腰围、腰高比与肱踝脉搏波传导速度的相关性研究

目的 研究腰围和腰高比与肱踝脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)的关系,探索腹型肥胖对外周动脉弹性的影响.方法 选取2018年3月-2019年5月在中国医科大学附属第一医院体检中心体检的2718名体检者,采用动脉硬化测定仪检测双侧肢体的baPWV,根据baP...     

Waist circumference and waist-to-height ratio of Hong Kong Chinese children

Background  

Central body fat is a better predictor than overall body fat for cardiovascular (CV) risk factors in both adults and children. Waist circumference (WC) has been used as a proxy measure of central body fat. Children at high CV risk may be identified by WC measurements. Waist-to-height ratio (WHTR) has been proposed as an alternative, conveniently age-independent measure of CV risk although WHTR percentiles have not been reported. We aim to provide age- and sex-specific reference values for WC and WHTR in Hong Kong Chinese children.     

广州市6～18岁儿童青少年腰围和腰围身高比分布特征

目的探讨广州市6～18岁儿童青少年腰围（WC）和腰围身高比（wH氓）分布特征。方法采用年级分层整班抽样方法对参加2010年全国学生体质健康调研的广州市12所监测学校（广州市城乡各3所中学和3所小学）6～18岁学生进行腰围和身高检测,计算各个年龄组城乡男女生腰围和腰围身高比百分位数、腰围身高比的均值,比较腰围和腰围身高比年龄、城乡和性别差异。结果2010年调查5141名学生,城市男生1287名、城市女生1256名、农村男生1300名、农村女生1298名。广州市6-18岁学生随年龄增长腰围不断增加,女生在青春发育期腰围值接近男生,其他年龄组均是男生超过女生。同性别各年龄组的腰围城市大于乡村。城乡男女生6-18岁WHtR在0．40至0．45范围内波动,13岁前城乡男生WHtR高于女生,13岁后女生wHtR大于男生或与男生重叠。同性别各年龄组的WHtR均是城市大于乡村。结论广州市6～18岁城乡学生腰围和腰围身高比在年龄、性别、城乡表现出差异;该数据为制定全国儿童青少年腰围：腰围身高比的体质量超标、肥胖筛查标准提供广州地区基础资料。     

宁夏儿童青少年BMI腰围与食物消费体力活动的相关性

评价儿童青少年超重肥胖与食物消费、体力活动和社会经济水平的关系,为制定营养教育和干预措施提供依据.方法 采用分层整群抽样方法,选取宁夏南部5个地区义务教育阶段三至九年级2 472名学生为调查对象,进行问卷调查和体格检查.结果 宁夏南部地区儿童青少年按体质量指数(BMI)判断的超重/肥胖率为4.3%,按照腰围(WC)和腰围身高比(WHtR)判断的腹型肥胖率分别为5.4%,10.6%.家庭经济水平、母亲职业、腌制食品摄入频率与儿童青少年BMI有关(P值均<0.05);家庭经济水平,母亲文化程度及职业,肉类食品、膨化食品及腌制食品摄入频率与儿童青少年WC有关(P值均<0.05);母亲职业与儿童青少年WHtR有关(P<0.05).Logistic回归结果显示,家庭经济水平高是BMI,WC增高的危险因素(OR值分别为2.078,2.336,95%CI值分别为1.024~4.250,1.201~4.660,P值均<0.05);母亲职业为职员、公务员和个体是WC,WHtR增高的危险因素(OR值分别为2.115,1.624,95% CI值分别为1.179~3.797,1.039~2.538,P值均<0.05);膨化食品摄入频率高是BMI,WC水平增高的危险因素(OR值分别为1.960,1.618,95%CI值分别为1.208~3.179,1.046~2.505,P值均<0.05);腌制食品摄入频率低者BMI,WC,WHtR均较高(OR值分别为0.348,0.368,0.679,95%CI值分别为0.189~0.640,0.217~0.624,0.473~0.974,P值均<0.05).结论 采用BMI,WC,WHtR判断的儿童青少年肥胖主要与社会经济水平和食物消费有关.     

