Cut-off values of body mass index, waist circumference, and waist-to-height ratio to identify excess abdominal fat: population-based screening of Japanese school children

Background

School-based screening and prevention programs for adiposity generally target school children in grades 4 and 6 (age 9–11 years). The aims of this study were to evaluate the validity of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) in identifying abdominal adiposity in fifth-grade Japanese school children and to determine optimal cut-off values for anthropometric measures.

Methods

The target population was fifth-grade school children enrolled in 2 schools in Shizuoka, Japan between 2008 and 2010; 422 of the 466 children participated in the present study. Abdominal adiposity was defined as percent trunk fat in the 95th percentile or higher, as determined by dual-energy x-ray absorptiometry (DXA). We analyzed the validity of BMI, WC, and WHtR using receiver operating characteristic (ROC) curve analysis. The Youden index was used to determine cut-off values of BMI, WC, and WHtR that identify excess abdominal fat.

Results

Optimal cut-off values to identify abdominal adiposity were 20.8 kg/m² (BMI), 76.5 cm (WC), and 0.519 (WHtR) for boys, and 19.6 kg/m² (BMI), 73.0 cm (WC), and 0.499 (WHtR) for girls. Areas under the ROC curve were 0.983 (BMI), 0.987 (WC), and 0.981 (WHtR) for boys, and 0.981 (BMI), 0986 (WC), and 0.992 (WHtR) for girls.

Conclusions

BMI, WC, and WHtR successfully identified a high proportion of children with excess abdominal fat as measured by DXA, demonstrating that these measures are useful indices for school screening.Key words: child, screening, obesity, statistics as topic, reference values     

How useful is waist circumference for assessment of abdominal obesity in Korean pre-menopausal women during weight loss?

Asian women are known to have a larger amount of abdominal fat (AF) for the same level of BMI compared with Caucasian and African-American women. This study was aimed to determine whether waist circumference (WC) could be useful as an index of AF compared with AF measured by dual energy x-ray absorptiometry (DXA) before and after a weight-loss program in Asian women. Thirty-eight healthy, pre-menopausal obese Korean women (body fat percent>30%) were enrolled and followed during a 6-week weight-loss program including herbal formula, calorie restriction, and exercise. Anthropometry and DXA measurements were performed before and after weight-loss. A specific region of interest (ROI, L2-iliac crest) by DXA was correlated with anthropometry at baseline: WC (gamma=0.91)>BMI (gamma=0.87)>Waist-Height ratio (WHtR, gamma=0.82)>WHR (gamma=0.46); and after weight loss: BMI (gamma=0.88)>WC (gamma=0.84)>WHtR (gamma=0.82), all p<0.01. The change in DXA ROI showed a reasonable correlation with change in anthropometry: BMI (gamma=0.63, p<0.01)>WC (gamma=0.39, p<0.05)>WHtR (gamma=0.37, p<0.05). A stepwise multiple regression analysis revealed that 83% of the variance in DXA derived AF was explained by WC at baseline, WC and BMI at follow-up, respectively. This study suggests that WC could be a good predictor of AF for Korean pre-menopausal women.     

Relation of central adiposity and body mass index to the development of diabetes in the Diabetes Prevention Program

BACKGROUND: Greater central adiposity is related to the risk of diabetes. OBJECTIVE: We aimed to test the hypothesis that central adiposity measured by computed tomography (CT) is a better predictor of the risk of diabetes than is body mass index (BMI), waist circumference (WC), waist/hip ratio (WHR), or waist/height ratio. DESIGN: Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were measured at the L2-3 and L4-5 disc spaces in 1106 of the 3234 participants in the Diabetes Prevention Program. Sex-specific proportional hazards models were used to evaluate the association between VAT and SAT at both cuts, BMI, and other measures of central adiposity as predictors of the development of diabetes. RESULTS: Men had more VAT than did women. White subjects had more VAT at both cuts than did other ethnic groups. The ratio of VAT to SAT was lowest in African Americans of both sexes. Among men in the placebo group, VAT at both cuts, WC, BMI, waist/height ratio, and WHR predicted diabetes (hazard ratio: 1.79-1.44 per 1 SD of variable). Among women in the lifestyle group, VAT at both cuts predicted diabetes as well as did BMI, and L2-3 was a significantly better predictor than was WC or WHR. SAT did not predict diabetes. None of the body fat measurements predicted diabetes in the metformin group. CONCLUSIONS: In the placebo and lifestyle groups, VAT at both cuts, WHR, and WC predicted diabetes. No measure predicted diabetes in the metformin group. CT provided no important advantage over these simple measures. SAT did not predict diabetes.     

