我国18～69岁居民体重自我评价与实测体质指数比较分析

目的了解我国18~69岁居民对自身体重的评价,并将自评体重与实测体质指数(BMI)值比较分析,探讨不同群体对自身体重的认知。方法利用2007年中国慢性病及其危险因素监测资料,采用多阶段分层随机整群抽样的方法抽取18~69岁成年人44 521人,采用问卷调查和体格测量收集数据,比较不同群体对自身体重的认知。计数资料的比较采用χ2检验。结果样本人群自评体重偏瘦率、正常率和偏胖率分别为23.24%,52.09%和24.67%,并且存在着性别、年龄、文化程度和地区上的差异(P0.01)。居民自评体重与实测BMI值的一致率为54.40%,BMI偏低组、正常组和超重组的一致率分别为63.16%,58.69%和46.81%,3组一致率有随BMI增加而降低的趋势。其中BMI超重组一致率女性高于男性,城市高于农村,年龄越大一致率越低,文化程度越高一致率越高(P0.001)。结论不同群体对自身体重的认知存在差异,正确认识自身体重状况的健康教育及预防控制超重和肥胖的工作十分必要。     

深圳市餐饮成年消费人群体质指数值与体重自我评价调查

目的探讨体质指数(BMI)在深圳成年人的分布特征和体重自我评价情况。方法2008年3月采用随机整群抽样方法随机抽取某些时间段在深圳市某连锁餐饮单位所有的成年消费人群作为调查对象,通过自制问卷实施调查。结果共收集有效问卷703份。样本人群BMI的均值为(21.34±2.94)kg/m2,消瘦、超重和肥胖率分别为15.1%、15.6%和2.6%;女性的消瘦比例显著高于男性,男性的超重比例显著高于女性;18~岁年龄组超重和肥胖率最低,随着年龄的增长,超重和肥胖率都呈上升趋势。样本人群对自身体重评价与BMI值的一致率为66.3%,男性和女性对自身体重评价与BMI值的一致率分别为65.5%和67.3%,两者之间差异无统计学意义。结论BMI与性别和年龄有密切关系,正确地认识自身体重状况的健康教育及预防控制超重和肥胖的工作任重道远。     

南昌市高中生体重自我评价与BMI分类一致性分析

目的了解江西省南昌市高中生体质指数(BMI)分类及体重自我评价现况及两者一致性情况,探讨体重自我评价对行为的影响,为建立青少年正确的自我评价开展相应的健康教育奠定基础。方法于2015年6月采取分层整群随机抽样法抽取南昌市5所学校884名学生,调查高中生的主要健康危险行为,分析BMI分类与体重自我评价的关系。结果被调查884名高中生中,52.38%体重自我评价与BMI分类一致,26.24%高估了自己的体重,21.38%低估了自己的体重。体重自我评价与BMI分类一致性不同的高中生计划采取的行为有统计学差异(χ2=239.019,P <0.001)。多元无序logistic回归分析显示,对体重计划采取减肥与高估呈正性相关(OR=4.972,P <0.001),与低估呈负性相关(OR=0.234,P <0.001);女性更容易高估自己的体重(OR=2.369,P <0.001)。结论青少年正确的体重自我评价对其生长发育具有重要意义,正确自我评价体型可以促使良好饮食习惯的培养和运动,而错误的自我认知可能导致不科学的减肥行为,应对此展开健康教育工作。     

1989-2006年辽宁省成年居民体质指数分布及变化趋势

目的 探讨1989-2006年辽宁省成年居民不同性别、年龄和居住社区体质指数(BMI)分布及变化趋势.方法 利用1989、1991、1993、2000、2004和2006年"中国健康与营养调查"项目6次追踪资料,选取辽宁地区18～45岁的健康成年居民作为本次研究对象.结果 1989-2006年辽宁省18～45岁成年居民BMI均值呈现逐年增长的趋势,1989年BMI均值为(22.1±9.4)kg/m2,而2006年上升到(24.0±5.2)kg/m2.其中男性BMI均值从(22.1±2.1)kg/m2上升到(24.6±5.1)kg/m2,女性BMI均值从(22.1±2.6)kg/m2上升到(23.9±4.3)kg/m2,男性增长幅度大于女性.30岁及以上成年居民BMI均值增长较快,到2006年BMI均值已超过24.0 kg/m2;城市、郊区、县城和农村居民BMI均值1989年分别为(21.8±2.4)kg/m2、(21.8±2.6)kg/m2、(22.1±2.7)kg/m2和(21.1±2.2)kg/m2,到2006年分别增长为(24.0±4.2)kg/m2、(23.9±4.0)kg/m2、(24.2±4.2)kg/m2和(22.6±3.5)kg/m2.城市、郊区和县城居民BMI均值增长较快,农村居民BMI均值增长较慢.随着BMI水平的提高,成年居民低体重率逐年降低,而超重肥胖率呈现快速增长的趋势.1989年辽宁省成年居民低体重率为6.9%,超重肥胖率为10.3%,到2006年该人群低体重率为4.5%,超重肥胖率为31.9%,17 a间居民超重肥胖率增长了21.6个百分点,其增长幅度为209.7%,平均每年增长率为6.9%.结论 辽宁省成年居民BMI逐年增长,应加以控制.     

