Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis
Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis
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DOI：
10.1111/j.1467-789x.2011.00952.x
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发表时间：
2012-03-01
期刊：
影响因子：
8.9
通讯作者：
Gibson, S.
中科院分区：
文献类型：
--
作者：
Ashwell, M.;Gunn, P.;Gibson, S.
我们的目的是区分腰高比（WHtR）和腰围（WC）在不同国籍人群中对成人心脏代谢风险的筛查潜力，并将两者与体重指数（BMI）进行比较。我们对使用受试者工作特征（ROC）曲线评估人体测量指标在区分高血压、2型糖尿病、血脂异常、代谢综合征和一般心血管结局（CVD）成人中的区分能力的研究进行了系统回顾和荟萃分析。31篇论文符合纳入标准。使用所有结果的数据，研究组内的平均值，WHtR与BMI相比具有显着更大的区分能力。与BMI相比，WC使不良结局的识别率提高了3%（P < 0.05），WHtR使不良结局的识别率提高了45%（P < 0.01）。最重要的是，研究内AUC差异的统计分析显示，对于糖尿病、高血压、CVD和所有结局，WHtR显著优于WC（P < 0.005）在男性和女性中。第一次，来自几个种族群体中超过30万成年人的研究的有力统计证据，显示WHtR在检测男女心脏代谢危险因素方面优于WC和BMI。因此，腰围与身高的比例应被视为一种筛选工具.
Our aim was to differentiate the screening potential of waist-to-height ratio (WHtR) and waist circumference (WC) for adult cardiometabolic risk in people of different nationalities and to compare both with body mass index (BMI). We undertook a systematic review and meta-analysis of studies that used receiver operating characteristics (ROC) curves for assessing the discriminatory power of anthropometric indices in distinguishing adults with hypertension, type-2 diabetes, dyslipidaemia, metabolic syndrome and general cardiovascular outcomes (CVD). Thirty one papers met the inclusion criteria. Using data on all outcomes, averaged within study group, WHtR had significantly greater discriminatory power compared with BMI. Compared with BMI, WC improved discrimination of adverse outcomes by 3% (P < 0.05) and WHtR improved discrimination by 45% over BMI (P < 0.01). Most importantly, statistical analysis of the within-study difference in AUC showed WHtR to be significantly better than WC for diabetes, hypertension, CVD and all outcomes (P < 0.005) in men and women.For the first time, robust statistical evidence from studies involving more than 300 000 adults in several ethnic groups, shows the superiority of WHtR over WC and BMI for detecting cardiometabolic risk factors in both sexes. Waist- to- height ratio should therefore be considered as a screening tool.