Lee Kayoung, Song Yun-Mi, Sung Joohon
Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Pusan, Korea.
Obesity (Silver Spring). 2008 Apr;16(4):834-40. doi: 10.1038/oby.2007.109. Epub 2008 Jan 24.
No consensus exists as to the most sensitive and specific obesity indicator associated with metabolic risk factors. We aimed to validate anthropometry as the predictor for obesity-related metabolic risk factors through comparison with direct body composition measures in Korean adults. A total of 995 Korean women and 577 Korean men who participated in the Healthy Twin study were the subjects. Anthropometric measurements included BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHTR). Direct body composition measures included the percentage of body fat (%BF) measured using dual-energy X-ray absorptiometry scanners and bioelectrical impedance analyzer (BIA). The following criteria were used to define abnormal metabolic risk factors: blood pressure > or = 130/85 mm Hg, fasting glucose (> or = 100 mg/dl), insulin (> or = 25 microU/ml), homeostasis model assessment (HOMA) (> or = 2.61), high-density lipoprotein (HDL) (<40 mg/dl for men or <50 mg/dl for women), triacylglycerol (> or = 150 mg/dl), uric acid (>7 mg/dl for men or >6 mg/dl for women), high-sensitivity C-reactive protein (hs-CRP) (> or = 2.11 mg/l). In multiple regression analyses (adjusted for age, education, smoking, alcohol, exercise and past/current medical history, and treated families as a random effect), WC, WHTR, and BMI were consistently associated with all metabolic risk factors regardless of the subject's gender. Some of the areas under the receiver-operating characteristic curves regarding abnormal metabolic risk factors were significantly higher for the three indicators of central obesity than for %BF. Our study validates the usefulness of anthropometry over direct body fat measures to predict metabolic risks.
关于与代谢风险因素相关的最敏感和特异的肥胖指标，目前尚无共识。我们旨在通过与韩国成年人的直接身体成分测量结果进行比较，验证人体测量学作为肥胖相关代谢风险因素预测指标的有效性。共有995名韩国女性和577名韩国男性参与了健康双胞胎研究，作为研究对象。人体测量指标包括体重指数（BMI）、腰围（WC）、腰臀比（WHR）和腰高比（WHTR）。直接身体成分测量包括使用双能X线吸收仪扫描仪和生物电阻抗分析仪（BIA）测量的体脂百分比（%BF）。以下标准用于定义异常代谢风险因素：血压≥130/85 mmHg、空腹血糖（≥100 mg/dl）、胰岛素（≥25 μU/ml）、稳态模型评估（HOMA）（≥2.61）、高密度脂蛋白（HDL）（男性<40 mg/dl或女性<50 mg/dl）、三酰甘油（≥150 mg/dl）、尿酸（男性>7 mg/dl或女性>6 mg/dl）、高敏C反应蛋白（hs-CRP）（≥2.11 mg/l）。在多元回归分析中（对年龄、教育程度、吸烟、饮酒、运动以及既往/当前病史进行了调整，并将家庭作为随机效应处理），无论受试者性别如何，WC、WHTR和BMI均始终与所有代谢风险因素相关。关于异常代谢风险因素的受试者工作特征曲线下的一些面积，中心性肥胖的三个指标显著高于%BF。我们的研究验证了人体测量学在预测代谢风险方面优于直接体脂测量的有用性。
