Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
J Atheroscler Thromb. 2010 Dec 26;17(12):1237-45. doi: 10.5551/jat.5694. Epub 2010 Sep 7.
The accumulation of Visceral fat is known to precede metabolic disorders and atherosclerosis. This study aimed to determine the relationships between body mass index (BMI), waist circumference (WC), estimated visceral fat area (eVFA) measured by bioelectrical impedance analysis (BIA), and obesity-related cardiovascular risk factors.
The study population was 2,870 middle-aged Japanese employees (males/females=2,322/ 548), who had undergone a health check-up.
In the receiver operating characteristic (ROC) curve, the cutoff levels yielding maximal sensitivity plus specificity for predicting the prevalence of ≥ 2 risks were, 24.5 kg/m(2) for BMI, 84.6 cm for WC, and 111 cm(2) for eVFA in males, and 23.6 kg/m(2), 81.5 cm, and 67 cm(2) in females. The average number of risk factors was over 1.0 in those with a BMI ≥ 25 kg/m(2) and with a WC ≥ 85 cm for males, ≥ 28 kg/m(2) and ≥ 95 cm respectively for females, and those with an eVFA ≥ 100 cm(2) for both males and females. In males, it was around 1.0 with cutoff levels of BMI, WC, and eVFA from the ROC curve. However, in females, it was around 0.6, because the prevalence of subjects with obesity and multiple risks was very low.
These results suggested that the cutoff level for visceral fat reduction should be set based on an absolute value of risk factors, rather than a calculated value. In regular health check-up, it may be useful to set an absolute cutoff value for eVFA at 100 cm(2) as criteria to screen for multiple obesity-related cardiovascular risk factors.
内脏脂肪的积累已知先于代谢紊乱和动脉粥样硬化。本研究旨在确定体重指数（BMI）、腰围（WC）、生物电阻抗分析（BIA）测量的估计内脏脂肪面积（eVFA）与肥胖相关心血管风险因素之间的关系。
研究人群为 2870 名中年日本员工（男性/女性=2322/548），他们接受了健康检查。
在受试者工作特征（ROC）曲线中，对于预测≥2 种风险的患病率具有最大敏感性和特异性的截断值为，男性的 BMI 为 24.5kg/m²、WC 为 84.6cm 和 eVFA 为 111cm²，女性的 BMI 为 23.6kg/m²、WC 为 81.5cm 和 eVFA 为 67cm²。在 BMI≥25kg/m²和 WC≥85cm 的男性、BMI≥28kg/m²和 WC≥95cm 的女性以及男性和女性的 eVFA≥100cm²的人群中，平均风险因素数超过 1.0。在男性中，BMI、WC 和 eVFA 的 ROC 曲线的截断值约为 1.0。然而，在女性中，这一数值约为 0.6，因为肥胖和多种风险因素的受试者的患病率非常低。
这些结果表明，减少内脏脂肪的截断值应基于风险因素的绝对值，而不是计算值。在常规健康检查中，将 eVFA 的绝对截断值设定为 100cm²作为筛查多种肥胖相关心血管风险因素的标准可能是有用的。
