Body mass index and waist circumference in non-alcoholic fatty liver disease

OBJECTIVE: To evaluate the association of anthropometric indexes (body mass index and waist circumference) in patients with non-alcoholic fatty liver disease (NAFLD), and its association with insulin resistance (IR), metabolic syndrome (MS) and histological findings. METHODS: From August 2003 to July 2004 a case series of 81 outpatients with clinic and/or histological diagnosis of NAFLD were selected at the Bahia University Gastro-Hepatology Clinic, Brazil. Liver function tests, lipid profile, glucose and insulin were performed in all patients. Body mass index (BMI) and waist circumference (WC) were determined according to WHO criteria. IR was measured by means of the homeostasis model assessment (HOMA) and IR was considered with HOMA > or =3. MS was defined according to the Adult Treatment Panel III (ATP III). Liver biopsy was performed in 37 cases. RESULTS: Body mass index > or = 30 kg m(-2) (obesity) was found in 39% of the cases and BMI > or = 25-29.9 kg m(-2) (overweight) in 53%. BMI was correlated with IR (r = 0.29; P = 0.02) and WC with ALT (r = 0.02; P = 0.03). Increased WC also was related to IR and to MS. The presence of steatohepatitis with fibrosis on liver biopsy was associated with overweight (68%) and increase of WC (41%). CONCLUSIONS: Body mass index and WC are frequent associated with MS, IR and histological findings (steatohepatitis and fibrosis) in patients with NAFLD.     

Body mass index and waist circumference in midchildhood and adverse cardiovascular disease risk clustering in adolescence

BACKGROUND: Body mass index (BMI) may not indicate the level of central adiposity associated with the clustering of cardiovascular disease (CVD) risk factors. Hence, it has been recommended that waist circumference be used as an alternative measure. OBJECTIVE: The objective was to investigate whether waist circumference in midchildhood is more effective at predicting cardiovascular disease risk clustering in adolescence than is BMI. DESIGN: Anthropometric measurements were made in 342 children aged 8 y. Seven years later, anthropometric measurements were made in 290 participants, and metabolic profiles were determined in 172 participants. RESULTS: At 15 y, between 9.4% and 11.0% of adolescents were defined as having CVD risk clustering. Children who were overweight or obese at 8 y of age were 7 times (odds ratio: 6.9; 95% CI: 2.5, 19.0; P < 0.001) as likely to have CVD risk clustering in adolescence than were their peers who were not overweight or obese. Those with an increased waist circumference at 8 y were 4 times (3.6; 1.0, 12.9; P = 0.061) as likely to have CVD risk clustering in adolescence than were children with a smaller waist circumference. Neither BMI nor waist circumference were predictive of CVD risk clustering if adiposity was not included as a risk factor. CONCLUSIONS: The association between measures of adiposity in midchildhood and later adverse CVD risk is a result of the tracking of adiposity status. Our results do not support the need to measure waist circumference in children, in addition to BMI, to identify those at increased risk of CVD risk factor clustering in adolescence.     

Body mass index and risk of Parkinson's disease: a prospective cohort study

High body mass index has been associated with increased risk of several chronic diseases, including cardiovascular disease, and, recently, Alzheimer's disease. There are few data on the association of body mass index with Parkinson's disease, and results have been inconsistent. The authors conducted a prospective study among 10,812 men in the Harvard Alumni Health Study, followed from 1988 to 1998 (mean age at baseline: 67.7 years), to test the hypothesis that body mass index is associated with Parkinson's disease risk. Among 106 incident cases of Parkinson's disease, body mass index at baseline was not associated with Parkinson's disease risk (for body mass index <22.5, 22.5-<24.9, and > or =25.0 kg/m2: multivariate relative risks = 1.51 (95% confidence interval: 0.95, 2.40), 1.00 (referent), and 0.86 (95% confidence interval: 0.53, 1.41)). The authors had information on body mass index during late adolescence, when men entered college; this was unrelated to Parkinson's disease risk as well. Subjects who lost at least 0.5 units of body mass index per decade between college entry and 1988 had a significantly increased Parkinson's disease risk, compared with men having stable body mass index (multivariate relative risk = 2.60, 95% confidence interval: 1.10, 6.10). The authors conclude that body mass index is unrelated to Parkinson's disease risk and speculate that the observation of increased risk with body mass index loss since late adolescence may reflect weight loss due to Parkinson's disease that preceded clinical diagnosis.     

