Wu Lihong, Zhu Wenhua, Qiao Qiaohua, Huang Lijuan, Li Yiqi, Chen Liying
Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, #3 East Qingchun Road, Hangzhou, 310016, Zhejiang, China.
Nutr Metab (Lond). 2021 Jan 6;18(1):3. doi: 10.1186/s12986-020-00536-x.
Metabolic syndrome (MetS) in non-overweight/obese people is insidiously associated with cardiovascular disease. Novel anthropometric indices can reflect central obesity better than the traditional anthropometric indices. Therefore, we hypothesize that these newly developed anthropometric indices can better identify MetS in non-overweight/obese people than conventional indices.
Cross-sectional data of sociodemographic, biochemical and anthropometric indices were collected from 2916 non-overweight/obese Chinese people. A body shape index (ABSI), body roundness index (BRI), waist-to-height ratio (WHtR), weight-adjusted-waist index (WWI) and abdominal volume index (AVI) were calculated. Partial correlation analysis was used to clarify the correlation between anthropometric indices and MetS variables. Binary logistic regression analysis was applied to assess the association between anthropometric indices and MetS and its components. Receiver-operating characteristic curve was used to identify the diagnostic ability of anthropometric indices for MetS and its components. The area under curve (AUC) difference between WHtR and each new anthropometric index was compared in pairs.
After adjusting for covariates, AVI had the optimal ability of identifying MetS (AUC: 0.743 for male, 0.819 for female) and the strongest correlation with high-density lipoprotein cholesterol (HDL-C) (coe: - 0.227 for male, - 0.207 for female) and the highest odds rations (OR) with low HDL-C group (male: OR = 1.37, female: OR = 1.55). The WHtR was comparable to BRI in assessing MetS (AUC: 0.739 for male, 0.817 for female). WHtR or BRI could also well identify hypertension (AUC: 0.602 for male, 0.688 for female) and dysglycemia (AUC: 0.669 for male, 0.713 for female) and female's high triglyceride level (AUC 0.712). The recognition ability of the two was equivalent. The ability of ABSI and WWI to identify MetS was weak.
AVI is the optimal anthropometric indices to identify MetS in non-overweight/obese Chinese adults. BRI and WHtR can also be considered as discriminators, while ABSI and WWI are weak discriminators. WHtR is easy to measure. So, it is recommended as an early preliminary screening method for the MetS in non-overweight/obese people.
非超重/肥胖人群中的代谢综合征(MetS)与心血管疾病存在潜在关联。新型人体测量指数比传统人体测量指数能更好地反映中心性肥胖。因此,我们假设这些新开发的人体测量指数比传统指数能更好地识别非超重/肥胖人群中的MetS。
收集了2916名非超重/肥胖中国人的社会人口统计学、生化和人体测量指数的横断面数据。计算了身体形状指数(ABSI)、身体圆润度指数(BRI)、腰高比(WHtR)、体重调整腰围指数(WWI)和腹围指数(AVI)。采用偏相关分析来阐明人体测量指数与MetS变量之间的相关性。应用二元逻辑回归分析来评估人体测量指数与MetS及其组成成分之间的关联。采用受试者工作特征曲线来确定人体测量指数对MetS及其组成成分的诊断能力。成对比较了WHtR与每个新人体测量指数之间的曲线下面积(AUC)差异。
在调整协变量后,AVI具有识别MetS的最佳能力(男性AUC:0.743,女性AUC:0.819),与高密度脂蛋白胆固醇(HDL-C)的相关性最强(男性系数:-0.227,女性系数:-0.207),与低HDL-C组的比值比(OR)最高(男性:OR = 1.37,女性:OR = 1.55)。在评估MetS方面,WHtR与BRI相当(男性AUC:0.739,女性AUC:0.817)。WHtR或BRI也能很好地识别高血压(男性AUC:0.602,女性AUC:0.688)和血糖异常(男性AUC:0.669,女性AUC:0.713)以及女性的高甘油三酯水平(AUC 0.712)。两者的识别能力相当。ABSI和WWI识别MetS的能力较弱。
AVI是识别非超重/肥胖中国成年人中MetS的最佳人体测量指数。BRI和WHtR也可被视为鉴别指标,而ABSI和WWI是较弱的鉴别指标。WHtR易于测量。因此,建议将其作为非超重/肥胖人群中MetS的早期初步筛查方法。