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1.
Simpson JA MacInnis RJ Peeters A Hopper JL Giles GG English DR 《Obesity (Silver Spring, Md.)》2007,15(4):994-1003
Objective: Our goal was to examine five different measures of adiposity as predictors of all‐cause mortality. Research Methods and Procedures: Subjects were 16,969 men and 24,344 women enrolled between 1990 and 1994 in the Melbourne Collaborative Cohort Study (27 to 75 years of age). There were 2822 deaths over a median follow‐up period of 11 years. BMI, waist circumference, and waist‐to‐hip ratio were obtained from direct anthropometric measurements. Fat mass and percentage fat were estimated by bioelectric impedance analysis. Results: Comparing the top quintile with the second quintile, for men there was an increased risk of between 20% and 30% for all‐cause mortality associated with each of the anthropometric measures. For women, there was an increased risk of 30% (95% confidence interval for hazard ratio, 1.1–1.6) observed for waist circumference and 50% (1.2–1.8) for waist‐to‐hip ratio, but little or no increased risk for BMI, fat mass, and percentage fat. Waist‐to‐hip ratio was positively and monotonically associated with all‐cause mortality for both men and women. There was a linear association between waist circumference and all‐cause mortality for men, whereas a U‐shaped association was observed for women. Discussion: Measures of central adiposity were better predictors of mortality in women in the Melbourne Collaborative Cohort Study compared with measures of overall adiposity. We recommend measuring waist and hip circumferences in population studies investigating the risk of all‐cause mortality associated with obesity. The use of additional measures such as bioelectric impedance is not justified for this outcome. 相似文献
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Objective: Prior randomized and non‐randomized training studies have failed to establish a dose‐response relationship between vigorous exercise and weight loss; this failure may be due, in part, to their short durations and small sample sizes. The objectives of this study were to determine whether exercise reduces body weight and to examine the dose‐response relationships between changes in exercise and changes in total and regional adiposity. Research Methods and Procedures: This was a large prospective study of 3973 men and 1444 women who quit running (detraining), 270 men and 146 women who started running (training), and 420 men and 153 women who remained sedentary during 7.4 years of follow‐up. The outcomes measured were weekly running distance, body weight, BMI, body circumferences, and bra cup size. Results: There were significant inverse relationships between the changes in the amount of vigorous exercise (km/wk run) and the changes in weight and BMI in men (slope ± standard error: ?0.039 ± 0.005 kg/km per week and ?0.012 ± 0.002 kg/m2 per km/wk, respectively) and in older women (?0.060 ± 0.018 kg/km per week and ?0.022 ± 0.007 kg/m2 per km/wk) who quit running, and in initially sedentary men (?0.098 ± 0.017 kg/km per week and ?0.032 ± 0.005 kg/m2 per km/wk) and women (?0.062 ± 0.023 kg/km per week and ?0.021 ± 0.008 kg/m2 per km/wk) who started running. Changes in waist circumference, an indicator of intra‐abdominal fat, were also inversely related to changes in running distance in men who quit (?0.026 ± 0.005 cm/km per week) or started running (?0.078 ± 0.017 cm/km per week). Discussion: The initiation of vigorous exercise and its cessation decrease and increase, respectively, body weight and intra‐abdominal fat, and these changes are proportional to the change in exercise dose. 相似文献
3.
