Department of Anesthesiology and ICU, Aristotle University Thessaloniki, St. Kiriakidi 1, P.O, 54634, Thessaloniki, Greece.
Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, P.O, 54634, Thessaloniki, Greece.
Obes Surg. 2021 Sep;31(9):4134-4141. doi: 10.1007/s11695-021-05530-7. Epub 2021 Jun 29.
INTRODUCTION/PURPOSE: The accuracy of body mass index (BMI) in detecting obesity in patients treated by intragastric balloon (IGB) remains still speculative. We aimed to determine the discriminatory performance of BMI as an estimate of excess body fat (%BF) in an IGB-treated population.
Retrospective analysis of prospectively collected data of 476 patients who completed the 6-month IGB treatment period and were subjected to body composition analysis. We evaluated the relationship between BMI and %BF or lean mass and the diagnostic performance of BMI ≥ 30 kg/m for adipose tissue detection, stratified by age (< 40 and ≥ 40 years) and gender. Moreover, we identified anthropometric and body composition parameters serving as predictors of obesity according to %BF-based criteria (> 25% in men or > 35% in women).
Gender emerged as an effect modifier in the quadratic polynomial relationship between BMI and %BF (R = 0.849 for men, R = 0.715 for women), while BMI was linearly associated with %BF in both age groups (R = 0.435 for men, R = 0.474 for women). BMI was strongly correlated with both %BF (r = 0.67) and lean mass (r = - 0.65). The overall area under the ROC curve for BMI ≥ 30 kg/m to detect %BF was 0.87 (95%CI 0.85-0.90). A regression model including lean mass, total body water, age, BMI, and female gender explained 0.970 of the variance in %BF.
The discriminatory performance of BMI as an estimate of excess body fat is enhanced by the implementation of gender- and age-specific BMI thresholds for defining obesity, in IGB-treated patients.
简介/目的：胃内球囊（IGB）治疗患者的体重指数（BMI）在肥胖检测中的准确性仍存在争议。我们旨在确定 BMI 作为 IGB 治疗人群中多余体脂肪（%BF）的估计值的判别性能。
对 476 例完成 6 个月 IGB 治疗期并接受身体成分分析的患者前瞻性收集数据进行回顾性分析。我们评估了 BMI 与 %BF 或瘦体重之间的关系，以及 BMI≥30kg/m2 对脂肪组织检测的诊断性能，按年龄（<40 岁和≥40 岁）和性别分层。此外，我们根据 %BF 为基础的标准（男性>25%或女性>35%）确定了作为肥胖预测指标的人体测量学和身体成分参数。
性别是 BMI 与 %BF 之间二次多项式关系的效应修饰剂（男性 R = 0.849，女性 R = 0.715），而 BMI 与两个年龄组的 %BF 呈线性相关（男性 R = 0.435，女性 R = 0.474）。BMI 与 %BF（r = 0.67）和瘦体重（r = -0.65）均高度相关。BMI≥30kg/m2 检测 %BF 的 ROC 曲线下总面积为 0.87（95%CI 0.85-0.90）。包括瘦体重、总体水量、年龄、BMI 和女性性别在内的回归模型解释了 %BF 变异的 0.970。
在 IGB 治疗患者中，实施性别和年龄特异性 BMI 阈值来定义肥胖，可增强 BMI 作为多余体脂肪估计值的判别性能。
