首頁資訊 4種肥胖測(cè)量指標(biāo)與高脂血癥關(guān)系的比較研究及適宜切點(diǎn)的選擇

4種肥胖測(cè)量指標(biāo)與高脂血癥關(guān)系的比較研究及適宜切點(diǎn)的選擇

來源：泰然健康網(wǎng) 時(shí)間：2025年07月20日 16:33

目的比較腰圍(waist circumference,WC)、腰臀比(waist hip ratio,WHR)、腰圍身高比(waist-to-height ratio,WHtR)、體質(zhì)指數(shù)(body mass index,BMI)4種肥胖測(cè)量指標(biāo)對(duì)高脂血癥的風(fēng)險(xiǎn)效應(yīng),并選擇最佳指標(biāo)計(jì)算適宜切點(diǎn),作為人群高脂血癥防控的簡(jiǎn)便目標(biāo)。方法樣本數(shù)據(jù)為泰州人口健康隊(duì)列Ⅲ期基線調(diào)查,應(yīng)用Pearson相關(guān)、Logistic回歸來分析4種指標(biāo)之間及其與血清膽固醇升高(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)的關(guān)聯(lián)。選擇風(fēng)險(xiǎn)貢獻(xiàn)最大的指標(biāo),計(jì)算防控適宜切點(diǎn)及人群歸因危險(xiǎn)度(population attributable risk,PAR)。結(jié)果相關(guān)系數(shù)矩陣顯示,WHtR與各代謝指標(biāo)的綜合相關(guān)性最高;調(diào)整常見混雜因素后的Logistic回歸分析顯示,WHtR對(duì)高TC、高LDL及低HDL的風(fēng)險(xiǎn)均相對(duì)最高,OR (95%CI)分別為1.34 (1.28~1.35)、1.42 (1.37~1.48)及1.45 (1.30~1.54)。而對(duì)于高TG,風(fēng)險(xiǎn)最高的指標(biāo)為WC,調(diào)整常見混雜因素后OR（95%CI）為2.09 (1.97~2.22),其余依次為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)?？梢奧HtR對(duì)高脂血癥有最大的風(fēng)險(xiǎn)效應(yīng)。性別和年齡分層后,4種指標(biāo)的風(fēng)險(xiǎn)排序不變。以WHtR作為預(yù)測(cè)高脂血癥的指標(biāo)選擇最優(yōu)切點(diǎn),范圍為0.51~0.53。以0.52為防控目標(biāo)計(jì)算人群PAR%,可防止人群中約27%的高TG、23%的高TC、近30%的高LDL和16%的低HDL-C的發(fā)生。結(jié)論在反映高脂血癥的肥胖測(cè)量指標(biāo)中,WHtR具有最大的風(fēng)險(xiǎn)效應(yīng)。可將WHtR<0.52作為預(yù)防高脂血癥的簡(jiǎn)易防控目標(biāo),發(fā)揮其在健康教育與自我管理中的作用。

Abstract

Objective There were 4 kinds of obesity measurement indexes:waist circumference (WC),waist hip ratio (WHR),waist-to-height ratio (WHtR) and body mass index (BMI).We tried to compare the risk effect of each index on hyperlipidemia,and choose the optimum cut-off points of the best index for disease prevention.Methods We collected data from the survey of Taizhou Population Health Cohort phase Ⅲ.We used Pearson correlation,Logistic regression analysis to investigate the association between each 4 obesity indexes and serum high cholesterol (high TC),high triglycerides (high TG),high low-density lipoprotein cholesterol (high LDL) and low high-density lipoprotein (low -HDL).Then we selected the optimal index,determined the optimum cut-off points and population attributable risk (PAR).Results The correlation matrix showed that WHtR had the supreme pearson correlation with the metabolic indexes;The Logistic regression analysis showed that after adjusting the common confunding factors,WHtR had the greatest OR on high TC,high LDL and low HDL,the OR (95%CI) was as follows:1.34 (1.28-1.35),1.42 (1.37-1.48) and 1.45 (1.30-1.54).For high TG,the order of OR (95%CI) were WC of 2.09 (1.97-2.22),WHtR of 1.97 (1.86-2.09),WHR of 1.93 (1.82-2.05) and BMI of 1.80 (1.75-1.86).After gender and age stratification,we got the same consequence.Finally we chose WHtR as the best index for estimating hyperlipidemia,and the optimal cut-off point ranging from 0.51 to 0.53.We selected 0.52 as the optimal cut-off point for hyperlipidemia prevention,and by this control target we can prevent about 27% of high TG,23% of high TC,almost 30% of high LDL and 16% of low-HDL.Conclusions In the 4 obesity indexes,WHtR has the greatest risk value for hyperliipidemia.WHtR<0.52 can be a simple control targets for the prevention of hyperlipidemia,it can play a positive role in public health education and self-management.

關(guān)鍵詞

高脂血癥 /腰圍 /腰臀比 /腰圍身高比 /體質(zhì)指數(shù) /最優(yōu)切點(diǎn){{custom_keyword}} /

Key words

hyperlipidemia /waist circumference /waist hip ratio /waisttoheight ratio /body mass index /optimal cutoff value{{custom_keyword}} /

王琨1,李淑元1,金力1,2,王笑峰1,2△.4種肥胖測(cè)量指標(biāo)與高脂血癥關(guān)系的比較研究及適宜切點(diǎn)的選擇[J]. 復(fù)旦學(xué)報(bào)(醫(yī)學(xué)版), 2015, 42(03): 332-336 https://doi.org/10.3969/j.issn.16728467.2015.03.008

WANG Kun1, LI Shu-yuan1, JIN Li1,2, WANG Xiao-feng1,2△.Comparison of the relationship between 4 obesity measure indexes and hyperlipidemia and the optimal cut-off value selection[J]. Fudan University Journal of Medical Sciences, 2015, 42(03): 332-336 https://doi.org/10.3969/j.issn.16728467.2015.03.008

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