- 期刊
Obesity Criteria for Identifying Metabolic Risks
代谢综合征的肥胖标准
摘要
与多个代谢危险因素相关的中国人群的肥胖标准尚存在争议。本研究目的是寻找检出代谢综合征的最佳人体测量指标及适宜切点值。于2007 年4 月至8月期间，调查了北京市四个社区的年龄在18-85 岁之间的居民，其中男性3704 位，女性6392 位。所有人检测了身高、体重、腰围（WC）、臀围、血压（BP）、血清甘油三酯水平（TG）、高密度脂蛋白胆固醇（HDL-C）水平及空腹血糖水平。分别计算了每个人的体重指数(BMI) 、腰围身高比（WSR）和腰臀比（WHR）。四个代谢危险因素包括1）高血压; 2)高TG 血症; 3)低HDL-C 血症; 4)高血糖。分析人体测量指标与代谢风险关系的统计方法包括偏相关分析、方差分析、线性回归和接收器運作特性(ROC)曲线分析，适宜切点值由ROC 分析得出。所有肥胖指标均与代谢危险因素有正相关。校正年龄后，腰围检出2 个以上代谢危险因素聚集的敏感性、特异性最佳。男性腰围切点值是89 cm，而女性在小於40 岁、40-60 岁和大於60 岁年龄组的腰围切点值分别为80.5 cm、82.5 cm 和89.5 cm。因此，在本研究的人体测量指标中，腰围与中国成人代谢危险因素的相关性最强，老年女性人群的肥胖指标高于較年輕女性。
並列摘要
Criteria of obesity in the Chinese population with multiple metabolic risk factors remains unclear. The objective was to determine the best anthropometrical measurements with regard to the metabolic syndrome (MetS) and to propose optimal cut-off values. Between April and August, 2007, 3,704 men and 6,392 women aged 18-85 years were recruited from four community centers. Medical examinations included measurement of weight, height, waist circumference (WC), hip circumference, fasting blood triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), glucose concentrations, and blood pressure (BP). Body mass index (BMI), waist to hip ratio (WHR), WC and waist to stature ratio (WSR) were calculated. Four metabolic risk factors were examined: 1) high BP; 2) high levels of TG; 3) low levels of HDL-C; 4) impaired glucose tolerance. The relationships between studied indices and risk factors were analyzed using partial correlation analyses, analysis of variance (ANOVA), linear regression, and Receiver Operator Characteristic (ROC) curve analysis. The optimal cut-off values of each obesity index were calculated using ROC analysis respectively. All obesity indices were positively associated with metabolic risk factors. Area under curve (AUC) of WC was the largest for ≥ 2 risk factors after adjustment for age in both genders. Optimal cut-off points for WC were 89 cm in men, and 80.5cm, 82.5cm, and 89.5cm in ＜ 40-yr, 40-60-yr, and ＞ 60-yr women respectively. Waist circumference is best associated with metabolic risk factors among the studied indices in Chinese adults. Indices of abdominal obesity for older age groups tend to be higher than younger age groups in women.