体质指数、腰围、腰臀比与高血压、高血糖的关系及三者对高血压、高血糖的预测价值

目的探讨体质指数（BMI）、腰围（WC）、腰臀比（WHR）与高血压、高血糖的关系及三者对高血压高血糖的预防价值。方法2006年4-9月整群抽取黑龙江省电力医院健康检查中心体检的1751人,测量身高、体重、腰围、臀围、血压和空腹血糖。结果①BMI、WC与血压的相关性比WHR好;WHR、WC与血糖的相关性比BMI好;②logistic回归分析表明3个指标中BMI是高血压重要的预测因子,而WC是高血糖及二者聚集重要的预测因子;③BMI、WC与WHR三者之间两两指标同时存在时对高血糖、高血压及二者聚集都存在交互作用;④当BMI≥25kg/m2时,其OR值在3.02-4.01之间,ARP在58.13%-69.21%之间,PARP在43.79%-55.77%之间;当WC≥85cm（男性）、WC≥80cm（女性）时,其OR值在4.04-6.70之间,PARP在56.47%-75.52%之间;敏感度和特异度均较好,正确指数高,具有较高的公共卫生价值。结论BMI、WC分别是高血压、高血糖重要的预测因子,以BMI≥25kg/m2或WC≥85cm（男性）、WC≥80cm（女性）为超重肥胖切点时,诊断价值最高,建议以此为诊断界值。     

肥胖对高血压、高血糖的预测作用分析

目的探讨体质指数、腰围及腰臀比对高血压、高血糖的预测作用。方法采用分层整群抽样法调查20岁以上,在深圳居住5年及以上8 207名常住社区居民高血压、糖尿病患病与肥胖相关数据,进行偏相关分析、交互作用分析,并在体质指数、腰围及腰臀比各切点上进行相对危险度、归因危险比、人群归因危险比分析。结果按性别分层,控制年龄进行相关分析显示血压、血糖与BMI、WC、臀围、WHR呈正相关(P(0.0001)。交互作用分析提示,BMI与WC、BMI与WHR 对高血压、高血糖、二者聚集有交互作用。BMI、WC取不同切点,各自对高血压、高血糖及二者聚集的人群危险度及归因比分析提示,BMI切点在25及以上者约占23%,控制此切点,可改善总人群 34%的高血压,23%的高血糖,44%的危险因素聚集。而男性WC切点在85cm及以上,女性WC切点在 80cm及以上者占总人群的29%,控制此因素可改善总人群45%的高血压,33%的高血糖,59%的危险因素聚集。结论结合分析偏相关系数,高血压、糖尿病的危险度,及人群预防的公共卫生意义,筛选深圳市该类疾病高危人群适当的界点是:高血压取BMI≥25cm,高血糖取男性WC≥85cm, 女性WC≥80c...     

体重指数、腰围与代谢性健康风险的关系

目的比较体重指数（BMI）、腰围（WC）与代谢性健康风险的大小。方法对苏州市和常熟市两个社区的江苏省多代谢异常和代谢综合征（MS）防治研究中，经济发达地区基线资料的1604例对象按BMI和WC分组，在正常体重（BMI：18～23．9）、超重（BMI：24～27．9）、肥胖（BMI≥28）类别中，计算高血压、高血糖、血脂异常的相对危险度（RR），并对WC类别中腹型肥胖（男≥85cm，女≥80cm）和WC正常个体进行比较。结果无论是男性还是女性，其高血压、糖脂代谢各项指标以及MS的罹患率均与BMI和WC相关，控制混杂因素后，这样的相关性依然存在；但仅BMI超重时，各项表示代谢性健康风险的aRR值基本上都低于BMI超重合并腹型肥胖的aRR值；男、女性BMI正常但有腹型肥胖时，均较BMI超重而WC正常者的健康风险高。结论WC在表示代谢性健康风险方面比BMI更为有效。     

