Kruger H Salome, Schutte Aletta E, Walsh Corinna M, Kruger Annamarie, Rennie Kirsten L
Centre of Excellence for Nutrition, North-West University, Potchefstroom, 2520, South Africa.
Hypertension in Africa Research Team, North-West University, Potchefstroom, South Africa.
Eur J Nutr. 2017 Feb;56(1):193-202. doi: 10.1007/s00394-015-1069-9. Epub 2015 Oct 12.
To determine optimal body mass index (BMI) cut-points for the identification of cardiometabolic risk in black South African adults.
We performed a cross-sectional study of a weighted sample of healthy black South Africans aged 25-65 years (721 men, 1386 women) from the North West and Free State Provinces. Demographic, lifestyle and anthropometric measures were taken, and blood pressure, fasting serum triglycerides, high-density lipoprotein (HDL) cholesterol and blood glucose were measured. We defined elevated cardiometabolic risk as having three or more risk factors according to international metabolic syndrome criteria. Receiver operating characteristic curves were applied to identify an optimal BMI cut-point for men and women.
BMI had good diagnostic performance to identify clustering of three or more risk factors, as well as individual risk factors: low HDL-cholesterol, elevated fasting glucose and triglycerides, with areas under the curve >.6, but not for high blood pressure. Optimal BMI cut-points averaged 22 kg/m for men and 28 kg/m for women, respectively, with better sensitivity in men (44.0-71.9 %), and in women (60.6-69.8 %), compared to a BMI of 30 kg/m (17-19.1, 53-61.4 %, respectively). Men and women with a BMI >22 and >28 kg/m, respectively, had significantly increased probability of elevated cardiometabolic risk after adjustment for age, alcohol use and smoking.
In black South African men, a BMI cut-point of 22 kg/m identifies those at cardiometabolic risk, whereas a BMI of 30 kg/m underestimates risk. In women, a cut-point of 28 kg/m, approaching the WHO obesity cut-point, identifies those at risk.
确定用于识别南非黑人成年人心脏代谢风险的最佳体重指数（BMI）切点。
我们对来自西北省和自由邦省的25至65岁健康南非黑人（721名男性，1386名女性）的加权样本进行了横断面研究。记录了人口统计学、生活方式和人体测量指标，并测量了血压、空腹血清甘油三酯、高密度脂蛋白（HDL）胆固醇和血糖。根据国际代谢综合征标准，我们将心脏代谢风险升高定义为具有三个或更多风险因素。应用受试者工作特征曲线来确定男性和女性的最佳BMI切点。
BMI在识别三个或更多风险因素的聚集以及个体风险因素方面具有良好的诊断性能：低HDL胆固醇、空腹血糖和甘油三酯升高，曲线下面积>.6，但对高血压则不然。男性和女性的最佳BMI切点平均分别为22kg/m²和28kg/m²，与BMI为30kg/m²相比，男性（44.0 - 71.9%）和女性（60.6 - 69.8%）的敏感性更高（BMI为30kg/m²时，男性和女性的敏感性分别为17 - 19.1%、53 - 61.4%）。在调整年龄、饮酒和吸烟因素后，BMI分别>22kg/m²和>28kg/m²的男性和女性，心脏代谢风险升高的概率显著增加。
在南非黑人男性中，BMI切点为22kg/m²可识别出有心脏代谢风险的人群，而BMI为30kg/m²会低估风险。在女性中，接近世界卫生组织肥胖切点的28kg/m²的切点可识别出有风险的人群。
