Performance of waist circumference relative to BMI in predicting risk of obesity and hypertension among affluent Indian adults

In view of the fact that Asians have higher abdominal fat at lower levels of body mass index (BMI), measures of abdominal adiposity such as waist circumference (WC) and waist to hip ratio (WHR) were investigated as predictors of hypertension. Data on BMI, WC, WHR and blood pressure (BP) were recorded through a cross-sectional study on 419 urban adults (210 men and 209 women;aged 30-60 years) in Pune, India. Abdominal obesity was higher among women than men (35.9% vs. 32.4%). However, age adjusted mean systolic BP (124.3 ± 15.1 mmHg vs. 114.7 ± 17.2 mmHg), diastolic BP (82.9 ± 10.5 mmHg vs. 76.4 ± 10.7 mmHg) and prevalence of hypertension (34.3% vs. 21.5%) was significantly higher (p < 0.01) among men than among women. Although both WC and WHR increased with increase in BMI, correlation coefficient of BMI with WC was significantly (p < 0.01) higher than that with WHR in both sexes, suggesting that WC could be better for assessing adiposity. In men, odds ratio [OR (95% CI) = 2.19 (1.08-4.45)] for hypertension was significant (p < 0.05) only for those in highest tertile of WC while it was significant (p < 0.01) even in the middle tertile in case of women [8.24 (2.67-25.43) for higher and 5.71 (1.82-17.89) for middle tertile]. Optimal cutoff for identifying obesity and hypertension showed significant (p < 0.01) area under curve (AUC) and sensitivity for WC than WHR in both sexes. The risk cutoffs were lower compared to those proposed by the World Health Organization especially for men, but were comparable with reported Asian studies. Thus, it was evident that WC performed better than BMI and WHR for assessing the risk of hypertension and may be used as a simple, convenient and inexpensive screening tool in epidemiological studies.

Correlation between waist circumference and other factors in menopausal women in Thailand

Objective: To find the correlation between waist circumference and other factors such as lipid profiles, fasting blood glucose and blood pressure in healthy menopausal women attending menopause clinic. Material and methods: A cross sectional study was carried out at the Menopause clinic, Faculty of Medicine, Chiang Mai University, Thailand. Four-hundred healthy menopause women who had no medication for hypertension, dyslipidemia, diabetes mellitus and other medical conditions were enrolled. Waist circumference, hip circumference, body weight, height, blood pressure were measured and their blood samples were taken for lipid profiles and fasting blood glucose level after 12 hours fasting. Results: The mean age of participants was 53.4 ± 5.8 years. Mean waist and hip circumference were 76.2 ± 8.0 and 95.9 ± 6.7 cm, respectively. Mean body mass index was 23.3 ± 3.1 kg/m2. Positive correlations were found between waist circumference and other factors: triglyceride level, fasting blood glucose and blood pressure. There was a negative correlation between waist circumference and HDL-Cholesterol level. The prevalence of metabolic syndrome among participants by modified National Cholesterol Education Program Adult Treatment panel III (NCEP ATP-III) with Asian waist circumference was 21.0%. Conclusion: Waist circumference had a positive correlation with triglyceride level, fasting blood glucose and blood pressure and a negative correlation with HDL-C.

Measures of Abdominal Adiposity and Risk of Stroke:A Dose-Response Meta-analysis of Prospective Studies

Objective Waist circumference, waist-to-hip ratio and waist-to-height ratio, which are the indicators or measures of abdominal adiposity, have long been hypothesized to increase the risk of stroke; yet evidence accumulated till date is not conclusive. Here, we conducted a dose-response meta-analysis to summarize evidences of the association between these measures of abdominal adiposity and the risk of stroke. Methods PubMed and Web of Science databases were searched from inception to May 2015. Two investigators independently conducted the study selection and data extraction. Dose-response relationships were assessed by the generalized least squares trend estimation, while the summary effect estimates were evaluated by the use of fixed- or random-effect models. Subgroup and sensitivity analyses were performed to assess the potential sources of heterogeneity and the robustness of the pooled estimation. Publication bias of the literature was evaluated using Begg＇s and Egger＇s test. Results Altogether 15 prospective cohort studies were identified in this study. The summary of relative risks （95% confidence intervals） of stroke for the highest versus the lowest categories was 1.28 （1.18-1.40） for waist circumference, 1.32 （1.21-1.44） for waist-to-hip ratio, and 1.49 （1.24-1.78） for waist-to-height ratio. For a 10-cm increase in waist circumference, the relative risk of stroke increased by 10%; for a 0.1-unit increase in waist-to-hip ratio, the relative risk increased by 16%; and for a 0.05-unit increase in waist-to-height ratio, the relative risk increased by 13%. There was evidence of a nonlinear association between waist-to-hip ratio and stroke risk, Pnonlinearity=0.028, Conclusion Findings from our meta-analysis indicated that waist circumference, waist-to-hip ratio, and waist-to-height ratio were positively associated with the risk of stroke, particularly ischemic stroke.

