Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions.

OBJECTIVE: To review the prevalence of overweight and obesity in Australian children and adolescents in two national samples, 10 years apart, using the new standard international definitions of the International Obesity Task Force Childhood Obesity Working Group. DESIGN: Body mass index (BMI) cut-off points defining overweight and obesity were applied to the individual BMI values in the two cross-sectional samples. SETTING: Australian community. PARTICIPANTS: 8,492 schoolchildren aged 7-15 years (Australian Health and Fitness Survey, 1985) and 2,962 children aged 2-18 years (National Nutrition Survey, 1995). MAIN OUTCOME MEASURE: Prevalence of overweight and obesity. RESULTS: In the 1985 sample, 9.3% of boys and 10.6% of girls were overweight and a further 1.7% [corrected] of boys and 1.6% [corrected] of girls were obese. In the 1995 sample, overall 15.0% of boys (varied with age from 10.4% to 20.0%) and 15.8% of girls (varied with age from 14.5% to 17.2%) were overweight, and a further 4.5% of boys (2.4%-6.8%) and 5.3% of girls (4.2%-6.3%) were obese. The prevalence of overweight and obesity in the 1995 sample peaked at 12-15 years in boys and 7-11 years in girls. In schoolchildren aged 7-15 years, the rates represent a relative risk of overweight in 1995 compared with 1985 of 1.79 (95% CI, 1.59-2.00) and of obesity of 3.28 (95% CI, 2.51-4.29). Compared with previous estimates from these samples, the revised prevalence data are slightly higher for the 1985 data and considerably higher for the 1995 data. CONCLUSION: The secular trend of increasing overweight and obesity in the decade from 1985 and the high prevalence rates in Australian children and adolescents are a major public health concern.     

2014年中国7~18岁学生血压状况与营养状况的关联分析——基于中国儿童青少年血压评价标准

目的：分析2014年中国7~18岁儿童青少年学生血压状况的流行病学现状及其与营养状况之间的关联性,为制定儿童血压防控措施提供依据。方法：利用2014年“中国学生体质与健康调研”结果中7~18岁的儿童青少年数据,依据我国儿童青少年分年龄、性别、身高百分位血压标准来评价血压状况,包括儿童血压偏高前期、血压偏高、单纯性收缩压偏高、单纯性舒张压偏高和混合性血压偏高。按照国际儿童青少年体质量指数（body mass index,BMI）标准评价儿童青少年营养状况,包括消瘦（重度消瘦和轻度消瘦）、正常BMI、超重和肥胖（重度肥胖和轻度肥胖）。利用多因素Logistics回归模型分析血压偏高与营养状况之间的关联性,并计算人群归因危险度评估超重肥胖控制对于预防儿童血压偏高的公共卫生学意义。结果：2014年中国7~18岁儿童青少年血压偏高和血压偏高前期的检出率分别为14.9%和 9.2%,儿童青少年血压偏高者中收缩压偏高、舒张压偏高和混合性血压偏高检出率分别为3.1%、8.8%和3.0%。血压偏高状况整体呈现为男生高于女生,乡村高于城市,随年龄逐渐增高,随地区（东部、中部和西部）逐渐降低,随BMI 的增加而增加的趋势。重度肥胖组的血压偏高检出率最高,男女生分别为 44.2%和38.8%,分别是正常组（15.8%和10.6%）的2.8倍和3.7倍。血压偏高与消瘦（重度消瘦和轻度消瘦）呈负相关,与超重肥胖呈正相关。血压偏高归因于超重肥胖的危险度为16.2%,控制超重肥胖后,血压偏高的期望检出率为12.5%,且对单纯性收缩压偏高和混合性血压偏高影响较大,归因危险度分别为28.7%和35.1%。结论：我国儿童青少年血压偏高检出率较高,且以单纯性舒张压偏高为主。超重肥胖可显著增加血压偏高的风险,尤其是对单纯性收缩压偏高和混合性血压偏高影响较大,通过控制超重肥胖可显著降低全国儿童高血压的发生风险,从而对预防成年期慢性病的发生具有重要意义。     

Overweight and obesity from childhood to adulthood: a follow-up of participants in the 1985 Australian Schools Health and Fitness Survey

