腰围/身高比与儿童血压的相关性

目的 探讨儿童腰围／身高比（WHtR）与血压的关系，评估WHtR对儿童高血压的预测价值。方法 对贵阳市2个城区3550名（8～12岁）儿童进行身高、腰围（WC）、臀围及高血压的抽样调查，分析WHtR与血压的相关性，所获资料均进行统计学处理。结果 1．贵阳市儿童WHtR有明显的年龄和性别特征，高血压组WHtR高于正常血压组，差异有统计学意义（P〈0．05）；控制年龄、性别、身高影响的偏相关分析显示，WHtR与收缩压（SBP）及舒张压（DBP）呈显著正相关（r=0．1929，0．0878P。〈0．01）。2．WHtR与WC呈显著正相关（r=0．9347P〈0．01），其与身高的相关性较WC与身高的相关性明显减弱（r=0．0494，0．3950P〈0．05，〈0．01）。结论 WHtR计算简单，与WC高度相关；受其身高影响小，可作为儿童高血压患病风险的预测指标。     

腰围与肥胖儿童血脂水平的关系

目的 研究腰围与肥胖儿童血脂代谢的关系.方法 回顾性分析2002年1月至2006年9月仁济医院肥胖专科门诊206例6～14岁单纯性肥胖患儿的临床资料,男134例,女72例.测量肥胖儿童体重、身高、腰围、臀围并测定空腹血脂水平.2006年9～12月对上海市浦东新区1 180名6～14岁学生测量体重、身高、腰围、臀围,以此为依据建立同龄同性别腰围百分位值.结果 1 180名在校儿童腰围超过同龄同性别85 th和95th百分位分别为170名(14.4%)和65名(5.5%);206名肥胖儿童腰围均趟过85 th百分位值,腰围在85 th和95 th百分位值之间的儿童16名(7.8%),超过95 th百分位190名(92.2%).肥胖儿童出现血脂代谢紊乱109名(52.9%),其中1项指标异常者76名(36.9%),2项指标异常者23名(11.2%),3项指标异常者10名(4.9%),血总甘油三酯ゥ(TG)升高100名(48.5%),总胆固醇(TC)升高31名(15.0%),低密度脂蛋白(LDL)升高14名(6.8%),高密度脂蛋白(HDL)降低8名(3.9%).腰围在85 th和95 th百分位值之间的16名肥胖儿童有8名(50%)血脂异常,其中1项指标异常6名,2项指标异常2名.190名腰围超过95 th百分位肥胖儿童中101名(53.2%)血脂异常,其中1项血脂指标异常70名(36.8%),2项血脂指标异常21名(11.1%),3项血脂指标异常为10名(5.3%).校正年龄和性别因素后,腰围不仅与血清TG水平呈明显正相关(r=0.17,P＜0.05),还与血脂紊乱程度明显相关(r=0.15,P＜0.05).结论 以同龄同性别95 th百分位为标准,1 180名6～14岁在校学生中心性肥胖发生率为5.5%.中心性肥胖儿童更易发生血脂代谢紊乱,以血清TG和TC升高最常见.     

儿童青少年腰围与代谢综合征危险因素关系的研究

目的比较南宁地区不同腰围水平青少年罹患代谢综合征(MS)及各相关代谢指标异常率,探讨腰围与MS危险因素的相关性。方法采用分层整群随机抽样方法从南宁市396所中小学中抽取14所学校中6~18岁的中小学生共7 893名,进行体格检查及相关代谢生化数据的检测,包括空腹血糖(FBG)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)。结果南宁地区男女生均于10岁以后才逐渐出现各检测指标的异常,与IDF(2007)诊断标准中<10岁不诊断MS结果一致。MS相关指标异常率比较,男女生均依次为:HDL-C、TG、FBG、血压,且男生的血压和FBG异常率显著高于女生,差异有统计学意义(P<0.05)。MS检出率随着腰围的增大而增加。腰围值P90者中该比例则增加400%。除与HDL-C负相关外,腰围与其余指标呈正相关。结论儿童青少年腰围与MS危险因素密切相关,各危险因素的均值(除HDL-C外)及异常率随着腰围的增大而增加。     

