中央肥胖

中央肥胖
http://chinese.wsj.com/Big5/20110513/hea081625.asp

The Fatter The Belly, The Bigger The Risk	腰圍越圓大 身體越危險
A new study offers fresh evidence that belly fat is the chief culprit in the link between obesity and cardiovascular disease.	一項最新研究發現﹐腹部脂肪堆積是導致肥胖與心血管疾病之間存在相關性的罪魁禍首。
The report also raises the possibility that people can be overweight without significantly raising their heart risk, so long as they carry the extra fat in places other than their belly. In fact, a few extra pounds may even lower the risk of death from heart disease, researchers found.	該報告還提出一種可能性﹐即體重超標不一定會顯著增加心臟病患者的風險﹐前提是脂肪不堆積在腹部﹐而是分佈在身體其他部位。事實上﹐研究人員發現﹐超重幾公斤甚至有可能降低因心臟疾病死亡的幾率。
Previous medical studies have also pointed to a possible protective effect of being overweight -- a phenomenon that has been called the 'obesity paradox.' Such findings have caused some doctors and patients to wonder whether being obese or overweight is that big a deal in managing heart risk.	此前的醫學研究也指出﹐體重超標可能會對人體產生一種保護作用——這種現象被成為“肥胖悖論”(obesity paradox)。這些發現不禁讓一些醫生和患者產生了疑問﹕肥胖或超重還能否算是心臟病風險防範措施中的一個重要考慮因素。
But the new study suggests the issue isn't about the dangers of obesity, but rather the limitations of the tool called body mass index, or BMI, that is typically used to measure it.	然而﹐這項最新研究顯示﹐問題並不在於肥胖是否對心臟存在危害﹐而在於衡量體型是否健康的“身體品質指數”(BMI)存在一定的缺陷。
The new report says obesity is clearly an important factor in heart risk. 'Fat does matter,' says Francisco Lopez-Jiminez, a cardiologist at Mayo Clinic, Rochester, Minn., and senior author of the study. 'But it depends on how you measure [it]. It's mostly about fat distribution and not total fatness.' The report was published online Monday by the Journal of the American College of Cardiology.	這份新報告說﹐肥胖顯然是心臟病風險的重要因素之一。該研究的主要執筆人、明尼蘇達州羅切斯特市(Rochester)梅奧診所(Mayo Clinic)的心臟病學家法蘭西斯科•羅帕茲-吉米尼茲(Francisco Lopez-Jiminez)說﹐“脂肪的確會產生影響﹐但要看具體的衡量方式﹐重點是考慮脂肪的分佈狀況﹐而非脂肪總量。”該報告於2011年5月2日發表在《美國心臟學院雜誌》(Journal of the American College of Cardiology)網路版上。
In the study, which pooled data from nearly 16,000 patients with heart disease, the researchers found that the bigger your waistline, the higher your chances of dying in the months and years after a heart attack or major heart procedure.	在該研究中﹐研究人員從近16,000名心臟病患者那裡獲取病史資料﹐發現患者的腰圍越大﹐則在心臟病發作或接受重大心臟手術後數月或數年內死去的幾率就越高。
The heightened risk remained even for people considered normal weight according to the BMI measurement tool.	然而﹐如果按照身體品質指數的衡量方式﹐腰圍超標的人死於心臟病的幾率跟腰圍正常的人是一樣的。
BMI, which is based on a ratio of height and weight, is widely accepted as a way to measure obesity in a large population. But its failure to differentiate between body fat and muscle mass or to account for where fat is located are among reasons its value in sizing up an individual patient has been challenged.	身體品質指數是基於身高和體重的比率得出的一個數值﹐廣泛用於衡量大量人口的肥胖程度﹐但無法區分脂肪過多和肌肉發達之間的差異﹐也不考慮脂肪的分佈位置。正因為這兩個缺陷以及其他一些原因﹐身體品質指數用於評估患者肥胖度的可信性已經遭到質疑。
When patients in the study were assessed on BMI alone, without factoring in waist measurements, those who were overweight or obese had a 16% to 25% lower risk of dying than people whose BMIs ranked them as normal weight. Patients were followed for a median period of 2.3 years after a heart attack or heart procedure.	在此項研究中﹐當僅以身體品質指數來評估患者而不考慮其腰圍時﹐超重或肥胖的患者要比體重正常（按身體品質指數的標準）的患者死於心臟疾病的幾率低16%到25%。這些患者在心臟病發作或心臟手術後接受觀察期的中位值為2.3年。
But patients with bulging waistlines, as measured by either waist circumference or waist-to-hip ratio, had a higher risk of death. They were 1.7 times as likely to die during the follow-up period as those with normal waist measurements, the researchers said.	然而﹐有“將軍肚”的心臟病患者——無論是按腰圍週長還是按腰圍臀圍比率來看——死於心臟病的幾率更大。研究人員表示﹐這些人在觀察期內死亡的幾率是腰圍正常者的1.7倍。
