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。

Study on the cut-off points of obesity indexes for predicting hypertension and dyslipidemia among the elderly aged 60 years and above at 13 monitoring sites in Hunan Province

Objective To explore the correlations of the obesity rates determined by three obesity indexes, body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) with hypertension and dyslipidemia among the elderly aged 60 years and above at 13 monitoring points in Hunan Province, and to assess the ability of these indexes in prediction of risk of hypertension and dyslipidemia. Methods Based on provincial-level representative survey data of chronic diseases and risk factors in China, receiver operating characteristic (ROC) curve analysis was performed to determine the appropriate cut-off points of different obesity indexes, BMI, WC and WHtR for predicting hypertension and dyslipidemia in the elderly in Hunan Province. Results The overweight and obesity rate (BMI ≥ 24) of the elderly aged 60 years and above at 13 monitoring sites in Hunan Province was 42.91%, the central obesity rate 31.26%, and the obesity rate of WHtR ≥ 0.5 68.97%. The ROC curve was drawn with hypertension as the dependent variable, showing that the area under the ROC curve of men's and women's WHtR was relatively high, with the cut-off values of 0.50 and 0.53, respectively. Taking dyslipidemia as the dependent variable, the results indicated that the area under the ROC curve of BMI was the highest, with the cut-off values being 21.40 and 22.06, respectively.Conclusion Different indexes for evaluating obesity have different predictive effects on hypertension and dyslipidemia, of which WHtR is the best for predicting hypertension in the elderly. BMI is the best and summary index for diagnosing dyslipidemia in the elderly.