人体测量指标诊断维持性血液透析病人腹型肥胖的一致性研究

Concordance study of anthropometric indicators in diagnosing abdominal obesity in MHD patients

目的:研究锥度指数(CI)、身体质量指数(BMI)、腰臀比(WHR)以及体脂百分比(BFR)在维持性血液透析(MHD)病人的腹型肥胖中的应用。方法:采用定点整群抽样方法抽取2023年9月至12月在重庆医科大学附属第三医院血液透析中心接受透析治疗的病人,收集研究对象年龄、透析龄、身高、体质量、生化检查指标等信息,使用InBody S10进行人体成分分析并以内脏脂肪面积作为腹型肥胖判定依据,比较身体质量指数、体脂百分比、腰臀比以及锥度指数在预测MHD病人腹型肥胖中的应用。结果:共纳入病人151例,其中腹型肥胖MHD病人65例,非腹型肥胖MHD病人86例。结果显示在腹型肥胖与非腹型肥胖MHD病人中性别、体质量、BMI、内脏脂肪面积、体脂百分比、腰臀比、锥度指数以及糖尿病患病率的差异均具有统计学意义(均P<0.05)。一致性检验结果显示,采用BMI、体脂百分比和腰臀比判定腹型肥胖与内脏脂肪面积法一致性较弱,其中锥度指数Kappa系数最大(P<0.05)。受试者工作特征(ROC)曲线分析显示,在MHD病人中,锥度指数ROC曲线下面积最大为0.765,诊断效能最高(P<0.05)。结论:锥度指数、身体质量指数、腰臀比及体脂百分比等身体测量指标均可用于MHD病人腹型肥胖诊断,其中锥度指数诊断效能更高。

Objective:To study the application of conicity index(CI),body mass index(BMI),waist-to-hip ratio(WHR)and body fat ratio(BFR)in abdominal obesity in maintenance hemodialysis(MHD)patients.Methods The patients who received dialysis treatment in the hemodialysis center of the Third Affiliated Hospital of Chongqing Medical University from September to December 2023 were selected by fixed-point cluster sampling,and the age,dialysis age,height,weight,biochemical examination indexes and other information of the study subjects were collected,and the body composition analysis was performed using InBody S10 and the visceral fat area was used as the basis for the determination of abdominal obesity.The applications of body mass index,body fat ratio,waist-to-hip ratio and conicity index in predicting abdominal obesity in MHD patients were compared.Results A total of 151 patients were enrolled,including 65 patients with abdominal obesity MHD and 86 patients with non-abdominal obesity MHD.The results showed that there were significant differences in gender,weight,BMI,visceral fat area,body fat ratio,waist-tohip ratio,conicity index and the prevalence of diabetes between patients with abdominal obesity and non-abdominal obesity(all P<0.05).The consistency test results showed that the consistency between using BMI,body fat percentage,and waist hip ratio to determine abdominal obesity with visceral fat area method was weak,with the conicity index Kappa coefficient having the largest value(P<0.05).The analysis of receiver operating characteristic(ROC)curve showed that the area under the ROC curve of conicity index was the highest,0.765,indicating the highest diagnostic efficacy(P<0.05)in MHD patients.Conclusion Conicity index,body mass index,waist-to-hip ratio and body fat ratio can be used in the diagnosis of abdominal obesity in MHD patients,among which the conicity index is more effective.