应用生物电阻抗法测定儿童体脂含量进行肥胖判定的探讨

应用生物电阻抗法测定儿童体脂含量进行肥胖判定的探讨北京军区军事医学研究所（石家庄０５００８１）于瑞敏董宏彬李清亚郑健忠判定儿童肥胖的方法很多，有身高体重法、身体质量指数（ＢＭＩ）法、皮褶厚度计算体脂百分含量（ＢＦ％）法、皮褶厚度与ＢＭＩ双超法、体重与...     

成人BMI与体脂含量和脂肪分布的关系

目的 :　调查成人超重和肥胖的发生率 ,探讨体质指数 ( BMI)与体脂含量、腰臀围之间的关系。方法 :　对 1 0 0 5名健康成年人进行人体测量 ,按 WHO对亚洲成年人的 BMI新定义分为 5组 ,对腰围、臀围、腰臀围比值和生物电阻抗法 ( BIA法 )及皮褶厚度法体脂含量的分布进行分析。结果 :　以 BMI法判断超重和肥胖的发生率 ,男性超重率和 度肥胖率明显高于女性 ,男女人群中 度肥胖发生率均较低 ;在相同 BMI组中 ,男性的平均年龄比女性低 ( P<0 .0 1 )。而 BIA法和皮褶厚度法肥胖检出率明显低于 BMI法 ,且女性体脂含量、三头肌皮褶厚度及肩胛下皮褶厚度显著高于男性。不同年龄组 BMI均与体脂含量呈显著正相关。女性超重组的腰围平均值为 80 cm,而男性 度肥胖组的腰围平均值 >90 cm。结论 :　男性超重和肥胖发生的年龄早于女性。以 BMI法判断肥胖和以 BIA法及皮褶厚度法体脂含量法判断肥胖有很大差别 ,仅以 BMI判断肥胖不够准确 ,尚需考虑年龄、性别及运动情况等影响因素。     

单纯性肥胖儿童体质状况调查分析

[目的 ]研究单纯性肥胖儿童与正常体重儿童身体形态、机能及素质发育状况。 [方法 ] 2 0 0 1年在济南市市区随机整群抽取 2所小学 ,在 2 3 0 0名 7～ 12岁学生中 ,通过目测 ,按身高标准体重和皮褶厚度并排除病理性肥胖筛选出肥胖儿童 14 3名作为肥胖组 ,以正常体重儿童 60人为对照组 ,检测形态指标 (身高、体重、胸围、皮褶厚度 )、机能指标 (血压、脉搏、肺活量、握力 )和素质指标 (立定跳远、仰卧起坐、坐位体前屈、2 5m× 4往返跑 ) ,采用《中国学生体质与健康研究检测细则》对受试儿童进行检测。 [结果 ]肥胖组的形态指标体质指数、胸围、皮褶厚度、肩胛下角皮褶厚度 /肱三头肌皮褶厚度均明显高于对照组 ;功能指标中 ,收缩压、舒张压、脉搏肥胖组均高于对照组 ,肺活量指数、握力指数肥胖组低于对照组 ;素质指标中 ,立定跳远、仰卧起坐、坐位体前屈肥胖组均低于对照组 ,2 5m× 4往返跑所用时间肥胖组多于对照组。体质指数、肥胖度、肩胛下角皮褶厚度 /肱三头肌皮褶厚度与血压均存在正相关关系。 [结论 ]单纯性肥胖已明显影响儿童的体质状况 ,已对健康构成危害。     

92名高校女生体质量指数腰围和皮褶厚度分析

目的探讨体质量指数、腰围与皮褶厚度的关系。方法对92名高校护理专业女生检测其身高、体质量、腰围及皮褶厚度,并进行统计分析。结果高护专业女生体质量超标和肥胖率显著低于一般人群,体质量超标肥胖组的腰围、皮褶厚度显著大于正常体质量组。回归分析表明体质量指数与肩胛部、腹部皮褶厚度呈显著正关,腰围与上臂部、腹部皮褶厚度呈显著正关。结论高护专业女生体质量超标和肥胖率较低。评估体质量超标和肥胖时,除了检测体质量指数与腰围以外,还应检测皮褶厚度,尤其是腹部皮褶厚度。     

