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。     

体重指数、腰围和腰臀比预测高血压、高血糖的实用价值及其建议值探讨

目的：探讨体重指数（BMI）、腰围（WC）、腰臀比（WHR）对于预测高血压、高血糖患病的实用价值及其诊断建议值，为确定我国肥胖和腹部肥胖的诊断指标及其界值提供科学依据。方法：利用1995－1997年全国糖尿病（DM）流行病学调查资料进行分析，方法包括偏相关分析、logistic多因素回归分析、交互作用分析，计算BMI、WC、WHR在不同截点暴露对高血压、高血糖和二者聚集的相对危险度（RR）、暴露组归因危险百分比（ARP）和人群归因危险百分比（PARP）。结果：①BMI、WC与血压和血糖的相关性比WHR好；②logistic调整了年龄、性别、职业性体力活动强度、休闲活动强度、文化强度和DM家族史后，BMI、WC、WHR是患高血压、高血糖以及二者聚集重要的预测因子，三者的相对重要性以BMI＞WC＞WHR；③BMI、WC、WHR三者之间对于高血压和高血糖患病率有相加交互作用，尤其以BMI与WC的交互作用普遍存在，其归因交互作用百分比[A[（AB）]在5．95－29．34％之间；④BMI≥23、≥24、≥25时，RR在2．5左右，从流行病学角度看，RR值处于暴露因子与疾病关联的中高度有害范围，其ARP在0．580－0．626之间，从流行病学角度看，RR值处于暴露因子与疾病关联中的中高度有害范围，其ARP在0．580－0．626之间，PARP在0．259－3．08之间，⑤男性WC≥85cm、女性WC≥80cm和男性WC≥90cm，女性WC≥80cm，RR分别在2．06－3．08之间，此时腹部肥胖对高血压、高血糖和二者聚集的PR值分别处于中、高度有害；RR分别在0．515－0．676之间，PARP分别在0．241－0．431之间。结论：从暴露对疾病危害的程度，人们对超重和肥胖的可接受性，我国开展肥胖防治处于初期阶段及公共卫生人群预防的角度综合考虑，在BMI、WC、WHR中，预测我国高血压和高血糖的实用价值以BMI和WC为好，建议以BMI为肥胖指标，BMI≥24诊断为超重和肥胖；以WC为腹部肥胖指标，男性WC≥80cm、女性WC≥80cm为诊断界值。     

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.     

体脂分布特征与血脂关系及其预测血脂异常的观察

目的 研究体脂分布特征与血脂关系及其预测血脂异常的价值.方法 采用整群抽样方法抽取北京市郊区居民有效样本784名,测量其身高、体重、腰围(WC)、臀围、身体成分与高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG),并计算体重指数(BMI)与腰臀比(WHR).结果 年龄调整偏相关分析显示WC与HDL-C(r=-0.310)、LDL-C(r =0.204),WHR与TC (r=0.151)、TG (r=0.271)的相关性最好.BMI、WC、WHR、躯干脂肪质量(TFM)分组分析显示WC、WHR、TFM能敏感地反应人体血脂水平的变化;BMI、WC、WHR、TFM能敏感地反应低HDL、高TG及血脂异常的风险.ROC曲线分析显示WC、WHR、BMI、TFM预测血脂异常风险的ROC曲线皆在参考线上方,且男女受试者WHR (0.684、0.630)、WC (0.667、0.616)、TFM(0.661、0.604)的ROC曲线下面积有大于BMI (0.629、0.597)的趋势,但差异均无统计学意义(P＞0.05).结论 体脂分布特征指标如WHR、WC、TFM与BMI相比,在预测血脂异常风险中的应用价值更高;以Youden指数最大值为判定依据预测血脂异常风险,男性理想界值点BMI为24 kg/m2,WHR为0.91,WC为85 cm,TFM为7.5 kg;女性BMI为25 kg/m2,WHR为0.91,WC为87 cm,TFM为9.Skg.由于样本量较少,有待进一步扩大范围的研究.     

