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广西壮族人群体脂率与常规肥胖指标的关系及其切点值研究

吕芳芳 莫彩梅 雷立地 李金秀 韦港杰 陆佩妮 许雪梅 黄泫茜 曾小云 仇小强 刘顺

吕芳芳, 莫彩梅, 雷立地, 李金秀, 韦港杰, 陆佩妮, 许雪梅, 黄泫茜, 曾小云, 仇小强, 刘顺. 广西壮族人群体脂率与常规肥胖指标的关系及其切点值研究[J]. 中华疾病控制杂志, 2024, 28(8): 937-943. doi: 10.16462/j.cnki.zhjbkz.2024.08.011
引用本文: 吕芳芳, 莫彩梅, 雷立地, 李金秀, 韦港杰, 陆佩妮, 许雪梅, 黄泫茜, 曾小云, 仇小强, 刘顺. 广西壮族人群体脂率与常规肥胖指标的关系及其切点值研究[J]. 中华疾病控制杂志, 2024, 28(8): 937-943. doi: 10.16462/j.cnki.zhjbkz.2024.08.011
LYU Fangfang, MO Caimei, LEI Lidi, LI Jinxiu, WEI Gangjie, LU Peini, XU Xuemei, HUANG Xuanqian, ZENG Xiaoyun, QIU Xiaoqiang, LIU Shun. Relationship between body fat percentage and conventional obesity indicators and its cut-off values in Guangxi Zhuang population[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(8): 937-943. doi: 10.16462/j.cnki.zhjbkz.2024.08.011
Citation: LYU Fangfang, MO Caimei, LEI Lidi, LI Jinxiu, WEI Gangjie, LU Peini, XU Xuemei, HUANG Xuanqian, ZENG Xiaoyun, QIU Xiaoqiang, LIU Shun. Relationship between body fat percentage and conventional obesity indicators and its cut-off values in Guangxi Zhuang population[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(8): 937-943. doi: 10.16462/j.cnki.zhjbkz.2024.08.011

广西壮族人群体脂率与常规肥胖指标的关系及其切点值研究

doi: 10.16462/j.cnki.zhjbkz.2024.08.011
基金项目: 

国家重点研发计划 2017YFC0907103

详细信息
    通讯作者:

    刘顺,E-mail: liushun@gxmu.edu.cn

  • 中图分类号: R181.3

Relationship between body fat percentage and conventional obesity indicators and its cut-off values in Guangxi Zhuang population

More Information
  • 摘要:   目的   探讨广西壮族自治区35~<75岁壮族人群体脂率(body fat percentage, BFP)与BMI和腰围(waist circumference, WC)的关系及其肥胖切点值。  方法   基于2018―2019年广西壮族自治区少数民族自然人群慢性病前瞻性队列的基线调查资料,选取12 311名壮族人群作为研究对象。通过曲线拟合确定BFP与BMI、WC的曲线关系,利用多元线性回归模型分析BFP的主要影响因素,分别构建BMI、WC预测BPF回归方程以计算BPF的超重和肥胖切点值,以BMI、WC判定标准为金标准计算BFP相应切点值的灵敏度、特异度和受试者工作特征(receiver operating characteristic, ROC)曲线下面积(area under curve, AUC)评估其诊断价值。  结果   BMI对BFP的预测价值优于WC;基于我国肥胖标准BMI为28 kg/m2计算的BFP肥胖切点值在男性和女性中分别为23.4%和35.6%,AUC分别为0.732和0.847;对应的灵敏度和特异度,男性为0.581和0.882,女性为0.818和0.876。  结论   在广西壮族自治区人群中,基于我国肥胖标准计算BFP切点值应以BMI为参考,计算出来的切点值在男性中低于国际标准,而以BMI≥30 kg/m2时计算所得切点值均高于国际标准,其合理性还需综合考虑阳性预测值和未来肥胖相关疾病风险的研究进一步予以验证。
  • 图  1  研究人群筛选流程图

    BFP:体脂率;WC:腰围。

    Figure  1.  Flow chart for screening the study population

    BFP: body fat percentage; WC: waist circumference.