OBJECTIVE: To examine overweight and obesity in Australian children followed through to adulthood. DESIGN AND PARTICIPANTS: A cohort study of 8498 children aged 7-15 years who participated in the 1985 Australian Schools Health and Fitness Survey; of these, 2208 men and 2363 women completed a follow-up questionnaire at age 24-34 years in 2001-2005. MAIN OUTCOME MEASURES: Height and weight were measured in 1985, and self-reported at follow-up. The accuracy of self-reported data was checked in 1185 participants. Overweight and obesity in childhood were defined according to international standard definitions for body mass index (BMI), and, in adulthood, as a BMI of 25-29.9 and > or =30 kg/m2, respectively, after correcting for self-report error. RESULTS: In those with baseline and follow-up data, the prevalence of overweight and obesity in childhood was 8.3% and 1.5% in boys and 9.7% and 1.4% in girls, respectively. At follow-up, the prevalence was 40.1% and 13.0% in men and 19.7% and 11.7% in women. The relative risk (RR) of becoming an obese adult was significantly greater for those who had been obese as children compared with those who had been a healthy weight (RR = 4.7; 95% CI, 3.0-7.2 for boys and RR = 9.2; 95% CI, 6.9-12.3 for girls). The proportion of adult obesity attributable to childhood obesity was 6.4% in males and 12.6% in females. CONCLUSION: Obesity in childhood was strongly predictive of obesity in early adulthood, but most obese young adults were a healthy weight as children.     

广州市海珠区10～14岁小学生肥胖现状及影响因素分析

目的 了解小学生肥胖现状及影响因素。方法 在海珠区随机抽取3所小学,对1100名学生进行体格检查,并对调查对象发放有关肥胖影响因素的调查问卷。结果 本次调查肥胖检出率为5．82％,其中男生533人,肥胖检出率为6．57％;女生567人,肥胖检出率为5．11％,男女间肥胖检出率差异无统计学意义;各年龄组肥胖检出率差异有统计学意义,其中11岁组的肥胖检出率最高;对相关影响因素进行logistic回归分析,进食速度OR=1．615,家长肥胖OR=1．808。结论 不良的生活方式与肥胖的发生密切相关,进食速度、家长肥胖是肥胖的危险因素。     

重庆市城区3～18岁儿童青少年肥胖症及相关疾病的流行病学调查

目的为掌握重庆市儿童青少年超重肥胖的发病情况,并对心血管疾病相关的高危指标进行观察。方法对重庆市城区23293名3~18岁儿童青少年进行了流行病学调查。测量指标包括身高、体重、腰围、臀围、血压。结果(1)总体检出超重12.44%,肥胖为3.72%,其中男孩分别为14.38%、4.99%,女孩为10.37%、2.35%。(2)肥胖组及超重组男女儿童的收缩压及舒张压高于90百分位及95百分位者均多于正常体重组,χ2值分别为404.535、618.486,115.912、131.641,P值均<0.005。(3)腰-臀围比值肥胖男孩中有10.89%腰-臀围比值>1.0,肥胖女孩中有75.00%腰-臀围比值>0.85。结论重庆市城区儿童青少年超重检出率为12.44%,肥胖检出率为3.72%。肥胖儿童中的血压升高者明显的多于同年龄同性别正常体重儿童。女孩中心性肥胖高于男孩。     

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.     

Prevalence of overweight and obesity in the United States, 1999-2004

Context  The prevalence of overweight in children and adolescents and obesity in adults in the United States has increased over several decades. Objective  To provide current estimates of the prevalence and trends of overweight in children and adolescents and obesity in adults. Design, Setting, and Participants  Analysis of height and weight measurements from 3958 children and adolescents aged 2 to 19 years and 4431 adults aged 20 years or older obtained in 2003-2004 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US population. Data from the NHANES obtained in 1999-2000 and in 2001-2002 were compared with data from 2003-2004. Main Outcome Measures  Estimates of the prevalence of overweight in children and adolescents and obesity in adults. Overweight among children and adolescents was defined as at or above the 95th percentile of the sex-specific body mass index (BMI) for age growth charts. Obesity among adults was defined as a BMI of 30 or higher; extreme obesity was defined as a BMI of 40 or higher. Results  In 2003-2004, 17.1% of US children and adolescents were overweight and 32.2% of adults were obese. Tests for trend were significant for male and female children and adolescents, indicating an increase in the prevalence of overweight in female children and adolescents from 13.8% in 1999-2000 to 16.0% in 2003-2004 and an increase in the prevalence of overweight in male children and adolescents from 14.0% to 18.2%. Among men, the prevalence of obesity increased significantly between 1999-2000 (27.5%) and 2003-2004 (31.1%). Among women, no significant increase in obesity was observed between 1999-2000 (33.4%) and 2003-2004 (33.2%). The prevalence of extreme obesity (body mass index 40) in 2003-2004 was 2.8% in men and 6.9% in women. In 2003-2004, significant differences in obesity prevalence remained by race/ethnicity and by age. Approximately 30% of non-Hispanic white adults were obese as were 45.0% of non-Hispanic black adults and 36.8% of Mexican Americans. Among adults aged 20 to 39 years, 28.5% were obese while 36.8% of adults aged 40 to 59 years and 31.0% of those aged 60 years or older were obese in 2003-2004. Conclusions  The prevalence of overweight among children and adolescents and obesity among men increased significantly during the 6-year period from 1999 to 2004; among women, no overall increases in the prevalence of obesity were observed. These estimates were based on a 6-year period and suggest that the increases in body weight are continuing in men and in children and adolescents while they may be leveling off in women.      

