Predictive performance of anthropometric indexes of central obesity for the risk of type 2 diabetes
Predictive performance of anthropometric indexes of central obesity for the risk of type 2 diabetes
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DOI：
10.1016/j.arcmed.2005.03.049
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发表时间：
2005-09-01
影响因子：
7.7
通讯作者：
Kulkarni, HR
中科院分区：
文献类型：
--
作者：
Mamtani, MR;Kulkarni, HR
背景资料。尽管有几个可用的人体测量学指标，但这些指标对预测2型糖尿病的相对价值仍不清楚。考虑到肥胖和糖尿病通常并存，我们的目标是直接比较中心性肥胖和一般肥胖症的测量结果，以预测2型糖尿病的风险。我们对150例2型糖尿病患者和150例年龄和性别匹配的对照组进行了病例对照研究。我们直接比较了五项人体测量学指标的预测效果：四项与中心性肥胖有关-腰围(WC)、腰臀比(WHR)、腹部体积指数(AVI)和锥度指数(CI)；以及一项与一般肥胖-身体质量指数(BMI)有关。采用受试者-操作特征(ROC)曲线、似然比、Logistic回归和Shannon‘s熵等多种统计方法，比较研究样本和自举样本中各指标的表现。WC的总体预测准确率最高，性别不敏感(男性AUC=0.77，女性0.74)；信息量与AVI相当(WC的Shannon‘s熵=1.81，AVI的1.84)，比所有其余指标更好地预测2型糖尿病的风险。腰围与血糖、血脂等糖尿病生化指标密切相关。WC是一种简单、无创和准确的2型糖尿病风险预测指标，可潜在地用于发展中国家的筛查项目。(C)2005年管理和社会保障制度。由爱思唯尔公司出版。
Background. In spite of several available anthropometric indexes, the relative merit of these indexes for the prediction of type 2 diabetes remains unknown. Considering that obesity and diabetes commonly coexist as co-morbidities, our objective was to directly compare the performance of measures of central and general obesity to predict the risk of type 2 diabetes.Methods. We conducted a case-control study of type 2 diabetes on 150 cases and 150 age- and gender-matched controls. We directly compared the predictive performance of five anthropometric indexes: four related to central obesity-waist circumference (WC), waist/hip ratio (WHR), abdominal volume index (AVI) and conicity index (CI); and one related to general obesity-body mass index (BMI). We used various statistical approaches like area under (AUC) receiver-operating characteristic (ROC) curves, likelihood ratios, logistic regression and Shannon's entropy to compare the performance of the indexes in the study sample as well as bootstrapped samples.Results. WC had the highest overall predictive accuracy that was gender insensitive (AUC = 0.77 in males and 0.74 in females); a comparable information content as that of AVI (Shannon's entropy = 1.81 for WC and 1.84 for AVI) and was a better predictor of the risk of type 2 diabetes than all the remaining indexes. WC also correlated strongly with the biochemical markers of diabetes like blood sugar and lipid profile.Conclusions. WC is a simple, non-invasive and accurate predictor of the risk of type 2 diabetes that can potentially be used in screening programs in developing countries. (c) 2005 IMSS. Published by Elsevier Inc.