简易体脂参数估测腹内型肥胖的可靠性评价

目的：评价体重指数（BMI）、腰围（WC）、腰臀比（WHR）估测腹内型肥胖的最佳临界点及敏感度、特异度。方法：应用核磁共振（MRI）对690名受试者（男305人，女385人）进行腹内脂肪（VA）测量，同时测量BMI、WC、WHR。以受试者工作特性（ROC）曲线评价简易体脂参数对腹内型肥胖的诊断价值。结果：①经MRI诊断，超重／肥胖者中61．7％，正常体重者中14．2％呈腹内型肥胖（VA≥100cm^2）；②BMI、WC、WHR与腹内脂肪面积呈显著正相关，尤以WC的相关性最好;③简易体脂参数估测腹内脂肪积聚的最佳切割点为BMI：26kg/m^2,WC:90cm,WHR:0.93;④BMI≥28kg/m^2、WC≥95cm时，95％的男性及90％左右的女性呈腹内型肥胖。结论：BMI、WC及WHR都可估测腹内型肥胖，但以腰围的准确率稍高。     

通辽市牧区蒙古族居民体质指数、腰臀比与血压水平的关系

目的了解通辽市牧区蒙古族居民体质指数（BMI）、腰臀比（WHR）与血压水平之间的关系。方法采用整群随机抽样的方法，抽取该市蒙古族相对集中的4个嘎查（村）居民1108名，进行现场询问和体格检查。结果该人群超重率、肥胖率、腹型肥胖率、高血压患病率依次为31．4％，15．5％，40．1％，47．65％。腹型肥胖时其1、2、3级高血压患病率显著升高（P〈0．05）：超重、肥胖、腹型肥胖者患高血压的危险分别是相对正常人群的1．2、1．6、1．7倍；血压水平随着BMI、WHR增大而升高：BMI和WHR均正常、BMI异常WHR正常、BMI正常WHR异常、BMI和WHR均异常时高血压患病率分别为37．80％，20．69％，44．62％，65．35％，其RR值分别为1．0，0．6，1．2，1．7。结论BMI和WHR与血压水平密切相关，预防与控制超重、肥胖和腹型肥胖应成为防治通辽市牧区蒙古族居民高血压的重要措施。     

1661名农村中老年人健康状况调查的分析

目的调查了解农村中老年人的健康状况并对相关测量指标的应用进行分析。方法随机抽取青岛市某农村1661名中老年人（男612人,女1049人）进行体格检查,包括身高、体重、腰围、臀围、血压、血糖、血红蛋白等指标。结果 1661名农村中老年人高血压患病率为63.4%,高血糖检出率为23.8%,贫血患病率为35.3%。中老年女性体质指数（BMI）、腰围（WC）、腰围/身高比值（WHtR）均高于男性（P〈0.05）,男性腰围/臀围比（WHR）高于女性（P〈0.05）。65岁之前BMI、WC均较高（BMI〉25kg/m^2,WC〉85cm）,65岁以后随年龄升高BMI、WC有逐渐降低的趋势（P〈0.05）。BMI、WC、WHR、WHtR4者与收缩压、舒张压、血糖的正相关系数均为WHtR最大（P〈0.01）。结论农村中老年人高血压、高血糖、贫血患病率均较高,中老年女性超重和肥胖率高于男性,比男性更易发生高血糖,同时45～65岁中老年人超重和肥胖的发生率也较高;WHtR与BMI、WC、WHR、收缩压、舒张压和血糖的相关性均较强,可以作为有效的腹型肥胖指标和预测高血糖与高血压的有效指标。     

