腰围身高比及其在高血压中的应用研究

我国成人体重指数和腰围对相关疾病危险因素异常的预测价值_适宜体重指数和腰围切点的研究我国成人体重指数和腰围对相关疾病危险因素异常的预测价值:适宜体重指数和腰围切点的研究引言：随着生活方式的转变和不健康饮食习惯的普及，我国成人的肥胖问题日益突出。

肥胖与多种慢性疾病的发生密切相关，如糖尿病、高血压和心脑血管疾病等。

相比于传统的体重指数（BMI）测量方法，腰围对于预测这些疾病的风险更具价值。

本文旨在探讨我国成人体重指数和腰围在相关疾病危险因素异常预测方面的价值，并提出适宜的体重指数和腰围切点。

一、我国成年人肥胖的现状随着生活水平的提高，我国成年人肥胖的比例逐年上升。

根据国家卫生健康委员会的统计数据，我国男性超重和肥胖的比例从2002年的47.6%上升到2015年的52.5%，女性从27.7%上升到34.3%。

这一数据显示了肥胖问题在我国成人群体中的严重性。

肥胖是导致许多慢性疾病的主要危险因素之一。

二、体重指数对相关疾病危险因素异常的预测价值体重指数是评价身体肥胖程度的重要指标，其计算公式为体重（kg）除以身高的平方（m^2）。

国际上，BMI≥25被认为是超重，而BMI≥30被认为是肥胖。

研究表明，BMI和相关疾病之间存在着较强的相关性。

例如，在我国的一项跨区域研究中，糖尿病和高血压的发病风险随着BMI的增加而增加。

因此，BMI在我国成人中对相关疾病危险因素异常的预测具有一定的价值。

三、腰围对相关疾病危险因素异常的预测价值相对于BMI作为肥胖评估指标的局限性，腰围被认为能更准确地判断脂肪在腹部的积聚情况。

研究显示，腰围与慢性疾病的发生存在更强的相关性。

根据世界卫生组织的建议，男性腰围大于102cm，女性大于88cm，被认为是中心性肥胖。

这种体脂分布模式与心脑血管疾病、高血压、胰岛素抵抗等疾病风险的增加密切相关。

因此，腰围对相关疾病危险因素异常的预测具有更高的价值。

四、适宜体重指数和腰围切点的研究由于我国人群的体型特点和生活方式的差异，外国推荐的体重指数和腰围切点并不一定适合我国人群。

腰围、腰围身高比联合体质指数预测血脂异常病人患病风险效果评价袁空军1，2，杨媛1，2，赵创艺1，2，周光清2*1.南方医科大学卫生管理学院，广东510515；2.南方医科大学南方医院健康管理中心Evaluation of the effect of waist circumference,waist⁃to⁃height ratio combined with body mass index in predicting the risk of disease in patients with dyslipidemiaYUAN Kongjun,YANG Yuan,ZHAO Chuangyi,ZHOU GuangqingSchool of Health Management,Southern Medical University，Guangdong510515ChinaCorresponding Author ZHOU Guangqing,E⁃mail:133***************Abstract Objective：To evaluate the effect of waist circumference（WC）and waist⁃to⁃height ratio（WHtR）combined with body mass index（BMI）in predicting the risk of disease in patients with dyslipidemia.Methods：From January to December2019，a total of29463 peoples who underwent physical examination in a tertiary grade A hospital in Guangzhou city were selected as the research subjects.The Kappa consistency test was applied to assess the consistency of BMI，WC and WHtR in determining overweight/obesity.Logistic regression model was used to analyze the association of BMI，WC and WHtR with the risk of dyslipidemia.And stratified analysis was used to assess the joint effect of BMI，WC and WHtR on the risk of dyslipidemia prevalence.Results：A total of9180patients（31.2%）with dyslipidemia were detected，including6984males（41.2%）and2196females（17.5%）.Using BMI alone，8.8%of WHtR central obesity and8.6%of WC central obesity were missed in those with BMI<24.0kg/ing WHtR or WC alone，18.9%and18.4%of overweight/obese were misclassified in those with normal WHtR or WC，respectively.The sensitivity of diagnosing dyslipidemia using the best cut point of BMI，WC or WHtR alone was not high in all cases，with33.65%，39.95%and40.57%of dyslipidemia individuals being missed，respectively，while the combined use of BMI and WC，and BMI and WHtR decreased to27.59%and27.71%of missed diagnoses.The results of Logistic regression analysis showed that BMI's association with low HDL cholesterolemia was higher than WC and WHtR，while the OR of WHtR to predict all other types of dyslipidemia was greater than that of BMI.Stratified analysis showed that the risk of dyslipidemia in those with overweight/obese BMI and centrally obese WC and WHtR was2.483and2.478times higher than both normal，respectively.Conclusions：BMI，WC and WHtR are all influencing factors in the prevalence of dyslipidemia in patients.WC and WHtR combined with BMI can efficiently identify people with dyslipidemia，and maintaining normal weight and WC can help reduce the risk of dyslipidemia.Keywords dyslipidemia；body mass index；waist⁃to⁃height ratio；waist circumference；effect摘要目的:评价腰围（WC）、腰围身高比（WHtR）联合体质指数（BMI）预测血脂异常病人患病风险的效果。

