目的评价腰围身高比(WHtR)结合体质指数(BMI)预测心血管病危险因素的效果,为心血管病的防治提供参考依据。方法收集辽宁省沈阳市东北大学1 327名职工2010年的体检资料,将WHtR(非中心性肥胖<0.5、中心性肥胖≥0.5)按BMI(正常体重<24.0 kg/m2、超重24.0~27.9 kg/m2、肥胖≥28.0 kg/m2)分层,比较不同组别人群高血压、高血糖、血脂异常、代谢综合征(MS)等心血管病危险因素的患病率。结果单独采用BMI指标,BMI<24.0 kg/m2者中有22.8%的中心性肥胖者被漏诊;单独采用WHtR指标,WHtR<0.5者中有15.0%的超重/肥胖者被错误分类;logistic回归分析结果显示,WHtR预测高血压、高血糖、血脂异常和MS的OR值分别为1.63、1.43、1.45和3.27,均大于BMI预测OR值的1.31、1.19、1.28和1.74;与BMI<24.0 kg/m2且WHtR<0.5的人群比较,BMI<24.0 kg/m2且WHtR≥0.5的人群患高血压、血脂异常和MS的风险分别为1.68、2.08和20.10倍,BMI24.0~27.9 kg/m2且WHtR<0.5的人群患高血糖和MS的风险分别为2.88和9.25倍,BMI24.0~27.9 kg/m2且WHtR≥0.5的人群患高血压、高血糖、血脂异常和MS的风险分别为2.57、3.09、2.94和61.70倍,BMI≥28.0 kg/m2且WHtR≥0.5的人群患高血压、高血糖、血脂异常和MS的风险分别为5.94、3.33、4.91和183.33倍。结论 WHtR与心血管病危险因素的关联强度大于BMI,WHtR结合BMI能够高效识别心血管病高危人群。 Objective To evaluate the effect of WHtR combined with body mass index (BMI) in predicting the risk of cardiovascular diseases and provide a reference for the prevention and treatment of cardiovascular diseases. Methods The physical examination data of 1 327 workers from Northeastern University in Shenyang City, Liaoning Province in 2010 were collected and analyzed according to BMI (normal body weight <24.0 kg / m2, overweight 24.0 ~ 27.9 kg, WHtR <0.5, central obesity≥0.5) / m2, obesity≥28.0 kg / m2) were stratified to compare the prevalence of cardiovascular risk factors such as hypertension, hyperglycemia, dyslipidemia and metabolic syndrome (MS) in different groups. Results BMI alone was used. 22.8% of central obesity patients with BMI <24.0 kg / m 2 were missed; WHtR alone was used to identify 15.0% of overweight / obese patients with WHtR <0.5; logistic regression analysis The results showed that the WHtR predictive value of hypertension, hyperglycemia, dyslipidemia and MS were 1.63, 1.43, 1.45 and 3.27, respectively, which were greater than 1.31, 1.19, 1.28 and 1.74, respectively, The risk of developing hypertension, dyslipidemia and MS was 1.68, 2.08 and 20.10 times higher in those with BMI <24.0 kg / m 2 and WHtR ≥ 0.5 compared with those with WHtR <0.5. The BMI ranged from 24.0 to 27.9 kg / m 2 and the WHtR < The risk of developing hyperglycemia and MS was 2.88 times and 9.25 times respectively for those with 0.5 and 0.5% respectively. The risk of developing hypertension, hyperglycemia, dyslipidemia and MS in those with BMI of 24.0-27.9 kg / m2 and WHtR≥0.5 were 2.57, 3.09, The risk of hypertension, hyperglycemia, dyslipidemia and MS were 2.94 and 61.70 times and those with BMI≥28.0 kg / m2 and WHtR≥0.5 were 5.94, 3.33, 4.91 and 183.33 times, respectively. Conclusion The association between WHtR and cardiovascular risk factors is greater than that of BMI. WHtR combined with BMI can effectively identify cardiovascular risk groups.