中国8个城市中学生腰围身高比值界值点和百分位数曲线

Waist-to-height ratio in Chinese student from 8 cities: Threshold values and percentile curves

目的确定城市中学生腰围身高比值(WHtR)的界值点并制作WHtR的百分位数曲线图,为临床评价儿童青少年生长发育和防控心血管疾病提供参考。方法对北京、绍兴、广州、太原、哈尔滨、鄂州、重庆和贵阳8个城市28所中学的初一、初二、高一、高二学生11 307名进行人体测量。采用偏相关和受试者工作特征曲线分析方法,分析WHtR与心血管疾病危险因素的关联强度,确定WHtR的界值点;采用LMS法建立WHtR的百分位数曲线。结果与WHtR关联性最强的2个因素是收缩压和三酰甘油,男生WHtR与收缩压和三酰甘油的相关系数分别为0.32和0.16(P值均<0.01),女生的相关系数分别为0.23和0.09(P值均<0.01);用关联性最强的2个因素(性别年龄组P85)预测WHtR的界值点,男、女生分别为0.436和0.450。百分位数曲线显示,12～13岁男生WHtR各百分位数曲线普遍高于女生,14～18岁女生WHtR的各百分位数曲线普遍高于男生。男生从12岁以后WHtR的P50开始下降,15岁WHtRP50最低,16岁以后又开始增加;女生WHtRP5012岁开始相对平稳,15岁开始升高。结论 WHtR可考虑用于临床监测,用LMS方法制定的WHtR百分位数曲线可正确反映儿童青少年生长发育。

Objective To determine correlation between weight-to-height ratio （WHtR ） and major risk factors of cardiovascular diseases （CVDs） , and the WHtR threshold that may predict risk factors of CVDs, and then to construct the reference percentile charts of waist-height-ratio （WHtR ） for Chinese middle school students. Methods A total of 11 307 effective samples were obtained from first grade and second grade junior and senior high school students, who were from 28 schools in eight Chinese cities. Then, use partial correlation analysis and receiver operating characteristic curve （ ROC ） analysis to figure out the correlation between WHtR and risk factors of CVDs and the threshold of WHtR. Based on LMS method and data from statistical analysis, the percentile curve of WHtR was established. Results There was a strong correlation between WHtR and both SBP and TG, the r between WHtR and SBP, TG was 0.32 and 0.16 （ P〈0.01 ） , respectively among boy students, for girls the statistic value was 0.23 and 0.09 （P〈0.01 ） ,respectively. WHtR thresholds predicting two of the major CVD risk factors were 0. 436/0. 450 for female and male respectively. WHtR percentile curve also showed that 12-13 year old male students had a higher WHtR than that of female students of the same age, while 14-18 year old female students had a higher WHtR than their male counterparts. Moreover, male students started to decrease WHiR after age 12, and reached the lowest value around age 15, but they rebound at age 16. For female middle school students, their WHtR grew continuously after they reached 15 years old. Conclusion Age-related waist-to-height ratio percentile curves, established by LMS method, can accurately represent the growth and development of adolescent. So WHtR may possess the feasibility for clinical use to monitor risk factors of cardiovascular diseases for adolescent.