深圳市某小学青少年超重及肥胖现况调查分析

目的：了解深圳市儿童青少年超重、肥胖流行现状和影响因素,为青少年肥胖的预防提供依据。方法采取分层整群抽样方法抽取深圳市某小学311名7～13岁青少年作为调查对象,通过问卷和体格检查资料,计算体重指数,利用中国肥胖问题工作组标准（WGOC标准）对不同性别和年龄段的体重指数、超重率和肥胖率进行分析。结果按WGOC标准分析,本次调查的青少年总体超重率为17.68%,肥胖率为9.32%。男生超重率为21.71%,肥胖率为12.00%;女生超重率为12.50%,肥胖率为5.88%。结论本次调查显示深圳市青少年总体超重和肥胖率较其他地区高,青少年的超重、肥胖现象男生比女生严重。不良的饮食习惯、缺乏运动和长时间静坐是主要的危险因素,学校、家长等有关方面应该对此引起注意并采取有效防治措施。     

Association between BMI and Dental Caries among School Children and Adolescents in Jiangsu Province,China

Obesity has reached epidemic levels in recent years and remains a global public health problem worldwide despite improvements in oral disease prevention programs. Additionally, the prevalence of oral disease has rapidly increased in a number of lowand middle-income countries, accelerated by the greatest burden and higher risk factors, such as presenting in changes of eating habits, use of tobacco, excessive consumption of alcohol, and weak oral hygiene habits. In addition to limited availability and accessibility of oral health services, a lack of health promotion is associated with poor oral health[1].     

Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002

Context  The prevalence of overweight and obesity has increased markedly in the last 2 decades in the United States. Objective  To update the US prevalence estimates of overweight in children and obesity in adults, using the most recent national data of height and weight measurements. Design, Setting, and Participants  As part of the National Health and Nutrition Examination Survey (NHANES), a complex multistage probability sample of the US noninstitutionalized civilian population, both height and weight measurements were obtained from 4115 adults and 4018 children in 1999-2000 and from 4390 adults and 4258 children in 2001-2002. Main Outcome Measure  Prevalence of overweight (body mass index [BMI] 95th percentile of the sex-specific BMI-for-age growth chart) among children and prevalence of overweight (BMI, 25.0-29.9), obesity (BMI 30.0), and extreme obesity (BMI 40.0) among adults by sex, age, and racial/ethnic group. Results  Between 1999-2000 and 2001-2002, there were no significant changes among adults in the prevalence of overweight or obesity (64.5% vs 65.7%), obesity (30.5% vs 30.6%), or extreme obesity (4.7% vs 5.1%), or among children aged 6 through 19 years in the prevalence of at risk for overweight or overweight (29.9% vs 31.5%) or overweight (15.0% vs 16.5%). Overall, among adults aged at least 20 years in 1999-2002, 65.1% were overweight or obese, 30.4% were obese, and 4.9% were extremely obese. Among children aged 6 through 19 years in 1999-2002, 31.0% were at risk for overweight or overweight and 16.0% were overweight. The NHANES results indicate continuing disparities by sex and between racial/ethnic groups in the prevalence of overweight and obesity. Conclusions  There is no indication that the prevalence of obesity among adults and overweight among children is decreasing. The high levels of overweight among children and obesity among adults remain a major public health concern.      