中心性肥胖对不孕女性体外受精-胚胎移植妊娠结局的影响

目的探讨中心性肥胖对不孕女性接受体外受精-胚胎移植后的妊娠结局的影响。方法回顾性选取2017年10月至2019年9月在温州医科大学附属第一医院生殖医学中心首次接受体外受精-胚胎移植的2801例不孕女性为研究对象。根据进入治疗周期时的BMI和腰臀比(WHR)分为正常BMI非中心性肥胖组1659例、正常BMI中心性肥胖组654例、肥胖非中心性肥胖组146例和肥胖中心性肥胖组342例,比较4组治疗过程中促性腺激素使用剂量、促排时间、获卵数、可用胚胎数及新鲜胚胎移植妊娠结局。采用多元线性回归分析中心性肥胖对促排周期获得可用胚胎数的影响,多因素logistic回归分析影响患者新鲜胚胎移植能否获得活产的相关因素。应用Kaplan-Meier生存曲线绘制各组单个取卵周期累积活产率。结果与正常BMI非中心性肥胖组相比,肥胖中心性肥胖组促性腺激素使用剂量增加,获卵数和可用胚胎数减少,新鲜胚胎移植后活产率下降,妊娠丢失率增加,单个取卵周期累积活产率下降,差异均有统计学意义(均P<0.05)。多元线性回归分析提示WHR≥0.85显著降低患者促排周期获得的可用胚胎数。不论BMI是否提示肥胖,WHR≥0.85的中心性肥胖女性,其单个取卵周期累积活产率较正常BMI非中心性肥胖组女性下降(均P<0.05)。多因素logistic回归分析发现腰围的增加会使新鲜胚胎移植后活产率降低(OR=0.978,95%CI:0.963~0.992,P=0.003)。Kaplan-Meier生存曲线显示随着胚胎移植周期数增多,4组患者单个取卵周期累积活产率比较差异有统计学意义(P<0.05)。结论中心性肥胖对女性体外受精-胚胎移植的妊娠结局造成不良影响。

线上产后康复促进项目活动方案的设计及实施

目的探讨线上产后康复促进项目活动方案对产妇产后母乳喂养、形体恢复的效果。方法以便利抽样法抽取符合纳入及排除标准的产妇70例,将产妇随机分为产康组与对照组各35例。对照组实施常规产褥期护理及随访,产康组按照线上产后康复促进项目活动方案实施护理干预。产后6个月比较两组纯母乳喂养率、婴儿体格发育情况、产妇盆底肌肌力及形体恢复情况。结果产后6个月,纯母乳喂养率对照组为42.86%,产康组为88.57%,两组差异有统计学意义(P<0.05)。产康组产妇臀围、腰围显著小于对照组,而盆底肌肌力评分显著高于对照组(均P<0.05)。两组婴儿身长及体质量差异无统计学意义(均P>0.05)。结论对产妇实施线上产后康复促进项目,可提升产妇纯母乳喂养率,促进产后形体恢复、改善盆底肌肌力。

Association of Obesity and Kidney Function Decline among Non-Diabetic Adults with eGFR >60 ml/min/1.73m²: Results from the Multi-Ethnic Study of Atherosclerosis (MESA)

