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。     

儿童单纯性肥胖的诊断和治疗

关于肥胖的诊断国内外并尚无统一的判断标准，WHO认为10岁以下和10岁以上应有不同的评价标准，推荐10岁以下儿童使用身高别体质量，10～24岁采用体质量指数（BMI），国际肥胖问题工作组织（IOTF）认为BMI适宜用来判断儿童青少年超重和肥胖。WHO和IOTF提出的18岁BMI超重、肥胖标准完全一样，分别为25和30kg／m^2，而中国肥胖问题工作组（WGOC）制定的标准较比前二者低，18岁BMI超重和肥胖界值点分别为24和28kg／m^2。儿童肥胖的治疗不同于成人，成人期可使用的手术去脂、药物减肥、饥饿疗法、禁食等，在儿童时期均不宜使用。目前国内外公认儿童肥胖治疗方法包括行为矫正、饮食调整和运动等综合治疗方案。     

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。     

儿童生长发育和营养状况评价标准的应用及局限性

衡量儿童青少年生长发育和营养状况的参考标准较多，有WHO推荐的生长参考标准、国际肥胖问题工作组（IOTF）针对营养过剩的肥胖标准，也有各个国家建立的本国儿童生长发育标准。在中国，除了WHO生长参考标准和IOTF肥胖标准外，常用的还有中国9城市7岁以下儿童体格发育参考值和中国学龄儿童青少年超重、肥胖筛查体重指数（BMI）值分类标准等。     

北京市儿童青少年青春期发育与肥胖相关关系的研究

目的 分析北京市6~18岁儿童青少年青春期发育与超重肥胖的关系。方法 利用2004年北京市儿童青少年代谢综合征调查总样本中19 085名6~18岁儿童青少年的青春期发育、体重指数（BMI）和体脂含量百分比（FMP）等数据。采用女性乳房和男性睾丸容积Tanner分期指标衡量青春期发育，结合个体年龄将群体分为早、晚发育组；以BMI和生物电阻抗法所测FMP作为反映体脂含量的指标；7~18岁人群超重和肥胖的诊断采用中国肥胖问题工作组（WGOC）推荐的中国学龄儿童青少年超重、肥胖筛查BMI值分类标准进行，6岁组采用美国疾病预防与控制中心 2000年发布的儿童超重和肥胖BMI标准第P85和第P95分位值进行诊断；采用多元线形回归、Logistic回归分析早发育与体脂含量和超重、肥胖的相关联系。结果 早发育组的超重（合并肥胖）率和肥胖率均高于晚发育组，女性两组间差异大于男性；控制可能的混杂因素后，女性BMI和FMP与早发育呈正相关（BMI：β=2.25，P<0.001；FMP：β=4.55，P<0.001）；而男性BMI和FMP与早发育的联系相反，早发育组的BMI高于晚发育组，而FMP却低于晚发育组；以晚发育为参照组，控制年龄、城郊居住地等因素的影响后，早发育预测超重、肥胖的OR值（95%CI）：女性为3.39（2.94~3.92）和3.12（2.53~3.85），男性为1.12（0.96~1.31）和1.31（1.06~1.62）。结论 北京市儿童青少年青春期发育与肥胖密切相关，在评价超重、肥胖率及进行不同地区间肥胖流行状况的比较时，要注意青春期发育的效应修正作用。     

不同参考标准下重庆城区儿童超重／肥胖检出率比较

目的比较3种筛查标准下重庆城区儿童超重/肥胖现况,寻求适宜的儿童肥胖筛查标准。方法按照整群抽样原则抽取本市3个城区的12534名2～18岁儿童作为调查对象,测量其身高及体质量。并分别采用WHO的身高标准体质量法标准(标准1)、国际肥胖工作组(IOTF)的超重/肥胖体质量指数(BMI)标准(标准2)和国立卫生统计中心/疾病预防控制中心(NCHS/CDC)的BMI标准(标准3)评价儿童的超重/肥胖。结果按照标准1、2和3的规定,重庆城区儿童的超重检出率分别为13.0%、9.8%、9.8%;肥胖检出率分别为9.8%、2.9%、6.0%,均有显著性差异(Pa<0.001),且男童超重/肥胖检出率均高于女童。3种标准间,健康儿童、超重儿童或肥胖儿童的BMI均值均有显著性差异(Pa<0.001)。采用标准1和2得到的超重检出率,或采用标准1和3得到的超重检出率均在6岁前和14岁后2个年龄段存在统计学差异(Pa<0.01)。在2～6岁各年龄组,采用标准1和3得到的儿童肥胖检出率比较无显著性差异;在6～18岁各年龄组,采用标准1得到的肥胖检出率均显著高于采用标准2和3得到的肥胖检出率(Pa<0.01);在3～6岁、8～10岁、13岁组采用标准2和3得到的儿童肥胖检出率比较有显著性差异。结论儿童肥胖已经成为重庆城区重要的健康问题之一。采用3种标准筛查的儿童超重/肥胖检出率在2～18岁各年龄组均有所不同,应谨慎使用。     

