Department of Endocrinology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, P.R. China.
Eur Rev Med Pharmacol Sci. 2019 May;23(10):4391-4397. doi: 10.26355/eurrev_201905_17946.
To investigate the correlation of waist circumference with metabolic risks among non-obese populations.
A retrospective analysis was conducted for the clinical information of 13,145 non-obese subjects who received physical examinations in the hospital from January 2015 to January 2018. Among them, 1,971 subjects were definitely diagnosed with diabetes mellitus, hypertension, and metabolic syndrome and set as the metabolic disorder group, with the remaining 11,174 cases as the control group. All metabolism-related indicators were compared between the patients in the two groups, the analysis was performed for the prevalence of diabetes, hypertension, and metabolic syndrome in patients with different waist circumference as well as males and females with different waist circumferences. Finally, the optimal cut-off points of waist circumference were determined.
According to the comparison, there were no statistically significant differences in subjects with low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and total cholesterol between the metabolic disorder group and the control group (p>0.05). The subjects in the metabolic disorder group had higher waist circumference, waist-to-hip ratio, triglyceride, fasting insulin, fasting blood glucose, and insulin resistance index than those in the control group, displaying statistically significant differences (p<0.05). When waist circumference was more than 70 cm, as it increased, the prevalence rates of diabetes, hypertension, and metabolic syndrome gradually elevated. When waist circumference was 60-90 cm, hypertension took the leading place in metabolic disorders, so did the metabolic syndrome and diabetes, with a waist circumference of more than 90 cm. There were no remarkable differences in the prevalence rates of diabetes, hypertension, and metabolic syndrome among male and female patients with different waist circumferences ((p>0.05). The patients with the waist circumference of over 90 cm exhibited gradually declined prevalence rates of diabetes, hypertension, and metabolic syndrome, while those in the patients with a waist circumference of 60-90 cm were gradually increased. The optimal cut-off points of waist circumference were calculated according to the prevalence rates of diabetes, hypertension, and metabolic syndrome among patients, and the calculation results were 78 cm, 79 cm, and 77 cm for male patients and 73 cm, 78 cm, and 73 cm for female patients. Based on the weight combined with the optimal cut-off points of waist circumference, the optimal waist circumference cut-off points for males and females were 78 cm and 74 cm, respectively.
There is a correlation between the waist circumference and metabolic risks among non-obese populations, but the screening for metabolic diseases should be conducted among males with a waist circumference of over 78 cm and females with a waist circumference of over 74 cm. The treatment measures are supposed to be taken promptly to improve the prognosis.
探讨腰围与非肥胖人群代谢风险的相关性。
回顾性分析 2015 年 1 月至 2018 年 1 月在我院体检的 13145 例非肥胖人群的临床资料,其中 1971 例患者被明确诊断为糖尿病、高血压和代谢综合征,设为代谢紊乱组,其余 11174 例患者为对照组。比较两组患者的所有代谢相关指标,分析不同腰围患者糖尿病、高血压和代谢综合征的患病率以及不同腰围男性和女性的患病率,确定腰围的最佳截断点。
与代谢紊乱组相比,低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和总胆固醇在代谢紊乱组和对照组之间无统计学差异(p>0.05)。代谢紊乱组患者的腰围、腰臀比、甘油三酯、空腹胰岛素、空腹血糖和胰岛素抵抗指数均高于对照组,差异有统计学意义(p<0.05)。当腰围超过 70cm 时,随着腰围的增加,糖尿病、高血压和代谢综合征的患病率逐渐升高。当腰围在 60-90cm 时,高血压在代谢紊乱中占主导地位,代谢综合征和糖尿病也占主导地位,腰围超过 90cm。不同腰围男性和女性患者的糖尿病、高血压和代谢综合征患病率差异无统计学意义(p>0.05)。腰围超过 90cm 的患者糖尿病、高血压和代谢综合征的患病率逐渐下降,而腰围在 60-90cm 的患者则逐渐升高。根据患者中糖尿病、高血压和代谢综合征的患病率计算腰围的最佳截断点,男性为 78cm、79cm 和 77cm,女性为 73cm、78cm 和 73cm。根据体重结合腰围的最佳截断点,男性和女性的最佳腰围截断点分别为 78cm 和 74cm。
非肥胖人群的腰围与代谢风险之间存在相关性,但应在腰围男性超过 78cm 和女性超过 74cm 时筛查代谢性疾病。应及时采取治疗措施,改善预后。