中国新疆地区哈萨克族7~18岁中小学生体重指数分布和超重肥胖筛查参考值的建立

目的 建立中国新疆地区哈萨克族7~18岁中小学生超重和肥胖的体重指数(BMI)百分位曲线和界值点参考标准。方法 采用横断面调查研究,在中国新疆阿勒泰市及其所属乡镇的中小学采用整群随机抽样方法抽取4所学校（共49个班级）同意参加调查的哈萨克族7~18岁中小学生为调查对象。采集性别、年龄、身高和体重测量资料;应用偏度-中位数-变异系数法建立哈萨克族7~18岁中小学生的BMI百分位曲线;利用儿童青少年超重和肥胖的BMI百分位数曲线在18岁通过国际肥胖工作小组（IOTF）定义的成人超重和肥胖BMI界值点(25 kg·m-2/30 kg·m-2) 和中国肥胖问题工作组（WGOC）定义的界值点( 24 kg·m-2和28 kg·m-2) 的方法,计算出哈萨克族7~18岁各年龄超重和肥胖的BMI界值点。结果 共采集7~18岁中小学生2 487名,其中男1 158名,女1 329名。①按照IOTF标准,超重和肥胖的BMI百分位曲线：男性分别为P88.63和P98.28,女性分别为P84.41和 P98.12;按照WGOC标准,超重和肥胖的BMI百分位数曲线：男性分别为P92.96和P99.28 ,女性分别为P90.53和P99.38。②哈萨克族男性超重和肥胖BMI标准曲线低于WGOC和IOTF标准;女性肥胖标准曲线13~14岁前低于WGOC和IOTF标准,之后略高于WGOC和IOTF标准。 ③哈萨克族男性超重、肥胖的界值百分位曲线均低于或接近的汉族和维吾尔族水平;哈萨克族女性超重界值百分位曲线在14岁前介于汉族和维吾尔族间,之后接近或达到汉族水平;肥胖界值百分位曲线在10岁前低于汉族和维吾尔族水平,14岁后达到或接近汉族水平。结论 儿童青少年BMI分布有显著的地域差异和民族差异,哈萨克族中小学生超重和肥胖BMI界值标准不同于IOTF和WGOC所建议的相应标准。因此哈萨克族中小学生超重、肥胖人群的筛查可以参考本研究建立的标准。     

出生体重与5至8岁儿童超重和肥胖关联的队列研究

目的以回顾性队列研究探讨出生体重与5~8岁儿童超重和肥胖的关系。方法利用上海市闵行区所辖的13家社区卫生服务中心3~12岁儿童的体格检查数据库,截取5~8岁儿童的身高和体重数据进行分析。体检时行问卷调查生育史、出生体重、妊娠情况和出生后喂养史。按照出生体重分为:2 500 g(低出生体重儿)、~3 000 g、~3 500 g、~4 000 g和≥4 000 g组(巨大儿)。采用多元logistics分析评估出生体重与5~8岁儿童超重和肥胖的关系,并调整相关因素的影响。结果 99 897名5~8岁儿童进入分析,超重发生率为10.1%,肥胖发生率为5.0%。11.4%的儿童为低出生体重,7.3%为巨大儿;出生体重2 500 g、~3 000 g、~3 500 g、~3 500 g、~4 000 g和≥4 000 g组超重检出率分别为8.4%、7.6%、9.2%、11.5%和14.5%;肥胖检出率分别为4.7%、3.9%、4.4%、5.9%和7.9%。2简单相关分析发现,~3 500 g、~4 000 g和≥4 000 g组出生体重与儿童体重呈正相关(P0.000 1),在调整了性别、年龄、身高、分娩史、孕周、喂养史和身高后,仍具有显著相关性。3与出生体重~3 500 g组相比,~4 000 g组超重和肥胖的发生率增加31%和43%,~4 500 g组超重和肥胖的发生率增加76%和103%;~3 000 g组发生超重和肥胖的风险最低(RR=0.80,95%CI:0.73~0.88,P0.000 1;RR=0.87,95%CI:0.77~0.98,P0.000 1),调整了年龄、性别、孕周和产式等因素后,仍具有相关性;5、6、7和8岁儿童~4 000 g和≥4 000 g组发生超重和肥胖的风险相近;2 500 g组肥胖的风险RR为1.07(95%CI:0.79~1.43),P=0.27。结论出生体重对5~8岁儿童超重和肥胖的影响呈非线性关系。出生体重3 500 g儿童5~8岁超重和肥胖的风险显著增高。     