广西南宁儿童青少年高血压现状及其与肥胖关系的研究

目的 了解广西南宁地区6~18 岁儿童青少年高血压现状及超重/ 肥胖与高血压发生的关系。方法 采用随机整群抽样方法对南宁地区7 893 名 6~18 岁儿童青少年进行问卷调查并测量血压、身高、体重等生长发育指标。结果 男女生收缩压（SBP）和舒张压（DBP）均随着年龄的增长呈递增趋势。高血压、高收缩压（HSBP）、高舒张压（HDBP）检出率分别为6.58%、4.02%、3.81%,其中男生高血压、HSBP 检出率明显高于女生（P<0.05）。正常组、超重组、肥胖组高血压检出率分别为3.87%、9.84%、19.23%。高血压、HSBP 及HDBP 检出率均表现为肥胖组> 超重组> 正常组 （P<0.05）。与正常组相比,超重组、肥胖组高血压发生的相对危险度（95%CI）分别为2.71（1.69~5.96）和5.91（3.46~7.63）。血压与年龄、身高、体重及体重指数均呈正相关（P<0.01）。结论 广西南宁6~18 岁儿童青少年血压的分布特征为：血压值与儿童青少年的性别、年龄、身高、体重和体重指数相关; 肥胖与高血压患病率密切相关,随着体重的增加,儿童青少年患高血压的危险亦增加。     

不同标准评估儿童青少年营养过剩发生率比较

目的采用常用的儿童青少年营养过剩评判标准,对同一研究人群进行超重与肥胖发生率描述,从而评估我国现行儿童青少年体质指数（BMI）标准。方法对7520例（年龄7～18岁,其中男／女：3725／3795例）中小学生的身高与体重值进行统计分析,分别按中国1995年发布的年龄别体重标准、美国国家疾病控制中心（CDC）2000年发布的BMI美国标准、中国2003年发布的试行BMI标准3项标准计算该人群超重、肥胖发生率,其中前2项标准的第90百分位定义为超重,第97百分位定义为肥胖,第3项标准则按已发布的超重与肥胖标准进行统计。比较两性别组营养过剩发生率差。结果“年龄别体重”标准对营养过剩以及肥胖检出率高于BMI标准检出率;采用美国CDC标准进行人群评价,漏查了相当数量的超重与肥胖个体,尤其是青春人群;中国儿童青少年BMI暂行标准更为可信。两性别组间比较可见,每一年龄段女孩的营养过剩发生率均显著低于男孩。结论作为儿童青少年人群超重与肥胖的筛查性指标,现行的中国儿童青少年BMI标准不失为一项有效标准;男孩组营养过剩的高检出率亦提出警示：该人群是超重与肥胖的重要防治人群。     

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。     

不同肥胖程度儿童罹患心血管代谢异常风险的横断面调查

目的 通过对肥胖学生健康评估体检,了解不同肥胖程度儿童青少年罹患高血压、高血糖和血脂异常等心血管代谢异常风险现况。方法 采用现况调查方法,对北京市西城区、海淀区和密云县17所中小学2012至2013年度参加学校常规年度体检并以BMI为评价指标筛查为肥胖的学生,进行以健康风险评估为目的的临床体检,体检内容包括体量（身高、体重及体质成分）,血压,空腹血糖,血脂（总胆固醇、三酰甘油、高密度脂蛋白和低密度脂蛋白）等指标。采用中国肥胖问题工作组（WGOC）制定的BMI超重、肥胖筛查标准判定肥胖状态;采用中国儿童青少年血压参照标准评定儿童高血压;采用儿童青少年血脂异常防治专家共识推荐的中国2岁以上儿童青少年血脂异常诊断标准判断血脂异常;以空腹血糖作为评价指标,采用美国糖尿病联盟推荐糖尿病诊断和分类标准进行评价。结果 1 809/3 227名(56.1%)肥胖学龄儿童青少年完成了现况调查且具有完整体检数据,平均年龄12.2岁。肥胖学生心血管代谢异常指标检出率分别为：高血压30.8%,血脂异常43.3%,糖尿病和空腹血糖受损66.6%,肝功能异常11.6%,脂肪肝16.0%,黑棘皮症21.9%。肥胖男生高血压、空腹血糖受损、肝功能异常、脂肪肝和2项及以上心血管代谢异常检出率均高于肥胖女生。重度肥胖占总肥胖人数的29.9%,协方差分析调整年龄和性别后,重度肥胖学生高血压、肝功能异常、脂肪肝、黑棘皮症和2项及以上心血管代谢异常检出率均高于轻中度肥胖学生。结论 肥胖儿童青少年高血压、高血糖和血脂代谢紊乱等心血管代谢异常高发,心血管代谢异常随肥胖程度增加呈上升趋势;儿童肥胖相关心血管代谢异常高发需要得到更广泛关注。     