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     

Waist circumference, waist:hip ratio, and risk of breast cancer in the Nurses' Health Study

This study examined prospectively the associations of waist circumference and waist:hip circumference ratio with risk of breast cancer. A total of 47,382 US registered nurses who reported their waist and hip circumferences in 1986 were followed up through May 1994 for identification of incident cases of breast cancer. During 333,097 person-years of follow-up, 1,037 invasive breast cancers were diagnosed. In proportional hazards analyses, waist circumference was nonsignificantly related to risk of premenopausal breast cancer but was significantly associated with postmenopausal breast cancer after adjustment for established breast cancer risk factors (for the highest quintile of waist circumference vs. the lowest, relative risk (RR) = 1.34; 95% confidence interval (CI): 1.05, 1.72). When the analysis was limited to postmenopausal women who had never received hormone replacement therapy, a stronger positive association was found (RR = 1.88; 95% CI: 1.25, 2.85). After the data were further controlled for body mass index, the positive association was only slightly attenuated (RR = 1.83; 95% CI: 1.12, 2.99). Among past and current postmenopausal hormone users, no significant associations were found. Similar but slightly weaker associations were observed between waist:hip ratio and breast cancer risk. These data suggest that greater waist circumference increases risk of breast cancer, especially among postmenopausal women who are otherwise at lower risk because of never having used estrogen replacement hormones.     

妊娠早期腰围、腰臀比、腰高比预测妊娠期糖尿病的临床价值

<正>美国糖尿病协会将妊娠期糖尿病(gestational diabetes mellitus,GDM)定义为妊娠前无明显糖代谢异常,妊娠中晚期首次发生的糖尿病~[1]。全球GDM的发生率逐年上升,我国GDM的患病率高达17. 5%～18. 9%~[2-3]。     

中学生不同肥胖判定指标与骨代谢标志物的关系

目的分析银川市中学生体质量指数(BMI)、腰围(WC)和腰围身高比(WHtR)与骨代谢标志物的关系,为评价青少年骨代谢状况提供依据。方法采用现况研究,以方便整群抽样的方法于2018年9—12月共抽取银川市某中学12～18岁青少年1 084名,进行问卷调查、体格检查及实验室检测。结果 BMI、WC、WHtR与Ca均呈负相关(r值分别为-0.10,-0.15,-0.15),WC与Ⅰ型胶原交联C末端肽(β-CTX)呈负相关(r=-0.06)(P值均<0.05);调整年龄、性别、维生素D补充情况等因素后,WC对Ca、β-CTX的影响结果均有统计学意义(β值分别为-0.33,-0.22,P值均<0.05)。Logistic回归分析结果显示,不同肥胖类型与骨钙素(OC)水平无显著关系(P值均>0.05),血清β-CTX水平肥胖者增加是正常学生的1.93倍,血清Ca水平肥胖者与腹型肥胖者(以WC定义)增加分别是正常学生的0.31和0.54倍。结论银川市青少年体内BMI、WC和WHtR与OC、β-CTX、Ca存在关联,且WC与Ca、β-CTX的关系更为密切,提示肥胖对骨吸收有负面影响...     

男性下尿路症状与腰围及腰臀比相关性分析

目的 采用国际前列腺症状评分量表(IPSS)对≥55岁临床术后良性前列腺增生(BPH)的男性进行调查,探讨下尿路症状(LUTS)程度与腰围(WC)及腰臀比(WHR)的关系.方法 2005年7月～2007年6月,收集280例55～85岁临床术后BPH男性的LUTS资料,同时测量腰围和臀围.采用多元Logistic回归模型对中～重度LUTS(梗阻性和刺激性症状)进行分析.结果 LULS的严重程度随年龄的增长呈显著性升高.在调整了多因素之后,WC>85cm和WHR≥0.9者发生中～重度LUTS(刺激性症状)的危险增加.WC与中～重度LUTS和刺激性症状的OR值分别为2.807和1.105(95%=2.506～15.587和1.023～2.892);WHR与发生LUTS(OR=3.635,95%CI=3.432～10.624)和刺激性症状(OR=1.195,95%CI=1.135～3.286)的危险性呈正相关.结论 向心性肥胖可能是LUTS的重要危险因素,不良生活行为方式可能是促使LUTS恶化的因素.     

