Objectives To evaluate the optimal cutoffs of body mass index ( BMI ), waist circumference ( WC ) and waist - height ratio ( WHtR ) in screening hypertension, hyperglycemia, and dyslipidemia. Methods A total of 20 000 participants aged 18 ~ 59 were chosen by cluster sampling method in Chongqing population. Height, weight, WC, blood pressure, fast plasma glucose, total cholesterol, triglyceride, and high density lipoprotein cholesterol were measured. Partial correlations were used to evaluate the performances of 3 anthropometric indices, hypertension, hyperglycemia and dyslipidemia. Areas under curves ( AUCs ) were estimated by maximizing the sums of sensitivity and specificity. Results WHtR was correlated significantly with WC ( r =0. 938 in male, r =0. 934 in female, P <0. 05 ). WHtR showed the largest AUCs in 3 indicators. Significantly difference was noted in AUCs clustered by blood glucose, dyslipidemia and any risk factors between BMI and WC, BMI and WHtR in males, and in AUCs by dyslipidemia and any risk factors between BMI and WHtR in females. Optimal cutoffs for BMI were 23. 29 -25. 38 kg/m2 in males, 22. 19 ~ 23. 81 kg/m2 in females, respectively; for WC 83. 25 ~ 85. 25 cm, 73. 40 ~ 75.25 cm, respectively; for WHtR 0. 50 ~0. 52, 0.48-0.49, respectively. Conclusion WHtR and WC can serves as effective predictors for cardiovascular risks in Chinese.%目的 探讨体质指数(BMI)、腰围(WC)及腰围身高比值(WHtR)对高血压、高血糖及高血脂的预测效果,找出最佳的预测切点.方法采用整群抽样,对重庆市20 000 名18～59 岁的在职成年人进行流行病学调查,测量身高、腰围、体质量,检测血压、血糖、血脂水平.分析3种人体测量指标间以及与高血压、高血糖和血脂异常的相关性,采用受试者工作特征曲线(ROC)分析计算不同水平的测量指标识别心血管疾病危险的敏感性和特异性,比较曲线下面积,找出ROC曲线距离最短的切点.结果 WHtR与WC腰围相关性最强(男性r=0.938;女性r=0.934,P＜0.05).3个指标中WHtR的ROC曲线下面积最大,男性高血糖、血脂异常和危险因素聚集的ROC曲线下面积BMI与WC比较,BMI与 WHtR比较,差异有统计学意义(P＜0.05),女性血脂异常和危险因素聚集的ROC曲线下面积BMI与 WHtR比较,差异有统计学意义(P＜0.05).BMI的预测值范围男性为23.29～25.38 kg/m2,女性为22.19～23.81 kg/m2;WC预测值男性为83.25～85.25 cm,女性为73.40～75.25 cm;WHtR的预测值为男性0.50～0.52,女性0.48～0.49.结论 WHtR 和WC是预测是心血管疾病危险的较理想的评定指标.
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