Body mass index and obesity-related metabolic disorders in Taiwanese and US whites and blacks: implications for definitions of overweight and obesity for Asians.
Body mass index and obesity-related metabolic disorders in Taiwanese and US whites and blacks: implications for definitions of overweight and obesity for Asians.
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DOI：
10.1093/ajcn/79.1.31
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发表时间：
2004
期刊：
影响因子：
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通讯作者：
W. Pan;K. Flegal;Hsing-Yi Chang;W. Yeh;C. Yeh;Wen-Chung Lee
中科院分区：
文献类型：
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作者：
W. Pan;K. Flegal;Hsing-Yi Chang;W. Yeh;C. Yeh;Wen-Chung Lee
背景：基于很少的数据，已经提出了降低亚洲人肥胖的体重指数（BMI；单位：kg/m(2)）的建议。目的：比较亚洲人与美国白人和黑人BMI与代谢共病之间的关系。方法利用1993-1996年第三次全国健康与营养调查和台湾地区营养与健康调查的数据，比较不同BMI水平下合并症的患病率、敏感性、特异性、预测值、影响率以及不同族群间BMI与合并症的关系。结果对于大多数BMI值，台湾的高血压、糖尿病和高尿酸血症的患病率高于美国白人。此外，台湾白人的高甘油三酯血症（P = 0.01）和高血压（P = 0.075）的比值比高于美国白人。在所有被研究的共病中，台湾黑人的bmi -共病关系比美国黑人强。台湾男性、美国白人男性和美国黑人男性的bmi分别为22.5、26和27.5，其阳性预测值和阴性预测值的总和最高。同样的顺序也适用于女性。对于bmi指数为bb27和bb1的人群，85%的台湾人、66%的白人和55%的黑人至少有一种合并症。然而，通过最大化敏感性和特异性，通常可以找到接近研究人群中位数的截断点。在美国，将BMI从bbb25降低到<25可以消除13%的肥胖合并症。台湾相应的截止值略小于24。这些数据表明，可能需要为亚洲人设定较低的BMI下限，但在哪里划定界限是一个复杂的问题。
BACKGROUND Recommendations based on scanty data have been made to lower the body mass index (BMI; in kg/m(2)) cutoff for obesity in Asians. OBJECTIVE The goal was to compare relations between BMI and metabolic comorbidity among Asians and US whites and blacks. METHODS We compared the prevalence rate, sensitivity, specificity, predictive values, and impact fraction of comorbidities at each BMI level and the BMI-comorbidity relations across ethnic groups by using data from the third National Health and Nutrition Examination Survey and the Nutrition and Health Survey in Taiwan (1993-1996). RESULTS For most BMI values, the prevalences of hypertension, diabetes, and hyperuricemia were higher for Taiwanese than for US whites. In addition, increments of BMI corresponded to higher odds ratios in Taiwanese than in US whites for hypertriglyceridemia (P = 0.01) and hypertension (P = 0.075). BMI-comorbidity relations were stronger in Taiwanese than in US blacks for all comorbidities studied. BMIs of 22.5, 26, and 27.5 were the cutoffs with the highest sum of positive and negative predictive value for Taiwanese, US white, and US black men, respectively. The same order was observed for women. For BMIs >27, >85% of Taiwanese, 66% of whites, and 55% of blacks had at least one of the studied comorbidities. However, a cutoff close to the median of the studied population was often found by maximizing sensitivity and specificity. Reducing BMI from >25 to <25 in persons in the United States could eliminate 13% of the obesity comorbidity studied. The corresponding cutoff in Taiwan is slightly <24. CONCLUSION These data suggest a possible need to set lower BMI cutoffs for Asians, but where to draw the line is a complex issue.