Waist circumference is a better predictor than body mass index of coronary heart disease risk in overweight premenopausal women

Waist circumference (WC) has been postulated to have stronger associations with biomarkers of coronary heart disease (CHD) than BMI. In this study, we measured the level of activity by determining steps walked per day and select biomarkers for CHD risk in 80 overweight or obese (BMI = 25-37 kg/m(2)) premenopausal women to evaluate whether these biomarkers are associated with WC or BMI. The plasma biomarkers measured, using samples from women who had fasted for 12 h, were lipids, apolipoproteins (apo), LDL peak diameter, LDL susceptibility to oxidation, glucose, leptin, and insulin. We identified subjects with the metabolic syndrome (11%) and insulin resistance (30%) to further distinguish subjects at increased risk for CHD. Both BMI and WC were positively correlated with insulin (r = 0.376 and 0.384, respectively, P < 0.05) and leptin (r = 0.614 and 0.512, respectively, P < 0.01) and negatively correlated with the number of steps taken per day (r = -0.245 and -0.354, respectively, P < 0.05). In addition, WC had positive correlations with diastolic blood pressure (r = 0.250, P < 0.05), plasma triglycerides (TG) (r = 0.270, P < 0.05), and apo C-III (r = 0.240, P < 0.05). Women with BMI > or = 30 kg/m(2) or WC > 88 cm had significantly higher leptin concentrations than women having a BMI < 30 kg/m(2) or a WC < or = 88 cm; women with WC > 88 cm also had higher diastolic pressure (P < 0.05), and higher plasma TG (P < 0.05) and apo C-III (P < 0.05) concentrations than those with WC < or = 88. In addition, subjects with the higher WC walked an average of 1000 fewer steps per day (P < 0.01). These results suggest that WC is a stronger predictor of CHD risk than BMI and is more closely associated with the level of exercise in premenopausal women.     

Body mass index and waist circumference are independent risk factors for low vital capacity among Japanese participants of a health checkup: a single-institution cross-sectional study

Objective

This study aimed to examine the associations between obesity and percentage vital capacity (%VC), as well as lifestyle-related disorders, among Japanese participants of a voluntary health checkup.

Methods

Subjects were 7,892 individuals who participated in a medical health checkup from January to December 2007. Multivariate logistic regression analysis was performed to assess associations between low %VC (<80) and body mass index (BMI) and waist circumference (WC), as well as lifestyle-related disorders.

Results

Medical histories of hypertension and dyslipidemia were more frequent in the low %VC group than in the normal %VC group in both sexes. In men, BMI was significantly associated with low %VC (25.0 ≤ C2 < 27.5, odds ratio (OR) = 2.10; 27.5 ≤ C3 < 30.0, OR = 2.23; C4 ≥ 30.0, OR = 3.46) relative to the first category (C1 < 25.0). A significant association was also observed between WC and low %VC (85 ≤ C2 < 90, OR = 1.40; 90 ≤ C3 < 95, OR = 1.55; 95 ≤ C4, OR = 2.51; relative to C1 < 85.0 cm). In women, BMI was significantly associated with low %VC in C3 and C4 (C3, OR = 2.05; C4, OR = 2.84), and WC was significantly associated with low %VC in C4 (C4, OR = 2.32).

Conclusion

Our results suggest that obesity may be associated with restrictive pulmonary function and underscore the importance of maintaining ideal body weight for the prevention of restrictive pulmonary dysfunction.     