Overweight, obesity, weight-related concerns and behaviours in Hong Kong Chinese children and adolescents

Aim: To study the prevalence of overweight and obesity, and weight-related concerns and behaviours among overweight, obese and non-overweight children and adolescents. Methods: We carried out a cross-sectional survey of all Chinese students in primary schools in the Central and Western District of Hong Kong in March 2002. Thirty-one of 32 schools participated, and 5402 boys and 5371 girls aged 8 to 15 y who completed a standardized questionnaire were included. We used the International Obesity Task Force definition (IOTF reference) to define overweight and obesity. Results: The prevalence (95% CI) of overweight was 16.4% (15.7-17.1%) (19.9% in boys, 12.9% in girls), and that of obesity was 7.7% (7.2-8.2%) (10.3% in boys and 5.1% in girls). The combined prevalence of overweight and obesity was similar to that based on the local reference. Overweight children had more concerns about their weight than obese children. They were more likely than obese children to feel fat, wish to be lighter, diet and exercise to lose weight. Although obese children were heavier, they did not make more effort to lose weight than overweight children.

Conclusions: The differences in weight-related concerns and behaviours among overweight, obese and non-overweight children suggested good validity of the IOTF reference and the self-reported data. The differences between overweight and obese children suggested that the two groups had different psychological states and that they needed different weight management programmes and other intervention strategies.     

Prevalence and regional distribution of childhood overweight and obesity in Shandong Province, China

Background

The rising prevalence of childhood obesity was observed in China. This study assessed the prevalence and district distribution of childhood obesity in Shandong Province, China.

Methods

A cross-sectional study was conducted in the province. A total of 42 275 students (21 222 boys and 21 053 girls) aged 7–18 years from 16 districts participated in this study. Height and body weight of all subjects were measured, and the body mass index (BMI) was calculated. The prevalence of overweight and obesity was obtained according to the International Obesity Task Force (IOTF) cut-offs.

Results

In 2010, the prevalence rates of combined overweight and obesity reached 26.86% in urban boys, 18.32% in rural boys, 14.36% in urban girls, and 11.31% in rural girls, respectively. An increasing trend was observed in the prevalence of overweight and obesity from the low socioeconomic status (SES) group to the moderate and high SES groups. The prevalence rates of combined overweight and obesity in the three SES groups were 18.46%, 21.08% and 27.31% in boys and 10.43%, 12.42% and 15.18% in girls, respectively.

Conclusions

There is a high level of overweight and obesity among children and adolescents in Shandong Province, China. The distribution of childhood obesity is positively associated with the regional SES.     

The role of 1-h physical activity every day in preventing obesity in adolescents in Shandong, China

Several studies have reported that physical inactivity and sedentary lifestyle are associated with being overweight and obese in children and adults. A new policy of 1-h physical activity (PA) every day was released by the Chinese government. The present study examined the role of 1-h PA every day in preventing obesity in adolescents in Shandong, China. A total of 29,030 students (14,578 boys and 14,452 girls) aged 10–18 years participated in this study. Height, weight, waist circumference (WC), and skinfold thickness (SFT) of all subjects were measured; body mass index (BMI) of adolescents was calculated from their height and weight, and the prevalence of overweight and obesity was obtained according to the International Obesity Task Force cutoffs. All subjects were divided into two groups. Group 1 had a PA of more than 1 h/day while group 2 had less than 1 h/day. Comparisons of BMI, WC, SFT, and prevalences of overweight and obesity between the two groups were made. The overall percentages of students in group 1 were 34.29 % in boys and 30.15 % in girls. The prevalences of overweight and obesity for both boys and girls were all significantly lower in group 1 than in group 2 in all age categories. In conclusion, 1-h PA every day has a beneficial effect in preventing obesity in adolescents in Shandong, China. These observations highlight the importance of PA in the prevention of overweight and obesity in adolescents.     

