To tackle the burden of obesity-induced cardiometabolic disease, the scientific community relies on accurate and reproducible adiposity measurements in the clinic. These measurements guide our understanding of underlying biological mechanisms and clinical outcomes of human trials. However, measuring adiposity and adipose tissue distribution in a clinical setting can be challenging, and different measurement methods pose important limitations. BMI is a simple and high-throughput measurement, but it is associated relatively poorly with clinical outcomes when compared with waist-to-hip and sagittal abdominal diameter measurements. Body composition measurements by dual energy X-ray absorptiometry or MRI scans would be ideal due to their high accuracy, but are not high-throughput. Another important consideration is that adiposity measurements vary between men and women, between adults and children, and between people of different ethnic backgrounds. In this Perspective article, we discuss how these critical challenges can affect our interpretation of research data in the field of obesity and the design and implementation of clinical guidelines.

为了解决肥胖引起的心脏代谢疾病的负担，科学界依赖于临床上准确且可重复的肥胖测量。这些测量指导我们了解人体试验的潜在生物学机制和临床结果。然而，在临床环境中测量肥胖和脂肪组织分布可能具有挑战性，并且不同的测量方法具有重要的局限性。 BMI 是一种简单且高通量的测量，但与腰臀围和矢状腹部直径测量相比，它与临床结果的相关性相对较差。通过双能 X 射线吸收测定法或 MRI 扫描进行身体成分测量是理想的选择，因为它们具有高精度，但吞吐量不高。另一个重要的考虑因素是，男性和女性、成人和儿童以及不同种族背景的人之间的肥胖测量结果存在差异。在这篇展望文章中，我们讨论这些关键挑战如何影响我们对肥胖领域研究数据的解释以及临床指南的设计和实施。