Predictive Values of Body Mass Index and Waist Circumference for Risk Factors of Certain Related Diseases in Chinese Adults - Study on Optimal Cut-off Points of Body Mass Index and Waist Circumference in Chinese Adults

The body mass index of Chinese population is lower than that of the Westerncountries, however, the trends of mean body mass index and prevalence of overweight inadults have increased significantly in recent 15 years[1]. Overweight and obesity areclosely r…     

Predictive Values of Body Mass Index and Waist Circumference for Rish Factors of Certain Related Diseases in Chinese Adults—Study on Optimal Cut—off Points of Body Mass Index and Waist Circumference

For prevention of obesity in Chinese population, it is necessary to define the optimal range of healthy weight and the appropriate cut-off points of BMI and waist circumference for Chinese adults. The Working Group on Obesity in China under the support of International Life Sciences Institute Focal point in China organized a meta-analysis on the relation between BMI, waist circumference and risk factors of related chronic diseases (e. g.,high diabetes, diabetes mellitus, and lipoprotein disorders). Methods 13 population studies in all met the criteria for enrollment, with data of 239 972 adults (20-70 year) surveyed in the 1990s. Data on waist circumference was available for 111411 persons and data on serum lipids and glucose were available for more than 80 000. The study populations located in 21provinces, municipalities and autonomous regions in mainland China as well as in Taiwan. Each enrolled study provided data according to a common protocol and uniform format. The Center for data management in Department of Epidemiology, Fu Wai Hospital was responsible for statistical analysis. Results and conclusion The prevalence of hypertension, diabetes, dyslipidemia and clustering of risk factors all increased with increasing levels of BMI or waist circumference. BMI at 24 with best sensitivity and specificity for identification of the risk factors, was recommended as the cut-off point for overweight, BMI at 28 which may identify the risk factors with specificity around 90 % was recommended as the cut-off point for obesity. Waist circumference beyond 85 cm for men and beyond 80 cm for women were recommended as the cut-off points for central obesity.Analysis of population attributable risk percent illustrated that reducing BMI to normal range (＜24) could prevent 45%-50% clustering of risk factors. Treatment of obese persons (BMI ≥ 28)with drugs could prevent 15%-17% clustering of risk factors. The waist circumference controlled under 85 cm for men and under 80 cm for women, could prevent 47%-58% clustering of risk factors. According to these, a classification of overweight and obesity for Chinese adults is recommended.     

内脏脂肪联合孕前体重指数预测妊娠期代谢综合征

目的 探讨内脏脂肪联合孕前体重指数（BMI）预测妊娠期代谢综合征（GMS）的临床意义。方法 选择上城区某社区卫生服务中心2014年7月~2016年6月具有GMS高风险因素的孕妇1212例作为研究对象,孕龄9~13周,采用内脏脂肪联合孕前BMI预测GMS,并与孕32~36周GMS诊断结果进行对照,比较单一内脏脂肪、孕前BMI与两项联合的预测价值。结果 1212例GMS高风险因素孕妇发生GMS 117例,发生率为9.65%;内脏脂肪预测102例,预测率为87.18%;孕前BMI预测90例,预测率为76.92%;两项联合预测114例,预测率为97.44%,差异有统计学意义（χ²=7.341,P<0.05）。内脏脂肪联合BMI的敏感度及准确度分别为97.44%、99.73%,均高于孕前BMI的76.92%、97.53%,差异有统计学意义（χ²=7.341、6.480,P<0.05）;高于内脏脂肪的87.18%、98.63%,差异无统计学意义（P>0.05）。结论 内脏脂肪联合孕前BMI可提高GMS的预测率,并具有安全、简便、准确的优点,能够对大部分GMS做出早期预测,为临床拟定营养干预方案,避免不良妊娠结局提供依据,值得推广应用。     

Effect of Body Mass Index on All—cause Mortality and Incidence of Cardiovascular Diseases—Report for Meta—Analysis of Prospective Studies on Optimal Cut—off Points of Body Mass Index in Chinese Ad

Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts. Methods The prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke. Results The data of 4 cohorts including 76 227persons, with 745 346 person-years of follow-up were collected and analyzed. The age-adjusted allcause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8 % increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by15 % for men, and 22 % of both diseases for women. Conclusion BMI ≤18.5, 24-27.9 and ≥28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in Chinese adults.     

体重指数和腰围预测血脂变化的价值

目的了解体脂参数与血脂参数的关系,比较体重指数(BMI)与腰围(WC)在预测血脂变化中的价值。方法对常规体检的空腹血糖<5.6mmol/L的公务员和职员1072例调查年龄、性别、BMI、WC、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和TC/HDL-C比值。结果①BMI、WC与TG、TC、LDL-C或TC/HDL-C比值呈正相关(相关系数在0.209～0.485之间,均P<0.01),与HDL-C呈负相关(相关系数为―0.344和―0.441,均P<0.01);②以TG、TC、LDL-C、HDL-C或TC/HDL-C比值为应变量,以年龄、性别、BMI和WC为自变量进行多元逐步回归分析,WC进入而BMI未进入TC、LDL-C或HDL-C的回归方程,BMI和WC均进入TG或TC/HDL-C比值回归方程,但WC的标准化回归系数大于BMI。结论在预测血脂参数的变化WC优于BMI。     