Background: Obesity is associated with higher end-stage renal disease incidence, but associations with earlier forms of kidney disease remain incompletely characterized. Methods: We studied the association of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with rapid kidney function decline and incident chronic kidney disease in 4573 non-diabetic adults with eGFR ≥ 60 ml/min/1.73m2 at baseline from longitudinal Multi-Ethnic Study of Atherosclerosis cohort. Kidney function was estimated by creatinine and cystatin C. Multivariate analysis was adjusted for age, race, baseline eGFR, and hypertension. Results: Mean age was 60 years old, BMI 28 kg/m2, baseline eGFRCr 82 and eGFRCys 95 ml/min/1.73m2. Over 5 years of follow up, 25% experienced rapid decline in renal function by eGFRCr and 22% by eGFRCys. Incident chronic kidney disease (CKD) developed in 3.3% by eGFRCys, 11% by eGFRCr, and 2.4% by both makers. Compared to persons with BMI 25, overweight (BMI 25 - 30) persons had the?lowest risk of rapid decline by eGFRCr (0.84, 0.71 - 0.99). In contrast, higher BMI categories were associated with stepwise higher odds of rapid decline by eGFRCys, but remained significant only when BMI ≥ 35 kg/m2 (1.87, 1.41 - 2.48). Associations of BMI with incident CKD were insignificant after adjustment. Large WC and WHR were associated with increased risk of rapid decline only by eGFRCys, and of incident CKD only when defined by both filtration markers. Conclusions: Obesity may be a risk factor for kidney function decline, but associations vary by filtration marker used.

肥胖与白内障的因果关系:一项孟德尔随机化研究

目的 使用两样本孟德尔随机化(MR)方法探索肥胖指标(体质量指数、腰围、髋围)与白内障是否存在因果关联。方法 使用IEU Open GWAS数据库体质量指数、腰围、髋围和白内障全基因组关联研究的汇总统计数据,使用单核苷酸多态性(SNP)作为因果推断的工具变量,进行两样本MR分析。采用逆方差加权法(IVW)评估体质量指数、腰围、髋围与白内障的是否存在因果关联,同时采用MR-Egger回归法、加权中位数法(WME)、异质性检验及敏感性分析对结果进行补充分析。结果 (1)筛选结果:暴露因素中,体质量指数共筛选出458个SNP,腰围共筛选出374个SNP,髋围共筛选出398个SNP;结局因素白内障筛选出459个SNP。(2)体质量指数:体质量指数是白内障发生的强相关因素,有统计学意义[OR=1.189,95%CI(1.135,1.247),F=52.452,P=0.000]。MR-Egger回归法显示不存在水平多效性(P>0.05),且体质量指数与白内障散点图斜率为正,表明二者存在因果关系。(3)腰围:腰围是白内障发生的强相关因素,有统计学意义[OR=1.221,95%CI(1.145,1.303),F=36.776,P=0.000]。MR-Egger回归法显示不存在水平多效性(P>0.05),且腰围与白内障存在因果关系散点图斜率为正,表明二者存在因果关系。(4)髋围:髋围是白内障发生的强相关因素,有统计学意义[OR=1.119,95%CI(1.061,1.180),F=16.850,P=0.000]。MR-Egger回归法显示不存在水平多效性(P>0.05),且髋围与白内障存在因果关系散点图斜率为正,表明二者存在因果关系。结论 体质量指数、腰围、髋围均与白内障的发生存在因果关系。其中,体质量指数的增高对白内障发生的影响更为明显。

Effects of Almond Milk on Body Measurements and Blood Pressure

In recent years, the demand for almond milk and its sales has increased owing to consumers’ perceptions about its health benefits. Hence, we sought to measure the effect of almond milk on body measurements such as body weight, body mass index and waist and hip circumference, in addition to diastolic and systolic blood pressures. Thirty volunteers of both sexes participated in the study, with a mean age of 23.27 ± 6.20 years. The study was conducted over 4 weeks, and the results showed that daily substitution of one serving of dairy product with one cup (240 ML) of almond milk significantly decreased body weight, body mass index and waist and hip circumference, However, no effects were observed on blood pressures.

