Impact of Waist Circumference and Body Mass Index on Risk of Cardiometabolic Disorder and Cardiovascular Disease in Chinese Adults: A National Diabetes and Metabolic Disorders Survey
单位：[1]Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China[2]Department of Endocrinology and Metabolism, Chinese People’s Liberation Army General Hospital, Beijing, China[3]Department of Endocrinology and Metabolism, Sun Yat-sen University Third Hospital, Guangzhou, China中山大学附属第三医院[4]Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China[5]Department of Endocrinology and Metabolism, First Affiliated Hospital, Chinese Medical University, Shenyang, Liaoning, China[6]Department of Endocrinology and Metabolism, Shanxi Province People’s Hospital, Taiyuan, Shanxi, China[7]Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China四川大学华西医院[8]Department of Endocrinology and Metabolism, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China[9]Department of Endocrinology and Metabolism, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China[10]Department of Endocrinology and Metabolism, Xinjiang Uygur Autonomous Region’s Hospital, Urmqi, Xinjiang, China[11]Department of Endocrinology and Metabolism, Fujian Provincial Hospital, Fuzhou, Fujiang, China[12]Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, China[13]Peking University First Hospital, Beijing, China[14]Department of Endocrinology and Metabolism, Henan Province People’s Hospital, Zhengzhou, Henan, China[15]Department of Endocrinology and Metabolism, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China[16]Department of Endocrinology and Metabolism, Xiangya Second Hospital, Changsha, Hunan, China[17]Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China[18]Department of Endocrinology and Metabolism, China–Japan Friendship Hospital, Beijing, China
Background: We updated the prevalence of obesity and evaluated the clinical utility of separate and combined waist circumference (WC) or body mass index (BMI) category increments in identifying cardiometabolic disorder (CMD) and cardiovascular disease (CVD) risk in Chinese adults. Methods and Findings: 46,024 participants aged >= 20 years, a nationally representative sample surveyed in 2007-2008, were included in this analysis. Taking the cutoffs recommended by the Chinese Joint Committee for Developing Chinese Guidelines (JCDCG) and the Working Group on Obesity in China (WGOC) into account, the participants were divided into four WC and four BMI groups in 0.5-SD increments around the mean, and 16 cross-tabulated combination groups of WC and BMI. 27.1%, 31.4%, and 12.2% of Chinese adults are centrally obese, overweight, or obese according to JCDCG and WGOC criteria. After adjustment for confounders, after a 1-SD increment, WC is associated with a 1.7-fold or 2.2-fold greater risk of having DM or DM plus dyslipidemia than BMI, while BMI was associated with a 2.3-fold or 1.7-fold higher hypertension or hypertension plus dyslipidemia risk than WC. The combination of WC and BMI categories had stronger association with CMD risk, i.e., the adjusted ORs (95% CI) of having DM, hypertension, and dyslipidemia for the combined and separate highest WC and BMI categories were 2.19 (1.96-2.44) vs 1.88 (1.67-2.12) and 1.12 (0.99-1.26); 5.70 (5.24-6.19) vs 1.51 (1.39-1.65) and 1.69 (1.57-1.82); and 3.73 (3.42-4.07) vs 2.16 (1.98-2.35) and 1.33 (1.25-1.40), respectively. The combination of WC and BMI categories was more likely to identify individuals with lower WC and lower BMI at CVD risk, even after the effects of CMD were controlled (all P<0.05). Conclusion: Central obesity, overweight, and obesity are epidemic in Chinese adults. The combination of WC and BMI measures is superior to the separate indices in identifying CMD and CVD risk.
基金：
Chinese Medical Association Foundation; Chinese Diabetes Society
第一作者单位：[1]Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China
通讯作者：
推荐引用方式(GB/T 7714)：
Hou Xuhong,Lu Juming,Weng Jianping,et al.Impact of Waist Circumference and Body Mass Index on Risk of Cardiometabolic Disorder and Cardiovascular Disease in Chinese Adults: A National Diabetes and Metabolic Disorders Survey[J].PLOS ONE.2013,8(3):doi:10.1371/journal.pone.0057319.
APA：
Hou, Xuhong,Lu, Juming,Weng, Jianping,Ji, Linong,Shan, Zhongyan...&Jia, Weiping.(2013).Impact of Waist Circumference and Body Mass Index on Risk of Cardiometabolic Disorder and Cardiovascular Disease in Chinese Adults: A National Diabetes and Metabolic Disorders Survey.PLOS ONE,8,(3)
MLA：
Hou, Xuhong,et al."Impact of Waist Circumference and Body Mass Index on Risk of Cardiometabolic Disorder and Cardiovascular Disease in Chinese Adults: A National Diabetes and Metabolic Disorders Survey".PLOS ONE 8..3(2013)
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