我国成年人体质指数和腰围与缺血性卒中发病风险的前瞻性研究

目的:分析我国成年人BMI和腰围与缺血性卒中发病风险的关联。方法:从2010年中国慢性病监测项目选取60个监测点人群（城市监测点25个、农村监测点35个）作为本次研究对象,共计36 632人。将2010年中国慢性病监测项目数据作为基线数据。2016-2017年对该60个监测点人群进行随访,实际完成者27 762人。采用...     

Body mass index and incident ischemic heart disease in South Korean men and women

Asian populations have a higher body fat percentage for a given body mass index (BMI) than Caucasians. However, little information is available on the association of BMI with ischemic heart disease (IHD) incidence in Asians at low BMI levels. The authors prospectively evaluated the association of BMI (weight (kg)/height m2) with IHD incidence over 9 years of follow-up (1993-2001) among 133,740 South Korean adults (89,050 men, 44,690 women) who participated in the 1990 and 1992 examinations of the Korea Medical Insurance Corporation Study. Average BMI at baseline was 23.4 (standard deviation, 2.3) in men and 22.3 (standard deviation, 2.3) in women. After multivariate adjustment, there was a 14% (95% confidence interval: 12, 16) increased risk of incident IHD per unit of increase in BMI. This trend was also observed within the range considered normal by Western standards, and a BMI of 24-<25 was associated with an IHD hazard ratio of 2.01 (95% confidence interval: 1.32, 3.05) in comparison with a BMI of 18-<19. The association of BMI with IHD in this cohort of relatively young South Korean men and women was progressive over the range of BMI values, with no threshold of change in risk and no indication of a U-shaped relation at low BMI levels.     

体质指数基础上腰围与心血管病危险因素的相关性研究

目的 研究体质指数(BMI)、腰围(WC)指标与心血管病危险因素的关系.方法 采用分层整群随机抽取的方法 ,于2009年3月～6月对某部40～87岁人员进行病史、体检和实验室检查,获得完整资料456份.对WC、BMI及高血压、高血糖、血脂异常等心血管病危险因素进行分析.结果 456人平均BMI为24.09±3.15,平均WC为82.89±8.89 cm.在同一BMI分层内男、女有腹部肥胖者其心血管病危险因素患病率均高于无腹部肥胖者,差异有统计学意义(P＜0.05).Logistic回归分析显示,同一BMI分层内,腹部肥胖者心血管病危险度增大,在调整了年龄、性别、吸烟和体力活动等因素后,其特点仍存在.结论 腹型肥胖者心血管病的患病危险性更大,应重视其在心血管病防治中的意义.     

中国22万男性人群体重指数与缺血性心脏病关系的15年前瞻陛研究

目的 探讨中国人群尤其是低体重人群中体重指数(BMI)与缺血性心脏病(IHD)死亡之间的关系.方法 数据来源于1990-1991年已随访15年共涉及中国220 000名40～79岁男性对象的前瞻性队列研究.利用Cox比例风险模型,在调整年龄、吸烟史及其他潜在混杂因素后,计算BMI与IHD死亡间的相对危险度(解).结果 基线BMI平均值为21.7 kg/m~2.15年随访期间,共有2763例对象死于IHD(占总死亡的6.8%).在排除了基线调查时已报告息有心脑血管疾病史的对象后,BMI与IHD死亡率之间呈"J"形关系.当BMI＞20 kg/m~2时,BMI与IHD死亡风险呈正相关.BMI值每升高5 kg/m~2,IHD死亡率相应增高21%(95%CI:9%～35%,P=0.0004).而当BMI＜20kg/m~2时,IHD死亡风险反而随着BMI的下降呈上升的趋势.在BMI值为20～21.9、18～19.9、＜18 kg/m~2范围时,其对应的RR值分别为1.00、1.11和1.14.在排除了前3年随访中死亡的病例或将分析局限于从不吸烟者中,BMI与IHD死亡风险的关系仍呈现相同趋势.结论 对于处在所谓正常BMI范围值内(20～25 kg/m~2)的人群,BMI与IHD死亡风险呈正相关,但当BMI低于这一范围,两者的关联极有可能为负相关.     

