湖南省成年人体脂率推测公式的建立与应用
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摘要
研究目的：
我国国民体质监测工作均通过皮褶厚度法推测体脂率来判定肥胖，但一直沿用国外的体脂率推测公式。国内学者相继制订了体脂率推测公式，但这些已制定的公式是否适用于其它地区成年人。本研究以湖南省20-59岁成年人为研究对象，通过比较体脂率的几种测试（或推算）方法的差异，建立适用于湖南省成年人体脂率的推测公式，并运用此公式来了解湖南省成年人身体成分的现状，结合《2010年湖南省国民体质监测问卷》，分析其影响因素，为湖南省成年人合理体重和控制体重、预防超重和肥胖提供可靠的预检方法，提高湖南省国民健康水平，并为今后建立适合我国国民体脂率的推测公式和标准提供方法学依据和奠定理论基础。
研究方法：
1、以湖南省20-59岁普通健康成年人240人，男、女性每10岁为1个年龄组，共8个组别，每组30人。严格按照《2010年国民体质监测工作手册》、BIA测试要求、DEXA测试要求测试身高、体重、胸围、腰围、臀围、上臂部皮褶厚度、肩胛下皮褶厚度、腹部皮褶厚度、体脂率等指标，验证日本长岭-铃木公式、王人卫公式和籍晓蕾公式推测湖南省成年人体脂率是否有效；检验BIA法和DEXA法在体脂率测试中的相关性和一致性，为BIA法在成年人身体成分研究中的应用提供依据。
2、采用等容量分层随机抽样方法，随机抽取湖南省20-59岁成年人960名作为研究对象。每10岁为一个年龄段。采用多元逐步回归方法，建立湖南省成年人体脂率推测公式。另采用研究一中的受试者用于交叉验证和回代检验。测试指标与要求同研究一部分。
3、基于2010年湖南省国民体质监测工作，应用所建立的湖南省成年人体脂率推测公式，了解湖南省成年人的身体成分现状，并结合《2010年湖南省国民体质调查问卷》了解湖南省成年人不同人口学特征的肥胖、超重发生率及其影响因素。
研究结果：
1、采用日本铃木-长岭公式1、2、籍晓蕾公式和王人卫公式推算出的全身体脂率均和DEXA法测试值呈中、高度相关（R=0.628-0.753，P<0.01）。但配对t检验结果发现用日本铃木-长岭公式1（即仅采用上臂部和肩胛部皮褶厚度来推测），均显著低估了湖南省成年男、女性的全身体脂率（P<0.01）；采用日本铃木-长岭公式2，也显著低估湖南省成年女性的全身体脂率（P<0.01）；运用王人卫公式来推测，则高估了湖南省成年男性体脂率，低估了湖南省成年女性体脂率（P<0.01）；运用籍晓蕾公式来推测，低估了湖南省成年人的全身体脂率（P<0.01）。
2、采用多元线性逐步回归分析拟合过程中R的趋1线性论，R2的变异比率论，以及方差分析、回归系数检验、残差检验等，建立了湖南省成年人体脂率推测公式20-29岁、30-39岁、40-49岁和50-59岁男、女性各4个回归方程。回代检验和交叉验证的结果表明通过所建立的回归公式推测出的体脂率与欧姆龙BIA法、DEXA法直接测试出来的体脂率之间军无显著性差异，且高度相关（P<0.001），Kappa检验表明所建公式与DEXA法的超重与肥胖检出率一致性理想，表明通过所建回归公式来推测湖南省成年人的体脂率是可靠的。
3、虽然2010年湖南省成人的体重、BMI、克莱托指数、围度、皮褶厚度等指标中的多数指标低于全国水平，却高于2005年湖南省水平。
4、与采用BMI法、日本铃木-长岭公式对湖南省成年人的超重、肥胖检出率比较，采用本研究建立的体脂率推测公式检出率与其他方法检出率有显著性差异（P<0.05）。
5、湖南省成年人的超重和肥胖状况有以下特点：呈随年龄增长而增长的趋势，中年是肥胖的高发年龄段；存在着城乡差异、经济水平差异；与受教育程度有关；与体力活动相关。
研究结论：
1、由于年龄、性别、不同地域、经济水平等的差异，直接采用国内外公式推测湖南省成年人体脂率时，有的高估、有的低估了湖南省成年人的体脂率。
2、本研究已建立的体脂率公式推测湖南省成年人体脂率是可行且可靠的。男性体脂率推测公式：
%BF20-29=0.278×肩胛部皮褶厚度+0.296×上臂部皮褶厚度+0.231×腹部皮褶厚度+6.215
%BF30-39=0.134×上臂部皮褶厚度+0.170×腹部皮褶厚度+0.228×腰围-1.180
%BF40-49=0.206×肩胛部皮褶厚度+0.267×上臂部皮褶厚度+0.220×腰围-3.018
%BF50-59=0.244×腹部皮褶厚度+0.368×上臂部皮褶厚度+0.144×腰围+1.726女性体脂率推测公式：
%BF20-29=0.205×上臂部皮褶厚度+0.479×腹部皮褶厚度+0.449×臀围-23.949
%BF30-39=0.373×上臂部皮褶厚度+0.214×腹部皮褶厚度+0.162×臀围+1.032
%BF40-49=0.168×肩胛部皮褶厚度+0.211×腹部皮褶厚度+0.395×臀围-13.720
%BF50-59=0.415×上臂部皮褶厚度+0.393×腹部皮褶厚度+0.238×臀围+1.808
3、采用本研究建立的体脂率公式能较准确检出湖南省成年人超重和肥胖情况。年龄、性别、受教育程度、每周外出就餐次数和体力活动状况是湖南省成年人超重或肥胖发生的影响因素。
Objective:
With the development of the economy, body composition research has attracted greatattention from the world, and it tends to be widely applied. The percentage of body fat is thetypical index reflecting the physical composition. Skinfold method is to speculate the fat ratein body as an assessment of obesity which is widely used in National Physique Monitoringwork in China. But the equations which they used are still not native. Some equations aredeveloped by domestic experts, but it is not clear whether these formulas are suitable for theadults in other areas. This research established the formulas applied to measure or speculatethe body fat rate of20-59years old adults in Hunan