Elobeid MA Desmond RA Thomas O Keith SW Allison DB 《Obesity (Silver Spring, Md.)》2007,15(10):2380-2383
Objective: The objective of this investigation was to examine the relationship between BMI and waist circumference (WC) by gender and race subgroups from U.S. population‐based data from 1959 to 2004 and to investigate the trend in WC over calendar time. Research Methods and Procedures: Demographic and anthropometric cross‐sectional data on 30,730 participants 18 to 79 years old across five national surveys were included. We regressed WC on BMI while controlling for age in each time period for blacks and whites by gender. Results: The relationship between BMI and WC as characterized by the slope of the linear regression of WC on BMI does not seem to be changing significantly over time. A small (range, 0.08 to 0.27 cm/yr) increase in WC over time was observed. Discussion: The implications of these findings for public health and for understanding any extant changes in the BMI‐mortality rate relationship remain to be elucidated. 相似文献
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Claudio Maffeis Angelo Pietrobelli Alessandra Grezzani Silvia Provera Luciano Tat 《Obesity (Silver Spring, Md.)》2001,9(3):179-187
Objective: Intra‐abdominal fat has been identified as being the most clinically relevant type of fat in humans. Therefore, an assessment of body‐fat distribution could possibly identify subjects with the highest risk of adverse lipid profile and hypertension. Few data on the relationship between body‐fat distribution and cardiovascular risk factors are available in children, especially before puberty. Research Methods and Procedures: This cross‐sectional study was undertaken to explore the relationship between anthropometric variables, lipid concentrations, and blood pressure (BP) in a sample of 818 prepubertal children (ages 3 to 11 years) and to assess the clinical relevance of waist circumference in identifying prepubertal children with higher cardiovascular risk. Height, weight, triceps and subscapular skinfolds, waist circumference, and BP were measured. Plasma levels for triacylglycerol, total cholesterol, high‐density lipoprotein (HDL) cholesterol, low‐density lipoprotein cholesterol, apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB) were determined. Results: Females were fatter than males (5.8 [3.5] vs. 4.8 [3.3] kg of fat mass; p < 0.01). Males had higher HDL cholesterol and ApoA1/ApoB plasma concentrations than females (p < 0.001 and p < 0.01, respectively). Waist circumference had a higher correlation with systolic and diastolic BP (r = 0.40 and 0.29, respectively; p < 0.001) than triceps (r = 0.35 and 0.21, respectively; p < 0.001) and subscapular (r = 0.28 and 0.16, respectively; p < 0.001) skinfolds and relative body weight (0.33 and 0.23, respectively; p < 0.001). Multivariate linear model analysis showed that ApoA1/ApoB, HDL cholesterol, total cholesterol/HDL cholesterol, and systolic as well as diastolic BP were significantly associated with waist circumference and triceps and subscapular skinfolds, independently of age, gender, and body mass index. Discussion: Waist circumference as well as subscapular and triceps skinfolds may be helpful parameters in identifying prepubertal children with an adverse blood‐lipids profile and hypertension. However, waist circumference, which is easy to measure and more easily reproducible than skinfolds, may be considered in clinical practice. Children with a waist circumference greater than the 90th percentile are more likely to have multiple risk factors than children with a waist circumference that is less than or equal to the 90th percentile. 相似文献
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Wells JC 《American journal of physical anthropology》2012,147(2):169-186
In the 19th century, two \"ecogeographical rules\" were proposed hypothesizing associations of climate with mammalian body size and proportions. Data on human body weight and relative leg length support these rules; however, it is unknown whether such associations are attributable to lean tissue (the heat-producing component) or fat (energy stores). Data on weight, height, and two skinfold thickness were obtained from the literature for 137 nonindustrialized populations, providing 145 male and 115 female individual samples. A variety of indices of adiposity and lean mass were analyzed. Preliminary analyses indicated secular increases in skinfolds in men but not women, and associations of age and height with lean mass in both sexes. Decreasing annual temperature was associated with increasing body mass index (BMI), and increasing triceps but not subscapular skinfold. After adjusting for skinfolds, decreasing temperature remained associated with increasing BMI. These results indicate that colder environments favor both greater peripheral energy stores, and greater lean mass. Contrasting results for triceps and subscapular skinfolds might be due to adaptive strategies either constraining central adiposity in cold environments to reduce cardiovascular risk, or favoring central adiposity in warmer environments to maintain energetic support of the immune system. Polynesian populations were analyzed separately and contradicted all of the climate trends, indicating support for the hypothesis that they are cold-adapted despite occupying a tropical region. It is unclear whether such associations emerge through natural selection or through trans-generational and life-course plasticity. These findings nevertheless aid understanding of the wide variability in human physique and adiposity. 相似文献
