摘要目的 探讨预测中国儿童青少年MS的WHtR适宜界值.方法 2009年10月至2010年10月选择北京、天津、上海、重庆、南宁和浙江省(市)19 284名6～15岁中小学生为调查对象,统一收集、整理、录人数据.采用受试者工作特征(ROC)曲线分析,研究预测儿童青少年具有≥2个危险组分的WHtR适宜界值.结果 ROC曲线显示6～9岁组男女童WHtR分别在第85、80百分位(P85、P80)具有较好的预测效果,灵敏度、特异度分别为35.78％、85.41％和49.21％、79.87％.男女童WHtR的P85的曲线下面积(AUC)分别为0.61、0.64,分别与同性别儿童WHtR的P80、P90 AUC比较,差异均无统计学意义;10 ～ 15岁组男女童的WHtR也分别在P85、P80具有较好的预测效果,灵敏度、特异度分别为49.60％、85.90％和47.01％、80.07％.男女童WHtR的P85 AUC分别为0.68、0.63,与同性别人群P80的AUC相比差异均无统计学意义,但均大于同性别P90的AUC(P＜0.05).结论 预测6～9岁组具有≥2个心血管疾病危险因素的WHtR切点应选在0.48;预测10～ 15岁组MS的WHtR切点,男性选择0.48、女性选择0.46较为适宜,均分别对应同性别年龄组人群WHtR的P85数值.

abstractsObjective This study aimed to determine the optimal cutoff point of Waist-to-height (WHtR) for the diagnosis of metabolic syndrome (MS) in children and adolescents in six areas of China.Methods Ninety thousand two hundred and eighty four children aged 6 to 15 years old from 6 areas,including Beijing,Tianjin,Zhejiang,Shanghai,Chongqing and Nanning in China,were surveyed in a random cluster sample.Receiver operating characteristic (ROC) curve analysis was employed to determine the optimal cutoff values of WHtR for detecting the children and adolescents with two or more risk factors of MS.Results The optimal WHtR cutoff values derived from the ROC analysis was 85th and 80th percentiles in males and females,with 6-15 years of age,respectively.The sensitivity and specificity under these cutoff values were 35.78％ and 85.41％ in males and 49.21％ and 79.87％ in females,for 6-9 years of age,while the sensitivity and specificity were 49.60％ and 85.90％ in males and 47.01％ and 80.07％ in females for 10-15 years of age.The areas under the ROC curves (AUCs) for WHtR 85th percentile were 0.61 and 0.64 in males and females for 6-9 years of age,and 0.68 and 0.63 in males and females for 10-15 years of age.The AUCs for WHtR 85th percentile in both genders were significantly larger than that for WHtR 90th percentile for 10-15 years of age.Conclusion Our findings indicated that the 85th percentile of WHtR (0.48 in both genders for 6-9 years of age,0.48 in males and 0.46 in females for 10-15 years of age) might be an appropriate cutoff to predict the children and adolescents with two or more risk factors.