Sebo Paul, Herrmann François R, Haller Dagmar M
Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and Geneva University, Geneva, Switzerland.
BMC Obes. 2017 Jun 29;4:23. doi: 10.1186/s40608-017-0158-0. eCollection 2017.
We recently showed that abdominal obesity measurements (waist and hip circumference, waist-to-hip ratio) were inaccurate when performed by general practitioners (GPs). We hypothesise that measurement error could be even higher in overweight and obese patients due to difficulty in locating anatomical landmarks. We aimed to estimate GPs' measurement error of general (weight, height and body mass index (BMI)) and abdominal obesity measurements across BMI subgroups.
This cross-sectional study involved 26 GPs in Geneva, Switzerland. They were asked to take measurements on 20 volunteers within their practice. Two trained research assistants repeated the measures after the GPs ("gold standard"). The proportion of measurement error was computed by comparing the GPs' values ( = 509) to the average value of two measurements taken in turn by the research assistants and stratified by BMI subgroup (normal/underweight: <25 kg/m, overweight: 25 ≤ BMI < 30 kg/m, obese: ≥30 kg/m).
General obesity measurements were less prone to measurement error than abdominal obesity measurements, regardless of the BMI subgroup. The proportions of error increased across BMI subgroups (except for height), and were particularly high for abdominal obesity measurements in obese patients.
Abdominal obesity measurements are particularly inaccurate when GPs use these measurements to assess overweight and obese patients. These findings add further strength to recommendations for GPs to favour use of general obesity measurements in daily practice, particularly when assessing overweight or obese patients.
我们最近发现，全科医生（GP）进行腹部肥胖测量（腰围、臀围、腰臀比）时结果不准确。我们推测，由于难以确定解剖学标志，超重和肥胖患者的测量误差可能更高。我们旨在评估全科医生在不同体重指数（BMI）亚组中对一般肥胖指标（体重、身高和体重指数）及腹部肥胖指标的测量误差。
这项横断面研究涉及瑞士日内瓦的26名全科医生。他们被要求在其诊所内对20名志愿者进行测量。两名经过培训的研究助理在全科医生测量后重复测量（“金标准”）。通过将全科医生的测量值（n = 509）与研究助理依次进行的两次测量的平均值进行比较来计算测量误差比例，并按BMI亚组分层（正常/体重过轻：<25kg/m²，超重：25≤BMI<30kg/m²，肥胖：≥30kg/m²）。
无论BMI亚组如何，一般肥胖测量比腹部肥胖测量更不易产生测量误差。误差比例在各BMI亚组中均有所增加（身高除外），在肥胖患者的腹部肥胖测量中尤其高。
当全科医生使用腹部肥胖测量来评估超重和肥胖患者时，测量结果尤其不准确。这些发现进一步支持了建议全科医生在日常实践中更倾向于使用一般肥胖测量指标，尤其是在评估超重或肥胖患者时。
