Validity of self‐reported body mass index of Japanese children and adolescents

Background: Self‐reported body mass index (BMI) has been widely used in epidemiological studies, but no study thus far has validated the self‐reported BMI of Japanese children and adolescents. The aim of the present study was to assess the accuracy of self‐reported BMI and its use for classification into weight categories. Methods: Fifth‐ and eighth‐grade students (n= 358) from all schools in Shunan City, Japan, from 2006 to 2010 were included. BMI was calculated from both self‐reported and measured data. Pearson's correlation, Kappa statistics and the number of overweight children, and Bland–Altman plots with 95% limits of agreement were calculated to assess the agreement. Results: Pearson's correlation between self‐reported and measured data ranged between 0.946 and 0.987 for height, 0.978 and 0.992 for weight, and 0.930 and 0.964 for BMI, depending on gender or age. Kappa was excellent: 0.949 for boys, 0.867 for girls, 0.897 for 10–11‐year‐old children, 0.928 for 13–14‐year‐old adolescents. The number of overweight children based on self‐reported BMI was not significantly different from that based on measured BMI. The 95% limits of agreement were ?3.62 and 2.90 cm for height, ?2.80 and 2.38 kg for weight, and ?1.42 and 1.44 kg/m² for BMI. Conclusions: Self‐reported BMI was generally reliable for predicting the number of overweight Japanese children and adolescents. There is slight discrepancy, however, between self‐reported BMI and measured BMI, and self‐reported BMI should be used with caution, keeping the variance and concordance rate in mind.     

Body image and depressive symptoms in 13‐year‐old adolescents

Aims: To evaluate the prevalence of body dissatisfaction and the association with depressive symptoms in 13‐year‐old adolescents, according to gender, and also to analyse the possible modifying effect of body mass index on this association. Methods: We evaluated 1868 adolescents as part of a population‐based study in an urban community in Porto, Portugal. Using the Figure Rating Scale, participants choose their perceived and their desired figures; body dissatisfaction was measured by the difference between these values. The Beck Disorder Inventory II was used to measure depressive symptoms. Weight and height were measured by trained interviewers. To quantify the association between depressive symptoms and body dissatisfaction, regression parameters and 95% confidence intervals (CIs) were obtained by linear regression and bootstrapping. Results: Among females, 15.8% desired a bigger figure and 41.4% desired a thinner figure. Among males, this occurred for 34.1% and 33.5%, respectively. After adjustment, we found that body dissatisfaction was associated with increased depressive symptoms, in both genders, especially in those participants who wish to be thinner and in those presenting higher discrepancy between figures (B = 6.5, 95% CI 4.1;9.3 for females, B = 3.3, 95% CI 1.3;6.8 for males). The association between body dissatisfaction and depressive symptoms was stronger among non‐overweight (for participants who wish to be thinner: B = 5.18 95% CI 3.56; 6.95 vs. B = 3.49, 95% CI 1.70; 5.29 among females and B = 2.47, 95% CI 0.73; 4.76 vs. B = 1.60, 95% CI 0.34; 2.88 among males). Conclusions: The direct association between the wish to be thinner and depressive symptoms was stronger among the non‐overweight youth.     

The population prevalence of adverse concentrations and associations with adiposity of liver tests among Australian adolescents

Aim: Paediatric overweight has a high incidence and has serious consequences for health, including non‐alcoholic fatty liver disease (NAFLD). However, very little is known about NAFLD among young people, particularly from a population perspective. This paper reports the prevalence of elevated concentrations of four liver enzymes and their associations with adiposity in a representative population sample of Australian adolescents. Methods: Overnight fasting blood samples were collected from a representative population sample of 500 Grade 10 students (15‐years‐old) attending schools in Sydney, Australia, between February and May, 2004. Weight, height and waist girth were measured. The prevalence of adverse concentrations of the enzymes alanine aminotransferase (ALT), gamma‐glutamyltransferase (GGT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were described for all boys and girls and by body mass index (BMI) categories. The nature of the associations between the enzyme concentrations and indices of adiposity were characterised, and regression equations for estimating enzyme concentrations from BMI were prepared. Results: The prevalence of adverse concentrations of ALT (most likely as a result of NAFLD) and GGT were approximately 10%, while the prevalence of adverse concentrations of AST and ALP were approximately 7% and 5% respectively. The prevalence of adverse concentrations of ALT, GGT and AST increased across BMI categories, while the prevalence of adverse concentrations of ALP declined across BMI categories. Conclusions: The high prevalence of NAFLD in a population sample of healthy Australian adolescents represents a significant burden of disease.     