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。     

Predictive performances of lipid accumulation product vs. adiposity measures for cardiovascular diseases and all-cause mortality, 8.6-year follow-up: Tehran lipid and glucose study

Background  

The body mass index (BMI) is the most commonly used marker for evaluating obesity related risks, however, central obesity measures have been proposed to be more informative. Lipid accumulation product (LAP) is an alternative continuous index of lipid accumulation, which is computed from waist circumference (WC, cm) and triglycerides (TGs, mmol/l): (WC-65) ×TG (men) and (WC-58) ×TG (women). We sought in this study to assess if LAP can outperform BMI, waist-to-height-ratio (WHtR), or waist-to-hip-ratio (WHpR) in identifying prevalent and predicting incident diabetes.     

Relationship of Anthropometric Indicators of General and Abdominal Obesity with Hypertension and Their Predictive Performance among Albanians: A Nationwide Cross-Sectional Study

Anthropometric indicators of general and abdominal obesity can predict cardiovascular disease outcomes. Their performance in predicting hypertension (HTN) varies across populations. We aimed to analyze the relationship of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and conicity index (CI) with HTN, to examine their predictive performance and to determine their optimal cut-offs in a nationally representative sample of Albanians aged 15–59 years (n = 20,635). Logistic regression models were fitted and sex-specific receiver-operating characteristic (ROC) curves were constructed. The indicators were positively associated with HTN. Sex modified the relationships, as associations appeared significantly stronger among females than males in the highest categories of the indicators. The area under ROC curves (AUCs) for BMI were 0.729 (95% confidence interval (CI): 0.720–0.738) among females and 0.648 (95% CI: 0.633–0.663) among males, and AUCs for WHtR were 0.725 (95% CI: 0.716–0.734) among females and 0.637 (95% CI: 0.622–0.652) among males. However, the AUCs for BMI and WHtR did not differ significantly among females (p = 0.279) and males (p = 0.227). BMI outperformed WC and CI in both sexes. The optimal BMI cut-offs were 27.0 kg/m² among females and 25.6 kg/m² among males, and that for WHtR were 0.53 among females and 0.54 among males. BMI and WHtR demonstrated similar discriminatory power, and the identified cut-offs may inform initiatives for structured HTN screening in Albania.     

Optimal cut-offs of five anthropometric indices and their predictive ability of type 2 diabetes in a nationally representative Kenyan study

BackgroundType 2 diabetes (T2D) is one of the top non-communicable diseases in Kenya and prevention strategies are urgently needed. Intervening to reduce obesity is the most common prevention strategy. However, black populations develop T2D at lower obesity levels and it is unclear which anthropometric cut-offs could provide the best predictive ability for T2D risk. This study, therefore, aimed to determine the optimal anthropometric cut-offs and their predictive ability of T2D in Kenya.MethodsThe study included 2159 participants (59% women) aged 35–70 years from the Kenya STEPwise survey conducted in 2014. Five anthropometric indices were used—body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR) and waist divided by height^0.5(WHt.5R). Diabetes was defined as a fasting blood glucose of ≥7.0 mmol/l or a previous diagnosis by a health worker. Optimal anthropometric cut-offs and their receiver operating characteristics, such as the area under the curve (AUC), were computed.ResultsOverall, the optimal cut-off for BMI, WC, WHR, WHtR and WHt.5R were 24.8 kg.m⁻², 90 cm, 0.88, 0.54 and 6.9. On disaggregation by sex, the optimal cut-off for BMI, WC, WHR WHtR and WHt.5R was 27.1 kg.m⁻², 87 cm, 0.85, 0.55 and 6.9 in women, and 24.8 kg.m⁻², 91 cm, 0.88, 0.54 and 6.9 in men. Overall, WC (AUC 0.71 (95% confidence interval 0.65, 0.76)) WHtR (AUC 0.71 (0.66, 0.76)) and WHt.5R (AUC 0.70 (0.65,0.75)) had a better predictive ability for T2D than BMI (AUC 0.68 (0.62, 0.73)).ConclusionsWC, WHtR and WHt.5R were better predictors of T2D than BMI and should be used for risk stratification in Kenya. A WC cut-off of 87cm in women and 91cm in men, a WHtR cut-off of 0.54 or a WHt.5R of 6.9 in both men and women should be used to identify individuals at an elevated risk of T2D.     