北京市3～18岁人群腰围和腰围身高比分布特征及其适宜界值的研究

目的 研究北京市3～18岁人群腰围（WC）、腰围身高比（WHtR）的分布特征；在心血管疾病（CVD）危险因素评估的基础上提出6～18岁人群WC和WHtR的适宜界值。方法 对2004年北京市儿童青少年代谢综合征研究项目总人群中3～18岁人群的WC、WHtR进行描述性分析；基于CVD危险因素评估，采用工作者特征曲线分析方法，研究6～18岁人群WC和WHtR的适宜界值；并利用《北京市学校卫生防病工作规划》（2006）血脂健康调查中6~17岁人群生理、生化检测数据，对上述界值进行交叉验证。结果 基于CVD危险因素评估基础上的WC适宜界值为性别年龄组的第80百分位值，WHtR的适宜界值为0.46。交叉验证显示：按WC和WHtR适宜界值划分的肥胖组血压、血脂等CVD危险因素无论均值还是检出率均显著高于正常体重组。结论 上述WC、WHtR适宜界值可敏感地区分高血压、高三酰甘油和低高密度脂蛋白胆固醇等CVD危险因素，WC作为相对简单的测量方法应列入学生体检的常规测量项目。     

儿童体格发育评价及其应用

生长评价是儿童保健的日常工作之一。但儿童生长问题常不被认识与诊断,往往在儿童出现生长偏离后才得到健康工作者的监测。许多儿童在定期健康检查时亦未能得到常规测量体质量,甚至一些儿童可能从未进行过体格测量。如因测量方法不正确或生长曲线点画不准确可致错误的解释,使儿     

家庭环境与学龄前儿童发育性协调障碍的相关性

目的探讨家庭环境对学龄前儿童发育性协调障碍(DCD)的影响。方法按分层随机整群方法抽取4~6岁儿童1 727例,应用"儿童运动协调能力成套评估工具"对其进行DCD筛查;采用"城市学龄前儿童运动发育家庭环境量表"及自行设计的问卷评估儿童家庭环境状况。结果 117例儿童确诊为DCD。DCD组和正常对照组儿童在母亲文化程度、家庭结构的比较中差异有统计学意义。家庭环境因素中"让孩子管理自己的日常物品"和"包办孩子一切事务"两项得分在DCD组和正常对照组儿童之间差异有统计学意义。在控制儿童性别、年龄情况下,多因素logistic回归分析显示,"母亲文化程度""家庭结构""让孩子管理自己的日常物品"及"包办孩子一切事物"是影响儿童DCD发生的主要因素(均P0.05)。结论家庭环境对学龄前儿童DCD的发生存在影响,家长在养育孩子的过程中,不要包办孩子一切事务,应为儿童提供更多的管理自己日常生活的机会,以促进其早期运动协调能力的发展,预防DCD的发生。     

