167 065名中国0～7岁儿童BMI/Kaup指数研究

目的 探讨使用体块指数（BMI／Kaup指数）筛查儿童单纯肥胖症的价值以及确定界值点应考虑的条件。方法 按WHO身高别体重参照人群值和筛查标准检出肥胖。对中国8市167065名0－7岁儿童BMI／Kaup指数的分布进行研究，对其中肥胖儿童与非肥胖儿童该指数的分布特征和界值点进行比较，亦与成人使用的界值点结果进行比较。结果 在确诊为肥胖的儿童中其Kaup指数在18－25之间的男童占91．8％，女童占84．5％，大于26者男童为2．8％。而15－18的肥胖儿童男童仍有5．6％，女童圾12．8％。无1例小于15。在对照组中，Kaup指数小于18者男童占87．5％，女童占85．4％；Kaup指数在18－25岁之间者男童占12．5％，女童占14．6％。无1例大于25。结论 在中国，目前就建议成人和儿童使用同一个界值点作为筛查肥胖的标准显然是不适当的。应当使用由我儿童人群计算出的参照指数及适合我国儿童的较为准确的界值点，并制定正确使用这个参数的方法与合理的解释。使用Kaup指数筛选肥胖儿童时，18是一个较为适合的界值点。     

铜陵市6～13 岁小学生血压状况分析

目的了解6～13岁儿童血压的分布特点及体质指数(BMI)的影响。方法对铜陵市3 146名6～13岁小学生的血压和体重、身高及BMI等相关因素进行调查,并进行统计学分析。结果3 146名儿童中患高血压217人,总患病率6.90%,其中男123人,患病率为7.41%,女94人,患病率为6.32%;肥胖儿童72人(2.29%),超重207人(6.58%),肥胖和超重儿童的高血压患病率(26.39%、14.49%)与BMI正常儿童的高血压患病率(5.86%)比较,差异有统计学意义。结论年龄与血压呈正相关,而BMI超过正常者高血压患病率明显升高,提示控制体重可减少儿童高血压的发生。     

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。     

960名3～6岁儿童体质测试结果分析

目的：探讨本辖区3－6岁儿童体质发育情况。方法：采用北京市体委、教委和卫生局联合颁布的北京市3－6岁儿童体质测定标准，对辖区的 6个幼儿园960名儿童进行体质测试。结果：优秀级占65．50％，良好级占23．65％，及格级占11．98％，不及格占1．18％。年龄组越大优秀率越高，小年龄组不及格者明显多于大年龄组。结论：儿童体质状况可能与幼儿园老师和家长养育方式密切关联，必须予以重视。     

全国0～6 岁儿童单纯性肥胖流行病学研究

目的 本研究旨在了解自1996年第二次全国儿童期单纯肥胖症流行学研究后10年来我国儿童期单纯肥胖症的发展特征和趋势;复核本工作组研究初期所确定的工作假设和所选择的指示参数的科学效应;修订本工作组所制定的中国儿童单纯肥胖症控制方案的科学性和可操作性.方法 选择沈阳、济南、青岛、郑州、长沙、重庆、西安、成都、深圳、海口、文昌11个城市,采取随机整群抽样的方法,共调查0～6岁儿童84 766名,代表人口1 414 220名儿童.儿童肥胖的判定标准为世界卫生组织(WHO)身高标准体重值,采用标准差计分法(Z-score),体重高于中位数1个标准差为超重、高于2个标准差为肥胖.测量体重、身长/身高、3岁以上儿童的腰围、臀围、大腿围及血压.计数、计量数据分别采用χ2检验和t检验进行分析,显著性检验水平为0.05.结果 (1)本次调查0～6 岁儿童肥胖、超重总检出率分别为7.2%、19.8%,其中男童肥胖、超重检出率分别为8.9%、22.2%,女童肥胖、超重检出率分别为5.3%、17.0%.较1996年分别增长了3.6、4.7倍,年均增长速度分别为156%和52%.肥胖、超重检出率北部高于西部,中南部居中;男童高于女童.肥胖、超重比仍处于高危水平.(2)出生后1个月儿童的平均体块指数(BMI)值＞16.5,于1个月时BMI均值达最高(17.8),之后逐渐降低,5.5岁时降至最低点(平均值15.7),然后随年龄上升,但最高BMI均值未超过18.(3)本次调查中,脂肪重聚年龄为5.5岁,较1996年后移半年.出生后前半年的脂肪重聚比(ARR1)为0.56,出生后半年(ARR2)为0.97,均处于可接受水平,且明显低于10年前的水平.(4)西部地区儿童由于身高不足,可以出现"假性超重".这既掩盖了早期线性生长不足和营养不良,又掩盖了可能产生的肥胖.(5)本次调查肥胖儿童血压高于第95百分位数的比例高达12.9%,其腰臀比大于本工作组设置的1.0的危险警戒水平者占17.2%.(6)本工作组所设立的BMI参照值及肥胖筛查界值点、脂肪重聚比/年龄等参照值及界值点、腰臀比参照值及界值点等指示参数在现场筛查和指示健康危险因素等方面是适宜、科学、实用的.结论 近10年儿童期单纯肥胖症检出率和肥胖儿童高血压率增加明显,且存在心血管高危状态,应加强儿童期单纯肥胖症的早期预防控制.     

