江苏省7~17岁儿童青少年体重指数百分位数参考值和曲线研究

目的：建立江苏省7~17岁儿童青少年体重指数(body mass index,BMI)百分位数参考值和曲线,为评价生长发育特点提供科学依据。方法：基于“2021年江苏省学生常见病和健康影响因素监测”项目,采用分层随机整群抽样法在江苏省13个市26个县(市、区),共选取45 595名7~17岁中小学生进行体格检查,使用偏度系数-中位数-变异系数法(LMS法)建立江苏省儿童青少年BMI百分位数参考值,拟合出相应的百分位数曲线并与全国水平比较。结果：江苏省7~17岁男女生BMI均随年龄增长而增加。男童9岁时BMI进入增长高峰,12 岁后增长减缓,女童10岁时BMI进入增长高峰,14 岁后增长减缓。江苏省儿童青少年各年龄组BMI 5 th、50 th、95 th百分位数均高于全国水平。结论：本研究呈现了江苏省儿童青少年的BMI分布状况; 基于LMS 法获得了江苏省儿童青少年BMI 百分位参考值和生长曲线,拟合效果良好;江苏省各年龄组男女生BMI主要百分位数均高于全国水平,各年龄组男生BMI中位数均大于女生。     

正常范围内γ-谷氨酰转肽酶与前期糖尿病的相关性

[目的]探讨正常范围内γ-谷氨酰转肽酶(GGT)与前期糖尿病的相关性.[方法]选择2017年6月—2019年12月在健康体检中心接受综合健康体检的20岁及以上成年人群中排除糖尿病患者及肝功能异常者的7 265名作为研究对象,依据GGT分为四分位,分析不同GGT水平人群各项指标水平,并采用Logistic回归方法分析不同GGT水平与前期糖尿病的患病危险及前期糖尿病的患病中体质量指数(BMI)与GGT的交互作用.[结果] 1)男性中随着GGT水平的增高,BMI、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)和血尿酸(SUA)水平均增高,而高密度脂蛋白(HDL)水平均下降.女性中随着GGT水平的增高,BMI、SBP、DBP、TC、TG、LDL、AST、ALT、SUA、肌酐及尿素氮水平均增高,肌酐、HDL水平均下降.2)男性未调整时,上四分位数GGT水平组患前期糖尿病的危险是下四分位数组的1.936倍(95%CI:1.389～2.698),调整年龄、BMI、血压、血脂、肾功能、肝功能等指标后上四分位数GGT水平组患前期糖尿病的危险是下四分位数组的1.507倍(95%CI:1.019～2.228);女性未调整时,上四分位数组GGT水平组患前期糖尿病的危险是下四分位数组的5.019倍(95%CI:3.306～7.618),调整年龄、BMI、血压、血脂、肾功能、肝功能等指标后上四分位数GGT水平组患前期糖尿病的危险是下四分位数组的2.813倍(95%CI:1.759～4.496);男女均在不同模型中随着GGT水平的增高而患糖尿病的危险也增加,且前期糖尿病的患病中BMI与GGT存在交互作用.[结论] GGT与前期糖尿病患病密切相关,且可与BMI协同作用,但不同性别人群间存在差异.     

阻塞性睡眠呼吸暂停低通气综合征与年龄、体重指数的关系

目的 探讨年龄、体重指数与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的关系.方法 选择526例经多导睡眠图(PSG)监测确诊为阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的患者资料,统计不同年龄、体重指数(BMI)患者分布差异,对OSAHS严重程度与年龄、BMI进行相关性分析.结果 中老年人(30-70岁)及肥胖者(BMI23.0～30或≥30.0)发病较多;年龄与暂停紊乱指数(AHI)呈负相关,BMI与AHI呈正相关;标准偏回归系数绝对值BMI大于年龄.结论 年龄、BMI与阻塞性睡眠呼吸暂停低通气综合征有密切关系,体重指数越大,病情越严重,而随着年龄的增大,病情反而减轻.体重比年龄对OSAHS的影响更大.     

