经脐水平测定腹围与腹内脂肪体积关系的研究

Association between intra-abdominal fat volume and waist circumference measured at the umbilicus level

目的 比较临床常用的3种腹围测量方法与CT测定的腹内脂肪体积的关系,探讨最能反映腹内脂肪堆积程度的腹围测量方法和临床应用价值.方法 对147例18岁以上经年龄和性别匹配的成年人进行身高、体重和臀围测量,分别采用髂嵴上缘水平（WC1）、肋骨下缘和髂嵴上缘连线中点水平（WC2）和脐水平（ WC3）测量腹围,与CT测量的腹内脂肪体积进行比较.结果 男性腹内脂肪体积高于女性[（1 236.0±608.4对931.0±665.0）cm3,P＜0.01].相关性分析显示WC1 （r=0.634）,WC2（r =0.677）和WC3（r=0.712）均与腹内脂肪体积呈正相关（均P＜0.01）,经性别、体重或体重指数校正后,WC3（r分别为0.488和0.432）与腹内脂肪体积的相关性优于WC1（r分别为0.347和0.293）和WC2（r分别为0.424和0.365）.多元逐步线性回归分析显示WC2和WC3均与腹内脂肪体积独立相关,其中以WC3相关性最强（β=0.270,R2C=0.504,P＜0.01）.结论 经髂嵴上缘水平、肋骨下缘与髂嵴上缘连线中点水平以及经脐水平腹围均能反映腹内脂肪含量,其中经脐水平测量腹围是简便易行、更好地反映腹内脂肪体积的方法.

Objective To explore the best measurement of waist circumference related with intra-abdominal fat volume evaluated by CT scan.Methods Height,weight,and hip circumference were measured among 147 subjects aged over 18 years old.Waist circumference was measured at 3 different levels：the upper brim of the iliac crest （ WC1 ）,the midpoint between costal brim and iliac crest （ WC2 ）,and the umbilicus （ WC3 ）.The intra-abdominal fat volume was evaluated by CT scan.Results Intra-abdominal fat volume was significantly higher in men than in women [ （ 1 236.0±608.4 vs 931.0±665.0）cm3,P〈0.01 ].Correlation analysis showed that WC1 （ r =0.634）,WC2（ r=0.677）,and WC3 （r =0.712）were positively correlated with intra-abdominal fat volume （ all P〈0.01 ）.Partial correlation analysis adjusted by gender,weight,or body mass index showed that the correlation of intra-abdominal fat volume with WC3 （ r were 0.488 and 0.432） was better than that with WC1 （ r were 0.347 and 0.293 ） and WC2 （ r were 0.424 and 0.365 ）.Multiple linear stepwise regression analysis demonstrated that WC2 and WC3 were independently associated with intra-abdominal fat volume and WC3 was the strongest impact factor （β =0.270,R2c =0.504,P〈0.01 ）.Conclusions Waist circumference is a simple anthropometric measurement parameter reflecting the degree of intraabdominal fat accumulation.All three different measurements of waist circumference may reflect intra-abdominal fat volume,while waist circumference at umbilical level is the best among them.