Body mass index (BMI) and waist circumference (WC) as screening tools for cardiovascular risk factors in Guadeloupean women
Body mass index (BMI) and waist circumference (WC) as screening tools for cardiovascular risk factors in Guadeloupean women
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DOI：
10.1016/s0895-4356(02)00430-4
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发表时间：
2002-10-01
影响因子：
7.2
通讯作者：
Suissa, S
中科院分区：
文献类型：
--
作者：
Foucan, L;Hanley, J;Suissa, S
高血压、血脂异常和2型糖尿病是重要的心血管风险因素，与肥胖密切相关。体重指数（BMI）和腰围（WC）是衡量肥胖的指标，可用于识别具有这些风险因素的个体。我们评估了这两种措施中哪一种在人口水平上更有信息性。研究人群包括1999年在瓜德罗普卫生中心（FWI）招募的5 149名18至74岁的连续妇女。计算并比较BMI和WC的ROC曲线下面积及其95%CI。Logistic回归分析BMI和WC以及两个年龄组（18-39岁和40-74岁）的ROC曲线下面积表明，年龄改变了这些参数识别CVD危险因素的判别能力。在BMI为52-70%和WC为55-80%的水平下，灵敏度等于特异性。通过BMI和WC识别每个危险因素的ROC面积分别为0.52 ~ 0.84和0.55 ~ 0.88。对于识别至少有一个CVD危险因素的女性，在整个人群中，BMI和WC的曲线下面积（分别为0.71; 95%CI：0.69-0.73和0.76; 95%CI：0.74-0.78）均显著大于0.5。这些相关面积之间的差异为0.04，95% CI [-0.05，-0.03]。在检测血脂异常的女性中，该区域的值最低，在检测2型糖尿病的女性中，该区域的值最高。腰围，一个实用的工具，有更高的判别能力比BMI在确定是否存在所有这些危险因素，似乎是最好的筛选工具，在这一人群中。(C)2002年爱思唯尔科技有限公司All rights reserved.
Hypertension, dyslipidemia and type 2 diabetes, important cardiovascular risk factors, are strongly linked to obesity. Body mass index (BMI) and waist circumference (WC) are measures of obesity that can be useful in identifying individuals with these risk factors. We assessed which of the two measures is more informative at the population level. The study population included 5,149 consecutive women aged 18 to 74 recruited in an Health Center of Guadeloupe (FWI) in 1999. The areas under the ROC curves of BMI and WC and their 95% CI were computed and compared. Logistic regression analysis of BMI and WC and the areas under the ROC curves in two separate age groups (18-39 years and 40-74 years) showed that age modifies the discriminant ability of these parameters in identifying the CVD risk factors. Sensitivity equalled specificity at levels between 52-70% for BMI and 55-80% for WC. ROC areas for identifying each risk factors by BMI varied from 0.52 to 0.84 and by WC from 0.55 to 0.88. For the identifying of women with at least one CVD risk factor, in the whole population, the areas under the curves for BMI and WC (respectively, 0.71; 95% CI: 0.69-0.73 and 0.76; 95% CI: 0.74-0.78) were both significantly greater than 0.5. The difference between these correlated areas was 0.04, 95% CI [-0.05, -0.03]. The lowest values of the areas were noted in detecting women with dyslipidemia and the highest in detecting those with type 2 diabetes. Waist circumference, a practical tool that had a higher discriminant ability than BMI in identifying presence or absence of all these risk factors, appears as the best screening tool in this population. (C) 2002 Elsevier Science Inc. All rights reserved.