非酒精性脂肪性肝病肥胖儿童人体成分及其影响因素分析

目的 分析肥胖儿童非酒精性脂肪性肝病（NAFLD）人体成分及其影响因素，为临床防治提供依据。方法纳入2019年1月至2021年7月首都医科大学附属北京儿童医院就诊236例肥胖儿童，依据诊断标准分组：NAFLD组135例、非NAFLD组101例。采用人体成分分析仪检测人体成分，并收集患儿一般资料，完善血生化、糖化血红蛋白、空腹胰岛素、空腹C肽、腹部彩超等检查，分析各指标特点。结果 236例肥胖患儿中男148例、女88例，年龄4～17岁，平均年龄为（9.78±2.39）岁。236例中体脂肪升高232例、体脂百分比升高235例，蛋白质升高22例、无机盐升高23例、肌肉量升高32例。两组指标体重指数、体脂肪、蛋白质、无机盐、体脂百分比、内脏脂肪面积、无脂肪质量指数（SMMI）、肌肉质量指数（FFMI）、基础代谢量比较，NAFLD组高于非NAFLD组，差异有统计学意义（P相似文献   

肥胖儿童高血压和心脏损害发生率的临床研究

目的 探讨肥胖儿童高血压和心脏损害情况.方法 选择2008年7月至2010年10月沈阳市儿童医院儿保门诊就诊的单纯性肥胖儿童516例为肥胖组,100例体检体重正常儿童为对照组.所有入组儿童均常规测量血压、心脏超声检查.结果 肥胖组收缩压、舒张压均高于对照组(P＜0.05),肥胖组高血压检出率为3.88％ (20/516).所有儿童左心收缩功能均正常,肥胖组左室壁增厚22例,平均厚度为(0.93±0.07) cm,与对照组比较差异无统计学意义(P＞0.05);肥胖合并高血压组儿童左室壁增厚19例,肥胖合并血压正常组儿童左室壁增厚3例,两组比较差异有统计学意义(P＜0.05);肥胖组心包外脂肪增厚268例,平均厚度(3.372±0.098) mm,与对照组比较差异有统计学意义(P＜0.001).结论 肥胖儿童高血压发生风险高于非肥胖儿童;肥胖儿童心包外脂肪增厚明显高于正常体重儿童,肥胖合并高血压儿童左室壁增厚高于血压正常儿童.     

肥胖儿童血浆内源性硫化氢水平变化的研究

目的 探讨肥胖儿童血浆硫化氢(H2S)水平及其影响因素.方法 2007年3月至6月选取北京大学第一医院儿科常规体检肥胖儿童36例(肥胖组),超重儿童40例(超重组),正常儿童40名(对照组).测量身高、体重,得出体重指数(BMI);常规测量血压;对其家族史进行调查.测量其血浆总胆固醇、三酰甘油(甘油三酯)、低密度脂蛋白和高密度脂蛋白水平;测定血浆H2S水平.结果 肥胖、超重组儿童体内H2S含量较对照组下降,差异有统计学意义(P<0.05).肥胖组、超重组三酰甘油高于对照组,高密度脂蛋白较对照组显著降低,差异有统计学意义(P<0.05).肥胖组收缩压较对照组升高,差异有统计学意义(P<0.05).结论 肥胖、超重儿童血浆H2S水平降低,提示肥胖儿童体内存在舍硫氨基酸体系代谢失衡.     

体质量指数预测儿童骨折相关风险的研究进展

儿童肥胖已成为世界范围内越来越严重的健康问题。了解生长期脂肪量对骨骼的影响,对提高峰值骨量及预防骨质疏松所致骨折至关重要。体质量指数(BMI)作为一种评价身体肥胖状态的指标,测量方法简便易行,且适用于大范围人群自我检测。现就BMI在肥胖与骨折之间相互作用中的角色及BMI水平衡量儿童骨折发生风险的相关研究进展作一综述。     