Waist measurements of 40 inches or more for men and 35 inches or more for women are considered in the danger zone as are waist-hip ratios (waist measurement divided by hip measurement) of greater than 0.9 for men and 0.85 for women.	男性腰圍超過40英寸（101.6釐米）和女性腰圍超過35英寸（88.9釐米）都被視為處於危險區域﹐男性的腰圍臀圍比率（即腰圍除以臀圍）超過0.9以及女性超過0.85也是如此。
'Fat is not created equal and where fat is located makes a difference,' says Michael Lauer, director of cardiovascular sciences at the National Institutes of Health's National Heart, Lung and Blood Institute.	美國國立衛生研究院(National Institutes of Health, NIH)下屬心肺血液研究院(National Heart, Lung and Blood Institute, NHLBI)的心血管學科主任邁克爾•羅爾(Michael Lauer)說﹐“脂肪並非生來平等﹐脂肪因其分佈位置不同而有高下之分。”
'We don't want people to get the message that it's OK to be fat,' he says. Dr. Lauer wasn't involved with the study.	羅爾博士也參與了該項研究﹐他說﹐“我們不希望人們產生誤會﹐認為肥胖並無大礙。”
The study looked only at patients who had suffered a heart attack or had a major heart procedure. Several other large studies suggest belly fat is associated with higher risk of heart attack and other heart problems among people who haven't been diagnosed with heart disease.	該研究只涵蓋有心臟病發作史或重大手術史的患者。另外幾項大型研究顯示﹐在沒有事先診斷出心臟疾病的人群中﹐一個人肚子上的脂肪越多﹐心臟病發作和出現其他心臟問題的幾率就越高。
One exception is a study published in March in the Lancet by British researchers. Among their findings: BMI and abnormal waist measurements were similarly associated with risk of disease.	也有一個例外﹐見於2011年3月英國研究人員發表在醫學期刊《柳葉刀》(Lancet)上的一份研究報告。他們發現﹕身體品質指數和腰圍大小在病人患病幾率方面存在類似的相關性。
But Salim Yusuf, executive director of the Population Health Research Institute at McMaster University in Hamilton, Ontario, says he thinks details in the British data were consistent with concerns about the impact of central obesity, the technical term for belly fat. He also noted that in patients without a history of heart problems, risks of obesity are reflected in conventional characteristics, such as blood pressure, elevated blood sugar and abnormal cholesterol.	不過﹐加拿大安大略省漢密爾頓市(Hamilton)麥克瑪斯特大學(McMaster University)人口健康研究學院(Population Health Research Institute)的院長薩利姆•優素福(Salim Yusuf)認為﹐英國這份報告中的一些細節資料驗證了人們對於中心性肥胖（即“將軍肚”的醫學名詞）所產生不利影響的擔憂。他還指出﹐在沒有心臟病史的患者中﹐肥胖對心臟造成的風險是通過一些常見症狀得以體現的﹐如高血壓、高血糖和高血脂等。
'For a given BMI, there is a huge variation in waist circumference and that variation make a huge difference,' said Jean-Pierre Despres, director of cardiology research and an obesity expert at institute universitaire de cardiologie et de pneumologie de Quebec in Quebec, Canada. He was author of an editorial accompanying the study.	加拿大魁北克心血管及呼吸科大學研究院(institute universitaire de cardiologie et de pneumologie de Quebec)心血管研究主任及肥胖研究專家讓-皮埃爾•戴斯普里斯(Jean-Pierre Despres)說﹐“有些人雖然身體品質指數相同﹐但腰圍尺寸差異很大﹐這種差異會導致他們在心臟病風險方面存在巨大差異。”他是這份最新研究報告的編輯評論文章的撰稿人。
The findings also underscore the importance of diet and especially physical exercise in combating belly fat. While you can't generally pick where you lose weight, research suggests that both aerobic exercise alone and in combination with resistance training has a beneficial effect on central obesity and overall heart risk -- even if they don't lead to significant weight loss.	該項研究也強調了在與“將軍肚”作鬥爭時﹐節食很重要﹐而鍛煉身體尤為重要。雖然人們通常無法想瘦哪裡就瘦哪裡﹐但研究人員建議﹐有氧運動以及有氧運動結合力量訓練對於減緩中心性肥胖和降低心臟病發病率有好處——即使這些運動沒有帶來顯著的減肥效果。
How does belly fat increase risk of heart disease? 'Fat isn't an inert substance,' says the NHLBI's Dr. Lauer. 'It's biologically very active tissue.'	肚子上的脂肪怎麼會導致心臟病風險的上升？心肺血液研究院的羅爾博士說﹐“脂肪不是無生命的組織﹐其實它是非常活躍的。”
Scientists believe that it releases a variety of toxins that can have adverse effects on blood vessels and the heart. Abdominal fat's proximity to both the liver and the heart may also help explain how the damage is done.	科研人員認為﹐脂肪會產生各種對血管和心臟有害的毒素。肝臟和心臟容易出現異常的脂肪堆積﹐這一點可能也有助於解釋損害的發生機制。