腰围身高比值预测成人高血压的Meta分析

The Predictive Value of Waist-height Ratio to Discriminate Adult Hypertension: a Meta Analysis

目的探索腰围身高比值是否能更好地反映肥胖对成人高血压的影响。方法以"腰围身高比值"或"腰围/身高比"或"腰围/身高"、"高血压"、"ROC"等为关键词或主题词,检索中外重要数据库,同时追溯相关参考文献。采用Meta分析方法,分性别以体质指数(BMI)、腰围(WC)、腰臀比(WHR)及腰围身高比值(WHTR)对高血压调查对象的工作曲线(ROC)下面积(AUC)作为评价指标,利用Stata9.2软件进行统计分析。结果共纳入8篇文献。全部人群男、女性WHTR的AUC(95%CI)分别为0.680(0.645～0.714)和0.718(0.676～0.761);对以中国人群为研究对象的3项研究进行亚组分析,男、女性WHTR的AUC(95%CI)分别为0.686(0.637～0.736)和0.795(0.770～0.819)。与BMI、WC及WHR相比,无论男女,均是WHTR对高血压的AUC合并值最大,但差别无统计学意义(P>0.05)。中国女性WHTR的合并值大于男性,差别有统计学意义(P<0.05)。结论WHTR可能比BMI、WHR、WC能更好地反映肥胖对成人尤其是对中国成年女性高血压的影响。

Objective To explore whether waist-height ratio （WHTR） is a better obesity-related index to discriminate adult hypertension. Methods Potential studies were searched in electronic databases of CNKI, VIP, CBMDISC, CMCC, Pub Med, Embase and Medline; and the relevant conference proceedings and reference lists were also hand-searched. According to the inclusion and exclusion criteria, two reviewers screened and assessed the potential studies independently. The assessed target included the AUC of body mass index （BMI）, waist circumference （WC）, waist hip ratio （WHR） and waist height ratio （WHTR） to hypertension in adult respectively. The inclusive studies about Chinese were merged and subgroup analysis was conducted by sex respectively. Meanwhile the publication bias was estimated. All statistical analyses were carried out with STATA version 9.2. Results Eight studies met the inclusion criteria; the quality of the inclusive studies was quite good. Before and after subgroup analysis, the merged AUC and 95%Clof WHTR to hypertension was 0.680 （0.645~0.714）for male, 0.718 （0.676~0.761） for female; 0.686 （0.637~0.736） for Chinese male and 0.795 （0.770-0.819） for Chinese female. The AUC of WHTR to hypertension was the largest among men and women, meanwhile the AUC of women＇s WHTR was larger than men＇s, but the difference was not significant. The AUC of Chinese women＇s WHTR was significantly larger than Chinese women＇s BMI and Chinese men＇s WHTR. The publication bias was small. Conclusion WHTR, prior to BMI, WHR, WC, may be the best obesity-related index to discriminate adult hypertension, especially for Chinese women. However, more studies are demanded before WHTR＇s application.