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Ming Wei Sharon P. Gaskill Steven M. Haffner Michael P. Stern 《Obesity (Silver Spring, Md.)》1997,5(1):16-23
Although a number of obesity-related variables are recognized risk factors for NIDDM, few studies have addressed which one is the best predictor. A cohort of 721 Mexican Americans aged 25–64 years who were free of NIDDM at baseline were followed for an average of 7.2 years; 105 new cases of NIDDM were diagnosed. Body weight, body mass index (BMI), waist and hip circumferences, waist/hip ratio (WHR), triceps and subscapular skinfolds were all positively predictive of NIDDM independent of age and sex. There were modest to strong correlations between these anthropometric variables, however, waist circumference was the strongest predictor of NIDDM. The predictive power of a single measurement of waist circumference was at least equal to that of WHR and BMI combined. The risk of NIDDM for those in the highest quartile of waist circumference was 11 times greater than for those in the lowest quartile (95% confidence interval: 4.2–28.8). The waist-NIDDM relation was stronger in subjects with BMI ≤ 27 kg/m2 (OR: 6.0 for a 1 SD difference) than in subjects with BMI > 27 kg/m2 (OR: 1.7 for a 1 SD difference). In multivariate analysis, waist circumference was the only significant predictor of NIDDM in models that included other anthropometric variables either separately or simultaneously. WHR and BMI were independent predictors of NIDDM after adjustment for each other, however, their predictive abilities disappeared after adjustment for waist circumference. The data indicate that waist is the best obesity-related predictor of NIDDM. This finding suggests that the distribution of body fat, especially abdominal localization, is a more important determinant than the total amount of body fat of the development of NIDDM in Mexican Americans. 相似文献
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Ortega FB Tresaco B Ruiz JR Moreno LA Martin-Matillas M Mesa JL Warnberg J Bueno M Tercedor P Gutiérrez A Castillo MJ;AVENA Study Group 《Obesity (Silver Spring, Md.)》2007,15(6):1589-1599
Objective: To determine whether physical activity, sedentary activities, and/or cardiorespiratory fitness are related to waist circumference in adolescents, as previously reported in adults. Research Methods and Procedures: The study subjects were a representative sample of Spanish adolescents (N = 2859; 1357 boys, 1502 girls; age, 13 to 18.5 years), all of whom were involved in the AVENA (Food and Assessment of the Nutritional Status of Adolescents) study. BMI, waist circumference, pubertal maturation status, and cardiorespiratory fitness were measured in all. Leisure‐time physical activity, sedentary activities, active commuting to school, and socioeconomic status were assessed by self‐reported questionnaires. Results: No relationship was found between leisure‐time physical activity and BMI or waist circumference. In contrast, and in both boys and girls and after adjustment for confounding variables, cardiorespiratory fitness was found to be inversely associated with waist circumference and BMI, independent of sedentary activities or physical activity (p ≤ 0.001). The maximum oxygen consumption explained 13% of the variance in waist circumference in boys and 16% in girls. Sedentary activities were independently and directly related to waist circumference in both boys and girls (p ≤ 0.05) and to BMI in boys (p ≤ 0.05). Sedentary activities explained 10% of the variance in waist circumference in boys and 18% in girls. The BMI‐adjusted waist circumference was inversely correlated with cardiorespiratory fitness in overweight‐obese boys (p ≤ 0.05) and showed a trend toward significance in girls (p ≤ 0.1). Discussion: Both moderate to high levels of cardiorespiratory fitness and sedentary activities, but not physical activity, are associated with lower abdominal adiposity, as measured by waist circumference. 相似文献
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本项目采用人体测量法,测量了976名(男性528人,女性448人)湖南土家族成人的身高、体质量以及肱三头肌、肩胛下、髂前上和小腿内侧皮褶的厚度,并根据公式计算体密度、体脂率、脂肪质量、脂肪质量指数、瘦体质量和瘦体质量指数。结果显示随年龄增长,小腿内侧皮褶厚度值逐渐减小,肱三头肌、肩胛下和髂前上棘皮褶以及体脂率、脂肪质量、瘦体质量、体质量指数、脂肪质量指数和瘦体质量指数值先增大后减小,体密度值先减小后增大;各年龄组中体密度、瘦体质量及其指数值女性明显低于男性,4项皮褶厚度值以及体脂率、脂肪质量及其指数值女性高于男性;与布朗族等24个族群比较,湖南土家族成人皮褶厚度处于中等水平,与门巴族、珞巴族、僜人、彝族等族群的亲缘关系较近。 相似文献
