江西省居民不同肥胖指标对脑卒中风险的预测效果  

Value of obesity indicators on risk prediction for stroke in Jiangxi Province

作　　者：周伟[1] 丁聪聪 祝玲娟[1] 王涛 鲍慧慧[2] 程晓曙[2] ZHOU Wei;DING Cong-cong;ZHU Lin-juan;WANG Tao;BAO Hui-hui;CHENG Xiao-shu(Center for Prevention and Treatment of Cardiovascular Diseases,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Cardiovascular Medicine,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院心血管病防治中心,南昌330006 [2]南昌大学第二附属医院心血管内科,南昌330006

出　　处：《中华疾病控制杂志》2020年第9期1021-1026,共6页Chinese Journal of Disease Control & Prevention

基　　金：国家“十二五”科技支撑项目(2011BAI11B01)。

摘　　要：目的探讨不同肥胖指标预测脑卒中风险的效果,以尽早发现高危人群.方法于2013年11月1日―2014年7月31日,采用多阶段分层随机抽样方法选取调查对象,进行问卷调查和体格测量.应用Logistic回归分析模型分析不同肥胖指标[体重指数(body mass index,BMI)、腰围(waist circumference,WC)、腰围身高比(waist-to-height ratio,WHtR)、身体圆度指数(body roundness index,BRI)、身体脂肪率(body fat rate,BFP)、内脏脂肪指数(visceral fat index,VAI)]与脑卒中的关系,并用受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under curve,AUC)分析各指标预测脑卒中的效果.结果15172名调查对象平均年龄为(53.00±17.91)岁;其中脑卒中患者226人.与非脑卒中人群相比,脑卒中人群的BMI、WC、WHtR、BRI、BFP、VAI均较高(均有P<0.05).多因素分析显示,各肥胖指标与脑卒中风险均呈正相关.各肥胖指标的AUC从大到小依次为BRI和VAI联合(0.648)、WHtR和VAI联合(0.645)、WHtR(0.631)、BRI(0.630)、WC(0.613)、VAI(0.609)、BFP(0.592)、BMI(0.572),前四个指标的AUC差异均无统计学意义(均有P>0.05).结论肥胖指标升高可增加脑卒中风险.BRI和VAI联合、WHtR和VAI联合、WHtR、BRI均是预测脑卒中的良好指标,WHtR或BRI预测脑卒中较简便,而BRI和VAI联合、WHtR和VAI联合预测脑卒中更全面.Objective To explore the effect of different obesity indexes on risk of stroke,so as to find the high-risk population.Methods From November 2013 to July 2014,a multi-stage stratified,random sampling method was used to select the subjects for questionnaire survey and physical measure-ment.Logistic regression was used to analyze the relationship between different obesity indexes body mass index(BMI),waist circumference(WC),waist-to-height ratio(WHtR),body roundness index(BRI),body fat rate(BFP),visceral fat index(VAI)and stroke,and the area under the receiver oper-ating characteristic(ROC)curve(AUC)was used to analyze the effect of each index in predicting stroke.Results The average age of 15172 subjects was(53.00±17.91)years old,including 226 stroke patients.Compared with non-stroke group,BMI,WC,WHtR,BRI,BFP and VAI of stroke popu-lation were higher(all P<0.05).Multivariate analysis showed that all obesity indexes were positively correlated with stroke risk.The AUC of each obesity index from large to small was BRI and VAI combined(0.648),WHtR and VAI(0.645),WHtR(0.631),BRI(0.630),WC(0.613),VAI(0.609),BFP(0.592),and BMI(0.572).Moreover,there was no significant difference in AUC of the first four indicators(all P>0.05).Conclusions The increase of obesity index value can increase the risk of stroke.The combination of BRI and VAI,combination of WHtR and VAI,WHtR and BRI are good indi-cators for predicting stroke.WHtR or BRI is easier to predict stroke,while BRI and VAI,WHtR and VAI are more comprehensive in predicting stroke.

关 键 词：肥胖指标 脑卒中 预测 受试者工作特征曲线 

分 类 号：R181.2[医药卫生—流行病学]