    表  1  研究对象一般特征及肥胖情况

    Table  1.   General characteristics and obesity prevalence of the study subjects

    特征 Characteristic 总人数 Total (n=12 311) 男性 Male (n=5 968) 女性 Female (n=6 343) χ2值 value P值 value
    年龄组/岁Age group/years 187.9 < 0.001
      35~<45 2 679(21.8) 1 547(25.9) 1 132(17.8)
      45~<55 3 869(31.4) 1 976(33.1) 1 893(29.8)
      55~<65 2 992(24.3) 1 252(21.0) 1 740(27.4)
      65~<75 2 771(22.5) 1 193(20.0) 1 578(24.9)
    受教育水平Level of education 1 689.0 < 0.001
      小学及以下Primary school and below 6 257(50.8) 1 934(32.4) 4 323(68.2)
      初中Middle school 3 768(30.6) 2 307(38.7) 1 461(23.0)
      高中及以上High school and above 2 286(18.6) 1 727(28.9) 559(8.8)
    家庭年收入Annual household income/10 000 yuan 303.3 < 0.001
      <3 6 535(53.1) 2 727(45.7) 3 808(60.0)
      3~<10 4 624(37.6) 2 488(41.7) 2 136(33.7)
      ≥10 1 152(9.4) 753(12.6) 399(6.3)
    职业Career 273.6 < 0.001
      农民Farmer 6 467(52.5) 2 677(44.9) 3 790(59.8)
      非农Non farmer 5 844(47.5) 3 291(55.1) 2 553(40.2)
    婚姻状况Marital status 52.4 < 0.001
      未婚和其他Unmarried and others 1 368(11.1) 537(9.0) 831(13.1)
      已婚Married 10 943(88.9) 5 431(91.0) 5 512(86.9)
    吸烟Smoking 4 458.0 < 0.001
      从未Never 9 145(74.3) 2 815(47.2) 6 330(99.8)
      戒烟Quit smoking 695(5.6) 693(11.6) 2(0)
      当前Current 2 471(20.1) 2 460(41.2) 11(0.2)
    饮酒Drinking 943.3 < 0.001
      否No 10 179(82.7) 4 290(71.9) 5 889(92.8)
      是Yes 2 132(17.3) 1 678(28.1) 454(7.2)
    体力活动Physical activity 91.7 < 0.001
      不活动Inactive 6 564(53.3) 3 122(52.3) 3 442(54.3)
      中等强度Moderate intensity 2 653(21.5) 1 160(19.4) 1 493(23.5)
      高强度High strength 1 707(13.9) 993(16.6) 714(11.3)
      中等兼有高强度Medium to high intensity 1 387(11.3) 693(11.6) 694(10.9)
    BFP肥胖BFP obesity 1 978(16.1) 657(11.0) 1 321(20.8) 219.8 < 0.001
    BMI肥胖BMI obesity 1 171(9.5) 573(9.6) 598(9.4) 0.1    0.743
    WC肥胖WC obesity 3 691(30.0) 1 630(27.3) 2 061(32.5) 39.3 < 0.001
    注:BFP, 体脂率;WC, 腰围。
    ①以人数(占比/%)表示。
    Note: BFP, body fat percentage;WC, waist circumference.
    ① Number of people(proportion/%).
    下载: 导出CSV

    表  2  BFP与BMI、WC的曲线拟合分析

    Table  2.   Curve fitting analysis of BFP with BMI and WC

    方程 Equation BMI预测BFP BMI prediction for BFP WC预测BFP WC prediction for BFP
    R2 F R2 F
    线性 Linear 0.884 93 969.421 0.862 76 981.040
    二次 Secondary 0.890 50 016.741 0.863 38 930.012
    三次 Thrice 0.892 34 038.505 0.863 38 930.012
    注:WC, 腰围;BFP, 体脂率。
    Note: WC, waist circumference; BFP, body fat percentage.
    下载: 导出CSV

