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目的利用受试者工作特征(ROC)曲线探讨体重指数(BMI)、颈围、腰围及腰臀比等不同的肥胖参数预测、筛查、确诊成年男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的最佳切点或参考切点并比较其价值。方法分析1110例成年男性患者的BMI、颈围、腰围及腰臀比与呼吸暂停低通气指数(AHI)之间的相关关系;用ROC曲线确定BMI、颈围、腰围、腰臀比预测OSAHS(AHI≥5次/h)的最佳切点及筛查、确诊OSAHS的参考切点;用ROC曲线下面积(AUC)判断各肥胖参数的整体准确性。结果①成年男性BMI、颈围、腰围及腰臀比均与AHI呈正相关,其相关系数分别为0.373、0.276、0.291、0.127,P值均<0.001;②BMI、颈围、腰围检出OSAHS的最佳切点值分别为26.5 kg/m~2、39 cm、95 cm,其诊断灵敏度分别为54%、57%、64%,特异度分别为73%、65%、53%;③ROC曲线分析显示BMI在检出成年男性患者有无OSAHS存在时比其他肥胖参数更有价值;④灵敏度达90%左右,漏诊率10%左右时不同肥胖参数筛查OSAHS的切点分别为BMI 23 kg/m~2、颈围35 cm、腰围85 cm;⑤特异度达90%左右,误诊率10%左右时不同肥胖参数确诊OSAHS的切点分别为BMI 29 kg/m~2、颈围43 cm、腰围105 cm。结论BMI预测成年男性OSAHS的价值大于颈围、腰围、腰臀比;BMI≥26.5 kg/m~2、颈围≥39 cm、腰围≥95 cm可作为预测成年男性OSAHS的最佳切点;BMI≥23 kg/m。、颈围≥35 cm、腰围≥85cm可作为筛查成年男性OSAHS的参考标准;BMI≥29 kg/m~2、颈围≥43 cm、腰围≥105 cm可作为诊断成年男性OSAHS的参考标准。
OBJECTIVE: To investigate the relationship between body mass index (BMI), neck circumference, waist circumference and waist-hip ratio (BMI) in obese subjects using obstructive sleep apnea hypopnea syndrome (OSAHS ) The best cut point or reference point and compare its value. Methods The relationship between BMI, neck circumference, waist circumference, waist-hip ratio and apnea-hypopnea index (AHI) was analyzed in 1110 adult male patients. The BMI, neck circumference, waist circumference and waist- AHI≥5 beats / h) and screened to confirm the reference point of OSAHS. The overall accuracy of each obesity parameter was judged by the area under ROC curve (AUC). Results ① The BMI, neck circumference, waist circumference and waist-to-hip ratio of adult men were all positively correlated with AHI, the correlation coefficients were 0.373,0.276,0.291,0.127, P <0.001 respectively; The diagnostic sensitivity was 54%, 57%, 64%, specificity was 73%, 65%, 53%, respectively. The ROC curve analysis showed that the best cut point value was 26.5 kg / m ~ BMI in the detection of adult male patients with or without OSAHS more valuable than other obesity parameters; ④ sensitivity of about 90%, missed the diagnosis rate of about 10% OSAHS obesity parameters were cut point BMI 23 kg / m ~ 2, neck circumference of 35 cm, waist circumference of 85 cm; ⑤ specificity of about 90%, misdiagnosis rate of about 10% when different obesity parameters confirm OSAHS cut points were BMI 29 kg / m ~ 2, neck circumference 43 cm, waist circumference 105 cm. Conclusion BMI predicts the value of OSAHS in adult men is greater than that of neck circumference, waist circumference and waist-to-hip ratio; BMI≥26.5 kg / m ~ 2, neck circumference≥39 cm, waist circumference≥95 cm can be used as the best cutoff point for predicting OSAHS in adult men; ≥23 kg / m. , Neck circumference ≥35 cm, waist circumference ≥85 cm can be used as a reference standard for screening adult male OSAHS; BMI≥29 kg / m ~ 2, neck circumference ≥43 cm, waist circumference ≥105 cm can be used as a reference standard for diagnosis of adult male OSAHS.