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。     

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 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.     

Increased prevalence of constipation and fecal soiling in a population of obese children

To determine the prevalence of constipation and fecal soiling in obese children, we asked standardized questions during the initial visit to the obesity clinic. In 80 obese children, 23% met the criteria for constipation, and 15% reported fecal soiling. Constipation and soiling are more prevalent in obese children.     

Nutritional state of Polish prepubertal children assessed by population-specific and international standards

OBJECTIVE: To assess the frequency of obesity, overweight and underweight (thinness) in Polish 7-9-year-old children using a population specific definition as compared to the French, US and IOTF references based on body mass index (BMI). DESIGN: Height and weight were measured and BMI was calculated in a randomly selected representative sample of 7-9-year-old Polish children (N = 2916; 1445 girls; 1471 boys) to define their nutritional status. Overweight (including obesity) was estimated according to four and underweight (thinness) according to three definitions Polish national references; French references; United States references and International Obesity Task Force references. RESULTS: According to Polish, French, U.S. and IOTF references overweight (including obesity) was found in 12.1, 14.3, 20.7 and 15.4% of children, respectively; 3.5, 9.4 and 3.6% of children were obese according to national, U.S. and IOTF references, respectively while underweight (thinness) was present in 6.9, 2.6 and 4.2% of children according to Polish, French and U.S. references, respectively. A trend of decreasing overweight and increasing underweight through age classes was observed. CONCLUSION: The rates of underweight (thinness), overweight and obesity in Polish 7-9-year-old children calculated according to the national, French, U.S. and IOTF references were significantly different. Therefore even if the IOTF reference is considered superior for international epidemiological studies, population specific standards should probably coexist for clinical practice.     

儿童体重指数与肠道菌群多样性的关联性研究

目的 对儿童体重指数(body mass index,BMI)与肠道菌群多样性的关联性进行初步探讨.方法 采用横断面调查方法,从2018年7月1日至7日在广东省茂名市共招募87名儿童,平均年龄(11±2)岁.以世界卫生组织2006年发布的儿童体格生长指标百分位数参考值为标准,将研究对象分成偏瘦、正常、超重以及肥胖4个组...     

上海市7~18岁学生1985至2014年的超重和肥胖流行趋势

目的：分析上海市1985至2014年7~18岁学生的超重和肥胖的动态变化趋势。方法：选取1985（n=14 677）、1995（n=7 916）、2000（n=15 270）、2005（n=7 492）、2010（n=14 301）和2014（n=15 423）年6次中国学生体质与健康调研上海地区资料进行分析。采用中国学龄儿童超重、肥胖BMI分类标准。结果：基于上海市6个区总调查样本量,以10年（1985、1995、2005和2014年）为1个周期,随年代增长上海市7～18岁男、女学生BMI P50百分位数曲线逐年提高,总体男生较女生提高更为明显,不同年龄组的男女生BMI均值呈上升趋势且均为男生高于女生。2014年上海市BMI和全国比较,P50男女生均高于全国水平,P85和P95男女生11和12岁前与全国水平重合,之后高于全国水平。与1985年比较,2014年上海市7～18岁男生超重检出率增加了11倍（19.3% vs 1.7%）,肥胖检出率增加了29倍（11.7% vs 0.4%）,平均增长率为12.3%;上海市7～18岁女生超重检出率增加了7倍（11.6% vs 1.5%）,肥胖检出率增加了31倍（6.4% vs 0.2%）,平均增长率为12.7%。各年龄组男生超重检出率14.3%~26.9%、肥胖检出率7.3%～17.0%,男生11岁超重和肥胖检出率最高;各年龄组女生超重检出率8.6%~14.0%、肥胖检出率2.8%～11.2%,女生7岁超重和肥胖检出率最高。男生各年龄段超重和肥胖检出率均高于女生。结论：上海市1985至2014年7~18岁学生超重与肥胖检出率持续增长。低年龄段男生超重流行程度较为严重,已处于国际高位水平。     

Recent anthropometric trends among Swedish school children: evidence for decreasing prevalence of overweight in girls

