Jackson Andrew S, Ellis Kenneth J, McFarlin Brian K, Sailors Mary H, Bray Molly S
Department of Health and Human Performance, The University of Houston, TX 77204-6015, USA.
Br J Nutr. 2009 Oct;102(7):1084-90. doi: 10.1017/S0007114509325738. Epub 2009 Apr 6.
The BMI cut-score used to define overweight and obesity was derived primarily using data from Caucasian men and women. The present study evaluated the racial/ethnic bias of BMI to estimate the adiposity of young men and women (aged 17-35 years) using dual-energy X-ray absorptiometry (DXA) determination of percentage body fat (DXA-BF%) as the referent standard. The samples were 806 women and 509 men who were tested from one to three times over 9 months providing 1300 observations for women and 820 observations for men. Linear mixed models (LMM) regression showed that with age and BMI controlled, DXA-BF% of African-American (AA) men and women, Asian-Indian men and women, Hispanic women and Asian women significantly differed from non-Hispanic white (NHW) men and women. For the same BMI of NHW women, the DXA-BF% of AA women was 1.76 % lower, but higher for Hispanic (1.65 %), Asian (2.65 %) and Asian-Indian (5.98 %) women. For the same BMI of NHW men, DXA-BF% of AA men was 4.59 % lower and 4.29 % higher for Asian-Indian men. Using the recommended BMI cut-scores to define overweight and obesity systematically overestimated overweight and obesity prevalence for AA men and women, and underestimated prevalence for Asian-Indian men and women, Asian women and Hispanic women. The present study extends the generalisability of research documenting the racial/ethnic bias of the universal overweight and obesity BMI cut-scores.
用于定义超重和肥胖的体重指数（BMI）临界值主要是根据白种男性和女性的数据得出的。本研究评估了BMI在估计17至35岁年轻男性和女性肥胖程度方面的种族/民族偏差，以双能X线吸收法（DXA）测定的体脂百分比（DXA-BF%）作为参考标准。样本包括806名女性和509名男性，他们在9个月内接受了1至3次测试，女性提供了1300次观察结果，男性提供了820次观察结果。线性混合模型（LMM）回归显示，在控制年龄和BMI的情况下，非裔美国（AA）男性和女性、亚裔印度男性和女性、西班牙裔女性和亚裔女性的DXA-BF%与非西班牙裔白人（NHW）男性和女性有显著差异。对于相同BMI的NHW女性，AA女性的DXA-BF%低1.76%，但西班牙裔女性（1.65%）、亚裔女性（2.65%）和亚裔印度女性（5.98%）的DXA-BF%更高。对于相同BMI的NHW男性，AA男性的DXA-BF%低4.59%，亚裔印度男性的DXA-BF%高4.29%。使用推荐的BMI临界值来定义超重和肥胖，系统地高估了AA男性和女性的超重和肥胖患病率，低估了亚裔印度男性和女性、亚裔女性和西班牙裔女性的患病率。本研究扩展了记录普遍超重和肥胖BMI临界值种族/民族偏差的研究的普遍性。
