Liu Yupeng, He Hangqian, Qian Keyu, Huang Yufeng, Ao Xuemei, Shi Xudong, Ruan Binye, Xue Ru, Fu Xiaoyi, Wang Shuran
Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China.
J Cachexia Sarcopenia Muscle. 2024 Dec;15(6):2651-2659. doi: 10.1002/jcsm.13609. Epub 2024 Oct 7.
Traditional metrics such as body mass index (BMI) and waist circumference (WC) fail to accurately assess the health outcomes associated with abdominal adiposity, because they neglect the intricacies of adipose tissue distribution. Notably, the variability in body composition scaled to height remains underexplored in Chinese demographics. This study introduces height-normalised indices of abdominal adiposity using computed tomography (CT) scans and further assesses their associations with various health outcomes.
In a large, diverse Chinese population (n = 1054 healthy individuals; n = 1159 with dyslipidemia; n = 803 with diabetes; n = 1289 with cardio-cerebrovascular diseases; n = 1108 with cancers; and n = 509 with abnormal bone mas), abdominal CT scans were performed and allometric growth model analyses were used to derive height-normalised indices (body composition/height). Logistic regression models assessed the associations between these indices and health outcomes.
Distinct scaling powers were observed for visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and total abdominal adipose tissue (TAT), as well as for sagittal diameter (SAD), with marked sex differences. Powers for VAT were 1.786 ± 1.270 for males and 1.274 ± 0.692 for females. Powers for SAT were 2.266 ± 0.856 for males and 1.656 ± 0.497 for females. Powers for TAT were 2.141 ± 0.967 for males and 1.438 ± 0.489 for females. Powers for SAD were 0.646 ± 0.217 for males and 0.678 ± 0.141 for females. After controlling for age, BMI and WC, VAT/height, TAT/height and SAD/height retained their significantly positive associations with the odds of health outcomes, whereas SAT/height did not.
Our findings endorse the clinical utility of height-normalised indices, particularly VAT/height, TAT/height and SAD/height, in health outcomes assessment. These indices, grounded in robust empirical data, underscore the necessity of a nuanced approach in obesity-related health evaluations, advocating for a departure from conventional methods like BMI.
传统指标如体重指数（BMI）和腰围（WC）无法准确评估与腹部肥胖相关的健康结果，因为它们忽略了脂肪组织分布的复杂性。值得注意的是，在中国人群中，按身高缩放的身体成分变异性仍未得到充分研究。本研究采用计算机断层扫描（CT）扫描引入腹部肥胖的身高标准化指数，并进一步评估它们与各种健康结果的关联。
在一个庞大、多样化的中国人群中（n = 1054名健康个体；n = 1159名血脂异常患者；n = 803名糖尿病患者；n = 1289名心脑血管疾病患者；n = 1108名癌症患者；n = 509名骨量异常患者），进行腹部CT扫描，并使用异速生长模型分析得出身高标准化指数（身体成分/身高）。逻辑回归模型评估这些指数与健康结果之间的关联。
观察到内脏脂肪组织（VAT）、皮下脂肪组织（SAT）和腹部总脂肪组织（TAT）以及矢状径（SAD）具有明显的缩放幂，且存在显著的性别差异。男性VAT的幂为1.786±1.270，女性为1.274±0.692。男性SAT的幂为2.266±0.856，女性为1.656±0.497。男性TAT的幂为2.141±0.967，女性为1.438±0.489。男性SAD的幂为0.646±0.217，女性为0.678±0.141。在控制年龄、BMI和WC后，VAT/身高、TAT/身高和SAD/身高与健康结果的几率仍保持显著正相关，而SAT/身高则不然。
我们的研究结果支持身高标准化指数，特别是VAT/身高、TAT/身高和SAD/身高，在健康结果评估中的临床实用性。这些基于可靠经验数据的指数强调了在肥胖相关健康评估中采用细致入微方法的必要性，提倡摒弃如BMI等传统方法。