青岛市成年人体质指数与冠心病发病关联的前瞻性研究

目的 分析青岛市成年人体质指数（BMI）与冠心病发病之间的关联。方法 研究对象来自中国慢性病前瞻性研究青岛市项目点,共纳入33 355名30~79岁研究对象,采用Cox比例风险回归模型,分析BMI与冠心病发病的关联。结果 调查对象平均随访9.2人年,共监测缺血性心脏病（IHD）2 712例,主要冠心病事件（MCE）420例。多因素Cox回归分析显示,与体重正常或过低的人群相比,超重和肥胖人群IHD及MCE的风险增加,超重组发病风险分别增加了41%和87%,HR值（95%CI）分别为1.41（1.27~1.56）和1.87（1.43~2.44）,肥胖组分别增加了91%和143%,HR值（95%CI）分别为1.91（1.72~2.13）和2.43（1.82~3.24）。结论 超重和肥胖会增加IHD和MCE的发病风险。     

Serum triglycerides and risk of coronary heart disease among Japanese men and women

To examine the relation of triglycerides with coronary heart disease among populations with low mean total cholesterol, the authors conducted a 15.5-year prospective study ending in 1997 of 11,068 Japanese aged 40-69 years (4,452 men and 6,616 women with mean total cholesterol = 4.73 mmol/liter and 5.03 mmol/liter, respectively), initially free of coronary heart disease or stroke. There were 236 coronary heart disease events comprising 133 myocardial infarctions, 68 angina pectoris events, and 44 sudden cardiac deaths. The coronary heart disease incidence was greater in a dose-response manner across increasing quartiles of nonfasting triglycerides for both sexes. The multivariate relative risk of coronary heart disease adjusting for coronary risk factors and time since last meal associated with a 1-mmol/liter increase in triglycerides was 1.29 (95% confidence interval (CI): 1.09, 1.53; p = 0.004) for men and 1.42 (95% CI: 1.15, 1.75; p = 0.001) for women. The trend was similar for myocardial infarction, angina pectoris, and sudden cardiac death. The relation of triglycerides with coronary heart disease was not influenced materially by total cholesterol levels or, in a subsample analysis (51% of total sample), by high density lipoprotein cholesterol levels. Nonfasting serum triglycerides predict the incidence of coronary heart disease among Japanese men and women who possess low mean values of total cholesterol. Further adjustment for high density lipoprotein cholesterol suggests an independent role of triglycerides on the coronary heart disease risk.     

Body mass index and mortality from ischaemic heart disease in a lean population: 10 year prospective study of 220,000 adult men

BACKGROUND: Increased body mass index (BMI) is known to be related to ischaemic heart disease (IHD) in populations where many are overweight (BMI>or=25 kg/m2) or obese (BMI>or=30). Substantial uncertainty remains, however, about the relationship between BMI and IHD in populations with lower BMI levels. METHODS: We examined the data from a population-based, prospective cohort study of 222,000 Chinese men aged 40-79. Relative and absolute risks of death from IHD by baseline BMI were calculated, standardized for age, smoking, and other potential confounding factors. RESULTS: The mean baseline BMI was 21.7 kg/m2, and 1942 IHD deaths were recorded during 10 years of follow-up (6.5% of all such deaths). Among men without prior vascular diseases at baseline, there was a J-shaped association between BMI and IHD mortality. Above 20 kg/m2 there was a positive association of BMI with risk, with each 2 kg/m2 higher in usual BMI associated with 12% (95% CI 6-19%, 2P=0.0001) higher IHD mortality. Below this BMI range, however, the association appeared to be reversed, with risk ratios of 1.00, 1.09, and 1.15, respectively, for men with BMI 20-21.9, 18-19.9, and <18 kg/m2. The excess IHD risk observed at low BMI levels persisted after restricting analysis to never smokers or excluding the first 3 years of follow-up, and became about twice as great after allowing for blood pressure. CONCLUSIONS: Lower BMI is associated with lower IHD risk among people in the so-called normal range of BMI values (20-25 kg/m2), but below that range the association may well be reversed.     