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目的 分析肥胖儿童骨密度(BMD)及其影响因素,为早期预防骨质疏松提供科学依据.方法 2007年1-12月从长沙市开福区5所小学7～12岁学龄儿童中,按照体质指数(BMI)法诊断单纯性肥胖,随机抽取119例单纯性肥胖儿童及103名正常儿童.采用双能X线骨密度仪(DEXA)全身扫描,测量BMD和身体成分.结果 单纯性肥胖儿童的身高、体重、BMI、腰围和腰臀比均显著高于正常儿童.单纯性肥胖儿童的各部位瘦组织含量(LM)、脂肪组织含量(FM)、体脂百分比(PBF)及躯干脂肪组织百分比均显著高于正常儿童,但四肢FM百分比却显著低于正常儿童.肥胖儿童各部位BMD和骨矿物质含量(BMC)均大于正常儿童.控制FM后,BMD(或BMC)与LM呈显著正相关:控制LM后,BMC与FM亦呈正相关.多元逐步回归分析显示,影响儿童BMD的主要因素是LM.结论 肥胖儿童BMD高于正常儿童,LM对儿童成长中骨的BMD起重要作用.     

大连地区儿童青少年体成分影响的调查研究

目的：探讨大连地区儿童青少年体成分的发育规律、特点,为指导其营养状况和制定保健措施提供科学依据,也为今后评价儿童青少年生长发育动态变化积累资料。方法研究抽取大连市全日制小学2所、初中2所、高中1所,每个年级共抽取4个班,共2027名6～18岁儿童青少年,测量身高,体重、体脂量、去脂体重、体脂率、骨量、肌肉量、体重指数、体水分率及基础代谢率。结果(1)大连男女学生的各项指标均随年龄的增长而增加,生长曲线呈上升趋势;体内水分随着年龄的增长而减少。(2)大连男女学生的肌肉量、去脂体脂及基础代谢量在所有年龄段均存在显著性差异,形态指标及其他的体成分指标在部分年龄段存在性差;仅脂肪率与脂肪量为女性大于男性,其余指标均为男性大于女性。(3)大连女学生肥胖检出率为35.7％,男学生的肥胖检出率为16.7％。结论(1)大连城市儿童青少年体重、身高及体成分构成比例符合儿童青少年生长发育规律。(2)大连男女学生的肌肉量、去脂体脂及基础代谢率在所有年龄段均存在显著性别差异,形态指标及其他的体成分指标在部分年龄段存在性别差异。(3)大连学生的肥胖检出率明显高于国家标准,控制儿童肥胖形势严峻。     

体重正常的阻塞性睡眠呼吸暂停低通气综合征患儿体脂含量与睡眠参数相关性研究

目的分析体重正常的阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患儿体脂肪含量的影响因素,为OSAHS患儿肥胖的早期筛查及干预提供依据。方法从2012年1月至2013年12月在上海儿童医学中心门诊就诊的鼾症患儿和社区招募的健康儿童且行PSG监测者中选取：体重正常、行人体成分检测、年龄3~7岁儿童。分为病例组（OSAHS轻度亚组、中重度亚组）和对照组（原发性鼾症亚组、健康儿童亚组）,分析睡眠参数与人体成分的差异,以多元线性回归分析人体成分与睡眠结构和觉醒参数的相关性。结果病例组纳入58例,其中OSAHS中重度亚组30例,OSAHS轻度亚组28例;对照组63例,其中原发性鼾症亚组33例,健康儿童亚组30例。4个亚组间年龄、性别和BMI Z评分差异无统计学意义(P>0.05)。①4个亚组在呼吸暂停低通气指数（AHI）、阻塞性呼吸暂停指数（OAI）、最低氧饱和度及呼吸相关脑电觉醒反应指数（RAI）、自发脑电觉醒反应指数（SAI）、睡眠压力指数（SPS）差异总体上有统计学意义（P<0.05）,亚组间两两比较显示,AHI、OAI、最低氧饱和度、RAI和SPS OSAHS轻度、OSAHS中重度亚组高于原发性鼾症亚组和健康儿童亚组（P<0.05）。②4个亚组间去脂体重、蛋白质、骨骼肌、静息代谢率、内脏脂肪面积、上臂围和腰臀比差异总体上无统计学意义,体脂肪含量和体脂肪百分比差异有统计学意义,其中OSAHS中重度亚组最高。③多元线性回归分析显示,体脂肪含量与SPS呈正相关（r=0.641）,与AHI、OAI、最低氧饱和度无显著相关性。 结论OSAHS可能与正常体重儿童的体脂肪含量增加相关,引起体脂肪含量增加的主要相关因素可能是睡眠片段化而非间歇性缺氧。     

儿童肥胖与维生素D缺乏

儿童肥胖和维生素D缺乏已成为两大公共卫生问题.近年来大量研究表明肥胖及其相关的代谢性疾病与血清低维生素D水平相关,但维生素D缺乏与肥胖之间的因果关系仍不明确.目前仍没有足够证据证明维生素D补充对改善体重、体块指数及脂肪量有益.肥胖可能导致了低维生素D状态,而维生素D和维生素D受体则可能通过作用于脂肪分化、脂肪细胞凋亡、脂质合成和分解、摄食行为及能量消耗方面影响能量平衡.     