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Objective: To investigate the role of obesity in general and waist circumference (WC) and BMI in particular as risk factors for 15‐year incidence of coronary heart disease (CHD) in the elderly. Research Methods and Procedures: This prospective study was based on 1597 (737 males and 860 females) 70‐year‐olds free from CHD and participants of three birth cohorts examined in 1971 to 1972 (Cohort I), 1976 to 1977 (Cohort II), and 1981 to 1982 (Cohort III) at Göteborg, Sweden. Fifteen‐year incidence of CHD (fatal and nonfatal) was ascertained from follow‐up examinations and registers. Relative risk (RR) for first ever CHD in reference to the lowest quartiles of WC and BMI was calculated from Cox regression. Results: In males, RRs for CHD in the highest WC and BMI quartiles were 1.36 [95% confidence interval (CI) 1.00 to 1.85] and 1.42 (95% CI 1.04 to 1.92), respectively, after adjustment for cohorts, smoking habits, diabetes, systolic blood pressure, and total cholesterol. In men, the risk associated with WC was independent of BMI. Neither WC nor BMI was related to CHD risk in females. After exclusion of first 5‐year all‐cause deaths, the adjusted RRs in the highest WC and BMI quartiles in males were 1.47 (95% CI 1.06 to 2.04) and 1.42 (1.04 to 1.92), respectively. In females, a significantly higher RR of 1.41 (95% CI 1.02 to 1.94) was observed in the second BMI quartile only after such exclusions. Discussion: WC, an indicator of both central and general obesity, appears to be a stronger predictor of CHD than BMI in elderly males, but in females, obesity was not a risk factor for CHD. 相似文献
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《Obesity (Silver Spring, Md.)》2006,14(11):2107-2117
Objective: We report the effects of several different measures of body size at baseline on the subsequent development of diabetes. High levels of body fat predict the onset of diabetes, but this association has not been previously reported in a large multiethnic population of overweight or obese people with impaired glucose tolerance. Research Methods and Procedures: Height, weight, waist circumference, hip circumference, and skinfolds were measured at baseline in 3234 participants enrolled in a randomized clinical trial to treat individuals with impaired glucose tolerance with placebo, metformin, or a lifestyle modification program. Cox proportional hazards models were used to assess the effect of baseline body size variables on the development of diabetes. Results: Over an average of 3.2 years in both the placebo and lifestyle groups, baseline waist circumference had the highest or second highest R2 value for predicting diabetes in both sexes. Cox hazard ratios per 1 standard deviation were 1.43 and 1.49 for men in the placebo or lifestyle groups, respectively, and 1.29 and 1.53 for women in the placebo and lifestyle groups, respectively, adjusted for age and self‐reported race/ethnicity. The c‐statistic from the receiver operating characteristic curves also favored the waist circumference in men and women in the lifestyle group and men in the placebo group. No components of body size were predictive in the metformin‐treated group, and metformin compared with the placebo group was effective in preventing diabetes only in individuals with a BMI ≥35 kg/m2 or a waist circumference ≥98.0 cm. Discussion: Large waist circumference was a better predictor of risk for developing diabetes than most other measures in the placebo and lifestyle groups. No baseline measure of body size or shape predicted risk of diabetes in the metformin‐treated group. 相似文献
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Shankuan Zhu Stanley Heshka ZiMian Wang Wei Shen David B. Allison Robert Ross Steven B. Heymsfield 《Obesity (Silver Spring, Md.)》2004,12(4):633-645
Objective: BMI (kilograms per meters squared) and waist circumference (WC) (measured in centimeters) are each associated with the risk of developing cardiovascular disease (CVD). Therefore, a combination of the two may be more effective in identifying subjects at risk than either alone. The present study sought to identify the combination of BMI and WC that has the strongest association with CVD risk factors in whites. Research Methods and Procedures: Subjects were 8712 white men and women from the Third National Health and Nutrition Examination Survey. The optimal combination of BMI and WC was developed using logistic regression models with BMI and WC as predictors and CVD risk factors as outcomes. The combined measure of BMI and WC using current cut‐off points was also examined. Sensitivity, specificity, and receiver operating characteristics curves were compared between the combined measures and BMI alone. Results: For white men, the optimal combination of BMI and WC for identifying CVD risk factors was 0.68 × BMI + 0.32 × WC. This combination generated a score that better estimated the odds of having CVD risk factors than either alone. For white women, WC alone largely determined the likelihood of having CVD risks. The combination of BMI and WC using current cut‐off points may provide an improved measure of CVD risk. Combined measures showed a higher sensitivity or a shorter distance in receiver operating characteristic curves in the identification of CVD risk factors. Discussion: Combined measures of BMI and WC may provide a higher overall test performance for CVD risk factors and may be useful in some ethnic groups as an improved means of screening subjects for further evaluation in the clinical setting. 相似文献