province, by comparing several methods.Then this study use these formulas to understand adult body composition of adults in HunanProvince, and to analyze the influence factors according to the statistical result of the dataprovided by the questionnaire in National Physique Monitoring in2010, and to supply somereliable monitoring methods which could help people to control their weight and preventoverweight and obesity in Hunan province, and finally to improve the health level of HunanProvince.
Methods:
1.240ordinary healthy adults aged20-59in Hunan province were analyzed by gender anddifferent age group in10years interval (8groups,30each group). According manuals of thenational constitution monitoring, test requirements of BIA and DEXA strictly, height, weight,BMI, chest circumference and waist, hip circumference, triceps, scapula, abdominal skinfold,body fat percentage were measured. This paper discussed the validity of Japan suzukichangling-formula, WangRenWei formula and JiXiaoLei formula in predicting the adults’body fat of Hunan province; analyzed the correlation and consistency of BIA and DEXAmethod in measuring body fat rate.
2.960adults of20-59years old in Hunan province were randomly sampled by multi-levelsampling in the study, and divided by gender and different age group in10years interval.Established the formulas applied to speculate the body fat rate of adults in Hunan provincethrough the methods of multiple linear stepwise regressions. Used the sample of the firststudy for cross validation and the back substitution separately test. Methods are the same withthe first study.
3. Based on the national constitution monitoring work, this thesis estimated the body fat rateof adults in Hunan province; analyzed the present situation of body composition, theincidence of obesity and the overweight and its influencing factors of adults with differentdemographic characteristics in Hunan province according to the statistical result of the dataprovided by the questionnaire in National Physique Monitoring in2010.
Results:
1.Compared with the measured results of the body fat rate by Japan Suzuki-Changlingformula1,2, JiXiaoLei formula and WangRenWei formula, and the results measured byDEXA, we found that the correlation coefficients between the above4methods and DEXAmethod all were moderate or high (R=0.628-0.753,P<0.01). But t test found compared withJapan Suzuki-Changling formula1(only used triceps， scapula skinfold), there weresignificantly undervalued the whole body fat percentage of Hunan adults (P<0.01);UsingJapan suzuki-only changling formula2(i.e. Abdominal skin-fold only used to estimate), isalso significantly undervalued the whole body fat percentage of Hunan female (P<0.01); UseWangRenWei formula is underestimated body fat percentage of male (P<0.01); UseJiXiaoLei formula underestimated the whole body fat percentage of all adults in Hunanprovince (P<0.01).