山东省大学生身体发育及体成分研究

目的了解山东省大学生发育及体成分的变化趋势,为改善大学生体质状况提供依据。方法按《中国学生体质健康调查研究测试细则》要求,固定专人测量身高、体质量、胸围,用皮褶卡钳测量右上臂肱三头肌部和肩胛下角部皮褶厚度,用长岭公式估测体密度,用Brozek公式估算体脂比(BF%),计算体脂肪(BF=BF%×体质量)和瘦体质量(LBM=体质量-BF)。结果2005年与2000年相比,山东省19~22岁大学生城男、城女、乡女身高分别平均增长0.90 cm、1.32 cm1、.84 cm、和0.56 cm;城女、乡男、乡女体成分都有明显变化,BF%分别下降1.30%、1.05%和1.87%(P<0.01)。结论近5年山东省大学生身体发育和体成分都有明显变化,制订大学生卫生保健措施时要结合其发育特点。     

受试者工作曲线法对常见儿童肥胖筛查指标的评价效果分析

目的 了解常见的儿童肥胖筛查指标评价效果,为更准确的选择儿童肥胖筛查指标提供参考.方法 按照《2010年全国学生体质健康调研工作手册》规定的方法进行身体指标测量,用ROC曲线法比较常见的儿童肥胖筛查指标的灵敏度和特异度.结果 采用常见指标筛查儿童超重/肥胖和单独筛查肥胖时,ROC曲线下面积均高于0.8,灵敏度和特异度均较高.其中腰高比的ROC曲线下面积最大.在筛查超重肥胖时,ROC曲线下面积分别达到0.975,0.958.结论 腰高比、皮褶厚度和维尔维克指数对儿童肥胖的筛查效果更好,应加强对这些指标的研究和关注.     

重庆市7～22岁学生皮褶厚度及其与生长发育的关系

目的 了解重庆市学生皮褶厚度现状.研究利用皮褶厚度指标评价学生生长发育水平的方法.方法 对重庆市2010年全国体质健康调研中的学生皮褶厚度随年龄变化趋势进行分析,根据长岭晋吉公式估算体密度D,根据brozek公式估算体成分,并利用体脂比判定肥胖状况,对不同性发育水平学生皮褶厚度进行比较.结果 男生皮褶厚度在11岁达到高峰,其后逐渐下降,18岁后义开始上升;女生皮褶厚度均随年龄增长呈现上升的趋势,尤其是青春后期增幅十分明显.男生体脂比从7岁的15.54％上升到11岁的19.95％,之后逐步下降;女生从7岁的19.17％的上升到11岁的21.84％,12岁最低,之后逐步上升,17,18岁有所下降.男生肥胖率为15.10％;女生14岁以下肥胖率为15.40％,15岁以上为6.40％,均为轻度肥胖所占比例最高.已初潮女生3处皮褶厚度均高于同龄末初潮女生,而已出现首次遗精的男生无此现象.结论 皮褶厚度是学生营养状况及体成分评价分析的一个重要指标,皮褶厚度与性发育早晚存在一定的关联.     

单纯性肥胖儿童的体质及健康状况分析

目的 探讨单纯性肥胖对儿童体质及健康的影响,为单纯性肥胖的预防及早期干预提供理论依据。方法 结合教育部、国家体育总局《国家学生体质健康标准》细则要求,并参照Achenbach 儿童行为量表,比较分析103例单纯性肥胖儿童和102例正常对照组儿童的体质及健康现状。结果 1)肥胖组儿童的身体形态指标包括体质指数、胸围、皮褶厚度均明显高于对照组;2)生理机能指标中,肺活量体质指数肥胖组低于对照组;3)身体素质指标中,立定跳远、实心球、坐位体前屈及握力指数肥胖组均低于对照组, 25 m×2往返跑所用时间肥胖组大于对照组;4)心理素质及社会适应能力肥胖组低于对照组;5)体质健康指标综合评价肥胖组优良率为11.7%,达标率为67.0%,对照组优良率为59.8%,达标率为91.2%。结论 单纯性肥胖明显影响儿童的身体形态、生理机能、体质、心理及社会适应能力等,对儿童健康成长构成危害,应当引起医学及教育工作者的高度重视。     