天津市7123名学龄期儿童腰围、臀围及相关指标特征分析

目的 了解天津市学龄期儿童腰围、臀围、腰臀比(WHR)水平及年龄、性别特征,分析其与身高、体质量及体质量指数(BMI)的关系,并探讨腰围与三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)及尿酸(UA)的关系.方法 测量7123名天津市学龄期儿童的身高、体质量、腰围、臀围,计算其WHR、BMI,记录各个年龄组男童和女童的腰围、臀围和WHR,通过两组独立样本资料的t检验分析各年龄组腰围、臀围和WHR的性别差异,并对各指标进行相关性分析.其中1 811名留取静脉血行TG、TC、HDL、LDL、UA检测.结果 儿童的腰围和臀围均随年龄的增长而增长,且男童大于女童(Pa<0.05);男童WHR无明显变化,女童WHR随年龄增长而呈下降趋势,各年龄组男童大于女童(Pa<0.05);BMI均随年龄的增长而增长,各年龄组男童大于女童(Pa<0.05);腰围和臀围分别与年龄、身高和体质量呈正相关,WHR与体质量呈正相关(男童r=0.419,P<0.05;女童r=0 241,Pa<0.05),BMI与年龄、身高和体质量均呈正相关.腰围与TG、TC、LDL、UA呈正相关(r=0.076、0.098、0.137、0.401,Pa<0 05),与HDL呈负相关(r=-0.319,P<0.05).结论 天津市学龄期儿童腰围、臀围和BMI均与身高、体质量有关,WHR与体质量有关,腰围与TG、TC、HDL、LDL、UA有关.腰围及相关指标可作为儿童肥胖及相关疾病的预测指标.     

儿童血压发育规律的研究

高血压的发生率随年龄增加而升高 ,在 2 5～ 34和 45～ 54岁这两个年龄段女性高血压的发病率从 3 %升高至 2 0 % ,男性高血压发生率从 9%增加到 2 5 %。流行病学研究发现成人原发性高血压可能起始于儿童期 ,本文总结儿童血压的轨迹现象及影响其血压分布的因素 ,旨在探讨儿童血压发生规律 ,对高血压易患者早期识别、干预、对预防成人高血压有重要意义。     

语言发育迟缓儿童的发育水平剖析

目的 探索语言发育迟缓儿童的发育特征,为其早期发现和干预提供参考性的建议.方法 对200例语言发育迟缓的儿童进行Gesell婴幼儿发育量表的测试,并分析36个月前后Gesell 4个能区的发育商(DQ)、生理年龄与发育年龄之间的差距以及发育异常的比例.结果 200例语言发育迟缓儿童的Gesell发育评估显示,4个能区的平均发育商(DQ)均低于正常;对应的4个能区生理年龄与发育年龄之间的差距(月)分别为5.3±7.0、7.2±8.2、14.2±7.2、8.4±7.2.36个月以上组儿童的4个能区DQ显著低于36个月以下组(P<0.01),且生理年龄与发育年龄之间的差距增大(P<0.01).结论 36个月后语言发育仍落后者,绝大部分儿童并不是单纯的语言问题,更可能是全面的发育迟缓,且发育年龄与生理年龄相差至少11个月,将面临语言交流、社会交往、生活适应和学习等诸多困难,是特别需要高度关注和干预的对象.     

打鼾对儿童发育的影响

打鼾是阻塞性睡眠呼吸暂停综合征(OSAS)的一种重要症状,引起越来越多学者的重视。为寻找打鼾与耳鼻咽喉科疾病的关系和打鼾对儿童发育的影响,我们对卫辉市3000名4岁～9岁儿童进行了调查,报告如下。     

Population-based waist circumference and waist-to-height ratio reference values in preschool children

Aim:  To establish new reference values for measurements of waist circumference and waist-to-height ratio in preschool children.
Methods:  A population-based, cross-sectional study of 4502 children aged 0–5 years derived from child health care in a Swedish county. Measurements of weight, height and waist circumference were recorded using a standardized procedure.
Results:  New reference values for waist circumference and waist-to-height ratio for preschool children are presented. Reference charts were constructed and are presented. Waist circumference increased with age (r = 0.80, p < 0.001). After adjustment to the individual height, expressed as waist-to-height ratio, there was an inverse correlation to age during the first 5 years of age (r = −0.87, p < 0.001).
Conclusion:  The new reference values for waist circumference and waist-to-height ratio for Swedish preschool children enable future identification of new risk populations for childhood obesity. For clinicians, new reference charts for these two variables are provided for practical use.     

