中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2010年
6期
609-615
,共7页
马冠生%季成叶%马军%米杰%宋银子%熊丰%严卫丽%胡小琪%李艳平%杜松明%房红芸%蒋竞雄
馬冠生%季成葉%馬軍%米傑%宋銀子%熊豐%嚴衛麗%鬍小琪%李豔平%杜鬆明%房紅蕓%蔣競雄
마관생%계성협%마군%미걸%송은자%웅봉%엄위려%호소기%리염평%두송명%방홍예%장경웅
腰围%心血管疾病危险因素%儿童
腰圍%心血管疾病危險因素%兒童
요위%심혈관질병위험인소%인동
Waist circumference%Cardiovascular disease risk factor%Children
目的 根据儿童不同腰围水平罹患心血管疾病的危险,研究中同学龄儿童青少年腰围的适宜界值点.方法 利用受试者工作特征曲线(ROC)法分析从全国汇总的65 898名7～18岁学龄儿童青少年腰围及其相关代谢指征数据,探索预测心血管疾病的腰围最佳界值点.结果 儿童青少年腰围值小于第75百分位数(P75)时,收缩压、舒张压、血糖、总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平以及血压升高率、血糖升高率、血脂异常率随腰围变化趋势不明显,当腰围大于P75后,上述指标逐渐增加,从P90开始,增加趋势明显,高密度脂蛋白胆固醇的变化趋势相反.ROC曲线结果表明,预测血压增加的腰围最佳界值点为P75;预测至少两项心血管疾病危险因素聚集的最佳界值点为P90.与腰围低于P75,的儿童青少年相比,在腰围处于P75～P90者中至少聚集两项心血管疾病危险因素的比例增加了1倍,腰围大于P90者中该比例则增加了5倍.按体重指数分类标准分层后,儿童青少年血压升高率仍然随腰围增加而显著增加.结论 建议将中国儿童青少年腰围的年龄别性别P7,和P90作为儿童青少年心血管病危险开始增加和明显增加的界值点.
目的 根據兒童不同腰圍水平罹患心血管疾病的危險,研究中同學齡兒童青少年腰圍的適宜界值點.方法 利用受試者工作特徵麯線(ROC)法分析從全國彙總的65 898名7～18歲學齡兒童青少年腰圍及其相關代謝指徵數據,探索預測心血管疾病的腰圍最佳界值點.結果 兒童青少年腰圍值小于第75百分位數(P75)時,收縮壓、舒張壓、血糖、總膽固醇、甘油三酯和低密度脂蛋白膽固醇水平以及血壓升高率、血糖升高率、血脂異常率隨腰圍變化趨勢不明顯,噹腰圍大于P75後,上述指標逐漸增加,從P90開始,增加趨勢明顯,高密度脂蛋白膽固醇的變化趨勢相反.ROC麯線結果錶明,預測血壓增加的腰圍最佳界值點為P75;預測至少兩項心血管疾病危險因素聚集的最佳界值點為P90.與腰圍低于P75,的兒童青少年相比,在腰圍處于P75～P90者中至少聚集兩項心血管疾病危險因素的比例增加瞭1倍,腰圍大于P90者中該比例則增加瞭5倍.按體重指數分類標準分層後,兒童青少年血壓升高率仍然隨腰圍增加而顯著增加.結論 建議將中國兒童青少年腰圍的年齡彆性彆P7,和P90作為兒童青少年心血管病危險開始增加和明顯增加的界值點.
목적 근거인동불동요위수평리환심혈관질병적위험,연구중동학령인동청소년요위적괄의계치점.방법 이용수시자공작특정곡선(ROC)법분석종전국회총적65 898명7～18세학령인동청소년요위급기상관대사지정수거,탐색예측심혈관질병적요위최가계치점.결과 인동청소년요위치소우제75백분위수(P75)시,수축압、서장압、혈당、총담고순、감유삼지화저밀도지단백담고순수평이급혈압승고솔、혈당승고솔、혈지이상솔수요위변화추세불명현,당요위대우P75후,상술지표축점증가,종P90개시,증가추세명현,고밀도지단백담고순적변화추세상반.ROC곡선결과표명,예측혈압증가적요위최가계치점위P75;예측지소량항심혈관질병위험인소취집적최가계치점위P90.여요위저우P75,적인동청소년상비,재요위처우P75～P90자중지소취집량항심혈관질병위험인소적비례증가료1배,요위대우P90자중해비례칙증가료5배.안체중지수분류표준분층후,인동청소년혈압승고솔잉연수요위증가이현저증가.결론 건의장중국인동청소년요위적년령별성별P7,화P90작위인동청소년심혈관병위험개시증가화명현증가적계치점.
Objective To explore the optimal threshold values of waist circumference (WC) in detecting the risk on cardiovascular (CV) among the Chinese children and adolescents. Methods Association of WC and CV risk factors were studied among 65 898 children and adolescents aged 7-18 years whose data were pooled from nine studies carried out in China. Receive-operating characteristic analysis (ROC) and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting the CV risk factors. Results A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, and at the 90th percentiles it could detect at least two of the above three CV risk factors. In comparison with children whose waist circumference was below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between 75th and 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing remained significant with waist circumference after having been stratified by BMI category. Conclusion The 75th and the 90th percentile of WC appeared to be the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents.
