Waist-to-Height Ratio and Cardiovascular Risk Factors among Chinese Adults in Beijing

ObjectivesTo examine whether waist-to-height ratio (WHtR) performed better than, body mass index (BMI) or waist circumference (WC) in relation to hypertension, diabetes, and dyslipidemia among Chinese adults in Beijing.MethodsA total of 5720 adults (2371 men and 3349 nonpregnant women) aged 18 to 79 years were selected from the general population in a cross-sectional study. Data from a standardized questionnaire, physical examination, and blood sample were obtained.ResultsThe area under curve (AUC) values for WHtR (0.661–0.773) were significantly higher than those for BMI for all outcomes in both sexes, except that WHtR and BMI had similar AUCs for dyslipidemia in men. The AUCs for WHtR were significantly higher than those for WC with respect to hypertension in both sexes, and to diabetes in women. AUCs for the relationships between anthropometric indices and the three outcomes were larger in women than in men, and tended to decrease with age. Optimal cutoffs for WHtR were 0.51–0.53 and 0.48–0.50 in men and women, respectively. With regard to the current Chinese criteria for BMI (≥24 kg/m2), WC (≥90 cm for men, and ≥85 cm for women), and the recommended cutoff of WHtR (≥0.5), WHtR yielded the greatest odds ratio for hypertension and diabetes in both sexes, and dyslipidemia in women. BMI had the highest odds ratio for dyslipidemia in men. The odds ratios of anthropometric indices for hypertension and diabetes, but not for dyslipidemia, were higher in women than in men. The association between anthropometric indices and the three outcomes decreased with age.ConclusionWHtR performed better than BMI and WC for the association with hypertension and diabetes. More studies should be conducted to explore the age differences in the relationships between obesity indices and cardiovascular risk factors.

研究目标：探讨腰高比（waist-to-height ratio, WHtR）相较于体质指数（body mass index, BMI）与腰围（waist circumference, WC），在中国北京成人人群中与高血压、糖尿病及血脂异常的关联是否更具优势。
研究方法：本横断面研究从普通人群中纳入5720名年龄18~79岁的成人（男性2371名，非妊娠女性3349名），收集标准化调查问卷、体格检查及血液标本相关数据。
研究结果：男女各结局指标中，腰高比的曲线下面积（area under curve, AUC）值（0.661~0.773）均显著高于体质指数；仅男性血脂异常的AUC值在腰高比与体质指数间无统计学差异。在高血压关联分析中，男女腰高比的AUC值均显著高于腰围；女性糖尿病关联分析中结果一致。人体测量指标与三项结局的关联AUC值在女性中高于男性，且随年龄增长呈下降趋势。男女腰高比的最佳截断值分别为0.51~0.53与0.48~0.50。参照当前中国体质指数判定标准（≥24 kg/m²）、腰围判定标准（男性≥90 cm、女性≥85 cm）及推荐的腰高比截断值（≥0.5），腰高比在男女高血压、糖尿病及女性血脂异常的关联中均呈现最高的比值比；而男性血脂异常的关联中，体质指数的比值比最高。女性高血压与糖尿病关联的人体测量指标比值比高于男性，但血脂异常关联无此差异。人体测量指标与三项结局的关联强度随年龄增长而减弱。
研究结论：腰高比与高血压、糖尿病的关联效果优于体质指数与腰围。未来需开展更多研究以探讨肥胖指标与心血管危险因素间关联的年龄差异。