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Objective: We examined the relationship between income and education level with BMI and waist circumference to provide further understanding of the relationship between socioeconomic status and obesity and to identify the presence of sex differences. Research Methods and Procedures: A total of 7962 people ≥20 years of age (3597 men; 4365 women) who participated in the 1998 Korean National Health and Nutrition Examination Survey provided data including height, weight, waist circumference, education, and income level. We examined adjusted BMI and waist circumference according to level of income and education and the association between income and education with obesity and abdominal obesity by multiple logistic regression analysis. Results: In men, significant dose‐response relationships were noted between income and obesity (trend, p < 0.05) and abdominal obesity (trend, p < 0.05). Compared with the lowest income group, the adjusted odds ratios (ORs) (95% confidence interval) of the highest income group for obesity and abdominal obesity were 1.65 (1.18 to 2.32) and 1.37 (0.94 to 1.98), respectively. However, income was not associated with obesity or abdominal obesity in the fully adjusted models in women. With regard to education, women showed significantly decreased ORs, with inverse trends for obesity and abdominal obesity across all education levels. Compared with the lowest education group, the adjusted ORs (95% confidence interval) for obesity and abdominal obesity were 0.66 (0.57 to 0.76) and 0.40 (0.35 to 0.45), respectively, among women with 7 to 12 years of schooling and 0.27 (0.21 to 0.34) and 0.15 (0.12 to 0.18), respectively, among women with 13 or more years of schooling. Discussion: Socioeconomic difference has a considerable impact on the prevalence of obesity among the Korean population, and the patterns differ substantially across sex. 相似文献
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Miller JC Grant AM Drummond BF Williams SM Taylor RW Goulding A 《Obesity (Silver Spring, Md.)》2007,15(1):165-171
Objective: To compare parental assessments of child body weight status with BMI measurements and determine whether children who are incorrectly classified differ in body composition from those whose parents correctly rate child weight. Also to ascertain whether children of obese parents differ from those of non‐obese parents in actual or perceived body weight. Research Methods and Procedures: Weights, heights, BMI, and waist girths of New Zealand children ages 3 to 8 years were determined. Fat mass, fat percentage, and lean mass were measured by DXA (n = 96). Parents classified child weight status as underweight, normal‐weight, slightly overweight, or overweight. Centers for Disease Control and Prevention 2000 percentiles of BMI were used. Results: Parents underestimated child weight status. Despite having 83% more fat mass than children with BMI values below the 85th percentile, only 7 of 31 children with BMI values at or above the 85th percentile were rated as slightly overweight or overweight. In the whole sample, participants whose weight status was underestimated by parents (40 of the 96 children) had l9% less fat mass but similar lean mass as children whose weight status was correctly classified. However, children of obese and non‐obese parents did not differ in body composition or anthropometry, and obese parents did not underestimate child weight more than non‐obese parents. Discussion: Because parents underestimate child weight, but BMI values at or above the 85th percentile identify high body fat well, advising parents of the BMI status of their children should improve strategies to prevent excessive fat gain in young children. 相似文献
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Janne Bigaard Anne Tjnneland Birthe Lykke Thomsen Kim Overvad Berit Lilienthal Heitmann Thorkild I.A. Srensen 《Obesity (Silver Spring, Md.)》2003,11(7):895-903
Objective: Measurement of waist circumference alone as a proxy of abdominal fat mass has been suggested as a simple clinical alternative to BMI for detecting adults with possible health risks due to obesity. Research Methods and Procedures: From 1993 to 1997, 27, 178 men and 29, 875 women, born in Denmark, 50 to 64 years of age, were recruited in the Danish prospective study Diet, Cancer and Health. By the end of the year 2000, 1465 deaths had occurred. We evaluated the relationship between waist circumference and BMI (simultaneously included in the model) and all‐cause mortality. We used Cox regression models to estimate the mortality‐rate ratios and to consider possible confounding from smoking. Results: Waist circumference among both men and women showed a strong dose‐response type of relationship with mortality when adjusted for BMI, whereas the low range of BMI was inversely associated with mortality when adjusted for waist circumference. A 10% larger waist circumference corresponded to a 1.48 (95% confidence interval: 1.36 to 1.61) times higher mortality over the whole range of waist circumference. The associations were independent of age and time since baseline examination. Restriction to never smokers showed a similar pattern, but a weakening of the associations. Discussion: Despite the high correlation between waist circumference and BMI, the combination may be very relevant in clinical practice because waist circumference for given BMI was a strong predictor of all‐cause mortality. The inverse association between BMI and mortality for given waist circumference was diminished in never smokers, particularly for high values of BMI. 相似文献
