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。

Comparison of the performance of waist circumference,waist-height ratio,and body mass index in predicting metabolic disorders among children and adolescents

Objective To examine the performance of waist circumference (WC),waist-height ratio (WHtR) and body mass index (BMI) for predicting metabolic disorders in children and adolescents,and to provide scientific evidence for early warning of metabolic disorders. Methods A total of 1 170 children and adolescents aged 7~17 years from urban area of Jinan were included in this study.Receiver operating characteristic curve (ROC) analysis was used to compare the area under curves (AUCs) of WC,WHtR and BMI for predicting metabolic disorders.Logistic regression model was conducted to examine obesity defined using WC (≥age- and sex- specific P₉₀),WHtR (≥0.50) and BMI (≥age- and sex- specific obesity cut-offs) respectively,for predicting the risk of metabolic disorders. Results The area under curve value (AUC) of WC for predicting more than one or two of four metabolic disorders (including hyperglycemia,hypertension,lowered HDL-C,and elevated TG) were 0.63 (0.59~0.66) and 0.74 (0.69~0.79),respectively.The corresponding values of WHtR were 0.62 (0.58~0.65) and 0.74 (0.69~0.79),and the corresponding values of BMI were 0.64(0.60~0.67) and 0.75(0.70~0.80),respectively.The odds ratios (ORs) of abdominal obesity defined by WC in predicting ≥1 or ≥2 metabolic disorders were 2.88(2.15~3.86) and 6.83(4.47~10.44),respectively,which were similar with the corresponding values of WHtR2.63(1.86~3.71) and 5.77(3.65~9.13)],as well as BMI3.03(2.17~4.23) and 6.35(4.03~10.00)]. Conclusions WC,WHtR and BMI are all important predictors for metabolic disorders in children and adolescents.Considering the similar performance of WC,WHtR and BMI,WHtR may be suitable to replace WC and BMI as an early warning predictor of metabolic disorders in children and adolescents.