体重指数完全代替腰围或腰臀比用于肥胖评估的可行性研究

摘要

Objective To compare the correlativity of three obesity indicators and metabolic indexes, and explore the feasibility of body mass index(BMI)substitute for waist circumference(WC) or waist to hip ratio(WHR) entirely. Methods Totally 2054 individual records from Jan. 2009 to Jun. 2010 in the health care center database of Renji Hospital were selected in the study, including 1322 males and 732 females. The correlativity of three obesity indicators and metabolic indexes was calculated in different gender groups. And the discrepancy was analysed among BMI, WC and WHR, when assessing obesity of the same subjects. Results Results the levels of TG, HDL, LDL, FPG, HbAlC and blood pressure were significantly different between the normal and abnormal group (P<0. 05) , using any of the obesity indicators. The incidences of obesity differed from each other, when using different obesity indicators to assess obesity in the same subjects. The incidence of abnormal WC was 19. 3% and 33. 8% in males and females with BMK25 kg/m2. If 23. 2 kg/m2 had been used as the cut point of female BMI, the sensitivity and specificity of screening abdominal obesity would be improved to 78. 1% and 87. 9%. Conclusion BMI cannot substitute for WC or WHR entirely, especially when screening the abdominal obesity. There are significantly gender differences in BMI. If 23. 2 kg/m2 has been used as the cut point of female BMI, the accuracy of screening abdominal obesity would be significantly improved.%目的 比较腰围、腰臀比及BMI与代谢相关指标的相关性,探讨BMI本身存在的性别差异及其完全取代腰围或腰臀比的可行性.方法 利用仁济医院健康保健(体检)中心2009年1月至2010年6月客户体检数据库,研究纳入人数2054例,其中男性1322例,女性732例,按不同的性别分析腰围、腰臀比及BMI异常对血脂、血糖及血压的影响,同时比较腰围、腰臀比及BMI用于评估同一群体肥胖发生率的差异.结果 本研究结果显示除了女性BMI正常组和异常组之间总胆固醇水平的差异无统计学意义(P>0.05)外,腰围、腰臀比和BMI异常组的三酰甘油、总胆固醇、高密度脂蛋白、低密度脂蛋白、空腹血糖、糖化血红蛋白及血压水平与正常组相比差异均有统计学意义(P<0.05).在评估同一群体的肥胖发生率时,3种方式的评估结果差异也有统计学意义(P<0.05).男性和女性BMI＜25 kg/m2的群体中,腰围异常的比例分别为19.3%和33.8%.进一步对女性群体的分析发现,如果女性BMI以23.2 kg/m2为切点,对于腹型肥胖筛查的灵敏度和特异度可分别提高到78.1%和87.9%.结论 BMI不能完全取代腰围或腰臀比对腹型肥胖人群的筛查价值.BMI存在明显的性别差异,如果女性BMI以23.2 kg/m2为切点,可以明显提高腹型肥胖筛查的准确度.