New criteria for 'obesity disease' in Japan
New criteria for 'obesity disease' in Japan
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DOI：
10.1253/circj.66.987
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发表时间：
2002-11-01
影响因子：
3.3
通讯作者：
Nagai, M
中科院分区：
文献类型：
--
作者：
Matsuzawa, Y;Nakamura, T;Nagai, M
本研究的目的是建立适当的标准，在日本与肥胖相关的并发症的“肥胖病”的分类。受试者为1，193名日本受试者（775名男性，418名女性;年龄：20-84岁，体重指数（BMI）：14.9-56.4kg/m2），包括接受健康检查的受试者和前往肥胖诊所就诊的肥胖受试者。腹部CT测量内脏脂肪面积（VFA）和皮下脂肪面积（SFA）。测量体重指数（BMI）、腰围（W）、腰围/臀围（W/H）、腰围/身高（W/BH）。高血压、血脂异常和高血压被评估为肥胖相关并发症。分析各参数与并发症发生率的关系。并发症的数量随着BMI的增加而增加，在BMI为25时，平均值大于1.0。检测具有多种危险因素的受试者的灵敏度和特异性的最佳组合是BMI为25。BMI与SFA呈显著正相关（r=0.82），BMI ≥ 25时也呈显著正相关（r=0.77），而与VFA的相关性较弱（r=0.54）。BMI ≥ 25的肥胖者VFA个体差异较大，BMI与VFA无相关性。在100 cm（2）的VFA处，疾病数量大于1.0，确定具有多种风险因素的受试者的灵敏度和特异性的最佳组合是100 cm（2）的VFA。在VFA的测量值和简单人体测量值之间，证明W与VFA的关系在男性（r=0.68）和女性（r=0.65）中最密切。简单相关分析的回归线表明，VFA 100 cm（2）对应的W，男性为84.4 cm，女性为92.5 cm。这些数据表明，在日本，肥胖症的患病率和程度仍然较轻，肥胖症被充分地指定为BMI大于或等于25。将VFA的临界点确定为100 cm（2）是合理的，这表明肥胖相关疾病的风险，男性腰围为85 cm，女性腰围为90 cm，接近该内脏脂肪量。
The present study was designed to establish adequate criteria for categorizing 'obesity disease' in Japan in relation to obesity-related complications. The subjects were 1,193 Japanese subjects (775 men, 418 women; age: 20-84 years old, body mass index (BMI): 14.9-56.4kg/m(2)) including subjects undergoing a health examination and obese subjects visiting an obesity clinic. Visceral fat area (VFA) and subcutaneous fat area (SFA) were deter-mined by computed tomography (CT) at the umbilical level. Anthropometric parameters, including BMI, waist circumference (W), waist/hip circumference (W/H), ratio and waist circumference/body height (W/BH) ratio, were measured. Hyperglycemia, dyslipidemia, and hypertension were evaluated as obesity-related complications. The relationship between each parameter and the prevalence of the complications was investigated. The number of complications increased in accordance with BMI and the average value was greater than 1.0 at a BMI of 25. The best combination of the sensitivity and specificity for detecting subjects with multiple risk factors was a BMI of 25. BMI showed a close positive correlation with SFA (r=0.82), even for BMI greater than or equal to25 (r=0.77), but had a weaker correlation with VFA (r=0.54). The obese subjects with a BMI greater than or equal to25 had no correlation between BMI and VFA because of the wide individual variation of VFA. The number of disorders was greater than 1.0 at 100 cm(2) of VFA and the best combination of the sensitivity and specificity for determining subjects with multiple risk factors was 100 cm(2) of VFA. Between the simple anthropometric values and measurement of VFA, it was proven that W had the closest relationship with VFA in both men (r=0.68) and women (r=0.65). The regression line obtained from simple correlation analyses indicated that the W corresponding to 100 cm(2) of VFA was 84.4 cm in men and 92.5 cm in women. These data suggest that obesity is adequately specified as a BMI greater than or equal to25 in Japan where the prevalence and degree of obesity remains mild. It is reasonable to establish the cut-off point of VFA at 100 cm(2) as indicative of the risk of obesity-related disorders and a waist circumference of 85cm in men and 90cm in women approximates to this visceral fat mass.