Receiver-operating characteristic analyses of body mass index, waist circumference and waist-to-hip ratio for obesity: Screening in young adults in central south of China

BACKGROUND & AIMS: Recent data suggest that current obesity diagnostic criterion based on body mass index (BMI) above 30 in Caucasians may not be appropriate for Asian populations. Our aim was to identify the usefulness of BMI, waist circumference (WC) and waist-to-hip ratio (WHR) in screening for obesity in an Asian population. METHODS: A cross-sectional sample of 1109 males and 879 females aged 20-45-yr were recruited. Height, weight, WC, hip circumference and percentage body fat (PBF) were measured in all subjects. Then receiver-operating characteristic analyses were used to evaluate the performances of the three anthropometric indices. RESULTS: BMI, WC and WHR showed strong positive correlation with PBF (r=0.47-0.75) in both males and females within both age groups. True-positive rates ranged from 82.4% to 94.1% and 68.8% to 86.3% in males and females, respectively. True-negative rates ranged from 64.1% to 84.7% and from 56.9% to 79.0%, respectively. The areas under the curves (AUCs) for WC and BMI were high (0.76-0.92) in both sexes and divided age groups (20-30-yr and 31-45-yr), and those for WHR were a little lower (0.74-0.88). CONCLUSIONS: BMI and WC are two important predictors for obesity in Chinese, and WHR is an alternative.     

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。     

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.     

人体测量指标预测肥胖儿童非酒精性脂肪肝的研究

目的 研究人体测量指标对儿童肥胖伴非酒精性脂肪肝的预测作用,探讨不同指标筛查非酒精性脂肪肝的切点值。方法 选取自2018年6月—2019年12月在西安交通大学第二附属医院小儿内分泌门诊就诊的94例肥胖儿童为研究对象,进一步分为肥胖伴非酒精性脂肪肝组与肥胖不伴非酒精性脂肪肝组,52例正常儿童为对照组。测量身高(H)、体重(W)、腰围(WC)、臀围(HC)和血甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);行肝脏B超的检查。计算体质指数(BMI)、腰臀比(WHR)、腰高比(WHtR)、腹部体积指数(AVI)、脂质蓄积指数(LAP)和内脏脂肪指数(VAI)等指标。通过绘制人体测量指标的受试者工作特征曲线(ROC曲线)评估人体测量指标与肥胖儿童非酒精性脂肪肝的相关性,并比较各项人体测量指标的曲线下面积(AUC)确定切点值。结果 肥胖组BMI、WC、WHR、WHtR、AVI、LAP、VAI及TG均高于对照组(t=23.090、21.068、12.547、22.855、17.578、8.159、5.394、6.183,P＜0.001)。肥胖伴非酒精性脂肪肝组BMI、WC、AVI、LAP、VAI均高于肥胖不伴非酒精性脂肪肝组(t=2.180、2.389、2.362、3.643、2.839,P＜0.05)。人体测量指标的ROC曲线下面积按从大到小的顺序依次为 LAP、VAI、 WC、 AVI、 BMI。对肥胖伴非酒精性脂肪肝的联合诊断指标进行筛查效能分析结果显示,LAP+AVI 曲线下面积为0.706(95%CI:0.595~0.817,P＜0.001);AVI+VAI 曲线下面积为0.685(95%CI:0.570~0.800,P＜0.01);BMI+WC 曲线下面积为0.652(95%CI:0.537~0.768,P＜0.05)。联合指标的ROC曲线下面积从大到小为LAP+AVI、AVI+VAI、BMI+WC。结论 LAP联合AVI对儿童肥胖伴非酒精性脂肪肝具有较好的筛查作用。     

Measures of adiposity in the identification of metabolic abnormalities in elderly men