2. With the multiple linear regression analysis fitting process R trend of1linear, R2variationratio theory, and analysis of variance, regression coefficient test, residual of normal sexualinspection and so on,8regression equation of body fat rate were establishedin20-29,30-39,40-49, and50-59age and divided by men and women.
3. Most of index such as weight, BMI, klein's index and skin-fold are below the national level,but are higher than level of2005in Hunan province, especially male30-44age group andfemale30-34age group are significantly higher (P<0.05).
4. Compared with the detection rates of overweight and obesity of adults in Hunan provincemeasured by BMI method and Japan Suzuki-Changling formulas,the detection rates aresignificantly different with those of measured by this established predicting equations (P<0.05).
5. The characteristics of overweight and obesity condition of adults in Hunan province are:(1)it increased with aging;(2) there were differences between urban and rural areas (3) therewere differences among different economic levels.(4) there were differences among differenteducation levels.
Conclusion:
1. Due to different ages,sexs, regions,economical levels,the way of using predicting equationsof body fat percentage for adults at home or abroad directly overestimate or underestimatethe body fat percentage of adults in Hunan province.
2. These initial equations are reliable for predicting body fat percentage of adults in Hunanprovince.
Predicting equations of body fat percentage for females are as follows:
%BF20-29=0.278X1+0.296X3+0.231X2+6.215
%BF30-39=0.134X3+0.170X2+0.228X4-1.180
%BF40-49=0.206X1+0.267X3+0.220X4-3.018
%BF50-59=0.244X2+0.368X2+0.144X4+1.726Predicting equations of body fat percentage for females are as follows:
%BF20-29=0.205X3+0.479X2+0.449X5-23.949
%BF30-39=0.373X3+0.214X2+0.162X5+1.032
%BF40-49=0.168X1+0.211X2+0.395X5-13.720
%BF50-59=0.415X3+0.393X2+0.238X5+1.808
(X1: scapula skinfold, X2: abdominal skinfold, X3: triceps skinfold, X4: waistcircumference, X5: hip circumference.)
3.This established body fat percentage equations can improve the detection rates and knowthe situation of overweight and obesity of adults in Hunan province more precisely.Age,sex,education level,frequency of dining out and physical activity are influence factors.
我国国民体质监测工作均通过皮褶厚度法推测体脂率来判定肥胖，但一直沿用国外的体脂率推测公式。国内学者相继制订了体脂率推测公式，但这些已制定的公式是否适用于其它地区成年人。本研究以湖南省20-59岁成年人为研究对象，通过比较体脂率的几种测试（或推算）方法的差异，建立适用于湖南省成年人体脂率的推测公式，并运用此公式来了解湖南省成年人身体成分的现状，结合《2010年湖南省国民体质监测问卷》，分析其影响因素，为湖南省成年人合理体重和控制体重、预防超重和肥胖提供可靠的预检方法，提高湖南省国民健康水平，并为今后建立适合我国国民体脂率的推测公式和标准提供方法学依据和奠定理论基础。
研究方法：
1、以湖南省20-59岁普通健康成年人240人，男、女性每10岁为1个年龄组，共8个组别，每组30人。严格按照《2010年国民体质监测工作手册》、BIA测试要求、DEXA测试要求测试身高、体重、胸围、腰围、臀围、上臂部皮褶厚度、肩胛下皮褶厚度、腹部皮褶厚度、体脂率等指标，验证日本长岭-铃木公式、王人卫公式和籍晓蕾公式推测湖南省成年人体脂率是否有效；检验BIA法和DEXA法在体脂率测试中的相关性和一致性，为BIA法在成年人身体成分研究中的应用提供依据。
