罗钰,刘帝,聂四平,冉利梅
LUO Yu,LIU Di,NIE Siping,RAN Limei

• 1:贵州医科大学营养与食品卫生学教研室
• 2:贵州医科大学儿少卫生与妇幼保健学教研室
• 3:贵州医科大学附院健康管理中心

摘要(Abstract)：

目的:探讨不同体格测量指标对血脂水平的预测价值。方法:随机整群抽样健康管理中心参加体检人员1 429例,其中男800例、女629例,测量其身高、体质量、臀围及腰围(WC)等体格指标,并计算体质量指数(BMI)、腰臀比(WHR)和腰高比(WHtR);检测血清甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及高密度白胆固醇(HDL-C);根据一级预防动脉粥样硬化性心血管疾病的血脂诊断标准,按血脂水平将被检人群分为男、女正常组、边缘升高组和升高组,并利用受试者工作曲线下面积(AUC)比较不同体格测量指标预测血脂水平异常的价值。结果:男性受检者WC、BMI、WHR、WHtR、TG、TC、LDL-C和non-HDL-C均高于女性,而女性HDL-C水平高于男性,差异有统计意义(P<0.05);男性血脂异常率高于女性,差异有统计意义(P<0.05);边缘升高组和升高组男、女性被检者的WC、BMI、WHR和WHtR均高于正常组,差异有统计意义(P<0.05);以血脂异常为标准,各体格测量指标AUC从大到小依次为WHtR、WC、BMI及WHR。结论:不同体格测量指标对血脂异常均有预测价值,其中WHtR能更好筛查或预测血脂异常。
Objective: To investigate the value of anthropometric indices from different physiques in predicting the level of blood lipid. Methods: 1 429 people were examined at the health management center, of which 800 males and 629 females. Their height, weight, hip and waist circumference(WC) were measured; body mass index(BMI), waist-to-hip ratio(WHR) and waist height ratio(WHtR) were calculated. Blood biochemical indicators including triglyceride(TG), serum total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), and high-density lipoprotein cholesterol(HDL-C) were investigated. Subjects were divided into normal group, marginal hyperlipidemia group and hyperlipidemia group according to the blood lipid level, in accordance with the diagnostic standard of 1 st class ASCVD prevention. The area under the receiver operating curve(ROC) was used to compare the effects of different anthropometric indices on dyslipidemia. Results: The levels of WC, BMI, WHR, WHtR, TG, TC, LDL-C and non-HDL-C in males were higher than those of females(P<0.05), while the levels of HDL-C of females were higher than those of males(P<0.05). And the rate of dyslipidemia in males was higher than that in females(P<0.05). Dyslipidemia rate of males were higher than that of females, differences were statistically significant(P<0.05); the WC, BMI, WHR and WHtR of the marginal hyperlipidemia group and the hyperlipidemia group were higher than those of the normal group in both males and females(P<0.05). Taking the appropriate level of dyslipidemia as the criterion, the area under the receiver operating characteristic curve of different anthropometric indices in descending order were: WHtR, WC, BMI, WHR. Conclusion: The value of anthropometric indices from different physiques in predicting the level of blood lipids was effective. Among them, WHtR can better predicate dyslipidemia.

关键词(KeyWords)： 血脂;体质量指数;腰围;腰臀比;腰高比
blood lipid;body mass index;waist circumference;waist-to-hip ratio;waist height ratio

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 罗钰,刘帝,聂四平,冉利梅
LUO Yu,LIU Di,NIE Siping,RAN Limei

DOI: 10.19367/j.cnki.1000-2707.2019.09.013

参考文献(References)：

• [1] 国家卫生和计划生育委员会疾病预防控制局.中国居民营养与慢性病状况报告(2015年)[M].北京:人民卫生出版社,2015.
• [2] 丁文清,董虹孛,米杰.中国儿童青少年血脂异常流行现状Meta分析[J].中华流行病学杂志,2015,36(1):71-77.
• [3] 诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,16(10):15-35.
• [4] 中华医学会内分泌学分会肥胖学组.中国成人肥胖症防治专家共识[J].中华内分泌代谢杂志,2011,27(9):711-717.
• [5] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中国糖尿病杂志,2014,30(8):893-942.
• [6] 陈春明.国际生命科学学会中国办事处中国肥胖问题工作组联合数据汇总分析协作组.中国成人体质指数分类的推荐意见简介[J].中华预防医学杂志,2001,35(5):349-350.
• [7] 贺媛,田京利,陈志恒,等.中国成人腰围身高比与血脂异常的关系[J].中华健康管理学杂志,2013(1):9-13.
• [8] 国家体育总局.国民体质测定标准手册[M].北京:人民体育出版社,2003.
• [9] LANCET T.Global burden of disease study 2016[J].Dialyse Aktuell,2017,17(7):353.
• [10]SANIP Z B,SUHAIMI M Z B,MAN C N,et al.Relationship between hair nicotine levels with blood pressure,body composition,lipid profile and leptin among healthy male smokers in Kelantan[J] .Journal of Taibah University Medical Sciences,2016,11(1):50-55.
• [11]LI X X,ZHAO Y,HUANG L X,et al.Effects of smoking and alcohol consumption on lipid profile in male adults in northwest rural China[J] .Public Health,2018,157:7-13.
• [12]TSENG C H,CHONG C K,CHAN T T,et al.Optimal anthropometric factor cutoffs for hyperglycemia,hypertension and dyslipidemia for the Taiwanese population[J].Atherosclerosis,2010,210(2):585-589.
• [13]BROWNING L M,HSIEH S D,ASHWELL M.A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes:0.5 could be a suitable global boundary value[J].Nutrition Research Reviews,2010,23(2):247-269.
• [14]徐丽华,颜应琳,于凯,等.老年人颈围、腰围、体重指数、腰身指数对血脂异常及其组分的预测价值[J].中国医刊,2016,51(9):45-49.
• [15]陈说,张帆,彭卫群,等.健康体检人群体脂率与代谢指标的相关性研究[J].中国医药科学,2018,8(3):23-25.

文章评论(Comment)：