BACKGROUND: Body mass index (BMI; in kg/m(2)) is considered a poor indicator of overall and abdominal obesity in the elderly. OBJECTIVES: Our goal was to determine which simple anthropometric measurements [BMI, waist-to-hip ratio (WHR), waist circumference (WC), percentage body fat (%BF), or fat mass (FM)] are most closely associated with metabolic risk factors and insulin resistance in elderly men. DESIGN: This was a cross-sectional study of 2924 men aged 60-79 y with no history of coronary heart disease, stroke, or diabetes who were drawn from general practices in 24 British towns. RESULTS: BMI and WC were the measures most strongly associated with the metabolic syndrome (>/=3 of the following: hypertension, low HDL cholesterol, high triacylglycerols, or high blood glucose) and insulin resistance. For a 1-SD increase in BMI, WC, WHR, %BF, and FM, the odds ratios (95% CIs) of having the metabolic syndrome after adjustment for age, socioeconomic status, smoking status, and physical activity were as follows: BMI, 1.61 (1.44, 1.79); WC, 1.65 (1.48, 1.81); WHR, 1.49 (1.34, 1.66); %BF, 1.41 (1.25, 1.59); and FM, 1.53 (1.38, 1.70). For insulin resistance, the odds ratios (95% CIs) were as follows: 2.48 (2.22, 2.77), 2.46 (2.19, 2.65), 1.75 (1.59, 1.93), 1.79 (1.60, 2.00), and 2.10 (1.88, 2.34), respectively. In normal-weight (BMI < 25) and overweight (BMI 25-29.9) men, the presence of the metabolic syndrome and insulin resistance increased with increasing WC; this did not occur in obese men. CONCLUSIONS: BMI and WC are the simple measures of adiposity most strongly associated with metabolic abnormalities in elderly men. Our findings suggest that WC can be used as a complementary measurement to identify health risks in normal-weight and overweight elderly persons.     

Prevalence of metabolic syndrome among Filipino adults aged 20 years and over

This study sought to determine the prevalence of metabolic syndrome, using data collected from 4,541 adults aged 20 years and over covered in the Fifth National Nutrition Survey conducted in 1998. The metabolic variables analyzed were: total cholesterol, LDL-c, HDL-c, triglycerides and fasting blood glucose. In addition, measurements of obesity such as body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC) as well as blood pressure were taken. Comparing the mean metabolic characteristics of the non-obese, total obese and the android obese, results showed significant differences in almost all the variables except for the HDL-c. By gender, non-significant differences were observed between males and females in the non-obese group in terms of the BMI and glucose levels and in the android group, in terms of total cholesterol. In all three groups, the biggest difference was observed in the mean triglycerides, where males had significantly higher mean than the females. Comparing adults with >125 mg/dl fasting blood sugar (FBS) there were higher rates of hypertension, high waist-to-hip ratio (WHR), high cholesterol, high triglycerides, high LDL-c, low HDL-c, among the overweight and obese than among those with normal BMI. In general, the proportion of subjects with co-morbid factors increased with higher levels of FBS, except for high cholesterol wherein no pattern was established. The highest prevalence of high FBS was found in both males (35.8%) and females (14.5%) with the following combined characteristics: high BMI, high WHR and high WC. Males with co-existing high BMI, high WHR, and high WC were observed to have the highest prevalence rate of hypertension (66.5%). Among females, the highest prevalence rate of hypertension (37.9%) was seen among those with high fasting blood sugar. The proportion of subjects with hypertension generally increased with age irrespective of the BMI status. One of the significant correlates of high FBS is waist-hip ratio. Males with WHR of equal or greater than 1 have almost six times the risk of having high FBS, while females with WHR of equal or greater than 0.85 have five times the risk of having high FBS compared to those with normal WHR. Among females with triglyceride levels of equal or greater than 200 mg/dL, the risk of having high FBS is five times compared to those with triglyceride levels below 200 mg/dL. Univariate analysis to see the effect of the type of obesity to dyslipidaemia and hypertension revealed that females with high waist circumference generally provided greater risk compared to those who were overweight and obese as well as those with android obesity. For males, high waist circumference had greater risk of developing high triglyceride and high LDL-c. Android obese males had greater risk to high FBS. The results showed that the prevalence rate of metabolic syndrome is 0.28%, based on the number of individuals with the following characteristics: high FBS, hypertensive, android obese, with body mass index (BMI) of > or =25.0 and high WC. Females had a higher rate than males - almost twice. Considering that metabolic syndrome, with its co-morbidity factors is prevalent among some Filipino adults aged 20 years and over, it is recommended that health programs geared towards minimizing the morbid risk factors be properly developed, promoted and fully implemented.     

