文章摘要
翟屹,赵文华,周北凡,陈春明.中国成年人中心性肥胖腰围切点值的进一步验证[J].中华流行病学杂志,2006,27(7):560-565
中国成年人中心性肥胖腰围切点值的进一步验证
Verification of the cut-off waist circumference for defining central obesity in Chinese adults
收稿日期:2006-05-29  出版日期:2014-09-12
DOI:
中文关键词: 肥胖  糖尿病  腰围  中国成年人
英文关键词: Obesity  Diabetes mellitus  Waist circumference  Adults Chinese
基金项目:卫生部专项经费资助项目(2001DEA30035、2003DIA6N008);科技部重大专项经费资助项目(ZKJBPT100369);卫生部和世界卫生组织合作项目(WKC/WK/VH/JC/ai C2-AHP-05-043)
作者单位
翟屹 中国疾病预防控制中心营养与食品安全所, 北京 100021 
赵文华 中国疾病预防控制中心 
周北凡 中国医学科学院北京阜外心血管病医院 
陈春明 中国疾病预防控制中心 
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中文摘要:
      目的描述中国人群腰围的分布特征,进一步探讨和验证中国成年人中心性肥胖的腰围切点及其对糖尿病患病危险的预测价值。方法利用2002年中国居民营养与健康状况调查的大样本数据,分析中国人群腰围的分布特征、南方和北方人群腰围的分布特征以及身材高大人群的腰围分布特征。分析不同的腰围切点与体重指数(BMI)≥24的诊断一致性。以ROC曲线的最短距离确定适合的腰围切点。用多元logistic回归分析不同腰围水平下调查对象的糖尿病患病相对风险。结果中国人群腰围分布呈正偏态;对腰围进行年龄调整后,男性腰围均值为79.0cm,女性为74.8cm。男性腰围均值大于女性;腰围水平随年龄增长而逐渐增加;不论男女,北方人群的腰围均大于南方;身材高大的人腰围水平大于总人群。男性腰围以85cm、女性80cm作为切点,与BMI≥24的诊断一致性最好,且ROC曲线的距离最短。男性腰围超过85cm、女性腰围超过80cm,患糖尿病的相对危险均增加1.1倍,空腹血糖受损的患病相对危险会增加1.0倍和1.7倍;当男性腰围超过95cm、女性腰围超过90cm时,患糖尿病的相对危险就会增加2.6倍和3.0倍,空腹血糖受损的患病相对危险会增加2.2倍和2.3倍。腰围越大,糖尿病的患病风险及空腹血糖受损的患病风险则越大。结论中国卫生部颁发的《中国成年人超重与肥胖症预防与控制指南》中推荐的腰围以85cm和80cm分别作为诊断男性和女性中心性肥胖的切点,得到了进一步的验证,应在预防中应用。
英文摘要:
      Objective To describe the characteristics for distribution of waist circumference(WC) in Chinese adults and validate-cut-off points of WC defining the central obesity for Chinese adults. Methods Data of 131 509 adults from the 2002 National Nutrition and Health Survey was used to analyze the characteristics of waist circumference distribution of Chinese adults, the differences between southern and northern Chinese and the WC of the tall adults. Kappa test was used to estimate the consistency of different cut-off for WC with body mass index(BMI)≥24 in defining obesity. The odds ratios of diabetes in different cut-off of WC were calculated by multiple logistic regression. Results The characteristic of WC showed normal positive skewed distribution. The means of WC, adjusted by age, were 79.0 cm in males and 74.8 cm in females. The mean of WC increased with age while higher in tall person than in other subjects. The WC at 85 cm for male and 80 cm for female had the best consistency with BMI at 24, and distance of ROC curve the shortest. The OR value of diabetes beyond 85 cm for males and 80 cm for females increased 1.1 times more than the normal group. The OR values of IFG were 2.0 and 2.7, WC at 95 cm for males and 90 cm for females. The OR values of diabetes were 2.6 and 3.0 respectively, and up to 2.2 and 2.3 accordingly for IFG. The OR value of diabetes and IFG increased in tandem with WC level. Conclusion The recommended cut-off points for central obesity as 85 cm for males and above, 80 cm for females in the "Guidelines for Overweight and Obesity Prevention and Control for Chinese Adults" were verified and could be applied in preventive activities.
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