Peng Yaguang, Li Wei, Wang Yang, Bo Jian, Chen Hui
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
PLoS One. 2015 Dec 7;10(12):e0144539. doi: 10.1371/journal.pone.0144539. eCollection 2015.
To explore a scientific boundary of WHtR to evaluate central obesity and CVD risk factors in a Chinese adult population. The data are from the Prospective Urban Rural Epidemiology (PURE) China study that was conducted from 2005-2007. The final study sample consisted of 43 841 participants (18 019 men and 25 822 women) aged 35-70 years. According to the group of CVD risk factors proposed by Joint National Committee 7 version and the clustering of risk factors, some diagnosis parameters, such as sensitivity, specificity and receiver operating characteristic (ROC) curve least distance were calculated for hypertension, diabetes, high serum triglyceride (TG), high serum low density lipoprotein cholesterol (LDL-C), low serum high density lipoprotein cholesterol (HDL-C) and clustering of risk factors (number≥2) to evaluate the efficacy at each value of the WHtR cut-off point. The upper boundary value for severity was fixed on the point where the specificity was above 90%. The lower boundary value, which indicated above underweight, was determined by the percentile distribution of WHtR, specifically the 5th percentile (P5) for both males and females population. Then, based on convenience and practical use, the optimal boundary values of WHtR for underweight and obvious central obesity were determined. For the whole study population, the optimal WHtR cut-off point for the CVD risk factor cluster was 0.50. The cut-off points for severe central obesity were 0.57 in the whole population. The upper boundary values of WHtR to detect the risk factor cluster with specificity above 90% were 0.55 and 0.58 for men and women, respectively. Additionally, the cut-off points of WHtR for each of four cardiovascular risk factors with specificity above 90% in males ranged from 0.55 to 0.56, whereas in females, it ranged from 0.57 to 0.58. The P5 of WHtR, which represents the lower boundary values of WHtR that indicates above underweight, was 0.40 in the whole population. WHtR 0.50 was an optimal cut-off point for evaluating CVD risks in Chinese adults of both genders. The optimal boundaries of WHtR were 0.40 and 0.57, indicating low body weight and severe risk for CVD, respectively, in Chinese adults.
探索腰围身高比（WHtR）在评估中国成年人群中心性肥胖及心血管疾病（CVD）风险因素方面的科学界限。数据来自2005 - 2007年开展的中国城乡前瞻性流行病学（PURE）研究。最终研究样本包括43841名年龄在35 - 70岁的参与者（18019名男性和25822名女性）。根据美国国家联合委员会第7版提出的CVD风险因素分组以及风险因素聚类情况，计算了高血压、糖尿病、高血清甘油三酯（TG）、高血清低密度脂蛋白胆固醇（LDL - C）、低血清高密度脂蛋白胆固醇（HDL - C）以及风险因素聚类（数量≥2）的一些诊断参数，如敏感度、特异度和受试者工作特征（ROC）曲线最小距离，以评估WHtR切点各值的有效性。严重程度的上限值固定在特异度高于90%的点上。下限值，即表示高于体重过低的界限，由WHtR的百分位数分布确定，具体为男性和女性人群的第5百分位数（P5）。然后，基于便利性和实际应用，确定了体重过低和明显中心性肥胖的WHtR最佳界限值。对于整个研究人群，CVD风险因素聚类的最佳WHtR切点为0.50。全人群中严重中心性肥胖的切点为0.57。检测特异度高于90%的风险因素聚类的WHtR上限值，男性为0.55，女性为0.58。此外，男性中特异度高于90%的四种心血管风险因素各自的WHtR切点范围为0.55至0.56，而女性为0.57至0.58。代表高于体重过低的WHtR下限值的P5在全人群中为0.40。WHtR 0.50是评估中国成年男女CVD风险的最佳切点。在中国成年人中，WHtR的最佳界限分别为0.40和0.57，分别表示低体重和CVD的严重风险。
