Folsom A R, Burke G L, Ballew C, Jacobs D R, Haskell W L, Donahue R P, Liu K A, Hilner J E
Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis.
Am J Epidemiol. 1989 Nov;130(5):911-24. doi: 10.1093/oxfordjournals.aje.a115424.
Persons whose body fat is distributed predominantly in the abdomen compared with the hips are at increased risk of several chronic diseases. This study examined the cross-sectional relation of percent body fat, computed from skinfold thickness, and fat distribution, measured by the waist-to-hip girth ratio, to physiologic cardiovascular risk factors in a biracial sample (blacks and whites) of young adults aged 18-30 years. The subjects were persons who were examined at baseline (1984-1986) in the Coronary Artery Risk Development in Young Adults Study in four US metropolitan areas. The two hypotheses tested were that 1) after adjusting for percent body fat, waist-to-hip girth ratio is associated with several physiologic risk factors, and 2) fasting concentrations of serum insulin partly explain such association. Percent body fat was significantly associated with all measured blood lipids, lipoproteins, apolipoproteins, uric acid, and blood pressure. Waist-to-hip girth ratio was significantly, although more weakly, associated in multivariate models with blood concentrations of triglycerides, high density lipoprotein (HDL) cholesterol, HDL2 cholesterol, apolipoproteins A-I and B, low density lipoprotein cholesterol (in women only), uric acid, and systolic blood pressure, but was not associated in either sex with total cholesterol, HDL3 cholesterol, or diastolic blood pressure. Fasting serum insulin concentrations were significantly associated with percent body fat (Pearson r = 0.45-0.53), waist-to-hip girth ratio (Pearson r = 0.18-0.27), and most of the physiologic risk factors. Inclusion of fasting insulin in multivariate models reduced, but rarely eliminated, associations between waist-to-hip girth ratio and the physiologic risk factors. These findings suggest that obese young adults, especially those with abdominal fat preponderance, carry a physiologic profile that places them at higher risk of cardiovascular disease, and that fasting insulin concentrations are only partly explanatory.
与臀部相比，身体脂肪主要分布在腹部的人患几种慢性病的风险会增加。本研究调查了通过皮褶厚度计算得出的体脂百分比以及通过腰臀围比测量的脂肪分布与18至30岁双种族（黑人和白人）年轻成人生理心血管危险因素之间的横断面关系。研究对象是在美国四个大都市地区参加青年成人冠状动脉风险发展研究基线检查（1984 - 1986年）的人群。所检验的两个假设是：1）在调整体脂百分比后，腰臀围比与几种生理危险因素相关；2）空腹血清胰岛素浓度部分解释了这种关联。体脂百分比与所有测量的血脂、脂蛋白、载脂蛋白、尿酸和血压显著相关。在多变量模型中，腰臀围比与甘油三酯、高密度脂蛋白（HDL）胆固醇、HDL2胆固醇、载脂蛋白A - I和B、低密度脂蛋白胆固醇（仅在女性中）、尿酸和收缩压的血液浓度显著相关，尽管相关性较弱，但在任何性别中与总胆固醇、HDL3胆固醇或舒张压均无关联。空腹血清胰岛素浓度与体脂百分比（Pearson相关系数r = 0.45 - 0.53）、腰臀围比（Pearson相关系数r = 0.18 - 0.27）以及大多数生理危险因素显著相关。在多变量模型中纳入空腹胰岛素可降低但很少消除腰臀围比与生理危险因素之间的关联。这些发现表明，肥胖的年轻成年人，尤其是腹部脂肪占优势的那些人，具有使其患心血管疾病风险更高的生理特征，并且空腹胰岛素浓度只是部分具有解释作用。
