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Comparison of Anthropometric Indices of Obesity in Predicting Subsequent Risk of Hyperglycemia among Chinese Men and Women in Mainland China

中国大陆地区成年男女肥胖指数对高血糖症罹患风险的预测

摘要


研究背景:肥胖是高血糖症的一个重要危险因素。然而,腰高比(WHtR)、腰臀比(WHR)、腰围(WC)和体质指数(BMI)对高血糖症的预测效用尚未取得一致的研究结论,而且也存在种族差异。研究目的:比较以腰高比、腰臀比、腰围和体质指数预测中国的成人高血糖症的效用,并估计最佳切点值。研究设计:在中国南京于2004-2007年间实施的社区为基础的人群队列研究。腰高比、腰臀比、腰围、体质指数、空腹末梢血糖、相关协变量和混杂因素在基线和终点时分别进行了测量。研究结果:总的高血糖症的累计发生率为8.6%(男性8.0%,女性9.0%)。在男性成人中,腰高比、腰臀比、腰围、体质指数预测高血糖症的相对危险度,按4 等份由低到高分别为1.00、1.33、1.67、3.40,1.00、2.38、2.53、3.87,1.00、1.29、1.75、2.90,及1.00、1.45、1.49、2.41;女性成人的相对危险度則为1.00、1.24、1.99、2.87,1.00、1.14、2.28、2.66,1.00、1.32、1.80、3.14,及1.00、1.39、1.50、2.08。针对每一个上述变量和性别,p 值都小于0.05。调整混杂因素并未实质改变这种剂量反应关系。ROC 曲线分析表明腰高比具有最佳的预测高血糖症的灵敏度和特异度。对男性而言,腰高比、腰臀比、腰围、和体质指数的最佳切点值分别为0.51、0.92、85和24;女性則为0.55、0.86、82和25。结论:腰高比、腰臀比、腰围、体质指数都与高血糖症的发生存在正向的联系。针对中国成人的高血糖症,腰高比和腰围的预测效用最好。

關鍵字

腰高比 腰臀比 腰围 体质指数 高血糖症

並列摘要


Background: Obesity is a strong risk factor for hyperglycemia. However, the performance of waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), waist circumference (WC) and body mass index (BMI) in predicting hyperglycemia was inconclusive; and ethnic differences may exist in the associations. Objective: The objective was to compare WHtR, WC, WHR and BMI in predicting hyperglycemia among Chinese adults and identify optimal cut-off points. Design: A community-based prospective cohort study was conducted during 2004-2007 in Nanjing China. WHtR, WC, WHR, BMI, fasting capillary blood glucose, covariates and potential confounders were assessed at baseline and third year of follow-up. Results: The overall cumulative incidence of hyperglycemia was 8.6% (8.0% in men, 9.0% in women). Relative risks across quartiles of WHtR, WHR, WC and BMI were 1.00, 1.33, 1.67, 3.40; 1.00, 2.38, 2.53, 3.87; 1.00, 1.29, 1.75, 2.90; and 1.00, 1.45, 1.49, 2.41 in men, and 1.00, 1.24, 1.99, 2.87; 1.00, 1.14, 2.28, 2.66; 1.00, 1.32, 1.80, 3.14; and 1.00, 1.39, 1.50, 2.08 in women, respectively. p for trend was <0.01 for each marker and gender. Adjustment for potential confounders did not change such dose-response relationships materially. ROC analysis indicated that WHtR had the best sum of sensitivity and specificity compared to the other measures .Optimal cut-offs for WHtR, WHR, WC and BMI were 0.51, 0.92, 85 and 24 for men, while 0.55, 0.86, 82 and 25 for women, respectively. Conclusion: WHtR, WHR, WC and BMI were positively associated with subsequent hyperglycemia. WHtR and WC best predicted hyperglycemia among Chinese adults.

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