社区为基础的系统性红斑狼疮女性人群中肥胖及其测量。
Obesity and its measurement in a community-based sample of women with systemic lupus erythematosus.
机构信息
Arthritis Research Group, University of California, San Francisco, CA 94143-0920, USA.
出版信息
Arthritis Care Res (Hoboken). 2011 Feb;63(2):261-8. doi: 10.1002/acr.20343.
OBJECTIVE
To determine the prevalence of obesity and evaluate how accurately standard anthropometric measures identify obesity among women with systemic lupus erythematosus (SLE).
METHODS
Dual x-ray absorptiometry (DXA), height, weight, and waist and hip circumference measurements were collected from 145 women with SLE. Three anthropometric proxies of obesity (body mass index [BMI]≥30 kg/m2, waist circumference [WC]≥88 cm, and waist:hip ratio [WHR]≥0.85) were compared with a DXA-based obesity criterion. Correspondence between measures was assessed with Cohen's kappa. Receiver operating characteristic curves determined optimal cut points for each anthropometric measure relative to DXA. Framingham cardiovascular risk scores were compared among women who were classified as not obese by both traditional and revised anthropometric definitions, obese by both definitions, and obese only by the revised definition.
RESULTS
Of the 145 women, 28%, 29%, 41%, and 50% were classified as obese by WC, BMI, WHR, and DXA, respectively. Correspondence between anthropometric and DXA-based measures was moderate. Women misclassified by anthropometric measures had less truncal fat and more appendicular lean and fat mass. Cut points were identified for anthropometric measures to better approximate DXA estimates of percent body fat: BMI≥26.8 kg/m2, WC≥84.75 cm, and WHR≥0.80. Framingham risk scores were significantly higher in women classified as obese by either traditional or revised criteria.
CONCLUSION
A large percentage of this group of women with SLE was obese. Substantial portions of women were misclassified by anthropometric measures. Utility of revised cut points compared with traditional cut points in identifying risk of cardiovascular disease or disability remains to be examined in prospective studies, but results from the Framingham risk score analysis suggest that traditional cut points exclude a significant number of at-risk women with SLE.
目的
确定肥胖的患病率，并评估标准人体测量学指标在系统性红斑狼疮（SLE）女性中识别肥胖的准确性。
方法
从 145 名 SLE 女性中收集双能 X 线吸收法（DXA）、身高、体重、腰围和臀围测量值。将三种肥胖的人体测量学指标（BMI≥30kg/m2、WC≥88cm 和 WHR≥0.85）与基于 DXA 的肥胖标准进行比较。采用 Cohen's kappa 评估测量值之间的一致性。接收者操作特征曲线确定每个人体测量学指标相对于 DXA 的最佳截断点。根据传统和修订的人体测量定义，将女性分为不肥胖、肥胖（两种定义都）和仅肥胖（仅修订定义），比较这些女性的弗雷明汉心血管风险评分。
结果
在 145 名女性中，28%、29%、41%和 50%分别通过 WC、BMI、WHR 和 DXA 被归类为肥胖。人体测量学和基于 DXA 的测量之间的一致性为中度。通过人体测量学指标分类错误的女性躯干脂肪较少，四肢瘦体重和脂肪量较多。确定了人体测量学指标的截断点，以更好地近似 DXA 估计的体脂肪百分比：BMI≥26.8kg/m2、WC≥84.75cm 和 WHR≥0.80。根据传统或修订标准被归类为肥胖的女性，弗雷明汉风险评分显著更高。
结论
该组 SLE 女性中肥胖的比例较大。大量女性通过人体测量学指标被错误分类。修订后的截断点与传统截断点在识别 SLE 女性心血管疾病或残疾风险方面的效用仍需在前瞻性研究中进行检验，但弗雷明汉风险评分分析结果表明，传统截断点排除了大量存在风险的 SLE 女性。
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