辽宁省农村居民不同肥胖相关人体测量指数与脑卒中患病关系

目的了解辽宁省农村居民不同肥胖相关人体测量指数与脑卒中患病的关系,为脑卒中的预防控制提供参考依据。方法于2012年1月—2013年8月采取多阶段随机整群抽样方法在辽宁省大洼、彰武和辽阳县抽取3个镇26个村11 345名≥35岁农村居民进行问卷调查、体格检查和实验室检测,分析身体形态指数(ABSI)、身体圆度指数(BRI)、体质指数(BMI)、腰围(WC)、腰臀比(WHR)5种肥胖相关人体测量指数与脑卒中患病的关系。结果辽宁省11 345名≥35岁农村居民中,脑卒中患者996例,脑卒中患病率为8.8%;在调整了年龄、民族、文化程度、家庭年均收入、吸烟、饮酒、收缩压、舒张压、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血脂、血尿酸等混杂因素后,对ABSI、BRI、BMI、WC、WHR等5种肥胖相关人体测量指数第四四分位数与第一四分位数脑卒中患病情况比较,多因素非条件logistic回归分析结果显示,在男性人群中,对脑卒中患病均无预测意义(均P0.05);在女性人群中,BRI预测能力较强(OR=1.81,95%CI=1.36~2.42),其次为WHR(OR=1.75,95%CI=1.31~2.34),再次为WC(OR=1.55,95%CI=1.16~2.07)和BM I(OR=1.47,95%CI=1.09~1.98),ABSI预测能力最弱(OR=1.42,95%CI=1.08~1.87)。结论 ABSI、BRI、BM I、WC、WHR等5种肥胖相关人体测量指数在辽宁省农村居民中对脑卒中的预测能力不一致,其中BRI在女性中显示出较好的预测能力。     

新型肥胖指标与中国农村人群糖尿病前期的关系研究

目的 探讨身体形态指数(A Body Shape Index, ABSI)、中国内脏脂肪指数(Chinese Visceral Adiposity Index, CVAI)、脂质蓄积指数(Lipid Accumulation Product, LAP)、身体圆度指数(Body Roundness Index, BRI)和锥削指数(Conicity Index, CI)五个肥胖指标与糖尿病前期的关系,为糖尿病前期预防提供依据。方法 以宁夏自然人群队列基线数据中13 142名研究对象为基础,采用logistic回归分析探讨以上五个新型肥胖指标与糖尿病前期的关系,同时采用C统计量分析各肥胖指标对糖尿病前期的预测价值。结果 本研究共纳入13 142例研究对象,其中男性5 222例(占39.7%),女性7 920例(占60.3%); 1 481例糖尿病前期患者,患病率为11.3%。ABSI、CVAI、LAP、BRI和CI按四分位数分组,随着各指标四分位数的增加,空腹血糖水平和糖尿病前期患病率均呈上升趋势(P_趋势<0.05)。调整混杂因素后,经logistic回归分析显...     

