人体测量学指标在基层地区成人糖尿病筛查中的应用  

Application of Anthropometric Indices for the Screening of Diabetes in Adults From Rural Areas

作　　者：黄滨[1] 刘静[1] 季旭东 马旭红 尹建新 杨乃鸿 赵能江[4] 李津[5] HUANG Bin;LIU Jing;JI Xudong;MA Xuhong;YIN Jianxin;YANG Naihong;ZHAO Nengjiang;Li Jin(Department of Physical Examination,the First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China;Department of Physical Examination,Jimusar Traditional Chinese Medicine Hospital,Jimusar Xinjiang 831700,China;Department of Internal Medicine,Quanzijie Health Clinic of Jimusar County,Jimusar Xinjiang 831700,China;Department of Traditional Chinese Medicine,the First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China;Department of Cadre Health Wards,the First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China)

机构地区：[1]厦门大学附属第一医院体检部,福建厦门361003 [2]吉木萨尔县中医医院体检部,新疆吉木萨尔831700 [3]吉木萨尔县泉子街镇卫生院内科,新疆吉木萨尔831700 [4]厦门大学附属第一医院中医科,福建厦门361003 [5]厦门大学附属第一医院干部保健科,福建厦门361003

出　　处：《中国卫生标准管理》2023年第4期89-94,共6页China Health Standard Management

基　　金：福建省中医药科研项目(2021zyg178);昌吉回族自治州科技项目(2017S06-13)。

摘　　要：目的探讨各项人体测量学指标在基层地区成人糖尿病筛查中的应用价值。方法这项横断面研究以2017年10月—2018年10月在新疆吉木萨尔县泉子街镇卫生院常规体检的成人作为研究对象,测量并计算腰围、身体质量指数(body mass index,BMI)、腰高比(waist-to-height ratio,WHtR)、A型形态指数(A body shape index,ABSI)、身体圆度指数(body roundness index,BRI)、锥削度指数(conicity index,CI)、BMI√腰围和WHt.5R等一系列人体测量学指标。采用Logistic回归模型和受试者工作特征曲线(receiver operating characteristic,ROC)对比分析各项人体测量学指标对于糖尿病筛查的应用价值。结果总共纳入4215例(男性1653例,女性2562例)研究对象,其中糖尿病患者为452例(占比10.2%)。Logistic回归模型显示,糖尿病患病风险增加与WHtR和BRI水平升高的相关性最强,而与ABSI的相关性最弱。ROC曲线分析显示,WHtR和BRI的AUC最大;WHtR的诊断切点分别为0.48(男)和0.49(女),BRI的诊断切点分别为3.02(男)和3.05(女)。结论各项人体测量学指标对基层地区成人糖尿病患病均有一定的预测价值,其中以WHtR和BRI的效能最高。Objective To investigate values of various anthropometric indices for the screening of diabetes in adults from rural areas.Methods In this cross-sectional study,adults underwent health examinations in Xinjiang Quanzijie health clinic between October 2017 to October 2018 were enrolled.A variety of anthropometric indices were measured and calculated,including waist circumference,waist-to-height ratio(WHtR),body roundness index(BRI),body mass index(BMI),conicity index(CI),A body shape index(ABSI),BMI√circumference and WHt.5R.The abilities of above indices for the screening of diabetes were evaluated by Logistic regression model and receiver operating characteristic(ROC)curve.Results A total of 4215 adults(1653 men and 2562 women)were enrolled,including 452 diabetes patients(10.2%).Logistic regression model indicated that for elevated diabetes risks,WHtR and BRI were most relevant while ABSI was most irrelevant.ROC curve analysis suggested that WHtR and BRI were the strongest predictor of diabetes for both men and women.The optimal cutoffs of WHtR and BRI were 0.48(males)/0.49(females)and 3.02(males)/3.05(females),respectively.Conclusion The present study indicated that anthropometric indices are useful for the screening of diabetes in adults from rural areas,while WHtR and BRI showed the highest ability.

关 键 词：糖尿病 成年人 人体测量学指标 基层地区 LOGISTIC回归模型 ROC曲线 

分 类 号：R587[医药卫生—内分泌]