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从旧到新:肥胖诊断标准及其影响的全面综述

From Old to New: A Comprehensive Review of Obesity Diagnostic Criteria and Their Implications.

作者信息

Hong Sangmo, Park Cheol-Young

机构信息

Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, Korea.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Endocrinol Metab (Seoul). 2025 Aug;40(4):517-522. doi: 10.3803/EnM.2025.2590. Epub 2025 Aug 20.

Abstract

Obesity is a chronic, multifactorial disease that imposes significant health burdens worldwide. Although body mass index (BMI) is widely used for its simplicity and utility at the population level, it fails to capture critical clinical aspects, including body composition, fat distribution, metabolic health, and functional impairment. This review explores the limitations of current BMI-based diagnostic criteria for obesity and introduces a new definition and diagnostic framework proposed by the Commission on Clinical Obesity. The new criteria redefine obesity using clinical and biological markers and distinguish between clinical and preclinical obesity based on functional consequences and risk stratification. This approach aims to facilitate more accurate diagnoses, individualized treatment, and evidence-based health policies, while also addressing issues such as weight stigma and overdiagnosis. Further research is needed to validate this model and support its integration into clinical practice.

摘要

肥胖是一种慢性、多因素疾病,在全球范围内带来了重大的健康负担。尽管体重指数(BMI)因其在人群层面的简单性和实用性而被广泛使用,但它未能涵盖关键的临床方面,包括身体成分、脂肪分布、代谢健康和功能损害。本综述探讨了当前基于BMI的肥胖诊断标准的局限性,并介绍了临床肥胖委员会提出的新定义和诊断框架。新标准使用临床和生物学标志物重新定义肥胖,并根据功能后果和风险分层区分临床肥胖和临床前肥胖。这种方法旨在促进更准确的诊断、个性化治疗和基于证据的健康政策,同时也解决体重歧视和过度诊断等问题。需要进一步的研究来验证该模型,并支持将其整合到临床实践中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6295/12409152/2a6b4cb9ddaf/enm-2025-2590f1.jpg

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