| 翟屹,赵文华,陈春明.中国中老年人群和高个成年人中心型肥胖的腰围界值点验证[J].中华流行病学杂志,2010,31(6):621-625 |
| 中国中老年人群和高个成年人中心型肥胖的腰围界值点验证 |
| Verification on the cut-offs of waist circumference for defining central obesity in Chinese elderly and tall adults |
| 收稿日期:2010-03-24 出版日期:2014-09-10 |
| DOI：10.3760/cma.j.issn.0254-6450.2010.06.005 |
| 中文关键词: 腰围 界值点 糖尿病 中老年人 高个成年人 |
| 英文关键词: Waist circumference Cut-offpoint Diabetes mellitus Elderly Tall adults |
| 基金项目:科技部重点基金(2001DEA30035,2003DIA6N008);2002年科技部专项基金(2002D2A40022);卫生部2001-2002年度中国居民营养与健康状况调查项目 |
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| 中文摘要: |
| 目的 探讨中国中老年人群和高个成年人的适宜腰围界值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数据,分析≥45岁人群和身高在全人群第85百分位数(P85)以上成年人的腰围分布特征,分析不同的腰同界值点与体重指数(BMI:kg/m2)≥24的诊断一致性,采用多元logistic回归分析不同腰围水平的调查对象患糖尿病和空腹血糖受损的相对风险,并以ROC曲线最短距离确定上述人群的适宜腰围界值点.结果 中国中老年人腰围男性均值为80.8 cm,女性均值为79.4 cm;高个男性腰围均值为84.1 cm,女性为77.9 cm.中老年人腰围以男性85 cm、女性80 cm作为界值点,与BMI≥24的诊断一致性最好,预测糖尿病的ROC曲线距离最短.与腰围<85 cm组相比,85 cm～组、90 cm～组和95 cm～组的中老年男性患糖尿病[OR值分别为2.1(95%CI:1.6～2.8)、3.0(95%CI:2.3～4.0)和4.5(95%CI:3.4～5.8)]和空腹血糖受损[OR值分别为1.6(95%CI:1.2～2.2)、2.6(95%CI:1.9～3.5)和3.5(95%CI:2.6～4.6)]的相对风险明显增加.与腰围<80 cm组相比,80 cm～组、85 cm～组和90 cm～组中老年女性患糖尿病[OR值分别为1.9(95% CI:1.4-2.6)、3.2(95%CI:2.4～4.3)和4.8(95%CI:3.7～6.1)]和空腹血糖受损[OR值分别为2.5(95%CI:1.8～3.4)、3.2(95%CI:2.4～4.4)和4.2(95%CI:3.2～5.6)]的相对风险明显增高.高个成年人腰围以男性90 cm、女性85 cm作为界值点,预测糖尿病患病的ROC曲线距离最短.与腰围<85 cm组相比,95cm～组高个男性患糖尿病和空腹血糖受损的相对风险明显增高[OR值分别为3.6(95%CI:2.1～6.4)和5.5(95%CI:3.0～10.1)].与腰围<80cm组相比,85 cm～、90 cm～组高个女性患糖尿病的相对风险明显升高[OR值分别为5.0(95%CI:2.7～9.4)和8.0(95%CI:4.6～14.1)],90 cm～组患空腹血糖受损的相对风险OR=3.7(95%CI:2.0～6.9).结论 男性85 cm和女性80 cm是中老年人群的适宜腰围界值点;对于高个成年人,此腰围界值点对于空腹血糖受损有预测价值;人群中心型肥胖预防指标建议使用男性85 cm和女性80 cm作为腰围界值点. |
| 英文摘要: |
| Objective To describe the characteristics for distribution of waist circumference (WC) and validate the cut-offs of WC in defining the central obesity among Chinese elderly and tall adults. Methods Data from the 2002 National Nutrition and Health Survey was used to analyze the characteristics of WC distribution among subjects aged 45 and above and their height beyond the P85 percentile of Chinese adults. Kappa test was used to estimate the consistency of different cut-offs for WC with body mass index (BMI)≥24 in defining obesity. The odds ratios of diabetes and impaired fasting glucose in different cut-offs on WC were calculated by multiple logistic regression. ROC curves analysis was used to determine the cut-offs. Results The means of WC were: 80.8 cm in male elderly, 79.4 cm in female elderly, 84.1 cm in tall male and 77.9 em in tall female, respectively. The WC at 85 cm for male and 80 cm for female elderly had the best consistency with BMI at 24, and the distance of ROC curve was the shortest. The odds ratios for diabetes significantly increased from WC categories of 85-cm (OR=2.1,95% CI: 1.6-2.8), 90-cm (OR=3.0,95 % CI: 2.3-4.0), and 95-cm (OR=4.5,95%CI:3.4-5.8) in male elderly,and 80-cm (OR= 1.9,95%CI: 1.4-2.6),85-cm (OR=3.2, 95% CI: 2.4-4.3), and 90-cm (OR=4.8, 95% CI: 3.7-6.1 ) in female elderly (P<0.01). The odds ratios for impaired fasting glucose also significantly increased from WC categories of 85-cm (OR= 1.6, 95% CI: 1.2-2.2), 90-cm (OR=2.6,95% CI: 1.9-3.5), and 95-cm (OR=3.5,95% CI:2.6-4.6) in male elderly, and 80-cm (OR=2.5, 95% CI: 1.8-3.4), 85-cm (OR=3.2, 95% CI:2.4-4.4), and 90-cm (OR=4.2,95% CI: 3.2-5.6) in female elderly (P<0.01). The odds ratios for diabetes (OR=3.6, 95% CI: 2.1-6.4) and impaired fasting glucose (OR=5.5, 95% CI: 3.0-10.1)significantly increased from WC≥95 cm in tall males. The odds ratios for diabetes significantlyincreased from WC categories of 85-cm (OR=5.0,95%CI: 2.7-9.4) and 90-cm (OR=8.0,95%C1:4.6-14.1 ), and odds ratio for impaired fasting glucose of WC≥90 cm was 3.7 (95%CI: 2.0-6.9) intall females. Conclusion The recommended cut-off points of WC were 85 cm for elderly males and80 cm for elderly females. The eut-offs of WC were also effective predictors for impaired fasting glucose among tall adults. The cut-offs of WC in the Guidelines for Overweight and ObesityPrevention and Control for Chinese Adults were verified and should be applied as preventiveindicators. |
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