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Objective: To derive regression equations for fat percentage by using simple anthropometric measurements applicable in normal and immobile (cannot stand or walk) older people. Research Methods and Procedures: The study population comprised 352 females and 261 males, apparently well and community‐dwelling, aged 69 to 82 years. Fifty‐one females and 27 males were recruited for external validation. Body weight, standing height, arm span, triceps and biceps skinfold thicknesses (SFTs), and midarm circumference were measured. The reference method of total body fat percentage was dual‐energy X‐ray densitometry. Predictive equations for fat percentages were derived by stepwise multiple linear regression on anthropometric indices and gender. Results: Upper‐limb SFTs, body mass index, and gender yielded the more predictive equation. The SEE was 4.1% weight. There was a significant trend of underestimation in overweight subjects, especially in females. The equation using SFTs and midarm circumference was less reliable but more applicable to older immobile people and those with significant kyphoscoliosis. Conclusions: The combination of body mass index and upper‐limb SFTs gives reliable prediction of fat percentages in older Chinese people, except in the obese. 相似文献
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Simon W. Kok Sebastiaan Overeem Tommy L.S. Visscher Gert Jan Lammers Jaap C. Seidell Hanno Pijl Arend E. Meinders 《Obesity (Silver Spring, Md.)》2003,11(9):1147-1154
Objective: To determine the prevalence of obesity among patients with narcolepsy, to estimate associated long‐term health risks on the basis of waist circumference, and to distinguish the impact of hypocretin deficiency from that of increased daytime sleepiness (i.e., reduced physical activity) on these anthropometric measures. Research Methods and Procedures: A cross‐sectional, case‐control study was conducted. Patients with narcolepsy (n = 138) or idiopathic hypersomnia (IH) (n = 33) were included. Age‐matched, healthy members of the Dutch population (Monitoring Project on Risk Factors for Chronic Diseases and Doetinchem Project; n = 10, 526) were used as controls. BMI and waist circumference were determined. Results: Obesity (BMI ≥ 30 kg/m2) and overweight (BMI 25 to 30 kg/m2) occurred more often among narcolepsy patients [prevalence: 33% (narcoleptics) vs. 12.5% (controls) and 43% (narcoleptics) vs. 36% (controls), respectively; both p < 0.05]. Narcoleptics had a larger waist circumference (mean difference 5 ± 1.4 cm, p < 0.001). The BMI of patients with IH was significantly lower than that of narcolepsy patients (25.6 ± 3.6 vs. 28.5 ± 5.4 kg/m2; p = 0.004). Discussion: Overweight and obesity occur frequently in patients with narcolepsy. Moreover, these patients have an increased waist circumference, indicating excess fat storage in abdominal depots. The fact that patients with IH had a lower BMI than narcoleptics supports the notion that excessive daytime sleepiness (i.e., inactivity) cannot account for excess body fat in narcoleptic patients. 相似文献
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Luz M. Len‐Muoz Pilar Guallar‐Castilln Esther Lpez García Jos R. Banegas Juan L. Gutirrez‐Fisac Fernando Rodríguez‐Artalejo 《Obesity (Silver Spring, Md.)》2005,13(8):1398-1404
Objective: To examine the relationship of BMI, waist circumference (WC), and weight change with use of health care services by older adults. Research Methods and Procedures: This was a prospective cohort study conducted from 2001 to 2003 among 2919 persons representative of the non‐institutionalized Spanish population ≥60 years of age. Analyses were performed using logistic regression, with adjustment for age, educational level, size of place of residence, tobacco use, alcohol consumption, and presence of chronic disease. Results: Obesity (BMI ≥ 30 kg/m2) and abdominal obesity (WC >102 cm in men and >88 cm in women) in 2001 were associated with greater use of certain health care services among men and women in the period 2001–2003. Compared with women with WC ≤ 88 cm, women with abdominal obesity were more likely to visit primary care physicians [odds ratio (OR): 1.36; 95% confidence limit (CL): 1.06–1.73] and receive influenza vaccination (OR: 1.30; 95% CL: 1.03–1.63). Weight gain was not associated with greater health service use by either sex, regardless of baseline BMI. Weight loss was associated with greater health service use by obese and non‐obese subjects of both sexes. In comparison with those who reported no important weight change, non‐obese women who lost weight were more likely to visit hospital specialists (OR: 1.45; 95% CL: 1.02–2.06), receive home medical visits (OR: 1.61; 95% CL: 1.06–2.45), be hospitalized (OR: 1.88; 95% CL: 1.29–2.74), and have more than one hospital admission (OR: 2.31; 95% CL: 1.19–4.47). Discussion: Obesity and weight loss are associated with greater health service use among the elderly. 相似文献