Obesity and Health Risk of Children in the Mississippi Delta

BACKGROUND: Mississippi (MS) Delta adults and youth report obesity rates far exceeding those of the state and nation. State law requires in-school physical activity and nutrition practices to address childhood obesity but does not require evaluation of outcomes, specifically the impact on weight-related outcomes. This paper offers 3 things: (1) describes the weight status of elementary school-age children in the MS Delta; (2) explains the importance of including waist-to-height ratio (WHtR) values when reporting body mass index (BMI); and (3) provides impetus for policy that requires weight-related health risk, as measured by WHtR, to be assessed regularly as a means to evaluate school health policy. METHODS: We took anthropometric measures in a cross-sectional investigation of 1136 children from 11 public elementary schools in the MS Delta. Measures included BMI, waist circumference (WC) and WHtR. RESULTS: The prevalence of overweight and obesity (BMI ≥85th percentile) was 47.1% (18.3% overweight and 28.8% obese). In this sample, 59.9% and 42.0% were "at risk" for weight-related chronic disease based on WC (≥75th percentile) and WHtR (>0.5), respectively. The differences in these proportions were statistically significant. The predominantly black districts reported higher on all of the weight-related measures. CONCLUSIONS: Investigators recommend the assessment of health policy include measures of health risk in addition to BMI, namely WHtR as it accounts for growth in both WC and height over age. Furthermore, WHtR is a more accurate indicator of fat distribution and health risk than WC alone.     

贵阳市减重门诊患者腰围、腰身比与高甘油三酯血症的相关性研究

目的 评价体质指数（body mass index,BMI）、腰围、腰身比和体脂肪率与高甘油三酯血症的关系及其筛检价值。方法 收集2015年2月~12月贵州医科大学附属医院体重管理门诊患者119例。检测身高、体重、腰围、体成分及血脂水平。采用受试者工作特征曲线（receiver operating characteristic curve,ROC）法分析BMI、腰围、腰身比、体脂肪率对甘油三酯超标的筛检率,用曲线下面积（area under curve,AUC）表示。采用多重线性回归分析探讨BMI、腰围、腰身比和体脂率在不同人群中与甘油三酯超标的关系。结果 在女性患者中,腰围和腰身比的AUC高于BMI和体脂肪率（均有P<0.05）;男性患者中,腰身比的AUC最大。在女性和男性中,腰身比和腰围高的患者发生甘油三酯超标的风险均高于腰身比和腰围低的患者（均有P<0.05）。结论 腰围和腰身比对高甘油三酯血症的筛检价值优于体脂肪率和BMI。     

