体质指数与腰围指标联合应用对心血管病危险的预测作用  

Predictive value of combined measurements of body mass index and waist circumference for the risk of cardiovascular disease

作　　者：王薇[1] 赵冬[1] 孙佳艺[1] 刘静[1] 刘军[1] 秦兰萍[1] 吴兆苏[1] 

机构地区：[1]首都医科大学附属北京安贞医院北京市心肺血管疾病研究所流行病研究室,100029

出　　处：《中华心血管病杂志》2008年第7期655-658,共4页Chinese Journal of Cardiology

基　　金：“八五”国家科技攻关课题资助项目（85-915-01-02）;北京心血管病高技术实验室资助项目（953850700）

摘　　要：目的分析和评价在体质指数（BMI）分层基础上，增加腰围指标对心血管病危险因素的检出作用以及对心血管病发病危险的预测作用。方法以1992年建立的中国多省市前瞻性队列35～64岁共30378人数据为依据，在基线BM1分为正常、超重和肥胖的基础上，分析和评价加入腰围指标对心血管病代谢因素的检出作用以及心血管病发病危险的预测作用。诊断标准分别参照《中国成人超重和肥胖症预防控制指南》中的BMI切点和《中国成人血脂异常防治指南》中的腹部肥胖切点。结果（1）联合应用BMI和腰围指标诊断肥胖时，呈现交叉重叠情况。以BMI为标准，队列人群肥胖率是10％，其中76．4％的人同时伴有腹部肥胖；以腰围为标准诊断人群腹部肥胖率为17．5％，其中有43．4％的人同时符合BMI的肥胖标准。（2）在BM1分层中加入腰围指标，男女两性有腹部肥胖者其心血管病危险因素患病率均高于无腹部肥胖组。在调整了年龄、性别、吸烟和体力活动等因素后，其特点仍存在，并有统计学的显著性。（3）以BMI和腰围均正常组为对照，多因素分析显示：超重和肥胖组中有腹部肥胖者的缺血性心血管病发病危险分别增加了38％（RR=1．383，95％CI1．083～1．765）和57％（RR=1．570，95％CI1．226～2．010）。结论在BM1分层中加入腰围指标可增加心血管病代谢危险因素以及心血管病发病危险的预测作用。Objective To evaluate the predictive value of the combined measurements of body mass index （BMI） and waist circumference （WC） for the risk of cardiometabolic diseases （including diabetes, hypertension, and dyslipidemia ） and ischemic cardiovascular disease. Method A total of 30 378 Chinese people from 11 provinces were studied in this prospective study conducted from 1992 to 2003. Multivariable logistic and Cox regression were used respectively to determine the predictive value of WC for cardiometabolic diseases and ischemic cardiovascular disease within each BMI categories. Results （ 1 ） The prevalence of obesity were 10% defined by BMI. Among them, 76.4% had abdominal obesity defined by WC. The prevalence of abdominal obesity was 17.5% by WC categories, and 43.4% of them were classified as obesity by BMI. （2） The prevalence rates of cardiometabolic diseases were higher in individuals with elevated WC within each BMI category. （3） Compared with subjects with normal BMI and WC, the risk of ischemic cardiovascular disease increased by 38% （ RR = 1. 383, 95% CI 1. 083-1. 765 ） in overweight subjects with elevated WC and by 57% （ RR = 1. 570, 95% CI 1. 226-2. 010） in obese subjects with elevated WC. Condusion Combined measurements of BMI and WC provide a better prediction for the risk of cardiometabolic diseases and ischemic cardiovascular disease.

关 键 词：人体质量指数 腰围 危险因素 前瞻性研究 

分 类 号：R686[医药卫生—骨科学]