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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

泰然健康网
2025-07-20 16:33

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。

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.

关键词

高脂血症 /腰围 /腰臀比 /腰围身高比 /体质指数 /最优切点{{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[J]. 复旦学报(医学版), 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