中国成人身体形态指数构建及其与血压水平关系

目的构建中国成人身体形态指数(ABSI),评价其与血压水平的关联性,为研制适用于中国人群的肥胖指标提供参考依据。方法于2010年5—6月和2014年6—7月采用分层整群随机抽样方法在辽宁省沈阳、丹东和朝阳3个国民体质国家定点监测城市抽取9 592名20～69岁成人进行体质测定;应用体重、身高和腰围3个人体测量指标构建ABSI公式,根据异速生长模型,以In(腰围)为因变量,In(体重)和In(身高)为自变量进行线性回归分析,推导出男性和女性的ABSI。结果男性线性回归方程为In(腰围)=-2.641+0.700×In(体重)-0.945×In(身高)(R~2=0.748,P0.001),女性线性回归方程为In(腰围)=-2.750+0.734×In(体重)-1.060×In(身高)(R~2=0.688,P0.001);男性ABSI公式为ABSI(kg~(-0.7)m~(1.945))=腰围(m)/(BMI(kg/m~2)~(0.7)×(身高(m)~(0.455)),女性ABSI公式为ABSI(kg~(-0.734)m~(2.06)=腰围(m)/(BMI(kg/m~2)~(0.734)×身高(m)~(0.408))。本研究人群中,男性ABSI为(0.072±0.004) kg~(-0.7)m~(1.945),高于女性ABSI的(0.064±0.004)kg~(-0.734)m~(2.06)(t=73.09,P0.001)。相关分析结果显示,本研究构建公式计算的男性和女性ABSI均与腰围呈正相关(r=0.487和0.550,均P0.01),与身高、体重、BMI均不存在相关关系(均P0.05)。二分类logistic回归分析结果显示,男性ABSI 0.070～0.072和≥0.073 kg~(-0.7)m~(1.945)组患高血压的风险分别为ABSI0.070 kg~(-0.7)m~(1.945)组的1.45倍(OR=1.45,95%CI=1.23～1.71)和1.63倍(OR=1.63,95%CI=1.38～1.92);女性ABSI 0.062～0.065和≥0.066 kg~(-0.734)m~(2.06)组患正常偏高血压、高血压的风险分别为ABSI0.062kg~(-0.734)m~(2.06)组的1.37倍(OR=1.37,95%CI=1.10～1.71)和1.69倍(OR=1.69,95%CI=1.36～2.11)、1.66倍(OR=1.66,95%CI=1.35～2.04)和2.49倍(OR=2.49,95%CI=2.04～3.03)。结论ABSI是腰围以体重和身高标准化的中心性肥胖指标,与BMI不存在相关关系;ABSI的增加能增大中国成人患高血压的风险。     

老年人运动强度指南

适量运动对老年人的重要性不言自明。骨科医生—直在强调,适当的身体活动和锻炼能改善老年人的身体协调能力、预防跌倒,增强骨骼健康、改善骨质疏松等好处。实际上,运动对老年人来说还有以下好处:改善全因死亡率、心血管疾病死亡率、新发高血压、新发位点特异性肿瘤(如膀胱癌、乳腺癌、结肠癌、子宫内膜癌、食管腺癌、胃癌和肾癌等)、新发2型糖尿病、心理健康(焦虑和抑郁症状减少)、认知健康和睡眠;肥胖指数也能改善。     

老年人高血压风险预测肥胖指标筛选

目的评价肥胖指标与高血压的关联性,筛选预测老年人高血压风险的良好肥胖指标。方法分析辽宁省国民体质监测点1 608名60～69岁老年人的数据资料。传统肥胖指标包括体质指数(BMI)、体格指数(PI)、腰围(WC)、腰臀比(WHR)和锥削度指数(CI);新肥胖指标包括腰围身高比(WHtR)、身体形态指数(ABSI)、身体圆润指数(BRI)、腰臀脂肪指数(AVI)、臀围指数(HI)和身体脂肪指数(BAI)。应用受试者工作特征(ROC)曲线比较不同肥胖指标预测高血压的效果,采用logistic回归分析评价肥胖指标与高血压风险的关联强度。结果辽宁省60～69岁老年人高血压率为38.6%(620/1 608),男性为41.5%(323/778),女性为35.8%(297/830)。男、女性BMI、WC、WHtR、AVI、PI、BRI、BAI预测高血压的ROC曲线下面积均有统计学意义,最佳切点值为:BMI(男:25.4 kg/m~2,女:25.6 kg/m~2),WC(男:83.5 cm,女:86.6 cm),WHtR(男:0.50,女:0.53),AVI(男:14.3 cm~2,女:15.2 cm~2),PI(男:14.6 kg/m3,女:16.1 kg/m~3),BRI(男:3.4,女:4.1)和BAI(男:25.4,女:32.6)。多元logistic回归分析表明,BMI和WHtR是预测男、女性高血压风险的良好肥胖指标;男性BMI≥25.4 kg/m~2者高血压风险是BMI 25.4 kg/m~2者的1.53倍,WHtR≥0.50者高血压风险是WHtR 0.50者的1.55倍;女性BMI≥25.6 kg/m~2者高血压风险是BMI 25.6 kg/m~2者的1.62倍,WHtR≥0.53者高血压风险是WHtR 0.53者的1.81倍。将BMI与WHtR结合,男性BMI≥25.4 kg/m~2且WHtR≥0.50者高血压风险是BMI 25.4 kg/m~2且WHtR 0.50者的2.33倍(95%CI=1.63～3.34);女性BMI≥25.6 kg/m~2且WHtR≥0.53者高血压风险是BMI 25.6 kg/m~2且WHtR 0.53者的2.88倍(95%CI=2.03～4.09)。结论 BMI和WHtR是预测老年人高血压风险的良好肥胖指标;BMI与WHtR联合应用,能够显著提高预测高血压风险的效果。     