Aim: To assess the recent prevalence of overweight and obesity in 10 year old children in Göteborg, Sweden. Methods: Cross‐sectional data on weight and height from school health examinations, including fourth grade children, born in 1974 (n = 4126), 1990 (n = 4683) and 1994 (n = 4193) and measured in academic years 1984/1985, 2000/2001 and 2004/2005, were used. Weight classification was based on age‐ and sex‐specific body mass index cutoff values. The two latest cohorts were classified according to socio‐economic areas. Results: Between 2000/2001 and 2004/2005, the prevalence of overweight plus obesity in girls decreased from 19.6% to 15.9% (p < 0.01). Prevalence of obesity was 3.0% and 2.5% (nonsignificant), respectively. In boys, all differences between the corresponding cohorts were nonsignificant: 17.1% versus 17.6% were overweight (including obese) and 2.9% versus 2.8% were obese. In 1984/1985, prevalence of overweight plus obesity was only 8.6% among girls and 7.2% among boys, while 0.8% and 0.7% were classified as obese, respectively. The socio‐economic gradient in overweight prevalence remained, particularly in girls. Conclusions: This study suggests that the obesity epidemic in 10–11 year olds may be easing off in urban Sweden, and possibly reversing among girls. Even if future monitoring confirms these findings, much health promoting work still remains since the power of the ‘obesogenic environment’ will probably continue to be strong.     

Weight/height2.88 as a screening test for obesity or thinnes in schoolage children

We wished to determine a weight for height measure for use as a simple screening test throughout the schoolage years for obesity or thinness similar to the body mass index in adults but not correlated with either height or age. Single measurements of height, weight, pubertal stage and two site skinfold thickness were collected on 979 healthy London schoolchildren (559 male) aged 4.6–18.8 years from 11 schools by one anthropometrist. Weight/ height^2.88 was uncorrelated with height or age in either sex. The median (95% confidence interval of the median) value for boys (12.74, 12.58–12.90) did not vary within this age group, height or pubertal stage. In girls the median value 12.46 (12.20–12.61) was valid for all girls less than breast stage 4 but rose sharply to 13.64 (13.21–14.06) there-after. Percentile charts and nomograms are provided.Conclusion Weight/height^2.88 may be a simple screening test for obesity or thinness throughout the schooling years and that its independence of age and height greatly simplifies longitudinal assessment.     

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。     

Body mass index reference curves for Tunisian children

Body mass index (BMI) reference curves are used to assess children's health. The aim of this work is to construct BMI reference curves for Tunisian children and adolescents and compare them with local and international references. The BMI reference curves were constructed using the LMS method using data from 4358 Tunisian children (2182 girls and 2176 boys) aged 0–18 years. The result of this study presents the smoothed percentile curves of BMI on the basis of age and sex of Tunisian children. The reference curves of Tunisian children demonstrated some variations in comparison with the median percentiles with the references of the International Obesity Task Force (IOTF), the World Health Organization (WHO), and with local references from Algeria and Turkey. The prevalence study indicated that the rate of overweight has increased mainly in adolescent children.

A cross-sectional study on the prevalence rate and influencing factors of nonalcoholic fatty liver disease in overweight/obese children北大核心CSCD

目的 调查医院就诊的超重/肥胖儿童非酒精性脂肪肝病(non-alcoholic fatty liver disease,NAFLD)的患病率,并探讨NAFLD发生的影响因素,为超重/肥胖儿童NAFLD的预防提供依据。方法 招募2019年6月-2021年9月在湖南省儿童医院就诊的超重/肥胖儿童作为研究对象,调查NAFLD患病率,并采用logistic回归分析探讨NAFLD,包括单纯性脂肪肝(non-alcoholic fatty liver,NAFL)和非酒精性脂肪肝炎(non-alcoholic steatohepatitis,NASH)发生的影响因素。采用受试者操作特征曲线分析评价影响因素对NAFL及NASH的预测价值。结果 共纳入844例超重/肥胖儿童,年龄为6~17岁。NAFLD患病率为38.2%(322/844),其中NAFL和NASH患病率分别为28.8%(243/844)和9.4%(79/844)。多因素logistic回归分析显示,腰臀比(waist-to-hip ratio,WHR)增加及低高密度脂蛋白胆固醇血症与NAFL和NASH的发生有关(P<0.05)。受试者操作特征曲线分析显示:WHR和高密度脂蛋白胆固醇联合检测预测NAFL的曲线下面积为0.653 (95%CI:0.613~0.694);二者联合检测预测NASH的曲线下面积为0.771 (95%CI:0.723~0.819)。结论 医院就诊的超重/肥胖儿童NAFLD的患病率较高;WHR和高密度脂蛋白胆固醇与NAFLD的发生有关,二者联合检测对NAFLD的发生具有一定的预测价值。     

