剖宫产与学龄前儿童感觉统合失调的前瞻性队列研究

目的 采用前瞻性队列研究,评价剖宫产与学龄前儿童感觉统合失调的关联。 方法 依托上海交通大学医学院附属新华医院和附属国际和平妇幼保健院2012年建立的多中心母婴队列,于2017年采用儿童感觉统合能力发展评定量表,从前庭平衡、触觉防御和本体觉3个维度评价392名学龄前儿童感觉统合功能。剖宫产出生为暴露因素,阴道分娩者作为对照组。采用多因素logistic回归分析评估剖宫产与感觉统合各维度失调的关联。 结果 学龄前儿童感觉统合失调率为21.9%（86/392）,前庭平衡、触觉防御和本体觉失调率分别为5.9%（23/392）、5.4%（21/392）和15.1%（59/392）。调整母亲分娩年龄、母亲受教育程度及儿童出生情况等混杂因素后,剖宫产儿童发生本体觉失调的风险性显著增加（RR=4.16,95%CI：1.41~12.30,P<0.05）。按性别分层分析发现,剖宫产男童本体觉失调的发生风险高于阴道分娩男童（RR=5.75,95%CI：1.26~26.40,P<0.05）。 结论 剖宫产能显著增加学龄前儿童本体觉失调的发生风险,尤其是对男童的影响更为明显。     

1 732例儿童血清维生素K2临床分析及其与骨代谢标志物关系的研究

目的 分析儿童血清维生素K₂（vitamin K₂,VitK₂）临床特征及其与骨钙素（osteocalcin,OC）、Ⅰ型前胶原氨基端前肽（type Ⅰ procollagen amino-terminal peptide,PINP）、Ⅰ型胶原交联羧基末端肽（type Ⅰ collagen carboxy-terminal peptide,CTX）的相关性。 方法 前瞻性选取2020年10月至2021年10月门诊常规体检儿童1 732例,测定血清VitK₂、25羟维生素D［25-hydroxyvitamin D,25(OH)D］水平,按年龄段分为<1岁组、1~3岁组、>3~6岁组、>6~14岁组,进行血清VitK₂相关临床分析。筛选出25(OH)D≥50 nmol/L的儿童共309例,测定血清OC、PINP、CTX水平,分析不同年龄段水平及其与血清VitK₂的相关性。 结果 血清VitK₂缺乏率为52.31%（906/1 732）。VitK₂缺乏组超重/肥胖、生长痛（≥3岁）发生率均高于VitK₂正常组（P<0.05）;1~3岁组和>6~14岁组血清VitK₂缺乏率（P<0.0083）、血清VitK₂水平（P<0.05）差异有统计学意义。<1岁组儿童血清CTX水平高于>3~6岁组和>6~14岁组,而<1岁组儿童血清PINP水平低于>3~6岁组和>6~14岁组（P<0.05）;<1岁组血清OC水平低于>6~14岁组（P<0.05）。血清VitK₂与OC呈正相关（r_s=0.347,P<0.01）,CTX与PINP呈负相关（r_s=-0.317,P<0.01）。 结论 VitK₂缺乏可能与超重/肥胖有关;血清VitK₂可影响OC水平进而影响骨骼健康。     

运动康复训练对支气管哮喘儿童运动能力和生活质量干预效果的系统评价

目的 系统评价运动康复训练对支气管哮喘儿童运动能力和生活质量的干预效果。 方法 检索PubMed、Cochrane Library、Web of Science、EBSCO、中国知网、维普数据库、万方数据库等数据库从建库至2021年2月关于运动康复训练对支气管哮喘儿童影响的随机对照试验。采用RevMan 5.3软件进行Meta分析。 结果 共纳入14项研究,共计990例受试者。Meta分析结果显示：（1）运动康复组运动能力优于常规治疗组：6 min步行试验的步行距离（MD=108.13,P<0.01）、自我疲劳感觉值（MD=-2.16,P<0.001）、峰值功率（MD=0.94,P=0.001）均显著优于常规治疗组;（2）在儿科哮喘生活质量问卷中,运动康复组生活质量总评分（SMD=1.28,P=0.0002）显著高于常规治疗组,活动受限评分（SMD=1.38,P=0.0002）、症状评分（SMD=1.02,P<0.001）、情感功能评分（SMD=0.86,P<0.001）均显著高于常规治疗组。 结论 运动康复训练对支气管哮喘儿童运动能力和生活质量具有一定的改善作用,但受纳入研究数量和质量的限制,作为指导临床应用还需进一步研究和验证。     

