Buchan Duncan S, Boddy Lynne M, Grace Fergal M, Brown Elise, Sculthorpe Nicholas, Cunningham Conor, Murphy Marie H, Dagger Rebecca, Foweather Lawrence, Graves Lee E F, Hopkins Nicola D, Stratton Gareth, Baker Julien S
Institute of Clinical Exercise and Health Science, University of the West of Scotland, Lanarkshire, Hamilton, ML3 0JB, United Kingdom.
The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, United Kingdom.
Am J Hum Biol. 2017 May 6;29(3). doi: 10.1002/ajhb.22934. Epub 2016 Nov 1.
To evaluate the ability of BMI, WC, and WHtR to identify increased cardiometabolic risk in pre-adolescents.
This is a cross-sectional study involving 192 children (10.92 ± 0.58 years, 56% female) from the United Kingdom between 2010 and 2013. Receiver operating characteristic curves determined the discriminatory ability of BMI, WC and WHtR to identify individuals with increased cardiometabolic risk (increased clustered triglycerides, HDL-cholesterol, systolic blood pressure, cardiorespiratory fitness, and glucose).
A WHtR ≥ 0.5 increased the odds by 5.2 (95% confidence interval 2.6 - 10.3) of having increased cardiometabolic risk. Similar associations were observed for BMI and WC. Both BMI-z and WHtR were fair predictors of increased cardiometabolic risk, although BMI-z demonstrated the best trade-off between sensitivity and specificity, 76.1% and 63.6%, compared with 68.1% and 65.5% for WHtR. Cross-validation analysis revealed that BMI-z and WHtR correctly classified 84% of individuals (kappa score = 0.671, 95% CI 0.55, 0.79). The sensitivity of the cut-points suggests that 89.3% of individuals were correctly classified as being at risk with only 10.7% misdiagnosed whereas the specificity of the cut-points indicated that 77.8% of individuals were correctly identified as being healthy with 22.2% of individuals incorrectly diagnosed as being at risk.
Findings suggest that WHtR provides similar cardiometabolic risk estimates to age and sex adjusted BMI.
评估体重指数（BMI）、腰围（WC）和腰高比（WHtR）识别青春期前儿童心脏代谢风险增加的能力。
这是一项横断面研究，纳入了2010年至2013年间来自英国的192名儿童（10.92±0.58岁，56%为女性）。受试者工作特征曲线确定了BMI、WC和WHtR识别心脏代谢风险增加个体（聚集性甘油三酯、高密度脂蛋白胆固醇、收缩压、心肺适能和血糖升高）的鉴别能力。
WHtR≥0.5使心脏代谢风险增加的几率提高了5.2倍（95%置信区间2.6 - 10.3）。BMI和WC也观察到类似的关联。BMI-z和WHtR都是心脏代谢风险增加的中等预测指标，尽管BMI-z在敏感性和特异性之间表现出最佳权衡，分别为76.1%和63.6%，而WHtR为68.1%和65.5%。交叉验证分析显示，BMI-z和WHtR正确分类了84%的个体（kappa评分=0.671，95%CI 0.55，0.79）。切点的敏感性表明，89.3%的个体被正确分类为有风险，只有10.7%被误诊；而切点的特异性表明，77.8%的个体被正确识别为健康，22.2%的个体被错误诊断为有风险。
研究结果表明，WHtR提供的心脏代谢风险估计与年龄和性别调整后的BMI相似。
