Epidemiology Division, Indian Institute of Toxicology Research (CSIR), Lucknow, India.
Indian J Med Res. 2012;135(1):72-7. doi: 10.4103/0971-5916.93427.
BACKGROUND & OBJECTIVES: Several studies have raised the suspicion that the body mass index (BMI) cut-off for overweight as defined by the WHO may not adequately reflect the actual overweight status. The present study looked at the relationship between BMI and body fat per cent (BF %) / health risks (hypertension and type 2 diabetes) in male residents of Lucknow city, north India to evaluate the validity of BMI cut-off points for overweight.
One thousand one hundred and eleven male volunteer subjects (18-69 yr) who participated in different programmes organized by the Institute during 2005 to 2008 were included in the study. BF% was measured using commercially available digital weight scale incorporating bioelectrical impedance (BI) analyzer. The proposed cut-off for BMI based on BF % was calculated using receiver operating characteristics (ROC) curve analysis.
Forty four per cent subjects showed higher BF % (>25%) with BMI range (24-24.99 kg/m²). Sensitivity and specificity at BMI cut-off at 24.5 kg/m³ were 83.2 and 77.5, respectively. Sensitivity at BMI cut-off >25 kg/m² was reduced by 5 per cent and specificity increased by 4.6 per cent when compared to 24.5 cut-off.
INTERPRETATION & CONCLUSIONS: The study subjects showed higher body fat percentage and risk factors like hypertension and type 2 diabetes at normal BMI range proposed by the WHO. The cut-off for BMI was proposed to be 24.5 kg/m² for our study population. If overweight is regarded as an excess of body fat and not as an excess of weight (increased BMI), the cut-off points for overweight based on BMI would need to be lowered. However, the confidence of estimate of the BMI cut-off in the present study may be considered with the limitations of BI analysis studies.
多项研究表明,世界卫生组织(WHO)定义的超重体重指数(BMI)切点可能不能充分反映实际超重状况。本研究旨在探讨印度北部勒克瑙市男性居民的 BMI 与体脂百分比(BF%)/健康风险(高血压和 2 型糖尿病)之间的关系,以评估超重 BMI 切点的有效性。
本研究纳入了 2005 年至 2008 年期间参加该研究所组织的不同项目的 1111 名男性志愿者(18-69 岁)。BF%使用商业上可用的数字体重秤结合生物电阻抗(BI)分析仪进行测量。使用受试者工作特征(ROC)曲线分析计算基于 BF%的 BMI 切点。
44%的受试者的 BF%(>25%)与 BMI 范围(24-24.99 kg/m²)相匹配。在 BMI 切点为 24.5 kg/m³时,敏感性和特异性分别为 83.2%和 77.5%。与 24.5 切点相比,BMI 切点>25 kg/m²时敏感性降低 5%,特异性增加 4.6%。
本研究对象在 WHO 提出的正常 BMI 范围内表现出较高的体脂百分比和高血压、2 型糖尿病等危险因素。本研究提出 BMI 切点为 24.5 kg/m²。如果超重被视为体脂过多,而不是体重增加(BMI 增加),则基于 BMI 的超重切点需要降低。然而,考虑到 BI 分析研究的局限性,本研究中 BMI 切点的估计置信度可能需要谨慎。