Prediction of metabolic syndrome among postmenopausal Ghanaian women using obesity and atherogenic markers

ABSTRACT: BACKGROUND: Metabolic syndrome (MetS) is an important health problem which puts individuals at risk for cardiovascular diseases and type 2 diabetes as well as obesity-related cancers such as colon and renal cell in men, and endometrial and oesophageal in women. OBJECTIVE: This study was aimed at examining how obesity indicators and related determinants influence metabolic syndrome, and how the factors can be used to predict the syndrome and its cut-offs in postmenopausal Ghanaian women. METHODS: Two hundred and fifty (250) Ghanaian subjects were involved in the study with one hundred and forty-three (143) being premenopausal women and one hundred and seven (107) postmenopausal women. The influence of traditional metabolic risk factors including high blood pressure, dyslipidemia and glucose intolerance on obesity and atherogenic indices i.e. body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), Waist-to-thigh ratio (WTR), waist-to-height ratio (WHtR), high density lipoprotein cholesterol to total cholesterol ratio (HDL-C/TC), high density lipoprotein cholesterol to low density lipoprotein ratio (HDL-C/LDL-C) and triglyceride to high density lipoprotein cholesterol ratio (TG/HDL-C) were identified according to the Harmonization (H_MS) criterion. RESULTS: The most significant anthropometric marker that significantly influence metabolic risk factors among the pre- and postmenopausal women was waist-to-hip ratio (premenopausal: p- 0.004, 0.026 and 0.002 for systolic blood pressure (SBP), fasting blood glucose (FBG) and HDL-C; postmenopausal: p-0.012, 0.048, 0.007 and 0.0061 for diastolic blood pressure (DBP), FBG, triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) respectively). Using the receiver operating characteristic (ROC) analysis, the area under the curve for WC, WHR, TG/HDL-C and HDL-C/TC among postmenopausal women were estimated at 0.6, 0.6, 0.8 and 0.8 respectively. The appropriate cut-off values for WC, WHR, TG/HDL-C and HDL-C/TC that predicted the presence of metabolic syndrome were 80.5 cm, 0.84, 0.61 and 0.34 respectively. CONCLUSION: The presence of metabolic syndrome among Ghanaian postmenopausal women can be predicted using WC, WHR, TG/HDL-C and HDL-C/TC.     

Abdominal adiposity and clustering of multiple metabolic syndrome in White, Black and Hispanic americans

PURPOSE: The aim of this study was to evaluate the association of abdominal adiposity assessed by waist circumference (WC) with clustering of multiple metabolic syndromes (MMS) in White, Black and Hispanic Americans. MMS was defined as the occurrence of two or more of either hypertension, type 2 diabetes mellitus, dyslipidemia, hypertriglyceridemia or hyperinsulinemia. METHODS: The number of MMS and fasting insulin (a surrogate measure of MMS) were each used as dependent variables in gender-specific multiple linear regression models, adjusting for age, smoking and alcohol intake. The contribution of WC to interethnic differences in clustering of MMS and fasting insulin concentration was assessed in gender-specific linear regression models. The risk of MMS due to large waist was estimated by comparing odds ratio for men with WC >/= 102 cm with those with WC < 102, and women with WC >/= 88 cm with women with WC < 88 cm in the logistic regression model adjusting for age, smoking and alcohol intake. RESULTS: WC was positively and independently associated with clustering of MMS and increased fasting insulin concentration adjusting for age, smoking and alcohol intake in the three ethnic groups (p < 0.01). Black ethnicity was associated with clustering of MMS and fasting insulin concentration (p < 0.01). Hispanic ethnicity was also associated with clustering of MMS in men and associated with fasting insulin concentration in both men and women (p < 0.01). In both men and women, the risk of MMS clustering was strongly associated with increased WC in all ethnic groups independent of BMI. CONCLUSION: WC appears to be a marker for multiple metabolic syndromes in these ethnic groups. The results of this investigation lend support to the view that waist measurement should be considered as a clinical variable for assessing the risk of cardiovascular diseases.     

2004年河北省城乡成人体质测量指标分析

目的了解河北省城乡成年居民体质测量指标及其超重与肥胖的状况。方法采用多阶段随机抽样的方法，对4200例成年居民进行体质测量及其超重与肥胖的现况流行病学调查，分析不同人群超重与肥胖及其危险因素。结果男性各指标为城市高于农村组，女性身高、体重、臀围城市均高于农村；性别相比，男性身高、体重、腰围、腰臀比均高于女性（P〈0．01），而臀围、体质指数女性高于男性（P〈0．01）；不同职业中，国家机关、党群组织、企事业单位负责人和办事人员和有关人员及离退休人员的平均腰围、臀围、体质指数均居各组前3位；超重与肥胖均随年龄增长而增加，男性和女性的体质指数均为城市高于农村，以65岁以上年龄组尤为突出；城市及农村女性体质指数和腰围均随文化程度的升高而下降，而农村男性则随文化程度升高而升高；在城乡男性不同职业人员中，机关、办事人员体质指数较高；女性则为农、林、牧、渔、水利生产人员、离退休人员体质指数较高；农村男性和城市男、女性体质指数、腰围随家庭年收入的增加而增高。结论河北省成年居民体质测量指标存在城乡、性别、职业差异；超重与肥胖与职业、城乡、文化程度、家庭收入关系密切。     