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。     

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.     

徐州市0～18岁青少年儿童身高、体重和体质指数标准的研制

目的 建立徐州市0～18岁青少年儿童年龄别身高(HFA)、年龄别体重(WFA)及年龄别体质指数(BMI)百分位标准。方法 (1)采用分层整群随机抽样法，收集徐州市0～19岁儿童30007例(男15729例，女14278例)的性别、出生年月及2002～2004年身高和体重测量资料；(2)应用LMS方法建立徐州市0～18岁儿童HFA、WFA和BMI百分位曲线。结果 (1)运用LMS软件，分别获得0～18岁男女儿童WFA、HFA和BMI百分位曲线各9条，为P3、P15、P10、P25、P50、P75、P90、P95和P97，BMI还增加了P85；(2)徐州市男女孩的身高随年龄增长，男孩到15岁后，女孩14岁后趋于平坦。徐州市男孩身高在17岁之前均大于WHO标准，徐州女孩身高在14岁之前高于WHO标准，之后低于WHO标准；(3)徐州市男女孩的体重随年龄增长，到15岁以后均趋于平坦，徐州男孩体重16岁之前高于WHO标准，16岁以后则低于WHO；徐州女孩体重在14岁之前高于WHO标准，14岁以后低于WHO标准；(4)应用LMS方法，获得男孩和女孩18岁时通过25kg／m^2和30kg／m^2的体质指数分别为第80．2和第94.8百分位及第89．4和第98．4百分位。由此估算徐州市18岁男女孩中的超重流行率分别为19．8％和10．6％，肥胖流行率分别为5．2％和1．6％。结论 应用LMS软件，获得了徐州市0～18岁青少年儿童身高、体重和BMI百分位参考值。     

儿童至成年体质指数变化对成年血压水平的影响

目的 探讨儿童到成年体质指数(BMI)变化对成年血压的影响.方法 对1987年"北京儿童血压研究"队列人群于18年后(2005年)追访,进行身高、体重、血压测量和高血压相关器官功能检测等.结果 ①受试对象儿童期超重肥胖检出率8.7%,有86.1%的超重肥胖儿童成年后仍然超重肥胖;BMI正常的儿童中,成年后超重的比例为25.8%,成年后肥胖的比例为8.8%.②控制年龄、性别,儿童、成年两时期BMI均正常组和儿童期超重或肥胖成年BMI正常组的收缩压(SBP)/舒张压(DBP)均值水平基本一致,明显低于成年超重或肥胖组;儿童至成年持续超重肥胖组成年SBP/DBP均值水平最高,其次为儿童期BMI正常成年肥胖组和儿童期BMI正常成年超重组.③调整儿童时期血压对成年血压的影响,无论儿童期BMI是否正常或超重,只要成年BMI正常后,高血压患病率均明显低于成年超重或肥胖组,其中儿童期BMI正常,成年肥胖者和儿童至成年持续超重肥胖者,成年高血压患病率明显增加.④Logistic同归分析,儿童至成年持续超重或肥胖,成年罹患高血压的风险最强,是两时期BMI都正常者的31.5倍(95%CI=7.5～132.8);儿童期BMI正常,成年肥胖或成年超重,高血压患病风险办明显增强,分别为是两时期BMI都正常者的22.9倍(95%CI=6.0～86.6)和6.0倍(95%CI=1.8～19.9);儿童期曾经超重肥胖,成年BMI转为正常者成年高血压患病风险与两时期BMI都正常者比较为零.结论 儿童期曾经超重肥胖,成年BMI恢复正常后,血压仍可恢复正常;儿童到成年期持续超重肥胖以及BMI的过快增长均可导致成年血压水甲以及高血压患病率增加,因此,防治儿童期超重、肥胖,尤其是预防儿童期超重肥胖向成年延续以及由儿童至成年BMI的过快增长是预防成人高血压的重要措施和有效手段.     

