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中国东北地区成年人中用于预测心血管疾病风险因素及代谢综合征的肥胖指数最佳切点

Optimal cut-off of obesity indices to predict cardiovascular disease risk factors and metabolic syndrome among adults in Northeast China.

作者信息

Yu Jianxing, Tao Yuchun, Tao Yuhui, Yang Sen, Yu Yaqin, Li Bo, Jin Lina

机构信息

Epidemiology and Biostatistics, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun, 130021, Jilin, China.

Department of Immunization Program, Changchun Center for Disease Control and Prevention, Changchun, 130021, Jilin, China.

出版信息

BMC Public Health. 2016 Oct 13;16(1):1079. doi: 10.1186/s12889-016-3694-5.

Abstract

BACKGROUND

CVD risk factors (hypertension, dyslipidemia and diabetes) and MetS are closely related to obesity. The selection of an optimal cut-off for various obesity indices is particularly important to predict CVD risk factors and MetS.

METHODS

Sixteen thousand seven hundred sixty-six participants aged 18-79 were recruited in Jilin Province in 2012. Five obesity indices, including BMI, WC, WHR, WHtR and BAI were investigated. ROC analyses were used to evaluate the predictive ability and determine the optimal cut-off values of the obesity indices for CVD risk factors and MetS.

RESULTS

BMI had the highest adjusted ORs, and the adjusted ORs for hypertension, dyslipidemia, diabetes and MetS were 1.19 (95 % CI, 1.17 to 1.20), 1.20 (95 % CI, 1.19 to 1.22), 1.12 (95 % CI, 1.10 to 1.13), and 1.40 (95 % CI, 1.38 to 1.41), respectively. However, BMI did not always have the largest adjusted AUROC. In general, the young age group (18 ~ 44) had higher ORs and AUROCs for CVD risk factors and MetS than those of the other age groups. In addition, the optimal cut-off values for WC and WHR in males were relatively higher than those in females, whereas the BAI in males was comparatively lower than that in females.

CONCLUSIONS

The appropriate obesity index, with the corresponding optimal cut-off values, should be selected in different research studies and populations. Generally, the obesity indices and their optimal cut-off values are: BMI (24 kg/m), WC (male: 85 cm; female: 80 cm), WHR (male: 0.88; female: 0.85), WHtR (0.50), and BAI (male: 25 cm; female: 30 cm). Moreover, WC is superior to other obesity indices in predicting CVD risk factors and MetS in males, whereas, WHtR is superior to other obesity indices in predicting CVD risk factors and MetS in females.

摘要

背景

心血管疾病风险因素(高血压、血脂异常和糖尿病)以及代谢综合征与肥胖密切相关。选择各种肥胖指数的最佳切点对于预测心血管疾病风险因素和代谢综合征尤为重要。

方法

2012年在吉林省招募了16766名年龄在18 - 79岁的参与者。研究了包括体重指数(BMI)、腰围(WC)、腰臀比(WHR)、腰高比(WHtR)和体脂指数(BAI)在内的五种肥胖指数。采用ROC分析来评估预测能力,并确定肥胖指数对心血管疾病风险因素和代谢综合征的最佳切点值。

结果

BMI的调整后比值比最高,高血压、血脂异常、糖尿病和代谢综合征的调整后比值比分别为1.19(95%置信区间,1.17至1.20)、1.20(95%置信区间,1.19至1.22)、1.12(95%置信区间,1.10至1.13)和1.40(95%置信区间,1.38至1.41)。然而,BMI并不总是具有最大的调整后曲线下面积(AUROC)。总体而言,年轻年龄组(18至44岁)心血管疾病风险因素和代谢综合征的比值比和AUROC高于其他年龄组。此外,男性WC和WHR的最佳切点值相对高于女性,而男性的BAI相对低于女性。

结论

在不同的研究和人群中应选择合适的肥胖指数及其相应的最佳切点值。一般来说,肥胖指数及其最佳切点值为:BMI(24kg/m²)、WC(男性:85cm;女性:80cm)、WHR(男性:0.88;女性:0.85)、WHtR(0.50)和BAI(男性:25cm;女性:30cm)。此外,在预测男性心血管疾病风险因素和代谢综合征方面,WC优于其他肥胖指数,而在预测女性心血管疾病风险因素和代谢综合征方面,WHtR优于其他肥胖指数。

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