磁共振成像定量评估儿童非酒精性脂肪肝的研究进展

随着肥胖及糖尿病患儿增多,儿童非酒精性脂肪肝的发病率越来越高,严重影响儿童的健康成长。儿童非酒精性脂肪肝的病理改变以肝内脂肪浸润为主,因此,肝脏脂肪含量的测定在脂肪肝的诊治中有重要作用。目前,定量评估肝脏脂肪含量的磁共振技术有 Dixon 技术、化学位移成像技术及 MRS 技术等。该文综述定量评估儿童非酒精性脂肪肝的磁共振技术及其相关研究进展。     

腹型肥胖对儿童、青少年代谢的影响及评价标准的确立

腹型肥胖是脂肪组织主要积聚于腹腔内脏周围的一种肥胖类型,内脏脂肪堆积导致代谢紊乱和心血管疾病发生的作用独立于整体脂肪含量,彰显了腹型肥胖在代谢综合征(MS)中的重要地位。脂肪细胞因子介导的炎症反应是腹型肥胖致胰岛素抵抗进而发展成MS的重要原因。腰围测量简便,与内脏脂肪水平、胰岛素抵抗、心血管疾病风险的相关性均明显强于体质指数(BMI),已成为衡量腹型肥胖的最常用指标,而腰围身高比(WHtR)因其特有的优势,在儿科临床应用前景广阔。关注儿童青少年腹部脂肪堆积,在新近公布的我国儿童青少年腰围正常值基础上,尽快确定异常界值点,早期筛查,及早干预,对预防MS及相关并发症的发生、提升人群健康水平有重要意义。     

Measurement of body fat using leg to leg bioimpedance.

AIMS: (1) To validate a leg to leg bioimpedance analysis (BIA) device in the measurement of body composition in children by assessment of its agreement with dual energy x ray absorptiometry (DXA) and its repeatability. (2) To establish a reference range of percentage body fat in Hong Kong Chinese children. METHODS: Sequential BIA and DXA methods were used to determine body composition in 49 children aged 7-18 years; agreement between the two methods was calculated. Repeatability for the BIA method was established from duplicate measurements. Body composition was then determined by BIA in 1139 girls and 1243 boys aged 7-16 years, who were randomly sampled in eight local primary and secondary schools to establish reference ranges. RESULTS: The 95% limits of agreement between BIA and DXA methods were considered acceptable (-3.3 kg to -0.5 kg fat mass and -3.9 to 0.6% body fat). The percentage body fat increased with increasing age. Compared to the 1993 Hong Kong growth survey, these children had higher body mass index. Mean (SD) percentage body fat at 7 years of age was 17.2% (4.4%) and 14.0% (3.4%) respectively for boys and girls, which increased to 19.3% (4.8%) and 27.8% (6.3%) at age 16. CONCLUSION: Leg to leg BIA is a valid alternative method to DXA for the measurement of body fat. Provisional reference ranges for percentage body fat for Hong Kong Chinese children aged 7-16 years are provided.     

An evaluation of body adiposity in Roman schoolchildren

The purpose of this study is to assess the body fat content of 871 Roman children, aged 7-14 years, by a simple method based on measurement of body density from skinfold thickness. Weight, height, triceps, biceps, subscapular and suprailiac skinfold were measured for every child and calculated body mass index and percentage of body fat. Girls tended to have more fat than boys and an increase of values with age; boys presented an increase of fat until 11 years, than a decrease more considerable at 14 years. Body fat percentage has a higher correlation with age than BMI and therefore is added to other body mass indices, based on weight and height, for a careful assessment of body composition.     