银川市青少年体重指数与血压关系的研究

目的探讨银川地区13-18岁青少年体重指数(BMI)与血压的关系。方法按照WGOC推荐的中国儿童青少年超重、肥胖分类标准建议以及中国学生体质与健康研究组推荐的儿童高血压标准。采用随机整群抽样的方法,对银川市7619名13-18岁青少年的体质指数和血压进行了横断面的调查。结果在控制了年龄、性别、民族的影响后,13-18岁青少年的BMI与收缩压(SBP)和舒张压(DBP)正相关,偏相关系数分别为0.219和0.207(P<0.01);并且随BMI的增大SBP和DBP也不断升高(P<0.05)。高SBP率、高DBP率、高血压患病率以及患高血压的相对危险度(RR)随BMI值的增加而增高,与正常体重组相比,超重组和肥胖组的高血压患病率分别高达0.77%和3.19%,RR分别为2.20和9.11(P<0.05);不同年龄组中,与BMI正常组比较,超重、肥胖组的男、女性及汉、回族中高SBP率、高DBP率显著增高(P<0.05);不同体重组中,男性高SBP率、高DBP率显著高于女性(P<0.05);汉、回族间无差别。结论银川地区13-18岁青少年的BMI与血压呈独立正相关,超重和肥胖者患高血压的危险性显著增加。     

Application of the WHO Growth Reference （2007） to Assess the Nutritional Status of Children in China

Objective To assess the nutrition status of children and adolescents in China using the WHO growth reference （2007） in comparison with that defined by the International Obesity Task Force （IOTF） and the Working Group on Obesity in China （WGOC）. Methods Overweight and obesity were defined by age-, sex-, specific BMI reference developed by WHO （2007）, IOTF （2000）, and WGOC （2004）, respectively. Stunting and thinness were defined as height and BMI less than two standard deviations （SD） of the WHO growth reference （2007）, respectively. Data of children and adolescents aged 5 to 19 years （n=54 857, 28 273 boys, 26 584 girls） from the 2002 China National Nutrition and Health Survey （CNNHS） were used in the study. Results The prevalence of overweight, obesity, stunting and thinness among Chinese children and adolescents aged 5-19 years was 5.0%, 1.2%, 13.8%, and 7.4%, respectively when the WHO growth reference （2007） was used, whereas the estimated absolute total number affected by these 4 conditions were 14.6, 3.7, 40.6, and 21.8 million, respectively. The prevalence of overweight and obesity was 18.1% in large cities, while the stunting prevalence was 25.1% in rural 4. Obesity prevalence assessed by the WHO growth reference was higher than that as assessed by the IOTF reference, and obesity prevalence assessed by the WGOC reference was lower than that as assessed by the IOTF reference. Conclusion The nutritional status of children and adolescents is not equal in different areas of China. Stunting is still the main health problem of the poor, while overweight and obesity are the main health problems in large cities.     

Obesity and metabolic risks in children

BACKGROUND: We undertook this study to establish the prevalence of overweight, obesity, abdominal obesity, high blood pressure, and high glucose and triglyceride levels in school-age children from Mexico City, as well as to determine how overweight and obesity are related to the other risk factors. METHODS: The study was a cross-sectional survey comprised of 1819 children (6-13 years of age) attending six elementary schools. Gender, age, weight, height, waist circumference, blood pressure, and levels of triglycerides and glucose were registered. Percentiles were calculated according to American standards for BMI, height, waist circumference, and blood pressure. RESULTS: Compared to American references, mean percentiles for waist circumference and BMI were >50, and mean height percentiles were <50. Prevalence of overweight was 22.3 and 23.6% for boys and girls, respectively; obesity, 28 and 21.2%; abdominal obesity, 22.1 and 11.7%; high triglyceride levels, 11.3 and 15.4%; high blood pressure, 4.8 and 5.8%, respectively. Overweight, obesity, and abdominal obesity are associated with higher blood pressure and triglyceride levels (odds ratio>1.0, p<0.05). Percentiles for BMI, waist circumference, systolic blood pressure, and diastolic blood pressure also had significant correlations (r>0.2, p<0.001). CONCLUSIONS: This population of Mexican school-age children was shorter and heavier than their American standards. The prevalence of metabolic risks was similar to those reported in American adolescents in NHANES surveys.     