北京市社区中老年男性体重指数和前列腺特异性抗原相关性的多中心研究

目的 了解北京地区中老年男性人群体重指数(BMI)和前列腺特异性抗原(PSA)的相关性.方法 选择北京社区50岁以上男性作为研究对象,行体格检查并计算体重指数(BMI),按WHO提出的亚洲人体重分级建议进行BMI分层,测血清总前列腺特异性抗原(TPSA)及游离前列腺特异性抗原(FPSA),应用SPSS 13.0统计软件对BMI和TPSA的相关性进行统计学分析.结果 符合标准并资料全面者1573人,平均年龄(64±10)岁,平均BMI:(24±3)kg/m2,PSA中位数:1.0 μg/L(0.6～1.9 μg/L),平均前列腺体积:(30±18)ml3.BMI分级:低体重54例(3.43%),正常体重441例(28.04%),超重423例(26.89%),肥胖597例(37.95%),重度肥胖58例(3.69%).正常组和超重组分别与肥胖组PSA比较差异均有统计学意义(P=0.002、0.010).在调整年龄和前列腺体积情况下,BMI和PSA呈负相关(r=-0.068,P=0.007).年龄及前列腺体积与PSA呈正相关(r=0.204,P=0.000;r=0.401,P=0.000).在不同年龄分层,各年龄组之间BMI和PSA均不相关(均P>0.1).结论 BMI影响血清PSA结果,BMI和PSA呈负相关.在前列腺癌诊断时,应当考虑BMI对PSA的影响.     

子宫内膜癌患者BMI、胰岛素抵抗、炎性因子的检测及对预后的影响

目的:观察子宫内膜癌患者体重指数(body mass index,BMI)、胰岛素抵抗(insulin resistance,IR)及炎性因子表达水平的变化,并探讨其对远期预后的影响.方法:选取2012年8月～2014年12月于本院就诊的新发子宫内膜癌患者110例作为观察组,另以60例同期体检的健康妇女作为对照组,观察两组研究对象的BMI、空腹血糖(fasting glucose,FG)、空腹胰岛素(fasting insulin,FIN)及炎性因子水平.采用稳态模型评估法计算胰岛素抵抗指数(HOMA-IR),Pearson相关分析BMI、IR与炎性因子的相关性,多因素Logistic回归分析BMI、IR及炎性因子与预后的关系.结果:与健康对照组比较,观察组患者BMI、HOMA-IR、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)及γ干扰素(IFN-γ)水平均明显高于对照组(P均＜0.05).不同分期时,Ⅲ、Ⅳ期子宫内膜癌患者BMI、IR及血清炎症因子水平较Ⅰ期时均显著增加(P均＜0.05).Pearson相关分析结果显示,BMI与CRP呈正相关(r=1.72,P=0.033),而与其他炎性因子未见明显相关性;IR与CRP、TNF-α、IL-6和IFN-γ均呈正性相关(P均＜0.05).多因素Logistic回归分析显示BMI、IR、CRP、TNF-α、IL-6及IFN-γ水平均为影响子宫内膜癌预后的危险因素(P均＜0.05).结论:代谢及炎症等因素导致机体出现胰岛素抵抗,促进肿瘤生长与转移,影响子宫内膜癌的进展和预后.     

新诊断的2型糖尿病患者血浆Apelin水平研究

目的 观察未经治疗的新诊断2型糖尿病(T2DM)患者血浆Apelin水平,探讨Apelin与胰岛素分泌及血糖代谢的关系.方法 选择75例未治疗的新诊断T2DM患者(T2DM组)和36例健康者(对照组),两组的性别、年龄、体质指数(BMI)及血脂相匹配.分别测定两组受检者的血浆Apelin、空腹血糖(FPG)、空腹胰岛素(FINS)、C反应蛋白(CRP)水平及糖化血红蛋白(HbA1c),计算胰岛素抵抗指数(HOMS-IR)和胰岛素分泌指数(HOMA-IS).结果 与对照组比较,T2DM患者血浆Apelin水平显著降低[0.11(0.08～0.14)ng/ml与0.25(0.19～0.30)ng/ml],差异有统计学意义(P＜0.01).血浆Apelin水平与CRP(r=-0.357,P=0.001)、HOMA-IR(r=-0.509,P＜0.01)呈负相关,与HOMA-IS呈正相关(r=0.566,P＜0.01).与最低四分位数比较,最高的HOMA-IS四分位数具有明显高的Apelin水平(0.27 ng/ml与0.07 ng/ml,P＜0.01).Apelin与FPG及HbA1c呈负相关(P值分别为0.015和0.031),甚至在调整了HOMA-IS、HOMA-IR、FINS、BMI和年龄后,与最高四分位数比较,最低四分位数的血浆Apelin水平具有明显高的FPG和HbA1c(P均＜0.01).结论 未治疗的新诊断T2DM患者血浆Apelin水平较健康者显著降低;此外,HOMA-IS、Apelin及糖代谢之间存在一个独立的关系.     