大鼠不同时期高脂饮食对子代糖脂代谢的影响及机制研究

目的 探讨Sprague-Dawley母鼠不同时期高脂饮食对子代糖脂代谢的影响及相关机制。 方法 根据孕前及孕期哺乳期饮食的不同,将母鼠随机分为4组（n=9）：CC组（孕前、孕期哺乳期均正常饮食）、HC组（孕前高脂饮食、孕期哺乳期正常饮食）、CH组（孕前正常饮食、孕期哺乳期高脂饮食）、HH组（孕前、孕期哺乳期均高脂饮食）;子代生后3周断奶后,全部给予正常饮食。记录母鼠孕前、孕期体重及仔鼠体重。取各组幼年期（3周）、成年期（12周）雄性仔鼠,检测空腹血糖（glucose,GLU）、胰岛素（insulin,INS）及肝脏三酰甘油（triglyceride,TG）、总胆固醇（total cholesterol,TC）水平,计算胰岛素抵抗指数（homeostasis model assessment of insulin resistance,HOMA-IR）、糖耐量试验（glucose tolerance test,GTT）及胰岛素耐量试验（insulin tolerance test,ITT）的曲线下面积（area under the curve,AUC）;取肝脏组织行苏木精-伊红染色和油红O染色,观察肝脏脂质沉积;检测肝脏糖脂代谢关键基因IR、IRS、AKT和FASN、SREBP1c、PPARα的mRNA及其蛋白表达水平。 结果 孕前高脂饮食组（HC组、HH组）母鼠体重较正常饮食组（CC组、CH组）显著增加（P<0.001）;HC组、CH组、HH组母鼠孕期增重较CC组显著增加（P<0.001）。生后3周时,HC组、CH组、HH组的仔鼠体重、肝脏TG及TC含量,以及FASN、SREBP1c、PPARα的mRNA及其蛋白表达水平均较CC组显著增加（P<0.05）,肝脏脂质沉积增加,其中HH组增加最显著;HH组的空腹GLU及INS水平、HOMA-IR、GTT-AUC、ITT-AUC及肝脏p-IRS蛋白表达水平均较CC组显著增加,肝脏IR、IRS的mRNA及其蛋白表达水平均较CC组显著降低（P<0.05）。生后12周时,HC组、CH组、HH组的仔鼠体重、空腹GLU及INS水平、HOMA-IR、GTT-AUC、ITT-AUC、肝脏TG及TC含量、p-IRS蛋白表达水平,以及FASN、SREBP1c、PPARα的mRNA及其蛋白表达水平均较CC组显著增加（P<0.05）,肝脏脂质沉积增加,其中HH组增加最显著;HC组、CH组、HH组IR、IRS、AKT的mRNA水平均较CC组显著降低,IR、IRS、p-AKT蛋白表达水平均较CC组显著降低（P<0.05）。HC组与CH组在不同时期的糖脂代谢水平未见显著性差异（P>0.05）。 结论 大鼠怀孕前后不同时期的高脂饮食对子代的糖脂代谢具有不同的影响,孕前、孕期、哺乳期全程高脂饮食对子代糖脂代谢影响最大;大鼠高脂饮食对其子代糖脂代谢的影响考虑与糖脂代谢基因的表达改变有关。 引用格式:     

肥胖儿童阻塞性睡眠呼吸暂停的临床特征

目的 研究肥胖儿童合并阻塞性睡眠呼吸暂停（obstructive sleep apnea，OSA）的临床特征。 方法 对在深圳市儿童医院呼吸科行多导睡眠监测的肥胖并诊断为OSA的33例7~15岁儿童的临床资料进行回顾性分析，并选取50例体重正常的、性别及年龄相匹配的OSA患儿作为对照组。 结果 33例合并肥胖的OSA儿童中，常见的日间症状前3位为：注意力不集中30例（91%），嗜睡22例（67%），晨起疲劳21例（64%）；夜间症状前3位为：打鼾27例（82%），张口呼吸20例（61%），出汗16例（48%）。与正常儿童参考值相比，肥胖OSA组和对照组两组患儿浅睡眠延长，深睡眠缩短，快速动眼期明显缩短，但两组之间这些指标的比较差异无统计学意义（P>0.05）。与对照组比较，肥胖OSA组呼吸暂停低通气指数和阻塞性呼吸暂停低通气指数均显著增加（P<0.05）；快速动眼期及非快速动眼期氧减指数均显著增加（P<0.05）；肥胖OSA组睡眠期间最低血氧饱和度显著低于对照组（P<0.05）。 结论 肥胖合并OSA儿童临床日间症状以注意力不集中、嗜睡、晨起疲劳为主，夜间症状以打鼾、张口呼吸、出汗为主。与体重正常OSA患儿相比，肥胖合并OSA儿童的睡眠结构无明显差别，但呼吸事件及血氧饱和度下降更严重。 引用格式:     

