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刘佳, 肖焕波, 袁作雄, 鲁杨. 中国成年人群糖尿病筛查肥胖相关身体测量指标分布特征及其适宜切点[J]. 中国公共卫生, 2017, 33(2): 173-176. DOI: 10.11847/zgggws2017-33-02-01
引用本文: 刘佳, 肖焕波, 袁作雄, 鲁杨. 中国成年人群糖尿病筛查肥胖相关身体测量指标分布特征及其适宜切点[J]. 中国公共卫生, 2017, 33(2): 173-176. DOI: 10.11847/zgggws2017-33-02-01
LIU Jia, XIAO Huan-bo, YUAN Zuo-xiong.et al, . Distribution of obesity related anthropometric indicators and optimal cut points for screening diabetes mellitus in Chinese adults[J]. Chinese Journal of Public Health, 2017, 33(2): 173-176. DOI: 10.11847/zgggws2017-33-02-01
Citation: LIU Jia, XIAO Huan-bo, YUAN Zuo-xiong.et al, . Distribution of obesity related anthropometric indicators and optimal cut points for screening diabetes mellitus in Chinese adults[J]. Chinese Journal of Public Health, 2017, 33(2): 173-176. DOI: 10.11847/zgggws2017-33-02-01

中国成年人群糖尿病筛查肥胖相关身体测量指标分布特征及其适宜切点

Distribution of obesity related anthropometric indicators and optimal cut points for screening diabetes mellitus in Chinese adults

  • 摘要: 目的 了解中国成年人群糖尿病(DM)筛查肥胖相关身体测量指标分布特征及其适宜切点,为DM的预防控制提供科学依据。方法 于2009年9-12月采用分层整群随机抽样方法对在黑龙江、辽宁、河南、山东、江苏、湖北、湖南、广西和贵州9个省抽取的8 824名中国成年人群进行体格检查和空腹血糖检测;采用受试者工作特征曲线(ROC)分析各肥胖相关身体测量指标筛检DM的价值,并根据约登指数确定其适宜切点值。结果 调查的8 824名中国成年人群中,DM患病673例,DM患病率为7.63%;男性DM患病率为8.85%,高于女性的6.50%,差异有统计学意义(χ2=17.04,P<0.001);不同年龄成年人群比较,不同年龄男性和女性人群肥胖相关身体测量指标差异均有统计学意义(均P<0.001);在中国成年男性中,腰围(WC)是最适宜筛检DM的肥胖相关身体测量指标,其在18岁~、35岁~、55岁~和≥75岁年龄组筛检DM的受试者工作特征曲线下面积(AUC)均>0.70,WC的适宜切点分别为88.10、84.15、86.90和87.5 cm;在中国成年女性中,筛检DM的适宜肥胖相关身体测量指标随年龄不同呈多元化,腰臀比(WHpR)、腰围身高比(WHtR)和体质指数(BMI)分别为18岁~、35岁~、≥55岁女性人群最适宜筛检DM的肥胖相关身体测量指标,各AUC均>0.67,18岁~人群WHpR、35岁~人群WHtR、35岁~和≥75岁人群BMI的适宜切点分别为0.824、0.528、23.110 kg/m2和21.432 kg/m2结论 WC对中国成年男性人群DM具有较好的筛检价值,WHpR、WHtR和BMI分别对中国18岁~、35岁~、≥55岁女性人群具有较好的筛检价值。

     

    Abstract: Objective To explore distributions and optimal cut points of obesity related anthropometric indicators for screening diabetes mellitus (DM) among Chinese adults and to provide evidences for the prevention and control of DM.Methods Using multi-stage stratified randomized sampling,8 824 Chinese adult permanent residents (≥18 years old) were selected from nine provinces (Heilongjiang,Liaoning,Henan,Shandong,Jiangsu,Hubei,Hunan,Guangxi,and Guizhou province) and surveyed with physical examination and fasting blood glucose (FBG) measurement between September and December 2009.The receiver operating characteristic curve (ROC) was used to study the value of obesity related anthropometric indicators for DM screening and the appropriate cut points were determined based on Youden index.Results Of the 8 824 subjects,673 DM cases were identified,with an overall prevalence rate of 7.63% and a significantly higher prevalence rate among the males than among the females (8.85% vs.6.50%,χ2=17.04;P<0.001).There were significant between-age differences in obesity related anthropometric indicators among both male and female participants (P<0.001).Among the male participants,the waist circumference (WC) was the most suitable obesity related anthropometric indicator for DM screening,with the area under the curve (AUC) values of greater than 0.70 for all various age groups and the optimal cut points of 88.1,84.15,86.9,and 87.5 centimeters for the participants aged 18-34,35-54,55-74,and ≥75 years.While among the female participants,the appropriate obesity related anthropometric indicator for DM screening varied for different age groups;waist-to-hip ratio (WHpR),waist to height ratio (WHtR) and body mass index (BMI) were the most appropriate obesity related anthropometric indicators for DM screening for the participants aged 18-34,35-54,and ≥55 years,with all the AUC values of greater than 0.67;the optimal cut points of the DM screening indicators for the female participants aged 18-34,35-54,55-74,and ≥75 years were 0.824 (WHpR),0.528 (WHtR),23.110 kg/m2 (BMI),and 21.432 kg/m2 (BMI),respectively.Conclusion Waist circumference is an appropriate indicator for DM screening in Chinese adult men,while waist-to-hip ratio,waist to height ratio and body mass index are suitable indicators for DM screening for Chinese women aged 18-34,35-54,and ≥55 years,respectively.

     

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