中华疾病控制杂志 2012 年 5 月第 16 卷第 5 期
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农村中老年高血压患者血压水平 与身体测量指标的相关性研究
1 1 1 1 1 2 1 1 3 1 陶源 ，许敏锐 ，燕燕 ，王伟业 ，秦献辉 ，邢厚恂 ，唐根富年高血压患者血压水平与肥胖相关身体测量指标的关系 。 方法 采用横 断面调查方法， 对连云港农村社区 9 991 名 45 ～ 75 岁原发性高血压患者进行流行病学问卷调查， 测量血压， 并计算 身体测量指标， 包括体质指数、 腰围、 腰臀比、 腰围身高比、 锥削度指数等。 结果 除了女性锥削度指数， 舒张压在 在调整了年 其他各项肥胖指标四分位数组的分布均呈逐渐升高趋势（ 均有 P ＜ 0． 001 ） ； 多元线性回归分析表明， 龄、 血糖、 血脂、 吸烟、 饮酒等混杂因素后， 体质指数、 腰围身高比、 腰臀比与男性高血压患者的收缩压相关， 其中体 R2 = 0． 052 ， P = 0． 002 ） ； 体质指数、 腰围身高比、 腰围与女性高血压患者的收缩压相关， 质指数影响最大（ β = 1． 011 ， R2 = 0 ． 040 ， P ＜ 0． 001 ） 。各肥胖指标对男女性舒张压影响均有统计学意义（ 均有 以体质指数影响最大（ β = 0． 870 ， P ＜ 0． 001 ） ， R2 = 0 ． 147 ， P ＜ 0 ． 001 ） 。 结论 各项肥胖指标均能不同程度的反映 以体质指数影响最大（ β = 2． 001 ， 农村社区中老年高血压人群的血压水平， 其中体质指数与其血压水平关联更为密切 。 【关键词】 农村人口； 高血压； 危险因素； 流行病学研究 【中图分类号】R181． 1 ； R544． 1 【文献标识码】A 【文章编号】16743679 （ 2012 ） 05037104 The relationships between anthropometric indices and blood pressures among middle aged and aged hypertension rui1 ，YAN Yan1 ，WANG Weiye1 ，QIN Xianhui1 ，XING Houxun2 ， population in rural areas TAO Yuan1 ，XU MinTANG Genfu1 ，ZANG Tonghua1 ，XU Xin3 ，XU Xiping1 ． 1 ． Institute of Biomedicine，Anhui Medical University，Hefei 230032 ， China； 2 ． Lianyungang Modern Cardiovascular Disease Prevention and Treatment Center， Lianyungang 222006 ，China； 3 ． Institute of Biomedicine，Shenzhen University，Shenzhen 518060 ，China 【Abstract】 Objective To investigate the correlation between anthropometric indices and blood pressure levels in middle aged and aged hypertensive residents in rural areas． Methods A total of 9 991 aged 4575 years participants with essential hypertension were recruited through a crosssectional survey during 2008 and 2009 from rural areas of Lianyungang hip ratio （ WHR ） ，waistheight ratio City． Blood pressure，body mass index （ BMI ） ，waist circumference （ WC ） ，waist（ WHtR） and conicity index （ CI） were measured． Results Except for the CI of female， there was a tendency of increased diastolic blood pressure with high levels of obesity indicators （ P ＜ 0． 001 ） ． It showed that BMI， WHtR and WHR were significantly related with systolic blood pressure in men and BMI was the most significant index（ β = 1． 011 ，R2 = 0. 052 ，P = 0. 002 ） by multiple linear regression analysis adjusted for age，fasting plasma glucose，blood fat，smoking and alcohol consumption and so on． BMI，WHtR and WC were the influencing factors of systolic blood pressure in women by using multiple linear regression，of which BMI was the most significant indexing （ β = 0． 870 ，R2 = 0． 040 ，P ＜ 0． 001 ） ． All obesity indices were significant for diastolic blood pressure for both genders，of which BMI was the strongest （ β = 2． 001 ，R2 = 0. 147 ，P ＜ 0． 001 ） ． Conclusions All obesity indices are related to blood pressure levels in varying degrees among middle aged and aged patients with primary hypertension in the rural areas，while BMI is most closely related with blood pressure levels in hypertension population． 【Key words】 Rural population； Hypertension； Risk factors； Epidemiologic studies （ Chin J Dis Control Prev 2012 ， 16 （ 5 ） ： 371 374 ）

