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目的确定城市中学生腰围身高比值(WHtR)的界值点并制作WHtR的百分位数曲线图,为临床评价儿童青少年生长发育和防控心血管疾病提供参考。方法对北京、绍兴、广州、太原、哈尔滨、鄂州、重庆和贵阳8个城市28所中学的初一、初二、高一、高二学生11 307名进行人体测量。采用偏相关和受试者工作特征曲线分析方法,分析WHtR与心血管疾病危险因素的关联强度,确定WHtR的界值点;采用LMS法建立WHtR的百分位数曲线。结果与WHtR关联性最强的2个因素是收缩压和三酰甘油,男生WHtR与收缩压和三酰甘油的相关系数分别为0.32和0.16(P值均<0.01),女生的相关系数分别为0.23和0.09(P值均<0.01);用关联性最强的2个因素(性别年龄组P85)预测WHtR的界值点,男、女生分别为0.436和0.450。百分位数曲线显示,12～13岁男生WHtR各百分位数曲线普遍高于女生,14～18岁女生WHtR的各百分位数曲线普遍高于男生。男生从12岁以后WHtR的P50开始下降,15岁WHtRP50最低,16岁以后又开始增加;女生WHtRP5012岁开始相对平稳,15岁开始升高。结论 WHtR可考虑用于临床监测,用LMS方法制定的WHtR百分位数曲线可正确反映儿童青少年生长发育。
Objective To determine the cut - off point of waist height ratio (WHtR) of urban middle school students and to make the curve of WHtR percentile, so as to provide a reference for the clinical evaluation of the growth and development of children and adolescents and prevention and treatment of cardiovascular diseases. Methods The anthropometry was performed on 11,307 students of first, second, first and second year senior high school in 28 high schools in eight cities of Beijing, Shaoxing, Guangzhou, Taiyuan, Harbin, Ezhou, Chongqing and Guiyang. Partial correlation and receiver operating characteristic curve analysis were used to analyze the association between WHtR and risk factors of cardiovascular disease and to determine the cutoff point of WHtR. The WHtR percentile curve was established by LMS. Results The two factors that had the strongest association with WHtR were systolic blood pressure and triglyceride. The correlation coefficient of WHtR to systolic blood pressure and triglyceride were 0.32 and 0.16 respectively (all P <0.01), and the correlation coefficients were 0.23 and 0.09, respectively (all P <0.01). The WHtR cut-off point was predicted by two factors with the highest correlation (P85 of gender). The male and female were 0.436 and 0.450 respectively. The percentile curve showed that the WHtR percentiles for boys aged 12 to 13 were generally higher than those for girls, and the WHtR percentiles for girls aged 14 to 18 were generally higher than those for boys. WHtR boys from 12 years old after the P50 began to decline, the lowest 15-year-old WHtRP50, began to increase after 16 years of age; girls WHtRP5012 began relatively stable, 15-year-old began to rise. Conclusions WHtR can be considered for clinical monitoring. The WHtR percentile curve formulated by LMS can accurately reflect the growth and development of children and adolescents.