Takesian Mariane, Santo Marco Aurelio, Gadducci Alexandre Vieira, Santarém Gabriela Correia de Faria, Greve Julia, Silva Paulo Roberto, Cleva Roberto de
Department of Gastroenterology.
Department of Orthopedics and Traumatology, Medical School of University of São Paulo São Paulo, SP, Brazil.
Arq Bras Cir Dig. 2018 Jun 21;31(1):e1362. doi: 10.1590/0102-672020180001e1362.
Body mass index (BMI) has some limitations for nutritional diagnosis since it does not represent an accurate measure of body fat and it is unable to identify predominant fat distribution.
To develop a BMI based on the ratio of trunk mass and height.
Fifty-seven patients in preoperative evaluation to bariatric surgery were evaluated. The preoperative anthropometric evaluation assessed weight, height and BMI. The body composition was evaluated by bioimpedance, obtaining the trunk fat free mass and fat mass, and trunk height. Trunk BMI (tBMI) was calculated by the sum of the measurements of the trunk fat free mass (tFFM) and trunk fat mass (tFM) in kg, divided by the trunk height squared (m2)). The calculation of the trunk fat BMI (tfBMI) was calculated by tFM, in kg, divided by the trunk height squared (m2)). For the correction and adjustment of the tBMI and tfBMI, it was calculated the relation between trunk extension and height, multiplying by the obtained indexes.
The mean data was: weight 125.3±19.5 kg, height 1.63±0.1 m, BMI was 47±5 kg/m2) and trunk height was 0.52±0,1 m, tFFM was 29.05±4,8 kg, tFM was 27.2±3.7 kg, trunk mass index was 66.6±10.3 kg/m², and trunk fat was 32.3±5.8 kg/m². In 93% of the patients there was an increase in obesity class using the tBMI. In patients with grade III obesity the tBMI reclassified to super obesity in 72% of patients and to super-super obesity in 24% of the patients.
The trunk BMI is simple and allows a new reference for the evaluation of the body mass distribution, and therefore a new reclassification of the obesity class, evidencing the severity of obesity in a more objectively way.
体重指数(BMI)在营养诊断方面存在一些局限性,因为它不能准确衡量体脂,也无法识别主要的脂肪分布。
基于躯干质量与身高的比值制定一种BMI。
对57例接受减肥手术术前评估的患者进行评估。术前人体测量评估包括体重、身高和BMI。通过生物电阻抗评估身体成分,获取躯干去脂体重、脂肪量和躯干高度。躯干BMI(tBMI)通过将躯干去脂体重(tFFM)和躯干脂肪量(tFM)的测量值(以千克为单位)之和除以躯干高度的平方(平方米)来计算。躯干脂肪BMI(tfBMI)通过以千克为单位的tFM除以躯干高度的平方(平方米)来计算。为了对tBMI和tfBMI进行校正和调整,计算躯干长度与身高的关系,并乘以获得的指数。
平均数据为:体重125.3±19.5千克,身高1.63±0.1米,BMI为47±5千克/平方米,躯干高度为0.52±0.1米,tFFM为29.05±4.8千克,tFM为27.2±3.7千克,躯干质量指数为66.6±10.3千克/平方米,躯干脂肪为32.3±5.8千克/平方米。93%的患者使用tBMI时肥胖等级增加。在III级肥胖患者中,72%的患者tBMI重新分类为超级肥胖,24%的患者重新分类为超超级肥胖。
躯干BMI简单易行,可为身体质量分布评估提供新的参考,从而对肥胖等级进行新的重新分类,更客观地证明肥胖的严重程度。