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肥胖人体测量学指标在预测肥胖2型糖尿病患者微血管并发症中的应用

The Use of Anthropometric Measurements of Obesity in Prediction of Microvascular Complications in Obese Type 2 Diabetic Patients.

作者信息

Bulum Tomislav, Blaslov Kristina, Duvnjak Lea

机构信息

Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia

School of Medicine, University of Zagreb, Zagreb, Croatia

出版信息

Acta Clin Croat. 2016 Jun;55(2):217-23. doi: 10.20471/acc.2016.55.02.06.

Abstract

Waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) are superior to body mass index (BMI) in predicting type 2 diabetes mellitus (T2DM) development. The aim of this study was to investigate the predictive power of BMI, WC, WHR and WHtR for microvascular (chronic kidney disease (CKD), retinopathy and peripheral neuropathy) prevalence in obese (BMI ≥35 kg/m2) T2DM patients. This cross-sectional study included 125 T2DM patients of both genders. The validity of each test was assessed by Receiver Operating Characteristic (ROC) curves; the area under the curve (AUC) was calculated for each anthropometric parameter and microvascular complication. AUCs for WHtR were significantly higher than AUCs for WC with respect to CKD. Optimal cut-off for WHtR was >0.593 and WC >112 cm regarding CKD. The AUC for peripheral neuropathy was significant only for WHR and optimal cut-off for WHR was >1.409 with low sensitivity and high specificity. Our study demonstrated that WHtR, WC and WHR might be used as simple and noninvasive methods for detection of CKD and peripheral neuropathy in obese T2DM population.

摘要

腰围(WC)、腰臀比(WHR)和腰高比(WHtR)在预测2型糖尿病(T2DM)发生方面优于体重指数(BMI)。本研究的目的是调查BMI、WC、WHR和WHtR对肥胖(BMI≥35kg/m²)T2DM患者微血管病变(慢性肾脏病(CKD)、视网膜病变和周围神经病变)患病率的预测能力。这项横断面研究纳入了125例男女T2DM患者。通过受试者工作特征(ROC)曲线评估每个检测指标的有效性;计算每个人体测量参数和微血管并发症的曲线下面积(AUC)。就CKD而言,WHtR的AUC显著高于WC的AUC。关于CKD,WHtR的最佳截断值>0.593,WC>112cm。仅WHR对周围神经病变的AUC具有统计学意义,WHR的最佳截断值>1.409,敏感性低、特异性高。我们的研究表明,WHtR、WC和WHR可作为肥胖T2DM人群检测CKD和周围神经病变的简单且非侵入性方法。

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