The relation of obesity to cardiovascular risk factors among children: the CARDIAC project

West Virginia's prevalence of obesity is among the highest in the nation, contributing to an excess mortality rate from heart disease. Individuals who are overweight and obese have a greater risk for coronary artery disease. To gain insight into the impact of obesity on other modifiable cardiovascular disease (CVD) risk factors among children, 5,887 students from 27 rural West Virginia counties participated in the school-based Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project during the 1999-2002 school years. Results confirmed a very high prevalence of overweight and obese children in this rural, pre-adolescent population. Almost 43 percent of the children screened were considered to be overweight (BMI > or = 85th percentile), and over one-fourth of them were obese (BMI > or = 95th percentile). This high rate of obesity among schoolchildren in West Virginia is associated with increased prevalence of other CVD risk factors such as hypertension, dyslipidemia, and insulin resistance. Interventions for prevention of excess weight and obesity should be implemented through schools and community-based programs.     

3. Management and prevention of obesity and its complications in children and adolescents

Obesity in children and adolescents has reached alarming levels--20%-25% of children and adolescents are overweight or obese, and 4.9% of boys and 5.4% of girls are obese. Rates of obesity have increased significantly in Australia from 1985 to 1995, with the prevalence of overweight doubling and obesity trebling. Body mass index (related to reference standards for age and sex) is recommended as a practical measure of overweight and obesity in children, and is used in monitoring individual progress in clinical practice. Obesity in childhood and adolescence may be associated with a range of medical and psychological complications, and can predispose individuals to serious health problems in adult life, including type 2 diabetes, hypertension, dyslipidaemia and non-alcoholic steatohepatitis. Obesity interventions for which there is some evidence include family support, a developmentally appropriate approach, long-term behaviour modification, dietary change, and increased physical activity and decreased sedentary behaviour. Prevention of obesity in children and adolescents requires a range of strategies involving changes in both the microenvironment (eg, housing, neighbourhoods, recreational opportunities) and the macroenvironment (eg, food marketing, transport systems, urban planning).     

成都市儿童青少年肉类、脂肪、脂肪酸摄入情况与 超重肥胖的关系

目的 了解成都市龙泉驿区7～15岁儿童青少年超重肥胖情况以及肉类、脂肪和脂肪酸摄入现状,并初步探讨两者间的关系。方法 采用分层整群抽样法,选取成都市龙泉驿区1 811名7~15岁儿童青少年为研究对象,采用问卷调查和现场测量分别收集膳食和体格数据并计算体质量指数(BMI)、BMI标准差评分(BMI SDS)、腰围/身高比值(WHtR)、超重率和肥胖率,通过秩和检验和卡方检验比较正常体质量、超重肥胖儿童肉类、脂肪、脂肪酸摄入情况的差异以及不同年龄段儿童肉类、脂肪、脂肪酸低、中、高摄入量组间超重率、肥胖率、BMI SDS及WHtR的差异。结果 成都市龙泉驿区7～15岁儿童青少年超重率为10.34%,肥胖率为6.59%。男生超重率(12.05%)与超重肥胖合并率(18.97%)均高于女生(8.55%,14.80%)( P<0.05)。总肉类、红肉、白肉及脂肪供能比摄入情况均为女生高于男生,总肉类、红肉、白肉、饱和脂肪酸及单不饱和脂肪酸摄入量随年龄增长而增加( P<0.05)。女生中,超重肥胖组平均每日脂肪供能比、饱和脂肪酸及单不饱和脂肪酸摄入量高于体质量正常组;BMI SDS与WHtR均随脂肪供能比增加而升高,BMI SDS在平均每日单不饱和脂肪酸高摄入量组中最高( P<0.05)。结论 红肉、脂肪供能比、饱和脂肪酸、单不饱和脂肪酸摄入量可能与儿童青少年超重肥胖相关,性别差异有待进一步研究。     

克拉玛依市区儿童青少年肥胖与父母社会经济状况的关系

目的 掌握克拉玛依区儿童青少年超重及肥胖的发生率与其父母社会经济状况的关系.方法 测身高、体重,采用国内儿童青少年年龄-性别-BMI超重、肥胖判定标准,调查父母文化程度及职业.结果 超重和肥胖的检出率分别为13.6％、7.67％,男性高于女性,各民族间差异有统计学意义.超重和肥胖在父母文化程度和职业较高中检出率高.结论 克拉玛依市区儿童青少年超重及肥胖已达1/5,与家庭的社会经济状况呈正相关.     

