Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston, School of Public Health, Dallas, Texas, USA.
Center for Pediatric Population Health, School of Public Health, University of Texas Health Science Center, Dallas, Texas, USA.
Obesity (Silver Spring). 2024 Aug;32(8):1558-1567. doi: 10.1002/oby.24090. Epub 2024 Jul 12.
Early screening prevents chronic diseases by identifying at-risk adolescents through anthropometric measurements, but predictive value in diverse groups is uncertain.
A cross-sectional analysis of 12- to 19-year-old individuals from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) assessed the predictive ability of BMI percentile, total body fat percentage, waist circumference (WC), and waist-hip ratio (WHR) for four cardiometabolic risk factors across race and ethnicity groups using receiver operating characteristic curves.
The unweighted sample (N = 1194; 51.2% male individuals; 23.7% Hispanic, 13.2% non-Hispanic Black [NHB], 51.1% non-Hispanic White [NHW], 12.0% other/multirace) had a weighted prevalence of elevated blood pressure of 2.7%, hyperglycemia of 36.8%, hypertriglyceridemia of 4.8%, and low high-density lipoprotein (HDL) cholesterol of 15%. WHR (area under the curve [AUC] = 0.77), WC (AUC = 0.77), and BMI percentile (AUC = 0.73) outperformed total body fat percentage (AUC = 0.56) in predicting elevated blood pressure (p < 0.001 for all). BMI percentile was more accurate than total body fat percentage in predicting hypertriglyceridemia (AUC = 0.70 vs. 0.59; p = 0.02) and low HDL cholesterol (AUC = 0.69 vs. 0.59; p < 0.001). Race and ethnicity-based predictions varied: NHW adolescents had the highest AUC (0.89; p < 0.01) for elevated blood pressure prediction compared with Hispanic and NHB adolescents (AUC = 0.77 for both). Total body fat percentage was more accurate in predicting low HDL cholesterol among Hispanic versus NHW adolescents (AUC = 0.73 vs. 0.58; p = 0.04).
WHR, WC, and BMI percentile are better predictors of cardiometabolic risk factors in adolescents than total body fat percentage. Predictive abilities differed by race and ethnicity, highlighting the importance of tailored risk assessment strategies.
通过人体测量学指标对处于危险中的青少年进行早期筛查，从而预防慢性病，但不同人群的预测价值尚不确定。
对 2017-2018 年全国健康与营养调查（NHANES）中 12 至 19 岁的个体进行横断面分析，使用受试者工作特征曲线评估 BMI 百分位数、体脂肪百分比、腰围（WC）和腰臀比（WHR）对 4 种心血管代谢危险因素的预测能力在不同种族和族裔群体中的表现。
未加权样本（N=1194；51.2%为男性个体；23.7%为西班牙裔，13.2%为非西班牙裔黑人[NHB]，51.1%为非西班牙裔白人[NHW]，12.0%为其他/多种族）的加权高血压患病率为 2.7%，高血糖患病率为 36.8%，高甘油三酯血症患病率为 4.8%，低高密度脂蛋白（HDL）胆固醇患病率为 15%。WHR（曲线下面积[AUC] = 0.77）、WC（AUC = 0.77）和 BMI 百分位数（AUC = 0.73）优于体脂肪百分比（AUC = 0.56；所有比较的 p<0.001）在预测高血压方面（p<0.001）。与体脂肪百分比相比，BMI 百分位数在预测高甘油三酯血症（AUC = 0.70 与 0.59；p=0.02）和低 HDL 胆固醇（AUC = 0.69 与 0.59；p<0.001）方面更为准确。基于种族和族裔的预测存在差异：与西班牙裔和 NHB 青少年相比，NHW 青少年的高血压预测 AUC（0.89；p<0.01）最高（AUC 为 0.77）。与 NHW 青少年相比，体脂肪百分比在预测西班牙裔青少年低 HDL 胆固醇方面更为准确（AUC 为 0.73 与 0.58；p=0.04）。
WHR、WC 和 BMI 百分位数在预测青少年心血管代谢危险因素方面优于体脂肪百分比。预测能力因种族和族裔而异，这突出表明了制定有针对性的风险评估策略的重要性。
