Tian Simiao, Zhang Xiuzhi, Xu Yang, Dong Huimin
Department of Scientific Research Project Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning Province, People's Republic of China.
Medicine (Baltimore). 2016 Aug;95(34):e4642. doi: 10.1097/MD.0000000000004642.
The body mass index (BMI) and waist circumference (WC) are commonly used anthropometric measures for predicting cardiovascular diseases risk factors, but it is uncertain which specific measure might be the most appropriate predictor of a cluster of cardiometabolic abnormalities (CMA) in Chinese adults. A body shape index (ABSI) and body roundness index (BRI) have been recently developed as alternative anthropometric indices that may better reflect health status. The main aims of this study were to investigate the predictive capacity of ABSI and BRI in identifying various CMA compared to BMI, WC, waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR), and to determine whether there exists a best single predictor of all CMA.We used data from the 2009 wave of the China Health and Nutrition Survey, and the final analysis included 8126 adults aged 18 to 85 years with available fasting blood samples and anthropometric measurements. Receiver-operating characteristic (ROC) analyses were conducted to assess the best anthropometric indices to predict the risk of hypertension, diabetes, dyslipidemia, hyperuricemia, and metabolic syndrome (MetS). Logistic regression models were fit to evaluate the OR of each CMA according to anthropometric indices.In women, the ROC analysis showed that BRI and WHtR had the best predictive capability in identifying all of CMA (area under the curves [AUCs] ranged from 0.658 to 0.721). In men, BRI and WHtR were better predictor of hypertension, diabetes, and at least 1 CMA (AUC: 0.668, 0.708, and 0.698, respectively), whereas BMI and WC were more sensitive predictor of dyslipidemia, hyperuricemia, and MetS. Furthermore, the ABSI showed the lowest AUCs for each CMA. According to the multivariate logistic regression analysis, BRI and WHtR were superior in discriminating hyperuricemia and at least 1 CMA while BMI performed better in predicting hypertension, diabetes, and MetS in women. In men, WC and BRI were the 2 best predictor of all CMA except MetS, and the ABSI was the worst.Our results showed the novel index BRI could be used as a single suitable anthropometric measure in simultaneously identifying a cluster of CMA compared to BMI and WHtR, especially in Chinese women, whereas the ABSI showed the weakest discriminative power.
体重指数（BMI）和腰围（WC）是预测心血管疾病风险因素常用的人体测量指标，但在中国成年人中，尚不确定哪种具体指标可能是一组心脏代谢异常（CMA）的最合适预测指标。体型指数（ABSI）和体圆度指数（BRI）是最近开发的可更好反映健康状况的替代人体测量指标。本研究的主要目的是调查与BMI、WC、腰臀比（WHpR）和腰高比（WHtR）相比，ABSI和BRI在识别各种CMA方面的预测能力，并确定是否存在所有CMA的最佳单一预测指标。我们使用了中国健康与营养调查2009年的数据，最终分析纳入了8126名18至85岁的成年人，他们均有空腹血样和人体测量数据。进行了受试者工作特征（ROC）分析，以评估预测高血压、糖尿病、血脂异常、高尿酸血症和代谢综合征（MetS）风险的最佳人体测量指标。拟合逻辑回归模型，根据人体测量指标评估每种CMA的比值比（OR）。在女性中，ROC分析表明，BRI和WHtR在识别所有CMA方面具有最佳预测能力（曲线下面积[AUC]范围为0.658至0.721）。在男性中，BRI和WHtR是高血压、糖尿病和至少一种CMA的较好预测指标（AUC分别为0.668、0.708和0.698），而BMI和WC是血脂异常、高尿酸血症和MetS更敏感预测指标。此外，ABSI在每种CMA中显示出最低的AUC。根据多变量逻辑回归分析，BRI和WHtR在区分高尿酸血症和至少一种CMA方面更具优势，而BMI在预测女性高血压、糖尿病和MetS方面表现更好。在男性中，WC和BRI是除MetS外所有CMA的两个最佳预测指标，而ABSI最差。我们的结果表明，与BMI和WHtR相比，新指标BRI可作为同时识别一组CMA的单一合适人体测量指标，尤其是在中国女性中，而ABSI的判别力最弱。
