新疆地区维吾尔族35岁及以上人群最适腰臀比切点分析

The optimal cutoff point of waist-to-hip ratio for screening Uyghur population aged 35 years and over at high-risk of cardiovascular diseases in Xinjiang

目的 探讨在新疆地区维吾尔族35岁及以上成年人中筛查心血管疾病高危人群的最适腰臀比（WHR）切点.方法 新疆地区心血管疾病风险调查（CRS）于2007年10月至2010年3月进行,应用4阶段分层抽样方法,在新疆地区选择有代表性的维吾尔族人14 618名,测量人体测量学数据、血压、血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）以及空腹血糖水平,并进行问卷调查.参与调查的维吾尔族人总共4 767名,选取其中35岁及以上有完整调查数据的4 657名研究对象进行统计学分析.计算不同WHR水平预测心血管疾病危险因素的灵敏度、特异度以及在受试者工作特征（ROC）曲线上距离.采用ROC曲线分析方法,确定筛查心血管疾病高危人群的最适WHR切点.结果 （1） WHR ＜0.75、0.75≤WHR＜0.80、0.80≤WHR＜0.85、0.85≤WHR＜0.90、0.90≤WHR＜0.95、0.95≤WHR＜ 1.00、WHR≥1.00男性之间的高血压、糖尿病、高胆固醇血症、低HDL-C血症、高甘油三酯血症患病率差异有统计学意义（P＜0.01或0.05）,高LDL-C血症患病率差异无统计学意义（P=0.139）;WHR＜ 0.75、0.75≤WHR＜0.80、0.80≤WHR＜0.85、0.85≤WHR ＜0.90、0.90≤WHR＜0.95、0.95≤WHR＜ 1.00、WHR≥1.00女性之间的高血压、糖尿病、高胆固醇血症、高甘油三酯血症患病率差异有统计学意义（P均＜0.01）,高LDL-C血症、低HDL-C血症患病率差异无统计学意义（P均＞0.05）.（2）高血压、血脂异常、糖尿病及≥2个上述危险因素所对应的ROC曲线上最短距离显示,男性最适WHR切点为0.92,女性最适WHR切点为0.90.结论 在新疆地区维吾尔族35岁及以上成年人中筛查心血管疾病高危人群的WHR切点值较高.

Objective To explore the appropriate waist-to-hip ratio （WHR） cutoffs to identify people at high risk of cardiovascular disease of Uygur population aged 35 years and over in Xinjiang.Methods The cardiovascular risk survey （CRS） in Xinjiang was conducted from October 2007 to March 2010,using 4-stagestratified random sampling method and 14 618 representative participated this survey,and the questionnaire survey,anthropometric data,blood pressure,serum total cholesterol,triglyceride,low density lipoprotein （LDL-C）,high density lipoprotein （HDL-C） and fasting glucose were measured.A total of 4 657 participants aged 35 years and over with complete anthropometric data were analyzed.The sensitivity,specificity and distance on the receiver operating characteristic （ROC） curve of different WHR levels predicting risk factors of cardiovascular disease were calculated.The analysis method of ROC curve was used to determine the optimum cut-off point of WHR predicting risk factors of cardiovascular disease.Results （1）There were significantly differences in prevalence of hypertension,diabetes mellitus,hypercholesterolemia,low HDL-C level,and hypertriglyceridemia between WHR 〈 0.75,0.75 ≤ WHR 〈 0.80,0.80 ≤ WHR 〈 0.85,0.85 ≤ WHR 〈 0.90,0.90 ≤ WHR 〈 0.95,0.95 ≤ WHR 〈 1.00,WHR ≥ 1.00 in male participants （P 〈 0.01 or 0.05）,LDL-C level was similar among groups in males （P =0.139）.There were significantly differences in prevalence of hypertension,diabetes mellitus,hypercholesterolemia and hypertriglyceridemia between WHR 〈 0.75,0.75 ≤ WHR 〈 0.80,0.80 ≤ WHR 〈 0.85,0.85 ≤ WHR 〈 0.90,0.90 ≤ WHR 〈 0.95,0.95 ≤ WHR 〈 1.00,WHR ≥ 1.00 in female participants （all P 〈 0.01）,and there were no significantly differences in prevalence of high LDL-C level and low HDL-C level among groups in females （both P 〉 0.05）.（2） ROC analysis for hypertension,dyslipidemia,diabetes and ≥2 of these risk factors suggested a WHR cutoff of 0.92 for men and 0.90 for women as the optimal cutoff value for predicting high risk of cardiovascular disease of Uygur population aged 35 years and over in Xinjiang.Conclusion Higher WHR cutoffs are needed for screening people at high risk of cardiovascular disease among Uygur population aged 35 years and over in Xinjiang.