成都市中小学生超重肥胖流行现状分析

目的 了解成都市中小学生超重、肥胖的发生情况,为制定中小学生肥胖防治措施提供依据.方法 四川大学华西第二医院儿童保健科2006年在成都市5城区中小学中整群抽样,测量身高、体重,计算体重指数(BMI),使用"中国学龄儿童超重、肥胖BMI筛查分类"参考标准进行超重、肥胖判断,计算超重、肥胖检出率.结果 超重检出率男14.1%、女8.2%,肥胖检出率男6.8%、女3.2%;男性超重和肥胖检出率都比女性高,经X2检验,差异有统计学意义(超重X2=281.05、肥胖X2=73.29,P均<0.01).无论男女,7～<12岁组和12～<19岁组之间超重检出率比较,差异无统计学意义(男X2=1.429,女X2=0.862,P均>0.05).男女肥胖检出率比较,差异有统计学意义,7～<12岁组肥胖检出率高于12～<19岁组(男X2=11.70,女X2=10.14,P均<0.01).结论 成都市中小学生超重、肥胖检出率高,有必要制定相应防治措施防止肥胖大规模流行;有必要制定成都市中小学生BMI参考值.     

超重肥胖儿童青少年代谢综合征流行现状调查

目的 了解上海市浦东新区川沙地区超重肥胖儿童青少年中代谢综合征(MS)的流行现状和临床特点.方法 对432例7～15岁超重肥胖儿童青少年进行体格测量和血液生化检测.应用Cook定义诊断MS,具有下列5项中至少3项者诊断为MS:腹型肥胖、高血压、高血糖、高甘油三脂(TG)血症和低高密度脂蛋白胆固醇(HDL-C)血症.结果 腹型肥胖、高血压、高血糖、高TG血症和低HDL-C血症的总检出率分别为85.9%、44.4%、13.4%、48.6%和9.0%.具有0、1、2和3项及3项以上MS组分者分别占4.4%、28.3%、36.3%和31.0%.约95%的个体至少有1项MS组分异常,约60%～70%的个体至少有2项异常.共检出MS134例,检出率为31.0%.结论 川沙地区超重肥胖儿童青少年多存在明显的代谢紊乱,MS的流行已相当严重,接近发达国家水平.     

两种评价方法对3912例儿童青少年超重及肥胖检出率的比较

目的 评价身高标准体重法(weight-for-height,WFH)和中国儿童体质指数(body mass index,BMI)法对儿童青少年超重及肥胖检出率的吻合程度.方法 于2006年8-10月采用分层整群随机抽样方法抽取上海市徐汇区3所小学和2所中学7～15岁儿童、青少年3 912人,其中男性2 070人,女性1 842人,分别用上述两种方法检测超重及肥胖儿童的人数,计算检出率并进行比较.结果 采用WFH及BMI标准对肥胖及超重的检出率分别为27.7%和26.5%,差异无统计学意义(x2=1.3683,P>0.05).两种方法对儿童青少年超重及肥胖的检出一致性较好(Kappa=0.70,P=0.013);并且均显示男性超重及肥胖率高于女性(WFH男:女=31.82%:21.72%;BMI男:女=30.82%:21.99%),超重比例高于肥胖(WFH 超重:肥胖=14.9%:12.9%BMI超重:肥胖=14.4%:12.1%),青春前期高于青春发育期.结论 WFH和BMI检测儿童、青少年超重及肥胖具有较好的一致性,两者均可应用于对儿童及青少年营养状况的评价.     