Long‐term experience of steroid‐free pediatric renal transplantation: Effects on graft function,body mass index,and longitudinal growth

Increased focus on the potential negative side effects of steroid usage in pediatric transplantation has led to steroid minimization or steroid‐free transplantation. In this study, we report results after complete steroid avoidance in renal transplantation in the period 1994–2009. We evaluate the effects of complete steroid avoidance on allograft function, BMI, and linear growth. The majority of transplanted children were induced with antithymocyte globulin and immunosuppressed with a calcineurin inhibitor and mycophenolate mofetil. Steroids were given only when rejection occurred or due to comorbidities. Anthropometric data were collected from 65 transplantations in 60 children. Patient survival was 93%; graft survival was 81% after five yr (N = 42) and 63% after 10 yr (N = 16). Acute rejection within the first year of transplantation was 9%. The distribution of the children's BMI before transplantation was normal; the mean BMI‐SDS was 0.21 before transplantation, and this value remained stable during the next five yr. Post‐transplantation the children demonstrated significant improved growth as the mean height‐SDS increased significantly from ?1.7 to ?1.1. Catch‐up growth was most pronounced in the youngest (< six yr). Steroid‐free immunosuppression in pediatric renal transplantation is safe and protects against steroid‐induced obesity and short stature.     

儿童青少年体位性心动过速综合征体质量指数变化

目的　目的 探讨儿童青少年体位性心动过速综合征（POTS）体质量指数（BMI）的变化。方法　回顾性分析2009年8月至2018年6月因不明原因晕厥或晕厥先兆在中南大学湘雅二医院儿童晕厥专科门诊就诊、并诊断为POTS的4～17岁儿童青少年的临床资料。POTS组127例,男63例,女64例,平均年龄（11.31±2.53）岁。将同期在该院儿童保健专科门诊进行健康检查的127例7～17岁儿童青少年作为对照组,男64例,女63例,平均年龄（11.60±3.27）岁。测量两组儿童身长、 体质量,计算BMI。采用SPSS 22.0软件进行数据统计分析。结果　（1）病程和晕厥频次：POTS组病程为（8.13±13.76）个月,晕厥频次为（1.45±4.43）次。（2）BMI组间比较： POTS组与对照组比较, 年龄、 身长、 体质量差异无统计学意义（P＞0.05）, BMI明显降低［（17.32±2.65） kg/m2 vs.（18.17±2.42 ）kg/m2, t＝2.655, P＜0.01］。（3）BMI分类： 体质量过低在POTS组（69.29%, 88/127）高于对照组（56.69%,72/127）, 体质量正常在POTS组（29.13%, 37/127）低于对照组（41.73%, 53/127）, 组间比较χ2 ＝4.444, P＜0.05。结论　儿童青少年POTS组BMI明显降低, 且女性低于男性。     

青少年儿童体质指数与血压关系探讨

目的探讨青少年儿童体质指数（BMI）与血压的关系。方法测量7963例贵阳市两城区8～17岁青少年儿童的血压、身高、体重,按WGOC标准将受检对象分为超重、肥胖及正常体重组,分析比较各组血压值差异及血压值与BMI的关系。结果①不同BMI组间收缩压（SBP）、舒张压（DBP）均值都是肥胖组〉超重组〉正常体重组（P〈0.01）;②BMI与SBP、DBP呈显著正相关（r=0.520、0.365,P均〈0.01）;控制年龄、性别、身高影响的偏相关分析显示BMI与SBP、DBP呈独立正相关（r=0.390、0.210,P均〈0.01）;③不同BMI组间高血压患病率分别为24.49%、10.76%、2.65%,肥胖组〉超重组〉非超重组（P〈0.01）;④超重、肥胖青少年儿童的高血压发病危险是体重正常青少年儿童的4倍和9倍。结论青少年儿童的BMI与血压密切相关,应重视对超重、肥胖青少年的行为干预。     