2、采用等容量分层随机抽样方法，随机抽取湖南省20-59岁成年人960名作为研究对象。每10岁为一个年龄段。采用多元逐步回归方法，建立湖南省成年人体脂率推测公式。另采用研究一中的受试者用于交叉验证和回代检验。测试指标与要求同研究一部分。
3、基于2010年湖南省国民体质监测工作，应用所建立的湖南省成年人体脂率推测公式，了解湖南省成年人的身体成分现状，并结合《2010年湖南省国民体质调查问卷》了解湖南省成年人不同人口学特征的肥胖、超重发生率及其影响因素。
研究结果：
1、采用日本铃木-长岭公式1、2、籍晓蕾公式和王人卫公式推算出的全身体脂率均和DEXA法测试值呈中、高度相关（R=0.628-0.753，P<0.01）。但配对t检验结果发现用日本铃木-长岭公式1（即仅采用上臂部和肩胛部皮褶厚度来推测），均显著低估了湖南省成年男、女性的全身体脂率（P<0.01）；采用日本铃木-长岭公式2，也显著低估湖南省成年女性的全身体脂率（P<0.01）；运用王人卫公式来推测，则高估了湖南省成年男性体脂率，低估了湖南省成年女性体脂率（P<0.01）；运用籍晓蕾公式来推测，低估了湖南省成年人的全身体脂率（P<0.01）。
2、采用多元线性逐步回归分析拟合过程中R的趋1线性论，R2的变异比率论，以及方差分析、回归系数检验、残差检验等，建立了湖南省成年人体脂率推测公式20-29岁、30-39岁、40-49岁和50-59岁男、女性各4个回归方程。回代检验和交叉验证的结果表明通过所建立的回归公式推测出的体脂率与欧姆龙BIA法、DEXA法直接测试出来的体脂率之间军无显著性差异，且高度相关（P<0.001），Kappa检验表明所建公式与DEXA法的超重与肥胖检出率一致性理想，表明通过所建回归公式来推测湖南省成年人的体脂率是可靠的。
3、虽然2010年湖南省成人的体重、BMI、克莱托指数、围度、皮褶厚度等指标中的多数指标低于全国水平，却高于2005年湖南省水平。
4、与采用BMI法、日本铃木-长岭公式对湖南省成年人的超重、肥胖检出率比较，采用本研究建立的体脂率推测公式检出率与其他方法检出率有显著性差异（P<0.05）。
5、湖南省成年人的超重和肥胖状况有以下特点：呈随年龄增长而增长的趋势，中年是肥胖的高发年龄段；存在着城乡差异、经济水平差异；与受教育程度有关；与体力活动相关。
研究结论：
1、由于年龄、性别、不同地域、经济水平等的差异，直接采用国内外公式推测湖南省成年人体脂率时，有的高估、有的低估了湖南省成年人的体脂率。
2、本研究已建立的体脂率公式推测湖南省成年人体脂率是可行且可靠的。男性体脂率推测公式：
%BF20-29=0.278×肩胛部皮褶厚度+0.296×上臂部皮褶厚度+0.231×腹部皮褶厚度+6.215
%BF30-39=0.134×上臂部皮褶厚度+0.170×腹部皮褶厚度+0.228×腰围-1.180
%BF40-49=0.206×肩胛部皮褶厚度+0.267×上臂部皮褶厚度+0.220×腰围-3.018
%BF50-59=0.244×腹部皮褶厚度+0.368×上臂部皮褶厚度+0.144×腰围+1.726女性体脂率推测公式：
%BF20-29=0.205×上臂部皮褶厚度+0.479×腹部皮褶厚度+0.449×臀围-23.949
%BF30-39=0.373×上臂部皮褶厚度+0.214×腹部皮褶厚度+0.162×臀围+1.032
%BF40-49=0.168×肩胛部皮褶厚度+0.211×腹部皮褶厚度+0.395×臀围-13.720
%BF50-59=0.415×上臂部皮褶厚度+0.393×腹部皮褶厚度+0.238×臀围+1.808
3、采用本研究建立的体脂率公式能较准确检出湖南省成年人超重和肥胖情况。年龄、性别、受教育程度、每周外出就餐次数和体力活动状况是湖南省成年人超重或肥胖发生的影响因素。
Objective:
With the development of the economy, body composition research has attracted greatattention from the world, and it tends to be widely applied. The percentage of body fat is thetypical index reflecting the physical composition. Skinfold method is to speculate the fat ratein body as an assessment of obesity which is widely used in National Physique Monitoringwork in China. But the equations which they used are still not native. Some equations aredeveloped by domestic experts, but it is not clear whether these formulas are suitable for theadults in other areas. This research established the formulas applied to measure or speculatethe body fat rate of20-59years old adults in Hunan province, by comparing several methods.Then this study use these formulas to understand adult body composition of adults in HunanProvince, and to analyze the influence factors according to the statistical result of the dataprovided by the questionnaire in National Physique Monitoring in2010, and to supply somereliable monitoring methods which could help people to control their weight and preventoverweight and obesity in Hunan province, and finally to improve the health level of HunanProvince.
