Nghiên
Cứu Về Bệnh Loãng Xương và Mập Phì tại Thái Lan
Ts Nguyễn Văn Tuấn và các
đồng nghiệp
1) Pongchaiyakul C, Panichkul S, Songpatanaslip
T, Nguyen TV.
A nomogram for predicting osteoporosis risk
based on age, weight and quantitative ultrasound measurement. Osteoporosis
International 2006; in-press.
Quantitative ultrasound measurement (QUS) or clinical risk index alone
is not a reliable tool for the identification of women with osteoporosis.
This study examined the prognostic value of combined QUS and clinical
risk index for predicting osteoporosis risk in Thai women.
The study was designed as a cross-sectional investigation with 300 women
of Thai background, aged between 38 and 85 years (mean age: 58). Femoral
neck bone mineral density (BMD) was measured by DXA (Hologic QDR-4500;
Hologic,Waltham, MA, USA) A BMD T-scores ≤ -2.5 was defined as “osteoporosis”;
otherwise, “non-osteoporosis”. QUS was measured by Achilles+ (GE Lunar,
Madison,WI, USA) and converted to T-score Three models for predicting
osteoporosis were considered: Model 1 included age, weight and QUS ; model
2 included age and weight ; and model 3 included only QUS.
The prognostic performance among the models was assessed by the area under
the receiver operating characteristic curve (AUC).
The prevalence of osteoporosis was 36% (n = 107) by femoral neck BMD.
Age, weight and QUS were each significantly associated with osteoporosis
risk.
The AUC±SE value for model I was 0.81±0.02, which was significantly higher
(p = 0.002) than model II (AUC = 0.74±0.03) or model III (AUC = 0.74±0.03).
Based on the estimated parameters of model I, a nomogram was constructed
for predicting osteoporosis for an individual.
These data suggest that the combination of QUS and clinical risk index
could significantly improve the prognosis of osteoporosis in Asian women.
2) Pongchaiyakul C, Pongchaiyakul C, Wanothayaroj
E, Nguyen TV, Rajatanavin R. Association
between waist circumference and percentage body fat among
rural Thais J Med Assoc Thai. 2006 Oct;89(10):1592-600.
OBJECTIVE: Determine the association between waist circumference (WC)
and percentage body fat (%BF) and to develop cut-off values and evaluate
the accuracy of WC in the definition of obesity in rural Thai population.
MATERIAL AND METHOD: A cross-sectional, epidemiologic study in 181 men
and 255 women aged 50+/-16 yr (mean+/-SD; range: 20-84 yr) sampled by
stratified clustering sampling method, was designed. Percentage body fat
was measured by dual energy X-ray absorptiometry (GE Lunar Corp, Madison,
WI). The "golden standard"for defining obesity was%BF > or
= 25 in men and%BF > or = 35 in women. Waist circumference in centimeter
was measured.
RESULTS: In this study, the %BF-based prevalence of obesity in men and
women was 8.3% and 44%, respectively. However using the WC cut-off (WHO)
of 102 cm in men and 88 cm in women, only 1.7% of men and 24% of women
were classified as obese. WC was a significant predictor of %BF, such
that in men, a WC of 93 cm would predict a %BF of25%, and in women a WC
of 84 cm would correspond to a %BF of 35%. The area under the receiver
operating characteristic curve was 0. 87 and 0. 88 in men and women, respectively.
In conclusion, waist circumference is a reasonably useful indicator of
obesity. CONCLUSION: The cut-off values of WC for diagnosing obesity should
be lower in Thailand than in Western countries.
3) Pongchaiyakul C, Nguyen TV, Kosulwat V, Rojroongwasinkul
N, Charoenkiatkul S, Pongchaiyakul C, Sanchaisuriya P, Rajatanavin R.
Defining obesity by body mass index in the
Thai population: an epidemiologic study. Asia Pac
J Clin Nutr. 2006;15(3):293-9.
The objective of this study was to develop cut-off values and evaluate
the accuracy of body mass index (BMI) in the definition of obesity in
the Thai population. A cross-sectional, epidemiologic study in 340 men
and 507 women aged 50 +/- 16 yr (mean +/- SD; range: 20-84 yr), were sampled
by stratified clustering sampling method. Body composition, including
percentage body fat (%BF), was measured by dual energy X-ray absorptiometry
(GE Lunar Corp, Madison, WI). BMI was obtained by dividing weight (in
kg) by height (in m2). The "golden standard "for defining obesity
was %BF > or =25% in men and %BF > or =35% in women. The %BF-based
prevalence of obesity in men and women was 18.8% and 39.5%, respectively.
However, using the BMI cut-off of > or =30, only 2.9% of men and 8.9%
of women were classified as obese. In the cubic regression model, BMI
was a significant predictor of %BF, such that in men a BMI of 27 kg/m2
would predict a %BF of 25%, and in women a BMI of 25 kg/m2 would correspond
to a %BF of 35%.
The area under the receiver operating characteristic curve for BMI was
approximately 0.87 (95% CI: 0.82-0.92) and 0.86 (95% CI: 0.83-0.90) in
men and women, respectively.
In conclusion, for the Thai population, BMI is a reasonably useful indicator
of obesity; however, the cut-off values of BMI for diagnosing obesity
should be lowered to 27 kg/m2 in men and 25 kg/m2 in women
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