women over 65 years, but good predictability in women under 65 years; our study revealed the following as ideal cut-off values for non-menopausal female: WHtR<0.49, WC<78 cm, WHR<0.79, BMI<24 kg/m(2); for menopausal women, WHtR<0.54, WC<83 cm, WHR<0.84, BMI<24.4 kg/m(2). It was concluded that obesity alone is not a reliable predictor of MS risks in women over the age of 65, and cut-off values for obesity indicators need to be further reduced in non-menopausal women.
虽然多发性硬化症的诊断标准可能因种族而异,但肥胖仍然是其发展的一个关键风险因素。在台湾,肥胖和多发性硬化症在女性中的发病率一直在上升;然而,不同女性群体中用于诊断多发性硬化症的肥胖定义的截止值尚未明确确定。本研究的目的是检查各种肥胖的人体测量指标在预测多发性硬化症标准存在方面的适用性,并确定这些指标在不同年龄和月经状况的女性中的适当截止值。该样本来自于 2002 年“台湾三高流行调查”数据库。根据年龄和月经状况将女性分为三组。应用受试者工作特征(ROC)曲线分析肥胖的人体测量指标,包括体重指数(BMI)、腰围(WC)、腰臀比(WHR)、腰高比(WHtR),以确定其在预测多发性硬化症方面的价值。共纳入 2848 例病例。结果发现,大多数多发性硬化症的组成值随着年龄的增长和绝经后而恶化。肥胖指标对 65 岁以上绝经后女性的多发性硬化症风险预测能力较差,但对 65 岁以下女性的预测能力较好;我们的研究表明,对于非绝经女性,理想的截止值为:WHtR<0.49、WC<78cm、WHR<0.79、BMI<24kg/m²;对于绝经女性,理想的截止值为:WHtR<0.54、WC<83cm、WHR<0.84、BMI<24.4kg/m²。研究得出结论,肥胖本身并不能可靠地预测 65 岁以上女性多发性硬化症的风险,并且需要进一步降低非绝经女性肥胖指标的截止值。