Ravensbergen Henrike Rianne Joanna Cornelie, Lear Scott Alexander, Claydon Victoria Elizabeth
1 Department of Biomedical Physiology and Kinesiology, Simon Fraser University , Burnaby, British Columbia, Canada .
J Neurotrauma. 2014 Feb 1;31(3):292-300. doi: 10.1089/neu.2013.3042. Epub 2013 Dec 11.
Obesity is an important identifier of cardiovascular disease (CVD) risk, but is challenging to determine accurately in individuals with spinal cord injury (SCI). Body mass index (BMI) is used worldwide as a simple indicator of obesity, but is difficult to measure in individuals with SCI. Furthermore, standard BMI cutoffs underestimate obesity in this population. Therefore, we aimed to identify the best marker of obesity in individuals with SCI, considering both practicality, and ability to detect adiposity and CVD risk. Five anthropometric measures were evaluated: BMI; waist circumference (WC); waist-to-height ratio (WHtR); waist-to-hip ratio; and neck circumference. We evaluated relationships between these measures and abdominal and total body-fat percentage, seven cardiovascular metabolic risk factors (fasting insulin, glucose, glucose tolerance, triglycerides, high-density lipoprotein, low-density lipoprotein, and total cholesterol), and the Framingham risk score. BMI, WC, and WHtR were correlated with abdominal fat percentage. WC and WHtR were correlated with five metabolic risk factors as well as the Framingham risk score. WC is a more practical measure for an SCI population. The optimal cutoff for identifying adverse CVD risk in individuals with SCI was identified as WC ≥94 cm, with 100% sensitivity and 79% specificity. We propose that WC is a simple, more sensitive alternative to BMI in this population that is easy to use in multiple settings. The cutoff provides a simple tool to predict adverse CVD risk profiles that can be used to guide risk management, as well as as a practical aid for individuals with SCI to maintain a healthy body composition.
肥胖是心血管疾病（CVD）风险的重要标识，但准确判定脊髓损伤（SCI）个体的肥胖情况具有挑战性。体重指数（BMI）作为肥胖的简单指标在全球范围内被使用，但在SCI个体中难以测量。此外，标准的BMI临界值会低估该人群的肥胖情况。因此，我们旨在确定SCI个体中肥胖的最佳标志物，同时考虑实用性以及检测肥胖和CVD风险的能力。评估了五项人体测量指标：BMI；腰围（WC）；腰高比（WHtR）；腰臀比；以及颈围。我们评估了这些指标与腹部和全身脂肪百分比、七种心血管代谢风险因素（空腹胰岛素、血糖、糖耐量、甘油三酯、高密度脂蛋白、低密度脂蛋白和总胆固醇）以及弗雷明汉风险评分之间的关系。BMI、WC和WHtR与腹部脂肪百分比相关。WC和WHtR与五种代谢风险因素以及弗雷明汉风险评分相关。对于SCI人群，WC是一种更实用的测量方法。确定SCI个体不良CVD风险的最佳临界值为WC≥94 cm，灵敏度为100%，特异度为79%。我们建议，在该人群中，WC是一种比BMI更简单、更敏感的替代指标，易于在多种环境中使用。该临界值提供了一个预测不良CVD风险概况的简单工具，可用于指导风险管理，同时也为SCI个体维持健康的身体成分提供了实用帮助。