9~12岁超重/肥胖男童血脂代谢谱研究

目的 探讨9~12岁超重/肥胖男童的血脂代谢谱变化特征及儿童超重/肥胖发生的可能机制。方法 将招募的72名9~12岁男童根据体重指数（BMI）分为对照组（n=42）和超重/肥胖组（n=30）。采集清晨空腹静脉血,对受试者的BMI、腰臀比、身体成分及血脂进行测量,同时采用超高效液相色谱与四极杆飞行时间质谱联用的代谢组学检测方法测试血清脂质化合物,并对数据进行统计分析和可视化。结果 超重/肥胖组男童的腰臀比、体脂百分数和三酰甘油水平显著高于对照组（P < 0.05）,高密度脂蛋白胆固醇水平显著低于对照组（P < 0.05）。代谢组学分析筛选出两组150种具有显著差异的脂质化合物,主要包含甘油脂类（40.7%）、甘油磷脂类（24.7%）、脂肪酰基类（10.7%）和鞘脂类（7.3%）。大多数甘油脂类水平在超重/肥胖组呈显著上调,而大部分甘油磷脂和鞘脂类出现下调。关键差异脂质被显著富集到2个KEGG代谢通路中,分别为醚酯代谢以及萜类生物骨架合成通路（P < 0.05）,并可能进一步影响下游的辅酶Q及其他萜类的生物合成代谢（P=0.06）。结论 9~12岁超重/肥胖男童的脂质代谢谱紊乱,绝大部分甘油脂类含量增加,甘油磷脂和鞘脂下调,并可能存在醚酯代谢以及萜类甚至辅酶Q的生物合成紊乱。     

父母超重/肥胖与子代孤独症谱系障碍的关系

目的 探讨母孕前父母超重/肥胖与子代孤独症谱系障碍（ASD）发生的关系。方法 选取ASD儿童36名（ASD组）及性别、年龄与之相匹配的72名正常儿童（对照组）纳入研究。采用问卷调查的方式收集母亲孕前两组儿童父母身高、体重以及母亲孕期增重等信息,采用单因素和多因素logistic回归法分析母孕前父母超重/肥胖与子代ASD的关系。结果 ASD组母孕前父亲超重/肥胖的检出率高于对照组（56% vs 32%,P=0.018）。单因素和多因素logistic回归分析均显示母孕前父亲超重/肥胖是子代发生ASD的危险因素（分别OR=2.66、2.58,P < 0.05）。结论 母孕前父亲超重/肥胖是子代罹患ASD的独立危险因素,因此在母亲妊娠前,父亲的体重指数应控制在正常范围内,以减少子代ASD的发生。     

两种标准筛查儿童超重和肥胖的比较

目的 探讨更适合中国儿童的超重、肥胖初筛标准.方法 对广西南宁地区13万余儿童(年龄7～18周岁)进行流行病学调查,参照国内、国际两种儿童超重及肥胖标准进行分析比较.结果 大多数年龄组超重及肥胖儿童国内标准的检出率均高于国际标准,肥胖的发生率在7～10岁组升高,男童超重及肥胖的检出率高于女童.结论 使用国内的儿童超重及肥胖标准可能更有利于我国儿童青少年超重、肥胖的早期干预.     

上海地区7 326名在校学生高血压分布趋势及相关因素分析

目的了解上海城区中小学生血压现况、高血压检出率,为预防儿童高血压提供依据。方法测量上海城区11所中小学7326名6-18岁在校学生身高、体重、血压。结果在校学生高血压总检出率为6．9％（502／7326例）,高血压检出率在体质指数（BMI）正常学生中仅为4．8％（303／6053例）,在超重和肥胖学生分别为8．8％（84／946例）、17．9％（113／630例）;超重和肥胖学生高血压检出率显著高于BMI正常者（χ^2=98．9、78、7,P均〈0．01）;上海地区6—18岁儿童青少年血压与BMI独立正相关。结论在校儿童青少年超重和肥胖者高血压的危险性明显增加,上海地区6—18岁在校学生血压与BMI独立相关。防治儿童青少年超重和肥胖是预防高血压的重要措施。     

