Caminha Tainá C S, Ferreira Haroldo S, Costa Narithania S, Nakano Ricardo P, Carvalho Renata Elyonara S, Xavier Antônio F S, Assunção Monica L
aFaculty of Nutrition bInstitute of Biological and Health Sciences, Federal University of Alagoas, Campus A. C. Simões, Cidade Universitária, Maceió, AL, Brazil.
Medicine (Baltimore). 2017 Jan;96(2):e5874. doi: 10.1097/MD.0000000000005874.
The WHO recommends the use of some anthropometric parameters as a screening resource for individuals under cardiometabolic risk. However, in the validation of these indicators, Brazilian women were not included. These women have different anthropometric profile compared to women who integrated the samples of the validation studies. We aimed to verify the accuracy of anthropometric indicators as a resource for the screening of women with hypertension. A cross-sectional study, with a probability sample of 3143 women (20-49 years) from the state of Alagoas (northeast of Brazil), was carried out. Hypertension was identified by systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or regular use of antihypertensive drugs. The anthropometric indicators analyzed were BMI, waist circumference, waist-to-hip ratio, waist-to-height ratio (WHtR), body fat percentage, and conicity index. The accuracy definition of the indicators and the identification of best cut-off points were carried out on the basis of ROC curve analysis and Youden index, respectively. The prevalence of hypertension was 21.8%. All indicators used in hypertension identification had area under the ROC curve (AUC) >0.5. The WHtR with cut-off point of 0.54 was the best performance indicator (AUC = 0.72; P < 0.05; sensitivity = 67%, specificity = 66%). The WHtR with cut-off point of 0.54 has constituted the most accurate indicator in the screening of women with hypertension. In the absence of specific studies and considering the largest ethnic proximity and environmental/epidemiological similarity, the findings now obtained can be extended to women of other Brazilian states, especially those in the Northeastern region.
世界卫生组织建议使用一些人体测量参数作为筛查心血管代谢风险个体的资源。然而，在这些指标的验证过程中，未纳入巴西女性。与纳入验证研究样本的女性相比，这些巴西女性具有不同的人体测量特征。我们旨在验证人体测量指标作为筛查高血压女性资源的准确性。我们开展了一项横断面研究，从巴西东北部阿拉戈斯州抽取了3143名年龄在20至49岁之间的女性作为概率样本。通过收缩压（SBP）≥140 mmHg和/或舒张压≥90 mmHg和/或规律使用降压药物来确定高血压。分析的人体测量指标包括体重指数（BMI）、腰围、腰臀比、腰高比（WHtR）、体脂百分比和锥度指数。指标的准确性定义和最佳切点的确定分别基于ROC曲线分析和尤登指数。高血压患病率为21.8%。用于识别高血压的所有指标的ROC曲线下面积（AUC）均>0.5。切点为0.54的WHtR是最佳性能指标（AUC = 0.72；P < 0.05；敏感性 = 67%，特异性 = 66%）。切点为0.54的WHtR是筛查高血压女性最准确的指标。在缺乏具体研究的情况下，考虑到最大的种族相近性以及环境/流行病学相似性，目前获得的研究结果可推广至巴西其他州的女性，尤其是东北地区的女性。
