比较体质指数与体脂百分比在中国肥胖评估中的应用
Comparison of body mass index with body fat percentage in the evaluation of obesity in Chinese.
机构信息
Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
出版信息
Biomed Environ Sci. 2010 Jun;23(3):173-9. doi: 10.1016/S0895-3988(10)60049-9.
OBJECTIVE
To evaluate the present Chinese body mass index (BMI) criteria with body fat percentage (BF%) in determining obesity in Chinese population.
METHODS
A total of 4 907 subjects (age: 20-90 yrs) were enrolled in the baseline survey of a longitudinal epidemiological study, and 2 638 of them were reevaluated in 5.5 years later. The Chinese BMI and WHO BF% were used to define obesity, respectively.
RESULTS
The diagnostic agreement between the Chinese BMI and WHO BF% definitions for obesity was poor for both men (kappa: 0.210, 95% CI: 0.179-0.241) and women (kappa: 0.327, 95% CI: 0.296-0.358). However, BMI had a good correlation with BF% both in men (r: 0.785, P<0.01) and women (r: 0.864, P<0.01). The age and sex-adjusted relative risks (RR) for incidence of type 2 diabetes (T2DM) were significantly higher in subjects with intermediate BF% (BF%:20.1%-25% for men, 30.1%-35% for women) (RR: 2.35, 95% CI: 1.23-4.48) and high BF%(BF%>25% for men and > 35% for women)(RR: 2.89, 95% CI: 1.43-5.81), or in subjects with high BMI (BMI>or=28 kg/m(2)) (RR: 2.46, 95% CI: 1.31-4.63) when compared to those with low BF% (BF%<or=20% for men and<or=30% for women) or low BMI (BMI24 kg/m(2)) respectively. No difference in risk could be found in those with intermediate BMI (BMI: 24-27.9 kg/m(2)) (RR: 1.44, 95% CI: 0.86-2.40), as compared to those with low BMI (BMI<24 kg/m(2)), whose BF% ranged widely from 7.8 to 50.3%.
CONCLUSION
BMI was correlated with BF%. Both BMI and BF% were associated with high risk for T2DM. However, BMI had its limitations in the interpretation of subjects with BMI between 24 and 27.9 kg/m(2).
目的
评估目前的中国身体质量指数（BMI）标准与体脂百分比（BF%）在确定中国人群肥胖中的应用。
方法
共纳入了一项纵向流行病学研究的基线调查中的 4907 名受试者（年龄：20-90 岁），其中 2638 名在 5.5 年后进行了重新评估。分别使用中国 BMI 和世界卫生组织 BF%来定义肥胖。
结果
中国 BMI 和世界卫生组织 BF% 定义的肥胖诊断一致性在男性（kappa：0.210，95%CI：0.179-0.241）和女性（kappa：0.327，95%CI：0.296-0.358）中均较差。然而，BMI 与男性（r：0.785，P<0.01）和女性（r：0.864，P<0.01）的 BF%均具有良好的相关性。与低 BF%（男性：BF%<20%，女性：BF%<30%）或低 BMI（男性：BMI<24kg/m²，女性：BMI<24kg/m²）相比，中间 BF%（男性：BF%20.1%-25%，女性：BF%30.1%-35%）和高 BF%（男性：BF%>25%，女性：BF%>35%）或高 BMI（男性：BMI>28kg/m²，女性：BMI>28kg/m²）的受试者中，2 型糖尿病（T2DM）的发病相对风险（RR）明显更高（RR：2.35，95%CI：1.23-4.48）和（RR：2.89，95%CI：1.43-5.81），或高 BMI（男性：BMI>28kg/m²，女性：BMI>28kg/m²）的受试者（RR：2.46，95%CI：1.31-4.63）。与低 BF%（男性：BF%<20%，女性：BF%<30%）或低 BMI（男性：BMI<24kg/m²，女性：BMI<24kg/m²）相比，中间 BMI（男性：BMI 24-27.9kg/m²，女性：BMI 24-27.9kg/m²）的受试者之间没有发现风险差异（RR：1.44，95%CI：0.86-2.40），而这些受试者的 BF%范围很广，从 7.8%到 50.3%。
结论
BMI 与 BF%相关。BMI 和 BF%均与 T2DM 的高风险相关。然而，BMI 在解释 BMI 在 24 到 27.9kg/m² 之间的受试者时存在局限性。
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