中国成人多重心血管危险因素聚集的最佳腰围切割点

目的探讨中国成人多重心血管危险因素聚集的最佳腰围切割点。方法分析1994年全国糖尿病普查的15628例年龄≥25岁的中国成人资料。以腰围〈70cm组（每隔5cm分为一组）作为对照,计算其他各组发生多重心血管危险因素的优势比OR值和95％CI。采用ROC曲线分析计算不同腰围水平对多重心血管危险因素聚集识别的敏感性和特异性,以诊断指数（诊断指数=1-假阳性-假阴性）最大的腰围作为最佳切割点。结果无论男性还是女性。胰岛素抵抗、血脂异常、高血压和高血糖的百分比均随着腰围的增加而增加。男性腰围≥85cm、女性腰围≥80cm后发生代谢综合征的OR值显著增加[分别为2．08（95％CI1．80-2．39）和1．66（95％CI1．41-1．97）1。ROC分析显示以上相应腰围切割点具有最佳的敏感性和特异性。结论反映中国成人多重心血管危险因素聚集的男性最佳腰围切割点为85cm、女性为80cm。

The optimal waist circumference cut-off point for identifying cardiovascular risk factors clustering among Chinese adults

OBJECTIVE: The waist circumference (WC) cut-off point for abdominal obesity is gender and ethnic-group specific. The aim of the study was to explore the best WC cut-point for identifying cardiovascular risk factors clustering among Chinese adults. METHOD: The data from 15,628 Chinese adults aged > or = 25 years in 1994 National Diabetes Mellitus Survey were reanalyzed. Odds ratios for different WC categories (stratified in units of 5 cm) were calculated with the first stratum (WC < 70 cm) as reference category. Receiver Operator Characteristic curve (ROC) analysis was employed to determine the optimal WC cut-point for detecting multiple cardiovascular disease risk factors. RESULTS: The prevalences of insulin resistance, dyslipidemia, hypertension and hyperglycemia were higher among higher WC categories for both men and women. Odds ratios for metabolic syndrome significantly increased from the WC category of > or = 85 cm in man (OR = 2.08, 95% CI: 1.80 - 2.39) and > or = 80 cm in women (OR = 1.66, 95% CI: 1.41 - 1.97). The ROC analysis showed that the optimal WC cut-point was 85 cm in men with the sensitivity of 60.79% and specificity of 69.66%, and 80 cm in women with sensitivity of 59.88% and specificity of 65.35%. CONCLUSION: The best WC cut-point is 85 cm in men and 80 cm in women for identifying Chinese adults at high risk of cardiovascular disease.