[腹部肥胖中内脏脂肪的评估及其临床应用]

[Evaluation of visceral adipose in abdominal obesity and its clinical application].

作者信息

Pu Yun-Fei, He Hong-Bo, Zhao Zhi-Gang, Chen Jing, Ni Yin-Xing, Zhong Jian, Liu Hao-Yu, Yan Zhen-Cheng, Zhu Zhi-Ming

机构信息

Department of Hypertension and Endocrinology, Chongqing Institute of Hypertension, Center for Hypertension and Metabolic Diseases, Daping Hospital, Third Military Medical University, Chongqing 400042, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2008 Sep 9;88(34):2391-4.

DOI:

PMID:19087712

Abstract

OBJECTIVE

To compare the values of measurements of obesity, including body mass index(BMI), waist circumference (WC), waist-to-hip ratio (WHR), bioelectrical impedance analyzer(BIA) (fat mass and FAT%), ultrasonography (US) (subcutaneous fat distance and intraabdominal fat distance), and computed tomography (CT) in predicting the quantification of visceral adipose in abdominal obesity, and to evaluate the best cut-off point, sensitivity and specificity of these methods.

METHODS

4,301 inpatients with hypertension, 2,155 males and 2,146 females, aged (56.4 +/- 13.8) (11 - 89), all with at least 1 risk factor of cardiovascular diseases, underwent simple body fat measurement. 3458 received BIA, 2,553 received B mode ultrasonography, 1039 underwent CT examination, and 659 received all kinds of examination. Abdominal visceral adipose area (VA) measured with CT >or= 100 cm(2) was the diagnostic criteria of visceral fat obesity (VFO). Receiver operating characteristic (ROC) curve was used to analyze the body fat indexes to determine the best cut-off point.

RESULTS

(1) It was accurate for WC, fat mass, BMI, intraabdominal fat distance, FAT%, and WHR were all accurate in diagnosis of VFO with the values of area under ROC of 0.730 - 0.867. WC was the most effective measurement. (2) The best cut-off points of these methods in predicting abdominal visceral obesity in males and females were as follows: WC: 89.5 cm and 85.5 cm for WC. 25 kg/m(2) and 26 kg/m(2) for BMI, 0.97 and 0.95 for WHR, 29% and 38% for fat composition, 18.6 kg, and 20.4 kg for fat mass, and 38.5 mm and 34.7 mm for intraabdominal fat distance.

CONCLUSIONS

WC, fat mass, BMI, intraabdominal fat distance, simple fat parameters, and WHR all can predict visceral adipose in abdominal obesity, in which WC is the best. For a given WC, the type of obesity can be determined by BIA and US.

摘要

目的

比较包括体重指数（BMI）、腰围（WC）、腰臀比（WHR）、生物电阻抗分析仪（BIA）（脂肪量和脂肪百分比）、超声检查（US）（皮下脂肪厚度和腹内脂肪厚度）以及计算机断层扫描（CT）在内的肥胖测量值在预测腹型肥胖中内脏脂肪定量方面的价值，并评估这些方法的最佳切点、敏感性和特异性。

方法

4301例高血压住院患者，其中男性2155例，女性2146例，年龄（56.4±13.8）岁（11 - 89岁），均至少有1项心血管疾病危险因素，接受了简单的体脂测量。3458例接受了BIA检查，2553例接受了B型超声检查，1039例接受了CT检查，659例接受了所有检查。以CT测量的腹部内脏脂肪面积（VA）≥100 cm²作为内脏脂肪性肥胖（VFO）的诊断标准。采用受试者操作特征（ROC）曲线分析体脂指标以确定最佳切点。

结果

（1）WC、脂肪量、BMI、腹内脂肪厚度、脂肪百分比和WHR在诊断VFO方面均准确，ROC曲线下面积值为0.730 - 0.867。WC是最有效的测量指标。（2）这些方法预测男性和女性腹部内脏肥胖的最佳切点如下：WC：男性为89.5 cm，女性为85.5 cm；BMI：男性为25 kg/m²，女性为26 kg/m²；WHR：男性为0.97，女性为0.95；脂肪成分：男性为29%，女性为38%；脂肪量：男性为18.6 kg，女性为20.4 kg；腹内脂肪厚度：男性为38.5 mm，女性为34.7 mm。