视黄醇结合蛋白4、内脂素与代谢综合征的相关性研究

目的 探讨视黄醇结合蛋白4(RBP4)、内脂素水平与代谢综合征(MS)的相关性.方法 在2011年某医院参加健康体检的人群中,选取各项检测指标完整的780人作为研究对象,分析RBP4、内脂素与MS的相关性.结果 ①MS组年龄、体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(GLU)、谷氨酰基转移酶(GGT)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、尿酸(UA)、RBP4、内脂素水平均高于对照组(P<0.001);②RBP4、内脂素水平随着MS组分异常数目的增加而逐渐升高(P趋势<0.001);③未调整时,第三分位数组RBP4和内脂素患MS危险分别是第一分位数组的7.697倍(95％CI:4.424～13.392)和12.858倍(95％CI:7.229～22.870);调整年龄、性别等混杂因素后,RBP4水平对MS没有影响(OR=2.018,95％CI:0.862～4.721),内脂素仍是NAFLD的危险因子(OR=5.011,95％CI:1.883～13.333).结论 内脂素是MS的独立危险因子,RBP4影响MS但不是MS的独立危险因子.     

血浆类固醇性激素水平与女性乳腺癌危险性的关系

目的 :评价绝经前后血浆类固醇性激素水平与汉族女性乳腺癌危险性的关系。方法 :采用放射免疫法检测原发性乳腺癌病例 90例和 116例匹配对照组血浆雌二醇 (E2 )、睾酮 (T)及孕酮 (P)水平 ,并应用条件Logistic回归等方法分析绝经前后血浆E2 、T、P水平 ,以及体质指数 (BMI)和腰臀围比 (WHR)对乳腺癌的危险度 (OR)及 95 %可信限(CI)。结果 :①绝经前 ,病例组血浆P水平显著低于对照组 ;绝经后血浆T、E2 水平、BMI和WHR ,病例组均显著高于对照组 ;②以下四分位 (P2 5)为非暴露参考 ,绝经前 ,血浆P上四分位 (P75)水平调整OR(95 %CI)为 0 .2 1(0 .11～0 .6 0 ) ,趋势P =0 .19;绝经后 ,血浆E2 P75水平OR为 3.74 (1.17～ 11.96 ) ,调整OR为 2 .98(0 .84～ 7.96 ) ,趋势P =0 .0 3;③BMI和WHR与绝经后乳腺癌有正性联系 ,OR分别为 4 .97(2 .0 9～ 11.79)和 2 .80 (1.2 7～ 6 .17)。结论 :血浆性激素水平与乳腺癌的危险性相关。血浆P水平对绝经前乳腺癌有保护作用 ;血浆E2 为绝经后乳腺癌的危险因素 ,且存在剂量反应暴露效应 ;BMI和WHR与血浆E2 呈正相关且为绝经后乳腺癌的危险因素。     