不同肥胖测量指标对北京市社区人群动脉僵硬度的评价

目的 探讨社区人群肥胖及其不同测量指标与动脉僵硬度的相关性.方法 北京市4个社区参加体检的2664名经知情同意的研究对象(男性1379名,女性1285名),平均年龄(53.19±15.73)岁,测量身高、体重、腰围(WC)、臀围,并计算其体重指数(BMI)、腰围臀围比(WHR),应用自动PWV分析仪测定颈-股动脉脉搏波传导速度(cfPWV),分析不同肥胖指标(BMI、WC、WHR)与cfPWV的关系.结果 2664名受试者中,BMI(r=0.0829,P＜0.01)、WC(r=0.2659,P＜0.01)、WHR(r=0.2749,P＜0.01)与cfPWV均呈正相关.单因素分析结果显示:将研究对象分为A组(cfPWV≤12 m/s)、B组(cfPWN＞12 m/s),与A组相比,B组的WC、WHR高于A组,差异有统计学意义(P＜0.05).BMI在A组与B组之间差异无统计学意义(P≥0.05).逐步回归分析显示:WC是cfPWV的危险因素,独立于性别、年龄、收缩压、高密度脂蛋白胆固醇、餐后2h血糖因素存在.结论 该社区人群中肥胖是动脉僵硬度的独立危险因素,其中不同的肥胖测量指标与动脉僵硬度的相关性不同.

Abstract：

Objective The aim of this study was to investigate the relationship between obesity [measured by body mass index(BMI), waist circumference(WC), waist-to-hip ratio(WHR)]and arterial stiffness on community populations in Beijing area. Methods In a cross-sectional study of 2664 subjects(1379 men and 1285 women)aged(53.19 ± 15.73 years, mean±standard deviation), BMI, WC, WHR and other cardiovascular risk factors, were measured and carotidfemoral pulse wave velocity(cfPWV)was measured to assess the arterial stiffness. All the data were analyzed with linear correlation analysis, univariate analysis and stepwise regression method to explore the relationship between obese indexes and arterial stiffness. Results We noticed that a showed the existence of positive correlations between BMI(r=0.0829,P＜0.01)and cfPWV, WC(r=0.2659, P＜0.01)and cfPWV, WHR(r=0.2749, P＜0.01)and cfPWV, in univariate analysis,cfPWV was associated with WC≥85 cm(male)or ≥80 cm(famale)(P＜0.01), WHR≥0.90(male)or≥ 0.85(famale)(P＜ 0.01). Stepwise regression analysis revealed that WC was an independent risk factor of cfPWV, other than age, gender, systolic blood pressure, HDL-C, OGTT2h etc. Conclusion Our findings indicated that obesity was an independent risk factor of cfPWV, which was an early marker of cardiovascular and renal diseases, among community population in Beijing area. There were different relationships between obesity measurement parameters(BMI, WC, WHR)and cfPWV.     

2006年青岛市35岁以上人群腰围与糖耐量调查及3年后转归情况分析

[目的]了解35岁以上人群腰围与糖耐量情况,探讨影响糖耐量正常人群糖耐量转归的因素,为糖尿病预防提供科学依据。[方法]在青岛市城乡选取2006年糖耐量正常的684名35～74岁人群,测量其腰围值,3年后进行随访。[结果]2006年684名糖耐量正常者中,腹型肥胖罹患率为53.22%。3年后随访上述684人,IGR累积发病率为28.07%,其中腹型肥胖组为34.89%,腰围正常组为20.31%(P<0.01);DM累积发病率为3.51%,其中腹型肥胖者为4.67%,腰围正常组为2.19%(P>0.05)。684人中,2006年腰围为82.38±9.23cm,2009年腰围为85.29±9.45cm(P<0.01)。多因素非条件Logistic回归分析结果,影响糖耐量情况的因素有收缩压(SBP)、腰围(WC)、低密度脂蛋白胆固醇(LDL)、总胆固醇(TC)、尿酸(UA),OR值分别为1.011、1.047、0.643、1.584、1.003。[结论]腹型肥胖者较腰围正常者易发生IGR;收缩压高、腰围值高、低密度脂蛋白胆固醇含量低、总胆固醇含量高、尿酸高的人容易转归为IGR和/或DM。     

