Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, P R China.
J Epidemiol. 2012;22(4):317-23. doi: 10.2188/jea.je20110120. Epub 2012 May 10.
Obesity is closely associated with chronic diseases such as hypertension, type 2 diabetes mellitus (T2DM), and dyslipidemia. We analyzed the optimal obesity index cut-off values for metabolic syndrome (MetS), and identified the obesity index that is more closely associated with these chronic diseases, in a population of northern Chinese.
We surveyed 8940 adults (age, 20-74 years) living in northern China for chronic diseases. Receiver operating characteristics (ROC) analysis, relative risk, and multivariate regression were used to develop an appropriate index and optimal cut-off values for MetS and obesity-related chronic diseases.
Waist circumference (WC) and body mass index (BMI) were good markers for MetS, WC was a good marker for T2DM and dyslipidemia, and BMI was a good marker for hypertension. The optimal BMI cut-off value of MetS was 24 kg/m², and the optimal WC cut-offs were 86 cm and 78 cm in men and women, respectively. Relative risk regression models showed that BMI was associated with hypertension, T2DM, and hypertriglyceridemia and a higher prevalence ratio (PR) for hypertension: 2.35 (95% CI, 2.18-2.50). WC was associated with T2DM, hypertension, and hypertriglyceridemia, with PRs of 2.05 (1.63-2.55) for T2DM and 2.47 (2.04-2.85) for hypertriglyceridemia. In multivariate regression models, the standardized regression coefficients (SRCs) of BMI were greater for SBP and DBP, and the SRC of WC was greater for fasting blood glucose, 2-hour postload blood glucose, triglyceride, and total cholesterol.
Our analysis of a population of northern Chinese indicates that the optimal cut-off values for MetS are WCs of 86 cm in men and 78 cm in women and a BMI of 24 kg/m² in both sexes. BMI was strongly associated with hypertension, while WC was strongly associated with T2DM and dyslipidemia.
肥胖与高血压、2 型糖尿病（T2DM）和血脂异常等慢性病密切相关。我们分析了中国北方人群代谢综合征（MetS）的最佳肥胖指数切点值，并确定了与这些慢性病关系更密切的肥胖指数。
我们对中国北方 8940 名年龄在 20-74 岁的成年人进行了慢性病调查。采用受试者工作特征（ROC）分析、相对风险和多元回归来制定合适的指数和 MetS 及肥胖相关慢性病的最佳切点值。
腰围（WC）和体重指数（BMI）是 MetS 的良好标志物，WC 是 T2DM 和血脂异常的良好标志物，BMI 是高血压的良好标志物。MetS 的最佳 BMI 切点值为 24kg/m²，男性和女性的最佳 WC 切点值分别为 86cm 和 78cm。相对风险回归模型显示，BMI 与高血压、T2DM 和高甘油三酯血症相关，高血压的患病率比值（PR）较高：2.35（95%CI，2.18-2.50）。WC 与 T2DM、高血压和高甘油三酯血症相关，PR 分别为 2.05（1.63-2.55）和 2.47（2.04-2.85）。在多元回归模型中，BMI 的标准化回归系数（SRC）对 SBP 和 DBP 的影响更大，WC 的 SRC 对空腹血糖、餐后 2 小时血糖、甘油三酯和总胆固醇的影响更大。
对中国北方人群的分析表明，MetS 的最佳切点值为男性 WC 86cm、女性 WC 78cm、男女 BMI 均为 24kg/m²。BMI 与高血压密切相关，WC 与 T2DM 和血脂异常密切相关。