The invisible fat

Childhood and adolescence are decisive periods in human life. Body composition and psychological changes determine nutritional requirements as well as eating and physical activity behavior variability. Aims of the present paper are to discuss recent advances in measurements for quantifying total body and regional adiposity, and for mapping adipose tissue distribution in order to evaluate metabolic risk factors in children. Among the new methods available for assessing pediatric body composition, magnetic resonance imaging (MRI) can serve as a reference method for measuring tissue and organ volumes because estimates is reliable independent of age. MRI is the method of choice for calibrating field methods designed to measure adipose tissue and skeletal muscle in vivo and is the only method available for measurement of internal tissues and organs. MRI can be used to validate measures of important molecular level components such as fat measured by dual energy X-ray absorptiometry and bioimpedance analysis. Moreover, the large gap in available information for certain topics makes MRI measurement a dynamic and growing scientific area of body composition investigation.     

Body composition measured by dual-energy X-ray absorptiometry half-body scans in obese children

Aim: To perform a methods comparison of a left or right half‐body scan versus whole‐body scan for measuring body composition in a sample of obese children. Methods: A group of obese children (n = 58; ≥95th BMI percentile; 8–18 years) were required to undergo a dual‐energy X‐ray absorptiometry (DXA) body composition measurement as part of an ongoing cohort study; 34 fit within the imaging field of the DXA scanner and were eligible for inclusion in the present analysis. Percent fat, total mass, fat mass, lean mass and bone mineral content (BMC) were estimated from half‐body scans and compared with the whole‐body results. Assessment was completed using GE enCORE 11.40 software. Results: In comparing left‐ and right‐side scans to whole‐body scans, there was significant correlation for all body composition variables (p ≤ 0.005, R² = 0.996–1.0). Bland Altman analyses also showed high levels of agreement between half‐body estimates and whole‐body measurements. Conclusion: This study supports using a half‐body scan methodology for percent fat, total mass, fat mass, lean mass, and BMC as a valid alternative to full‐body analysis in obese children and youth.     

Neonatal body composition: dual-energy X-ray absorptiometry, magnetic resonance imaging, and three-dimensional chemical shift imaging versus chemical analysis in piglets.

An animal study to evaluate dual-energy x-ray absorptiometry (DXA) and magnetic resonance (MR) imaging and spectroscopy for measurement of neonatal body composition was performed. Twenty-three piglets with body weights ranging from 848 to 7550 g were used. After measuring total body water, animals were killed and body composition was assessed using DXA and MR (1.5 T; MR imaging, T1-weighted sagittal spin-echo sequence; MR spectroscopy, three-dimensional chemical shift imaging) as well as chemical carcass analysis (standard methods) after homogenization. Body composition by chemical analysis (percent of body weight, mean +/- SD) was as follows: body water, 75.3 +/- 3.9%; total protein, 13.9 +/- 8.8%; and total fat, 6.5 +/- 3.7%. Absolute content of fat and total ash was 7-674 and 35-237 g, respectively. Mean hydration of fat-free mass was 0.804 +/- 0.011 g/kg and decreased with increasing body weight (r2 = 0.419) independent of age. Using DXA, bone mineral content was highly correlated with calcium content (r2 = 0.992), and calcium per bone mineral content was 44.1 +/- 4.2%. DXA fat mass correlated with total fat (r2 = 0.961). Using MR, spectroscopy and chemical analysis were highly correlated with fat-to-water ratio (r2 = 0.984) and absolute fat content (r2 = 0.988). Total fat by MR imaging volumetry showed a lower correlation (r2 = 0.913) and overestimated total fat by a factor of 2.46. Conversion equations for DXA were developed (total fat = 1.31 x fat mass measured by DXA--68.8; calcium = 0.402 x bone mineral content + 1.7), which improved precision and accuracy of DXA measurements. In conclusion, both DXA and MR spectroscopy give accurate and precise estimates of neonatal body composition and may become valuable tools for the noninvasive assessment of neonatal growth and nutritional status.     

Bodyfat percentage in girls increased steadily with age and percentile rank of body mass index

BACKGROUND: The purpose of the present study was to determine the body composition of elementary school children by bioelectrical impedance analysis (BIA) method with a subject in a standing position. The method is frequently used in Japan. The other aim was to evaluate the relationship between the body composition and percentile rank of the body mass index (BMI) in Japanese children. METHODS: The number of subjects were 1042 children (530 boys and 512 girls aged from 6- to 12-years-old) from an elementary school. The bioelectrical impedance (BI) in the standing position was measured late in the morning before lunch. The fat percentage was derived from the body density according to the formula of Brozek et al. Each percentile value of BMI for each age and sex was determined from the frequency table of height and weight published by the Ministry of Education in Japan. RESULTS: The fat percentage in both boys and girls was significantly correlated with the BMI, however, girls showed a closer linear relation than boys. The fat percentage in girls increased steadily with age and percent rank of the BMI. The fat percentage in boys was scattered in a wide range at each percentile rank of the BMI. CONCLUSIONS: The fat percentage measured by the BIA in the standing position is closely associated with the percentile rank of the BMI in elementary school girls. For boys, it will be necessary to compare data among different types of BI measurement methods.     