乌鲁木齐市家长喂养行为现状及其与儿童体重指数的相关性

目的 探讨家长喂养行为与儿童体重指数（BMI）间的相关性,为预防和干预儿童超重、肥胖提供科学依据。方法 采用分层随机整群抽样的方法,抽取乌鲁木齐市新市区7所幼儿园976名儿童,通过问卷调查和体格测量获得相关数据。结果 共发放调查问卷976份,收回有效问卷924份（94.7%）。儿童体重不足、超重、肥胖总检出率分别为3.1%（29例）、9.2%（85例）、6.7%（62例）。家长喂养行为以监督饮食水平最高,其次为限制饮食,逼迫进食水平最低。其中汉族儿童家长采用限制饮食及逼迫进食的水平高于维吾尔族儿童家长（P < 0.01）。家长喂养行为中,限制饮食与汉族及维吾尔族男童BMI均呈正相关（P < 0.01）;逼迫进食与汉族男童及女童BMI均呈负相关（P < 0.01）,与维吾尔族男童及女童BMI均呈正相关（P < 0.01）;监督饮食与维吾尔族和汉族男童及女童BMI均呈负相关（P < 0.05）。汉族及维吾尔族男童中超重/肥胖儿童其父母限制饮食得分高于正常体重儿童家长（P < 0.05）;维吾尔族男童及女童中,超重/肥胖儿童其父母逼迫进食得分高于正常体重儿童其家长（P < 0.01）;汉族、维吾尔族男童及女童中超重及肥胖儿童其父母监督饮食得分低于正常体重儿童家长（P < 0.01）。结论 乌鲁木齐市家长喂养行为状况总体较好,其中维吾尔族儿童家长喂养行为略优于汉族儿童家长。家长喂养行为与儿童BMI密切相关,其相关性在不同民族及性别间存在差异。高水平的监督饮食及低水平的限制饮食、逼迫进食可能有利于预防和控制儿童超重、肥胖的发生与发展。     

血清miR-922及miR-506对儿童急性淋巴细胞白血病诊断及预后判断的价值

目的 探讨血清miR-922及miR-506表达水平对儿童急性淋巴细胞白血病（acute lymphoblastic leukemia,ALL）诊断及预后判断的价值。 方法 前瞻性选取132例ALL患儿（ALL组）和80例健康儿童（健康对照组）纳入本研究,采用实时荧光定量PCR技术检测ALL组和健康对照组血清miR-922及miR-506表达水平。绘制受试者工作特征曲线分析miR-922及miR-506对儿童ALL的诊断价值。应用Kaplan-Meier法绘制生存曲线,采用多因素COX回归模型分析影响ALL患儿预后不良的因素。 结果 ALL组血清miR-922及miR-506表达水平均明显高于健康对照组（P<0.001）。受试者工作特征曲线分析结果显示,miR-922及miR-506诊断儿童ALL的最佳截断值分别为1.46、2.17。miR-922高表达组（≥1.46）及miR-506高表达组（≥2.17）的淋巴结肿大、白细胞计数≥50×10⁹/L、中高危险度分层、MLL基因重排、染色体核型异常的发生率均明显高于miR-922及miR-506低表达组（P<0.05）。Kaplan-Meier分析结果显示,miR-922及miR-506高表达与ALL患儿生存期短有关（P<0.05）。多因素COX回归分析结果显示,白细胞计数≥50×10⁹/L、危险度分层为中高危、MLL基因重排、miR-922≥1.46及miR-506≥2.17可提示ALL患儿预后不良（P<0.05）。 结论 miR-922及miR-506表达水平对儿童ALL诊断及预后判断均有较好的价值。     

