常用肥胖诊断标准对新疆墨玉县农村维吾尔族围绝经期妇女超重和肥胖状况的对比分析

Comparison of diagnostic criterions for overweight and obesity among Rural Uyghur perimenopausal women in Moyu county of Xinjiang

目的比较常用肥胖诊断标准对农村维吾尔族围绝经期妇女超重和肥胖检出率的特点,为肥胖症的预防和控制提供科学依据。方法 2007年采用多阶段分层抽样的方法从新疆墨玉县364个自然村中抽取15个村中的1 650名维吾尔族成人,完成慢性肾脏病等慢性疾病检出率的横断面调查,资料完整的40~65岁的围绝经期女性为274人。2013年再次对该人群进行跟踪调查,资料完整的围绝经期女性为361人,2次调查均进行问卷调查、体格检查。分析常用的5种诊断指标和5种肥胖诊断标准下,维吾尔族妇女超重和肥胖的检出率。结果 2007-2013年墨玉县围绝经期女性超重和肥胖患病率呈升高趋势。中心性肥胖诊断一致性较好的是WC(中国肥胖问题工作组,WGOC)≥80cm、WHtR(世界卫生组织,WHO)>0.85、一致率为92.2%%(κ≥0.7)。超重和肥胖检出率最高的是中国肥胖病体质量分类标准,与亚太标准(BMI≥25kg/m^2)诊断吻合度较高,一致率为74.8%(κ=0.590),符合中华医学会糖尿病分会(CDS,2004)BMI切点。超重和肥胖诊断吻合度最好的是WHO亚洲标准和WGOC-BMI标准,一致率为86.5%(κ≥0.7),WHO亚洲标准与亚太标准也有较好的诊断吻合度,一致率为79.8%(κ≥0.7)。结论 WC(WGOC)≥80cm、WHtR(WHO)>0.85,诊断标准对于维吾尔族围绝经期女性中心性肥胖有很好的诊断价值,对于肥胖和超重检出率最高的是中国肥胖病体质量分类标准,推荐其作为筛选肥胖高危人群的诊断依据。

Objective To compare the prevalence of overweight,obesity and central obesity among rural Uyghur perimenopausal women in Moyu county according to various standards of BMI or waist-to-height ratio（WHtR）indicators,etc.and assess their concordance to recommend which criteria to use in this population group.Methods We had conducted an epidemiological survey of CKD in Uyghur adults from 15 out of 364 villages of Moyu county in 2007.The population were randomly selected by using a stratified,multistage sampling and were investigated again in 2013,and all subjects received the questionnaire,physical examination and biochemical analysis.Uyghur perimenopausal women aged 40-65 years with complete data collection were 274 in 2007 and 361 in 2013,respectively.The prevalence of overweight,obesity and central obesity was determined by five definitions of obesity.Results The prevalence rates of overweight,obesity and central obesity were increased among rural Uyghur perimenopausal women in Moyu county.The greatest concordance for central obesity was found between the waist circumference（WGOC）and the waist-to-height ratio（WHO）,92.2%（κ≥0.7）.The highest prevalence of obesity was found by the Chinese obesity classification standard which showed higher concordance in the criteria of Asia Pacific（BMI≥25Kg/m2）,the cut-point of BMI is same with the criteria of Chinese Diabetes Society in 2004.The greatest concordance was between the criteria of WHO Asian and WGOC-BMI,then was the criteria of WHO Asia and the Asia Pacific（κ≥0.7）.Conclusion Assessing the prevalence of central obesity among rural Uyghur perimenopausal women,the waist circumference（WGOC）has a greatest concordance with WHtR（WHO）,while for overweight and obesity,the recommendation to diagnose criteria would be used by the Chinese obesity classification standard due to the highest detection rate of high-risk populations.