Nature Reviews:腰围应被纳入临床肥胖管理的常规指标(共识声明)
  • 由于腹部肥胖正流行,缺乏腰围测量不足以准确描述与全球肥胖的健康风险;
  • 无论年龄与性别,各BMI区间的腰围均与健康问题相关,其略优于BMI的预测能力与其考虑腹部脂肪量相关;
  • 鉴定高风险肥胖特征时,结合使用腰围和BMI比单独使用效果好;
  • 无论年龄、性别和种族,健康饮食和运动均可达到减少腰围的作用,有时甚至无关于体重;
  • 建议未来统一腰围检测规范,检测髂骨稜或其与最后一根肋骨间的中间点,并根据不同BMI区间制定不同腰围阀值。
国际动脉粥样硬化学会和国际心脏代谢风险学会,近期在Nature Reviews Endocrinology上发表共识声明,建议将腰围测量纳入临床常规检测中用于管理肥胖。该声明总结了过去诸多研究,证明腰围能有效预测心血管疾病等肥胖疾病风险及死亡率,其预测功能在与BMI结合后更加有效。尽管目前还没有统一的测量规范以及针对不同BMI、年龄、性别和种族的参考指标,但相信在不久的将来相关的前瞻性研究会交出一份答卷。

Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity



2020-02-04, Review

Abstract & Authors:展开

Despite decades of unequivocal evidence that waist circumference provides both independent and additive information to BMI for predicting morbidity and risk of death, this measurement is not routinely obtained in clinical practice. This Consensus Statement proposes that measurements of waist circumference afford practitioners with an important opportunity to improve the management and health of patients. We argue that BMI alone is not sufficient to properly assess or manage the cardiometabolic risk associated with increased adiposity in adults and provide a thorough review of the evidence that will empower health practitioners and professional societies to routinely include waist circumference in the evaluation and management of patients with overweight or obesity. We recommend that decreases in waist circumference are a critically important treatment target for reducing adverse health risks for both men and women. Moreover, we describe evidence that clinically relevant reductions in waist circumference can be achieved by routine, moderate-intensity exercise and/or dietary interventions. We identify gaps in the knowledge, including the refinement of waist circumference threshold values for a given BMI category, to optimize obesity risk stratification across age, sex and ethnicity. We recommend that health professionals are trained to properly perform this simple measurement and consider it as an important ‘vital sign’ in clinical practice.

First Authors:
Robert Ross

Correspondence Authors:
Robert Ross

All Authors:
Robert Ross,Ian J Neeland,Shizuya Yamashita,Iris Shai,Jaap Seidell,Paolo Magni,Raul D Santos,Benoit Arsenault,Ada Cuevas,Frank B Hu,Bruce A Griffin,Alberto Zambon,Philip Barter,Jean- Charles Fruchart,Robert H Eckel,Yuji Matsuzawa,Jean-Pierre Després