Misra A, Pandey R M, Sinha S, Guleria R, Sridhar V, Dudeja V
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Indian J Med Res. 2003 Apr;117:170-9.
BACKGROUND & OBJECTIVES: Optimal limit of body mass index (BMI) for Asian Indians remains to be defined. In this study, we describe the anthropometric and lipid profiles and determine the appropriate cut-offs of BMI for defining obesity in dyslipidaemic patients.
Correlations were carried out between lipid profile and anthropometric variables in 217 dyslipidaemic Asian Indians and the data were compared to those of 123 healthy historical controls. Receiver operating characteristics (ROC) curve analysis was carried out to determine the appropriate cut-offs of BMI for defining obesity taking the percentage of body fat (% BF) as the standard.
Dyslipidaemic patients had high waist-hip ratio (W-HR) and percentage of BF. The prevalence of obesity as measured by percentage of BF was significantly (P < 0.05) higher as compared to obesity defined by the BMI cut-off. W-HR was the most important independent predictor (odds ratio: 2.8; 95% CI: 1.02-7.83) of atherogenic dyslipidaemia on multivariate logistic regression analysis. On ROC curve analysis the suggested appropriate cut-offs of BMI were; males 24.0 kg/m2 (sensitivity, 74.7%, and specificity, 79.7%), and females 23.0 kg/m2 (sensitivity, 85.7% and specificity, 62.5%). According to the suggested lower limits of BMI, an additional 15 per cent dyslipidaemic patients will be diagnosed as obese.
INTERPRETATION & CONCLUSION: The observations in dyslipidaemic Asian Indians suggest high prevalence rates of generalized and abdominal obesity, and that high values of W-HR alone predisposes to atherogenic dyslipidaemia. Further, obesity may be optimally defined by a lower cut-off of BMI. The revised criteria for the BMI-based diagnosis of obesity will lead to a more rational management of dyslipidaemia in Asian Indians.
亚洲印度人的最佳体重指数（BMI）界限仍有待确定。在本研究中，我们描述了人体测量学和血脂谱，并确定了血脂异常患者中用于定义肥胖的合适BMI临界值。
对217名血脂异常的亚洲印度人的血脂谱与人体测量学变量进行相关性分析，并将数据与123名健康历史对照者的数据进行比较。以体脂百分比（%BF）为标准，进行受试者操作特征（ROC）曲线分析，以确定用于定义肥胖的合适BMI临界值。
血脂异常患者的腰臀比（W-HR）和%BF较高。通过%BF测量的肥胖患病率与根据BMI临界值定义的肥胖相比显著更高（P<0.05）。在多因素逻辑回归分析中，W-HR是致动脉粥样硬化性血脂异常的最重要独立预测因素（优势比：2.8；95%置信区间：1.02-7.83）。在ROC曲线分析中，建议的合适BMI临界值为：男性24.0kg/m²（敏感性74.7%，特异性79.7%），女性23.0kg/m²（敏感性85.7%，特异性62.5%）。根据建议的较低BMI界限，另外15%的血脂异常患者将被诊断为肥胖。
血脂异常的亚洲印度人的观察结果表明，全身性肥胖和腹型肥胖的患病率较高，且仅W-HR升高就易患致动脉粥样硬化性血脂异常。此外，肥胖可能通过较低的BMI临界值得到最佳定义。基于BMI诊断肥胖的修订标准将导致对亚洲印度人的血脂异常进行更合理的管理。