腰围、腰围身高比、体重指数预测儿童青少年代谢紊乱的效果比较

目的 探讨腰围(WC)、腰围身高比(WHtR)和体重指数(BMI)预测儿童青少年代谢紊乱的效果,为儿童青少年代谢紊乱的早期预警提供科学依据。方法 选取济南市城区1 170名7~17 岁儿童青少年,利用受试者工作特征曲线(ROC)比较WC、WHtR和BMI预测代谢紊乱的曲线下面积(AUC),采用Logistic回归模型分析WC、WHtR和BMI诊断的肥胖预测儿童青少年代谢紊乱的风险。结果 WC预测4种代谢紊乱(高血糖、高血压、低HDL-C和高TG)中≥1项或≥2项组分的ROC曲线下面积(AUC,95%CI)分别为0.63(0.59~0.66)和0.74(0.69~0.79),WHtR对应值分别为0.62(0.58~0.65)和0.74(0.69~0.79),BMI对应值分别为0.64(0.60~0.67)和0.75(0.70~0.80)。WC诊断的腹型肥胖(WC≥性别和年龄别的P₉₀)预测儿童青少年4种代谢紊乱中的≥1项或≥2项组分的OR(95%CI)值分别为2.88(2.15~3.86)和6.83(4.47~10.44),WHtR诊断的腹型肥胖(WHtR≥0.50)对应的OR(95%CI)值分别为2.63(1.86~3.71)和5.77(3.65~9.13),BMI诊断的肥胖(BMI≥性别和年龄别的肥胖界值) 对应的OR(95%CI)值分别为3.03(2.17~4.23)和6.35(4.03~10.00)。结论 WC、WHtR和BMI均可作为儿童青少年代谢紊乱的重要预测因子,WC、WHtR和BMI预测代谢紊乱的效果相当。考虑到WHtR 界值的简单易记性,WHtR或许可替代WC和BMI作为儿童青少年代谢紊乱的早期预警指标。     

Diabetes prediction,lipid accumulation product,and adiposity measures; 6-year follow-up: Tehran lipid and glucose study

Background

The body mass index (BMI) is the most commonly used marker for evaluating obesity related risks, however, central obesity measures have been proposed to be more informative. Lipid accumulation product (LAP) is an alternative continuous index of lipid accumulation, which is computed from waist circumference (WC, cm) and triglycerides (TGs, mmol/l): (WC-65) ×TG (men) and (WC-58) ×TG (women). We sought in this study to assess if LAP can outperform BMI, waist-to-height-ratio (WHtR), or waist-to-hip-ratio (WHpR) in identifying prevalent and predicting incident diabetes.

Results

The cross-sectional analyses were performed on a sample included 3,682 men and 4,989 women who were not pregnant, aged ≥ 20 years. According to the age (≥ 50 and <50 years) - and sex-specific analyses, odds ratios (ORs) of LAP for prevalent diabetes were higher than those of BMI, WHpR, or WHtR among women, after adjustment for mean arterial pressure and family history of diabetes. The OR of LAP in old men was lower than those of other adiposity measures; in young men, however, LAP was superior to BMI but identical to WHpR and WHtR in identifying prevalent diabetes. Except in young men, LAP showed highest area under the receiver operating characteristic curves (AROC) for prevalent diabetes (P for trend ≤ 0.005).For longitudinal analyses, a total of 5,018 non-diabetic subjects were followed for ~6 years. The ORs of BMI, WHpR, and WHtR were the same as those of LAP in both sexes and across age groups; except in young men where LAP was superior to the BMI. AROCs of LAP were relatively the same as anthropometric adiposity measures.

Conclusions

LAP was a strong predictor of diabetes and in young individuals had better predictability than did BMI; it was, however, similar to WHpR and WHtR in prediction of incident diabetes.

     

银川城区儿童青少年骨矿物质含量与肥胖相关关系的研究

目的 分析儿童青少年骨矿物质含量(BMC)与肥胖之间的关系,为预防儿童青少年骨质疏松提供更有力的依据.方法 于2017-2020年以整群随机抽样的方法从银川市随机抽取1578名儿童青少年作为研究对象,进行问卷调查、体格检查、骨矿物质含量测定,采用二元Logistic回归分析不同定义的肥胖指标与骨矿物质含量之间的关系.结...     

不同肥胖指标与MS其他组分患病风险研究

目的分析体质指数(BMI)、腰围(WC)、腰围/身高比值(WHtR)3个肥胖指标与MS及其他组分的相关性。方法选取2008年参加健康体检的延吉市某社区居民,进行问卷调查、血压测量、体格检查及生化指标检测。对资料完整的886例对象按照不同的BMI、WC水平进行分层,比较分析代谢异常组分患病情况。对WHtR指标与MS其他组分异常数量的相关性进行分析,并寻找适合的切点,分析其对MS的患病风险。结果调查对象中肥胖程度比较严重,且各项指标存在性别差异;各项代谢异常患病率均与BMI和WC有关,两者均异常时,各项表示代谢性健康风险的OR值明显高于BMI与WC各单项异常组(P﹤0.01),但仅有腹型肥胖时,其OR值均高于BMI超重而WC正常者;WHtR与代谢异常数量之间存在正相关(r=0.479,P﹤0.01),当WHtR超过0.50时,个体MS患病危险度显著增加(OR:1.564,95%CI:1.046～1.896,P﹤0.01)。结论 BMI和WC异常可增加代谢异常疾病的患病风险,WHtR是较好代表中心性肥胖的指标,在防治MS其他组分时应将体脂增多同时伴有脂肪分布异常者列为重点高危人群。     

