比较糖尿病青少年中两种腰高比测量值与心血管代谢危险因素的关系。
Comparing Two Waist-to-Height Ratio Measurements with Cardiometabolic Risk Factors among Youth with Diabetes.
作者信息
Liu Lenna L, Kahn Henry S, Pettitt David J, Fino Nora F, Morgan Tim, Maahs David M, Crimmins Nancy A, Lamichhane Archana P, Liese Angela D, D'Agostino Ralph B, Bell Ronny A
机构信息
University of Washington and Seattle Children's Hospital, Seattle, WA 98122, USA.
Centers for Disease Control and Prevention, Mail Stop K-10, 4770 Buford Highway, NE Atlanta, GA 30341-3717, USA.
出版信息
Int J Child Health Nutr. 2016;5(3):87-94.
BACKGROUND
Waist circumference (WC) is commonly measured by either the World Health Organization (WHO) or National Health and Nutrition Examination Survey (NHANES) protocol.
OBJECTIVE
Compare the associations of WHO . NHANES WC-to-height ratio (WHtR) protocols with cardiometabolic risk factors (CMRFs) in a sample of youth with diabetes.
METHODS
For youth (10-19 years old with type 1 [N=3082] or type 2 [N=533] diabetes) in the SEARCH for Diabetes in Youth Study, measurements were obtained of WC (by two protocols), weight, height, fasting lipids (total cholesterol, triglycerides, HDL cholesterol, Non-HDL cholesterol) and blood pressures. Associations of CMRFs with WHO and NHANES WHtR were modeled stratified by body mass index (BMI) percentiles for age/sex: lower BMI (<85 BMI percentile; N=2071) . higher BMI (≥85 percentile; N=1594).
RESULTS
Among lower-BMI participants, both NHANES and WHO WHtR were associated (p<0.005) with all CMRFs except blood pressure. Among higher-BMI participants, both NHANES and WHO WHtR were associated (p<0.05) with all CMRFs. WHO WHtR was more strongly associated (p<0.05) than NHANES WHtR with triglycerides, non-HDL cholesterol, and systolic blood pressure in lower-BMI participants. Among high-BMI participants, WHO WHtR was more strongly associated (p<0.05) than NHANES WHtR with triglycerides and systolic blood pressure.
CONCLUSION
Among youth with diabetes, WHtR calculated from either WC protocol captures cardiometabolic risk. The WHO WC protocol may be preferable to NHANES WC.
背景
腰围（WC）通常按照世界卫生组织（WHO）或美国国家健康与营养检查调查（NHANES）的方案进行测量。
目的
比较WHO和NHANES的WC与身高比值（WHtR）方案与糖尿病青年样本中心血管代谢危险因素（CMRFs）之间的关联。
方法
在青少年糖尿病研究（SEARCH for Diabetes in Youth Study）中，对10至19岁的1型糖尿病患者（N = 3082）和2型糖尿病患者（N = 533）进行测量，获取WC（通过两种方案）、体重、身高、空腹血脂（总胆固醇、甘油三酯、高密度脂蛋白胆固醇、非高密度脂蛋白胆固醇）和血压数据。根据年龄/性别的体重指数（BMI）百分位数对CMRFs与WHO和NHANES的WHtR之间的关联进行分层建模：较低BMI（<85 BMI百分位数；N = 2071）和较高BMI（≥85百分位数；N = 1594）。
结果
在较低BMI参与者中，NHANES和WHO的WHtR均与除血压外的所有CMRFs相关（p<0.005）。在较高BMI参与者中，NHANES和WHO的WHtR均与所有CMRFs相关（p<0.05）。在较低BMI参与者中，WHO的WHtR与甘油三酯、非高密度脂蛋白胆固醇和收缩压的关联比NHANES的WHtR更强（p<0.05）。在高BMI参与者中，WHO的WHtR与甘油三酯和收缩压的关联比NHANES的WHtR更强（p<0.05）。
结论
在糖尿病青年中，根据任何一种WC方案计算出的WHtR都能反映心血管代谢风险。WHO的WC方案可能优于NHANES的WC方案。
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