体质指数、腰围、腰臀比与高血压、高血糖的关系及三者对高血压、高血糖的预测价值

目的探讨体质指数（BMI）、腰围（WC）、腰臀比（WHR）与高血压、高血糖的关系及三者对高血压高血糖的预防价值。方法2006年4-9月整群抽取黑龙江省电力医院健康检查中心体检的1751人,测量身高、体重、腰围、臀围、血压和空腹血糖。结果①BMI、WC与血压的相关性比WHR好;WHR、WC与血糖的相关性比BMI好;②logistic回归分析表明3个指标中BMI是高血压重要的预测因子,而WC是高血糖及二者聚集重要的预测因子;③BMI、WC与WHR三者之间两两指标同时存在时对高血糖、高血压及二者聚集都存在交互作用;④当BMI≥25kg/m2时,其OR值在3.02-4.01之间,ARP在58.13%-69.21%之间,PARP在43.79%-55.77%之间;当WC≥85cm（男性）、WC≥80cm（女性）时,其OR值在4.04-6.70之间,PARP在56.47%-75.52%之间;敏感度和特异度均较好,正确指数高,具有较高的公共卫生价值。结论BMI、WC分别是高血压、高血糖重要的预测因子,以BMI≥25kg/m2或WC≥85cm（男性）、WC≥80cm（女性）为超重肥胖切点时,诊断价值最高,建议以此为诊断界值。

Predictive values and relationship of body mass index,waist circumference and waist-hip ratio with hy-pertension and hyperglycosemia

Objective Discussion on predictive values and relationship of body mass index （BMI）, waist circumference （WC） and waist-hip ratio （WHR） with hypertension and hyperglycosemia. Methods A cluster sampling was conducted in Heilongjiang Electricity Power Hospital from April to September in 2006. 1 751 adults were examined on height, weight, WC and so on. Results （1）The correlations between BMI, WC and blood pressure were better than WHR. The correlations between WHR, WC and blood glucose were better than BMI. （2）logistic regression analysis showed that BMI was a main prediction factor of hypertension, while WC was a main prediction factor of hyperglycosemia and both the clusters. （3）WHR and BMI, WHR and WC, BMI and WC had interactions to three morbid states. （4）When BMI≥25 kg/m^2, OR values were between 3.02 and 4.01, and PARP were from 43.79 % to 55.77 % ; When WC ≥ 85 cm in men or WC ≥80 cm in women, OR values were between 4.04 and 6.70, and PARP were from 56.47 % to 75.52 %. Their sensitivity and specificity were better, meanwhile, they had higher correct index and public health value. Conclusions BMI and WC have great influence on hypertension and hyperglycosemia respectively. BMI ≥25 kg/m^2 and WC ≥85 cm in men or WC ≥80 cm in women have the best diagnostic value. It is therefore suggested that they be recommended as diagnostic cut-off points.