Circ J. 2002 Nov;66(11):987-92. doi: 10.1253/circj.66.987.
The present study was designed to establish adequate criteria for categorizing 'obesity disease' in Japan in relation to obesity-related complications. The subjects were 1,193 Japanese subjects (775 men, 418 women; age: 20-84 years old, body mass index (BMI): 14.9-56.4 kg/m(2)) including subjects undergoing a health examination and obese subjects visiting an obesity clinic. Visceral fat area (VFA) and subcutaneous fat area (SFA) were determined by computed tomography (CT) at the umbilical level. Anthropometric parameters, including BMI, waist circumference (W), waist/hip circumference (W/H), ratio and waist circumference/body height (W/BH) ratio, were measured. Hyperglycemia, dyslipidemia, and hypertension were evaluated as obesity-related complications. The relationship between each parameter and the prevalence of the complications was investigated. The number of complications increased in accordance with BMI and the average value was greater than 1.0 at a BMI of 25. The best combination of the sensitivity and specificity for detecting subjects with multiple risk factors was a BMI of 25. BMI showed a close positive correlation with SFA (r=0.82), even for BMI > or =25 (r=0.77), but had a weaker correlation with VFA (r=0.54). The obese subjects with a BMI > or =25 had no correlation between BMI and VFA because of the wide individual variation of VFA. The number of disorders was greater than 1.0 at 100 cm(2) of VFA and the best combination of the sensitivity and specificity for determining subjects with multiple risk factors was 100 cm(2) of VFA. Between the simple anthropometric values and measurement of VFA, it was proven that W had the closest relationship with VFA in both men (r=0.68) and women (r=0.65). The regression line obtained from simple correlation analyses indicated that the W corresponding to 100 cm(2) of VFA was 84.4 cm in men and 92.5 cm in women. These data suggest that obesity is adequately specified as a BMI > or =25 in Japan where the prevalence and degree of obesity remains mild. It is reasonable to establish the cut-off point of VFA at 100 cm(2) as indicative of the risk of obesity-related disorders and a waist circumference of 85 cm in men and 90 cm in women approximates to this visceral fat mass.
本研究旨在建立与肥胖相关并发症相关的、适用于日本“肥胖病”分类的充分标准。研究对象为1193名日本受试者（775名男性，418名女性；年龄：20 - 84岁，体重指数（BMI）：14.9 - 56.4 kg/m²），包括接受健康检查的受试者和前往肥胖诊所就诊的肥胖受试者。通过脐水平的计算机断层扫描（CT）测定内脏脂肪面积（VFA）和皮下脂肪面积（SFA）。测量了包括BMI、腰围（W）、腰臀围比（W/H）以及腰围身高比（W/BH）等人体测量参数。将高血糖、血脂异常和高血压评估为肥胖相关并发症。研究了各参数与并发症患病率之间的关系。并发症数量随BMI升高而增加，BMI为25时平均值大于1.0。检测具有多种危险因素受试者的敏感性和特异性的最佳组合是BMI为25。即使对于BMI≥25的情况（r = 0.77），BMI与SFA仍呈密切正相关（r = 0.82），但与VFA的相关性较弱（r = 0.54）。BMI≥25的肥胖受试者中，由于VFA个体差异较大，BMI与VFA无相关性。VFA为100 cm²时疾病数量大于1.0，确定具有多种危险因素受试者的敏感性和特异性的最佳组合是VFA为100 cm²。在简单人体测量值与VFA测量之间，已证明腰围在男性（r = 0.68）和女性（r = 0.65）中与VFA的关系最为密切。简单相关分析得到的回归线表明，VFA为100 cm²时对应的腰围男性为84.4 cm，女性为92.5 cm。这些数据表明，在日本肥胖患病率和程度仍较轻的情况下，将肥胖适当定义为BMI≥25是合理的。将VFA的截断点设定为100 cm²以指示肥胖相关疾病的风险是合理的，男性腰围85 cm和女性腰围90 cm接近这一内脏脂肪量。