代谢综合征组分对2型糖尿病的预测作用及调控意义

目的探讨社区居民糖尿病患病情况及代谢综合征组分对2型糖尿病的预测作用与调控意义。方法采用分层整群抽样方法对徐州市社区20岁以上成人糖尿病及代谢综合征的患病情况进行研究,SPSS16.0软件进行统计分析。结果社区人群糖尿病、代谢综合征患病率分别为4.4%、10.3%,代谢综合征中糖尿病患病率高于一般人群(P﹤0.05)。排除血糖后,代谢综合征单组分中体质指数(OR=1.692,95%CI 1.139～2.515),血压(OR=4.152,95%CI 2.814～6.126)是糖尿病的独立预测因子。代谢综合征多组分组合中体质指数合并高血压和高甘油三酯组(OR=3.218,95%CI 2.037～5.082,P﹤0.01)对糖尿病的预测作用最强。结论代谢综合征单组分体质指数和高血压是2型糖尿病的独立预测因素,体质指数合并高血压和高甘油三酯聚合体对2型糖尿病有较强预测作用。对代谢综合征组分的综合调控可能对糖尿病及心脑血管疾病的预防具有公共卫生意义。     

6278名体检人员腰围和体质指数及其对代谢性疾病的预测能力

目的比较体质指数(BMI)和腰围(WC)对高血压、糖尿病、高脂血症等胰岛素抵抗相关的代谢性疾病的预测能力,为该类疾病的预防提供参考。方法以某医院2010-2013年6278名体检人员为调查对象,测量身高、体质量和腰围,计算体质指数。比较体质指数正常腰围超标与未超标2组人员高血压、糖尿病、高脂血症等胰岛素抵抗相关的代谢性疾病的发病率。结果女性BMI异常率、WC超标率和2项同时异常的发生率均高于男性,差异有显著性(P0.05)。体质指数正常但腰围超标的374人中,高血压、糖尿病、高脂血症的发病率分别为15.51%、9.61%、9.89%;体质指数正常且腰围不超标4088人中,高血压、糖尿病、高脂血症的发病率分别为9.30%、6.78%、7.46%;前者明显高于后者,差异有显著性(P0.05,P0.01)。结论腰围对胰岛素抵抗相关的代谢性疾病的预测能力比体质指数更强。     

海南百岁老人12项肥胖相关指标与全因死亡的关联研究

目的描述和分析BMI、腰围、腰臀比、腰高比、小腿围、腰围小腿围比值(WCR)、脂质蓄积指数(LAP)、内脏脂肪指数(VAI)、中国内脏脂肪指数(CVAI)、身体形态指数、中国身体形态指数(CABSI)和身体圆度指数与海南百岁老人全因死亡间的关联。方法整群抽样方法抽取的海南百岁老人共1 002人。随访时间的M(Q1, Q3)为4.16(1.31, 5.04)年, 结局为全因死亡, 使用Cox比例风险回归分析各肥胖相关身体测量指标与全因死亡的关联, 并使用受试者工作特征曲线曲线下面积(AUC)进行比较。结果总人群中小腿围对全因死亡的判定能力最强, AUC为0.61(95%CI:0.57～0.64), 分性别结果与总人群一致(P<0.05)。WCR次之(AUC为0.58), 再次是BMI、LAP和腰围, AUC分别为0.55、0.55和0.54, 而CABSI、腰臀比和VAI的判定能力较弱, AUC分别为0.51、0.50和0.50。结论本研究比较了12项肥胖相关指标与海南百岁老人全因死亡间的关联, 发现小腿围的预测判定能力最好, 且呈剂量反应关系, 提示可作为长寿老人死亡风险预测的参...     