体质指数和腰臀比与代谢综合征患病关系

目的探讨体质指数（BMI）和腰臀比（WHR）与代谢综合征（MS）中高血压、高血糖和血脂紊乱患病率的关系。方法通过整群抽样，对合肥市4726名35岁以上脑力劳动者进行MS流行病学调查，比较分析BMI、WHR异常者的3种代谢异常疾病（高血压、高血糖和血脂紊乱）患病情况。结果调查对象BMI异常检出率为36．5％，WHR异常检出率为40．9％，且均随年龄增长肥胖患病率呈增加趋势；WHR异常组的高血糖患病率高于BMI异常组（P〈0．001），OR分别为3．22和1．90，95％CI=2．50～4．15和1．39～2．61；BMI与WHR均异常组的3种代谢异常疾病患病率均明显高于BMI、WHR各单项异常组（P〈0．001）。结论中老年脑力劳动者肥胖问题较为严重，BMI异常、WHR异常（尤其BMI与WHR均异常）可增加代谢异常疾病的患病风险，预防肥胖在代谢综合征及其他疾病防治中具有重要意义。     

吸烟、饮酒与蒙古族高血压的关联性

目的 探讨吸烟、饮酒与蒙古族高血压的关联及关联强度。方法 对2589名≥20岁的蒙古族居民进行血压的测量及吸烟、饮酒等因素的调查，采取单因素X^2及多因素非条件Logistic回归模型分析，以OR值作为评价关联及关联强度的指标，用Mantel—HaenszelX^2趋势检验法分析饮酒与高血压间的剂量-反应关系。结果 单因素分析结果显示，年龄、性别（男性）、吸烟、饮酒、超重[体质指数（BMI）≥25]、腹型肥胖[腰臀比（WHR）≥0．9]、高血糖（血糖≥6．1）以及高血压家族史与高血压相关联（P〈0．05）。经Logistic回归模型分析，调整了年龄、性别、BMI、WHR、血糖和家族史等因素后，吸烟与高血压的关联差异无统计学意义（OR；0．823，P〉0．05），而饮酒与高血压之间的关联差异有统计学意义（OR=1．705，P〈0．0001）。剂量-反应关系分析结果显示，蒙古族人群患高血压的危险性有随着饮酒量的增加而增高的趋势。结论 饮酒可能是蒙古族高血压的独立危险因素，随着饮酒量的增加患高血压的危险性增高，而吸烟可能不是蒙古族高血压的危险因素。     

乌鲁木齐市376例维吾尔族居民体格测量指标与血压的关系

目的探讨维吾尔族居民不同体格测量指标与血压的关系,为高血压的干预提供科学依据。方法用随机整群抽样法对乌鲁木齐市维吾尔族较集中的4个社区中的376名40岁以上维吾尔族居民进行调查,测量身高、体重、腰围（WC）和血压,计算体质指数（BMI）和腰围身高比值（WHtR）,同时探讨BMI、WC、WHtR与血压的关系。结果376名维吾尔族居民中,超重和肥胖的检出率分别为29．79％和51．60％,高血压检出率为45．74％。分别以性别将WHtR以0．5、WC以85／80cm和BMI以24．0kg／m^2为切点进行分组后,WC≥85cm的男性SBP【（138．3±20．9）mmHg】、DBP[（82．3±12．1）mmHg]高于WC〈85cm的男性[分别为（124．7±16．3）和（74．0±7.3）mmHg】,差异有统计学意义（P〈0．01）;WC≥80cm的女性SBP[（135．0±21．8）mmHg]、DBP[（77．9±10．5）mmHg]均高于WC〈80cm的女性[分别为（116.2±18．1）、（70．4±7．6）mmHg],差异有统计学意义（P〈0．01）;BMI≥24．0kg／m^2的男性SBP[（140．2±21．3）mmHg]高于BMI〈24．0kg／m^2的男性[（126．3±14．7）mmHg],差异有统计学意义（t=-4．028,P=0．001）;BMI≥24．0kg／m^2的女性SBP[（136．7±21．9）mmHg]、DBP[（78．2±10．8）mmHg]均高于BMI〈24．0kg／m^2的女性[分别为（119．1±16．9）、（73．4±8．5）mmHg],差异均有统计学意义（P〈0．01）;WHtR≥0．5女性组的SBP[（134．8±21．8）mmHg]、DBP[（77．8±10．5）mmHg]均高于WHtR〈0．5组[分别为（116．6±19．5）和（70．5±8．3）mmHg],差异均有统计学意义（P〈0．01,P〈0．05）。男性BMI与SBP呈正相关（r=0．180,P〈0．05）,女性WHtR、WC、BMI均与SBP、DBP呈正相关（P〈0．01）。结论维吾尔族居民超重和肥胖问题显著,高血压检出率高,BMI、WC和WHtR与血压之间具有稳定的正向关系,WHtR在预测高血压的风险方面有一定作用。     

