González-Rivas Juan P, Mechanick Jeffrey I, Iglesias-Fortes Rocio, De-Oliveira-Gomes Diana, Silva Jesús, Valencia José, Figueroa Estherbany, Duran Maritza, Ugel Eunice, Infante-García María M, Marulanda María Inés, Nieto-Martínez Ramfis
International Clinical Research Center, St Anne's University Hospital Brno, Brno, Czech Republic; Department of Global Health and Population. Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts, USA; Foundation for Clinic, Public Health, and Epidemiological Research of Venezuela (FISPEVEN), Caracas, Venezuela.
Divisions of Cardiology and Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Arch Cardiol Mex. 2020 Dec 23;91(3):272-280. doi: 10.24875/ACM.20000165.
: Waist circumference (WC) value reflects abdominal adiposity, but the amount abdominal fat that is associated to cardiometabolic risk factors varies among ethnicities. Determination of metabolic abnormalities has not undergone a WC adaptation process in Venezuela. The aim of the study was (1) to determine the optimal WC cutoff value associated with ≥2 cardiometabolic alterations and (2) incorporating this new WC cutoff, to determine the prevalence of abdominal obesity and cardiometabolic risk factors related in Venezuela.
: The study was national population-based, cross-sectional, and randomized sample, from 2014 to 2017. To assess performance of WC for identifying cardiometabolic alterations, receiver operating characteristics curves, area under the curve (AUC), sensitivity, specificity, and positive likelihood ratios were calculated.
: Three thousand three hundred eighty-seven adults were evaluated with mean age of 41.2 ± 15.8 years. Using the best tradeoff between sensitivity and specificity, WC cutoffs of 90 cm in men (sensitivity = 72.4% and specificity = 66.1%) and 86 cm in women (sensitivity = 76.2% and specificity = 61.4%) were optimal for aggregation of ≥2 cardiometabolic alterations. AUC was 0.75 in men and 0.73 in women using these new cutoffs. Prevalence of abdominal obesity and metabolic syndrome was 59.6% (95 CI; 57.5-61.7) and 47.6% (95 CI; 45.2-50.0), respectively. Cardiometabolic risk factors were associated with being men, higher age, adiposity, and living in northern or western regions.
: The optimal WC values associated with cardiometabolic alterations were 90 cm in men and 86 cm in women. More than half of the Venezuelan population had abdominal obesity incorporating this new WC cutoff.
腰围(WC)值反映腹部肥胖情况,但与心血管代谢危险因素相关的腹部脂肪量在不同种族之间存在差异。在委内瑞拉,代谢异常的判定尚未经历腰围适应性调整过程。本研究的目的是:(1)确定与≥2种心血管代谢改变相关的最佳腰围截断值;(2)纳入这一新的腰围截断值,确定委内瑞拉腹部肥胖及相关心血管代谢危险因素的患病率。
该研究为基于全国人口的横断面随机抽样研究,时间跨度为2014年至2017年。为评估腰围用于识别心血管代谢改变的效能,计算了受试者工作特征曲线、曲线下面积(AUC)、敏感性、特异性和阳性似然比。
共评估了3387名成年人,平均年龄为41.2±15.8岁。在敏感性和特异性之间进行最佳权衡后,男性腰围截断值为90厘米(敏感性=72.4%,特异性=66.1%),女性为86厘米(敏感性=76.2%,特异性=61.4%)时,对于聚集≥2种心血管代谢改变最为理想。使用这些新的截断值时,男性的AUC为0.75,女性为0.73。腹部肥胖和代谢综合征的患病率分别为59.6%(95%置信区间;57.5 - 61.7)和47.6%(95%置信区间;45.2 - 50.0)。心血管代谢危险因素与男性、较高年龄、肥胖以及居住在北部或西部地区有关。
与心血管代谢改变相关的最佳腰围值男性为90厘米,女性为86厘米。纳入这一新的腰围截断值后,超过一半的委内瑞拉人口存在腹部肥胖。