代谢综合征的诊断

代谢综合征是一组以肥胖、高血糖、高血压以及血脂异常为主要症状的临床症候群，常聚集发病，严重影响人类健康，是2型糖尿病和心血管疾病发病的高危因素。研究指出，代谢综合征人群发生心血管事件及中风的患病率和死亡危险是非代谢综合征人群的2～3倍，糖尿病的患病危险增高5倍。因此，早期识别、诊断和干预代谢综合征，有助于遏制糖尿病和心血管疾病的流行。     

不同肥胖评价指标对贵州省侗族和苗族成人高血压预测价值分析

目的 探讨贵州省侗族及苗族成人不同肥胖评价指标与高血压的相关性,并筛选预测高血压的最佳指标及切点值。方法 于2018年5月—2019年9月采用多阶段分层抽样方法选取贵州省30～79岁侗族及苗族人群作为研究对象。采用二分类logistic回归模型分析肥胖评价指标体质量指数（body mass index,BMI）、腰围（waist circumference,WC）、内脏脂肪指数（visceral adiposity index,VAI）、脂质蓄积指数（lipid accumulation product, LAP）、身体形态指数（a body shape index, ABSI）及身体肥胖指数（body adiposity index,BAI）与高血压之间的关系;通过受试者工作特征（receiver operating characteristic,ROC）曲线下面积（area under curve,AUC）评价不同肥胖评价指标对高血压的预测价值,并以最大约登指数确定其切点值。结果 贵州省30～79岁侗族和苗族人群,纳入符合标准的共10 076人,高血压检出率分别为22.51%和22...     

Differential Associations of 6 Adiposity Indices With Dementia in Older Adults: The MIND-China Study

ObjectivesThe cross-sectional association between late-life obesity and dementia is often explained by the obesity paradox. We assessed the potential differential associations of various adiposity indices with dementia and subtypes of dementia in rural Chinese older adults.DesignA population-based cross-sectional study.Setting and ParticipantsA total of 5277 participants (age ≥60 years; 57.23% female) who were living in rural communities and were examined in March–September 2018 for MIND-China.MethodsWe used weight, height, and waist circumference (WC) to calculate 6 adiposity indices: body mass index (BMI), waist-to-height ratio (WHtR), weight-adjusted-waist index (WWI), A Body Shape Index (ABSI), body roundness index (BRI), and Conicity Index (ConI). Dementia, Alzheimer's disease (AD), and vascular dementia (VaD) were clinically diagnosed following the international criteria. Data were analyzed with logistic regression models.ResultsOf the 5277 participants, 303 were diagnosed with dementia, including 193 with AD and 99 with VaD. The multivariable-adjusted odds ratio (95% CI) of dementia associated with the highest (vs lowest) quintile of adiposity index was 2.32 (1.40–3.85) for WWI, 1.56 (1.03–2.36) for ABSI, and 1.40 (0.92–2.11) for ConI. Similarly, higher levels of these 3 adiposity indices were significantly associated with an increased likelihood of AD, whereas a higher BMI was associated with a decreased likelihood of AD. None of the 6 examined adiposity indices was significantly associated with VaD when adjusting for multiple confounders.Conclusions and ImplicationsThe adiposity index WWI is linearly associated with the likelihood of dementia and AD. An increased WWI may be a clinical marker for the dementia syndrome and Alzheimer's dementia.     

适于胎龄新生儿身体指数纵向监测的意义探讨

建立适于胎龄新生儿体格发育指数的纵向监测参考值,并探讨其使用价值。方法用计算机演算１７５７例ＡＧＡ新生儿的５项身体指数,即ＱｕｅｔｅｌｅｔＩｎｄｅｘ（ＱＩ）、ＲｏｈｒｅｒＩｎｄｅｘ（ＲＩ）、身长顶臂长指数、身长／头围、中臂围／头围比值。     

Assessing body shape index as a risk predictor for cardiovascular diseases and metabolic syndrome among Iranian adults

