Hartz A J, Rupley D C, Rimm A A
Am J Epidemiol. 1984 Jan;119(1):71-80. doi: 10.1093/oxfordjournals.aje.a113727.
Most epidemiologic studies which evaluate the association between obesity and disease consider only total adipose tissue and ignore its distribution. The present study used data from a national survey of women in TOPS (a weight reduction organization) in 1969. The purpose of this study was to evaluate the distribution of adipose tissue as a risk factor for disease using girth, height, and weight measurements in 21,065 women 40-59 years of age and 11,791 women 20-39 years of age. It was found that an index of body fat distribution, the ratio of waist girth to hip girth, was significantly associated with diabetes, hypertension, and gallbladder disease in women aged 40-59 and with menstrual abnormalities in women aged 20-39. Relatively more fat around the waist (as compared to hips) was associated with higher disease prevalence even among women with comparable total body fat. These findings suggest that indices based only on weight and height may not adequately characterize the risks associated with obesity.
大多数评估肥胖与疾病之间关联的流行病学研究仅考虑总脂肪组织，而忽略了其分布情况。本研究使用了1969年对TOPS（一个减肥组织）中女性进行的全国性调查数据。本研究的目的是通过对21065名40 - 59岁女性和11791名20 - 39岁女性进行腰围、身高和体重测量，评估脂肪组织分布作为疾病风险因素的情况。研究发现，身体脂肪分布指数，即腰围与臀围之比，在40 - 59岁女性中与糖尿病、高血压和胆囊疾病显著相关，在20 - 39岁女性中与月经异常显著相关。即使在总体脂肪量相当的女性中，腰部周围（相对于臀部）脂肪相对较多也与较高的疾病患病率相关。这些发现表明，仅基于体重和身高的指数可能无法充分表征与肥胖相关的风险。