血清谷丙转氨酶与儿童超重、肥胖的关系

目的：探讨血清谷丙转氨酶（ALT）与儿童超重、肥胖的关系。方法：对年龄7～18岁的2889例正常儿童及702例超重、肥胖儿童的资料进行分析,测量身高、体重、腰围、血压,检测空腹血糖、血脂、ALT、胰岛素等生化指标,计算胰岛素抵抗指数。结果：男童ALT水平高于女童。随着体重指数（BMI）的增加,男女童正常组、超重组、肥胖组ALT水平均逐渐增加。ALT与BMI、腰围、甘油三酯、胰岛素抵抗指数等相关。在超重、肥胖儿童中,男童ALT升高组BMI、腰围、血压、甘油三酯、低密度脂蛋白、胰岛素抵抗指数均较ALT正常组高（P<0.05）;女童ALT升高组腰围、血压、胰岛素抵抗指数高于ALT正常组,而高密度脂蛋白降低（P<0.05）。结论：ALT与儿童超重、肥胖及其引起代谢异常如血脂异常、胰岛素抵抗相关。     

新疆和田地区维吾尔族儿童糖尿病患病率调查

目的 调查新疆和田地区维吾尔族儿童糖尿病（diabetes mellitus,DM）患病率,以及DM患病的影响因素。 方法 采用整群随机抽样的方法抽取新疆和田地区5 308名在校中小学、幼儿园4~18岁儿童作为研究对象。调查方式包括问卷调查及身高、体重测量。对所有研究对象进行空腹指尖微量血糖检测,以调查DM和空腹血糖受损（impaired fasting glucose,IFG）的患病率。 结果 回收有效问卷5 184份,检出DM 14例（0.27%）,包括8例1型DM,2例2型DM,4例未分型DM;检出IFG 29例（0.56%）。男生和女生DM及IFG患病率的比较差异无统计学意义（P>0.05）。4~<10岁、10~<15岁和15~18岁组DM的患病率分别为0.18%、0.47%、0.07%,各年龄组比较差异无统计学意义（P=0.072）;以上3个年龄组IFG的患病率分别为0.18%、0.94%、0.42%,各年龄组间比较差异有统计学意义（P=0.007）。DM儿童DM家族史比例和超重/肥胖比例显著高于非DM儿童（P<0.05）,而DM儿童喜食粗粮比例显著低于非DM儿童（P<0.05）。 结论 新疆和田地区维吾尔族儿童DM和IFG的患病率较低;不同性别和年龄段儿童DM患病率无明显不同,但不同年龄段儿童IFG患病率不同。DM家族史、超重/肥胖、粗粮摄取不足可能与DM的发生有关。     

Lipin基因表达与宫内发育迟缓大鼠肝脏脂肪含量的相关性研究

目的 探讨宫内发育迟缓（intrauterine growth retardation,IUGR）大鼠肝脏Lipin2基因和内脏脂肪组织Lipin1基因的表达与肝脏脂肪含量的相关性。 方法 使用母孕期低蛋白（10%蛋白）饮食法喂养孕鼠制造IUGR仔鼠模型,对照组孕鼠在孕期使用正常蛋白饲料喂养（蛋白含量21%）。分别在两组仔鼠生后1 d、1周、3周、8周和12周时称体重并留取仔鼠的肝脏组织,在生后3周、8周和12周留取两组仔鼠的内脏脂肪组织。采用3.0T氢质子磁共振波谱法检测两组大鼠生后3周、8周、12周时肝脏脂肪含量;采用Real-time PCR法检测两组大鼠各时间点肝脏组织Lipin2、内脏脂肪组织Lipin1基因的mRNA表达水平;采用Western blot法检测两组大鼠肝脏组织Lipin2、内脏脂肪组织Lipin1蛋白表达水平。采用Pearson相关分析Lipin mRNA及其蛋白表达与肝脏脂肪含量的相关性。 结果 生后3周、8周、12周时,IUGR组仔鼠内脏脂肪组织Lipin1 mRNA及其蛋白表达水平均高于对照组（P<0.05）。生后1 d时IUGR组肝脏组织Lipin2 mRNA及其蛋白表达水平低于对照组（P<0.05）,而生后1周、3周、8周、12周时Lipin2 mRNA及其蛋白表达水平均高于对照组（P<0.05）。生后3周时IUGR仔鼠和对照组肝脏脂肪含量比较差异无统计意义（P>0.05）,生后8周、12周时IUGR组仔鼠肝脏脂肪含量显著高于对照组（P<0.05）。Lipin1蛋白和mRNA表达与肝脏脂肪含量呈正相关（分别r=0.628、0.521,P<0.05）,Lipin2蛋白和mRNA表达与脂肪含量呈正相关（分别r=0.601、0.524,P<0.05）。 结论 IUGR大鼠内脏脂肪组织Lipin1和肝脏组织Lipin2 mRNA及其蛋白表达上调可引起肝脏脂肪含量增加,可能与导致IUGR大鼠成年期肥胖有关。     

