身体质量指数评价广西苗族成人肥胖的准确性  

Accuracy of body mass index in evaluation of obesity among Miao nationality adults in Guangxi

作　　者：贾宏伟 邓琼英[1] 刘鹏[1] 周丽宁[1] 龚继春[1] 陈兴才[1] 黄丽仟 龚健古[1] 徐林[1] JIA Hongwei;DENG Qiongying;LIU Peng;ZHOU Lining;GONG Jichun;CHEN Xingcai;HUANG Liqian;GONG Jiangu;XYU Lin(Human Anatomy Teaching and Research Department,Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学人体解剖学教研室,南宁530021

出　　处：《公共卫生与预防医学》2021年第5期11-14,共4页Journal of Public Health and Preventive Medicine

基　　金：国家自然科学基金项目(31360259)。

摘　　要：目的探讨身体质量指数(BMI)作为广西苗族成人肥胖评价标准的准确性,计算适合苗族成人肥胖评价标准的BMI界值,为苗族成人肥胖的防治工作提供可靠的参考界值。方法采用横断面研究的方法,以广西融水苗族自治县的苗族村寨中18岁以上常驻居民作为研究对象,测量其体成分。以体脂率(PBF)标准作为肥胖的“金标准”,以中国成人肥胖的BMI标准作为筛检阳性标准,对BMI标准的准确性进行评价。ROC曲线分析确定适合作为苗族成人肥胖的最适BMI界值。结果BMI的检出率低于PBF(10.3%VS 19.0%,χ^(2)=426.62,P<0.001);BMI与PBF判断肥胖一致性较好(Kappa=0.59,P<0.001);BMI作为苗族成人肥胖筛查标准表现为特异度高,灵敏度低;约登指数较低;阳性预测值和阳性似然比较高;阴性预测值较低,阴性似然比较高。以PBF作为“金标准”时,BMI对苗族成人肥胖的诊断性能好(AUC=0.959,95%CI(0.947~0.972),P<0.001),广西苗族成人肥胖最适BMI切点男女分别为25.85 kg/m^(2)和25.55 kg/m^(2)。结论BMI对苗族成人肥胖的诊断具有重要价值,但不宜作为肥胖的排除标准,尤其在样本量较小的情况下,引起错分偏倚的风险较大。Objective To investigate the accuracy of body mass index(BMI)as the evaluation standard for obesity in Miao adults in Guangxi,to find out the BMI cutoff value suitable for the evaluation standard of adult obesity,and to provide an accurate and reliable reference value for the prevention and treatment of obesity in Miao nationality adults.Methods Using a cross-sectional design,residents aged 18 years or older in the Miao villages in Rongshui Miao Autonomous County,Guangxi,were selected as the research subjects,and their body composition was measured.The percent body fat(PBF)standard was used as the"gold standard"for obesity,and the BMI standard for obesity in Chinese adults was used as the positive screening standard.The accuracy of the BMI standard was evaluated,and the ROC curve analysis was used to determine the optimal BMI cutoff value for obesity in Miao adults.Results The detection rate of obesity of Miao adults in Guangxi by BMI method was lower than that by PBF method(10.3%vs 19.0%),(χ^(2)=426.62,P<0.001).The results of reliability evaluation showed that BMI was in good agreement with PBF in judging obesity(Kappa=0.59,P<0.001).BMI as a screening criterion for obesity in Miao adults showed high specificity and low sensitivity,low Yordon index,high positive predictive value and high positive likelihood ratio,and low negative predictive value and high negative likelihood ratio.When the PBF was used as the"gold standard",BMI had a good diagnostic performance for obesity in Miao adults(AUC=0.959,P<0.001).The optimal BMI cutoff points for obesity in adults of Miao nationality in Guangxi were 25.85 kg/m^(2) and 25.55 kg/m^(2) for men and women,respectively.Conclusion BMI is of great value for the diagnosis of obesity in Miao adults,but it should not be used as an exclusion criterion for obesity.Especially in the case of a small sample size,the risk of misclassification bias is relatively high.

关 键 词：苗族 身体质量指数 肥胖 准确性 

分 类 号：R151[医药卫生—营养与食品卫生学]