基于不同体块指数筛查标准的2011年北京市儿童青少年超重和肥胖检出率比较研究

目的 描述2011年北京市7~18岁儿童青少年超重和肥胖的检出率,并比较基于不同BMI筛查标准的检出率的差异。方法 研究对象为2011年北京市中小学体检的7~18岁学龄儿童青少年。采用BMI作为评价超重和肥胖的指标。超重和肥胖筛查分别采用4种不同的国内（CN2010和WGOC）和国际（IOTF和WHO2007）标准。不同BMI筛查标准之间超重、肥胖检出率比较采用McNemar检验。结果 ①92 212名男女生BMI在P50、P85和P95上均显著高于全国水平(2009年“中国0~18岁儿童青少年体块指数的生长曲线”),男女生在对应百分位曲线上无交叉现象,男生BMI水平高于女生。②基于CN2010和WGOC标准,男生肥胖检出率分别为17.8%和18.2%,女生检出率分别为10.8%和10.9%;基于IOTF和WHO2007标准,男生肥胖检出率分别为12.9%和21.0%,女生检出率分别为6.0%和8.6%。③基于CN2010和WGOC标准,男生超重（含肥胖）检出率两标准间差异无统计学意义,均为36.0%,各年龄组差异亦不明显,但女生检出率CN2010标准高于WGOC标准（28.1％ vs 24.1%）,在7~15岁组差异较为明显,但在16~18岁组差异较小;与国际标准相比,基于国内标准的男生超重（含肥胖）检出率略高于IOTF标准,但却明显低于WHO2007标准,女生检出率超重（含肥胖）明显高于IOTF标准,但与WHO2007标准较为接近。④与基于WGOC标准的2004年北京市7~18岁儿童青少年超重和肥胖检出率相比,2011年超重和肥胖检出率显著增长,男女肥胖检出率分别增长5.8%和3.8%,超重（含肥胖）检出率分别增长9.3%和7.6%。结论 2011年北京市7~18岁学生中有1/3处于超重或肥胖状态。国内标准与国际标准存在明显差异,在反映中国儿童的超重肥胖流行状况时建议采用国内标准,而理想的国内标准应实现2～18岁的统一,并与成人接轨。     

Prevalence of overweight and obesity in Danish preschool children over a 10-year period: a study of two birth cohorts in general practice

Aim: To determine change in the prevalence of overweight and obesity in preschool children, over a 10‐year period and to identify possible predictors of overweight in 5‐year‐old children. Methods: Anthropometric data from birth and routine child health examinations at 3 and 5 years of age performed in general practice were collected in 5580 children from two Funen birth cohorts (1992 and 2001, respectively) representing 48% of the total population at similar age. The prevalence of overweight and obesity was classified using the International Obesity Task Force definitions. Results: In a Danish representative survey of preschool children, the average body mass index (BMI) and prevalence of overweight and obesity did not vary significantly during the 10‐year period. No significant changes in mean birth weight were registered and mean BMI in the group of obese children did not increase. Overweight or obesity at 5 years was strongly associated with overweight and obesity at 3 years and with birth weight and gender. Conclusion: The prevalence of overweight and obesity was observed to be stable over a decade in Danish preschool children without changes in mean BMI in the group of obese children. A strong association between overweight and obesity at 3 and at 5 years of age was detected.     

