Swainson Michelle G, Batterham Alan M, Tsakirides Costas, Rutherford Zoe H, Hind Karen
Institute of Sport, Physical Activity and Leisure, Leeds Beckett University, Headingley, Leeds, United Kingdom.
Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.
PLoS One. 2017 May 11;12(5):e0177175. doi: 10.1371/journal.pone.0177175. eCollection 2017.
The conventional measurement of obesity utilises the body mass index (BMI) criterion. Although there are benefits to this method, there is concern that not all individuals at risk of obesity-associated medical conditions are being identified. Whole-body fat percentage (%FM), and specifically visceral adipose tissue (VAT) mass, are correlated with and potentially implicated in disease trajectories, but are not fully accounted for through BMI evaluation. The aims of this study were (a) to compare five anthropometric predictors of %FM and VAT mass, and (b) to explore new cut-points for the best of these predictors to improve the characterisation of obesity.
BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and waist/height0.5 (WHT.5R) were measured and calculated for 81 adults (40 women, 41 men; mean (SD) age: 38.4 (17.5) years; 94% Caucasian). Total body dual energy X-ray absorptiometry with Corescan (GE Lunar iDXA, Encore version 15.0) was also performed to quantify %FM and VAT mass. Linear regression analysis, stratified by sex, was applied to predict both %FM and VAT mass for each anthropometric variable. Within each sex, we used information theoretic methods (Akaike Information Criterion; AIC) to compare models. For the best anthropometric predictor, we derived tentative cut-points for classifying individuals as obese (>25% FM for men or >35% FM for women, or > highest tertile for VAT mass).
The best predictor of both %FM and VAT mass in men and women was WHtR. Derived cut-points for predicting whole body obesity were 0.53 in men and 0.54 in women. The cut-point for predicting visceral obesity was 0.59 in both sexes.
In the absence of more objective measures of central obesity and adiposity, WHtR is a suitable proxy measure in both women and men. The proposed DXA-%FM and VAT mass cut-offs require validation in larger studies, but offer potential for improvement of obesity characterisation and the identification of individuals who would most benefit from therapeutic intervention.
肥胖的传统测量方法采用体重指数(BMI)标准。尽管这种方法有其益处,但人们担心并非所有有肥胖相关疾病风险的个体都能被识别出来。全身脂肪百分比(%FM),特别是内脏脂肪组织(VAT)质量,与疾病发展轨迹相关且可能与之有关,但通过BMI评估并不能完全体现。本研究的目的是:(a)比较%FM和VAT质量的五种人体测量预测指标;(b)探索这些预测指标中最佳指标的新切点,以改善肥胖的特征描述。
对81名成年人(40名女性,41名男性;平均(标准差)年龄:38.4(17.5)岁;94%为白种人)测量并计算BMI、腰围(WC)、腰臀比(WHR)、腰高比(WHtR)和腰/身高0.5(WHT.5R)。还采用带有Corescan的全身双能X线吸收法(GE Lunar iDXA,Encore版本15.0)来量化%FM和VAT质量。应用按性别分层的线性回归分析来预测每个人体测量变量的%FM和VAT质量。在每种性别中,我们使用信息论方法(赤池信息准则;AIC)来比较模型。对于最佳的人体测量预测指标,我们得出了将个体分类为肥胖(男性>25% FM或女性>35% FM,或VAT质量>最高三分位数)的暂定切点。
男性和女性中%FM和VAT质量的最佳预测指标都是WHtR。预测全身肥胖的切点男性为0.53,女性为0.54。预测内脏肥胖的切点两性均为0.59。
在缺乏更客观的中心性肥胖和肥胖度测量方法的情况下,WHtR在男性和女性中都是合适的替代测量指标。所提出的DXA-%FM和VAT质量切点需要在更大规模的研究中进行验证,但为改善肥胖特征描述以及识别最能从治疗干预中获益的个体提供了潜力。