First reference curves of waist circumference and waist-to-height ratio for Tunisian children

Abdominal obesity for childrenWaist circumference (WC) and waist-to-height ratio (WTHR) reference curves are used to assess the risk of cardiovascular disease in children. The aim of this study was to develop age- and sex-smoothed WC and WTHR reference curves for Tunisian children. Data were collected during the period 2014–2015 in a cross-sectional study including 2308 children aged 6–18 years. The percentiles of WC and WTHR were developed using the LMS method. The optimal percentiles, which are associated with the body mass index (BMI) according to International Obesity Task Force (IOTF) criteria to identify overweight/obesity and with the 0.5 boundary value of WTHR to estimate cardiovascular risk, were identified by ROC curves and the Youden index (j). The results show the smoothed percentiles of WC and WTHR reference curves for Tunisian children. A comparison of the 50th percentiles with other references showed different trends in WC values. The 75th percentiles of WC and WTHR are the optimal percentiles that correspond to both PBMI25 (the percentile linked to BMI ≥ 25) and the 0.5 boundary value. However, the 90th percentiles correspond to PBMI30 (the percentile linked to BMI ≥ 30) in boys and girls.ConclusionThe new WC and WTHR reference curves can be added to clinical tools to help specialists in pediatric and physical health to reduce cardiovascular risk in Tunisian children.     

Preschool children born moderately preterm have increased waist circumference at two years of age despite low body mass index

Aim: To investigate the development of waist circumference (WC) in preschool children born preterm compared with a population‐based reference. Background: Children born preterm are reported to be insulin resistant, despite being lean during early childhood. We hypothesize that the mechanism is through increased visceral adiposity. Methods: Data from 4446 preschool children (2169 girls/2277 boys) born in 2001–2006 from a population‐based study were compared with longitudinal measurements of body mass index (BMI) and WC from a cohort of 152 children (64 girls/88 boys) born moderately preterm in 2002–2004 (gestational age, 32–37 weeks). Results: In the preterm children, the mean WC was 2.8 cm larger compared with the reference group (p < 0.001) at 2 years of age but not at 5 years of age. There was no significant difference in the mean BMI at 2 years of age. The preterm group was significantly leaner at 5 years of age, with a mean BMI of 15.13 compared with 15.98 in the reference group (p < 0.001). Conclusion: Children born moderately preterm present as lean during early childhood but have an increased waist circumference in infancy, pointing towards a change in fat distribution with more abdominal fat. This may have implications for their metabolic status.     

腰围预测肥胖儿童非酒精性脂肪性肝病的价值

目的探讨腰围预测肥胖儿童发生非酒精性脂肪性肝病(NAFLD)的价值。方法2003-06—2006-09对浙江大学医学院附属儿童医院儿科197例9~14岁肥胖儿童进行腰围、体质指数(BMI)测定,作肝脏B超检查、血清肝酶测定,并与正常对照组比较。同时对肥胖儿童进行腰围、BMI与脂肪肝严重程度、血清ALT水平的相关性分析,以及腰围、BMI诊断肥胖儿童发生NAFLD曲线下面积的ROC分析。结果肥胖组腰围[(91.99±11.03)cm]显著大于正常对照组[(66.27±4.76)cm],BMI、肝酶水平也显著高于正常对照组。197例9~14岁肥胖患儿中诊断为NAFLD者147例,占74.62%;肥胖组NAFLD患儿腰围、BMI均大于非NAFLD患儿。肥胖患儿腰围、BMI与脂肪肝严重程度、血清ALT水平均呈正相关(r=0.478、0.356、0.302、0.205,均P<0.01);腰围和BMI诊断NAFLD的ROC曲线下面积分别为0.767、0.717(均P<0.01)。结论9~14岁肥胖儿童NAFLD发生与腰围密切相关,腰围、BMI对肥胖儿童发生NAFLD有一定的预测价值。     

Associations between vitamin D status in infants and blood lipids, body mass index and waist circumference

