Belarmino Giliane, Torrinhas Raquel S, Sala Priscila, Horie Lilian M, Damiani Lucas, Lopes Natalia C, Heymsfield Steven B, Waitzberg Dan L
1Department of Gastroenterology, Surgical Division, LIM 35, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, 2° andar, sala 2208, São Paulo, Cerqueira César CEP: 01246-903 Brazil.
Research Institute - Hospital do Coração de São Paulo, São Paulo, Brazil.
BMC Obes. 2018 Oct 1;5:25. doi: 10.1186/s40608-018-0202-8. eCollection 2018.
Body mass index (BMI) has been used to assess body adiposity, but it cannot adequately reflect body fat (BF) amount. The body adiposity index (BAI) has been shown a better performance than BMI for this purpose, but it can be inaccurate to estimate BF under extreme amounts of fat. Here, we propose a new anthropometric index, the Belarmino-Waitzberg (BeW) index, for specific estimation of BF in severely obese patients.
In 144 adult patients with severe obesity, BF was estimated by air displacement plethysmography (ADP), as the reference method, along with the follow anthropometric measurements: height, abdominal circumference (AC), hip circumference (HC), weight, BMI (weight/ height) and BAI ([HC(cm) / height (m)) - 18] × 100). Patients were proportionately distributed into two distinct databases, the building model database (BMD) and the validation model database (VMD), which were applied to develop and validate the BeW index, respectively. The BeW index was tested for gender and ethnicity adjustment as independent variables. The agreement of BF% values obtained by the new index and by BAI with ADP was also assessed.
The BF% was 52.05 ± 5.42 for ADP and 59.11 ± 5.95 for the BeW index (all results are expressed as the mean ± standard deviation). A positive Pearson correlation ( = 0.74), a good accuracy (Cb = 0.94), and a positive Lin's concordance correlation (CCC = 0.70) were observed between the two groups. The 95% limits of individual agreement between the BeW index and ADP were 6.8 to 7.9%, compared to - 7.5 to 14.8% between the BAI and ADP. The new index, called the Belarmino-Waitzberg (BeW) index, showed an improvement of 2.1% for the R value and a significant gender effect, therefore resulting in two different indexes for females and males, as follows: Female BeW = - 48.8 + 0.087 × AC(cm) + 1.147 × HC(cm) - 0.003 × HC(cm)2 and Male BeW = - 48.8 + 0.087 × AC(cm) + 1.147 × HC(cm) - 0.003 × HC(cm)2-7.195.
The new BeW index showed a good performance for BF estimation in patients with severe obesity and can be superior to the BAI for this purpose.
体重指数（BMI）一直用于评估身体肥胖程度，但它不能充分反映体脂（BF）量。为此，身体肥胖指数（BAI）已显示出比BMI更好的性能，但在脂肪量极高的情况下估计体脂可能不准确。在此，我们提出一种新的人体测量指数，即贝拉米诺 - 魏茨贝格（BeW）指数，用于特定评估重度肥胖患者的体脂。
在144例成年重度肥胖患者中，采用空气置换体积描记法（ADP）作为参考方法来估计体脂，同时进行以下人体测量：身高、腹围（AC）、臀围（HC）、体重、BMI（体重/身高）和BAI（[HC（厘米）/身高（米）） - 18]×100）。患者按比例分配到两个不同的数据库，即构建模型数据库（BMD）和验证模型数据库（VMD），分别用于开发和验证BeW指数。以性别和种族调整作为自变量对BeW指数进行检验。还评估了新指数和BAI所获得的体脂百分比值与ADP的一致性。
ADP测得的体脂百分比为52.05±5.42，BeW指数测得的为59.11±5.95（所有结果均表示为平均值±标准差）。两组之间观察到正的皮尔逊相关性（= 0.74）、良好的准确性（Cb = 0.94）和正的林氏一致性相关性（CCC = 0.70）。BeW指数与ADP之间个体一致性的95%界限为6.8%至7. .9%，而BAI与ADP之间为 - 7.5%至14.8%。新指数，即贝拉米诺 - 魏茨贝格（BeW）指数，R值提高了2.1%，且存在显著的性别效应，因此得出女性和男性的两种不同指数，如下：女性BeW = - 48.8 + 0.087×AC（厘米）+ 1.147×HC（厘米） - 0.003×HC（厘米）²，男性BeW = - 48.8 + 0.087×AC（厘米）+ 1.147×HC（厘米） - 0. .003×HC（厘米）² - 7.195。
新的BeW指数在评估重度肥胖患者的体脂方面表现良好，在此目的上可能优于BAI。
