Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis

被引:844
作者
Lee, Crystal Man Ying [1 ]
Huxley, Rachel R. [1 ]
Wildman, Rachel P. [2 ]
Woodward, Mark [3 ]
机构
[1] Univ Sydney, Nutr & Lifestyle Div, George Inst Int Hlth, Sydney, NSW 2050, Australia
[2] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, New York, NY USA
[3] Mt Sinai Med Ctr, Dept Med, New York, NY 10029 USA
基金
英国医学研究理事会;
关键词
body mass index; cardiovascular risk factors; meta-analysis; obesity; ROC curve; waist-to-height ratio;
D O I
10.1016/j.jclinepi.2007.08.012
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective: To determine which simple index of overweight and obesity is the best discriminator of cardiovascular risk factors. Study Design and Setting: This is a meta-analysis of published literature. MEDLINE was searched. Studies that used receiver-operating characteristics (ROC) curve analysis and published area under the ROC curves (AUC) for overweight and obesity indices with hypertension, type-2 diabetes, and/or dyslipidemia were included. The AUC for each of the four indices, with each risk factor, was pooled using a random-effects model; male and female data were analyzed separately. Results: Ten studies met the inclusion criteria. Body mass index (BMI) was the poorest discriminator for cardiovascular risk factors. Waist-to-height ratio (WHtR) was the best discriminator for hypertension, diabetes, and dyslipidemia in both sexes; its pooled AUC (95% confidence intervals) ranged from 0.67 (0.64, 0.69) to 0.73 (0.70, 0.75) and from 0.68 (0.63, 0.72) to 0.76 (0.70, 0.8 1) in males and females, respectively. Conclusion: Statistical evidence supports the superiority of measures of centralized obesity, especially WHtR, over BMI, for detecting cardiovascular risk factors in both men and women. (c) 2008 Elsevier Inc. All rights reserved.
引用
收藏
页码:646 / 653
页数:8
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