Where is the beef? Waist circumference is more highly correlated with BMI and total body fat than with abdominal visceral fat in children.
Where is the beef? Waist circumference is more highly correlated with BMI and total body fat than with abdominal visceral fat in children.
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DOI：
10.1038/ijo.2013.170
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发表时间：
2014-06
影响因子：
4.9
通讯作者：
Bouchard, C.
中科院分区：
文献类型：
--
作者：
Katzmarzyk, P. T.;Bouchard, C.
几年前，IJO发表了一篇题为“BMI，脂肪量，腹部肥胖和内脏脂肪：“牛肉”在哪里？”的评论。介绍了与肥胖测量相关的几个概念，并描述了人体测量和更直接的肥胖测量之间的关系。[1] 2007年的评论强调了体重指数（BMI）、腰围（WC）、总内脏脂肪和腹部内脏脂肪（AVF）之间相关性的相似性。尽管在过去的几年中，肥胖症的表征取得了重大进展，仍然存在混淆的价值和相对优点，使用人体测量的措施，以估计总的和特定的身体脂肪库在成人和儿童。在这里，我们将Bouchard 1提出的结果扩展到儿童和青少年，并将模型扩展到包括双能X线吸收测定法（DXA）的结果。我们的样本包括82名白色女孩，118名非洲裔美国女孩，97名白色男孩和83名非洲裔美国男孩，年龄在5-18岁之间，BMI（kg/m2）范围包括正常体重，超重和肥胖类别。WC和BMI由经过培训的技术人员使用标准技术获得，而脂肪量（FM）和躯干脂肪使用全身DXA扫描仪（Hologic QDR 4500 A;贝德福德，MA，美国）评估。使用一系列5-8个横断面腹部磁共振图像（GE Signa Excite; GE Medical Systems，密尔沃基，WI，USA）评估AVF质量。2使用SAS统计软件包V9计算身体组成变量之间的经方差调整的偏相关。3（SAS Institute Inc.，卡里，北卡罗来纳州，美国）。分别计算了四个种族性别组的相关性，并计算了各组受试者数量加权的相关性平均值。相关性分析结果见图1。在四个种族性别组中，BMI和WC之间的年龄调整相关性非常高（r= 0.96;范围0.93-0.97），FM与BMI（r= 0.96;范围0.95-0.96）和WC（r= 0.95;范围0.94-0.97）之间的相关性也非常高。此外，躯干脂肪与BMI（r= 0.94;范围0.92-0.96）和WC（r= 0.95;范围0.93-0.97）之间的相关性也非常高。正如预期的那样，AVF与BMI（r= 0.84;范围0.82-0.87）、WC（r= 0.81;范围0.79-0.82）和FM（r= 0.83;范围0.81-0.84）之间的相关性略低于FM和躯干脂肪之间的相关性，但仍然相当强。此外，每个平均相关性的范围很窄，这表明四个种族和性别组之间的相关模式没有差异，我们在儿童和青少年中呈现的结果与Bouchard最初评论中的成年人非常相似，相关性具有可比性。1在成人中，WC和腹部矢状径通常被确定为AVF的最佳人体测量标志物，但WC是迄今为止最常用的。然而，正如之前在1、5岁成人和现在在儿童中所显示的那样，WC仅部分代表AVF水平。相反，WC与总FM和BMI的相关性比与AVF的相关性更高，因此应首先被视为总肥胖的标志物，而不是AVF本身。此外，我们的分析表明，BMI和WC与儿童AVF同样相关，尽管其水平低于总FM。基于这组横断面观察，似乎BMI在与青年AVF相关方面表现得与WC和DXA衍生的FM一样好。使用DXA的最新进展使...
Several years ago a commentary published in IJO entitled ‘BMI, fat mass, abdominal adiposity and visceral fat: where is the ‘beef’?’introduced several concepts related to the measurement of obesity and described the relationships among anthropometric and more direct measurements of adiposity. 1 The 2007 commentary served to highlight the similarity in correlations between body mass index (BMI), waist circumference (WC), and total and abdominal visceral fat (AVF). Despite significant progress in the characterization of obesity in the past several years, there remains confusion as to the value and relative merits of using anthropometric measures to estimate total and specific body fat depots in both adults and children. Here we extend the results presented by Bouchard 1 to children and adolescents, and expand the model to include results from dual-energy X-ray absorptiometry (DXA). Our sample included 82 white girls, 118 African-American girls, 97 white boys and 83 African-American boys, 5–18 years of age, with a range of BMI (kg/m2) across normal weight, overweight and obese categories. WC and BMI were obtained by trained technicians using standard techniques, whereas fat mass (FM) and trunk fat were assessed using a whole-body DXA scanner (Hologic QDR 4500A; Bedford, MA, USA). AVF mass was assessed using a series of 5–8 cross-sectional abdominal magnetic resonance images (GE Signa Excite; GE Medical Systems, Milwaukee, WI, USA). 2 Age-adjusted partial correlations among the body composition variables were computed using the SAS statistical package V9. 3 (SAS Institute Inc., Cary, NC, USA). Correlations were computed separately in the four race-by-sex groups, and correlation means weighted by the number of subjects in each group were computed. The results of the correlation analysis are presented in Figure 1. Within each of the four race-by-sex groups, the age-adjusted correlations between BMI and WC were very high (r= 0.96; range 0.93–0.97) as were correlations between FM and both BMI (r= 0.96; range 0.95–0.96) and WC (r= 0.95; range 0.94–0.97). Further, correlations between trunk fat and BMI (r= 0.94; range 0.92–0.96) and WC (r= 0.95; range 0.93–0.97) were also very high. As expected, correlations between AVF and BMI (r= 0.84; range 0.82–0.87), WC (r= 0.81; range 0.79–0.82) and FM (r= 0.83; range 0.81–0.84) were somewhat lower than the correlations with FM and trunk fat but were still quite strong. Further, the narrow ranges around each mean correlation demonstrate that there were no differences in the correlation patterns among the four race-by-sex groups.The results we have presented among children and adolescent are very similar to those presented for adults in the original commentary by Bouchard, and the correlations are of comparable magnitude. 1 Among adults, WC and abdominal sagittal diameter have often been identified as the best anthropometric markers of AVF among those available, 3, 4 but WC is by far the most commonly used. However, as was previously shown among adults 1, 5 and now among children, WC is only partially representative of AVF level. Rather, WC is more highly correlated with total FM and BMI than it is with AVF, and should therefore first and foremost be considered a marker of total adiposity rather than AVF per se. Further, our analysis has shown that BMI and WC are equally correlated with AVF in children, albeit at a lower level than with total FM. Based on this set of cross-sectional observations, it appears as though BMI performs as well as WC and DXA-derived FM in its association with AVF in youth. Recent advances using DXA have made the …
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