认知行为疗法干预联合阴阳调理灸对更年期肥胖患者的影响

目的探讨认知行为疗法干预联合阴阳调理灸对更年期肥胖患者的影响。方法选取湖北省中医院针灸科门诊2021年1月至2022年6月接诊的更年期肥胖患者80例作为研究对象,依据随机纸片法分为对照组和观察组,各40例。对照组给予认知行为疗法干预联合艾条灸,观察组给予认知行为疗法干预联合阴阳调理灸。比较两组干预前后体重指数(BMI)、臀围、腰围、气虚质症状评分、体重对生活冲击量表-简明版(IWQOL-Lite)评分。结果干预前,两组BMI、臀围、腰围、气虚质症状评分、IWQOL-Lite评分比较,差异无统计学意义(P>0.05)。干预后,两组BMI、臀围、腰围、气虚质症状评分、IWQOL-Lite评分均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论认知行为疗法干预+阴阳调理灸能够改善更年期肥胖症状,改善气虚质症状、IWQOL-Lite评分,值得推广应用。

不同体格测量指标与2型糖尿病发病风险关系的病例对照研究

目的探讨不同体格测量指标与2型糖尿病发病风险之间的关系,为早期预防2型糖尿病提供科学依据。方法纳入299对2型糖尿病患者和健康对照。运用Logistic回归模型分析BMI、腰围、腰臀比和腰围身高比与2型糖尿病发病风险之间的关系。结果在校正可能的混杂因素后,与正常组(BMI 18.5~23.9 kg/m^(2))相比,超重和肥胖组(BMI 24.0~27.9 kg/m^(2)和≥28.0 kg/m^(2))发生2型糖尿病风险的OR(95%CI)值分别是2.35(1.56~3.57)和6.47(2.92~14.33)。相比于正常腰围组(男<85 cm,女<80 cm),中心性肥胖前期组(男85~89.9 cm,女80~84.9 cm)和中心性肥胖组(男≥90 cm,女≥85 cm)发生2型糖尿病风险的OR值(95%CI)分别是2.99(1.81~4.95)和3.88(2.43~6.22)。腰臀比最高组(Q4)和腰围身高比最高组(Q4)发生2型糖尿病的风险是最低组(Q1)的4.35倍与3.45倍(95%CI:2.48~7.64,1.94~6.14,P<0.001)。结论超重、全身性肥胖、中心性肥胖前期和中心性肥胖可能增加2型糖尿病的发病风险。

基于孟德尔随机化探索肥胖与多囊卵巢综合征的关系

目的使用双样本双向孟德尔随机化(MR)方法探索肥胖与多囊卵巢综合征(PCOS)是否存在因果关联。方法利用公开可用的欧洲人群体重指数(BMI)、腰围(WC)、髋围(HC)、颈围(NC)和PCOS全基因组关联研究的汇总统计数据进行双样本双向MR分析。选取与BMI相关的367个单核苷酸多态性(SNP)、与WC相关的312个SNP、与HC相关的241个SNP、与NC相关的3个SNP以及与PCOS相关的4个SNP作为遗传工具变量。采用逆方差加权法评估上述肥胖指标与PCOS的因果关联。为了检验结果的可靠性,进一步敏感性分析包括MR-Egger回归法、加权中位数法、多效性残差与离群值法、Cochran's Q检验及留一性分析。结果在纳入的指标中,遗传预测的BMI和WC与PCOS发病存在因果关联。没有发现HC和NC与PCOS发病相关的证据;没有证据表明罹患PCOS将增加肥胖发生率。结论BMI和WC可能在PCOS发病中发挥作用。