飞行员社交回避及苦恼的心理社会因素研究

目的 探讨导致飞行员社交回避及苦恼的心理社会因素.方法 对458名飞行员进行量表测评,包括社交回避及苦恼量表、症状自评量表、卡特尔16种人格因素问卷、领悟社会支持量表、特质应对问卷、生活事件量表.数据采用SPSS10.0作相关、多因素回归分析.结果 飞行员社交回避及苦恼与心理健康水平、个性、社会支持、特质应对、生活事件有显著相关性;运输机飞行员社交回避(F=3.09,P＜0.05)和社交苦恼(F=4.05,P＜0.01)均显著大于其他机种;疾病组社交苦恼明显大于健康组(t:2.74,P＜0.01).多元回归分析显示,兴奋性、有恒性、敢为性和消极应对方式对社交回避行为的影响最大(标准回归系数依次为-0.346,0.230,-0.219,0.209);消极应对方式、兴奋性、社会支持和敢为性对社交苦恼情感的影响最大(标准回归系数依次为0.591,-0.324,0.185,-0.129).结论 个性、特质应对、社会支持、心理健康水平和生活事件等心理社会因素影响飞行员社交回避及苦恼.     

齐齐哈尔市居民体重指数、腰围与血压和血脂的相关性研究

目的分析齐齐哈尔市居民不同体重指数、腰围与血压、血脂的相关性,为本地区代谢综合征的防治提供参考。方法对齐齐哈尔市建华区社区1259位居民进行问卷调查、体格检查、测量血压及血液生化指标。采用SPSS18.0软件进行方差分析及偏相关分析。结果随着BMI、WC的增加,血压、TC、TG的均值也逐渐增加(P<0.01)。BMI、WC与血压(除女性舒张压)、TC、TG有相关性,WC与上述各指标的标准偏回归系数均大于BMI。结论 WC对各指标的影响大于BMI,是预测人群血压、总胆固醇、甘油三酯水平较好的人体测量学指标。     

宁夏地区儿童青少年体重指数与血压关系的研究

目的研究宁夏地区儿童青少年体重指数与血压的关系。方法收集2005年宁夏地区13039名7~18岁回汉中小学生的体质检查资料,以全国学龄儿童第95百分位数值判定高血压,统计分析儿童青少年体重指数与血压的关系。结果控制了年龄、性别、民族后,体重指数与收缩压、舒张压显著相关,偏相关系数分别为0.122和0.125(P<0.001);宁夏地区儿童青少年高血压患病率为4.83%,其中超重肥胖学生与体重正常学生高血压患病率分别为12.71%和4.16%,两者相比OR值为3.353。结论儿童青少年血压随体重指数的增加而升高,超重及肥胖者患高血压的危险是体重正常者的3倍,预防高血压应从儿童抓起。     

Report on Childhood Obesity in China （2） Verification of BMI Classification Reference for Overweight and Obesity in Chinese Children and Adolescents

Objective To verify Working Group for Obesity in China （WGOC） recommended body mass index （BMI） classification reference for overweight and obesity in Chinese children and adolescents using the data of 2002 China Nationwide Nutrition and Health Survey. Methods PediaWic metabolic syndrome （MetS） and abnormality of each risk factor for MetS were defined using the criteria for US adolescents. Definition of hyper-TC, LDL, and dyslipidemia in adults was applied as well. The average level and abnormality rate of the metabolic indicators were described by BMI percentiles and compared with general linear model analysis. Receiver operating characteristic analysis was used to summarize the potential of BMI to discriminate between the presence and absence of the abnormality of these indicators. Results There was neither significantly increasing nor significantly decreasing trend of biochemical parameter levels in low BMI percentile range （〈65th）. Slight increasing trend from the 75th and a significant increase were found when BMI≥85th percentile. In general, the prevalence of the examined risk factors varied slightly when BMI percentile〈75th, and substantial increases were consistently seen when BMI percentile≥75th. As an indicator of hyper-TG, hypertension and MetS, the sensitivity and specificity were equal at the point of BMI〈75th percentile, and the Youden＇s index of risk factors also reached peak point before 75th percentile except for MetS. When the BMI percentile was used as the screening indicator of MetS, Youden＇s index reached peak point at 85th percentile, just the point in the ROC graph that was nearest to the upper left comer. Conclusion The BMI classification reference for overweight and obesity recommended by WGOC is rational to predict and prevent health risks in Chinese children and adolescents. Lower screening cut-off points, such as 83th percentile or 80th percentile, should not be excluded when they are considered as overweight criteria in future intervention or prevention studies.     