Prevalence of overweight/obesity in Chinese children

BACKGROUND: The purpose of this paper was to report the prevalence of overweight/obesity by area, age, and gender in the year 2000 and to explore at what age adiposity rebound as measured by BMI occurs for Chinese children. METHODS: A cross-sectional study was carried out among 262,738 children aged 3.5-6.4 years in 26 counties/cities in China. Weight and height were measured from March 2000 through July 2000 by local trained health workers. International age- and gender-specific BMI cut-off points were used to obtain comparable prevalence rates of overweight/obesity. Multiple logistic regression was used to estimate odds ratios (OR) of being overweight/obesity for different comparisons. RESULTS: There were 19,390 overweight (16,738) or obese (2,652) children, resulting in an overall prevalence rate of 7.4% (95% CI: 7.3-7.5%). Girls were more likely to be overweight or obese than boys (OR = 1.14, 95% CI: 1.11-1.17). Compared with children living in the southern urban area, multivariate ORs for those living in northern rural and southern rural areas were 2.58 and 1.15, respectively. Compared with children aged 6.0-6.4 years old, multivariate ORs for children aged 3.5, 4.0, 4.5, 5.0 and 5.5 years were 1.96, 1.88, 1.56, 1.53, and 1.11, respectively (p<0.001). CONCLUSIONS: Childhood overweight/obesity in Chinese children in 2000 is similar to the conditions of Great Britain or the U.S. in the 1980s or earlier. Age at adiposity rebound as measured by BMI for Chinese children is >6.5 years old.     

儿童青少年超重及肥胖与代谢综合征的相关性研究

目的探讨儿童青少年超重肥胖与代谢综合征(MS)的相关性,为MS的早期干预提供参考。方法回顾性分析2007-2010年本院小儿内分泌门诊就诊的57例超重及155例肥胖儿童青少年的临床资料[血压、腰围、空腹血糖(FPG)、空腹血胰岛素(FINS)、血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)],以国际糖尿病联盟(IDF)的青少年MS定义为诊断标准计算MS检出率,并与同期常规体检的年龄性别匹配的228例非超重肥胖健康者进行比较。结果 (1)超重组、肥胖组与对照组比较,腰围、血压及FPG、TG、TC、LDL-C等多项糖脂代谢指标差别有统计学意义(P<0.05),但HDL-C各组间差别无统计学意义。(2)超重组、肥胖组与对照组比较,除HDL-C外其余MS各组分检出率升高,差别有统计学意义,检出率随体质量指数升高逐渐增加(趋势检验P<0.01)。(3)对照组未检出MS患者,超重组检出MS 3名(5.3%),肥胖组检出MS 56名(36.1%),MS检出率随体质量指数升高而增加(趋势检验P<0.01)。(4)超重组、肥胖组Lg HOMA-IR和Lg HOMA-β均较对照组升高(P<0.01)。(5)胰岛素抵抗指数与MS各单项指标显著相关(P均<0.01)。结论超重肥胖儿童青少年MS发生率较正常体质量者显著升高。儿童青少年超重肥胖与MS的发生密切相关,应重视并积极防治。     

Report on Childhood Obesity in China （1） Body Mass Index Reference for Screening Overweight and Obesity in Chinese School-age Children

Purpose To establish and propose a national body mass index （BMI） reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH （Chinese National Survey on Students Constitution and Health） data, including 216 620 primary and secondary school students aged 7 to 18 years old, were used as a reference population. Compared with those of the NCHS intematioanl reference, three temporary sets of cut-off BMI were proposed by testing different combinations of P85, P90, and P95. When physiological and biochemical measures between and among “obesity” “overweight”, and “normal weight” groups were taken into consideration, set Ⅱ was selected to be the most appropriate one. The sex-age-specific curves were then plotted and smoothed by using B-spline method. Results Based on the samples from costal developed metropolis, the BMI curves successfully overcame the shortcomings of lower and level-off tendency of the Chinese total population. Temporary set H, composed by cut-offs of P85 for overweight and P95 for obesity, was finally selected by its sensitivity and peculiarity. BMI 24 and 28 were used as cut-offs for overweight and obesity for both males and females aged 18 years old. These cut-offs, consistent with Chinese Adult＇s Reference, was proposed as the Body mass index reference for screening overweight and obesity in Chinese school-age children and adolescents. Conehlsion The new reference clearly showed its superiorty in both prospectivity and actuality. The proposed reference minimized the gaps of the BMI curve between Chinese adolescents and the international reference. Most importantly was that it was consistent with the Eastern Asia ethnic characteristics of body fatness growth. It was therefore proposed by the Working Group on Obesity in China （WGOC） to use it as an nationwide reference for screening overweight and obesity of school-age children and adolescents in China.