Self‐esteem in 6‐ to 16‐year‐olds with monosymptomatic nocturnal enuresis

Aim: Childhood nocturnal enuresis (NE) and incontinence has been shown to be associated with increased behavioural problems and reduced self‐esteem (SE) in Western populations. The impact on Asian children, however, is not known. This study investigates the relationship between SE and monosymptomatic NE in Malaysian children aged 6 to 16 years. Method: Children with wetting frequency of at least 4 out of 14 nights were recruited with controls matched for age, gender and race. SE scores were obtained using the ‘I Think I Am’ questionnaire for five domains: body image, talents and skills, psychological well‐being, relationship with family and relationship with others. Results: A total of 126 children were recruited; 22 enuretics aged 6–9 years and their matched controls (Group1) and 41 enuretics aged 10–16 years and their matched controls (Group 2). SE scores were similar between the enuretic and controls in Group 1, whereas in Group 2, enuretics had significantly lower scores (P < 0.05) in ‘body image’, ‘relationship with others’ and total SE scores. This difference was more pronounced among girls, adolescents and those who wet more than 10/14 nights. Conclusion: The SE of Malaysian children with monosymptomatic NE aged 10 years and above is significantly lower than their peers. This effect is seen particularly among girls, adolescents and those with frequent wetting. In the light of these findings, the ‘wait and see’ approach by the Malaysian medical profession is no longer appropriate. Treatment should begin before the age of 10 years.     

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.     

Television,computer use and body mass index in Australian primary school children

OBJECTIVE: To investigate relationships between children's body mass index (BMI) and parent reports of children's television and video game/computer habits, controlling for other potential risk factors for paediatric obesity. METHODS: Child BMI was calculated from measured height and weight collected in 1997 as part of a large, representative, cross-sectional study of children in Victoria, Australia. Parents reported the amount of time children watched television and used video games/computers, children's eating and activity habits, parental BMI and sociodemographic details. RESULTS: A total of 2862 children aged 5-13 years participated. Child mean BMI z-score was significantly related to television (F = 10.23, P < 0.001) but not video game/computer time (F = 2.23, P = 0.09), but accounted for only 1 and 0.2% of total BMI variance, respectively. When parental BMI, parental education, number of siblings, food intake, organized exercise and general activity level were included, television ceased to be independently significantly related to child BMI. Using adjusted logistic regression, the odds of being overweight and obese generally increased with increasing television viewing. No relationship was found for video game/computer use. CONCLUSIONS: A small proportion of variance in child BMI was related to television, but not video game/computer time. This was far outweighed by the influence of other variables. Causal pathways are likely to be complex and interrelated.     

Development of growth and body mass index after pediatric renal transplantation

Suboptimal final height and marked weight gain after renal transplantation (RTx) are common and may result in obesity. Steroid free immunosuppression has been advocated to improve growth and limit weight gain. We evaluated retrospectively the evolution of growth and body mass index (BMI) after renal transplantation to study risk factors for weight gain under steroid based treatment. Sixty-four pediatric patients (age 9.9 +/- 5.0 yr) were included in the study. To allow comparison between different age groups, standard deviation scores (SDS) for height and BMI for height age were calculated at time of transplantation and 3, 6, 9, 12, 24, 36, 48 and 60 months later. Induction immunosuppression consisted of basiliximab, cyclosporine and prednisone. Growth retardation at time of RTx was obvious with a SDS for height of -2.20 +/- 1.34. Height during the first year improved to an SDS of -2.0 +/- 1.27 (p < 0.01) but did further not increase in year 2 and 3. More than 40% of all patients remained 2 SDS below normal mean. SDS BMI for height age at transplantation was -0.19 +/- 0.98 and increased significantly during the first 3 months after transplantation to +0.64 +/- 1.07 (p < 0.01). Thereafter, BMI remained stable but did not decline to pretransplant values. A SDS BMI for height age of more than 2 SDS was observed in 2, 6, 9 and 11% of children at RTx and 1, 2 and 3 yr later respectively. BMI gain over 3 yr was significantly enhanced in children whose parents (especially the mother) were overweight. No influence of gender, BMI at RTx, dialysis modality prior to RTx or rejection episodes could be detected. We conclude that after RTx children exhibit some improvement in growth but height remains suboptimal. The BMI does increase significantly during the first months after RTx and does not return to baseline values under steroid-based immunosuppression. Obesity (>2 SDS above normal) does not occur more often than in the normal population. The most predictive parameter of inappropriate weight gain during 3 yr is the BMI of the mother. We would speculate that steroids may play a major role in weight gain in the early phase after RTx. However, genetic or environmental factors predict the long-term weight development.