目的探讨体质指数(BMI)和中心性肥胖指标与糖尿病(DM)、高血压患病风险的关系。方法采用横断面研究方法,人选2980名男性和3850名女性(年龄35~74岁)。分别检测受检者的BMI、腰围(WC)、腰臀比(WHR)、腰围与身高的比值(WSR)、空腹血糖(FBG)、餐后2h血糖(2hPG)和血压,并分析BMI、WC、WHR和WSR与心血管疾病的危险因素变量(FBG、2hPG、收缩压或舒张压)的关联。应用受试者工作特征曲线(ROC)下面积,评估检测的各项人体测量指标与DM和高血压关联程度的特异度和敏感度。结果(1)BMI、WC、WHR和WSR之间相关系数差异有统计学意义(P〈0.001),以WC和WSR间相关系数最大(男:0.94,女:0.95)。(2)与BMI相比,男性WSR与DM的关联更强(JP=0.081),女性WC和WSR的关联更强(P〈0.05)。ROC下面积经年龄调整为男性WSR0.735和女性WC0.749,均较BMI0.725大。(3)与中心性肥胖指标比较,不论男女,BMI与高血压有最强的关联(BMI比WHR,P〈0.001;比WSR,P〈0.01;比WC,P〈0.05)。BMI的ROC曲线下面积经年龄调整分别为男性WSR0.760和女性WC0.766,均较相应的中心性肥胖指标高。结论中心性肥胖指标与BMI比较,前者可能与DM患病风险关联更大;而后者可能导致高血压患病风险更大。
Objective To investigate the relationship among central obesity indicators and type 2 diabetes (T2DM) and hypertension. Methods A total of 2980 male and 3850 female subjects, aged 35 -74 years, were screened and enrolled in this cross-sectional study. Body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist circumference to height ratio (WSR), fasting blood glucose (FBG), postprandial 2 h blood glucose (2 hPG) and blood pressure were measured in all subjects. Results BMI, WC, WHR and WSR were correlated each other significantly (P 〈0. 001 ) , and strong correlation occurred between WC and WSR (r =0. 94 for male and 0. 95 for female, both P 〈 0. 001 ). WSR in male, and WC and WSR in female were strongly correlated with T2DM. White BMI had significantly strong correlation with hypertension in both male and female subjects. Conclusions Central obesity may be associated with high risk of T2DM. And BMI associates with high risk of hypertension than central obesity does.