Validating neck circumference and waist circumference as anthropometric measures of overweight/obesity in adolescents

Objective

To measure neck circumference and waist circumference, to compare it between normal and overweight/obese adolescents, and to validate these with body mass index.

Methods

This cross-sectional study was conducted in 1800 school-going adolescents. Body mass index, waist circumference and neck circumference were measured. Independent samples t-test and Pearson’s correlation were used as tests of significance to analyze quantitative data.

Results

Positive correlation of neck circumference and waist circumference with body mass index was observed. The neck circumference and waist circumference in overweight/obese adolescents were significantly higher than adolescents with normal body mass index (P<0.001). Area under curve of waist circumference was more than area under curve of neck circumference. Cut-off values of neck circumference for screening adolescent obesity in boys and girls were 30.75 cm, and 29.75 cm, respectively, and waist circumference cut-off value were 70.75 cm for boys and 69.25 cm for girls at fairly good levels of sensitivity and specificity.

Conclusion

Neck circumference and waist circumference may be used in clinical practice and epidemiological studies as an index of overweight/ obesity among school-going adolescents.

     

The usefulness of measuring body fat deposition for detecting obesity and atherogenesity in Japanese school children

Body fat deposition was measured in overweight and non-overweight children using a bioelectrical impedance method, and its relationship with serum lipids and apolipoproteins was investigated in 90 overweight children (over 120% of their ideal weight) and 241 non-overweight children aged 10–15 years in Niigata Prefecture. The results were as follows. Overweight boys had significantly higher levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), atherogenic index (AI), RLP-cholesterol (RLP-C), apoA1, apoA2, apoB, apoC2, apoC3, apoE and the ratio of apoB to apoAl than non-overweight boys. Overweight girls had significantly higher levels of TC, LDL-C, AI, remnant-like lopoprotein cholesterol (RLP-C), apoA2, apoB, apoC2, apoC3, apoE and the ratio of apoB to apoA1 than non-overweight girls. It has been reported that of all children studied 2.1% had higher levels of RLP-C than its upper limit known for adults (12 mg/dL). Of the overweight children in the present study, 4.4% had a high level of RLP-C whereas only 1.2% of non-overweight children had a high RLP-C level. No difference in the lipoprotein levels was found between overweight and non-overweight children. In both boys and girls, relative weight, body fat, skinfold thickness and body mass index (BMI) were correlated with the lipoprotein levels. Non-overweight boys whose body fat was over 20% had significantly higher levels of TC, LDL-C, apoA2, apoB, apoC2, apoE and apoB/A1 than those whose body fat was less than 20%. It was concluded that the measurement of body fat deposition, together with relative weight, was useful for detecting obesity and atherogenesity in Japanese school children.     

Body fat ratios in urban Chinese children

OBJECTIVE: As obesity has been increasing in China, the present study examined the body composition of children to assess their fatness. STUDY DESIGN: A total of 532 healthy schoolchildren who lived in central Beijing were examined. Skinfold thicknesses, hip and waist circumferences, and body fat percentage were measured, as well as height and weight. RESULTS: The prevalence of overweight (Body Mass Index (BMI) >or= 95% for age and sex of Chinese children) was 27.7% in boys and 14.2% in girls (chi-squared; P = 0.0001). The percentages of body fat (BF%), waist/hip ratios and skinfold thicknesses ratios (subscapular/triceps) in overweight children were significantly higher than those in non-overweight children (Mann-Whitney U-test). The BF% of non-overweight boys was significantly higher than that of non-overweight girls. CONCLUSION: Urban Chinese overweight children have high BF% with adverse fat distribution. They may have high risk of atherogeniety. Boys in the non-overweight category may have higher fat accumulation than predicted by BMI. The establishment of an intervention program for childhood obesity is strongly recommended.     

