Hsu Chun-Hsien, Lin Jiunn-Diann, Hsieh Chang-Hsun, Lau Shu Chuen, Chiang Wei-Yong, Chen Yen-Lin, Pei Dee, Chang Jin-Biou
Department of Family Medicine, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Nutr Res. 2014 Mar;34(3):219-25. doi: 10.1016/j.nutres.2014.01.004. Epub 2014 Jan 24.
Obesity is a major public health problem, and measuring adiposity accurately and predicting its future comorbidities are important issues. Therefore, we hypothesized that 4 adiposity measurements, body mass index (BMI), waist circumference (WC), waist-to-height ratio, and body fat percentage, have different physiological meanings and distinct associations with adverse health consequences. This study aimed to investigate the relationship of these 4 measurements with metabolic syndrome (MetS) components and identify the most associated factor for MetS occurrence in older, non-medicated men. Cross-sectional data from 3004 men, all 65 years of age and older, were analyzed. The correlation and association between adiposity measurements and MetS components were evaluated by Pearson correlation and multiple linear regression. Based on multivariate logistic regression, BMI and WC were significantly associated with MetS and were selected to build a combined model of receiver operating characteristic curves to increase the diagnosis accuracy for MetS. The results show that BMI is independently associated with systolic and diastolic blood pressure; WC and body fat percentage are associated with fasting plasma glucose and log transformation of triglyceride; BMI and WC are negatively associated with high-density lipoprotein cholesterol (HDL-C); and WC is a better discriminate for MetS than BMI, although the combined model (WC + BMI) is not significantly better than WC alone. Based on these results, we conclude that the 4 adiposity measurements have different clinical implications. Thus, in older men, BMI is an important determinant for blood pressure and HDL-C. Waist circumference is associated with the risk of fasting plasma glucose, HDL-C, triglyceride, and MetS occurrence. The combined model did not increase the diagnosis accuracy.
肥胖是一个主要的公共卫生问题,准确测量肥胖程度并预测其未来的合并症是重要的课题。因此,我们假设四种肥胖测量指标,即体重指数(BMI)、腰围(WC)、腰高比和体脂百分比,具有不同的生理意义,且与不良健康后果有着不同的关联。本研究旨在调查这四种测量指标与代谢综合征(MetS)各组分之间的关系,并确定老年非用药男性中与MetS发生最相关的因素。对3004名65岁及以上男性的横断面数据进行了分析。通过Pearson相关性分析和多元线性回归评估肥胖测量指标与MetS各组分之间的相关性和关联性。基于多因素逻辑回归分析,BMI和WC与MetS显著相关,并被选入构建受试者工作特征曲线的联合模型,以提高对MetS的诊断准确性。结果显示,BMI与收缩压和舒张压独立相关;WC和体脂百分比与空腹血糖及甘油三酯的对数转换值相关;BMI和WC与高密度脂蛋白胆固醇(HDL-C)呈负相关;WC对MetS的鉴别能力优于BMI,尽管联合模型(WC + BMI)并不比单独使用WC有显著改善。基于这些结果,我们得出结论,这四种肥胖测量指标具有不同的临床意义。因此,在老年男性中,BMI是血压和HDL-C的重要决定因素。腰围与空腹血糖、HDL-C、甘油三酯及MetS发生风险相关。联合模型并未提高诊断准确性。