Central obesity in Yemeni children: A population based cross-sectional study

AIM: To establish percentile curves and to explore prevalence and correlates of central obesity among Yemeni children in a population based cross-sectional study.METHODS: A representative sample of 3114 Yemeni children(1564 boys,1550 girls) aged 6-19 years participating in the HYpertension and Diabetes in Yemen study was studied.Data collection was conducted at home by survey teams composed of two investigators of both genders.Study questionnaire included questions about demographics,lifestyle,and medical history.Anthropometric measurements included body weight,height,waist circumference(WC) and hip circumferences.Waist to hip ratio(WHR) and waist-toheight ratio(WHtR) were then calculated.Age and gender specific smoothed percentiles of WC,WHR,and WHtR were obtained using lambda-mu-sigma parameters(LMS method).The independent predictors of central obesity defined as(1) WC percentile ≥ 90th;(2) WHtR ≥ 0.5;or(3) WC percentile ≥ 90thand WHtR ≥ 0.5,were identified at multivariate logistic regression analysis adjusted for age,gender,urban/rural location,years of school education,sedentary/active life-style.RESULTS: Percentile curves for WC,WHR and WHtR are presented.Average WC increased with age for both genders.Boys had a higher WC than girls until early adolescence and thereafter girls had higher values than boys.WHR decreased both in boys and girls until early adolescence.Thereafter while in boys it plateaued in girls it continued to decrease.Mean WHtR decreased until early adolescence with no gender related differences and thereafter increased more in girls than in boys towards adult age.Prevalence of central obesity largely varied according to the definition used which was 10.9% for WC ≥ 90thpercentile,18.3% for WHtR ≥ 0.5,and 8.6% when fulfilling both criteria.At adjusted logistic regression WC ≥ 90thpercentiles and WHtR ≥ 0.5 were less prevalent in rural than in urban areas(OR = 0.52,95%CI: 0.41-0.67 and 0.66,0.54-0.79 respectively),being more prevalent in children with sedentary lifestyle rather than an active one(1.52,95%CI: 1.17-1.98 and 1.42,95%CI: 1.14-1.75,respectively).CONCLUSION: Yemeni children central obesity indicespercentile curves are presented.Central obesity prevalence varied according to the definition used and was more prevalent in urban sedentary subjects.

颈围、腰围、腰臀比对2型糖尿病患者超重、肥胖及代谢综合征评价作用的比较研究

目的比较颈围、腰围、腰臀比对2型糖尿病患者超重、肥胖及代谢综合征的评价作用。方法选取北京三级甲等医院与15个城区社区联合开展糖尿病纵向管理项目的基线数据库中3 176例2型糖尿病患者(即2008年8月—2009年7月在北京市5个城区随机整群抽取的15个社区卫生服务中心所管辖的社区居民3 176例,均已诊断为2型糖尿病)。以BMI≥24/29 kg/m2分别作为超重/肥胖的诊断标准。代谢综合征的诊断依据中华医学会糖尿病学分会的诊断标准。采用SPSS 11.5统计软件绘制颈围、腰围、腰臀比评价超重、肥胖及代谢综合征的受试者工作特征(ROC)曲线,计算曲线下面积(AUC),并采用Med Calc软件中的Z检验进行比较分析。结果 3 176例2型糖尿病患者中,男1 291例(40.65%),女1 885例(59.35%);颈围为(36.6±3.7)cm;腰围为(89.0±9.4)cm;腰臀比为(0.89±0.06)。不同性别2型糖尿病患者年龄间差异无统计学意义(P>0.05);而颈围、腰围、腰臀比间差异有统计学意义(P<0.05)。颈围、腰围、腰臀比评价男性患者超重的AUC分别为0.721、0.833、0.677,评价女性患者超重的AUC分别为0.728、0.838、0.639;其中腰围、腰臀比评价男、女患者超重的AUC与颈围比较,差异均有统计学意义(P<0.05);腰臀比评价男、女患者超重的AUC与腰围比较,差异亦均有统计学意义(P<0.05)。颈围、腰围、腰臀比评价男性患者肥胖的AUC分别为0.779、0.870、0.703,评价女性患者肥胖的AUC分别为0.735、0.849、0.629;其中腰围、腰臀比评价男、女患者肥胖的AUC与颈围比较,差异均有统计学意义(P<0.05);腰臀比评价男、女患者肥胖的AUC与腰围比较,差异亦均有统计学意义(P<0.05)。颈围、腰围、腰臀比评价男性患者代谢综合征的AUC分别为0.667、0.772、0.629,评价女性患者代谢综合征的AUC分别为0.661、0.746、0.621;其中腰围评价男、女患者代谢综合征的AUC与颈围比较,差异均有统计学意义(P<0.05);腰臀比评价男、女患者代谢综合征的AUC与腰围比较,差异亦均有统计学意义(P<0.05)。结论评价超重、肥胖、代谢综合征时腰围优于颈围和腰臀比,颈围优于或与腰臀比相当。颈围可以替代腰臀比用于评价超重、肥胖及代谢综合征。