Exposure to hexachlorobenzene during pregnancy increases the risk of overweight in children aged 6 years

Abstract Aim: To determine whether prenatal exposure to hexachlorobenzene (HCB) has potential adverse effects on child's weight and body mass index (BMI) in a general population with no local pollution sources. Methods: Starting from mid 1997, all mothers presenting for antenatal exposure in Menorca were recruited. Subsequently, 482 children were enrolled. HCB was measured in cord blood. Weight and height were measured at birth and at age 6.5 years. Results: Children with HCB levels higher than 1.03 ng/mL in cord blood were 1.14 kg (0.38) heavier and had a higher BMI (beta= 0.80 (0.34)) than children with HCB levels lower than 0.46 ng/mL. No statistically significant associations were found in height. Children in the higher exposure group of HCB had an increased risk of 2.5 and 3.0 of being overweight and obese. Children from normalweight mothers also presented an increased risk of having higher BMI with increasing concentrations of HCB in cord serum. Conclusion: Prenatal exposure to HCB is associated with an increase in BMI and weight at age 6.5 years. Further studies with larger samples and longer follow-up are needed to confirm these results.     

Prevalence of overweight and obesity in primary school children in Port Said city

BackgroundThe highest prevalence rates of childhood obesity have been observed in developed countries, however, its prevalence is increasing in developing countries as well.ObjectivesTo estimate the prevalence of overweight and obesity among primary school children, aged from 6 to 12 years and to estimate risk factors of obesity and overweight, defined by body mass index (BMI).MethodsA cross-sectional study was carried out at Port Said city during the second term of school year 2010/2011. The researcher took the anthropometric measurements inside the nurse’s room in the school and gave a questionnaire to the students to be answered by one of the child’s parents. The questionnaire included questions related to socioeconomic status, life style (physical activity and eating habits) and family history of overweight and obesity.ResultsEight hundred and fifty-two students participated in this study. Prevalence of overweight and obesity was 17.7% and 13.5% respectively. The rate of obesity was the highest at the age of 7–8 years (grade 2) and decreased with an increase in age, while overweight increased with an increase in age to be the highest at the age of 9–10 (grade 4) and 10–11 (grade 5). Socioeconomic class, faulty dietary habits, sedentary life, low level of physical activity and positive family history of overweight and/or obesity were significantly associated with student’s BMI.ConclusionThis study found a relatively high prevalence of overweight and obesity among children aged 6–12 years in Port Said city. Decreased rate of obesity with an increase in age in our study, signifies that faulty feeding habits were the highest at lower ages.     

Prevalence of overweight and obesity in 5- and 12-year-old Finnish children in 1986 and 2006

Objective: To investigate the prevalence and the trends of overweight and obesity in Finnish 5- and 12-year-old children in 1986 and 2006.
Design: Retrospective cross-sectional study.
Subjects and methods: Anthropometric data were collected retrospectively from health examinations in Tampere and in three rural municipalities. The size of the 5- and 12-year-old cohorts were 2108 in 1986 and 4013 in 2006, respectively. The body mass index (BMI) was calculated. Overweight and obesity was estimated using the International Obesity Task Force cutoff values (ISO BMI).
Results: The prevalence of overweight (ISO BMI >25) and obesity (ISO BMI >30) in 5-year-old boys in 2006 was 9.8% and 2.5% and in girls 17.7% and 2.5%, respectively. At the age of 12 years, the corresponding figures in boys were 23.6% and 4.7% and in girls 19.1% and 3.2%. Between 1986 and 2006, the prevalence of overweight in 12-year-old children had increased 1.8 fold in boys (p < 0.001) and 1.5 fold in girls (p = 0.008). Overweight was significantly more common in rural than in urban areas.
Conclusion: During the last 20 years the prevalence of overweight has markedly increased in 12-year-old Finnish children, but remained nearly unchanged in 5-year-old children.     

Trends of underweight,overweight, and obesity in Brazilian children and adolescents

