Garrison R J, Kannel W B
Field Studies and Biometry Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland.
Int J Obes Relat Metab Disord. 1993 Jul;17(7):417-23.
Optimal body weight standards have most often been based on the relationship of relative weight to all cause mortality. This report proposes a strategy based on a more direct measure of adiposity, subscapular skinfolds and cardiovascular disease risk factors, rather than mortality. This approach provides a means for determining standards that are consistent with optimum cardiovascular health without the lengthy follow-up required for mortality studies. The report utilizes data on 2447 non-smoking men and women aged 20-59 years. Seven cardiovascular disease risk factors were significantly related to subscapular skinfold thickness in both sexes in an unfavourable direction. The optimal subscapular skinfolds based on these risk factors for 20-39 year olds were determined to be below 12 mm for men and 15 mm for women. Men and women who had subscapular skinfolds at or below the optimal level had a mean body mass index of 22.6 kg/m2 and 21.1 kg/m2 for men and women, respectively. The probability of being above the optimum adiposity rises rapidly across body mass index levels above 20 kg/m2 and plateaus at above 0.90 in both men and women with body mass index above 24 kg/m2. Thus, screening for above optimal adiposity is necessary only in individuals with body mass index at or below 24 kg/m2.
最佳体重标准通常基于相对体重与全因死亡率的关系。本报告提出了一种基于更直接的肥胖测量方法的策略，即肩胛下皮褶厚度和心血管疾病风险因素，而非死亡率。这种方法提供了一种确定与最佳心血管健康状况相符的标准的途径，而无需死亡率研究所需的长期随访。该报告利用了2447名年龄在20至59岁之间的不吸烟男性和女性的数据。七个心血管疾病风险因素在两个性别中均与肩胛下皮褶厚度呈显著的不利相关。基于这些风险因素，20至39岁人群的最佳肩胛下皮褶厚度被确定为男性低于12毫米，女性低于15毫米。肩胛下皮褶厚度处于或低于最佳水平的男性和女性，其平均体重指数分别为22.6千克/平方米和21.1千克/平方米。在体重指数高于20千克/平方米的人群中，肥胖程度高于最佳水平的概率随着体重指数的提高而迅速上升，在体重指数高于24千克/平方米的男性和女性中，该概率均稳定在0.90以上。因此，仅对体重指数等于或低于24千克/平方米的个体进行肥胖程度高于最佳水平的筛查是必要的。