Longitudinal association of anthropometric measures of adiposity with cardiometabolic risk factors in postmenopausal women

PurposeSome studies suggest that anthropometric measures of abdominal obesity may be superior to body mass index (BMI) for the prediction of cardiometabolic risk factors; however, most studies have been cross-sectional. Our aim was to prospectively examine the association of change in BMI, waist-to-hip ratio (WHR), waist circumference (WC), and waist circumference-to-height ratio (WCHtR) with change in markers of cardiometabolic risk in a population of postmenopausal women.MethodsWe used a subsample of participants in the Women's Health Initiative aged 50 to 79 years at entry with available fasting blood samples and anthropometric measurements obtained at multiple time points over 12.8 years of follow-up (n = 2672). The blood samples were used to measure blood glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides at baseline, and at years 1, 3, and 6. We conducted mixed-effects linear regression analyses to examine associations at baseline and longitudinal associations between change in anthropometric measures and change in cardiometabolic risk factors, adjusting for covariates.ResultsIn longitudinal analyses, change in BMI, WC, and WCHtR robustly predicted change in cardiometabolic risk, whereas change in WHR did not. The strongest associations were seen for change in triglycerides, glucose, and HDL-C (inverse association).ConclusionIncrease in BMI, WC, and WCHtR strongly predicted increases in serum triglycerides and glucose, and reduced HDL-C. WC and WCHtR were superior to BMI in predicting serum glucose, HDL-C, and triglycerides. WCHtR was superior to WC only in predicting serum glucose. BMI, WC, and WCHtR were all superior to WHR.     

Obesity in South Africa: the South African demographic and health survey

OBJECTIVES: To ascertain the anthropometric profile and determinants of obesity in South Africans who participated in the Demographic and Health Survey in 1998. RESEARCH METHODS AND PROCEDURES: A sample of 13,089 men and women (age, > or =15 years) were randomly selected and then stratified by province and urban and nonurban areas. Height, weight, mid-upper arm circumference, and waist and hip circumference were measured. Body mass index (BMI) was used as an indicator of obesity, and the waist/hip ratio (WHR) was used as an indicator of abdominal obesity. Multivariate regression identified sociodemographic predictors of BMI and waist circumference in the data. RESULTS: Mean BMI values for men and women were 22.9 kg/m(2) and 27.1 kg/m(2), respectively. For men, 29.2% were overweight or obese (> or =25 kg/m(2)) and 9.2% had abdominal obesity (WHR > or =1.0), whereas 56.6% of women were overweight or obese and 42% had abdominal obesity (WHR >0.85). Underweight (BMI <18.5 kg/m(2)) was found in 12.2% of men and 5.6% of women. For men, 19% of the variation of BMI and 34% of the variation in waist circumference could be explained by age, level of education, population group, and area of residence. For women, these variables explained 16% of the variation of BMI and 24% of the variation in waist circumference. Obesity increased with age, and higher levels of obesity were found in urban African women. DISCUSSION: Overnutrition is prevalent among adult South Africans, particularly women. Determinants of overnutrition include age, level of education, ethnicity, and area of residence.     