ObjectiveTo describe and analyze the trends of occurrence of underweight, overweight, and obesity in schoolchildren.MethodsThis was a longitudinal study of trends conducted in a voluntary sample of Brazilian children and adolescents. The sample was grouped by year of collection (period I: 2005 and 2006; period II: 2007 and 2008, and period III: 2009-2011), age category (children: 7 to 10 years, and adolescents: 11 to 14 years), and stratified by gender. The body mass index was used to classify the nutritional profile. Trend analysis was verified using multinomial logistic regression (p < 0.05).ResultsMean occurrences were 2.11% for underweight, 22.27% for overweight, and 6.8% for obesity. There was a decrease of underweight in male adolescents from period I to II, as well as an increase in female children from period II to III. Regarding overweight, there was an increase followed by a decrease in male children. Regarding obesity, there was an increase from period I to II in all age groups and for both genders.ConclusionThe prevalence of underweight was less than 5% in all categories of age and gender. However, the categories of overweight and obesity showed higher values, and together comprised almost 30% of the young Brazilian population; moreover, a trend toward increase in prevalence of obesity was observed up to the year 2008, followed by the maintenance of these high prevalence rates.     

Prevalence of overweight and obesity in children and adolescents in a county in Sweden

Overweight among young people in Sweden is increasing. The aim of the present study was to investigate the frequency of overweight and obesity based on body mass index (BMI) values among children and adolescents. Overweight was defined as a BMI value > or = 91st percentile and obesity as a BMI value > 98th percentile on an international reference BMI curve. The study population included boys and girls from four age groups: 9, 12, 15 and 18 y. The data consisted of self-reported measures of height and weight that were obtained from questionnaires used in a cross-sectional study in December 1997. A validation study was performed using a part of the study population. A total of 7011 (81.7%) participants completed the questionnaire. The correlation between self-reported estimations and objective measures of height and weight was high in the oldest age groups (0.88-0.98), but lower in the 9-y-old age groups (0.37-0.72). These self-reported estimations in the 9-y-olds were excluded from further analysis. It was found that 12.3%, 11.6% and 11.4% of the boys in the 12-, 15- and 18-y-old age groups and 6.8%, 5.5% and 4.8% of the girls in the same age groups were overweight and 7.9%, 8.9% and 7.3% of the boys and 5.1%, 4.2% and 3.9% of the girls were obese. Conclusion: The prevalence of overweight and obesity was found to be high in the study population and is a serious public health problem. The prevalence of obesity was significantly higher (p < 0.05) in 15-y-old boys living in rural areas than in city and town dwellers of the same age.     

中国0至18岁正常儿童青少年身体比例生长规律的研究

目的 分析中国0～18岁正常儿童青少年身体比例（坐高腿长比）的生长变化规律,性别、城乡和地区差异及长期变化趋势。方法 以2005年“中国九市7岁以下儿童体格发育调查”和“全国学生体质健康调研”中九城市正常汉族儿童青少年为研究对象。调查地区包括北京、哈尔滨、西安、上海、南京、武汉、广州、福州、昆明市的城区及乡村。身高（<3岁以身长表示）和坐高（<3岁以顶臀长表示）均为现场测量获得。按照气候、环境等因素将调查城市分为北部（北京、哈尔滨和西安）、中部（上海、南京和武汉）和南部（广州、福州和昆明）3个地区。探讨身体比例的自然生长规律;分析身体比例的性别、城乡和地区差异。以1985年上述两项调查的数据资料为参照,分析身体比例20年的变化趋势。结果 ①身体比例呈随年龄增长逐渐减小的趋势,男性在12~13岁、女性在10~11岁时身体比例降至最低,随后略微回升,17岁以后基本稳定。②身体比例的性别差异分析结果显示,不论城乡,11岁前男女差别甚微,11岁后女性略高于男性,在13岁时差别幅度最大。身体比例的城乡差异分析结果显示,不论性别,6~7岁前城乡差别不大,之后乡村略高于城区,12~13岁后城乡基本无差异。身体比例地区差异分析结果显示,不论城乡和性别,北、中和南部3个地区儿童青少年的身体比例曲线几乎重合。③2005年身体比例在7~12岁较1985年出现小幅下降,儿童早期和青春后期身体比例无明显变化。结论 中国0~18岁正常儿童青少年身体比例随年龄增长呈规律性变化;身体比例在青春期前性别差别不明显,青春期后女性略高于男性;身体比例不存在明显的城乡和地区差别,未呈现明显的长期变化趋势。