体质指数、腰臀比和糖尿病的调查研究

目的研究糖尿病与肥胖的关系。方法采用整群抽样方法，调查在深圳居住年限超过5午（含5午）、20岁以上的8200名常住居民。结果在所调查的对象中体质指数（BMI）≥25（肥胖），其糖尿病的发病率和糖耐量（IGT）为2．6，高出BMI〉25（不肥胖）组2．3倍；腰臀比（WHR）≥1组的糖尿病的发病率和糖耐量（IGT）为5，是WHR〈1组的2．5倍。当腰围增加1cm，患DM和IGT的比率相应地增加0．5％和1％。结论肥胖是引发糖尿病的一个重要因素，应该在此类人群中采取有效的干预性措施来预防糖尿病的发生。     

Evaluation of waist circumference to predict general obesity and arterial hypertension in women in Greater Metropolitan Belo Horizonte,Brazil

This study examined the capacity of waist circumference (WC) to identify subjects with overweight (BMI >/=25) and obesity (BMI >/=30), in agreement with internationally recommended levels of action. Data were obtained from 791 women, 15-59 years old. After identifying overweight and obesity according to WC values, sensitivity and specificity were calculated to verify whether WC could be a good risk predictor for hypertension. Associations were tested by linear regression and logistic regression, controlling for confounding. WC cut-off points of 80cm and 88cm correctly identified 89.8% and 88.5% of women with overweight and obesity, respectively. Abdominal obesity (WC >/=88cm) was statistically associated with hypertension in the multivariate analysis (OR = 2.88; 95% CI: 1.77-4.67). Hypertension was identified with a sensitivity of 63.8% and 42.8%, and with a specificity of 68.0% and 83.3%, for WC >/=80 and >/=88, respectively. The proposed cut-off points for abdominal obesity can potentially distinguish individuals at risk for future obesity, but has only moderate power to predict individuals with high blood pressure.     

Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men

BACKGROUND: Obesity is a strong risk factor for type 2 diabetes. However, few studies have compared the predictive power of overall obesity with that of central obesity. The cutoffs for waist circumference (WC) and waist-to-hip ratio (WHR) as measures of abdominal adiposity remain controversial. OBJECTIVE: The objective was to compare body mass index (BMI), WC, and WHR in predicting type 2 diabetes. DESIGN: A prospective cohort study (Health Professionals Follow-Up Study) of 27 270 men was conducted. WC, WHR, and BMI were assessed at baseline. Covariates and potential confounders were assessed repeatedly during the follow-up. RESULTS: During 13 y of follow-up, we documented 884 incident type 2 diabetes cases. Age-adjusted relative risks (RRs) across quintiles of WC were 1.0, 2.0, 2.7, 5.0, and 12.0; those of WHR were 1.0, 2.1, 2.7, 3.6, and 6.9; and those of BMI were 1.0, 1.1, 1.8, 2.9, and 7.9 (P for trend < 0.0001 for all). Multivariate adjustment for diabetes risk factors only slightly attenuated these RRs. Adjustment for BMI substantially attenuated RRs for both WC and WHR. The receiver operator characteristic curve analysis indicated that WC and BMI were similar and were better than WHR in predicting type 2 diabetes. The cumulative proportions of type 2 diabetes cases identified according to medians of BMI (>/=24.8), WC (>/=94 cm), and WHR (>/=0.94) were 82.5%, 83.6%, and 74.1%, respectively. The corresponding proportions were 78.9%, 50.5%, and 65.7% according to the recommended cutoffs. CONCLUSIONS: Both overall and abdominal adiposity strongly and independently predict risk of type 2 diabetes. WC is a better predictor than is WHR. The currently recommended cutoff for WC of 102 cm for men may need to be reevaluated; a lower cutoff may be more appropriate.     

