背景:已证实具有代谢肥胖正常体重(MONW)表型的人显着增加了不利健康后果的风险。本研究旨在研究传统和新型人体测量指标与MONW表型之间的关系,并比较不同人体测量指标在识别具有MONW表型的个体中的预测能力。
方法:这项横断面研究涉及来自南京的26,332名年龄在18岁或以上且体重正常的参与者,中国。社会人口统计信息,生化测量,并收集人体测量指标。新的体脂人体测量指标包括体形指数(ABSI),身体圆度指数(BRI),腹部容积指数(AVI),体重调整腰围指数(WWI),身体肥胖指数(BAI),锥度指数(CI),腰臀身高比(WHHR),以及腰围(WC)等传统指标,臀围(HC),体重指数(BMI),腰臀比(WHR),和腰围高度比(WHtR)。采用改良泊松回归的患病率比(PR)和受试者工作特征曲线下面积(AUC),比较不同肥胖指标对MONW表型的关联和预测能力。所有分析均按性别分层。
结果:改进的泊松回归分析显示体重,WC,HC,BMI,WHR,WHtR,ABSI,BRI,AVI,WWI,BAI,CI和WHHR与MONW表型的高风险独立相关,无论它们被视为连续变量还是分类变量(P<0.05)。值得注意的是,BRI在男性(最高四分位数与最低四分位数;PR=3.14,95CI,2.49,3.96;P<0.001)和女性(PR=4.63,95CI,3.81,5.62;P<0.001)中表现出最强的相关性。接收器工作特性分析表明,不同人体测量指标的AUC范围为0.50至0.80。BRI和WHtR在男性(AUC均=0.733;95%CI,0.717,0.750)和女性(AUC均=0.773;95%CI,0.761,0.786)中的AUC最大。BRI的最佳截止点,通过最大化尤登指数来确定,为3.102(灵敏度:63.2%,特异性:36.2%)男性和3.136(灵敏度:68.9%,特异性:44.2%)女性。此外,BRI和WHtR在年轻年龄组中表现出最高的诊断准确性,特别是18-34岁的男女。
结论:BRI成为MONW表型的最佳预测因子和独立决定因子,不分性别。这种关联在年轻人中尤为明显。
BACKGROUND: People with the metabolically obese normal weight (MONW) phenotype have been confirmed to significantly increase the risk of unfavorable health consequences. This study aimed to investigate the relationships between traditional and novel anthropometric indices with the MONW phenotype and compare the predictive ability of different anthropometric indices in identifying individuals with the MONW phenotype.
METHODS: This cross-sectional study involved a total of 26,332 participants aged 18 years or older with a normal weight from Nanjing, China. Sociodemographic information, biochemical measurements, and anthropometric indices were collected. The novel body fat anthropometric indices included body shape index (ABSI), body roundness index (BRI), abdominal volume index (AVI), weight-adjusted-waist index (WWI), body adiposity index (BAI), conicity index (CI), waist-hip-height ratio (WHHR), as well as traditional indices such as waist circumference (WC), hip circumference (HC), body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR).The prevalence ratio (PR) from modified poisson regression and area under the receiver-operating characteristic curve (AUC) were conducted to compare the association and predictive capacity of different obesity indicators for the MONW phenotype. All analyses were stratified by sex.
RESULTS: Modified poisson regression analyses revealed that weight, WC, HC, BMI, WHR, WHtR, ABSI, BRI, AVI, WWI, BAI, CI, and WHHR were independently associated with higher risk of the MONW phenotype, regardless of whether they were treated as a continuous or categorical variable (P < 0.05). Notably, BRI demonstrated the strongest association in both men (highest quartile VS lowest quartile; PR = 3.14, 95%CI, 2.49, 3.96; P < 0.001) and women (PR = 4.63, 95%CI, 3.81, 5.62; P < 0.001). Receiver operating characteristic analysis indicated that AUC for the different anthropometric indices ranged from 0.50 to 0.80. BRI and WHtR had the largest AUC in both males (both AUC = 0.733; 95% CI, 0.717, 0.750) and females (both AUC = 0.773; 95% CI, 0.761, 0.786). The optimal cut-off points for BRI, determined by maximizing the Youden\'s index, were 3.102 (sensitivity: 63.2%, specificity: 36.2%) in males and 3.136 (sensitivity: 68.9%, specificity: 44.2%) in females. Moreover, BRI and WHtR exhibited the highest diagnostic accuracy in younger age groups, specifically those aged 18-34 in both sexes.
CONCLUSIONS: BRI emerged as the optimal predictor and independent determinant of the MONW phenotype, regardless of gender. This association was particularly pronounced in young individuals.