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目的探讨腰围身高比值(WHtR)作为中心性肥胖指标在成人代谢综合征(MS)诊断中的价值和实用性。方法对1363例健康体检成人进行人体测量和生化检测,分析WHtR、腰围(WC)、体质指数(BMI)相关性。根据IDF(2005)MS诊断标准筛选出MS组分,分析WHtR对MS组分聚集的影响,计算相对危险度(RR)。用受试者工作特性曲线(ROC)求证最佳切点,确定WHtR诊断中心性肥胖的界限值。采用研究得出的WHtR指标,代替IDF(2005)标准中的WC指标[IDF(test)]诊断不同身高人群的MS,计算检出率,并与IDF(2005)的结果作比较。结果 WHtR与WC:男性r=0.961,女性r=0.959;WHtR与BMI:男性r=0.820,女性r=0.725,差别有统计学意义(P<0.01)。随WHtR值增高,MS组分检出率及聚集性增加,RR值上升。ROC曲线下面积男性为0.727,女性为0.716,对应的WHtR最佳切点均为0.49。以WHtR≥0.50为中心性肥胖的诊断标准,MS总检出率男女分别为15.9%,4.03%,IDF(2005)则分别为6.69%,4.32%,差别有统计学意义(P<0.01),两个标准在不同身高组检出的构成比差别有统计学意义,前者有利于身材较矮人群中的病例检出。结论 WHtR是中心性肥胖的良好指标,无性别差异,最佳切点为0.49,适合不同身高人群。
Objective To investigate the value and usefulness of the ratio of waist circumference (WHtR) as a central obesity index in the diagnosis of adult metabolic syndrome (MS). Methods The anthropometric and biochemical tests were performed on 1363 adult healthy adults. The correlations of WHtR, WC and BMI were analyzed. According to the diagnostic criteria of IDF (2005) MS, MS fractions were screened, and the influence of WHtR on the aggregation of MS fractions was analyzed to calculate the relative risk (RR). Subjects working curve (ROC) to verify the best cut-point, to determine WHtR diagnostic center obesity limits. The WHtR index was used instead of the WC index [IDF (test)] in IDF (2005) to diagnose MS in different height groups, and the detection rate was calculated and compared with the result of IDF (2005). Results WHtR and WC: male r = 0.961, female r = 0.959; WHtR and BMI: male r = 0.820, female r = 0.725, the difference was statistically significant (P <0.01). With the increase of WHtR, the detection rate and aggregation of MS components increased and RR value increased. The area under the ROC curve was 0.727 for males and 0.716 for females, corresponding to a best WHC cut point of 0.49. According to the diagnostic criteria of WHtR≥0.50 as the central obesity, the total detection rate of MS was 15.9% and 4.03% for men and women, and 6.69% and 4.32% for IDF (2005) respectively, with statistical significance (P <0.01) The difference between the two standards in the detection of different height groups was statistically significant, the former is conducive to the detection of cases in the relatively short stature. Conclusion WHtR is a good indicator of central obesity, no gender differences, the best cut point is 0.49, suitable for different height groups.