Ivković-Lazar T
Institut za interne bolesti, Klinika za endokrinologiju, Klinicki centar, Novi Sad.
Med Pregl. 2000 Nov-Dec;53(11-12):584-7.
The classification of obesity into male or the android type and female or the gynoid type dates from the first clinical observations of J. Vague in the distant 1947. Researches carried out in the recent years show that in the android type of obesity there is an insulin resistance and hyperinsulinism as a metabolic bases for accelerated atherosclerosis. These insights imposed a need to determine body composition, and within it also the mass and the fat tissue distribution. The simplest anthropometric parameter which gives us insight into the nutritional status is BMI, while waist/hip ratio (WHR) offers orientation for the fat tissue distribution.
The subcutaneous fat tissue is measured by standard calipers. A particularly important anthropometric parameter which has been increasingly applied in the recent years is the sagittal abdominal diameter (SAD) measured by a simple caliper constructed by Kahn. This anthropometric indicator measures only the visceral fat tissue. As for other techniques, in the first place one should mention measuring of body density which presents a relation between the body mass an volume. Tetrapolar bioelectric impedance analysis is based on measuring the resistance of the body exposed to the impact of alternating current of 50 kHz and the strength of 800 microA. Double photon absorptiometry and X ray absorptiometry are precise methods for the determination of body composition, but they require expensive equipment and X ray absorptiometry also exposes the organism to certain radiation. Radio-isotopic techniques are based on measuring the total body liquid by marked deuterium or tritium and measuring of the total body potassium. Infrared spectrometry is a simple and not a particularly reliable method based on application of two sources of monochromatic light. Ultrasonographic measuring of fat tissue is a very favoured technique by which one can measure both the subcutaneous and visceral fat tissue. Measuring is carried out by transducer of 7.5 mHz for the subcutaneous and 3.5 mHz for visceral fat tissue. It is certain that fat-tissue depots can be most exactly measured by computerized tomography and nuclear magnetic resonance which, however, require a very expensive equipment.
Modern concept of obesity implies an obligatory determination not only of the degree, but, which is even more important, of the type of obesity. Within these activities, besides the techniques already used so far (BMI, WHR), it is recommended to introduce measuring of the visceral fat tissue by SAD and ultrasonographic measuring of both fat-tissue depots into the everyday routine work.
肥胖分为男性或男性型（向心性肥胖）以及女性或女性型（梨形肥胖）可追溯到1947年J. 瓦格最早的临床观察。近年来的研究表明，在男性型肥胖中，胰岛素抵抗和高胰岛素血症是加速动脉粥样硬化的代谢基础。这些见解使得有必要确定身体成分，其中也包括体重和脂肪组织分布。能让我们了解营养状况的最简单人体测量参数是体重指数（BMI），而腰臀比（WHR）则为脂肪组织分布提供了方向。
皮下脂肪组织用标准卡尺测量。近年来越来越多地应用的一个特别重要的人体测量参数是由卡恩制作的简易卡尺测量的腹矢状径（SAD）。这个人体测量指标仅测量内脏脂肪组织。至于其他技术，首先应该提到身体密度的测量，它表示体重与体积之间的关系。四极生物电阻抗分析基于测量身体在5 kHz交流电和800微安强度的电流冲击下的电阻。双能X线吸收法和X线吸收法是测定身体成分的精确方法，但它们需要昂贵的设备，而且X线吸收法还会使机体受到一定辐射。放射性同位素技术基于用标记的氘或氚测量总体液以及测量体内总钾。红外光谱法是一种基于应用两个单色光源的简单但不太可靠的方法。脂肪组织的超声测量是一种非常受欢迎的技术，通过它可以测量皮下和内脏脂肪组织。皮下脂肪组织测量时使用7.5兆赫兹的换能器，内脏脂肪组织测量时使用3.5兆赫兹的换能器。可以肯定的是，脂肪组织储存量可以通过计算机断层扫描和核磁共振最精确地测量，但这需要非常昂贵的设备。
现代肥胖概念意味着不仅要确定肥胖程度，更重要的是要确定肥胖类型。在这些工作中，除了迄今已使用的技术（BMI、WHR）外，建议在日常工作中引入通过SAD测量内脏脂肪组织以及对两种脂肪组织储存进行超声测量。
