Lapidus L, Bengtsson C, Björntorp P
Department of Medicine, University of Göteborg, Sweden.
Obes Res. 1994 Jul;2(4):372-7. doi: 10.1002/j.1550-8528.1994.tb00077.x.
Abdominal obesity is closely associated with the presence of metabolic risk factors and elevated blood pressure in selected materials. This has, however, never been analyzed quantitatively in a non-selected cohort. Therefore, in a population-based study of 1462 Swedish women, four selected risk factors for non-insulin dependent diabetes mellitus (NIDDM) and cardiovascular disease (CVD), serum triglycerides, blood glucose and systolic blood pressure and also serum insulin in a subsample, were examined in relation to regional and overall obesity. This was performed by subdividing the age adjusted sample into quintiles of waist to hip circumference ratio (WHR) or body mass index (BMI) as indicators of abdominal distribution of body fat and overall obesity, respectively. The risk factors serum triglycerides, blood glucose, blood pressure and serum insulin were defined as being elevated when the value of the risk factor was higher than the mean plus one or two standard deviations of the total age-adjusted cohort. The percentage of women with elevated risk factors according to this definition was then calculated in each of these quintiles. Having a risk factor which was elevated according to the definition was significantly correlated to WHR and BMI (p<0.0001) independent of age. The presence of one or several of these elevated risk factors was clearly higher than expected in the fifth quintile of WHR, and to a lesser extent in the fifth quintile of BMI while this was not the case in the lower quintiles of WHR and BMI. When studying the combination of the WHR and BMI, the presence of risk factors higher than the mean plus two standard deviations increased gradually with WHR in all five quintiles of BMI. A significant association was observed between WHR and presence of risk factors independent of BMI (p<0.0001) but BMI did not remain significantly correlated to presence of risk factors when controlling for WHR (p=0.09). These results indicate that abdominal distribution of body fat in women independently of general obesity is closely associated with metabolic risk factors including elevated blood pressure, a metabolic syndrome with increased risk for cardiovascular disease and non-insulin dependent diabetes mellitus.
在特定人群中，腹部肥胖与代谢风险因素及血压升高密切相关。然而，此前从未在非特定队列中对此进行过定量分析。因此，在一项针对1462名瑞典女性的基于人群的研究中，研究了非胰岛素依赖型糖尿病（NIDDM）和心血管疾病（CVD）的四个选定风险因素，即血清甘油三酯、血糖、收缩压，以及在一个子样本中的血清胰岛素，与局部肥胖和整体肥胖的关系。这是通过将年龄调整后的样本分别按照腰臀围比（WHR）或体重指数（BMI）划分为五分位数来进行的，WHR和BMI分别作为身体脂肪腹部分布和整体肥胖的指标。当风险因素的值高于整个年龄调整队列的均值加一或两个标准差时，将血清甘油三酯、血糖、血压和血清胰岛素这些风险因素定义为升高。然后计算每个五分位数中根据此定义风险因素升高的女性百分比。根据该定义，风险因素升高与WHR和BMI显著相关（p<0.0001），且与年龄无关。在WHR的第五个五分位数中，一个或多个这些升高的风险因素的存在明显高于预期，在BMI的第五个五分位数中程度稍低，而在WHR和BMI的较低五分位数中则并非如此。在研究WHR和BMI的组合时，在BMI的所有五个五分位数中，高于均值加两个标准差的风险因素的存在随WHR逐渐增加。观察到WHR与风险因素的存在之间存在显著关联，且与BMI无关（p<0.0001），但在控制WHR时，BMI与风险因素的存在不再显著相关（p=0.09）。这些结果表明，女性身体脂肪的腹部分布独立于一般肥胖，与包括血压升高在内的代谢风险因素密切相关，这是一种心血管疾病和非胰岛素依赖型糖尿病风险增加的代谢综合征。
