腰围身高比值与血压、糖脂代谢的关系及最佳切点的初步探讨

The relationship between waist to stature ratio and hypertension, diabetes, and dyslipidemia in Qingdao

目的探讨和评价青岛地区人群腰围身高比值（WSR）与高血压、糖尿病、脂代谢异常等心血管疾病危险因素的关系。方法选取青岛地区糖尿病流行病学调查数据库中资料完整的汉族成年人共30712例，分析BMI、腰围、WSR、腰臀比（WHR）和臀围与血糖、血压、血脂的相关关系；ROC曲线分析比较5个指标对糖尿病、高血压和脂代谢异常的预测价值并判断最佳切点；多因素logistic逐步回归分析比较5个指标对高血压、糖尿病、脂代谢异常风险的预测价值。结果（1）各人体测量学指标均与血压、血糖、血脂密切相关，并无性别差异（P〈0．001）；（2）WSR的AUC ROC最大，最佳切点是0．52；（3）多因素调整后，WSR≥0．52的糖尿病、高血压、脂代谢异常的OR值最大。结论（1）青岛地区人群中，人体测量学指标与血压、糖脂代谢关系密切，可作为预测、评估人群患病风险的简易指标；（2）WSR是该地区人群评价心血管风险最佳的人体测量学指标，预测多重心血管危险因素聚集的最佳切点为0．52。

Objective To evaluate the relationship between waist to stature ratio （WSR） and hypertension, diabetes, dyslipidemia in Qingdao. Methods Data were collected from a 2001 -2007 Qingdao area diabetes survey, population-based cross-sectional study, and 30 712 Chinese adults aged 〉 18 years old were enrolled. Correlation analysis of BMI, WSR, hip circumference, waist circumference, waist to hip ratio （WHR） with blood glucose, blood pressure, blood lipid were conducted. ROC curve analysis in diabetes, hypertension, dyslipidemia and multivariate logistic regression analysis were also conducted. Results Anthropometric indicators were related with hypertension, diabetes and dyslipidemia in both men and women. Comparing with other anthropometric indicators, WSR was found to have the largest area under the ROC curve and the best cut-off point of WSR was 0. 52. Multivariate logistic regression analysis showed that, after controlling age, disease history, physical activity, sex, the diabetes hypertension and dyslipidemia risk OR of WSR ≥ 0. 52 were largest. Conclusions Anthropometric indicators intimately related with cardiovascular risk factors in Qingdao region, and may predict and evaluate the risk of cardiovascular disease. WSR may be the best index for predicting cardiovascular risk factors in Qingdao area. The optimal WSR cut off point for identifying cardiovascular risk factors clustering is 0. 52.