Objective Central obesity is considered to be a central component of metabolic syndrome. Waist circumference （WC） has been widely used as a simple indicator of central obesity. This study is aimed to evaluate the sensitivity of WC cut-off values for predicting metabolic risk factors in middle-aged Chinese. Methods The study involved 923 subjects aged according to the Chinese Joint Committee for 40-65 years. The metabolic risk factors were defined Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. WC cut-off 85-90 cm and 〉90 cm were used as cut-off values of central pre-obesity and central obesity in males, respectively, while WC 80-85 cm and 〉85 cm were used as cut-off values of central pre-obesity and central obesity in females. Results First, WC values corresponding to body mass index （BMI） 24 kg/m2 and visceral fat area （VFA） 80 cm2 were 88.55 cm and 88.51 cm in males, and 82.46 cm and 82.52 cm in females respectively. Second, receiver operating characteristic curves showed that the optimal WC cut-off of value was 88.75 cm in males, higher than that in females （81.75 cm）. Third, the subjects with higher WC values were more likely to have accumulating metabolic risk factors. The prevalence of metabolic risk factors increased linearly and significantly in relation to WC levels. Conclusion WC cut-off values of central pre-/central obesity are optimal to predict multiple metabolic risk factors.
YIN Xue YaoZHENG Fen PingZHOU Jia QiangDU YingPAN Qian QianZHANG Sai FeiYU DanLI Hong
目的：探讨重庆市7~16岁儿童青少年代谢综合征（metabolic syndrome,MS）的组分及其影响因素,为有针对性的干预提供流行病学依据。方法：按照整群随机抽样方法抽取重庆市5所中小学7~16岁在校生共4481名进行代谢指标及影响因素问卷调查。按照体质指数（body mass index,BMI）法分为正常组、超重组、肥胖组。对各代谢指标进行分析,对MS影响因素进行Logistic回归分析,并比较MS影响因素的性别差异。结果：（1）重庆地区7~16岁儿童青少年总超重率9.8%,其中男生12.0%,女生7.4%。总肥胖率5.4%,其中男生7.3%,女生3.4%。男生超重率、肥胖率均高于女生（P〈0.05）。（2）随着BMI的增加,收缩压、舒张压、甘油三酯、胆固醇、低密度脂蛋白胆固醇、非高密度脂蛋白胆固醇、腰围有升高的趋势,高密度脂蛋白胆固醇呈降低趋势（P〈0.05）。（3）MS总体检出率为0.45%。肥胖组MS的患病率（6.9%）明显高于超重组（0.5%）和正常组（0.0%）（P〈0.05）,且男生患病率高于女生（P〈0.05）。肥胖儿童MS出现单项异常的检出率依次为高腰围（37.9%）、高甘油三酯（22.7%）、低高密度脂蛋白（19.7%）、高非高密度脂蛋白（7.4%）、高血压（4.4%）、高空腹血浆葡萄糖（2.0%）。（4）MS影响因素logistic回归分析结果显示,有3个因素与MS相关：腰围、每次肉类摄入量、高血脂家族史均与MS的发病率呈正相关。男生高腰围、每次肉类摄入量≥3两检出率高于女生（P〈0.05）。结论：MS组分异常已在重庆地区超重肥胖儿童青少年中发生。高腰围、高甘油三酯、低高密度脂蛋白是重庆肥胖儿童最常见的代谢异常,应引起社会的重视。
目的探讨孕中期血糖水平与不良妊娠结局的关系。方法回顾性分析2010年8月至2011年1月孕24周起于湖北省妇幼保健院产科行50 g葡萄糖负荷试验(glucose challenge test,GCT)的693例单胎自然受孕孕妇的临床资料,检测孕晚期孕妇空腹血糖(FBG)、空腹血清胰岛素、分娩后即刻脐血血糖及脐血胰岛素水平。分析孕中期50 g GCT血糖水平与不良妊娠结局的关系。结果 50 g GCT血糖水平分组:剖宫产的发生率随孕妇血糖水平升高而逐渐下降(P=0.000)。随孕妇血糖水平升高,妊娠高血压、剖宫产、早产及大于胎龄儿(LGA)的发生无固定优势趋势。但从第3组开始,患妊娠高血压的可能性递增,早产发生的可能性也呈递增趋势,剖宫产发生的可能性呈递减趋势,而第4组LGA发生率最高。FBG水平分组:剖宫产和早产的发生率在不同血糖水平中差异具有显著性。剖宫产发生的可能性随FBG的升高而递减,从第3组开始,患妊娠高血压的可能性递增,早产发生的可能性亦递增,而第5组LGA发生率最高。孕中期50 g GCT血糖水平与母亲胰岛素、脐血胰岛素、脐血血糖均无明显相关性(P>0.05),孕晚期FBG水平与母亲胰岛素、脐血胰岛素、脐血血糖的偏相关系数分别为0.402、0.080、0.159。按孕晚期FBG分组,母亲胰岛素及脐血胰岛素水平呈明显上升趋势(P<0.05)。结论在一定血糖范围内,LGA发生的可能性随孕中期50 g GCT血糖升高而升高。而随着孕期血糖升高,妊娠高血压及早产发生的可能性呈相似变化,剖宫产发生的可能性降低。