    表  3  BFP主要影响因素筛选

    Table  3.   Screening of main influencing factors of BFP

    模型 Model 决定系数 R2 方程 Equation
    性别 Gender 0.371 y= 28.379-11.906×性别 y= 28.379-11.906×gender
    性别+职业 Gender+occupation 0.383 y= 27.503-12.23×性别+2.175×职业 y= 27.503-12.23×gender+2.175×occupation
    性别+职业+体力活动 Gender+occupation+physical activity 0.388 y= 28.123-12.137×性别+1.94×职业-0.665×体力活动
    y= 28.123-12.137×gender+1.94×occupation-0.665×physical activity
    性别+职业+体力活动+吸烟
    Gender+occupation+physical activity+smoking
    0.389 y= 28.129-11.539×性别+1.942×职业-0.672×体力活动-0.638×吸烟
    y= 28.129-11.539×gender+1.942×occupation-0.672×physical activity-0.638×smoking
    性别+职业+体力活动+吸烟+家庭年收入Gender+occupation+physical activity+smoking+annual family income 0.390 y= 28.009-11.609×性别+1.719×职业-0.689×体力活动-0.633×吸烟+0.485×家庭年收入
    y= 28.009-11.609×gender+1.719×occupation-0.689×physical activity-0.633×smoking+0.485×annual family income
    性别+职业+体力活动+吸烟+家庭年收入+年龄Gender+occupation+physical activity+smoking+annual family income+age 0.391 y=27.485-11.588×性别+1.782×职业-0.671×体力活动-0.633×吸烟+0.538×家庭年收入+0.177×年龄
    y=27.485-11.588×gender+1.782×occupation-0.671×physical activity-0.633×smoking+0.538×annual family income+0.177×age
    注:BFP, 体脂率。
    Note: BFP, body fat percentage.
    下载: 导出CSV

    表  4  BFP预测方程构建

    Table  4.   Construction of BFP prediction equation

    模型 Model 决定系数 R2 方程 Equation
    BMI
      线性 Linear 0.699 y=-9.463-12.198×性别+1.616×BMI y=-9.463-12.198×gender+1.616×BMI
      二次 Secondary 0.700 y=-21.83-12.198×性别+2.666×BMI-0.022×BMI2 y=-21.83-12.198×gender+2.666×BMI-0.022×BMI2
      三次 Thrice 0.711 y=62.434-12.216×性别+0.437×BMI2-8.246×BMI-0.006BMI3 y=62.434-12.216×gender+0.437×BMI2-8.246×BMI-0.006BMI3
    WC
      线性 Linear 0.610 y=-12.679-13.729×性别+0.51×WC y=-12.679-13.729×gender+0.51×WC
      二次 Secondary 0.611 y=-28.076-13.739×性别+0.888×WC-0.002×WC2 y=-28.076-13.739×gender+0.888×WC-0.002×WC2
      三次 Thrice 0.611 y==-23.636-13.74×性别+0.712×WC-0.000009661×WC3 y==-23.636-13.74×gender+0.712×WC-0.000009661×WC3
    注:WC, 腰围;BFP, 体脂率。
    Note: WC, waist circumference; BFP, body fat percentage.
    下载: 导出CSV

    表  5  基于BMI、WC超重/肥胖标准计算的BFP切点值及诊断价值

    Table  5.   Corresponding BFP cut-off values and performance for diagnosing over-weight/obesity based on BMI and WC

    肥胖程度判定依据 Basis for determining obesity level BFP(%) 灵敏度 Sensitivity 特异度 Specificity 约登指数 Youden′s index ROC曲线下面积 Area under ROC curve
    男性Male
      超重/肥胖Overweight/Obesity (BMI≥24 kg/m2) 17.3 0.692 0.759 0.451 0.726
      超重/肥胖Overweight/Obesity (BMI≥25 kg/m2) 18.9 0.644 0.789 0.433 0.716
      肥胖Obesity (BMI≥28 kg/m2) 23.4 0.581 0.882 0.463 0.732
      肥胖Obesity (BMI≥30 kg/m2) 26.2 0.523 0.935 0.458 0.729
      肥胖Obesity (WC≥90 cm) 19.5 0.618 0.785 0.403 0.701
    女性Female
      超重/肥胖Overweight/Obesity (BMI≥24 kg/m2) 29.5 0.822 0.775 0.597 0.798
      超重/肥胖Overweight/Obesity (BMI≥25 kg/m2) 31.1 0.807 0.796 0.603 0.801
      肥胖Obesity (BMI≥28 kg/m2) 35.6 0.818 0.876 0.694 0.847
      肥胖Obesity (BMI≥30 kg/m2) 38.4 0.814 0.928 0.742 0.871
      肥胖Obesity (WC≥85 cm) 30.7 0.711 0.740 0.451 0.726
    注:WC, 腰围;BFP, 体脂率;ROC, 受试者工作特征。
    Note: WC, waist circumference; BFP, body fat percentage; ROC, receiver operating characteristic.
    下载: 导出CSV
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出版历程
  • 收稿日期:  2023-11-30
  • 修回日期:  2024-04-17
  • 网络出版日期:  2024-09-29
  • 刊出日期:  2024-08-10

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