Discrimination of health risk by combined body mass index and waist circumference

OBJECTIVE: NIH Clinical Guidelines (1998) recommend the measurement of waist circumference (WC, centimeters) within body mass index (BMI, kilograms per square meter) categories as a screening tool for increased health risk. RESEARCH METHODS AND PROCEDURES: The Canada Heart Health Surveys (1986 through 1992) were used to describe the prevalence of the metabolic syndrome in Canada and to test the use of the NIH guidelines for predicting metabolic risk factors. The sample included 7981 participants ages 20 to 74 years who had complete data for WC, BMI, high-density lipoprotein-cholesterol, triglycerides, diabetic status, and systolic and diastolic blood pressures. National Cholesterol Education Program Adult Treatment Panel III risk categories were used to identify the metabolic syndrome and associated risk factors. Logistic regression was used to test the hypothesis that WC improves the prediction of the metabolic syndrome, within overweight (25 to 29.9 kg/m(2)) and obese I (30 to 34.9 kg/m(2)) BMI categories. RESULTS: The prevalence of the metabolic syndrome was 17.0% in men and 13.2% in women. The odds ratios (OR) for the prediction of the metabolic syndrome were elevated in overweight [OR, 1.85; 95% confidence interval (95%CI), 1.02 to 3.35] and obese (OR, 2.35; 95%CI, 1.25 to 4.42) women with a high WC compared with overweight and obese women with a low WC, respectively. On the other hand, WC was not predictive of the metabolic syndrome or component risk factors in men, within BMI categories. DISCUSSION: In women already at increased health risk because of an elevated BMI, the additional measurement of WC may help identify cardiovascular risk.     

Body mass index and waist circumference in relation to lung cancer risk in the Women's Health Initiative

Investigators in several epidemiologic studies have observed an inverse association between body mass index (BMI) and lung cancer risk, while others have not. The authors used data from the Women's Health Initiative to study the association of anthropometric factors with lung cancer risk. Over 8 years of follow-up (1998-2006), 1,365 incident lung cancer cases were ascertained among 161,809 women. Cox proportional hazards models were used to estimate hazard ratios adjusted for covariates. Baseline BMI was inversely associated with lung cancer in current smokers (highest quintile vs. lowest: hazard ratio (HR) = 0.62, 95% confidence interval (CI): 0.42, 0.92). When BMI and waist circumference were mutually adjusted, BMI was inversely associated with lung cancer risk in both current smokers and former smokers (HR = 0.40 (95% CI: 0.22, 0.72) and HR = 0.61 (95% CI: 0.40, 0.94), respectively), and waist circumference was positively associated with risk (HR = 1.56 (95% CI: 0.91, 2.69) and HR = 1.50 (95% CI: 0.98, 2.31), respectively). In never smokers, height showed a borderline positive association with lung cancer. These findings suggest that in smokers, BMI is inversely associated with lung cancer risk and that waist circumference is positively associated with risk.     

Waist-to-height ratio, waist circumference, and body mass index as indices of cardiometabolic risk among 36,642 Taiwanese adults

Purpose

We aimed to investigate the association of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with cardiometabolic risk.

Methods

In this cross-sectional study, 21,038 men and 15,604 women who participated in a health check-up were included.

Results

In both men and women, the area under the curve (AUC) of WHtR was significantly greater than that of BMI or WC in the prediction of diabetes, hypertension, high total cholesterol, high triglycerides, and low HDL-cholesterol (P < 0.05 for all). The AUC for WHtR in the prediction of metabolic syndrome (MS) was also highest in the women (P < 0.05). After adjustment for potential confounders, the odds ratios and 95% confidence intervals for MS for each standard deviation increase in BMI, WHtR, and WC were 1.47 (1.46–1.49), 1.32 (1.31–1.33), and 1.19 (1.18–1.19), respectively. Finally, patients of either sex with a normal BMI or WC level, but with an elevated WHtR, had higher levels of various cardiometabolic risk factors in comparison with their normal BMI or WC, but low WHtR, counterparts (P < 0.05 for all).