2014年中国城乡居民超重肥胖流行现状——基于22省(市、区)国家国民体质监测点的形态数据

目的:分析评价城乡居民体重超重及肥胖现状,探讨超重肥胖流行在性别、年龄、城乡分类上的特征。方法:取2014年国家国民体质监测22个省(区、市)国家监测点20-69岁城乡居民共计107 330人的年龄、性别、城乡种类、身高、体重、BMI、腰围、臀围、腰臀比、腰围身高比进行统计和分析。结果:(1)样本总体BMI为23.83±3.33kg/m2,男性为24.40±3.26kg/m2,女性为23.24±3.30kg/m2;超重率为34.26%,男性和女性分别为39.91%、28.42%,城镇和乡村分别为34.03%、34.70%;肥胖率为10.98%,男性和女性分别为13.29%、8.59%,城镇和乡村分别为10.19%、12.47%。(2)腰围、腰臀比、腰围身高比的均值,男性为85.88cm、0.904、0.507,女性为78.81cm、0.845、0.498;腰围、腰臀比、腰围身高比超标总率为49.67%、50.21%、50.34%,其中男性超标率为55.31%、54.19%和54.70%,女性为43.86%、46.11%和45.84%。(3)超重、肥胖和中心性肥胖的检出率随年龄增长而增加(全部P<0.01),并且男性比女性高(全部P<0.01)。(4)城镇男性体重、BMI、腰围均值高于乡村男性(P<0.01),乡村男性腰臀比、腰围身高比均值高于城镇男性(P<0.01),乡村女性体重、BMI、腰围、腰臀比、腰围身高比均值高于城镇女性(P<0.01)。结论:(1)20-69岁样本人群超重和肥胖合计达到45.24%,中心性肥胖人数过半,揭示城乡居民身体形态处于超重、肥胖和中心型肥胖的高发期。(2)超重、肥胖和中心性肥胖的检出率随年龄增长而增加,男性高于女性。其中,城镇男性高于乡村男性,乡村女性高于城镇女性。

35岁以上人群肥胖指标与高血压的关系研究

目的探讨广州地区35岁以上人群腰臀比(WHR)、腰围(WC)和体质指数(BMI)与高血压的关系。方法 2009年在广州市两个独立社区采用分层整群随机抽样的方法抽取35岁以上居民2 745人进行身高、体质量、WC、臀围、血压、心率的测量,并进行问卷调查。采用Pearson相关分析、多元逐步回归分析及受试者工作特征曲线(ROC曲线)分析各肥胖指标与高血压水平的关系。结果广州地区35岁以上居民中,不同BMI的男女居民收缩压(SBP)和舒张压(DBP)水平间差异均有统计学意义(P<0.05),而腹型肥胖组的血压水平及其高血压和高血压前期患病率均高于正常体型组,差异均有统计学意义(P<0.05)。在校正了年龄因素后,男性以WHR的OR值最高(1.526),而女性以WC的OR值最高(2.813),BMI的OR值在两性中均为最低(0.719/0.391)。ROC曲线表明,男性BMI、WC和WHR诊断高血压的切点、曲线下面积及95%CI间差异均无统计学意义;而在女性中,WC的曲线下面积最大(0.854),与BMI(0.77)、WHR(0.787)比较有统计学意义(P<0.05)。结论广州地区35岁以上人群,尤其在女性人群中,WC是反映肥胖对高血压影响的较好测量指标,而BMI和WHR可以作为有效补充。

老年人体质量指数、腰围和腰臀围比值与糖尿病或糖耐量异常的关系

目的：确定老年人人体测量指数与糖尿病或糖耐量异常（DM／IGT）之间的关系。方法：对537例（男性416例，女性121俐）参加健康体检的上海城市老年人（年龄60～85岁）进行调查，分析体质量指数（BMI）、腰围（WC）和腰臀围比值（WHR）分别与DM／IGT之间的关系；运用logisitc回归分析，受试者工作特性（ROC）曲线下面积（AUC）判断各人体测量指数对DM／IGT的预测价值。结果：（1）除女性WHR值外，本组老年男性和女性中具有DM／IGT者人体测量指数BMI、WC和WHR均高于非DM／IGT者，P〈0．05；同样，具有高BMI（≥25kg／m^2）、WC（≥90cm）和WHR（≥0．9）的DM／IGT发生率均分别大于低BMI、WC和WHR组。P〈0．05或P〈0．01。（2）在调整了年龄、活动强度和糖尿病家族史的影响后，对BMI、WC和WHR这3个因素与DM／IGT的关系进行logistic逐步回归分析，结果表明WHR和BMI分别是本组老年男性和女性DM／IGT的主要危险因素（P=0．0004，P=0．0002），ROC曲线分析表明老年男性WHR的AUC最大（P〈0．05），老年女性BMI的AUC最大（P〈0．05）。结论：在老年人群中肥胖与DM／IGT有相关性，WHR和BMI是较好的简易预测指标，在老年男女人群中分别测量WHR和BMI可以较好地预测DM／IGT的发生。

