Lam Benjamin Chih Chiang, Koh Gerald Choon Huat, Chen Cynthia, Wong Michael Tack Keong, Fallows Stephen J
Department of Family and Community Medicine, Khoo Teck Puat Hospital, Singapore, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
PLoS One. 2015 Apr 16;10(4):e0122985. doi: 10.1371/journal.pone.0122985. eCollection 2015.
Excess adiposity is associated with cardiovascular disease (CVD) risk factors such as hypertension, diabetes mellitus and dyslipidemia. Amongst the various measures of adiposity, the best one to help predict these risk factors remains contentious. A novel index of adiposity, the Body Adiposity Index (BAI) was proposed in 2011, and has not been extensively studied in all populations. Therefore, the purpose of this study is to compare the relationship between Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR), Waist-to-Height Ratio (WHtR), Body Adiposity Index (BAI) and CVD risk factors in the local adult population.
This is a cross sectional study involving 1,891 subjects (Chinese 59.1% Malay 22.2%, Indian 18.7%), aged 21-74 years, based on an employee health screening (2012) undertaken at a hospital in Singapore. Anthropometric indices and CVD risk factor variables were measured, and Spearman correlation, Receiver Operating Characteristic (ROC) curves and multiple logistic regressions were used. BAI consistently had the lower correlation, area under ROC and odd ratio values when compared with BMI, WC and WHtR, although differences were often small with overlapping 95% confidence intervals. After adjusting for BMI, BAI did not further increase the odds of CVD risk factors, unlike WC and WHtR (for all except hypertension and low high density lipoprotein cholesterol). When subjects with the various CVD risk factors were grouped according to established cut-offs, a BMI of ≥23.0 kg/m2 and/or WHtR ≥0.5 identified the highest proportion for all the CVD risk factors in both genders, even higher than a combination of BMI and WC.
BAI may function as a measure of overall adiposity but it is unlikely to be better than BMI. A combination of BMI and WHtR could have the best clinical utility in identifying patients with CVD risk factors in an adult population in Singapore.
肥胖与心血管疾病（CVD）的危险因素相关，如高血压、糖尿病和血脂异常。在各种肥胖测量方法中，哪一种最有助于预测这些危险因素仍存在争议。2011年提出了一种新的肥胖指数——身体肥胖指数（BAI），尚未在所有人群中进行广泛研究。因此，本研究的目的是比较体重指数（BMI）、腰围（WC）、腰臀比（WHR）、腰高比（WHtR）、身体肥胖指数（BAI）与当地成年人群心血管疾病危险因素之间的关系。
这是一项横断面研究，基于新加坡一家医院进行的员工健康筛查（2012年），涉及1891名年龄在21 - 74岁的受试者（华人占59.1%，马来人占22.2%，印度人占18.7%）。测量了人体测量指标和心血管疾病危险因素变量，并使用了Spearman相关性分析、受试者工作特征（ROC）曲线和多元逻辑回归分析。与BMI、WC和WHtR相比，BAI的相关性、ROC曲线下面积和比值比通常较低，尽管差异往往较小，95%置信区间有重叠。调整BMI后，与WC和WHtR不同，BAI并未进一步增加心血管疾病危险因素的比值比（高血压和低高密度脂蛋白胆固醇除外）。当根据既定临界值对患有各种心血管疾病危险因素的受试者进行分组时，BMI≥23.0 kg/m²和/或WHtR≥0.5在两性中识别出所有心血管疾病危险因素的比例最高，甚至高于BMI和WC的组合。
BAI可作为总体肥胖的一种测量方法，但不太可能优于BMI。在识别新加坡成年人群中具有心血管疾病危险因素的患者方面，BMI和WHtR的组合可能具有最佳的临床效用。