Physical size of 1887 aboriginal schoolchildren in the Kimberley region

This study has documented the weights and heights of 1887 Aboriginal schoolchildren from communities throughout the Kimberley region of Western Australia. The data have been analysed in relation to age and sex. Median weights and heights of the Aboriginal children approximated the 10th percentile for weight, and the 25th percentile for height of non-Aboriginal WA children. The data show that Aboriginal children who live in the more remote communities of the Kimberley region were smaller in weight and height than were those who lived in the towns. Retrospective data indicate that these differences between children from remote and town communities were present at their birth and through childhood. Median body mass indices (BMIs) approximated the 10th percentile values for BMI of non-Aboriginal children in the earlier years. The expected increase in BMI with age occurred later in Aboriginal children (at 11-12 years) than in non-Aboriginal children (eight years); in the older Aboriginal children (older than 11-12 years) median values approximated 25th percentile values of non-Aboriginal boys and 50th percentile values of non-Aboriginal girls of the same age.     

Prevalence of obesity among affluent school children in Dhaka

A cross sectional study was conducted in September 2006 in one of the private schools in Dhaka, Bangladesh to see the prevalence of obesity among affluent school children and adolescents. Informed consent was taken from school authority to take anthropometric measurement of all school children. Standing height was measured with a stadiometer and weight with a bathroom scale. Waist and hip circumference were measured with a measuring tape. The body mass index (BMI) was calculated using weight in kilogram/(height in meter)2 formula. Obesity was defined as BMI≥95th percentile for age and sex, over weight as BMI≥85th percentile for age and sex, normal weight as BMI between 5th and 84th percentile and underweight as BMI <5th percentile. Official centers for disease control (CDC) growth chart for boys and girls age 2-20 years was used. Children and adolescents were divided into group 1(3-5 years), Group 2(6-9years), group 3(10-13 years) and group 4(14-18 years). There were a total of 468 children and adolescents (male 266, female 202). In group 1 there were 110 children, in group 2 there were177 children, in group 3 and 4 there were 149 and 32 adolescents respectively. The prevalence of obesity was 17.9%, higher among males (19.9%), compared to females (15.3%). Obesity was highest (27.7%) in group 2, 14.5% in group 1, 10.7% in group 3 and 9.4% in group 4.     

高尿酸血症患者生活中相关危险因素的分析

目的：探讨影响高尿酸血症发生的主要危险因素。方法对2011年6月至2014年6月经我科首诊治疗的267例高尿酸血症患者的病例资料进行回顾性分析,同时选取250例非高尿酸血症患者的病例资料进行对比分析。结果对所有因素进行比较,发现性别、年龄、体质量指数（ BMI）、三酰甘油（ TG）、高密度脂蛋白胆固醇（ HDL-C）、低密度脂蛋白胆固醇（LDL-C）等有统计学差异（P＜0．05）;多因素分析结果显示：年龄、TG以及BMI与发病有着密切关系,是主要影响因素。结论年龄、BMI和总胆固醇是影响高尿酸血症发生的主要危险因素,人群应控制饮食,改善生活习惯,控制体质量,改善血尿酸水平。     

Epidemic increase in childhood overweight, 1986-1998.

CONTEXT: Overweight is the most common health problem facing US children. Data for adults suggest that overweight prevalence has increased by more than 50% in the last 10 years. Data for children also suggest that the prevalence of overweight continues to increase rapidly. OBJECTIVE: To investigate recent changes in the prevalence of overweight within a nationally representative sample of children. DESIGN, SETTING, AND PARTICIPANTS: The National Longitudinal Survey of Youth, a prospective cohort study conducted from 1986 to 1998 among 8270 children aged 4 to 12 years (24 174 growth points were analyzed). MAIN OUTCOME MEASURES: Prevalence of overweight children, defined as body mass index (BMI) greater than the 95th percentile for age and sex, and prevalence of overweight and at-risk children, defined as BMI greater than the 85th percentile for age and sex. The roles of race/ethnicity, sex, income, and region of residence were also examined. RESULTS: Between 1986 and 1998, overweight increased significantly and steadily among African American (P<.001), Hispanic (P<.001), and white (P =.03) children. By 1998, overweight prevalence increased to 21.5% among African Americans, 21.8% among Hispanics, and 12.3% among non-Hispanic whites. In addition, overweight children were heavier in 1998 compared with 1986 (P<.001). After adjusting for confounding variables, overweight increased fastest among minorities and southerners, creating large demographic differences in the prevalence of childhood overweight by 1998. The number of children with BMI greater than the 85th percentile increased significantly from 1986 to 1998 among African American and Hispanic children (P<.001 for both) and nonsignificantly among white children (P =.77). CONCLUSIONS: Childhood overweight continues to increase rapidly in the United States, particularly among African Americans and Hispanics. Culturally competent treatment strategies as well as other policy interventions are required to increase physical activity and encourage healthy eating patterns among children.     