Methods:
1.240ordinary healthy adults aged20-59in Hunan province were analyzed by gender anddifferent age group in10years interval (8groups,30each group). According manuals of thenational constitution monitoring, test requirements of BIA and DEXA strictly, height, weight,BMI, chest circumference and waist, hip circumference, triceps, scapula, abdominal skinfold,body fat percentage were measured. This paper discussed the validity of Japan suzukichangling-formula, WangRenWei formula and JiXiaoLei formula in predicting the adults’body fat of Hunan province; analyzed the correlation and consistency of BIA and DEXAmethod in measuring body fat rate.
2.960adults of20-59years old in Hunan province were randomly sampled by multi-levelsampling in the study, and divided by gender and different age group in10years interval.Established the formulas applied to speculate the body fat rate of adults in Hunan provincethrough the methods of multiple linear stepwise regressions. Used the sample of the firststudy for cross validation and the back substitution separately test. Methods are the same withthe first study.
3. Based on the national constitution monitoring work, this thesis estimated the body fat rateof adults in Hunan province; analyzed the present situation of body composition, theincidence of obesity and the overweight and its influencing factors of adults with differentdemographic characteristics in Hunan province according to the statistical result of the dataprovided by the questionnaire in National Physique Monitoring in2010.
Results:
1.Compared with the measured results of the body fat rate by Japan Suzuki-Changlingformula1,2, JiXiaoLei formula and WangRenWei formula, and the results measured byDEXA, we found that the correlation coefficients between the above4methods and DEXAmethod all were moderate or high (R=0.628-0.753,P<0.01). But t test found compared withJapan Suzuki-Changling formula1(only used triceps， scapula skinfold), there weresignificantly undervalued the whole body fat percentage of Hunan adults (P<0.01);UsingJapan suzuki-only changling formula2(i.e. Abdominal skin-fold only used to estimate), isalso significantly undervalued the whole body fat percentage of Hunan female (P<0.01); UseWangRenWei formula is underestimated body fat percentage of male (P<0.01); UseJiXiaoLei formula underestimated the whole body fat percentage of all adults in Hunanprovince (P<0.01).
2. With the multiple linear regression analysis fitting process R trend of1linear, R2variationratio theory, and analysis of variance, regression coefficient test, residual of normal sexualinspection and so on,8regression equation of body fat rate were establishedin20-29,30-39,40-49, and50-59age and divided by men and women.
3. Most of index such as weight, BMI, klein's index and skin-fold are below the national level,but are higher than level of2005in Hunan province, especially male30-44age group andfemale30-34age group are significantly higher (P<0.05).
4. Compared with the detection rates of overweight and obesity of adults in Hunan provincemeasured by BMI method and Japan Suzuki-Changling formulas,the detection rates aresignificantly different with those of measured by this established predicting equations (P<0.05).
5. The characteristics of overweight and obesity condition of adults in Hunan province are:(1)it increased with aging;(2) there were differences between urban and rural areas (3) therewere differences among different economic levels.(4) there were differences among differenteducation levels.
Conclusion:
1. Due to different ages,sexs, regions,economical levels,the way of using predicting equationsof body fat percentage for adults at home or abroad directly overestimate or underestimatethe body fat percentage of adults in Hunan province.
2. These initial equations are reliable for predicting body fat percentage of adults in Hunanprovince.
Predicting equations of body fat percentage for females are as follows:
%BF20-29=0.278X1+0.296X3+0.231X2+6.215
%BF30-39=0.134X3+0.170X2+0.228X4-1.180
%BF40-49=0.206X1+0.267X3+0.220X4-3.018
%BF50-59=0.244X2+0.368X2+0.144X4+1.726Predicting equations of body fat percentage for females are as follows:
%BF20-29=0.205X3+0.479X2+0.449X5-23.949
%BF30-39=0.373X3+0.214X2+0.162X5+1.032
%BF40-49=0.168X1+0.211X2+0.395X5-13.720
%BF50-59=0.415X3+0.393X2+0.238X5+1.808
(X1: scapula skinfold, X2: abdominal skinfold, X3: triceps skinfold, X4: waistcircumference, X5: hip circumference.)
3.This established body fat percentage equations can improve the detection rates and knowthe situation of overweight and obesity of adults in Hunan province more precisely.Age,sex,education level,frequency of dining out and physical activity are influence factors.
引文
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