Prospective study of optimal obesity index cutoffs for predicting development of multiple metabolic risk factors: the korean genome and epidemiology study

Background: In this prospective cohort study, we estimated the risk of developing more than 1 metabolic risk factor, using different obesity indices. In addition, we investigated the relative usefulness of the obesity indices for predicting development of such risk factors and calculated optimal cutoffs for the obesity indices.Methods: The cohort comprised 10 038 representative residents of a small city and a rural county who were recruited in 2001-2002. Follow-up examinations were conducted every 2 years. Among the 3857 participants without metabolic syndrome at baseline, 1102 new cases occurred during the 6-year follow-up. Receiver operating characteristic (ROC) curves for the obesity indices were plotted to compare the usefulness of the obesity indices.Results: The numbers of new cases of multiple metabolic risk factors among people in the highest quintiles of body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and waist-height ratio at the baseline examination were 2 to 3 times those in the lowest quintiles. The area under the ROC curve for WHR was significantly higher than that for BMI. The optimal BMI cutoff was 24 kg/m(2) in men and women, and the optimal WC cutoffs were 80 cm and 78 cm in men and women, respectively.Conclusions: Both overall obesity and central obesity predicted risk of developing multiple metabolic risk factors, and WHR appeared to be a better discriminator than BMI. To prevent development of metabolic diseases among Koreans, it might be useful to lower the cutoff for abdominal obesity, as defined by WC.     

苏州市成年人身体测量指标与糖尿病患病关系的研究

目的 探讨成年人身体测量指标与糖尿病患病的关系.方法 利用“中国慢性病前瞻性研究”(CKB)苏州市项目点53 260名30～79岁常住居民有效基线调查数据,通过logistic多元回归分析研究身体测量指标与糖尿病患病的关系.结果 调查人群糖尿病患病率为5.3%,其中半数为新检测发现患者.糖尿病患病率随年龄增加而升高,年龄每增加10岁,患病风险增加61%(OR=1.61,95%CI:1.54～1.67).无论男女性别,BMI、体脂比、腰围、臀围、腰臀比和腰身比均与糖尿病患病呈显著正相关.中心性肥胖指标与糖尿病患病风险的关系强于全身性肥胖指标,其中腰臀比与糖尿病患病风险的关系最强.腰臀比每增加1个标准差(s),男性(s=0.06)的糖尿病患病风险增加72%(61%～83%),女性(s=0.07)增加93%(83%～102%).在同一分析模型中“腰围”和“臀围”相互调整后,腰围值每增加5 cm,男女性糖尿病患病风险性分别增加65%和57%;但臀围值每增加5 cm,男女性糖尿病患病风险性分别减少38%和34%.结论 BMI、体脂比、腰围、腰臀比和腰身比等肥胖测量指标均与糖尿病患病呈显著正相关;中心性肥胖指标,尤其是“腰臀比”,与糖尿病患病风险的关系强于全身性肥胖指标.控制“腰围”后,“臀围”与糖尿病患病呈显著负相关.     

Smoking status and body fatness indicators: a cross-sectional survey among 1948 Chinese male adults

Aim

The relationship between cigarette smoking and obesity has been extensively studied, but the existing evidence is inconclusive. Moreover, few previous studies had examined the relationships of cigarette smoking with body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR) simultaneously, which could not fully assess the effects of smoking on fat distribution. This study aimed to investigate the associations of cigarette smoking with BMI, WC, HC and WHR in Chinese male adults.

Subjects and methods

A total of 1,948 Chinese male adults (including 982 non-smokers, 846 current smokers and 210 former smokers) were selected from a community-based chronic disease screening project in Guangzhou and Zhuhai, China. The selected subjects were surveyed about their smoking status and history, and their body fatness indicators (BMI, WC, HC and WHR) were measured. A series of analyses of covariance (ANCOVA) were performed to assess associations between smoking behaviors and the body fatness indicators with adjustment for potential confounders.

Results

Current smokers had lower BMI (23.3 vs. 23.5 kg/m²) and HC (93.5 vs. 94.1 cm) but higher WHR (0.867 vs. 0.859) than non-smokers. Within current smokers, heavy smokers (>15 cigarettes/day) had higher BMI (23.4 vs. 23.0 kg/m²) than light smokers (1–15 cigarettes/day) without controlling for WC, but this association was reversed after adjusting for WC (23.1 vs. 23.3 cm). Heavy smokers had higher WC and WHR but lower HC than non-smokers. Former smokers who had quit for shorter than 1 year had larger BMI than non-smokers and former smokers who quitted for 1 year or longer.

Conclusions

Cigarette smoking is associated with both of the reduced total body mass and the increased waist fat deposit, and the weight gain seems to occur and complete itself in a short time after smoking cessation. These findings may improve the understanding on how cigarette smoking is linked to fat distribution and provide scientific evidence regarding intervention in smoking and obesity.