河南省成年居民体质指数的动态变化研究

为观察体质指数的动态变化 ,为卫生研究和政策制订提供依据 ,采用分层多阶段整群随机抽样的方法 ,对抽取的观察户连续观察测量。结果显示 ,从 1989年～ 2 0 0 0年BMI小于 18 5的人数百分比呈下降趋势 ,1989年为 7 3% ,2 0 0 0年为 3 5 %。超重和肥胖的人数百分比呈增加的趋势 ,从 1989年的 10 7%猛增到2 0 0 0年的 2 5 2 % ,平均每年增加 1 5 %百分点。2 0 0 0年超重肥胖百分比高低依次为城市 33 3%、县城 31 7%、郊区 2 4 6 %和农村 2 1 1%。提示超重肥胖率较高 ,增加较快 ,应列为重大公共卫生问题之一 ,认真研究对待     

青年学生体重指数与其父母体重指数的关系

目的 探讨青年学生体重指数与其父母体重指数的关系,进一步了解遗传和环境因素在超重和肥胖流行中的作用,希望能为超重和肥胖的预防提供一定的指导。方法 按照中国肥胖问题工作组对中国成人体重指数(BMI)分类标准进行分组,即低BMI组(BMI<18.5),正常BMI组(BMI为18.5～23.9),超重组(BMI为24.0～27.9)和肥胖组(BMI≥28.0)。统计了505名青年学生和993名父母的BMI结果 男女学生超重肥胖者,其父母中单方也患有超重肥胖的比率从20.0％到50.0％,父母双方均患有超重肥胖的比率从6.7％到10.0％ 青年学生与其父母相比,超重肥胖率有显著性差异,女学生父母明显高于女学生,P<0.01;男学生父母也明显高于男学生,P分别小于0.01和0.05。在BMI<18.5组中,女学生明显高于父母,男学生高于其父亲,P<0.01。男女学生的父母亲比较,以及城乡比较,超重率和肥胖率无显著性差异。结论 男女学生超重肥胖者,其父母中单方也患有超重肥胖的比率平均约为30.0%,父母双方均患有超重肥胖的比率平均约为8.0%,从而证明超重和肥胖与遗传有关。但从超重和肥胖的现患率男女学生的父母亲明显高于男女学生这一事实,其差异的显著性表明,环境等因素在超重和肥胖形成中的作用可能更重要,因此,大多数超重和肥胖是可预防的。     

农村女性超重肥胖体质指数与体脂率法评价比较

目的 采用WHO体脂率标准评价中国现行体质指数诊断超重和肥胖标准的准确性。方法 于2013年5-7月横断面调查河北省玉田县648名18~59岁中青年农村女性,采用标准方法测量人体学指标,生物电阻抗法测量体脂率(BF%);体质指数(BMI)参照《中国成人超重和肥胖预防控制指南》,体脂率参照WHO标准。结果 调查对象平均BMI为(24.74±3.97) kg/m²,平均体脂率为(28.54±7.04)%;依据体脂率(>35%)和BMI(≥28.0 kg/m²)标准,调查对象肥胖检出率分别为18.98%和20.06%,差异无统计学意义(P>0.05)。以体脂率30%为超重标准,BMI 24 kg/m²的灵敏度和特异度分别为87.38和79.06%,诊断一致性(Kappa值)为0.66;以体脂率35%为肥胖标准,BMI 28 kg/m²的灵敏度和特异度分别为71.54和92.00%,Kappa值为0.62。BMI与体脂率呈二次曲线关系(R²=0.614,P<0.001)。结论 《中国成人超重和肥胖预防控制指南》推荐的超重和肥胖标准与WHO体脂率超重和肥胖标准的准确度和诊断一致性均较好。     