Aim: To study the relationships between 25‐hydroxyvitamin D status and blood lipids, insulin, glucose, body mass index and waist circumference in infants. Methods: In a cross‐sectional study, 255 infants aged 9 months with a blood sample for 25‐hydroxyvitamin D were examined. Plasma 25‐hydroxyvitamin D concentrations were analysed by chemiluminescent immunoassay. Associations between plasma 25‐hydroxyvitamin D and high‐density lipoprotein (HDL), low‐density lipoprotein, total cholesterol, triglycerides, insulin, glucose, body mass index and waist circumference were analysed. Results: Mean plasma 25‐hydroxyvitamin D was 77.2 ± 22.7 nM. At the time of examination, 97% received vitamin D supplementation. 25‐Hydroxyvitamin D was negatively associated with HDL (p = 0.003), cholesterol (p = 0.002) and triglycerides (p = 0.010) in multivariate analysis controlled for gender, season, body mass index, length, birth weight and breastfeeding. There were no associations between 25‐hydroxyvitamin D and glucose or insulin (all p > 0.05). 25‐hydroxyvitamin D was negatively associated with body mass index (p = 0.005) and waist circumference (p = 0.002) controlled for gender, season, breastfeeding, birth weight and length. Conclusion: Vitamin D status is negatively associated with blood lipids, body mass index and waist circumference in infants where nearly all received vitamin D supplements. Whether this has long‐term health effects remains to be elucidated.     

Predictive value of body mass index and waist circumference for metabolic syndrome in 6-12-year-olds

Aim: To determine the predictive value of body mass index (BMI) and waist circumference (WC) and their optimal cut‐off points for metabolic syndrome (MetS), and also the incidence of MetS. Methods: This study included 888 children, aged 6–12 years, who were followed for a mean of 6.6 years. BMI, WC and their optimal cut‐off points to predict MetS were investigated. Results: The cumulative incidence of MetS was 10.7%. The adjusted ORs for age, sex and family history to predict MetS for BMI and WC z‐scores were 2.6 (95% CI, 2.0–3.5) and 2.6 (95% CI, 1.9–3.5), respectively. In their correspondent models, area under the receiver operating characteristic (ROC) curve was 0.73 (95% CI, 0.68–0.79) for BMI z‐scores and 0.72 (95% CI, 0.67–0.78) for WC z‐scores with no statistically significant difference. The optimal cut‐off values for BMI were 16.5 kg/m² for boys and 16.3 kg/m² for girls and those for WC were 57.5 cm for boys and 56.5 cm for girls. Conclusions: Our findings suggest that both BMI and WC have the same power to predict MetS and also children with higher BMI or WC are more susceptible to MetS. Moreover, a high incidence of MetS in children highlights the importance of interventional strategies during early childhood.     

Relationship between pediatric adiposity and cardiovascular risk factors in Saudi children and adolescents

BackgroundThe etiology of childhood obesity is growing at alarming rates in developed and developing countries. The aim of the present study was to investigate the prevalence of cardiovascular risk factors (hypertension, dyslipidemia, and hyperglycemia) in a sample of Saudi children and to assess their association with different measures of body adiposity.MethodsA cross-sectional study was conducted of 200 Saudi children, who were randomly selected from the pediatric clinics at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Anthropometric variables were measured for all study subjects. Fasting blood samples were collected for measurement of blood glucose, insulin, and lipid profile.ResultsAlmost half of the study population was overweight and one tenth was obese according to body mass index levels, irrespective of sex. The prevalence of central obesity was higher using the waist-height ratio as opposed to waist circumference and this was true for both sexes. Significantly higher means levels of glucose, insulin, and lipids (P < 0.0001 in all) were seen among overweight and obese children than their lean counterparts. All obesity measures in children were significantly associated with cardiovascular risk factors.ConclusionThe severity of overall and abdominal obesity in Saudi children is associated with a higher prevalence of cardiovascular risk factors, with the relationship strength varying by sex.