A study of growth parameters and prevalence of overweight and obesity in school children from delhi

OBJECTIVE: (1) To assess the height, weight and body mass index (BMI) of school children from Delhi and generate percentile charts as appropriate for age, gender and socio-economic status. (2) To determine the prevalence of overweight and obesity in school children from low and upper socioeconomic status (LSES and USES respectively). DESIGN: Cross sectional evaluation of anthropometric parameters in Delhi school children (5-18 years) from different geographical zones. SETTING: Government schools (non-fee paying) and Private Schools (fee paying) in Delhi. SUBJECTS: 21485 children, 8840 (3566 boys, 5274 girls) from government schools and 12645 (6197 boys, 6448 girls) from private schools. Methods: Subjects underwent assessment of height and weight and calculation of BMI. Children were classified as normal, overweight and obese as per IOTF guidelines. Height, weight and BMI percentile charts specific for the socioeconomic status were generated using the LMS method. Prevalence of overweight and obesity was assessed and compared between the two socio-economic groups. RESULTS: A significant difference was noted in height, weight and BMI between LSES and USES. The prevalence of overweight and obesity in USES children was 16.75 % and 5.59 % in boys and 19.01 % and 5.03 % in girls respectively. CONCLUSIONS: There is a significant disparity in anthropometric parameters between children from USES and LSES, with a high prevalence of overweight and obesity in USES children.     

Prevalencia de obesidad infantil en la Región de Murcia,valorando distintas referencias para el índice de masa corporal

IntroductionChildhood obesity is a problem of high magnitude with serious repercussions on health, which justifies estimating its prevalence at local level to identify conditioning factors and to take preventive actions. The main objective of the present work is to estimate the prevalence of overweight and obesity in the children in the general population of the Murcia Region, using the body mass index (BMI) and applying the International Obesity Task Force (IOTF) criteria, and to compare these results with the ones obtained from other frequently used references in Spain.Material and methodsThe BMI of 178,894 children aged from 2 to 14 years was determined. The prevalence of overweight and obesity was compared to the IOTF, to the studies of the World Health Organization, as well as those of the Orbergozo Foundation (FO), and the Cross-sectional Spanish Growth Study (ETEC) references. The agreement between the different results was evaluated using the kappa index.ResultsThe evaluation using the IOTF cut-off points gave an overweight prevalence of 20.6% (95% CI: 20.4-20.8), an obesity prevalence of 11.4% (95% CI: 11.2-11.5) and an overweight plus obesity prevalence of 32% (95% CI: 31.8-32.2), with this last one being higher in girls (33.2%) than in boys (30.9%). The highest agreement is between IOTF and FO-2011 (kappa = .795) and between FO-2011 and ETEC (kappa = .794).ConclusionA high prevalence of overweight and obesity in children in the Region of Murcia was found. The ETEC and the FO-2011 study showed the highest agreement with the results obtained using the IOTF criteria.     

中国0～18岁儿童、青少年体块指数的生长曲线

目的 研究制定0～18岁中国儿童的体块指数(BMI)生长参照值及生长曲线.方法 根据"2005年中国九市7岁以下儿童体格发育调查"及"2005年中国学生体质与健康调研"所获得的资料,采用九省市93 702名0～19岁(差1天未满19岁)城区健康儿童青少年的身高(3岁以下测量身长)、体重测量数据,计算BMI值并应用LMS方法对数据进行拟合修匀,通过L、M、S三个参数计算产生所需要的百分位和标准差单位(Z分值)数值并绘制相应的曲线图.采用与中国成人BMI界值点接轨的方法探讨中国儿童超重肥胖的筛查界值点.结果 制定出0～18岁儿童的BMI百分位数及标准差单位生长参照值及曲线图,并计算出了筛查2～18岁儿童超重肥胖的参考界值点.本参照曲线与世界卫生组织(WHO)BMI曲线及美国疾病预防控制中心2000年(CDC2000)曲线进行比较,三者之间存在明显的差异,尤其是在青春期、第97百分位(P97)上.总体上中国男童BMI在p97处于三者之间,而女童最低.与日本比较,在P97也有明显差异.结论 使用BMI生长曲线图有利于儿童青少年的生长与营养监测,早期识别童的超重和肥胖,建议在临床工作及预防保健服务领域推广使用.     

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.