中老年人体质量指数、腰围、腰身比对血脂异常的预测价值
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摘要
目的:探讨中老年人腰围、体质量指数(BMI)及腰身比(WHtR)对血脂异常的预测价值。方法:收集年龄≥30岁的行健康体检的中老年人665例,获取身高、体质量、腰围以及血脂水平等指标,计算BMI及WHtR;按血脂水平分组,比较血脂正常组和血脂异常组体检者的BMI、腰围以及WHtR,建立受试者工作特征曲线(ROC),确定腰围、WHtR、BMI判断血脂异常的灵敏度、特异度及最佳切点。结果:血脂异常组被检者的BMI、腰围、腰身均高于血脂正常组(P <0. 05),年龄在50～<60岁、BMI在24～28、WHtR≥0. 5、腹型肥胖体检者血脂异常患病率高; BMI诊断血脂异常的ROC曲线下面积大于腰围以及WHtR,男性BMI大于22. 36 kg/m2及女性BMI大于21. 65 kg/m2可作为判断血脂异常的危险因素。结论:与腰围和身高比相比,BMI更能准确预测血脂异常。
Objective: To investigate the predictive value of waistline,waist-to-height ratio and BMI on dyslipidemia in middle-aged and elderly people. Methods: Collecting 655 physical check report from middle-aged and elderly people over 30 years old. Height,BMI,waistline and blood lipid levels are used to calculate Body mass index( BMI) and waist-to-height ratio( WHT). Grouping by blood lipid level,BMI,waistline and waist-to-height ratio of dyslipidemia group was compared with the control group,then establishing receiver operating characteristic curve( ROC). According to the ROC curve,the sensitivity,specificity and the best tangent point were determined in waistline,waist-toheight ratio and body mass index. Results: Dyslipidemia group showed higher result in BMI,waistline and waist-to-height ratio than control group( P < 0. 05); patients aged 50 to over 60,BMI ranged from24 to 28,waist-to-height ratio ≥0. 5,abdominal obesity patients showed higher dyslipidemia morbidity rate; the area under the BMI diagnosed dyslipidemia ROC curves were bigger than waistline and waistto-height ratio: BMI as a biomarker to diagnose dyslipidemia when the BMI is over 22. 36 kg/m2 and21. 65 kg/m2 of males and females respectively. Conclusion: BMI is more sensitive to predicate dyslipidemia than waistline and waist-to-height ratio in middle-aged and elderly people.
Objective: To investigate the predictive value of waistline,waist-to-height ratio and BMI on dyslipidemia in middle-aged and elderly people. Methods: Collecting 655 physical check report from middle-aged and elderly people over 30 years old. Height,BMI,waistline and blood lipid levels are used to calculate Body mass index( BMI) and waist-to-height ratio( WHT). Grouping by blood lipid level,BMI,waistline and waist-to-height ratio of dyslipidemia group was compared with the control group,then establishing receiver operating characteristic curve( ROC). According to the ROC curve,the sensitivity,specificity and the best tangent point were determined in waistline,waist-toheight ratio and body mass index. Results: Dyslipidemia group showed higher result in BMI,waistline and waist-to-height ratio than control group( P < 0. 05); patients aged 50 to over 60,BMI ranged from24 to 28,waist-to-height ratio ≥0. 5,abdominal obesity patients showed higher dyslipidemia morbidity rate; the area under the BMI diagnosed dyslipidemia ROC curves were bigger than waistline and waistto-height ratio: BMI as a biomarker to diagnose dyslipidemia when the BMI is over 22. 36 kg/m2 and21. 65 kg/m2 of males and females respectively. Conclusion: BMI is more sensitive to predicate dyslipidemia than waistline and waist-to-height ratio in middle-aged and elderly people.
引文
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[12]钟永泉,冯洁花.中老年人体质指数、腰围与血脂的相关性分析[J].宁夏医学杂志,2018,40(4):501-503.
[13]HSIEH S D,YOSHINAGA H,MUTO T. Waist-to-heightratio,a simple and practical index for assessing centralfat distribution and metabolic risk in Japanese men andwomen[J]. International Journal of Obesity,2003,27(5):610-616.
[14]JIA W,PAN J. Optimal waist circumference cutoffs forabdominal obesity in Chinese[M]. New York:Springer,2012:378.
[15]徐丽华,颜应琳,于凯,等.老年人颈围、腰围、体重指数、腰身指数对血脂异常及其组分的预测价值[J].中国医刊,2016,51(9):45-49.
[16]栗华,张建新,张中朝,等.河北省城乡成年居民血脂异常及其危险因素调查分析[J].实用预防医学,2008,15(2):327-331.
[2]JENSEN M D,RYAN D H,APOVIAN C M,et al. 2013AHA/ACC/TOS Guideline for the management of over-weight and obesity in adults:a report of the American col-lege of cardiology/American heart association task forceon practice guidelines and the obesity society[J]. Journalof the American College of Cardiology,2014,63(25):2985-3023.
[3]GROUP T D S. BMI compared with central obesity indi-cators in relation to diabetes and hypertension in asians[J]. Obesity,2012,16(7):1622-1635.
[4]杨雯雁,杨大刚,王惠群,等.贵阳市减重门诊患者腰围、腰身比与高甘油三酯血症的相关性研究[J].中华疾病控制杂志,2017,21(5):469-472.
[5]苏健,向全永,吕淑荣,等.江苏省成人肥胖测量指标与血脂异常患病关系[J].卫生研究,2015,44(5):827-831.
[6]中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,16(10):7-28.
[7]中华医学会内分泌学分会肥胖学组.中国成人肥胖症防治专家共识[J].中华内分泌代谢杂志,2011,27(9):711-717.
[8]WANG H,DU S,ZHAI F,et al. Trends in the distribu-tion of body mass index among Chinese adults,aged 20~45 years(1989-2000)[J]. International Journal of O-besity,2006,31(2):272-278.
[9] ROBINSON J G,STONE N J. The 2013 ACC/AHAguideline on the treatment of blood cholesterol to reduceatherosclerotic cardiovascular disease risk:a new para-digm supported by more evidence[J]. European HeartJournal,2015,36(31):2110-2115.
[10]MOKDAD A H,FORD E S,BOWMAN B A,et al.Prevalence of obesity, diabetes, and obesity-relatedhealth risk factors,2001[J]. Jama the Journal of the A-merican Medical Association,2003,289(1):76-79.
[11]POIRIER P,DESPRS J P. Obesity and cardiovasculardisease.[J]. Current Atherosclerosis Reports,2014,42(4):90-107.
[12]钟永泉,冯洁花.中老年人体质指数、腰围与血脂的相关性分析[J].宁夏医学杂志,2018,40(4):501-503.
[13]HSIEH S D,YOSHINAGA H,MUTO T. Waist-to-heightratio,a simple and practical index for assessing centralfat distribution and metabolic risk in Japanese men andwomen[J]. International Journal of Obesity,2003,27(5):610-616.
[14]JIA W,PAN J. Optimal waist circumference cutoffs forabdominal obesity in Chinese[M]. New York:Springer,2012:378.
[15]徐丽华,颜应琳,于凯,等.老年人颈围、腰围、体重指数、腰身指数对血脂异常及其组分的预测价值[J].中国医刊,2016,51(9):45-49.
[16]栗华,张建新,张中朝,等.河北省城乡成年居民血脂异常及其危险因素调查分析[J].实用预防医学,2008,15(2):327-331.
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