CAJ | 학술논문

目的探讨我国成人中心性肥胖和严重中心性肥胖的腰围切点值.方法利用中美心肺血管病流行病学合作研究1993至1994年的横断面调查资料,纳入其中年龄在35～69岁且资料完整者的10 265名作为研究对象.以腰围的每个整数厘米值为切点,计算各切点检出危险因素聚集(同一个体同时具有2个及以上主要心血管病危险因素)的敏感度、特异度及受试者工作特征(ROC)曲线距左上顶点的距离,以距离最短的腰围切点值作为诊断中心性肥胖的腰围切点,以特异度≥90％的腰围切点值作为诊断严重中心性肥胖的腰围切点.结果男性腰围为(80.5±9.9)cm,女性腰围为(77.8±10.0)cm.男女性危险因素聚集率分别为18.1％(890/4 921)和14.5％ (776/5 344).当男性腰围≥84 cm、女性腰围≥80 cm时,对应的ROC曲线距左上顶点距离最短,分别为0.430和0.450;当男性腰围≥93 cm、女性腰围≥91 cm时,预测危险因素聚集的特异度≥90％.结论本研究的成人中心性肥胖和严重中心性肥胖的腰围切点值与中国成人超重和肥胖症预防与控制指南推荐的切点值相同或相近.
목적 탐토아국성인중심성비반화엄중중심성비반적요위절점치.방법 이용중미심폐혈관병류행병학합작연구1993지1994년적횡단면조사자료,납입기중년령재35～69세차자료완정자적10 265명작위연구대상.이요위적매개정수전미치위절점,계산각절점검출위험인소취집(동일개체동시구유2개급이상주요심혈관병위험인소)적민감도、특이도급수시자공작특정(ROC)곡선거좌상정점적거리,이거리최단적요위절점치작위진단중심성비반적요위절점,이특이도≥90％적요위절점치작위진단엄중중심성비반적요위절점.결과 남성요위위(80.5±9.9)cm,녀성요위위(77.8±10.0)cm.남녀성위험인소취집솔분별위18.1％(890/4 921)화14.5％ (776/5 344).당남성요위≥84 cm、녀성요위≥80 cm시,대응적ROC곡선거좌상정점거리최단,분별위0.430화0.450;당남성요위≥93 cm、녀성요위≥91 cm시,예측위험인소취집적특이도≥90％.결론 본연구적성인중심성비반화엄중중심성비반적요위절점치여중국성인초중화비반증예방여공제지남추천적절점치상동혹상근.
Objective To investigate the appropriate cut-off values of waist circumference(WC)for central obesity and severe central obesity in Chinese adults.Methods A total of 10 265 participants aged 35-69 years from the cross-sectional survey of the PRC-USA Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology between 1993 and 1994 with integral data were included.Each integer unit in centimeters of WC in a given range was used as the cut-off point to detect clustering of risk factors,which was defined as an individual with 2 or more risk factors including hypertension,diabetes,hypercholesterolemia,hypertriglyceridemia and low levels of high-density lipoprotein cholesterol.Sensitivity,specificity and distance from the receiver operating characteristic (ROC) curves to the upper left corner of the ROC graph were calculated.The WC value corresponding to the point on the ROC curve nearest to the upper left corner was considered as the optimal cut-off value for central obesity and the value corresponding to the point with specificity of 90％ or more was considered as the optimal cut-off for severe central obesity.Results The mean WC was (80.5 ± 9.9) cm in men and (77.8 ± 10.0) cm in women;18.1％ (890/4 921) of men and 14.5％ (776/5 344) of women were identified with two or more major risk factors.Based on the ROC curve analysis,the optimal value of WC to detect clustering of risk factors was ≥ 84 cm for men and ≥80 cm for women,and the shortest distance to the upper left comer was 0.430 and 0.450,respectively.The cut-off values of WC to detect clustering of risk factors with specificity of 90％ or more were ≥93 cm and ≥91 cm for men and women,respectively.Conclusion The cut-off points of WC for central obesity and severe central obesity in Chinese adults obtained from this study are equal or similar to the WC cut-off values proposed by the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults.