Research Centre on Aging, affiliated with CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada.
Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada.
Menopause. 2021 Mar 1;28(6):678-685. doi: 10.1097/GME.0000000000001754.
First, to establish the respective ability of body mass index (BMI), waist circumference (WC), and relative fat mass index (RFM), to estimate body fat (BF%) measured by DXA (DXA-BF%) and correctly identify postmenopausal women living with obesity (BF% > 35). Second, to identify the best indicator of successful weight-loss intervention in postmenopausal women living with obesity.
A total of 277 women (age: 59.8 ± 5.3 y; BF%: 43.4 ± 5.3) from five weight-loss studies with complete data for anthropometric measurements [BMI = weight/height (kg/m2); WC (cm)] and BF% were pooled together. Statistical performance indicators were determined to assess ability of RFM [64-(20 × height/waist circumference) + (12 × sex)], BMI and WC to estimate BF% before and after weight-loss intervention and to correctly identify postmenopausal women living with obesity.
Compared with RFM (r = 0.51; r2 = 0.27; RMSE = 4.4%; Lin's CCC = 0.46) and WC (r = 0.49; r2 = 0.25; RMSE = 4.8%; Lin's CCC = 0.41), BMI (r = 0.73; r2 = 0.52; RMSE = 3.7%; Lin's CCC = 0.71) was the best anthropometric index to estimate DXA-BF% and correctly identify postmenopausal women living with obesity (sensitivity + specificity: BMI = 193; RFM = 152; WC = 158), with lower misclassification error, before weight-loss intervention. After weight-loss, the change in BMI was strongly correlated with change in DXA-BF%, indicating that the BMI is the best indicator of success weight-loss intervention.
In the absence of more objective measures of adiposity, BMI is a suitable proxy measure for BF% in postmenopausal women, for whom a lifestyle intervention is relevant. Furthermore, BMI can be used as an indicator to assess success of weight-loss intervention in this subpopulation.
首先，确定身体质量指数（BMI）、腰围（WC）和相对脂肪质量指数（RFM）各自的能力，以估计双能 X 线吸收法（DXA）测量的体脂肪（DXA-BF%），并正确识别患有肥胖症的绝经后妇女（BF%＞35%）。其次，确定肥胖绝经后妇女成功减肥干预的最佳指标。
共有 277 名来自五项减肥研究的女性（年龄：59.8±5.3 岁；BF%：43.4±5.3%），这些研究均具有完整的人体测量数据[BMI=体重/身高（kg/m2）；WC（cm）]和 BF%。汇总了这些数据，以确定 RFM[64-（20×身高/腰围）+（12×性别）]、BMI 和 WC 在减肥干预前后估计 BF%的能力，并正确识别患有肥胖症的绝经后妇女。
与 RFM（r=0.51；r2=0.27；RMSE=4.4%；Lin's CCC=0.46）和 WC（r=0.49；r2=0.25；RMSE=4.8%；Lin's CCC=0.41）相比，BMI（r=0.73；r2=0.52；RMSE=3.7%；Lin's CCC=0.71）是估计 DXA-BF%和正确识别患有肥胖症的绝经后妇女的最佳人体测量指标（灵敏度+特异性：BMI=193；RFM=152；WC=158），其分类错误率更低，且在减肥干预前。减肥后，BMI 的变化与 DXA-BF%的变化强烈相关，表明 BMI 是减肥干预成功的最佳指标。
在缺乏更客观的肥胖指标的情况下，BMI 是绝经后妇女 BF%的合适替代指标，对于需要生活方式干预的绝经后妇女，BMI 可作为评估减肥干预效果的指标。