浙江省农村成年居民体质指数调查分析

目的探讨体质指数(BMI)在浙江农村成年居民中的分布特征。方法2006年1月采用多阶段分层整群抽样方法随机抽取浙江省18个县(市),90个乡镇、5400个农村住户中的成年居民为调查对象,通过自制问卷实施入户调查及体测。结果共收集有效问卷14317份。样本人群BMI的均值为22.96±2.65,超重和肥胖率分别为26.8%和4.2%;男性的超重比例与女性无差别,肥胖比例低于女性;15～岁年龄组超重和肥胖率最低,随着年龄的增长,超重和肥胖率都呈上升趋势,45～岁组超重率最高(36.7%),55～岁组肥胖率最高(6.4%);已婚组的超重和肥胖率都高于未婚组,与离婚组无显著性差异;男性随文化程度的升高超重率和肥胖率呈上升趋势,女性的文化程度与体质指数关系不大。结论浙江省农村成年居民超重率高于巴基斯坦等发展中国家,且近几年呈上升趋势;其超重率和肥胖率都低于河北省等华北地区。     

8116例健康体检人群体质指数与相关疾病分析

目的：探讨8116例健康体检人群不同体质指数与相关疾病的流行情况。方法：选取2011-2012年我院体检的健康人群8116例,分析体质指数正常、超重、肥胖与血压、血脂、血糖及相关慢性病患病率的关系。结果：超重、肥胖人群的血压、血脂、血糖值高于体质指数正常人群;超重、肥胖人群患高血压、糖尿病、高脂血症、脂肪肝、心脑血管疾病等慢性病的比例高于体质指数正常人群。结论：体质指数与慢性病关系密切,对超重、肥胖人群体质指数的管理,合理控制体重,改变不良生活方式,控制慢性病发生,是三级预防的关键。     

孕前体重指数和孕期体重增长与新生儿体重的关系

目的探讨孕妇孕前体重指数（bodymassindex,BMI）和孕期体重增长与新生儿体重的关系。方法2006年7月1日至2007年6月30日,2734例于四川I大学华西第二医院住院分娩且病历资料完整孕妇,按孕前体重指数分组。体重指数〈16．75kg／m2,纳入低BMI组（n=51）,体重指数为（16．75～23．71）kg／m2纳入正常BMI组（n=2330）,体重指数〉23．71kg／m2,纳入高BMI组（n=353）。根据四川大学华西第二医院推荐的孕期适宜体重增长模式,将孕期体重增长分为三类：体重增长〈13．13kg,体重增长为（13．13～20．25）kg和体重增长≥20．25kg。将正常BMI组与高BMI组孕妇分别按体重增长进一步分为三个亚组,分析孕妇孕前体重指数和孕期体重增长与新生儿体重的关系。结果低BMI组、正常BMI组和高BMI组孕妇孕前体重指数与新生儿体重的相关系数（r）分别为0．128（P〉0．05）,0．138（P〈0．01）和0．126（P〈0．05）。低BMI组、正常BMI组和高BMI组孕妇孕期体重增加与新生儿体重的相关系数分别为0．629（P〈0．001）,0．236（P〈0．001）和0．195（P〈0．001）。正常BMI组孕妇孕期体重增加〈13．13kg亚组1与正常BMI组体重增加为（13．13～20．25）kg亚组1比较,巨大儿发生的OR=0．617,95％CI：0．424～0．864（P〈0．01）。正常BMI组孕妇孕期体重增加〉20．25kg亚组1与体重增加为（13．13～20．25）kg亚组1比较,巨大儿发生的OR=1．622,95％CI：1．116～2．356（P〈0．01）。正常BMI组中,各体重增长亚组比较,低体重儿发生率差异无显著意义（P〉0．05）。高BMI组中,各体重增长亚组比较,低体重儿、巨大儿发生率差异无显著意义（P〉0．05）。结论孕妇孕前体重指数及孕期体重增加与新生儿出生体重呈正相关。为降低巨大儿发生率,正常体重指数组孕期体重增加不宜超过20．25kg。     

浙西南地区儿童体重质量指数分析

为了解浙西南地区儿童的生长发育情况,于2005年对丽水市区4所小学11458名儿童进行体检,其中男6249名,女5209名,统计不同年龄段儿童的身高、体重、体重质量指数（BMI）情况,评价其儿童的生长发育情况.     

