Kagawa Masaharu, Uenishi Kazuhiro, Kuroiwa Chiharu, Mori Miki, Binns Colin W
School of Public Health, Curtin University of Technology, Perth, WA, Australia.
Asia Pac J Clin Nutr. 2006;15(4):502-7.
The aim of the study was to determine the sensitivity and specificity of the BMI cut-off points that have been applied in the National Nutritional Survey in Japan (NNS-J) for young Japanese females. The relationship between the body mass index (BMI) and percentage body fat (%BF) of 139 young Japanese females (aged 18-27 years old) was examined using dual energy x-ray absorptiometry (DXA) and anthropometry. The sensitivity and specificity of the BMI cut-off point that has been in use in Japan was compared with the cut-off point proposed for Asia-Pacific population (the WPRO classification). The regression equation calculated for the relationship between the BMI and %BF using the DXA scan data was %BF = -15.152+2.058*BMI; R2 = 0.612, SEE = 3.66. From this equation the BMI value that corresponded with %BF of 30% was calculated to be 21.9kg/m2 (95%CI: 16.9-28.6). From the sensitivity and specificity analysis, it was found that more than 90% of Japanese females with %BF >30% were misclassified as "not obese" when the BMI value of 25kg/m2 was used to identify obese individuals. The misclassification reduced to 60% when the BMI value of 23kg/m2 was used as a cut-off point. The results indicate that the current classification used in the NNS-J may not precisely reflect the obesity status of young Japanese females and a considerable proportion of females with a large fat deposition would be misclassified as not obese. The current study shows the importance of including detailed body composition assessments to determine obesity level of individuals.
本研究的目的是确定日本全国营养调查(NNS-J)中应用于日本年轻女性的体重指数(BMI)切点的敏感性和特异性。使用双能X线吸收法(DXA)和人体测量法,对139名日本年轻女性(年龄在18 - 27岁之间)的体重指数(BMI)与体脂百分比(%BF)之间的关系进行了研究。将日本一直使用的BMI切点的敏感性和特异性与为亚太人群提议的切点(西太区分类)进行了比较。利用DXA扫描数据计算出的BMI与%BF之间关系的回归方程为%BF = -15.152 + 2.058 * BMI;R2 = 0.612,标准误(SEE) = 3.66。根据该方程,计算出与30%的%BF相对应的BMI值为21.9kg/m2(95%置信区间:16.9 - 28.6)。从敏感性和特异性分析发现,当使用25kg/m2的BMI值来识别肥胖个体时,超过90%的%BF > 30%的日本女性被误分类为“不肥胖”。当使用23kg/m2的BMI值作为切点时,误分类率降至60%。结果表明,NNS-J中目前使用的分类可能无法准确反映日本年轻女性的肥胖状况,相当一部分脂肪堆积较多的女性会被误分类为不肥胖。本研究表明了纳入详细的身体成分评估以确定个体肥胖水平的重要性。