•论5种肥胖指标对不同性别及年龄组高血压的预测效果比较郭东辉、香利强'，李冰冰21.深圳市龙华区人民医院，广东深圳518102;2.河南大学慢性病风险评价研究所，河南大学护理与健康学院【摘要】目的比较不同肥胖指标对不同性别、年龄人群高血压风险的预测价值。

方法基于深圳市龙华区2018年社区居民健康调查数据，对体质指数(BMI)、腰围（W C)、腰围身高比（W H tR)、腰臀比（W H R)和人体肥胖指数(BAI)共5种肥胖指标进行标准化转换，根据Logistic回归分析所得CW值，比较各肥胖指标与高血压的相关性;根据受试者工作特征曲线（R0C)下面积C4W：),判断各肥胖指标对高血压的预测价值，进而综合评价各肥胖指标对高血压的预测能力。

结果在调整混杂因素后，W C和W H tR与男性和女性高血压的相关性强于其他肥胖指标。

W H tR对于男性和女性高血压的预测能力均强于其他肥胖指标，其/I{/C及95%C7分别为0.694 (0.659〜0.728)和 0.763(0.732~0.794),其截断值分别为0.51和0.50;女性中各肥胖指标预测高血压的zti/C均大于男性,各肥胖指标对女性高血压有更高的预测价值。

对男女进行年龄分层后，在男性中除W H R外各肥胖指标对于青年组（18 ~44岁）高血压的预测价值优于中年组(45 ~59岁）和老年组(60~80岁）；在女性中各肥胖指标对于高血压的预测价值随着年龄的增长而降低，依次为青年组> 中年组 >老年组。

结论在综合考虑性别和年龄后，中心型肥胖指标中的W HtR对高血压的预测能力优于W C、BMI、W HR和BAI。

【关键词】肥胖指标；高血压；预测；代谢综合征中图分类号：R195.4 文献标识码:A 文章编号：1671 -5039(2021)04-0411-05Prediction effect of five obesity indicators for hypertension in differentgender and ageGUO Dong-hui1, XIANG Li-qiang l, LI Bing-bing21. People5 Hospital o f S henzhenLonghua District, Shenzhen518102, C hina;2.1nstitute o f Chronic Disease Risks Assessment, School o f N ursing and H ealth, Henan University【Abstract】Objective To compare the predictive value of different obesity indicators for hypertension in different gender and age. Methods The study was based on the community health survey in 2018 in Longhua District, Shenzhen. After standardized transformation of five obesity indicators, including body mass index (BMI) , waist circumference (W C), waist height ratio (W H tR), waist-to-hip ratio (W H R) and body obesity index (BAI) , the correlation between the obesity indicators and hypertension was compared according to the OR values obtained from the Logistic regression analy­sis. The predictive value of each obesity indicator for hypertension was estimated by the area under the receiver operating characteristic curve (R O C). Furthermore, the ability of each obesity indicatorin predicting hypertension wascomprehen- sively evaluated. Results After adjusting for confounding factors, WC and WHtR were more strongly associated with hy­pertension in both genders than other obesity indicators. The predictive power of WHtR for hypertension in male and female were stronger than other obesity indicators, the AUC and 95% Cl were 0.694 (0.659-0.728) and 0.763 (0.732-0.794) ,the cut-off values were 0.51 and 0.50, respectively. Female had higher AUC of hypertension than m en, and each obesity indi­cator had higher predictive value for female hypertension. After stratified by age in both genders, the predictive value of obesity indicators except WHR in the young male group (18-44years old) was higher than that in the middle-aged groupDOI ： 10.12183/j .scjpm.2021.0411基金项目：深圳市龙华区科技创新资金项目（2017055)作者简介:郭东辉(1968—)，男，大学本科，主管医师，主要研究方向为社区健康管理通{_作者:李冰冰，E-mail:*********************(45-59 years old) and the elderly group (60-80 years old). In female, the predictive value of obesity indicators for hyper­tension decreased with age, followed by young group > middle-aged group >elderly group. Conclusion After considering both gender and age, the predictive power of WHtR in central obesity index for hypertension is better than WC, BMI, WHR and BAI.【Keywords】Obesity indicator; Hypertension; Prediction; Metabolic syndrome肥胖是当今严重的公共健康问题，也是心血管 疾病的重要危险因素。