天津市宝坻区老年人体质指数、腰围以及腰围身高比与高血压患病率的关联

  目的   探讨天津市宝坻区60岁及以上老年居民的体质指数(body mass index, BMI)、腰围(waist circumference, WC)以及腰围身高比(waist-to-height ratio, WHtR)与高血压患病率的关联。   方法   本研究对2018年4-5月参加天津市宝坻区口东卫生院体检的老年人(≥60岁)进行问卷调查和体格检查。采用分层分析和logistic回归分析BMI与WC(或WHtR)对高血压的联合作用和交互作用。   结果   共邀请1 692人, 1 417人(83.75%)参与本研究。老年人群的高血压患病率为46.36%、BMI超重和肥胖者占66.50%、WC中心型肥胖者占74.66%、WHtR超重和肥胖者占75.38%。与BMI或WC正常相比, BMI超重(OR=1.65, 95% CI:1.19~2.30)和肥胖(OR=3.41, 95% CI:2.23~5.20)及WC中心型肥胖(OR=1.49, 95% CI:1.00~2.23)均增加高血压的患病风险。BMI联合WC超重/肥胖(OR=2.49, 95% CI:1.78~3.46), 或BMI联合WHtR超重/肥胖(WHtR超重: OR=2.05, 95% CI:1.41~2.99;WHtR肥胖: OR=2.37, 95% CI:1.50~3.76)的患病风险高于后者单独作用的风险(WC超重/肥胖: OR=1.39, 95% CI:0.90~2.15;WHtR超重: OR=1.02, 95% CI:0.62~1.66;WHtR肥胖: OR=1.44, 95% CI:0.55~3.81)。   结论   三项指标中, BMI与高血压患病的关联性最强, 且BMI超重/肥胖增强WC(或WHtR)与高血压的关联, 提示控制BMI相关体重指标在正常范围内有助于预防和控制高血压。     

常用人体测量指标对高血糖的筛查价值探讨

目的探讨体质指数(BMI)、腰围(WC)、腰臀比(WHR)、腰围身高比(WHtR)、腰腿比(WTR)与高血糖的关系及其对高血糖的筛查价值。方法 2010年8月整群抽取在北京世纪坛医院健康体检中心体检的某机关工作人员1280名,测量其身高、体重、腰围、臀围、腿围、血压与空腹血糖及生化指标等。结果①此人群空腹高血糖检出率为40.16%,且随着年龄增长高血糖检出率亦增加;高血糖组的WC、BMI、WHtR、WHR、WTR、SBP、DBP、AST、TC、TG、CRE、UA水平均显著高于血糖正常组,而HDL-C水平低于血糖正常组,同时高血糖组脂肪肝的检出率也显著高于血糖正常组。②对于高血糖,WTR的受试者工作特征曲线(ROC)下面积(AUC)为0.716,高于WHtR(0.690)(P<0.001)、WHR(0.682)(P<0.001)、WC(0.682)(P<0.001)、BMI(0.665)(P<0.001);按性别分层后,在男性中,对于高血糖WTR的AUC(0.648)高于WHtR(0.611)(P<0.001)、WHR(0.614)(P<0.001)、WC(0.598)(P<0.001)和BMI(0.587)(P<0.001);在女性中,WTR对于高血糖的AUC为0.758,低于WHtR(0.774)(P<0.001)和WC(0.761)(P<0.001),但高于BMI(0.738)(P<0.001)和WHR(0.732)(P<0.001);在年龄≥35岁的女性中,WTR对于高血糖的AUC为0.725,高于WHtR(0.716)(P<0.001)、WC(0.705)(P<0.001)、WHR(0.676)(P<0.001)和BMI(0.665)(P<0.001);③在调整年龄和性别后,WTR与高血糖的相关性最强(OR=1.70,95%CI 1.37～2.11,每1 SD增量)。结论该机关工作人员空腹高血糖问题较为严重,WTR比其他4个指标能更好地筛查男性高血糖,在年龄大于35岁的女性中,WTR比其他四个能更好地筛查高血糖。     

