不同标准评价住院患者超重与肥胖的比较

Comparison of different evaluation criteria for judging overweight and obesity inpatients

背景:世界卫生组织采用体质量指数与腰臀比来判断个体肥胖和体脂分布的准确性是有限的。目的:比较体质量指数和体脂含量及腰臀比和内脏脂肪面积判断肥胖的差异。方法:选择471例内科住院患者,按性别分组后,再分为青年组、中年组和老年组,用生物电阻抗法分析体脂含量和内脏脂肪面积进行肥胖和超重分析,并与体质量指数、腰臀比判断情况进行比较。结果与结论:男女各年龄组之间的体质量指数差异不明显,女性各年龄组体脂含量存在明显差异(P<0.01),且随着年龄的增加,其数值越大。除了男性老年组体质量指数判断肥胖比例高于体脂含量外,其余男女各年龄组体脂含量判断肥胖比例均高于体质量指数。男女各年龄组之间腰臀比和内脏脂肪含量判断肥胖差异均较明显(P<0.01),随着年龄的增加其数值也增加,除了男性青年组两种方法判断腹部肥胖无差异外,其余男女各年龄组腰臀比判断腹部肥胖比例高(P<0.01)。说明体质量指数和体脂含量判断肥胖,腰臀比和内脏脂肪面积判断腹部肥胖均存在差异,可以选择体脂含量和腰臀比判断患者肥胖和腹部肥胖,但均需要更多的研究来证实。

BACKGROUND： Body mass index and waist-to-hip ratio are used by the World Health Organization for the judgment of obesity and body fat distribution. The veracity of this diagnosis method is limited. OBJECTIVE： To analyze the difference of body mass index, body fat content, waist-to-hip ratio and visceral fat area for the judgment of obesity. METHODS： A total of 471 hospitalized medical patients were selected and divided into three groups according to ages and genders： young group, middle age group and elder group. Body fat content and visceral fat area were measured by bioelectdcal impedance method to judge obesity and overweight. The veracity of the two judgment methods mentioned above were compared with that of body mass index and waist-to-hip ratio judgment methods. RESULTS AND CONCLUSION： There was no significant difference in body mass index of different age groups between genders. There was significant difference in female body fat content among different age groups （P 〈 0.01 ）; and it increased with age. The obesity rate diagnosed using body fat content was higher than that diagnosed using body mass index among all groups other than male elder group （obesity rate diagnosed using body fat content was lower）. There was significant difference in the abdominal obesity rate diagnosed using waist-to-hip ratio and visceral fat area in different age groups between genders （P 〈 0.01）; and it increased with age. The abdominal obesity rate diagnosed using waist-to-hip ratio was higher than that using visceral fat area among all groups （P 〈 0.01 ） other than male young group （no difference）. These findings indicate that there is difference in the obesity rate diagnosed using body mass index and body fat content; there is difference in the abdominal obesity rate diagnosed using waist-to-hip ratio and visceral fat area. Body fat content and waist-to-hip ratio can be used to diagnose obesity and abdominal obesity; however, further investigation is needed.