Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.
Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.
PLoS One. 2019 Apr 29;14(4):e0216069. doi: 10.1371/journal.pone.0216069. eCollection 2019.
This study examined a range of anthropometric indices and their relationships with metabolic syndrome (MetS). Despite recommendations that central obesity assessment should be employed as a marker of metabolic health, there is no consensus regarding the protocol for measurement. The present study included 720 men aged 71 ± 8 years and 919 women aged 71 ± 7 years from a rural village. We examined the relationship between anthropometric indices {e.g., body mass index (BMI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHpR)}, and MetS based on the modified criteria of the National Cholesterol Education Program's Adult Treatment Panel (NCEP-ATP) III report in a cross-sectional (N = 1,639) and cohort (N = 377) data. A receiver operating curve (ROC) analysis was performed to determine the optimal cut-off value and best discriminatory value of each of these anthropometric indices to predict MetS. In the cross-sectional study, WHtR as well as BMI and WHpR showed significantly predictive abilities for MetS in both genders; and WHtR showed the strongest predictive ability for the presence of MetS. Also in the cohort study, WHtR as well as BMI and WHpR showed significantly predictive abilities for incident MetS in both genders, and in men WHtR showed the strongest predictive ability for incident MetS, but in women BMI showed the strongest predictive ability. In the cross-sectional study, the optimal WHtR cutoff values were 0.52 (sensitivity, 71.0%; specificity, 77.9%) for men and 0.53 (sensitivity, 79.8%; specificity, 75.7%) for women. In the cohort study, the optimal WHtR values were 0.50 (sensitivity, 60.7%; specificity, 73.2%) for men and 0.50 (sensitivity, 75.0%; specificity, 56.1%) for women. Increased WHtR was significantly and independently associated with prevalence of MetS in both genders. These results suggest that WHtR is a useful screening tool for determining metabolic risk in Japanese elderly community dwelling individuals.
这项研究考察了一系列人体测量指数及其与代谢综合征（MetS）的关系。尽管有建议称，应将中心性肥胖评估作为代谢健康的标志物，但对于测量方法尚未达成共识。本研究纳入了一个农村社区的 720 名 71 ± 8 岁男性和 919 名 71 ± 7 岁女性。我们根据美国国家胆固醇教育计划成人治疗专家组（NCEP-ATP）III 报告的改良标准，在横断面（n = 1639）和队列（n = 377）数据中，研究了人体测量指数（如 BMI、腰高比（WHtR）、腰臀比（WHpR））与 MetS 的关系。我们进行了受试者工作特征曲线（ROC）分析，以确定这些人体测量指数预测 MetS 的最佳截断值和最佳鉴别值。在横断面研究中，WHtR 以及 BMI 和 WHpR 在两性中均对 MetS 具有显著的预测能力；而 WHtR 对 MetS 的存在具有最强的预测能力。同样在队列研究中，WHtR 以及 BMI 和 WHpR 在两性中均对新发 MetS 具有显著的预测能力，在男性中 WHtR 对新发 MetS 具有最强的预测能力，而在女性中 BMI 具有最强的预测能力。在横断面研究中，WHtR 的最佳截断值分别为男性 0.52（敏感性，71.0%；特异性，77.9%）和女性 0.53（敏感性，79.8%；特异性，75.7%）。在队列研究中，WHtR 的最佳值分别为男性 0.50（敏感性，60.7%；特异性，73.2%）和女性 0.50（敏感性，75.0%；特异性，56.1%）。WHtR 升高与两性中 MetS 的患病率显著且独立相关。这些结果表明，WHtR 是一种有用的筛查工具，可用于确定日本老年社区居住个体的代谢风险。
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