Overweight and obesity prevalence in children and adolescents from a private school in Recife

OBJECTIVES: To determine the prevalence of overweight and obesity in students from a private school in Recife; compare the prevalence rates of overweight and obesity in boys and girls and in different age groups (children and adolescents) and verify the correlation between body mass index and triceps skinfold thickness in this population. METHODS: Cross-sectional study with 762 students (332 children and 430 adolescents) from a middle/upper class school in Recife, in 1999. Overweight was defined as body mass index equal or above the 85th percentile for age and gender. Obesity was defined as body mass index and triceps skinfold thickness equal or above the 85th percentile. RESULTS: The prevalence rates were 26.2% (95%CI = 23 to 29%) for overweight, and 8.5% (CI95% = 6.5 to 10.5%) for obesity. Overweight was more prevalent among children (34.3%) than among adolescents (20.0%) (P<0.001). Obesity was more frequent among children (14.2%) than among adolescents (4.2%) (P<0.001). The prevalence of overweight in boys (34.6%) was higher than in girls (20.6%) (P<0.001). The prevalence of obesity was also higher in boys (14.7%) than in girls (4.4%) (P<0.001). The correlation coefficient between body mass index and triceps skinfold thickness was equal to 0.64 (95%CI = 0.60 to 0.68). CONCLUSIONS: The prevalence of overweight in our study population was as high as that found in industrialized countries; obesity, however, was less frequent.     

Neck circumference: an additional tool of screening overweight and obesity in childhood

Obesity, particularly in the upper part of body, is a major health problem. Central obesity is related to cardiovascular disease and metabolic disorders. There are various techniques for assessing upper body fat content for the overweight and obese subjects other than waist circumference (WC). We tried to find out if neck circumference (NC) alone can be used to assess overweight and obesity. Four hundred twelve overweight and obese patients (208 girls and 204 boys) and 555 healthy children (284 girls and 271 boys) aged 6–18 years were recruited for this present study. There were significant and positive correlations between BMI-WC, BMI-NC, and WC-NC (p < 0.001). NC cutoffs for overweight and obesity were determined for each age and pubertal period. NC cutoffs of boys were increased from 28.0 to 38.0. This range was 27.0–34.5 for girls in the same range. We also calculated NC cutoffs for prepubertal and pubertal periods (respectively, 29.0 and 32.5 for boys and 28.0–31.0 for girls). Conclusion: NC is a reliable and easy to use tool to determine overweight and obesity in children, and NC is not as good as WC in determining overweight and obesity, both providing similar information.     

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.     

Effects of overweight on lung function.

Spirometric data from 1586 healthy children, who did not smoke, were analysed to examine the effects of overweight as measured by the body mass index (weight/height2) on lung function. Overweight (72 boys, 88 girls) was defined as on or above the 90th percentile weight for height. After having controlled for the confounding variables of height and age, there were positive partial correlations between body mass index and lung function in girls whose weight was normal, in overweight girls, and in boys whose weight was normal, but not in overweight boys. In contrast to adults, body mass index has a positive effect on lung function in girls, whatever their weight. No such correlation between body mass index and lung function was seen in overweight boys. The observations may be accounted for by distinct sex dependent patterns of fat distribution in children.     

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.     

Body mass index references for Turkish children

Aim: To construct the body mass index reference curves for Turkish children aged 6 to 18 y, and to determine the prevalence of overweight and obesity. Subjects and methods: Height and weight measurements of healthy schoolchildren (1100 boys, 1019 girls) were obtained biannually. Body mass index was calculated from 11 648 height and weight measurements. Centile curves were constructed using the LMS method. Results: The smoothed percentile values and curves for body mass index in Turkish children show that there is a constant increase in body mass index values towards adulthood, especially during the pubertal years, in both sexes. The prevalence of overweight is 25% and obesity 4% in boys at age 18 y. The percentage of overweight and obesity in girls at age 14 was 15% and 1%, respectively. The sample size was too small to come to any conclusion regarding these rates at 18 y of age.

Conclusion: This study presents data and curves for body mass index values in healthy Turkish children aged 6 to 18 y. The values are in compliance with those of Western countries.