Diagnostic performance of body mass index to detect obesity in patients with coronary artery disease
Diagnostic performance of body mass index to detect obesity in patients with coronary artery disease
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DOI：
10.1093/eurheartj/ehm243
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发表时间：
2007-09-01
影响因子：
39.3
通讯作者：
Lopez-Jimenez, Francisco
中科院分区：
文献类型：
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作者：
Romero-Corral, Abel;Somers, Virend K.;Lopez-Jimenez, Francisco
研究背景新的证据表明，轻度升高的体重指数（BMI）与冠心病（CAD）患者的生存率提高和心血管事件减少有关。我们假设，这些结果与不良的诊断性能的BMI检测肥胖症，特别是在中间BMI ranges.Methods和结果的一个横断面研究95例CAD患者提到第二阶段心脏康复。用空气置换体积描记法测定体脂（BF）%。当天测量身高、体重、BMI和腰围。我们计算了BMI与BF%和瘦体重之间的相关性，并评估了BMI检测肥胖的诊断性能，定义为男性BF% >25%和女性>35%。虽然BMI与BF%有很好的相关性（rho = 0.66，P < 0.0001），但它与瘦体重也有很好的相关性（rho = 0.41，P < 0.0001），BMI无法区分两者（P值= 0.72）。BMI > 30 kg/m2具有较好的特异性（95%; 95% CI，83-100），但敏感性较差（43%; 95% CI，32-54）而BMI > 25 kg/m2具有良好的敏感性（91%; 95% CI，8497），但特异性较差（65%; 95%CI，42-88）来检测BF%-肥胖。结论在CAD患者中，BMI不能区分BF%和瘦体重，BMI < 30 kg/m2是诊断肥胖的不良指标。这些发现可能解释了有争议的发现，即轻度BMI升高与CAD患者更好的生存率和更少的心血管事件有关。身体成分技术，以准确诊断肥胖的CAD患者可能是必要的。
Background Emerging evidence suggests that a mildly elevated body mass index (BMI), is related to improved survival and fewer cardiovascular events in patients with coronary artery disease (CAD). We hypothesize that these results are related to the poor diagnostic performance of BMI to detect adiposity, especially in the intermediate BMI ranges.Methods and Results A cross-sectional study of 95 patients with CAD referred to phase II cardiac rehabilitation. Body fat (BF)% was estimated by air displacement plethysmography. Height, weight, BMI and waist circumference were measured the same day. We calculated the correlation between BMI and both, BF% and lean mass and assessed the diagnostic performance of BMI to detect obesity defined as a BF% >25% in men and >35% in women. Although BMI had a good correlation with BF% (rho = 0.66, P < 0.0001), it also had a good correlation with lean mass (rho = 0.41, P < 0.0001), and BMI failed to discriminate between both (P-value = 0.72). A BMI > 30 kg/m(2) had a good specificity (95%; 95% CI, 83-100) but a poor sensitivity (43%; 95% CI, 32-54) while a BMI > 25 kg/m(2) had a good sensitivity (91 %; 95% CI, 8497) but a poor specificity (65%; 95% CI, 42-88) to detect BF%-obesity.Conclusions In patients with CAD, BMI does not discriminate between BF% and lean mass, and a BMI < 30 kg/m(2) is a poor index to diagnose obesity. These findings may explain the controversial findings that link mild elevations of BMI to better survival and fewer cardiovascular events in patients with CAD. Body composition techniques to accurately diagnose obesity in patients with CAD might be necessary.