ObjectiveSeveral studies have concluded a positive association between abdominal obesity, general obesity, and chronic diseases. However, the best anthropometric measures to predict the risk for chronic diseases should be clarified in each population. Therefore, the aim of this study was to compare the predictive power of A Body Shape Index (ABSI), body mass index (BMI), and waist-to-height ratio and Clinica Universidad de Navarra-Body Adiposity Estimator for metabolic syndrome (MetS) and cardiovascular disease (CVD) risks among Iranians in different age and sex categories.MethodsThis population-based cross-sectional study conducted on 9555 individuals, ages ≥19 y. Anthropometric measures, blood pressure, and biochemical markers were measured using standard protocols. Hypertension, hyperglycemia, hypercholesterolemia, high low-density lipoprotein cholesterol and low high-density lipoprotein cholesterol levels were considered as the CVD risks.ResultsMean (SD) of age and BMI of participants were 38.7 y (mean 15.5) and 25.7 kg/m² (mean 4.6), respectively. ABSI demonstrated the weakest correlations and lowest area under curve (AUC) for various risk factors and MetS. However, the highest odds ratio was observed for ABSI and MetS in different age and sex categories.ConclusionsBased on the AUC, we concluded that ABSI is a weak predictor for CVD risks and MetS. More studies are needed to determine the best predictor of CVD risk among the Iranian population.     

Association between glycosylated hemoglobin level and cardiovascular and all-cause mortality in type 1 diabetes

Hyperglycemia is implicated in the development and progression of microvascular complications in type 1 diabetes. In contrast, the association between hyperglycemia and macrovascular complications or mortality in type 1 diabetes is not clear. The authors studied a population-based cohort of 879 individuals with type 1 diabetes from Wisconsin, free of cardiovascular disease and end-stage renal disease at the baseline examination (1980-1982). The main outcome of interest was all-cause (n=201) and cardiovascular (n=132) mortality as of December 31, 2001. Elevated glycosylated hemoglobin levels were associated with all-cause and cardiovascular mortality, independent of duration of diabetes, smoking, hypertension, and proteinuria. The multivariable relative risks comparing the highest quartile of glycosylated hemoglobin (>or=12.1%) with the lowest quartile (相似文献   

珠海市斗门区居民体重指数、腹围与血压关系的研究

目的研究珠海市斗门区居民体重指数（BMI）、腹围与血压的关系,为控制体重及向心性肥胖从而降低高血压发病率提供参考。方法按照分层、整群、随机相结合的方法,抽取斗门区两镇,对其农村居民进行面对面调查和体检。结果体重指数为〈24、24～28、≥28时,血压均值分别为125．49／79．81、135．62／85．42、／44．63／93．77mmHg,高血压患病率分别为27．5％、47．6％、71．0％;腹围从正常到腹部肥胖,血压均值从124．67／79．65mmHg上升到135．50／85．09mmHg,高血压患病率从25．5％上升到48．5％。体重指数对血压、高血压患病率的预测效果高于腹围;超重、肥胖与正常组相比,发生高血压的危险性分别增加3．0和5．2倍。结论珠海市斗门区居民血压值和高血压患病率随着体重指数、腹围的增加而上升,体重指数是预测高血压的重要指标,应采取有针对性的措施,控制体重指数在正常范围内。     

Predictive performance of obesity indexes for the risk of high blood pressure in an adult population

Background and objectives

Comparisons of predictive performance of various anthropometric measures in high blood pressure have not been investigated. This study aimed at evaluating and comparing the predictive power of Body Mass Index (BMI), Body Adiposity index (BAI) and A Body Shape Index (ABSI) for predicting hypertension in adults.

Body mass index and body girths as predictors of mortality in black and white men.

Anthropometric measurements collected from black and white men in the 1960 (n = 946) and 1963 (n = 456) examinations of the Charleston Heart Study cohort (Charleston County, South Carolina) were examined as predictors of all cause and coronary heart disease mortality. Anthropometric measurements included body mass index, chest girth (at the third intercostal space), abdominal girth (at the umbilicus) and midarm circumference. Vital status of 98 percent of the cohort was determined through 1988. Body mass index was not associated with mortality in the white men; however, it was predictive of all cause and coronary heart disease mortality in the black men. Analyses conducted separately in the lower and upper range of body mass index in black men showed the adjusted relative hazard at the 50th versus the 10th percentile of body mass index was 0.54 for all cause mortality, but was not significant for coronary heart disease mortality; whereas the adjusted relative hazard for the 90th relative to the 50th percentile was 1.7 for coronary heart disease deaths, but not significant for deaths from all causes. The circumference measurements were not predictive of all cause or coronary heart disease mortality in the white men. In the black men, the adjusted relative hazard ratios for all cause mortality for the 85th relative to the 15th percentiles were 0.22 for midarm circumference and 2.0 for abdominal circumference.     