Association of waist circumference with muscle and fat mass in adults with a normal body mass index

BACKGROUND/OBJECTIVESWe aimed to investigate the association of waist circumference (WC) with body composition among individuals with a normal body mass index (BMI) to distinguish muscle and fat mass, as both affect health differently.SUBJECTS/METHODSWe analyzed dual-energy X-ray absorptiometry data (derived from the Korean National Health and Nutrition Survey, which includes information on fat and lean mass) of 7,493 adults with a normal BMI. Subjects were categorized into four groups of increasing WC. The fourth group was defined as being centrally obese. Each number of subjects are as follows: 1,870, 695, 231, and 39 among men and 3,054, 1,100, 406, and 98 among women. We conducted a sex-stratified linear regression analysis of body composition according to WC group after adjustments for covariates.RESULTSWe observed a positive association of body fat with increasing WC in both men and women (all P for trend: < 0.001). The adjusted mean values for percent body fat with 95% confidence intervals (CIs) according to the four WC groups in ascending order were 17.8 (17.5–18.3), 21.0 (20.6–21.5), 22.1 (21.5–22.8), and 25.1 (24.2–26.1) in men and 29.7 (29.4–30.0), 32.0 (31.6–32.3), 32.9 (32.4–33.4), and 34.7 (33.2–36.1) in women. However, there was an inverted J-shaped association between muscle mass and WC. The fourth group had a higher percent body fat and lower muscle mass than other groups. The adjusted mean values for appendicular skeletal muscle mass index (kg/m²) with 95% CIs according to the four WC groups in ascending order were 7.55 (7.51–7.59), 7.62 (7.56–7.68), 7.65 (7.56–7.74), and 7.22 (7.04–7.41) in men and 5.83 (5.80–5.85), 5.96 (5.92–6.00), 6.03 (5.96–6.10), and 5.88 (5.73–6.03).CONCLUSIONSThere was a positive association between body fat and WC among individuals with normal BMI; conversely there was an inverted J-shaped association between lean body mass and WC. Our findings support the WC measurement should be included in obesity evaluations for adults with a normal BMI.     

湖南省13个监测点60岁及以上老人肥胖指标与高血压及血脂异常的切点研究

目的 探讨体质指数(body mass index,BMI)、腰围(waist circumference,WC)、腰高比(waist-to-height ratio,WHtR)三类肥胖指标判定的肥胖率分别与湖南省13个监测点60岁以上老人高血压、血脂异常的相关性,预测高血压及血脂异常患病风险的能力。 方法 采用具有省级代表性的中国慢性病与危险因素调查数据,通过受试者工作特征曲线分析,确定湖南省老年人不同肥胖指标预测高血压及血脂异常适宜的BMI、WC、WHtR切点。 结果 湖南省13个监测点60岁以上老年人超重肥胖率(BMI≥24)为42.91%,中心性肥胖率为31.26%,WHtR≥0.5的肥胖率68.97%。以高血压为因变量绘制受试者工作特征曲线,显示男、女性WHtR的曲线下面积相对较高,其切点值分别为0.50、0.53;以血脂异常为因变量,结果显示BMI的曲线下面积最高,其切点值分别为21.40、22.06。 结论 评价肥胖的不同指标对高血压及血脂异常的预测效果不同,其中腰高比在预测老年人高血压中的效果最好;BMI是诊断老年人血脂异常的最佳简易指标。     