影响老年2型糖尿病患者骨质疏松症发生的多因素分析

目的 阐明导致老年2型糖尿病患者发生骨质疏松症的相关因素, 为今后预防和治疗老年2型糖尿病患者骨质疏松症提供一定的指导建议.方法 随机选择121例老年2型糖尿病患者, 根据中国骨质疏松症诊疗指南把121例患者分成2组 (其中病例组53例, 正常组68例) , 收集2组患者性别、年龄、体重指数、生活及活动方式 (有氧活动、吸烟、饮酒、体力活动、饮食失衡、服用钙剂) 、血脂、肾功、甲状旁腺、钙磷乘积、C反应蛋白、糖尿病并发症、用药情况进行比较分析.结果 病例组和正常组年龄、BMI、糖尿病病程、甲状旁腺、尿素氮、肌酐、尿蛋白、有氧活动、服用钙剂、单纯胰岛素治疗差异均有统计学意义 (P<0.05) .结论 年龄、糖尿病病程、甲状旁腺、尿蛋白为老年2型糖尿病患者骨质疏松症发生的危险因素, 主动有氧活动、服用钙剂为老年2型糖尿病患者骨质疏松发生的保护因素.     

Obesity among children residing in Mexico City and its impact on lung function: a comparison with Mexican-Americans

BACKGROUND: The objective of the study was to describe the prevalence of obesity among Mexican children and its impact on ventilatory lung function. METHODS: We studied cross-sectionally 6784 students between 8 and 20 years of age attending schools located <2 km away from ten air pollution monitors located throughout metropolitan Mexico City. The comparison group was made up of 1924 Mexican-Americans of the same age, studied during the NHANES-III examination, which included information on spirometry and body mass index (BMI). RESULTS: Of all our subjects, 9.7% had a BMI >95(th) percentile of CDC growth charts (compared to 15.1% in Mexican-Americans) and 6.6% fulfilled the obesity criteria of the International Obesity Task Force (vs. 12.2%). Obesity was related to male gender, asthma and passive smoking. At the same height and gender, lung function was higher in Mexicans than in Mexican-Americans, perhaps due to altitude. In children 8-11 years of age, lung function increased in heavier subjects but, in older children and youths, function reached a plateau and decreased among children with highest BMI (inverted U pattern, seen in adults). CONCLUSIONS: Obesity is higher in Mexican-American children and youths than in Mexicans. Spirometric function is affected adversely by obesity, especially in young people.     

中青年人打鼾和正常高值血压的流行病学调查及影响因素分析

 目的 探讨中青年人群中鼾症和正常高值血压的流行及相关危险因素。方法 对619例样本，进行问卷调查和体格检查，并对相关因素进行统计学分析。结果 在619人中，打鼾者占49.9%，正常高值血压者占40.1%。不论青年人还是中年人，鼾症组的收缩压，心率和体重指数均显著高于无鼾症组 (P<0.01~0.05)。青年组的颈围鼾症组也大于无鼾症组。单因素分析显示，中青年人群中打鼾、年龄、性别、体重指数、腰臀比等与正常高值血压有关。进一步做多因素logistic回归分析结果表明：打鼾、腰臀比、性别和年龄4种因素对正常高值血压的影响较大。结论 鼾症和正常高值血压在城市中青年人群中有较高的流行。打鼾是除腰臀比、性别和年龄以外与正常高值血压相关的独立危险因素。习惯性打鼾可能通过长期心脏活动的增强导致正常高值血压的形成。