Conclusion

Among Taiwanese adults, a WHtR greater than 0.5 is a simple, yet effective indicator of centralized obesity and associated cardiometabolic risk, even among individuals deemed ‘healthy’ according to BMI and WC.     

广西城乡居民体质指数和腰围与糖尿病关系的研究

目的分析广西城乡居民成人体质指数(BMI)、腰围(WC)与糖尿病(DM)及空腹血糖受损(IFG)的关系。方法根据“2002年中国居民营养与健康状况调查”所确定的多阶段随机整群抽样方法,对广西4个城市和4个县18岁及以上3041名城乡居民进行了身高、体重、腰围测量以及空腹血糖测定,建立数据库,进行统计分析。结果城市居民糖尿病(DM)、空腹血糖受损(IFG)患病率分别为4.2%、1.6%,显著高于农村(0.8%、0.8%)(P<0.01)。BMI为<18.5,18.5～23.9,24～27.9及≥28者DM患病率分别为0.7%、1.4%、5.9%、9.8%,差异显著(P<0.01)。男性WC为<85cm,85～89cm及≥90cmDM患病率分别为1.4%、8.4%、6.0%;女性WC为<75cm,75～79cm,≥80cm者DM患病率分别为0.6%、1.3%、10.6%,均有显著差异(P<0.01)。除18～29岁外其他各年龄组随着BMI增大DM患病率不断上升;男性WC除18～29岁外、女性WC除30～45岁组外,各年龄组均呈现出随着WC增大DM患病率也明显上升趋势;男性30岁以上WC85～89cm的DM患病率达10.0%,是同年龄组WC<85cm的4.95倍,女性组WC≥80cm、18～29岁的DM患病率达11.1%,是同年龄组WC≤75cm组的17.5倍;还发现双重肥胖者(BMI≥28,同时男WC≥90cm或女性WC≥80cm)DM患病率高达10.9%。结论BMI和WC水平与DM/IFG有良好的相关性,尤其是BMI≥28或男性WC≥85cm30岁以上人群或女性WC≥80cm各年龄组以及双重肥胖者均是DM患病高危人群。因此保持或控制BMI≤24和/或WC<85cm(男)、WC<80cm(女)对防范DM、IFG发生至关重要。     

Circulating oxidized LDL is associated with increased waist circumference independent of body mass index in men and women

BACKGROUND: Obesity is associated with oxidative stress, and the oxidation of LDL is thought to play a crucial role in the generation of atherosclerotic lesions. OBJECTIVE: The objective was to describe the association of waist circumference (WC) and body mass index (BMI; in kg/m2) with plasma circulating oxidized LDL (ox-LDL) and C-reactive protein (CRP). DESIGN: This cross-sectional study included data for circulating ox-LDL and CRP from a subpopulation of 586 men and women enrolled in a population-based survey conducted in 2000 in Girona, Spain. Multivariate analysis was performed to describe the independent association of WC and BMI with ox-LDL and CRP. RESULTS: Multivariate logistic regression analysis adjusted for lifestyle, educational level, and dietary confounders showed a direct association of WC (quartile distribution) and BMI categories with ox-LDL (P for linear trend = 0.002) and CRP (P for linear trend = 0.004). Subjects in the top quartile of WC and with a BMI > 29.9 were at high risk of elevated circulating concentrations of ox-LDL and CRP. Further adjustment for cardiovascular disease risk factors did not substantially modify these associations. The risk of high ox-LDL concentrations in overweight (BMI = 25.0-29.9) or obese (BMI > or = 30) subjects with a WC < 102 cm (men) or < 88 cm (women) was not significantly different from that in normal-weight subjects with these WCs. In contrast, overweight or obese subjects with higher WCs (WC > or = 102 cm for men and > or = 88 cm for women) were at significantly higher risk of increased ox-LDL. CONCLUSION: High WC was associated with high concentrations of ox-LDL independently of BMI in the study population.     