维吾尔族大学生身体成分与身体形态指标的关系

目的了解维吾尔族大学生体成分及身体形态指标的关系,为维吾尔族大学生肥胖干预以及学生营养教育、科学参与体育锻炼提供理论依据。方法随机抽取新疆师范大学14个班的在校维吾尔族大学生659名,采用人体成分分析仪及《国家学生体质健康标准》规定的项目和测试要求进行测试,比较不同体成分大学生间身体形态指标。结果维吾尔族男女大学生肥胖组BMI指数均高于正常组,超重组的腰臀比均高于正常组,差异均有统计学意义(P值均<0.01);正常、超重、肥胖3组的上臂皮褶厚度差异无统计学意义(P>0.05)。结论维吾尔族大学生的脂肪主要堆积于腹部。应在控制高热量饮食的基础上进行科学的体育锻炼,加强营养知识的宣传和普及,倡导平衡膳食合理营养。     

湘西州7～15岁苗族学生皮褶厚度及体成分分析

目的 了解湘西州7～15岁苗族学生皮褶厚度及体成分发育特点,为增强少数民族学生体质提供参考。方法 2019年10—11月分层整群随机抽取湘西州7～15岁苗族学生1 064名,测量身高、体重和肱三头肌皮褶(TS)、肩胛下皮褶(SS)、腹部皮褶(AS)厚度。根据长岭和Brozek公式估算体成分。结果 随着年龄的增长,苗族学生皮褶均逐渐增厚,男生13岁、女生12岁后增幅明显;各年龄组女生TS、SS与AS均厚于男生,8岁(t=2.659、2.392、2.264)、11岁(t=3.317、3.251、3.179)、13岁(t=5.196、3.943、4.651)、14岁(t=5.941、4.630、3.228)和15岁(t=4.822、4.292、3.210)年龄组比较差异有统计学意义(P<0.05);体脂率、脂肪质量及其指数均值女生高于男生,差异有统计学意义(P<0.05或<0.01);男女生瘦体质量及其指数年龄变化曲线逐渐上升并出现2次交叉;除男生体脂率外,体成分各指标与皮褶厚度均与年龄呈显著正相关(P<0.01);与8个族群比较,苗族男生肱三头肌皮褶厚度(9.22 mm)与内蒙达斡尔族、肩胛下皮褶厚度(7.33 mm)与怒江怒族较为接近,女生肱三头肌皮褶厚度(11.98 mm)与内蒙达斡尔族、肩胛下皮褶厚度(9.35 mm)与广东瑶族较为接近。结论 湘西州苗族农村学生皮褶厚度及体成分发育符合生长发育一般规律,皮下脂肪含量相对较少,并存在性别和年龄差异。     

Receiver operating characteristic analysis of body mass index, triceps skinfold thickness, and arm girth for obesity screening in children and adolescents

BACKGROUND: Valid and practical methods based on health-related criteria for obesity screening in children and adolescents are not available. Arbitrarily defined body mass index (BMI) cutoffs have been proposed to select adolescents at high risk of developing obesity in adulthood. OBJECTIVE: We assessed the usefulness of BMI, triceps skinfold thickness, and upper arm girth for screening for obesity by using a health-related definition of obesity (> or = 25% body fat in boys and > or = 30% body fat in girls) and a criterion method (dual-energy X-ray absorptiometry) that estimates percentage fat without the potential bias associated with other methods in adolescents. DESIGN: This was a cross-sectional study of Portuguese boys (n = 165) and girls (n = 163) aged 10-15 y. Nonparametric receiver operating characteristic (ROC) analysis was used to define the best tradeoff between true-positive and false-positive rates. RESULTS: True-positive rates ranged from 67% to 87% and from 50% to 100% in girls and boys, respectively, and false-positive rates ranged from 0% to 19% and from 5% to 26%, respectively. For children aged 10-11 y, the areas under the curves (AUCs) for ROCs, an index of diagnostic accuracy, were close to 1.0, suggesting very good accuracy. For older boys and girls, AUCs for triceps skinfold thickness were similar to or greater than AUCs for BMI and upper arm girth. CONCLUSIONS: The results suggest that triceps skinfold thickness gives the best results for obesity screening in adolescents aged 10-15 y. BMI and upper arm girth were reasonable alternatives, except in 14-15-y-old boys, in whom both indexes were only marginally able to discriminate obesity.     