BMI is strongly associated with hypertension, and waist circumference is strongly associated with type 2 diabetes and dyslipidemia, in northern Chinese adults

Background

Obesity is closely associated with chronic diseases such as hypertension, type 2 diabetes mellitus (T2DM), and dyslipidemia. We analyzed the optimal obesity index cut-off values for metabolic syndrome (MetS), and identified the obesity index that is more closely associated with these chronic diseases, in a population of northern Chinese.

Methods

We surveyed 8940 adults (age, 20–74 years) living in northern China for chronic diseases. Receiver operating characteristics (ROC) analysis, relative risk, and multivariate regression were used to develop an appropriate index and optimal cut-off values for MetS and obesity-related chronic diseases.

Results

Waist circumference (WC) and body mass index (BMI) were good markers for MetS, WC was a good marker for T2DM and dyslipidemia, and BMI was a good marker for hypertension. The optimal BMI cut-off value of MetS was 24 kg/m², and the optimal WC cut-offs were 86 cm and 78 cm in men and women, respectively. Relative risk regression models showed that BMI was associated with hypertension, T2DM, and hypertriglyceridemia and a higher prevalence ratio (PR) for hypertension: 2.35 (95% CI, 2.18–2.50). WC was associated with T2DM, hypertension, and hypertriglyceridemia, with PRs of 2.05 (1.63–2.55) for T2DM and 2.47 (2.04–2.85) for hypertriglyceridemia. In multivariate regression models, the standardized regression coefficients (SRCs) of BMI were greater for SBP and DBP, and the SRC of WC was greater for fasting blood glucose, 2-hour postload blood glucose, triglyceride, and total cholesterol.

Conclusions

Our analysis of a population of northern Chinese indicates that the optimal cut-off values for MetS are WCs of 86 cm in men and 78 cm in women and a BMI of 24 kg/m² in both sexes. BMI was strongly associated with hypertension, while WC was strongly associated with T2DM and dyslipidemia.Key words: obesity, chronic disease, cut-off value     

Dyslipidemia and abdominal obesity: an assessment in three general populations

Several studies show a relationship between abdominal obesity and cardiovascular diseases, partially mediated through an altered metabolism of dyslipidemia. The present study was aimed at testing the robustness of this association across three contrasted populations and at assessing the performances of abdominal obesity as a screening tool for dyslipidemia. Data were drawn from three population health surveys recently conducted in two regions of a developed country (Switzerland, mostly of Caucasian origin, n = 2650) and in a less developed country (Seychelles, Indian Ocean, mostly of black descent, n = 806). Dyslipidemia was defined as a ratio of total cholesterol to high-density lipoprotein cholesterol (TC-HDL) greater than 5. Two anthropometric circumference measurements, waist-to-hip ratio (WHR) and waist circumference (WC), were used to define abdominal obesity either as WHR >/= 0.9 in men and WHR >/= 0.8 in women or as WC >/= 94 cm and WC >/= 80 cm, respectively. A consistent direct association between abdominal obesity and dyslipidemia (odds ratios varying from 1.85 to 4.56) was found in the three populations, independently of gender, age, body mass index, blood pressure, and smoking. This consistency across ethnicities and environments strengthens the hypothesis of a common etiopathological mechanism. The sensitivity for detecting dyslipidemia was generally higher for abdominal obesity, based on either WHR or WC, than for criteria based on the other risk factors under study. In addition, the sensitivity was higher in the study populations with a low prevalence of dyslipidemia (Swiss women and Seychellois of both sexes) than in the others. These findings support that WHR and WC may be useful as simple and inexpensive screening tools to select individuals eligible for more sophisticated and costly serum lipid determinations, especially in developing countries.     