儿童高血压与体质量指数腰围腰高比及腰臀比的关联性研究

探讨儿童高血压与体质量指数(BMI)、腰围、腰高比、腰臀比的关联性,为儿童高血压和成年期高血压的早期预防提供参考.方法 以2014年安徽省学生体质与健康调研检测中的8 890名7~17岁儿童(男童4 424名,女童4 466名)作为研究对象,测量其身高、体重、腰围、臀围、血压,计算体质量指数、腰高比、腰臀比,并进行Z分转化.分析高血压与各项肥胖相关指标Z分间的关系,采用相关性分析、多元线性回归模型、ROC曲线分析.结果 8 890名儿童的高血压检出率为13.61%(95%CI=12.90%~14.32%),其中男生(16.30%,95%CI=15.21%~17.39%)高于女生(10.95%,95%CI=10.03% ~ 11.87%),差异有统计学意义(x2=54.06,P<0.01).BMI、腰围、腰高比、腰臀比4项人体测量指标Z分均呈正相关(P值均<0.01).Logistic回归分析得出,4项人体测量指标均为高血压的影响因素(P值均<0.01),其中男、女童BMI的Z分指标对高血压的影响最大,OR值分别为1.79(95%CI=1.66~1.93)和1.69(95%CI=1.56~1.84).ROC曲线结果显示,BMI、腰围的Z分指标与血压间的相关性较其他人体测量指标强.结论 BMI和腰围与7~17岁儿童高血压有良好的相关性.     

Correlation of dyslipidemia with waist to height ratio, waist circumference, and body mass index in Iranian adults

Overweight and obesity are increasing problems in many countries and are related to multiple cardiovascular risk factors. Although imaging techniques can determine total body fat and its distribution reliably, anthropometric measurements remain important in clinical practice. The purpose of this study was to determine the association between some anthropometric measurements and dyslipidemia as an important cardiovascular risk factor in Iranian population. A total of 750 subjects (580 females and 170 males) were selected by multistage random sampling from residents of Arak (Iran) and related villages in 2005. None of them had any significant past medical history. Body mass index(BMI), waist circumference(WC), and waist to height ratio(W/Ht) of subjects were measured to identify their relationship with their lipid profile including total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), and the ratio of total cholesterol to high density lipoprotein cholesterol(TC/HDL-C). Fasting blood sugar (FBS) was also measured. WC and W/Ht showed greater correlation with TC, TG, LDL-C, TC/HDL-C level than did BMI. Among lipid profile, TG showed the closest correlation with W/Ht (r=0.309, p<0.001) and WC (r=0.308, p<0.001). HDL-C level did not show any statistical relationship with W/Ht, but it was weakly correlated with WC (r=-0.088, p<0.05). None of the indices showed any association with FBS level. It can be concluded that W/Ht and WC can best predict dyslipidemia in an Iranian adult population. We suggest using both W/Ht and WC as inexpensive and easy methods in clinical and epidemiological fields.     

上海市儿童青少年腰围百分位数值及曲线

目的 建立适合上海市儿童青少年生长发育特点的年龄别腰围、腰围指数的百分位数及曲线,为科学评价儿童青少年生长发育水平及中心性肥胖的防治提供参考.方法 以2010年上海市学生体质健康调研的7 ～18岁中小学生14 301名为样本,应用国际通用的LMS法分性别建立年龄别腰围、腰围指数正常值及百分位数曲线.结果 腰围百分位数曲线随年龄增长呈递增趋势,符合儿童青少年生长发育规律;腰围指数的P50百分位数曲线具有明显性别差异,7 ～12岁男生逐年上升,且高于女生,自13岁开始经交叉后低于女生.获得上海市7 ～18岁儿童青少年男女年龄别腰围、腰围指数百分位数(P5,P10,P15,P50,P85,P95,P95)及曲线.结论 儿童青少年年龄别腰围、腰围指数百分位数存在地区、性别差异.本研究所获得的百分位数及曲线可为进一步研究儿童青少年中心性肥胖提供基本数据.     