低出生体重婴儿体重指数的动态变化及其临床意义

目的：观察不同出生体重儿在婴儿期体重指数（BMI）的变化规律，探讨低出血体重婴儿在婴儿期是否具有肥胖趋势。方法：对107例不同出生体重儿跟踪随访一年，观察出生时，6个月、9个月及1岁时的BMI，采用SPSS统计软件进行分析。结果：正常足月儿各时期BMI均值无性别差异，6个月时BMI达高峰，此后逐渐下降，1岁时BMI与出生时体重、身长、BMI呈显著正相关。巨大出生时BMI显著增高，但6个月后维持正常高水平。低出生体重儿生后9个月内BMI呈追赶趋势，1岁时其BMI明显低于对照组。结论：婴儿期BMI与出生时体重、身长、BMI呈正相关，低出生体重儿在婴儿期虽然存在BMI的追赶现象，但无肥胖趋势。     

Occupational Class Differences in Body Mass Index and Weight Gain in Japan and Finland

Background

Occupational class differences in body mass index (BMI) have been systematically reported in developed countries, but the studies have mainly focused on white populations consuming a Westernized diet. We compared occupational class differences in BMI and BMI change in Japan and Finland.

Methods

The baseline surveys were conducted during 1998–1999 among Japanese (n = 4080) and during 2000–2002 among Finnish (n = 8685) public-sector employees. Follow-up surveys were conducted among those still employed, in 2003 (n = 3213) and 2007 (n = 7086), respectively. Occupational class and various explanatory factors were surveyed in the baseline questionnaires. Linear regression models were used for data analysis.

Results

BMI was higher at baseline and BMI gain was more rapid in Finland than in Japan. In Finland, baseline BMI was lowest among men and women in the highest occupational class and progressively increased to the lowest occupational class; no gradient was found in Japan (country interaction effect, P = 0.020 for men and P < 0.0001 for women). Adjustment for confounding factors reflecting work conditions and health behavior increased the occupational class gradient among Finnish men and women, whereas factors related to social life had no effect. No statistically significant difference in BMI gain was found between occupational classes.

Conclusions

The occupational class gradient in BMI was strong among Finnish employees but absent among Japanese employees. This suggests that occupational class inequalities in obesity are not inevitable, even in high-income societies.Key words: occupational class, body mass index, weight gain, international comparisons     

中年人群体重指数与代谢指标和相关疾病的相关性分析

目的 探讨上海地区社区中年人群体重指数（BMI）与代谢指标和相关疾病的关系.方法 选择上海地区社区45～59岁的2 296名中年人作为研究对象,进行横断面调查,计算BMI,根据WHO制定的BMI中国参考标准对人群进行分层,统计人群一般情况、有无高血压和糖尿病,监测其尿酸、空腹血糖、餐后2h血糖、低密度脂蛋白、高密度脂蛋白、总胆固醇和甘油三酯等代谢指标,分析BMI与代谢指标及疾病的相关性.结果 2 296名中年人偏瘦、正常和超重的比例为2.6％、47.0％和50.3％;超重人群高血压发生率、尿酸、空腹血糖、餐后2h血糖、低密度脂蛋白、高密度脂蛋白、总胆固醇和甘油三酯等代谢指标与偏瘦、正常人群比较有显著性差异（P＜0.05）;BMI与体重（r=0.742,P＜0.001）和甘油三酯）（r=0.202,P＜0.001）呈显著正相关,与身高呈负相关（r=0.116,P＜0.001）;其他相关代谢指标与BMI无相关性（P＞0.05）.结论 不同BMI人群中,高血压发生率、尿酸、空腹血糖、餐后2h血糖、低密度脂蛋白、高密度脂蛋白、总胆固醇和甘油三酯等代谢指标有显著性差异,BMI与甘油三酯呈显著正相关,控制甘油三酯能够有效地降低肥胖的发生率.     

Accuracy of Body Mass Index Categories Based on Self-Reported Height and Weight Among Women in the United States

Objective The purpose of this study was to assess the accuracy of BMI categories based on self-reported height and weight in adult women. Methods BMI categories from self-reported responses were compared to categories measured during physical examination from women, age 18 or older, who participated in the National Health and Examination Survey, 1999–2004. We first examined strength of agreement using Cohen’s kappa, which, unlike sensitivity and specificity, allows for the comparison of polychotomous measures beyond chance agreement. Kappa regression identifies potential threats to accuracy. Likelihood of bias, as measured by under-reporting, was examined using logistic regression. Results Cohen’s kappa estimates were 0.443 for pregnant women (N = 724) and 0.705 for non-pregnant women (N = 5,910). Kappa varied by age and race, but was largely unrelated to socioeconomic status, health and health behaviors. Women who visited a physician in the last year or been diagnosed with osteoporosis were more accurate, while women most likely to under-report were older, white, non-Hispanic, and college-educated. Conclusions Our results suggest substantial agreement between self-reported and measured categories, except for women who are pregnant, above the age of 75 or without physician visits. Under-reporting may be more prevalent in well-educated, white populations than minority populations.     