中青年体质指数、腰围及腰臀比与脑卒中发生的相关性研究

目的探讨中青年人肥胖的不同指标,如体质指数(BMI)、腰围(WC)及腰臀比(WHR)与脑卒中发生的关系。方法采用以医院为基础的病例对照研究。病例组由280例脑卒中(缺血性脑卒中和出血性脑卒中)患者组成,对照组为患其他与脑卒中无关的疾病同期入住和病例组相同医院的280例患者。采用标准调查表对研究对象进行调查,收集研究对象的人口学特征、生活方式、个体疾病史、脑卒中家族遗传史以及实验室检查等资料,同时对身高、体质量、WC、臀围进行测量,并计算BMI及WHR。采用多元Logistic回归分析对研究对象的BMI、WC及WHR与脑卒中的比值比(OR)及其95%可信区间(CI)进行估计。结果 280例脑卒中患者中出血性76例,缺血性204例。与正常BMI者相比较,调整年龄、性别后的分析结果显示,超重或肥胖的病例发生缺血性脑卒中的危险性明显高于对照组〔超重者:OR=2.03,95%CI(1.26,2.91),P<0.05;肥胖者:OR=1.88,95%CI(1.32,2.39),P<0.05〕。与BMI最低四分位数相比,BMI最高四分位数的病例发生缺血性脑卒中的危险性增加了18%〔OR=1.18,95%CI(1.06,3.54),P<0.01〕。WC最高四分位数的病例发生出血性和缺血性脑卒中的危险性分别是WC最低四分位数的1.80和1.96倍〔OR=1.80,95%CI(1.03,3.16)和OR=1.96,95%CI(1.37,3.78),P<0.01〕。与WHR最低四分位数比较,WHR最高四分位数的病例发生出血性及缺血性脑卒中的危险性分别增加了98%和126%〔OR=1.98,95%CI(1.41,3.59),P<0.01和OR=2.26,95%CI(1.34,2.79),P<0.01〕。结论 BMI增高是发生脑卒中的一个重要危险因素,WC增加可使发生缺血性脑卒中的危险性显著升高,而WHR与发生出血性及缺血性脑卒中的危险性呈正相关。维持正常体质量可能是脑卒中发病的保护因素。

肥胖与青少年腰椎间盘突出症发病关系

目的:探讨肥胖与青少年腰椎间盘突出症发病关系。方法:2018年1月至2019年7月经排除标准筛选后,581例接受手术治疗的腰椎间盘突出症患者纳入研究,其中男337例,女244例。按照联合国世界卫生组织对年龄的划分标准将其分为两组,青少年组235例,男145例,女90例,年龄14~44(32.2±7.3)岁;中老年组346例,男192例,女154例,年龄45~85(58.7±9.8)岁。入院时由同一名经过培训的调查员用卷尺测量身高、腰围、臀围,电子称测量体重。所有数据测量2次取平均值。计算得出体重指数(body mass index,BMI)和腰臀比。根据各个参数标准将患者分为正常、超重、肥胖,计算不同年龄组各个参数肥胖者的比例,并进行统计学分析。结果:青少年患者中BMI、腰围、腰臀比正常者分别为78例(33.2%),91例(38.7%),85例(36.2%);超重者分别为104例(44.3%),95例(40.4%),99例(42.1%);肥胖者分别为53例(22.5%),49例(20.9%),51例(21.7%)。中老年患者BMI、腰围、腰臀比正常者分别为145例(41.9%),138例(39.9%),147例(42.5%);超重者分别为153例(44.2%),162例(46.8%),155例(44.8%);肥胖者分别为48例(13.9%),46例(13.3%),44例(12.7%)。青少年组3个参数中肥胖者比例均高于中老年组(P<0.05)。结论:肥胖可能额外增加了青少年腰椎间盘的负荷,加速了腰椎退变,对于青少年来说肥胖是腰椎间盘突出症更为显著的危险因素,因此在青少年中控制体重、预防肥胖对减少腰椎间盘突出症的发生率更为重要。