Body composition in children: proposal for a method for calculating body fat percentage from total body density or skinfold-thickness measurements

A method is presented for assessing childhood obesity in a more objective way than most other routine methods used for diagnosing childhood obesity. The sum of bicipital, tricipital, subscapular, and suprailiacal skinfold thicknesses is related to total body density by use of theoretically defined prediction equations. Total body density is used to estimate total body fat percentage by use of age- and sex-dependent equations on the relation between body fat percentage and body density. These equations are constructed on the basis of published data on changes in the density of fat-free mass with age in children. With the proposed method childhood obesity can be assessed routinely in a more consistent way than with most other routine methods used to diagnose obesity in children. A preliminary validation study indicated that in children aged 7-10 y predicted body density differed on average less than 1% from measured body density. In addition, predicted body density was highly correlated (r greater than 0.7) with measured body density.     

中老年人身体脂肪含量的测定

用排水法和皮褶厚度法对55～69岁的115名中老年人体脂含量进行了测量和比较,结果表明,两种方法测得值差异有显著性。用前一种方法测值与体围指标(X_1:前臂围、X_2:上臂围、X_3:小腿围,X_4:大腿围、X_5:腹围、X_6:臀围)、BMI(Body mass index)建立测体脂含量(F％)的回归方程,男性F％=-15.88+1.37BMI+0.0102Y,女性为:F％=-34.96+0.51BMI+0.1469Y,其中Y为X_1+X_2+X_3+X_4+X_5+X_6之和,BMI=体重(kg)/身高(m~2)。该回归方程提供了测定中老年人体脂含量的简易方法。 将体脂含量百分比(F％)划分肥胖法与按超体重百分比和BMI划分肥胖法进行比较,结果是:超体重百分比法划分肥胖率较F％法低,BMI法则较F％法高。     

Precursors of essential hypertension. The role of body fat distribution pattern

Progression from normotension between 1964 and 1972 to essential hypertension by age 55 years was documented in 1,031 adult members of the Kaiser Permanente Medical Care Program (Northern California region) from computerized multiphasic health checkup records and medical record review. Each case was matched to a persistently normotensive control on age, sex, race, number, and dates of multiphasics. In 609 pairs with baseline measurements of subscapular and triceps skinfolds, mean interval from baseline to the case's first hypertensive multiphasic was 5.7 years, and mean age at onset of hypertension was 47 years. Baseline measures of body mass index, subscapular skinfold, and triceps skinfold were each predictive of development of hypertension (odds ratios 3.85, 3.75, and 2.29 respectively, comparing highest with lowest quintiles, p less than 0.0001 for each). When both skinfolds were included in the same model, subscapular skinfold was highly predictive and triceps skinfold was no longer related to risk. When the authors controlled for overall obesity (body mass index), subscapular skinfold remained highly predictive (p less than 0.0001). In 330 pairs who also had skinfold measurements at the hypertensive multiphasic, weight gain was a strong predictor of hypertension. Increase in subscapular skinfold conferred a small increase in risk in women only. The authors conclude that centrally deposited body fat increases risk for developing essential hypertension independent of the overall level of obesity, while peripherally deposited fat does not.     

Sensitivity and specificity of overweight classification of adolescents,Brazil

OBJECTIVE: To evaluate the prevalence, sensitivity and specificity of two risk classifications of obesity based on the body mass index (BMI). METHODS: Five-hundred and two adolescents, aged 12-18 years, participants of a health and nutrition survey conducted in 1996 in the city of Rio de Janeiro, Brazil, were evaluated. The study variables included: weight, stature, BMI, and subscapular skinfold, according to sex and age. The BMI classifications were compared to a fatness classification based on the 90th percentile of subscapular skinfold thickness in American adolescents. RESULTS: The prevalence of risk of obesity was higher when using the subscapular skinfold measurement (p<0.0001), compared to both BMI-based classifications, which showed similar values. Specificity was higher than sensitivity in both BMI-based classifications. The balance between sensitivity and specificity was close to the 70thBMI percentile for boys and girls below 14 years old. For boys older than 15 the cutoff value was the 50th percentile. CONCLUSION: Both BMI-based classifications were more suitable to identify adolescents without obesity, and their sensitivities were too low for tracking risk of obesity.     