Molecular analysis of the CART gene in overweight and obese Italian children using family‐based association methods

Aim: In our study, we evaluated if CART gene A1475G and ΔA1457 polymorphisms could be associated with obesity. Patients and methods: We recruited 133 Italian trios from among 103 (50 males and 53 females) overweight children (mean age 10.5 years, range 6–14 years; mean BMI 26.1 ± 3.2 kg/m²), and 30 (16 males and 14 females) obese children (mean age 9.0 years, range 6–11 years; mean BMI 32.3 ± 2.0 kg/m²). We also selected 187 non‐obese unrelated controls. Results: The allele frequencies of the A1475G single nucleotide polymorphism (SNP) were significantly higher in overweight children (0.07) than in control children (0.02) (p = 0.03) and control adults (0.02) (p = 0.02). Moreover, the allele frequencies were significantly different between obese children (0.08) and control children (0.02) (p = 0.03), and between obese children (0.08) and control adults (0.02) (p = 0.02). The ΔA1457 SNP showed no significant association with overweight/obesity. TDT statistic revealed a preferential transmission of the 1475G allele from heterozygous parents to overweight children (p < 0.01) and to obese children (p < 0.05). No statistically significant excess transmission of the ΔA1457 allele was found. Conclusion: Our results supported the hypothesis that inherited variations of the CART gene could influence the development of obesity also in Italian children.     

Evaluation of oxidant-antioxidant status in overweight and morbidly obese Saudi children

AIM: To evaluate the antioxidant enzymes and oxidative products in overweight and obese Saudi children before the onset of metabolic complications.METHODS: The study was carried out on 231 Saudi children. They were classified into three groups: uncomplicated overweight, uncomplicated morbid obesity, and the matched age group as control. All subjects underwent anthropometric measurements and activities of superoxide dismutase, catalase, glutathione peroxidase (GSH-Px), glutathione reductase, the concentrations of reduced GSH, malondialdehyde (MDA) oxidized low-density lipoprotein (ox-LDL) and advanced oxidation protein products (AOPPs) were measured in the blood of these groups.RESULTS: Overweight and obese children had a significantly higher body mass index, while obese children only had a significantly higher waist-to-hip ratio compared to that of the control group. The enzyme activities under study were significantly elevated in the overweight group, although they were significantly reduced among obese children. The concentration of GSH was reduced in both the overweight and obese groups. The mean values of ox-LDL, MDA and AOPP were non-significantly increased in overweight children, while they were significantly elevated in obese children compared to that of normal weight children. A significant disturbance of oxidant-antioxidant status was observed in severely morbid children.CONCLUSION: The increase of oxidative stress in obese children is associated with the increase in AOPPs and MDA which reflects an imbalance between reactive oxygen species production and antioxidant defense.     

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.     

Appropriateness of US and international BMI-for-age reference curves in defining adiposity among Israeli school children

Effective surveillance of trends in paediatric overweight and obesity requires the establishment of valid cutoff values to identify children at risk. In Israel, standard values for childhood BMI-for-age are currently based on growth charts published by the US Centers for Disease Control and Prevention. However, the appropriateness of using US reference values in populations outside the US is questionable, due to inherent differences in ethnicity, culture and socioeconomic status. We recorded data from 9,988 children aged 6–12 selected by random cluster sampling within the framework of school-based health surveys conducted in Israel during the years 1997 and 2000. We constructed population-specific centile BMI-for-age curves valid for Israeli children, and compared these curves to current standard US and international reference values. Curves were constructed using LMS statistical curve smoothing methods. The data set of Israeli schoolchildren produced reference centiles substantially different than those based on US children. Israeli reference values were closer to centile curves published by the International Obesity Task Force. In conclusion, local and national health planners should recognize the intrinsic limitations associated with the use of “standard” reference values in defining paediatric overweight and obesity in dissimilar populations. The results of this large population-based study highlight the need for population-specific BMI-for-age reference values, in order to accurately describe the prevalence of paediatric overweight and obesity.