EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal, Porto, Portugal.
Nutrition. 2019 Jul-Aug;63-64:75-80. doi: 10.1016/j.nut.2018.11.025. Epub 2018 Nov 24.
The aim of the present study was to compare the discriminatory ability of different adiposity indicators in distinguishing subclinical inflammatory levels in individuals 21 y of age.
Data from the EPITeen (Epidemiological Health Investigation of Teenagers in Porto) population-based cohort (N = 1547) was analyzed. Body mass index (BMI), body fat percentage (BF%), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were ascertained to assess their relationship to high-sensitivity C-reactive protein (hs-CRP). Logistic regression models were fitted to examine the association of each adiposity indicator with elevated hs-CRP (≥75th sex-specific percentile). The areas under the curve (AUCs) of the receiver operating characteristic curves were calculated for all adiposity indicators to compare their relative ability to correctly classify individuals with elevated hs-CRP.
After adjustment, all adiposity indicators were significantly associated with high hs-CRP in both sexes, except WHR in women (odds ratio, 1.15; 95% confidence interval [CI], 0.98-1.36). The magnitude of the associations was stronger in women. BMI presented the best discriminatory ability in women (AUC = 0.675; 95% CI, 0.632-0.717; cutoff values >22.6 kg/m). In men, both BF% (AUC = 0.604; 95% CI, 0.557-0.651; cutoff values >18%) and WHtR (AUC = 0.604; 95% CI, 0.557-0.651; cutoff values >0.5) showed the best discriminatory ability. On the contrary, WHR showed the least ability to discriminate high hs-CRP in both sexes (AUC = 0.539; 95% CI, 0.489-0.584 for women and AUC = 0.574; 95% CI, 0.528-0.620 for men).
WHR showed the least discriminatory ability for correctly identifying individuals with elevated hs-CRP. The small differences observed among the adiposity indices hinder the recommendation of a single best adiposity measure as predictor of low-grade inflammatory levels.
本研究旨在比较不同肥胖指标在区分 21 岁人群亚临床炎症水平方面的区分能力。
对基于人群的 EPITeen（波尔图青少年流行病学健康调查）队列（N=1547）的数据进行分析。测量体重指数（BMI）、体脂百分比（BF%）、腰围（WC）、腰臀比（WHR）和腰高比（WHtR），以评估它们与高敏 C 反应蛋白（hs-CRP）的关系。拟合 logistic 回归模型以检查每个肥胖指标与 hs-CRP 升高（≥第 75 个性别特异性百分位数）的关联。计算所有肥胖指标的受试者工作特征曲线下面积（AUC），以比较它们正确分类 hs-CRP 升高个体的相对能力。
调整后，除女性的 WHR（比值比，1.15；95%置信区间[CI]，0.98-1.36）外，所有肥胖指标在两性中均与 hs-CRP 升高显著相关。在女性中，关联的强度更大。BMI 在女性中具有最佳的区分能力（AUC=0.675；95%CI，0.632-0.717；截断值>22.6kg/m）。在男性中，BF%（AUC=0.604；95%CI，0.557-0.651；截断值>18%）和 WHtR（AUC=0.604；95%CI，0.557-0.651；截断值>0.5）均表现出最佳的区分能力。相反，WHR 在两性中显示出最低的区分 hs-CRP 的能力（女性 AUC=0.539；95%CI，0.489-0.584，男性 AUC=0.574；95%CI，0.528-0.620）。
WHR 对正确识别 hs-CRP 升高的个体的区分能力最低。肥胖指标之间观察到的微小差异使得无法推荐单一的最佳肥胖指标作为低度炎症水平的预测因子。
