摘要
目的利用受试者工作特征(ROC)曲线探讨体重指数(BMI)、颈围、腰围及腰臀比等不同的肥胖参数预测、筛查、确诊成年男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的最佳切点或参考切点并比较其价值。方法分析1110例成年男性患者的BMI、颈围、腰围及腰臀比与呼吸暂停低通气指数(AHI)之间的相关关系;用ROC曲线确定BMI、颈围、腰围、腰臀比预测OSAHS(AHI≥5次/h)的最佳切点及筛查、确诊OSAHS的参考切点;用ROC曲线下面积(AUC)判断各肥胖参数的整体准确性。结果①成年男性BMI、颈围、腰围及腰臀比均与AHI呈正相关,其相关系数分别为0.373、0.276、0.291、0.127,P值均<0.001;②BMI、颈围、腰围检出OSAHS的最佳切点值分别为26.5 kg/m^2、39 cm、95 cm,其诊断灵敏度分别为54%、57%、64%,特异度分别为73%、65%、53%;③ROC曲线分析显示BMI在检出成年男性患者有无OSAHS存在时比其他肥胖参数更有价值;④灵敏度达90%左右,漏诊率10%左右时不同肥胖参数筛查OSAHS的切点分别为BMI 23 kg/m^2、颈围35 cm、腰围85 cm;⑤特异度达90%左右,误诊率10%左右时不同肥胖参数确诊OSAHS的切点分别为BMI 29 kg/m^2、颈围43 cm、腰围105 cm。结论BMI预测成年男性OSAHS的价值大于颈围、腰围、腰臀比;BMI≥26.5 kg/m^2、颈围≥39 cm、腰围≥95 cm可作为预测成年男性OSAHS的最佳切点;BMI≥23 kg/m。、颈围≥35 cm、腰围≥85cm可作为筛查成年男性OSAHS的参考标准;BMI≥29 kg/m^2、颈围≥43 cm、腰围≥105 cm可作为诊断成年男性OSAHS的参考标准。
Objective To determine the best cutoff value and reference standard of obese indexes and to compare their diagnostic value in screening, predicting and diagnosing obstructive sleep apnea- hypopnea syndrome （OSAHS） in male adults by receiver operating characteristic curve （ROC）. Methods A total of 1110 male adults were included and cross-sectional study was adopted. Four parameters including： body mass index （BMI）, neck circumference （NC）, waist circumference （WC） and waist-to-hip ratio （WHR） were studied. The correlativity between apnea-hypopnea index（AHI） and BMI, NC, WC and WHR were analyzed by pearson correlation test. ROC curve was used to assess the diagnostic value and determine their best cutoff value to predict OSAHS and reference standard to screen/diagnose it. Their conformity in predicting OSAHS was analyzed by area under curve （AUC）. SPSS software version 13.0 was used for statistical analysis and P≤0.05 was considered to indicate statistical significance. Results （1）All of the four indexes （BMI, NC, WC and WHR） showed a significantly positive correlation with AHI in adult male patients, with their Pearson coefficients as 0.373, 0.276, 0.291 and 0.127, respectively, and their P value were all below 0.001; （2）The best cutoff value of BMI, NC and WC in predicting OSAHS were 26.5 kg/m^2 , 39 cm, 95 cm, and their corresponding sensitivity rates were 54 %, 57% and 64% while rates of specificity as 73%,65% and 53%; （3）BMI was better than other two indexes in predicting OASHS in adult male patients; （4）The value of BMI, NC and WC in screening OSAHS among adult male patients with 90% sensitivity and 10% rate of missed diagnosis as 23 kg/m^2 , 35 cm,85 cm; （5） The value of BMI, NC and WC in screening OSAHS in adult male patients with 90%specificity and 10% misdiagnosis rate as 29 kg/m^2 , 43 cm, 105 cm, respectively. Conclusion BMI seemed better in predicting OSAHS in male adults than NC, WC and WHR. The best cutoff values to predict OSAHS of BMI, NC and WC were 26.5 kg/m^2 ,39 cm and 95 cm, respectively. Their reference standards to screen OSAHS were 23 kg/m2 , 35 cm and 85 cm while 29 kg/m^2 , 43 cm and 105 cm to predict OSAHS.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2007年第10期1021-1025,共5页
Chinese Journal of Epidemiology
