De Schutter Alban, Lavie Carl J, Gonzalez Jose, Milani Richard V
Ochsner J. 2011 Fall;11(3):220-5.
Despite its many known shortcomings, body mass index (BMI) is the most widely used measure of obesity, in part because of its practicality. Other more physiologic measurements of obesity have been proposed, including percent body fat (BF). Few studies have compared BMI and BF, especially in patients with coronary heart disease (CHD).
We studied 581 patients with CHD following major CHD events. We divided patients into low (≤ 25% in men and ≤ 35% in women) and high BF (> 25% in men and > 35% in women) as determined by the sum of the skin-fold method and compared these findings with standard BMI determinations.
BMI and BF were highly correlated (r = 0.60; P < .001) and classified patients in the same category (obese vs nonobese) in 68% of cases. The agreement was optimal in the underweight (BMI < 18.5 kg/m(2)) and obese class II category (BMI 35-39.9 kg/m(2)), in which 100% of patients were classified as nonobese and obese, respectively, by both BMI and BF categories. The performance was worst in patients with BMIs in the overweight or preobese range (25-29.9 kg/m(2)), in which 58% of patients would be classified as obese according to BF criteria.
Although some CHD patients are classified differently by BMI and BF, especially within the overweight BMI group, in general BMI and BF are highly correlated, especially in the underweight and obese BMI groups. Prospective studies are needed to determine which index of obesity best predicts risk in primary and secondary prevention.
尽管体重指数（BMI）存在诸多已知缺点，但它仍是应用最广泛的肥胖衡量指标，部分原因在于其实用性。人们还提出了其他更具生理学意义的肥胖测量方法，包括体脂百分比（BF）。很少有研究比较BMI和BF，尤其是在冠心病（CHD）患者中。
我们研究了581例发生重大冠心病事件后的冠心病患者。根据皮褶厚度法计算得出的结果，将患者分为低体脂组（男性≤25%，女性≤35%）和高体脂组（男性>25%，女性>35%），并将这些结果与标准BMI测定结果进行比较。
BMI与BF高度相关（r = 0.60；P < 0.001），在68%的病例中，二者对患者的分类（肥胖与非肥胖）相同。在体重过轻（BMI < 18.5 kg/m²）和肥胖II级类别（BMI 35 - 39.9 kg/m²）中一致性最佳，在这两个类别中，分别有100%的患者根据BMI和BF类别被分类为非肥胖和肥胖。在BMI处于超重或肥胖前期范围（25 - 29.9 kg/m²）的患者中表现最差，根据BF标准，其中58%的患者会被分类为肥胖。
尽管一些冠心病患者根据BMI和BF的分类不同，尤其是在超重BMI组中，但总体而言，BMI和BF高度相关，尤其是在体重过轻和肥胖的BMI组中。需要进行前瞻性研究以确定哪种肥胖指标能最好地预测一级和二级预防中的风险。
