Jayawardene Wasantha, Dickinson Stephanie, Lohrmann David, Agley Jon
Applied Health Science, School of Public Health Bloomington, Indiana University, 116 SPH-B, 1025 E. 7th Street, Bloomington, IN 47405, USA.
Institute for Research on Addictive Behavior, School of Public Health Bloomington, Indiana University, 501 N. Morton St., Suite 110, Bloomington, IN 47404, USA.
J Obes. 2018 Sep 6;2018:7456461. doi: 10.1155/2018/7456461. eCollection 2018.
To determine whether arm circumference-to-height ratio (AHtR) predicts adolescents' cardiometabolic risk and how its predictive statistics compare to those of body mass index (BMI) percentile.
Pooled data for adolescents ( = 12,269, 12-18 years) from the National Health and Nutrition Examination Survey, U.S., 1999-2014, were analyzed. For each of the eight cardiometabolic variables, borderline-risk and high-risk were considered unhealthy, and being unhealthy on any variable was considered "unhealthy overall" in terms of cardiometabolic risk. Area under the curve and were used to compare BMI percentile and AHtR for accuracy in predicting risk.
Female AHtR ≥ 0.19 and BMI percentile ≥ 94 and male AHtR ≥ 0.16 and BMI percentile ≥ 64 predicted a probability of >0.7 being unhealthy overall. AHtR predicted overall risk and unhealthy levels of six variables more accurately than BMI percentile. Significant differences were overall risk ( = 4.18; =0.041), total cholesterol ( = 8.68; =0.003), glycated hemoglobin ( = 5.24; =0.022), and systolic pressure ( = 5.10; =0.024). AHtR had higher accuracy in predicting high-density cholesterol, fasting glucose, glycated hemoglobin, and systolic/diastolic pressures plus higher specificity in predicting all variables except triglycerides. BMI percentile had higher sensitivity for all variables. Sensitivity and accuracy were higher for males. No significant race/ethnicity differences were observed.
Without needing adjustment for age and weight, AHtR can predict some cardiometabolic risk factors of adolescents, especially of males, more accurately than BMI percentile, thus facilitating population risk estimation and early interventions. Further research is required to validate these findings in younger children.
确定臂围与身高比（AHtR）是否能预测青少年的心血管代谢风险，以及其预测统计数据与体重指数（BMI）百分位数的预测统计数据相比如何。
分析了来自1999 - 2014年美国国家健康与营养检查调查的青少年（n = 12269，12 - 18岁）的汇总数据。对于八个心血管代谢变量中的每一个，临界风险和高风险被视为不健康，并且在任何变量上不健康在心血管代谢风险方面被视为“总体不健康”。曲线下面积和……用于比较BMI百分位数和AHtR在预测风险方面的准确性。
女性AHtR≥0.19且BMI百分位数≥94，男性AHtR≥0.16且BMI百分位数≥64预测总体不健康的概率>0.7。AHtR比BMI百分位数更准确地预测了总体风险和六个变量的不健康水平。显著差异在于总体风险（……= 4.18；……= 0.041）、总胆固醇（……= 8.68；……= 0.003）、糖化血红蛋白（……= 5.24；……= 0.022）和收缩压（……= 5.10；……= 0.024）。AHtR在预测高密度胆固醇、空腹血糖、糖化血红蛋白以及收缩压/舒张压方面具有更高的准确性，并且在预测除甘油三酯外的所有变量时具有更高的特异性。BMI百分位数对所有变量具有更高的敏感性。男性的敏感性和准确性更高。未观察到显著的种族/族裔差异。
无需对年龄和体重进行调整，AHtR比BMI百分位数更能准确预测青少年尤其是男性的一些心血管代谢风险因素，从而有助于人群风险评估和早期干预。需要进一步研究以在年幼儿童中验证这些发现。