不同体质指标在不同MS诊断标准中应用比较

目的 探讨体质指数(BMI)、腰围(WC)、腰臀比(WHR)与代谢综合征(MS)的关系,比较它们在2004年中华医学会糖尿病学会分会(CDS)、2005年国际糖尿病联盟(IDF)和2005年美国国家胆固醇教育计划成人治疗组第3次报告修订版(NCEP-ATPⅢ)的MS诊断标准中的应用。方法 对研究资料分别采用CDS(2004)、IDF(2005)、ATPⅢ(2005)的诊断标准计算MS以及肥胖的患病率,比较不同MS标准下的BMI、WC和WHR以及它们的相关性。结果 CDS(2004),IDF(2005)、ATPⅢ(2005)的诊断标准下的MS患病率分别为15.2%,15.8%和22.6%;肥胖率分别为42%,30.5%和30.5%。3个诊断标准中MS的BMI平均值分别为27.8,28.0和27.1;男/女WC的平均值分别为93.7/87.4,96.8/89.4和93.7/851;男/女WHR的平均值分别为0.92/0.86,0.94/0.88和0.93/0.86。BMI、WC和WHR的相关系数分别为r₁(BMI/WC)=0.785,r₂(BMI/WHR)=0.580和r₃(WC/WHR)=0.878;3个诊断标准的BMI/WC相关系数分别为0.128,0.566和0.682,BMI和WC均呈正相关(P<0.01)。结论 BMI,WC和WHR与MS关系密切,并存在高度相关性:BMI和WC均可用于肥胖的判断以及作为MS诊断标准的组分;对中国人而言,肥胖在MS中的地位与其他组分地位应相同。     

成年人体质指数及相关指标与2型糖尿病关系

目的探讨江苏省南京市35岁～人群体质指数(BMI)、腰围(WC)、腰臀比(WHR)和腰身比(WHtR)与2型糖尿病(T2DM)关系。方法 2004年7月对南京市的3个城区和1个郊县的35岁～居民进行横断面调查;对无T2DM的研究对象于2007年7月进行随访;采用多因素Logistic回归和受试者工作特征曲线(ROC)评估基线4个肥胖指标对T2DM发生的预测作用。结果基线调查中无T2DM共4 058人,3年后共随访3 031人,随访率为74.7%;3年后新发生的T2DM患者共计72例,累计发病率为2.4%;其中男性33例,女性39例。随着基线肥胖程度的增加,T2DM的发病危险增加;WC超标和WHtR≥0.5者发生T2DM的风险无论男女性均较高。4个肥胖指标中,ROC曲线下面积WHtR最大。结论 BMI、WC、WHR和WHtR的增加均能提升T2DM发病的危险;WHtR可能是最重要的肥胖与T2DM相关预测指标。     

苏州市儿童青少年体质量指数腰围腰高比与血压偏高的关系

探讨苏州市儿童青少年体质量指数(BMI)、腰围和腰高比与血压偏高的关系,为制定适宜的儿童青少年血压综合防控策略和措施提供参考.方法 2019年9-10月采用分层整群抽样方法,对苏州市3 150名7~17岁儿童青少年进行问卷调查,测量身高、体重、腰围和血压,计算BMI和腰高比,分析血压偏高与各项肥胖指标的关系.结果 苏州市儿童青少年血压偏高率为11.3%,超重肥胖率为28.5%,采用腰围、腰高比标准筛查的中心性肥胖率分别为20.6%和23.7%.不同BMI、腰围和腰高比分组的儿童青少年血压偏高率差异均有统计学意义(x2值分别为157.80,105.87,124.17,P值均<0.01).Logistic回归分析显示,与正常体重组相比,超重肥胖组罹患血压偏高的可能性较大(OR=3.89,95%CI=3.09~4.90);与正常腰围或正常腰高比组相比,中心性肥胖组罹患血压偏高的可能性较大(腰围:OR=3.05,95%CI=2.41~3.86;腰高比:OR=3.35,95%CI=2.67~4.21).与BMI和腰围均正常者相比,同时超重肥胖和中心性肥胖者罹患血压偏高的可能性最大(OR=4.28,95%CI=3.31~5.53).结论 BMI、腰围和腰高比均与血压偏高存在相关,BMI与腰围或腰高比存在联合作用,保持正常体重和正常腰围/腰高比可能利于控制血压偏高.     