Identifying obesity indicators which best correlate with type 2 diabetes in a Chinese population

ABSTRACT: BACKGROUND: Obesity has been shown to be a prognostic indicator of type 2 diabetes (T2D); however, the power of different obesity indicators in the detection of T2D remains controversial. This study evaluates the detecting power of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHTR) for the presence of T2D in undiagnosed diabetics among the Chinese population. METHODS: Individuals were selected from an ongoing large-scale population-based Beijing Community Pre-Diabetes (BCPD) study cohort. The oral glucose tolerance tests (OGTT) were performed to diagnose diabetes. A total of 220 new cases of T2D and 1,868 normal blood glucose subjects were analyzed. ROC curve analyses were used to compare the association of different obesity indicators with T2D and determine the optimal cut-off points of the best predictor for identifying T2D in men and women. RESULTS: All indicators positively correlated with presence of T2D in both men and women. In women, WC, WHR and WHTR were similar, but were better in identifying T2D when compared to BMI (P < 0.0001, P=0.0016 and P=0.0001, respectively). In men, WC, WHTR and BMI were similar, but WC and WHTR were better than WHR (P=0.0234, P=0.0101, respectively). For women, 86 cm was the optimal WC cut-off point, and its sensitivity and specificity were 0.714 and 0.616; for men, the optimal cut-off point was 90 cm, and its sensitivity and specificity were 0.722 and 0.571. CONCLUSION: Compared with BMI, WHR and WHTR, WC is a simple and accurate measure for predicting T2D in the Chinese population.     

不同体重指数和腰围水平与其他心血管病危险因素聚集的关系

目的探讨不同体重指数(BMI)和腰围水平对人群中其他心血管病危险因素聚集的影响.方法将1992～1994年和1998年在我国不同地区中年人群中进行的2次心血管病危险因素调查资料合并共30 561人,比较不同BMI和腰围分组的研究对象其他心血管病危险因素聚集率和聚集的相对危险,其中危险因素聚集定义为同一研究对象具有高血压、高血清总胆固醇、低高密度脂蛋白胆固醇或空腹血糖异常之中的任意2项或2项以上者.结果随着BMI和(或)腰围的增加,人群其他心血管病危险因素的聚集率呈明显上升趋势, 按BMI分层各组中,男女两性腰围与其他心血管病危险因素的聚集率均呈明显的线性上升趋势,同样在不同的腰围分组中,BMI均与其他心血管病危险因素的聚集率呈明显的线性趋势.男性和女性年龄调整心血管病危险因素聚集率在BMI<24 kg/m2、腰围(男/女)<85/80 cm组分别为11.1%和10.4%,BMI<24 kg/m2、腰围(男/女)85～95.9/80～89.9 cm组分别为24.2%和16.9%, BMI 24.0～27.9 kg/m2、腰围(男/女)<85/80 cm组分别为24.0%和17.0%,BMI 24～27.9 kg/m2、腰围(男/女)85～95.9 /80～89.9 cm组分别为34.3%和24.0%. BMI 24.0～27.9 kg/m2、腰围(男/女)≥95/90 cm组分别为40.8%和29.6%,BMI≥28 kg/m2、腰围(男/女)85～95.9/80～89.9 cm组分别为44.2%和29.9%,BMI≥28 kg/m2、腰围(男/女)≥95/90 cm组分别为54.7%和35.4%.结论 BMI和腰围水平均与其他心血管病危险因素的聚集有独立的正相关性.保持BMI和腰围均在正常范围对心血管健康是很重要的.