出生体质量与体质量指数、腰围及体脂肪含量关系研究

目的　研究出生体质量与体质量指数（body mass index, BMI）、腰围和体脂肪含量之间的关系。方法　采用回顾性横断面研究方法收集上海市浦东新区高行镇2 561例学生为研究对象其中男生1 338人,女生1 223人。采集身高、体质量、腰围和体脂肪含量（生物电阻抗法）指标。出生体质量依据出生证明获得。出生后喂养情况、儿童每天运动时间、每月快餐次数、每周加工肉类、油炸食品、碳酸饮料频次、父母教育程度采用问卷调查获得。出生体质量与BMI腰围和体脂肪含量的关系采用广义线性模型,出生体质量与肥胖发生危险因素的关系采用多元Logistic回归分析。结果　本组学生平均出生体质量为(3 3391±4502) g,平均年龄为(92±21)岁。随着出生体质量增加,学生BMI、腰围和体脂肪含量也明显增加（均有P<0001）。每单位SD（≈450 g）出生体质量增长,可导致BMI增长025 kg/m2、腰围增长066 cm、体脂肪含量增加023个百分点。与出生体质量处于第一四分位组的学生相比较,出生体质量位于最高百分位组学生发生肥胖的危险因素增加42%（OR=142,95%CI为105~192）。结论　出生体质量较高的儿童其BMI和腰围明显高于出生体质量较低的儿童。高出生体质量是肥胖发生的危险因素之一。     

体质量对冠状动脉成像辐射剂量的影响

目的：探讨体质量指数(BMI)对螺旋CT冠状动脉血管成像(CCTA)辐射剂量的影响。方法对我院2013年3~5月收治的113例怀疑冠心病患者行CCTA,按不同BMI值分为三组,其中BMI<25的66例患者为A组,2530的6例患者为C组。采用回顾性心电门控,对不同组图像BMI和有效剂量进行比较。结果 A组、B组和C组患者的BMI值分别为(21.95±1.81)、(26.79±1.41)和(32.80±3.27),差异有显著统计学意义(F=166.53,P<0.01);A组、B组和C组的有效剂量分别为(14.28±2.46) mSv、(18.59±1.67) mSv和(21.72±3.06) mSv,差异有显著统计学意义(F=65.67,P<0.01);A组、B组和C组患者的图像质量评分分别为(3.96±0.10)分、(3.75±0.50)分和(3.66±0.81)分,差异无统计学意义(F=0.61,P>0.05)。结论在保证图像质量评分不变时,随着BMI值的增加,冠状动脉血管成像所得到的辐射剂量会增多。     

降低体重指数对原发性高血压病降压效果的影响及其临床意义

目的探讨降低体重指数(BodyMassIndex,BMI)对原发性高血压病降压效果的影响及其临床意义。方法选择40例超重或肥胖的(BMI≥24)原发性高血压病患者,分为治疗组与对照组,降低治疗组患者的体重指数,同时观察两组治疗前后血压的变化。结果发现治疗组患者降低体重指数后血压有明显下降,与对照组相比有显著的临床意义(P<0.05)。结论降低超重或肥胖的高血压病患者的体重指数可起到一定的降压效果,应注意降低患者的体重指数。     

根据体重指数预测老年糖尿病患者胰岛素抵抗的分析研究

目的 分析研究体重指数(BMI)是否可以作为预测老年糖尿病患者胰岛素抵抗(IR)的指标.方法 选取2018年6月至2019年12月在惠州市第一人民医院就诊的100例老年糖尿病患者作为研究对象.按照IR指数(HOMA-IR)值75％,本研究中为2.3,将纳入对象分为对照组和IR组,每组50例.测量所有受试者身高和体重,分...     

贺州市八步区城乡居民体质指数的调查分析

目的 为了解城乡居民营养状况及体质指数分布趋势,更科学地、简易地指导城乡居民的合理营养,平衡膳食.方法 按照全国营养调查方法,采用多阶整群随机抽样方法,按等概率原则在贺州市八步区城乡抽取3个乡镇的6个村委会、共537户.其中膳食调查177户共613人,健康体检2 401人.体格测量使用校正过的测量工具,由经过专门培训合格的人员进行测量及质控.结果 营养不良率男略高于女性,而超重率则是女性高于男性,但两者之间无差异统计学意义(P＞0.05).肥胖率女性显著高于男性(P＜0.01).60岁以上年龄组营养不良患病率最高,和广西平均水平接近;超重患病率接近广西平均水平;肥胖患病率低于广西平均水平.结论 在贺州地区,营养失衡发生率仍然很高,提示开展营养教育,正确引导食物消费,建立合理科学与健康的食物消费观念,控制超重或肥胖,具有十分重要意义.     

依据BMI值减少冠状动脉CTA辐射剂量

目的：探讨如何依据不同体质量指数(BMI)并使用iDOS3技术来减少256层螺旋CT冠状动脉血管成像(CCTA)的辐射剂量。方法对我院2013年10~12月289例怀疑冠心病患者行CCTA检查,按不同BMI值分为三组,其中BMI<25者168例(A组);2530者16例(C组)。每组患者分别降低辐射剂量的30%(方案1)、40%(方案2)及50%(方案3)进行扫描。采用回顾性心电门控+iDOS3技术。对不同组图像质量进行比较。结果 A组、B组及C组的图像质量的平均评分分别为(3.80±0.47)分、(3.69±0.51)分和(3.37±0.62)分,三组间比较差异无统计学意义(F=0.61,P=0.858>0.05)。结论在降低不同百分比辐射剂量条件下的冠状动脉血管成像中,不同BMI患者的图像质量虽然均有所降低,但均符合诊断要求。因此,对不同BMI值人群可采取不同的扫描条件,可达到既使图像质量符合诊断要求,又减少患者辐射剂量的目的。