Body mass index (BMI) and waist circumference (WC) as screening tools for cardiovascular risk factors in Guadeloupean women

Hypertension, dyslipidemia and type 2 diabetes, important cardiovascular risk factors, are strongly linked to obesity. Body mass index (BMI) and waist circumference (WC) are measures of obesity that can be useful in identifying individuals with these risk factors. We assessed which of the two measures is more informative at the population level. The study population included 5,149 consecutive women aged 18 to 74 recruited in an Health Center of Guadeloupe (FWI) in 1999. The areas under the ROC curves of BMI and WC and their 95% CI were computed and compared. Logistic regression analysis of BMI and WC and the areas under the ROC curves in two separate age groups (18-39 years and 40-74 years) showed that age modifies the discriminant ability of these parameters in identifying the CVD risk factors. Sensitivity equalled specificity at levels between 52-70% for BMI and 55-80% for WC. ROC areas for identifying each risk factors by BMI varied from 0.52 to 0.84 and by WC from 0.55 to 0.88. For the identifying of women with at least one CVD risk factor, in the whole population, the areas under the curves for BMI and WC (respectively, 0.71; 95% CI: 0.69-0.73 and 0.76; 95% CI: 0.74-0.78) were both significantly greater than 0.5. The difference between these correlated areas was 0.04, 95% CI [-0.05, -0.03]. The lowest values of the areas were noted in detecting women with dyslipidemia and the highest in detecting those with type 2 diabetes. Waist circumference, a practical tool that had a higher discriminant ability than BMI in identifying presence or absence of all these risk factors, appears as the best screening tool in this population.     

Relationship between body mass index, waist circumference, and waist-to-hip ratio and mortality in elderly women: a 5-year follow-up study

This study examines the association between body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC) and all-cause and cardiovascular mortality in elderly women in a 5-year longitudinal study of 575 female outpatients 60 years and over. The highest BMI, WHR, and WC quartiles and predefined BMI categories were analyzed as predictive variables. Death occurred in 88 (15.4%). Underweight (BMI < 18.5 kg/m2) was associated with all-cause mortality in uni- and multivariate analyses, regardless of age bracket. The survival curves and univariate analysis showed that the highest WHR quartile (> or = 0.97) was associated with all-cause mortality. However, after adjustment for age, smoking, and previous cardiovascular diseases, the increase in WHR was positively associated only in women from 60 to 80 years of age. None of the anthropometric measurements was associated with cardiovascular mortality. The results indicate that underweight and increased waist-to-hip ratio were predictors of all-cause mortality in elderly women, mainly among those under 80 years.     

代谢综合征腰围适宜切点ROC方法预测

目的研究社区20岁人群体质指数(BM I)、腰围(WC)的分布特征及其与代谢综合征的关系,探讨代谢综合征患者腰围的适宜切点。方法于2007年1-6月调查在江苏省徐州市云龙区和泉山区3所医院参加体检的20岁常住居民3 659人,根据中国代谢综合征诊断标准(CDS2004),应用受试者工作特征曲线(ROC),分析代谢综合征患者BM I与WC的相关关系,并以约登指数最大作为腰围适宜切点。结果代谢综合征患病率为15.2%,标化患病率为11.1%;男、女性代谢综合征患者腰围平均值分别为(85.8±9.6),(73.7±9.2)cm,BM I与WC相关性较高(r男性=0.780,r女性=0.788,P0.05);代谢综合征的WC最佳切入点男、女性分别为88.5,78.5 cm。结论中国代谢综合征诊断标准的BM I与WC具有较好的相关性,使用ROC研究中国人群代谢综合征腰围切点与国际糖尿病联盟标准和美国代谢综合征诊断标准的腰围切点相近。