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。     

Prevalence trends of obesity and overweight among 10-year-old children in western Sweden and relationship with parental body mass index

AIM: To determine the regional prevalence, secular and family-related trends of obesity and overweight among 10-y-old children. METHODS: A cross-sectional study of 10-y-old children, born in 1990, was performed during September 2000 to June 2001 at school health centres in three communities in the western part of Sweden. Evaluation was performed in 6311 children, or 81% of the target population. Data from a cohort of children, born in 1974, who form the national growth charts, were available for comparison. RESULTS: The mean body mass index was 17.9 kg/m2 in 10-y-old children born in 1990 and 17.0 kg/m2 for 10-y-olds born in 1974 (p < 0.0001). Of the 10-y-old children in 2000-2001, born in 1990, 18% were overweight and 2.9 % obese, which corresponds to a twofold increase in presence of overweight and a fourfold increase in presence of obesity among 10-y-old children from 1984 to 2000. There was a significant correlation between parental and child body mass index. The prevalence of obesity and being overweight appeared to be higher in children whose parents did not participate in the study. CONCLUSION: During a 16-y period, from 1984 to 2000, a twofold increase in being overweight and a fourfold increase in obesity were seen among 10-y-old children in the western part of Sweden. Parental ponderosity or reluctance to participate in the study was related to a higher prevalence of being overweight or obese in the children. There is a need for the healthcare system to recognize the threats to the health of the population of this new "epidemic" and initiate preventive measures and treatment programmes.     

Parental overweight/obesity,social factors,and child overweight/obesity at 7 years of age

Background: This study used gender‐based analyses to examine whether child overweight/obesity is related to parental overweight/obesity and sociodemographic factors, in a representative population‐based cohort of 7‐year‐old children. Methods: Data from the Québec Longitudinal Study of Child Development 1998–2010 was used. Children (n= 1336) were randomly selected from each public health region of Québec. The study was based on face‐to‐face interviews and a set of questionnaires addressed to mothers and fathers. Results: Compared to children with no overweight/obese parent, the adjusted odds ratio (OR) of being overweight/obese with two overweight/obese parents was 5 for boys (95% confidence interval [CI]: 2.31–10.85) and 5.87 for girls (95%CI: 2.63–13.12). Gender differences appeared when one parent was overweight/obese. For girls, having either an overweight/obese mother (OR, 3.10; 95%CI: 1.14–8.38) or father (OR, 3.64; 95%CI: 1.68–7.91) significantly increased the odds of being overweight/obese at 7 years. For boys, however, having only an overweight/obese father (OR, 2.05; 95%CI: 1.01–4.16) was related to overweight/obesity, but having only an overweight/obese mother was not related to overweight/obesity at 7 years for boys. In girls, but not in boys, having an immigrant mother also significantly related to overweight/obesity (OR, 2.71; 95%CI: 1.28–5.75) at 7 years, after controlling for other social factors. Conclusions: Gender differences in socialization may explain why at 7 years of age, girls' bodyweight is influenced by having even one overweight/obese parent (mother or father), while boys' bodyweight appears to be influenced only by father's overweight/obesity when only one parent is overweight/obese.     

Height-specific body mass index reference curves for Japanese children and adolescents 5−17 years of age

BACKGROUND: Body mass index (BMI) reference values in consideration of height variation have not previously been reported. This study established height-specific BMI reference curves for Japanese children and adolescents aged from 5 to 17 years. METHODS: The 2001 nationwide survey data were utilized for the study. First, the range of variation in BMI corresponding to height (mean +/- 2SD) at each age was compared with the range of variation in BMI corresponding to age (from minimum to maximum) at every cm height. Second, various age groups were combined, and percentile values of BMI (3rd, 5th, 15th, 50th, 85th, 95th, and 97th) were calculated for every cm height, regardless of age, and height-specific BMI reference values (males 100-179 cm, females 100-169 cm) were prepared. RESULTS: Variation in BMI due to variation in height at each age was significantly (P <0.05) greater than variation in BMI due to age at every cm height [males, 12.7 +/- 0.4 vs 9.2 +/- 0.4; females, 11.7 +/- 0.8 vs 8.8 +/- 0.3 (mean +/- SE)]. CONCLUSION: Although the use of standard values established in consideration of age and height is desirable for BMI-based guidelines for determining childhood overweight and obesity, to simplify the procedure for practical use, it is necessary to establish standard values by height, not by age. Height-specific BMI reference curves are useful for BMI-based evaluation of childhood overweight and obesity in the school health service and follow-up of obese children until adulthood.     

Recommended body mass index cutoff values for overweight screening programmes in Australian children and adolescents: Comparisons with North American values

Objectives: Guidelines for screening children and adolescents for overweight have recently been published by a North American Expert Committee. As Australian clinicians might uncritically adopt these recommendations, we explore the consequences of applying North American body mass index (BMI) cutoff values to an Australian population. Methodology The Australian BMI cutoffs were calculated using the methods recommended from height and weight data for 8492 schoolchildren aged 7-15 years old. Results Smoothed Australian BMI cutoffs were similar to those derived from the first United States National Health and Nutrition Examination Survey (NHANES-I) values for whites. However, the NHANES-I cutoffs would result in systematic misclassification. Among 7 year olds, the NHANES-I 85th percentile cutoff would wrongly classify 4.6% of normal males and 9.1% of normal females as ‘at risk of overweight’. At age 14 years, the NHANES-I 95th percentile cutoff would misclassify 3.5% of children as ‘overweight’ instead of ‘at risk of overweight’. Conclusion Australian screening programmes should use BMI cutoffs appropriately derived from local measurements, and these are given for Australian children.     

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.