Percentage body fat in apparently healthy school children from northern India

Context

Increased prevalence of obesity in childhood and adolescence, defined by the use of body mass index (BMI), has drawn attention towards direct measurement of body fat

Objective

To develop age-and sex-specific reference distribution of body fat in apparently healthy North-Indian children in the age group of 7–17 years and to assess agreement between obesity (defined by BMI) and excess body fat

Design

Study subjects for this cross sectional study included1640 apparently healthy school children (825 boys; 815 girls) aged 7–17 years. Total body fat was measured by dual energy X-rays absorptiometry (DXA). The excess body fat by DXA was defined by two methods, prevalence matching and with the use of 85th and 95th centile cutoffs.

Results

The mean ± SD, 3rd, 10th, 25th, 50th, 75th, 90th and 97th centile values of percentage body fat (PBF) are presented. PBF was highly correlated with BMI in both boys and girls (all boys: r=0.76, P<0.0001; all girls r=0.81, P<0.0001). There was no significant difference noted in PBF between boys and girls at the age of 7–8 years. From 9 years onwards, girls had significantly higher PBF than boys. Moderate degree of agreement was observed between BMI and PBF by DXA by both methods.

Conclusions

Smoothened reference distribution of PBF for North-Indian children and adolescents in Delhi are provided. Indian children accumulate more body fat during peri-pubertal years in comparison with US children.     

Body composition,as assessed by bioelectrical impedance spectroscopy and dual-energy X-ray absorptiometry,in a healthy paediatric population

The aim of this study was to determine the level of agreement between body composition measurements by dual-energy X-ray absorptiometry (DXA), single-frequency bioelectrical impedance analysis (BIA) and multifrequency bioelectrical impedance spectroscopy (BIS). Fat-free mass (FFM), body fat mass and body fatness (percentage fat) were measured by DXA, BIA and BIS in 61 healthy children (37M, 24F, aged 10.9-13.9 y). Estimates of FFM, body fat mass and body fatness were highly correlated (r = 0.73-0.96, p < 0.0001) between the different methods. However, a Bland-Altman comparison showed wide limits of agreement between the methods. The mean differences between methods for FFM ranged from -2.31 +/- 7.76 kg to 0.48 +/- 7.58 kg. Mean differences for body fat mass ranged from 0.16 +/- 5.06 kg to 2.95 +/- 5.65 kg and for body fatness from -2.3 +/- 7.8% to 0.8 +/- 9.3%. Calculations of body composition with BIS were not superior to BIA. However, BIA overestimated fat mass in lean, subjects and underestimated fat mass in overweight subjects more than BIS, compared with DXA. CONCLUSION: The methods used provided estimates of FFM, body fat mass and body fatness that were highly correlated in a population of healthy children. However, the large limits of agreement derived from the Bland-Altman procedure suggest that the methods should not be used interchangeably.     

Studies on the influence of various mathematical formulations on the determination of the proportion of fat in relation to bodyweight by means of skin fold measurements (author's transl)

The paper reports on investigations on the influence of various mathematical formulations on the determination of the proportion of fat in relation to body-weight by means of skin fold measurements. For this purpose, the various equations derived from Archimedes' law, as well as the densities of various body fractions as determined by different authors, are discussed. This is followed by a discussion of the deliberations on the methods to be employed for estimating the density of the body by means of skin fold measurements. The various formulations differ from each other mainly by the location and number of measuring points. It was shown by means of comparative studies that for children aged between 9 and 16, independent of their sex, it will be sufficient to employ two skin folds (triceps and scapula). The existence of a very close correlation between the measured data of these points of measurement was found when using different calipers and the relevant conversion factors. In this manner it becomes possible to use a nomogram which has already been determined by Parízková and which was converted into a matrix for easier calculation. The determination of the relative proportion of fat'via skin fold measurements cannot replace the determination of individual body density by weighing under water. However, in mass examinations it is very well suited for differentiating between various groups of children (e.g. overweight, underweight, trained, and untrained) in respect of their relative proportion of fat.