Metabolic syndrome mortality in a population-based cohort study: Jichi Medical School (JMS) Cohort Study

BACKGROUND: Metabolic syndrome is known to increase morbidity and mortality of cardiovascular disease. The National Cholesterol Education Program Adult Treatment Expert Panel III in 2001 (revised in 2005) and the Japanese definition of metabolic syndrome were launched in 2005. No study regarding the association between metabolic syndrome by Japanese definition and mortality has been performed. The aim of this study was to clarify the prevalence of metabolic syndrome and its effects to mortality in a population-based cohort study. METHODS: A total of 2,176 subjects who satisfied the necessary criteria for metabolic syndrome were examined between 1992 and 1995 as a part of Jichi Medical School Cohort Study by Japanese definition. Cox's proportional hazard models were used to analyze the association of metabolic syndrome with mortality. RESULTS: The prevalence of metabolic syndrome was 9.0% in males and 1.7% in females. There were 17 deaths (14 males), including 6 cardiovascular deaths (5 males), during a 12.5-year follow-up period among metabolic syndrome subjects. After adjusting for age, smoking status, and alcohol drinking status, the hazard ratio (95% confidence interval) for all-cause mortality was 1.13 (0.64-1.98) in males and 1.31 (0.41-4.18) in females, and HR for cardiovascular mortality was 1.84 (0.68-4.96) in males, and 1.31 (0.17-9.96) in females. CONCLUSION: No statistical significant relationship between metabolic syndrome by Japanese definition and all-cause mortality was observed in a population-based cohort study.     

Assessment of metabolic profile in a clinical setting

PURPOSE OF REVIEW: The metabolic syndrome, a clustering of abnormalities such as hyperglycemia, insulin resistance, hypertension, dyslipidemia, and central obesity, is a principal risk factor for cardiovascular disease, the leading cause of morbidity and mortality in the Western world. There are several definitions of the metabolic syndrome, all aiming at including as many persons at risk as possible. The assessment and, hence, the identification of such persons in a clinical setting is of utmost importance. RECENT FINDINGS: Clinicians should document the presence of central obesity, assessed by waist circumference measurement or determination of body composition using dual X-ray absorptiometry or measurement of visceral fat using computed tomography or magnetic resonance imaging. The presence of dyslipidemia, insulin resistance, and arterial hypertension constitutes the full profile of the metabolic syndrome. Nevertheless, elevated uric acid levels or presence of nonalcoholic fatty liver, or the diagnosis of the polycystic ovary syndrome in women of reproductive age, all are reflected in high risk of later occurrence of the full metabolic syndrome and atherosclerotic cardiovascular disease. SUMMARY: Although no unified definition for the metabolic syndrome exists, it is important to identify persons at risk, in order to reduce the resultant high morbidity and mortality rates.     

Association between the polycystic ovary syndrome and the metabolic syndrome in Puerto Rico

Polycystic ovary syndrome (PCOS) affects mostly young women causing chronic anovulation, hyperandrogenism, hirsutism and obesity with android pattern. The prevalence of the metabolic syndrome (abnormal glucose metabolism, dyslipidemia, hypertension and increased waist circumference) in PCOS is not defined although both have a common etiologic factor: insulin resistance. This retrospective study from medical records examined the presence of obesity and features of the metabolic syndrome in women with PCOS. The metabolic syndrome was defined as presence of two or more of the following signs: abnormal glucose metabolism, hypertriglyceridemia, low HDL, and hypertension. Thirty nine records of patients with PCOS were reviewed. The mean age was 29.4 years and the body mass index was 36 kg/m2. Hypertriglyceridemia was present in 43%, low HDL in 71%, hypertension in 36%, impaired glucose tolerance in 10% and diabetes mellitus type 2 in 37%. The metabolic syndrome was identified in 44% of sampled women with PCOS. These findings indicate that women with PCOS are at increased risk of diabetes mellitus type 2 at a young age. PCOS patients have higher prevalence of the metabolic syndrome than the rest of the population and thus are at increased risk of cardiovascular disease even if they don't develop diabetes mellitus type 2.