Reliability of doctors' anthropometric measurements to detect obesity
Reliability of doctors' anthropometric measurements to detect obesity
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DOI：
10.1016/j.ypmed.2008.06.012
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发表时间：
2008-10-01
影响因子：
5.1
通讯作者：
Bovier, Patrick A.
中科院分区：
文献类型：
--
作者：
Sebo, Paul;Beer-Borst, Sigrid;Bovier, Patrick A.
目标。评价医生对肥胖进行评估的人体测量指标（体重、身高、身体质量指数（BMI）、腰臀围（WC； HC）和腰臀比（WHR））的可靠性。2006年，在瑞士日内瓦，12名初级保健医生对24名成年志愿者进行了重复的人体测量。志愿者（54%为女性，平均年龄41岁）的平均BMI为28.1 （WC、HC和WHR的平均值分别为91.4、108.3和0.84）。根据这些测量结果计算观察者间信度系数(R)和志愿者分类（正常体重、超重、肥胖、腹部肥胖）的不一致百分比。体重、身高和导出BMI的观察者间信度非常好（R= 0.99），但WC （R=0.92）、HC （R=0.76）和whz （R=0.51）的观察者间信度不理想。基于BMI，只有1%的志愿者被错误地归类为超重或肥胖，而使用WC和WHR分别导致6%和23%的人被错误地归类。经过一小时的人体测量训练后，测量结果的可靠性得到了提高（WC的R=0.97， HC的R= 0.92， whz的R= 0.89），但尽管进行了WC（5%）和WHIR（9%）的训练，但错误分类的比例仍然很高。在医疗实践中，BMI仍然是检测肥胖最可靠的指标，而WC、HC和WHIR则不太可靠。这些结果挑战了目前基于腰围和腰宽比的肥胖相关心血管风险管理建议，并强调需要进一步研究以提高医生人体测量测量的可靠性。(C) 2008爱思唯尔公司版权所有。
Objective. To evaluate the reliability of anthropometric measurements (weight, height, Body Mass Index (BMI), waist and hip circumferences (WC; HC) and waist-to-hip ratio (WHR)) performed by doctors to assess obesity.Method. Repeated anthropometric measurements were performed by 12 primary care physicians on 24 adult volunteers in Geneva, Switzerland, 2006. Volunteers (54% women, mean age 41) had a mean BMI of 28.1 (respective mean values for WC, HC and WHR: 91.4, 108.3, 0.84). Inter-observer reliability coefficient (R) and percent disagreement in categorisation of volunteers (normal weight, overweight, obesity, abdominal obesity) were computed according to these measurements.Results. The inter-observer reliability for weight, height, and derived BMI were excellent (R>0.99), but unsatisfactory for WC (R=0.92), HC (R=0.76) and WHIZ (R=0.51). Based on the BMI, only 1% of the volunteers were misclassified as overweight or obese, whereas the use of WC and WHR lead to misclassification in 6% and 23% respectively. Reliability for the measurements improved after a one-hour training in anthropometric measurements (R=0.97 for WC, 0.92 for HC and 0.89 for WHIZ), but the proportion who were misclassified remained high despite the training session for WC (5%) and WHIR (9%).Conclusions. BMI remains the most reliable measure to detect obesity in medical practice, whereas WC, HC and WHIR are less reliable. These results challenge current recommendations on obesity-related cardiovascular risk management based on WC and WHR and underline the need for further research to improve the reliability of anthropometric measurements by doctors. (C) 2008 Elsevier Inc. All rights reserved.