Association of Body Mass Index and Body Mass Index Change with Mortality in Incident Peritoneal Dialysis Patients

Although high body mass index (BMI) appears to confer a survival advantage in hemodialysis patients, the association of BMI with mortality in continuous ambulatory peritoneal dialysis (CAPD) patients is uncertain. We enrolled incident CAPD patients and BMI was categorized according to World Health Organization classification for Asian population. BMI at baseline and one year after the initiation of peritoneal dialysis (PD) treatment was assessed to calculate the BMI change (∆BMI). Patients were split into four categories according quartiles of ∆BMI. Kaplan-Meier method and Cox regression proportional hazard analysis were performed to assess the association of BMI on outcomes. A total of 1263 CAPD patients were included, with a mean age of 47.8 ± 15.0 years, a mean BMI of 21.58 ± 3.13 kg/m². During a median follow-up of 25.3 months, obesity was associated with increased risk for cardiovascular diseases (CVD) death (adjusted hazard ratio (AHR) 2.01; 95% CI 1.14, 3.54), but not all-cause mortality. Additionally, patients with more BMI decline (>0.80%) during the first year after CAPD initiation had an elevated risk for both all-cause (AHR: 2.21, 95% CI 1.23–3.95) and CVD mortality (AHR 2.31, 95% CI 1.11, 4.84), which was independent of baseline BMI values.     

Self-reported Pre-pregnancy Weight Versus Weight Measured at First Prenatal Visit: Effects on Categorization of Pre-pregnancy Body Mass Index

To compare classification of pre-pregnancy body mass index (BMI) using self-reported pre-pregnancy weight versus weight measured at the first prenatal visit. Retrospective cohort of 307 women receiving prenatal care at the faculty and resident obstetric clinics at a Massachusetts tertiary-care center. Eligible women initiated prenatal care prior to 14 weeks gestation and delivered singleton infants between April 2007 and March 2008. On average, self-reported weight was 4 pounds lighter than measured weight at the first prenatal visit (SD 7.2 pounds; range: 19 pounds lighter to 35 pounds heavier). Using self-reported pre-pregnancy weight to calculate pre-pregnancy BMI, 4.2 % of women were underweight, 48.9 % were normal weight, 25.4 % were overweight, and 21.5 % were obese. Using weight measured at first prenatal visit, these were 3.6, 45.3, 26.4, and 24.8 %, respectively. Classification of pre-pregnancy BMI was concordant for 87 % of women (weighted kappa = 0.86; 95 % CI 0.81–0.90). Women gained an average of 32.1 pounds (SD 18.0 pounds) during pregnancy. Of the 13 % of the sample with discrepant BMI classification, 74 % gained within the same adherence category when comparing weight gain to Institute of Medicine recommendations. For the vast majority of women, self-reported pre-pregnancy weight and measured weight at first prenatal visit resulted in identical classification of pre-pregnancy BMI. In absence of measured pre-pregnancy weight, we recommend that providers calculate both values and discuss discrepancies with their pregnant patients, as significant weight loss or gain during the first trimester may indicate a need for additional oversight with potential intervention.     

Second Trimester Insulin Resistance,Early Pregnancy Body Mass Index and Gestational Weight Gain

Objectives Because prior work suggests an association between high insulin concentrations in early pregnancy and excess gestational weight gain, we examined such associations in a prospective cohort. Methods Multivariate regression analysis of early pregnancy insulin homeostasis and gestational weight gain among 434 women enrolled in the MGH Obstetrical Maternal Study. Results We found that the association between insulin quartile and gestational weight gain varied depending on maternal body mass index (BMI) in early pregnancy (P for interaction <0.0001). Among women with a BMI of 20, high fasting insulin was associated with greater gestational weight gain (multivariate-adjusted predicted mean 39.6, 95% CI 30.9–40.3 lbs for Quartile 4 (Q4) vs. 31.3, 95% CI 28.6–34.1 lbs for Q1) and higher risk of excessive weight gain. By contrast, among women with a BMI of 35, higher fasting insulin was associated with lower total gain (multivariate-adjusted predicted mean 25.7, 95% CI 22.6–28.7 lbs for Q4 vs. 33.2, 95% CI 10.5–55.9 lbs for Q1) and lower risk of excessive gain. Conclusion In our cohort, early pregnancy BMI modified the association between insulin homeostasis and gestational weight gain. These associations suggest that the physiologic consequences of hyperinsulinemia differ between normal weight and obese women.