The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison.
The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison.
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DOI：
10.1186/1471-2261-5-26
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发表时间：
2005-09-08
影响因子：
2.1
通讯作者：
Kahn HS
中科院分区：
文献类型：
--
作者：
Kahn HS
体重指数（BMI，kg/m2）可能不是评估肥胖相关疾病风险的最佳标志。与生理观察一致，另一种指标使用腰围（WC）和空腹甘油三酯（TG）浓度来描述脂质过度积累。使用第三次全国健康和营养检查调查（N = 9,180，统计加权代表 10005 万美国成年人）的 WC（预计人口最低男性 65 厘米，女性 58 厘米）和 TG 浓度来计算“脂质积累乘积”[LAP = (WC-65) × TG（男性）和 (WC-58) × TG（女性）] 并描述 圈。 LAP 和 BMI 作为分类变量和对数转换连续变量进行比较，以确定它们识别 11 种心血管危险因素不良水平的能力。近一半的代表人口的 LAP 和 BMI 的四分位数分配不一致。当将 LAP 序数四分位数 > BMI 四分位数的 2354 万人与 BMI 序数四分位数 > LAP 四分位数的 2536 万人（根据种族、民族和性别调整回归模型）进行比较时，前者在 7 个脂质变量、尿酸浓度、心率、收缩压和舒张压方面的不良风险水平高于后者 (p < 0.002)。除血压外，进一步调整年龄并没有实质性改变这些比较（p > 0.1）。作为连续变量，对于九个心血管风险变量 (p < 0.01)，LAP 提供的 β 系数（斜率）始终比 BMI 更不利，但对于血压则不然 (p > 0.2)。在识别美国成年人的心血管风险方面，LAP（描述脂质过度积累）比 BMI（描述体重过度积累）表现更好。与 BMI 相比，LAP 可能更好地预测心血管疾病的发病率，但这一假设需要前瞻性检验。
Body mass index (BMI, kg/m2) may not be the best marker for estimating the risk of obesity-related disease. Consistent with physiologic observations, an alternative index uses waist circumference (WC) and fasting triglycerides (TG) concentration to describe lipid overaccumulation. The WC (estimated population minimum 65 cm for men and 58 cm for women) and TG concentration from the third National Health and Nutrition Examination Survey (N = 9,180, statistically weighted to represent 100.05 million US adults) were used to compute a "lipid accumulation product" [LAP = (WC-65) × TG for men and (WC-58) × TG for women] and to describe the population distribution of LAP. LAP and BMI were compared as categorical variables and as log-transformed continuous variables for their ability to identify adverse levels of 11 cardiovascular risk factors. Nearly half of the represented population was discordant for their quartile assignments to LAP and BMI. When 23.54 million with ordinal LAP quartile > BMI quartile were compared with 25.36 million with ordinal BMI quartile > LAP quartile (regression models adjusted for race-ethnicity and sex) the former had more adverse risk levels than the latter (p < 0.002) for seven lipid variables, uric acid concentration, heart rate, systolic and diastolic blood pressure. Further adjustment for age did not materially alter these comparisons except for blood pressures (p > 0.1). As continuous variables, LAP provided a consistently more adverse beta coefficient (slope) than BMI for nine cardiovascular risk variables (p < 0.01), but not for blood pressures (p > 0.2). LAP (describing lipid overaccumulation) performed better than BMI (describing weight overaccumulation) for identifying US adults at cardiovascular risk. Compared to BMI, LAP might better predict the incidence of cardiovascular disease, but this hypothesis needs prospective testing.