Janssen Ian, Heymsfield Steven B, Allison David B, Kotler Donald P, Ross Robert
School of Physical and Health Education, Queen's University, Kingston, Ontario, Canada.
Am J Clin Nutr. 2002 Apr;75(4):683-8. doi: 10.1093/ajcn/75.4.683.
It is unknown whether the ability of waist circumference (WC) to predict health risk beyond that predicted by body mass index (BMI) alone is explained in part by the ability of WC to identify those with elevated concentrations of total or abdominal fat.
We sought to determine whether BMI and WC independently contribute to the prediction of non-abdominal (total fat - abdominal fat), abdominal subcutaneous, and visceral fat.
Fat distribution was measured by magnetic resonance imaging in 341 white men and women. Multiple regression analysis was performed to measure whether the combination of BMI and WC explained a greater variance in non-abdominal, abdominal subcutaneous, and visceral fat than did BMI or WC alone. These fat depots were also compared after a subdivision of the cohort into 3 BMI (normal, overweight, and class I obese) and 3 WC (low, intermediate, and high) categories according to the classification system used to identify associations between BMI, WC, and health risk.
Independent of age and sex, the combination of BMI and WC explained a greater variance in non-abdominal, abdominal subcutaneous, and visceral fat than did either BMI or WC alone (P < 0.05). For non-abdominal and abdominal subcutaneous fat, BMI was the strongest correlate; thus, by adding BMI to WC, the variance accrued was greater than when WC was added to BMI. However, when WC was added to BMI, the added variance explained for visceral fat was greater than when BMI was added to WC. Furthermore, within each of the 3 BMI categories studied, an increase in the WC category was associated with an increase in visceral fat (P < 0.05).
BMI and WC independently contribute to the prediction of non-abdominal, abdominal subcutaneous, and visceral fat in white men and women. These observations reinforce the importance of using both BMI and WC in clinical practice.
腰围（WC）预测健康风险的能力，是否超出仅由体重指数（BMI）所预测的健康风险，这一点部分上是否可由WC识别总脂肪或腹部脂肪浓度升高者的能力来解释，目前尚不清楚。
我们试图确定BMI和WC是否独立地有助于预测非腹部（总脂肪 - 腹部脂肪）、腹部皮下和内脏脂肪。
通过磁共振成像测量了341名白人男性和女性的脂肪分布。进行多元回归分析，以测量BMI和WC的组合，相较于单独的BMI或WC，是否能解释非腹部、腹部皮下和内脏脂肪中更大的方差。根据用于识别BMI、WC与健康风险之间关联的分类系统，将队列细分为3个BMI类别（正常、超重和I类肥胖）和3个WC类别（低、中、高）后，还对这些脂肪库进行了比较。
独立于年龄和性别，BMI和WC的组合，相较于单独的BMI或WC，能解释非腹部、腹部皮下和内脏脂肪中更大的方差（P < 0.05）。对于非腹部和腹部皮下脂肪，BMI是最强的关联因素；因此，将BMI添加到WC中时，所累积的方差大于将WC添加到BMI时。然而，当将WC添加到BMI时，对内脏脂肪解释的额外方差大于将BMI添加到WC时。此外，在研究的3个BMI类别中的每一个类别内，WC类别的增加与内脏脂肪的增加相关（P < 0.05）。
BMI和WC独立地有助于预测白人男性和女性的非腹部、腹部皮下和内脏脂肪。这些观察结果强化了在临床实践中同时使用BMI和WC的重要性。
