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目的 建立一个能够综合反映个体肥胖程度的指标,为慢病高危人群的筛查提供有力的工具.方法 应用2002年中国居民营养与健康状况调查资料,通过分析体重指数和腰围与相关慢性病指标的相关程度初步建立慢病风险指数,应用受试者工作特征曲线(ROC曲线)确定慢病风险指数的切点,并比较慢病风险指数、体重指数和腰围对慢性病的预测效率,进而分析慢病风险指数与体重指数和腰围预测慢病的一致性及不同慢病风险指数水平下相关慢性病的患病风险.结果 初步建立的慢病风险指数公式为慢病风险指数=体质指数+3.5腰围,ROC曲线分析显示慢病风险指数切点为300,并且慢病风险指数比体重指数和腰围有更高的筛查效率.慢病风险指数与体重指数、腰围分别有很高的一致性(P＜0.05).与慢病风险指数小于300组人群相比,慢病风险指数每增加20单位,相应慢病患病危险也大幅增长.结论 慢病风险指数对相关慢性病有较好的筛查效率,能够综合反映个体的肥胖程度,可以作为高危人群筛查的参考值.

Objectives To develop a measurement for obesity assessment which could be used as a simple tool of risk screening. Methods The data of National Nutrition and Health Survey ( 2002 ) were used to analyze the relationship between body mass index ( BMI ), waist circumference (WC) and chronic diseases, based on which chronic disease index ( CRI ) was established. Receiver operating characteristic curve (ROC) was used to determine the cut-off of CRI and to compare the predictive effectiveness of CRI,BMI and WC on chronic diseases. The kappa test was chosen to estimate the consistency of different cut-off of CRI with BMI and WC. The odds ratios of chronic diseases in different cut-offs of CRI were calculated by multiple Logistic regression analysis. Results CRI was calculated as CRI = BMI + 3.5 WC. In ROC curve,the cut-off of CRI was 300. The predictive effectiveness of CRI was higher than that of BMI and WC. CRI at 300 showed the best consistency with 24 kg/m2 BMI and 85 cm WC (P <0. 05 ). In comparison with CRI <300,the risk of chronic diseases was significantly increased with an increase of 20 U CRI. Conclusion CRI shows good predietive effectiveness and could be used to identify those with higher risk of chronic diseases.