腰围身高比值在成人代谢综合征中诊断价值的研究

Diagnostic Value of Waist-height Ratio in Metabolic Syndrome in Adults

目的探讨腰围身高比值(WHtR)作为中心性肥胖指标在成人代谢综合征(MS)诊断中的价值和实用性。方法对1363例健康体检成人进行人体测量和生化检测,分析WHtR、腰围(WC)、体质指数(BMI)相关性。根据IDF(2005)MS诊断标准筛选出MS组分,分析WHtR对MS组分聚集的影响,计算相对危险度(RR)。用受试者工作特性曲线(ROC)求证最佳切点,确定WHtR诊断中心性肥胖的界限值。采用研究得出的WHtR指标,代替IDF(2005)标准中的WC指标[IDF(test)]诊断不同身高人群的MS,计算检出率,并与IDF(2005)的结果作比较。结果 WHtR与WC:男性r=0.961,女性r=0.959;WHtR与BMI:男性r=0.820,女性r=0.725,差别有统计学意义(P<0.01)。随WHtR值增高,MS组分检出率及聚集性增加,RR值上升。ROC曲线下面积男性为0.727,女性为0.716,对应的WHtR最佳切点均为0.49。以WHtR≥0.50为中心性肥胖的诊断标准,MS总检出率男女分别为15.9%,4.03%,IDF(2005)则分别为6.69%,4.32%,差别有统计学意义(P<0.01),两个标准在不同身高组检出的构成比差别有统计学意义,前者有利于身材较矮人群中的病例检出。结论 WHtR是中心性肥胖的良好指标,无性别差异,最佳切点为0.49,适合不同身高人群。

Objective To study the practicality and value of waist-height ratio （WHtR） as a central obesity index to diagnose the metabolic syndrome in adults. Methods 1 363 adults taking the healthy cbeck-up were studied on their physical examination and biochemical measurement. Partial correlation analysis of WHtR with waist circumference （WC） or body mass index（ BMI ） was done. According to the diagnostic criteria of IDF （2005）, the components of MS were filtered, the WHtR influence on clustering of MS components and relative risk （RR）were analyzed. The best cut-off point was obtained with the receiver-operating characteristic curve （ROC）, and the boundary value of WHtR for diagnosis of central obesity was determined, then to study the detection rate of MS in populations with different body height and compared with the results by IDF （2005）. Results WHtR had significant positive correlations with WC, in male r=0.961 and in female r=0.959; and with BMI, in male r=0.820 and in female r= 0.725, all P〈0.O1. The RR, the detection rate and the accumulation of components of MS increased obviously with the WHtR rising. The area under the ROC curve was 0.727 in male and 0.716 in female, the best cut-off point was 0.49 both in male and female. With the boundary value （≥0.50）of WHtR as for the diagnosis standard for central obesity, the MS detection rate was 15.9% in men and 4.03% in womem, and with the IDF 2005, the rates were 6.69% and 4.32%, respectively, all P〈0.01, there were significant differences in detection rates of MS in different height group by two diagnostic criteria. Conclusion WHtR is a simple and better index for central obesity diagnosis, no gender differences, the best cut-off point is 0.49, suitable for populations with different height.