基于二胎政策下女性分娩次数与肥胖的关系

目的 高产次被认为是女性肥胖的危险因素。本研究探讨新疆墨玉县女性产次与全身性肥胖、中心性肥胖的相关性。方法 选取新疆和田墨玉县参与《新疆多民族自然人群队列建设研究》的35～74岁且有至少1次活产记录的女性为研究对象。使用体质指数（BMI）评估全身性肥胖,采用腰围（WC）和腰身比（WHtR）评估中心性肥胖。采用多元logistic回归模型分析产次与不同类型肥胖之间的关联。结果 共纳入6 987名研究对象。研究对象全身性肥胖患病率为56.9%（61.66 / 6 987）,通过WC和WHtR计算的中心性肥胖患病率分别为84.3%（5 897/6 987）和88.2%（3 977/6 987）。3种肥胖指标均值在产次为2中最低,WC和WHtR均值在不同产次中差异有统计学意义（P＜0.05）。调整潜在的混杂因素后,产次与3种肥胖指标均相关,BMI、WC、WHtR评估肥胖OR值分别为1.218（95%CI:1.033～1.436）、1.384（95%CI:1.130～1.695）和1.429（95%CI:1.144～1.785）。结论 高产次与肥胖风险,尤其是与中心性肥胖呈正相关。产次与3种中心性肥胖指标之间呈现V型趋势,生育2次可能是女性预防中心性肥胖最佳推荐值。     

Comparison of the association of predicted fat mass,body mass index,and other obesity indicators with type 2 diabetes risk: two large prospective studies in US men and women

Obesity, defined by body mass index (BMI), is a well-established risk factor of type 2 diabetes, but BMI has been criticized for its inability to discriminate fat mass and lean body mass. We examined the association between predicted fat mass and type 2 diabetes risk in two large US prospective cohorts, and compared the magnitude of the association with BMI and other obesity indicators. Validated anthropometric prediction equations previously developed from the National Health and Nutrition Examination Survey were used to estimate predicted fat mass and percent fat for 97,111 participants from the Health Professionals Follow-up Study (1987–2012) and the Nurses’ Health Study (1986–2012) who were followed up for type 2 diabetes. Multivariable-adjusted hazard ratios for type 2 diabetes across quintiles of predicted fat mass were 1.00, 1.96, 2.96, 3.90, and 8.38 for men and 1.00, 2.20, 3.50, 5.73, and 12.1 for women; of BMI were 1.00, 1.69, 2.45, 3.54, and 6.94 for men and 1.00, 1.76, 2.86, 4.88, and 9.88 for women. Predicted FM showed the strongest association with type 2 diabetes in men followed by waist circumference (WC), waist-to-height ratio (WHtR), predicted percent fat, BMI, Waist-to-hip ratio (WHR), and a body shape index (ABSI). For women, the strongest association was shown for WHtR, followed by WC, predicted percent fat, predicted fat mass, BMI, ABSI, and WHR. Compared to BMI, predicted fat mass demonstrated consistently stronger association with type 2 diabetes risk. However, there was inconclusive evidence to suggest that predicted fat mass is substantially superior to other obesity indicators.     

肥胖指标与糖尿病和高血压的关联分析

目的分析肥胖指标与糖尿病和高血压之间的关系。方法以2006年广西南宁市体检人群,共6031人为研究对象,分别检测体质指数（BMI）、腰围（WC）、腰围与身高的比值（WHtR）、空腹血糖（FBG）、餐后血糖（PBG）与血压,并对肥胖指标与糖尿病和高血压的关联性进行分析。结果糖尿病风险值,男性BMI：OR=1．290,95％CI：1．005～1．655,WC：OR=1．494,95％Ch1．159～1．927,WHtR：OR=1．565,95％Ch1．216～2．016;女性BMI：OR=2．337,95％CI：1．538～3．550,WC：OR=2．559,95％CI：1．686-3．883,WHtR：OR=3．102,95％CI：1．966～4．892。高血压风险值,男性BMI：OR=1．793,95％CI：1．529～2．103,WC：OR=2．077,95％CI：1．768～2．440,WHtR：OR=2．332,95％CI：1．976～2．725;女性BMI：OR=2．877,95％CI：2．228-3．714,WC：OR=2．896,95％CI：2．243～3．738,WHtR：OR=3．838,95％CI：2．897～5．116。不论男女,高血压和糖尿病与肥胖指标的关联强度顺序为WHtR〉WC〉BMI。结论与外周肥胖指标相比,中心型肥胖人群患糖尿病、高血压的风险更高。