2型糖尿病家系一级亲属同胞腰臀股围的变化

目的 研究 2型糖尿病家系一级亲属同胞糖代谢异常及糖耐量正常者的腰、臀、股围变化及其意义。 方法 在 5 6 0个临床表现为 2型糖尿病的家系中 ,去除 1型糖尿病、线粒体糖尿病和收集标本数少的家系后 ,得 4 0 6个 2型糖尿病家系。将其家系一级亲属同胞成员分为正常糖耐量组(NGT组 ,4 2 5例 )、糖耐量减退组 (IGT组 ,79例 )、糖尿病组 (DM组 ,6 94例 ) ,并以同胞配偶中的无糖尿病家族史的正常糖耐量者作为对照组 (C组 ,4 2 9例 ) ,比较各组间腰、臀、股围及其各个比值的 6个参数的差异。 结果 DM组腰围、腰臀比、腰股比、臀股比高于 C组 ,臀围、股围低于 C组 (腰围 P=0 .0 0 5 9,余均 <0 .0 0 1)。NGT组腰臀比 ,腰股比大于 C组 (P分别为 0 .0 0 0 9,0 .0 0 4 5 ) ,股围小于 C组(P=0 .0 32 1) ,均有显著差异。腰围、腰臀比、腰股比在 C组、NGT组、IGT组、DM组有逐渐增高趋势 ,臀围、股围在四组有逐渐减低趋势。去除用胰岛素治疗 ,或体重指数 <2 0 kg/ m2 或空腹血糖 >14mm ol/ L者比较 6个参数在 4组中的差异 ,显示上述变化趋势更显著。 结论 糖代谢异常患者 ,随着糖代谢异常的加重 ,其体脂有重新分布 ,逐渐向中心性肥胖发展的趋势。即腹围渐大 ,臀围 ,尤其是股围有逐渐相对缩小的趋势。值得注意?

4种肥胖测量指标与高脂血症关系的比较研究及适宜切点的选择

目的 比较腰围（waist circumference,WC）、腰臀比（waist hip ratio,WHR）、腰围身高比（waist-to-height ratio,WHtR）、体质指数（body mass index,BMI）4种肥胖测量指标对高脂血症的风险效应,并选择最佳指标计算适宜切点,作为人群高脂血症防控的简便目标.方法 样本数据为泰州人口健康队列Ⅲ期基线调查,应用Pearson相关、Logistic回归来分析4种指标之间及其与血清胆固醇升高（高TC）、三酰甘油升高（高TG）、低密度脂蛋白升高（高LDL）和高密度脂蛋白降低（低HDL）的关联.选择风险贡献最大的指标,计算防控适宜切点及人群归因危险度（population attributable risk,PAR）.结果 相关系数矩阵显示,WHtR与各代谢指标的综合相关性最高;调整常见混杂因素后的Logistic回归分析显示,WHtR对高TC、高LDL及低HDL的风险均相对最高,OR （95 ％CI）分别为1.34 （1.28～1.35）、1.42 （1.37～1.48）及1.45 （1.30～1.54）.而对于高TG,风险最高的指标为WC,调整常见混杂因素后OR（95％CI）为2.09 （1.97～2.22）,其余依次为WHtR的1.97 （1.86～2.09）,WHR的1.93 （1.82～2.05）和BMI的1.80 （1.75～1.86）.可见WHtR对高脂血症有最大的风险效应.性别和年龄分层后,4种指标的风险排序不变.以WHtR作为预测高脂血症的指标选择最优切点,范围为0.51～0.53.以0.52为防控目标计算人群PAR％,可防止人群中约27％的高TG、23％的高TC、近30％的高LDL和16％的低HDL-C的发生.结论 在反映高脂血症的肥胖测量指标中,WHtR具有最大的风险效应.可将WHtR＜0.52作为预防高脂血症的简易防控目标,发挥其在健康教育与自我管理中的作用.