Does waist circumference predict diabetes and cardiovascular disease beyond commonly evaluated cardiometabolic risk factors?
Does waist circumference predict diabetes and cardiovascular disease beyond commonly evaluated cardiometabolic risk factors?
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DOI：
10.2337/dc07-0945
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发表时间：
2007-12-01
期刊：
影响因子：
16.2
通讯作者：
Ross, Robert
中科院分区：
文献类型：
--
作者：
Janiszewski, Peter M.;Janssen, Ian;Ross, Robert
目的 - 虽然当前的临床指南推荐测量腰围 (WC)，但其临床实用性在最近的共识声明中受到质疑。作为回应，我们试图确定 WC 是否可以预测糖尿病和心血管疾病 (CVD)，而不仅仅是 BMI 和常见的心脏代谢危险因素（包括血压、脂蛋白和血糖）所解释的范围。 研究设计和方法 - 受试者包括来自 1999-2004 年国家健康和营养检查调查的 5,882 名成年人，该调查具有全国代表性和跨部门性。受试者被分为特定性别的 WC 和 BMI 三分位数。使用标准临床阈值对血压、甘油三酯、低密度脂蛋白和高密度脂蛋白胆固醇以及血糖进行分类。使用逻辑回归分析根据 WC 三分位数计算糖尿病和 CVD 的几率。 结果 - 在控制基本混杂因素后，与低 WC 三分位数相比，中和高 WC 三分位数更有可能患有糖尿病和 CVD（P < 0.05）。在回归模型中纳入 BMI 和心脏代谢危险因素后，比值比的大小有所减弱（即，对于糖尿病，高 WC 组的比值比从 6.54 下降到 5.03），但在中和高 WC 三分位数中对于糖尿病的预测仍然显着，但对于 CVD 则不然。结论 - WC 预测糖尿病，但不预测 CVD。 通过传统的心脏代谢危险因素和体重指数来解释。这些发现为将 WC 作为识别高危腹部肥胖患者的常规措施的建议提供了重要支持。
OBJECTIVE - while the measurement of waist circumference (WC) is recommended in current clinical guidelines, its clinical utility was questioned in a recent consensus statement. In response, we sought to determine whether WC predicts diabetes and cardiovascular disease (CVD) beyond that explained by BMI and commonly obtained cardiometabolic risk factors including blood pressure, lipoproteins, and glucose.RESEARCH DESIGN AND METHODS - Subjects consisted of 5,882 adults from the 1999-2004 National Health and Nutrition Examination Survey, which is nationally representative and cross-sectional. Subjects were grouped into sex-specific WC and BMI tertiles. Blood pressure, triglycerides, LDL and HDL cholesterol, and glucose were categorized using standard clinical thresholds. Logistic regression analyses were used to calculate the odds for diabetes and CVD according to WC tertiles.RESULTS - After controlling for basic confounders, the medium and high WC tertiles were more likely to have diabetes and CVD compared with the low WC tertile (P < 0.05). After inclusion of BMI and cardiometabolic risk factors in the regression models, the magnitude of the odds ratios were attenuated (i.e., for diabetes the magnitude decreased from 6.54 to 5.03 for the high WC group) but remained significant in the medium and high WC tertiles for the prediction of diabetes, though not for CVD.CONCLUSIONS - WC predicted diabetes, but not CVD, beyond that explained by traditional cardiometabolic risk factors and BMI. The findings lend critical support for the recommendation that WC be a routine measure for identification of the high-risk, abdominally obese patient.