Wang Fei, Chen Yintao, Chang Ye, Sun Guozhe, Sun Yingxian
Department of Cardiology, Jinhua Municipal Central Hospital, 351 Mingyue Street, Wucheng District, Jinhua, 321000, People's Republic of China.
Department of Cardiology, the First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, People's Republic of China.
BMC Cardiovasc Disord. 2018 Jan 30;18(1):14. doi: 10.1186/s12872-018-0754-z.
Various anthropometric indices can be used to estimate obesity, and it is important to determine which one is the best in predicting the risk of coronary heart disease (CHD) and to define the optimal cut-off point for the best index.
This cross-sectional study investigated a consecutive sample of 11,247 adults, who had lived in rural areas of China and were older than 35 years of age. Eight obesity indices, including the body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), abdominal volume index (AVI), body adiposity index (BAI), body roundness index (BRI) and a body shape index (ABSI) were investigated. The risk of CHD was evaluated by the 10-year coronary event risk (Framingham risk score). Receiver operating characteristic (ROC) curve analyses were used to evaluate the predictive ability of the obesity indices for CHD risk.
Of the whole population, 3636 (32.32%) participants had a risk score higher than 10%. Those who suffered medium or high CHD risk were more likely to have higher mean anthropometric indices, except for BMI in males. In the multivariate-adjusted logistic regression, all these anthropometric measurements were statistically associated with CHD risk in males. After adjusting for all the possible confounders, these anthropometric measurements, except for ABSI, remained as independent indicators of CHD risk in females. According to the ROC analyses, ABSI provided the largest area under the curve (AUC) value in males, and BMI showed the lowest AUC value, with AUC varying from 0.52 to 0.60. WHtR and BRI provided the largest AUC value in female, and similarly, BMI showed the lowest AUC value, with AUC varying from 0.59 to 0.70. The optimal cut-off values were as follows: WHtR (females: 0.54), BRI (females: 4.21), and ABSI (males: 0.078).
ABSI was the best anthropometric index for estimating CHD risk in males, and WHtR and BRI were the best indicators in females. Males should maintain an ABSI of less than 0.078, and females should maintain a WHtR of less than 0.54 or a BRI of less than 4.21.
多种人体测量指标可用于评估肥胖，确定哪一种指标最能预测冠心病（CHD）风险以及为最佳指标定义最佳切点十分重要。
这项横断面研究调查了11247名居住在中国农村地区、年龄超过35岁的成年人连续样本。研究了八项肥胖指标，包括体重指数（BMI）、腰围（WC）、腰臀比（WHR）、腰高比（WHtR）、腹围指数（AVI）、体脂率指数（BAI）、身体圆润度指数（BRI）和身体形状指数（ABSI）。通过10年冠心病事件风险（弗雷明汉风险评分）评估冠心病风险。采用受试者工作特征（ROC）曲线分析评估肥胖指标对冠心病风险的预测能力。
在整个人口中，3636名（32.32%）参与者的风险评分高于10%。除男性的BMI外，患有中度或高度冠心病风险的人更有可能具有较高的平均人体测量指标。在多变量调整的逻辑回归中，所有这些人体测量指标在男性中均与冠心病风险存在统计学关联。在调整所有可能的混杂因素后，除ABSI外，这些人体测量指标在女性中仍是冠心病风险的独立指标。根据ROC分析，ABSI在男性中提供了最大的曲线下面积（AUC）值，而BMI显示出最低的AUC值，AUC范围为0.52至0.60。WHtR和BRI在女性中提供了最大的AUC值，同样，BMI显示出最低的AUC值，AUC范围为0.59至0.70。最佳切点值如下：WHtR（女性：0.54）、BRI（女性：4.21）和ABSI（男性：0.078）。
ABSI是评估男性冠心病风险的最佳人体测量指标，WHtR和BRI是评估女性冠心病风险的最佳指标。男性应将ABSI维持在0.078以下，女性应将WHtR维持在0.54以下或BRI维持在4.21以下。
