内脏脂肪在肥胖诊断及其合并症预测中的应用现状及展望
收稿日期: 2024-11-22
录用日期: 2025-02-08
网络出版日期: 2025-02-25
基金资助
2022年东方英才计划领军项目(153);中国国家科技创新2030-四大慢病重大专项(2023ZD0508100)
Current applications and prospects of visceral fat in obesity diagnosis and comorbidity prediction
Received date: 2024-11-22
Accepted date: 2025-02-08
Online published: 2025-02-25
2021年，全球25岁及以上的成年人中有21.1亿人超重或肥胖，其中中国人数最多，达到4.02亿。预计到2050年，全球25岁以上超重或肥胖人口将攀升至38亿，其中中国的相关人口预计将达到6.27亿。肥胖与心血管疾病、癌症、2型糖尿病等疾病的发生、发展密切相关。因此，肥胖的诊断与管理已成为全球性的重大健康挑战。但传统以体质量指数（body mass index， BMI）为核心的诊断体系存在局限性，难以精准反映脂肪分布与代谢功能异常。内脏脂肪过度蓄积是肥胖相关代谢紊乱的关键性因素，而内脏脂肪面积（visceral fat area， VFA）作为肥胖评估的客观可量化指标，与肥胖及其合并症密切相关。近年来的多项研究显示，VFA在诊断和预测肥胖及其合并症中的价值高于BMI。此外，VFA在不同干预手段对肥胖的治疗疗效评价中体现出更优的价值。中国国家标准化代谢性疾病管理中心（Metabolic Management Center， MMC）的经验表明，借助统一的生物电阻抗分析技术所测定的VFA，在肥胖诊断和临床管理中具有重要价值。未来，肥胖及其合并症的诊断和临床管理应结合多种评价手段，应通过多维度分层分析及个体化精准评估，以进一步提高肥胖的临床综合管理能力。
张翼飞 , 石娟 , 许悦宁 . 内脏脂肪在肥胖诊断及其合并症预测中的应用现状及展望[J]. 诊断学理论与实践, 2025 , 24(01) : 7 -13 . DOI: 10.16150/j.1671-2870.2025.01.002
In 2021, 2.11 billion adults aged 25 and older worldwide were overweight or obese, with China having the highest number at 402 million. By 2050, the global population of overweight or obese adults is projected to rise to 3.8 billion, with China expected to account for 627 million of this total. Moreover, obesity is strongly associated with the occurrence and progression of various diseases, including cardiovascular diseases, cancers, and type 2 diabetes. Thus, the diagnosis and management of obesity have become a major global health challenge. However, traditional body mass index (BMI)-based diagnostic systems exhibit limitations in accurately reflecting abnormal fat distribution and metabolic dysfunction. Excessive visceral fat accumulation has been identified as a key factor in obesity-related metabolic disorders. Notably, visceral fat area (VFA), as an objective and quantifiable indicator for obesity assessment, demonstrates significant correlations with obesity and its comorbidities. Recent studies show that VFA outperforms BMI in the diagnosis and prediction of obesity and its associated comorbidities. Furthermore, VFA demonstrates superior value in evaluating the therapeutic efficacy of different interventions for obesity. Experience from China's Metabolic Management Center (MMC) has demonstrated the clinical value of VFA measured by standardized bioelectrical impedance analysis in obesity diagnosis and clinical mana-gement. In the future, the diagnosis and clinical management of obesity and its comorbidities should integrate multiple assessment methods incorporating multidimensional stratification analysis and personalized precision evaluation to further enhance comprehensive clinical management of obesity.
Key words： Visceral fat; Obesity; Diagnosis; Clinical management
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