腰围与腰围身高比预测儿童青少年血压偏高效果比较

探讨腰围(WC)与腰围身高比(WHtR)预测儿童青少年血压偏高的效果,为选择儿童青少年血压偏高的早期预警指标提供科学依据.方法 纳入1993-2011年中国健康和营养调查(GHNS)数据库中10 163名年龄在7~17岁儿童青少年为研究对象,利用受试者工作特征曲线(ROC)比较腰围与腰围身高比预测血压偏高的曲线下面积(AUC),采用Logistic回归模型分析腰围与腰围身高比诊断腹型肥胖预测血压偏高的风险.结果 腰围预测7~11岁男生、12~ 17岁男生、7~11岁女生和12~17岁女生血压偏高的ROC曲线下面积分别为0.64(95%CI=0.62~0.66),0.63 (95%CI=0.61 ~0.65),0.57(95%CI=0.55~0.59)和0.58 (95% CI=0.56~0.60),腰围身高比对应值分别为0.60(95% CI=0.58~ 0.62),0.59(95%CI=0.57~ 0.61),0.51(95%CI=0.49~0.53)和0.56(95%CI=0.54~0.58).两指标的ROC曲线下面积差异均有统计学意义(P值均<0.05).腰围与腰围身高比诊断的腹型肥胖均是儿童青少年血压偏高的危险因素,腰围诊断的腹型肥胖预测7~11岁男生、12~17岁男生、7~11岁女生和12~17岁女生血压偏高的OR(95%CI)值分别为4.12(2.76~6.16),2.65(2.01~3.50),2.21(1.40~3.49)和2.50(1.88~3.31),腰围身高比对应的OR(95% CI)值分别为2.74(1.98~3.80),2.27(1.75~2.94),1.63 (1.14~2.32)和1.75(1.37~2.24),腰围略优于腰围身高比.结论 腰围与腰围身高比均可作为儿童青少年血压偏高的重要预测因子,腰围的预测效果略优于腰围身高比.但考虑到腰围身高比界值的简单易记性,仍可推荐为儿童血压偏高的早期筛查指标.     

芜湖市2017年3～6岁儿童腰围特征及高腰围影响因素分析

目的 分析芜湖市3～6岁儿童腰围特征,探讨高腰围的影响因素.方法 2017年整群抽取芜湖市7所幼儿园3～6岁儿童,测量儿童的身高、体重、腰围,描述其腰围特征,对家长进行问卷调查,通过logistic回归分析3～6岁儿童高腰围影响因素.结果 调查1 924名儿童,其中男性1 009人,女性915人,男童平均腰围(52.35±4.85)cm,女童平均腰围(51.22±4.37)cm,腰围在各性别(t=5.344,x2＜0.05)、年龄(F=75.944,P＜0.05)组间差异有统计学意义.logistic回归多因素分析结果显示,儿童超重(OR=19.579,95％CI:13.902～27.573)、父亲超重(OR=1.722,95％CI:1.236-2.397)、iPad 使用时间≥1 h(OR=2.218,95％CI:1.212-4.058)、进餐速度快(OR=2.566,95％CI:1.582-4.165)、进餐速度过慢(OR=1.578,95％CI:1.053～2.363)、喜欢吃荤食(OR=1.526,95％CI:1.060～2.197)会增加高腰围发生的风险.结论 3～6岁儿童腰围受父母BMI、视频时间和自身的饮食习惯影响.