Silveira S L, Ledoux T A, Robinson-Whelen S, Stough R, Nosek M A
Department of Health and Human Performance, University of Houston, Houston, TX, USA.
Baylor College of Medicine, Department of Physical Medicine and Rehabilitation, Center for Research on Women with Disabilities, Houston, TX, USA.
Spinal Cord. 2017 Sep;55(9):812-817. doi: 10.1038/sc.2017.79. Epub 2017 Jul 11.
Narrative review.
Review methods used to measure and classify obesity in individuals with spinal cord injuries (SCI). Outline the strengths and weaknesses of each method used to measure obesity in individuals with SCI.
International.
PubMed was used to identify articles before 2016. Search terms ('obesity' or 'weight status' and 'spinal cord injury'). Filters: adults, English and human. Studies were retained that (1) included participants, 18 years or older, with SCI; (2) took place in inpatient, outpatient or community-based settings and (3) measured obesity status. Unique methods for classifying individuals with SCI as obese were identified and examples are presented.
Methods identified for classifying obesity were as follows: World Health Organization body mass index (BMI) cutoff⩾30 kg m, BMI cutoff ⩾25-29 kg m, and SCI-specific BMI cutoff ⩾22 kg m, waist circumference cutoff (women >102 cm, men >88 cm), percent body fat cutoffs ⩾25% using bioelectrical impedance analysis and dual-energy X-ray absorptiometry, computerized tomography scan visceral fat area ⩾100 cm and percentage of ideal body weight.
BMI is the most widely used measure of obesity in the SCI literature. Although some studies identified alternative cutoffs or other metrics, there is no standardized obesity classification in SCI. However, research is needed to determine and validate obesity classification specific to SCI due to physiological changes that occur following injury. We recommend that researchers and clinicians proceed with caution and use methodology based on the purpose of measurement.
叙述性综述。
回顾用于测量和分类脊髓损伤（SCI）个体肥胖情况的方法。概述用于测量SCI个体肥胖的每种方法的优缺点。
国际范围。
使用PubMed检索2016年之前的文章。检索词（“肥胖”或“体重状况”以及“脊髓损伤”）。筛选条件：成人、英文文献和人类研究。保留的研究需满足：（1）纳入18岁及以上的SCI参与者；（2）在住院、门诊或社区环境中进行；（3）测量肥胖状况。确定了将SCI个体分类为肥胖的独特方法并举例说明。
确定的肥胖分类方法如下：世界卫生组织体重指数（BMI）临界值≥30 kg/m²，BMI临界值≥25 - 29 kg/m²，以及特定于SCI的BMI临界值≥22 kg/m²，腰围临界值（女性>102 cm，男性>88 cm），使用生物电阻抗分析和双能X线吸收法测得的体脂百分比临界值≥25%，计算机断层扫描的内脏脂肪面积≥100 cm²以及理想体重百分比。
BMI是SCI文献中最广泛使用的肥胖测量指标。尽管一些研究确定了替代临界值或其他指标，但SCI中尚无标准化的肥胖分类。然而，由于损伤后发生的生理变化，需要开展研究以确定和验证特定于SCI的肥胖分类。我们建议研究人员和临床医生谨慎行事，并根据测量目的使用方法。
