Optimal Cut-Off Levels to Define Obesity: Body Mass Index and Waist Circumference, and Their Relationship to Cardiovascular Disease, Dyslipidaemia, Hypertension and Diabetes in Malaysia

在馬來西亞定義肥胖的理想切點：身體質量指數和腰圍，與心血管疾病、脂質異常、高血壓和糖尿病的相關性

Zaki Morad Mohd Zaher ； Robayaah Zambari ； Siew-Pheng Chan ； Vadivale Muruga ； Bernard Ng ； Geeta Appannah ； Teck Onn Lim

《Asia Pacific Journal of Clinical Nutrition》 18卷2期 (2009/06) Pp. 209-216

https://doi.org/10.6133/apjcn.2009.18.2.09

摘要

亞洲許多研究都認為亞洲人比西方人可能需要較低的身體質量指數（BMI）和腰圍切點，以分別定義肥胖和腹部肥胖。訂定適宜的身體質量指數和腰圍切點來評估這兩個體位指標和心血管疾病指標的相關性。應用接受器操作特性曲線（ROC）分析決定理想切點。研究樣本包含來自馬來西亞93個初級醫護診所中的1833個受試者（平均年齡44±14歲）。其中男性872位和女性960位。可預測血脂異常、高血壓、糖尿病或至少一個心血管疾病危險因子的身體質量指數切點範圍，在男性為23.5-25.5kg/m^2，女性為24.9-27.4kg/m^2。至於腰圍的適當切點範圍，男性為83-92cm，女性為83-88cm。從我們的研究中顯示，定義馬來西亞成年人的過重或肥胖標準，更適合的身體質量指數的理想切點，男性和女性分別為23.5kg/m^2和24.9kg/m^2；男性和女性腰圍的理想切點都為83cm。腰圍相較於身體質量指數，可能是一個評估男性和女性肥胖相關的心血管危險因子更好的預測指標。在亞洲，可能需要進一步使用一個更大的樣本數調查，以證實我們的發現。

關鍵字

腹部肥胖 ； 身體質量指數 ； 腰圍 ； 心血管疾病 ； 亞洲

並列摘要

Many studies in Asia have demonstrated that Asian populations may require lower cut-off levels for body mass index (BMI) and waist circumference to define obesity and abdominal obesity respectively, compared to western populations. Optimal cut-off levels for body mass index and waist circumference were determined to assess the relationship between the two anthropometric- and cardiovascular indices. Receiver operating characteristics analysis was used to determine the optimal cut-off levels. The study sample included 1833 subjects (mean age of 44 + 14 years) from 93 primary care clinics in Malaysia. Eight hundred and seventy two of the subjects were men and 960 were women. The optimal body mass index cut-off values predicting dyslipidaemia, hypertension, diabetes mellitus, or at least one cardiovascular risk factor varied from 23.5 to 25.5 kg/m2 in men and 24.9 to 27.4 kg/m2 in women. As for waist circumference, the optimal cut-off values varied from 83 to 92 cm in men and from 83 to 88 cm in women. The optimal cut-off values from our study showed that body mass index of 23.5 kg/m2 in men and 24.9 kg/m2 in women and waist circumference of 83 cm in men and women may be more suitable for defining the criteria for overweight or obesity among adults in Malaysia. Waist circumference may be a better indicator for the prediction of obesity-related cardiovascular risk factors in men and women compared to BMI. Further investigation using a bigger sample size in Asia needs to be done to confirm our findings.

並列關鍵字

abdominal obesity ； body mass index ； waist circumference ； cardiovascular ； Asia