体质量指数、腰围和腰围身高比对代谢综合征诊断能力的比较研究  

Comparative study on body mass index,waist circumference and waist-to-height ratio in the diagnosis of metabolic syndrome

作　　者：聂倩[1] 郝志华[1] 王忠丽[1] 刘承浩 翟俊轻[1] NIE Qian;HAO Zhihua;WANG Zhongli;LIU Chenghao;ZHAI Junqing(Hebei General Hospital,Shijiazhuang,050051, China)

机构地区：[1]河北省人民医院,河北石家庄050051

出　　处：《现代中西医结合杂志》2020年第24期2649-2653,2713,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省医学科学研究重点课题计划(20180056)。

摘　　要：目的探讨体质量指数、腰围和腰围身高比对于代谢综合征(MS)的最佳判断指标及其适宜切点。方法纳入2019年3—12月在河北省人民医院体检中心参加健康体检者10234例,收集受检者基本资料(年龄、性别、吸烟及饮酒情况、个人疾病史、家族史等)、人体测量学指标(身高、体质量、腰围、体质量指数、血压、腰围身高比)、生化检测指标(空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇)。将受检者分为MS组和非MS组,比较2组各指标的差异性,分析不同年龄段不同性别人体测量学指标与MS组分的相关性,采用受试者工作特征曲线(ROC曲线)判定体质量指数、腰围、腰围身高比对MS的诊断价值,并确定其理想切点、敏感度、特异度、曲线下面积。结果本研究中MS的总体患病率为21.0%(2150/10234)。相关性分析显示,无论性别及年龄的分布,体质量指数、腰围、腰围身高比与收缩压、舒张压、空腹血糖、三酰甘油均存在正相关(P均<0.05)。ROC曲线显示体质量指数、腰围、腰围身高比对MS的预测有显著意义(P均<0.05);在年龄≥60岁的男性及女性中,腰围的曲线下面积最大,AUC分别为0.817和0.827,预测MS的切点分别为89.5 cm和84.5 cm,男性敏感度和特异度分别为87.1%和69.9%,女性为88.3%和71.0%。在<60岁的男性及女性中,腰围身高比的曲线下面积最大,AUC分别为0.841和0.867,预测MS的切点分别为0.53和0.52,男性组敏感度和特异度分别为0.790%和76.6%,女性组为84.5%和79.5%。结论腰围、腰围身高比对于MS的诊断价值均优于体质量指数,<60岁的人群腰围身高比诊断价值优于腰围,而60岁及以上人群其腰围的诊断价值更高。Objective It is to explore the best indicators of body mass index,waist circumference and waist-to-height ratio for diagnosing metabolic syndrome(MS)and their appropriate cut points.Methods A total of 10,234 people participating in a health checkup were enrolled.The basic information(age,gender,smoking and drinking,personal disease history,family history,etc.),anthropometric indicators(height,weight,waist circumference,body mass index,blood pressure,waist-to-height ratio),biochemical test indicators(fasting blood glucose,total cholesterol,triglycerides,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol)of the subjects were collected.The subjects were divided into MS group and non-MS group,the differences of the indicators between the two groups were compared,and the correlation between anthropometric indicators of different ages and genders and MS components was analyzed,and the receiver operating characteristic curve(ROC curve)was used to assess the diagnostic value of body mass index,waist circumference,waist-to-height ratio for MS,and determine its ideal cut point,sensitivity,specificity,and area under the curve.Results The overall prevalence of MS in this study was 21.0%.Correlation analysis showed that no matter what the distribution of gender and age was,BMI,waist circumference,waist-to-height ratio were positively correlated with systolic blood pressure,diastolic blood pressure,fasting blood glucose,and triglycerides(P<0.05).The ROC curve shows that body mass index,waist circumference,and waist height ratio had significant significance in predicting MS(P<0.05);among men and women aged≥60 years,the area under the curve of waist circumference was the largest,with AUC of 0.817 and 0.827,respectively.The cut points for predicting MS were 89.5cm and 84.5cm,respectively,the sensitivity and specificity were 87.1%and 69.9%for men,and 88.3%and 71.0%for women.Among men and women under the age of 60 years,the area under the curve of waist-to-height ratio was the largest,with AUC of 0.841 and 0

关 键 词：腰围身高比 腰围 体质量指数 代谢综合征 筛查 

分 类 号：R589[医药卫生—内分泌]