A Three-year Study of Obesity and its Relationship to High Blood Pressure in Adolescents

A sample of 356 matched cases were tracked for three years during high school. Measures taken included self-reported behavior and clinical measures of height, weight, skinfold, blood pressure, and body mass index. Data were analyzed by ethnic group, age, and sex groups. Three year (1981-1982 to 1984-1985) trends for students who were overfat, overweight, and obese revealed: a relatively greater proportion of female to male students were overfat as seniors; overweight trends for each of the four groups (ethnic group and gender) were stable over the study period; a sharp increase of obesity trends among black females was observed; and significant positive relationships existed between Percent Ideal Body Weight, skinfold thickness, Body Mass Index, and blood pressure among females of both ethnic groups. The hypothesis that the early onset of obesity is an indicator of obesity in older adolescents was supported. Students classified at risk as freshmen are more likely to remain at risk as seniors.     

Obesity-related knowledge, attitudes, and behaviors in obese and non-obese urban Philadelphia female adolescents

OBJECTIVES: To examine relationships between knowledge, attitudinal and behavioral factors, and obesity and to determine how these factors influence obesity status in west Philadelphia female adolescents. RESEARCH METHODS AND PROCEDURES: A matched-pairs study was conducted with 32 stature- and age-matched pairs of obese (body mass index and triceps skinfold > or =95th percentile of National Health and Nutrition Examination Survey I) and non-obese (body mass index and triceps skinfold between the 15th and 85th percentiles of National Health and Nutrition Examination Survey I) female African American adolescents (aged 11 to 15 years), selected from a school-based study sample, based on obesity status and matching criteria. Adolescents were compared on the following measures: physical activity, inactivity, dietary intake, eating attitudes, health behavior knowledge, body image, self-esteem, and maturation status. Differences between obese and non-obese females were tested using paired t tests and Wilcoxon matched-pairs signed-rank tests. RESULTS: Physical activity, inactivity, and perception of ideal body size emerged as the most important contributory factors to obesity status. There were no statistically significant matched-pair differences in macronutrient and micronutrient intakes, self-esteem, eating attitudes, health behavior knowledge, or maturation status of these adolescents. Obese adolescents had significantly lower levels of physical activity, higher inactivity, and a larger perception of ideal body size than non-obese adolescents. DISCUSSION: Knowledge and attitudinal factors (with the exception of perception of ideal body size) had far less association with obesity than activity-related behavioral factors. These findings suggest that future intervention strategies should pay particular attention to physical activity, inactivity, and body image attitudes.     

Alternative anthropometric measurements for the Thai elderly: Mindex and Demiquet

This cross-sectional study examined the relationship between alternative anthropometric indices and the nutritional and metabolic status of the Thai elderly. Four rural communities, each from the 4 main regions of Thailand were surveyed. A total of 2,324 subjects, 60 years old and over were included in the study. Mindex and Demiquet had a very strong relationship to body mass index with the r values of 0.93 and 0.88, respectively. Fat weight had the highest correlation with body mass index in older women, r = 0.94 (P< 0.001) and with Mindex, r = 0.93 (P< 0.001). In regard to anthropometric measurements, the mid-arm circumference had the strongest relationship to all three Quetelet indices, r = 0.76-0.87 (P< 0.001), while subscapular skinfold thickness performed best among skinfold measurements, r = 0.69-0.74 (P< 0.001). BMI achieved a significantly higher degree of correlation with triceps and supra-iliac skinfold thickness, mid-arm circumference and fat weight than Demiquet (P< 0.001 for all variables). The lymphocyte count was the only laboratory test that related rather well to all three Quetelet indices. All three Quetelet indices had nearly the same pattern of relationship to various nutritional parameters. The cut-off points of Mindex denoting under-nutrition, overweight and obesity I in women were 55.95, 69.55 and 75.60 kilogram/metre, respectively. At the same time, the cut-off points of Demiquet denoting under-nutrition, overweight and obesity I in men were 75.60, 93.98 and 102.16 kilogram/metre2, respectively. All this information supports the benefit of using Mindex and Demiquet as alternatives to body mass index for nutritional assessment in older Asian people, especially for the malnourished ones.