Harmonization of anthropometric measurements for a multicenter nutrition survey in Spanish adolescents

OBJECTIVE: Although the need for accurate anthropometric measurement has been repeatedly stressed, reports on growth and physical measurements in human populations rarely include estimates of measurement error. We describe the standardization process and reliability of anthropometric measurements carried out in a pilot study. METHODS: For the intraobserver assessment of anthropometric measurements, we studied 101 adolescents (58 boys and 43 girls) from five cities. For interobserver assessment, we studied 10 adolescents from the same class in Zaragoza and different from those in the intraobserver sample. RESULTS: For skinfold thickness, intraobserver technical errors of measurement (TEMs) in general were smaller than 1 mm; for circumferences, TEMs in general were smaller than 1 cm. Intraobserver reliability for skinfold thickness was greater than 95% for almost all cases; for circumferences, intraobserver reliability generally was greater than 95%. Interobserver TEMs ranged from 1 to 2 mm for the six skinfold thicknesses measured; for circumferences, TEMs were smaller than 1 cm for the arm, biceps, and waist and between 1 and 2 cm for the hip and thigh. Interobserver reliabilities for skinfold thickness and circumference were always greater than 90%, except for biceps skinfold. CONCLUSIONS: Our results are in agreement with those recommended in the literature. Therefore, these anthropometric measures seem to be adequate to assess body composition in a multicenter survey in adolescents.     

The reliability of neonatal head circumference measurement

Interobserver reliability in head circumference measurement was assessed in a cohort of 1105 low birthweight (less than or equal to 2000 g) infants enrolled in a study of brain hemorrhage. In 927 (83.9%) subjects, head circumference was measured both by a pediatric resident or admitting pediatrician, and by a trained ultrasound technologist. The Pearson correlation coefficient for these two sets of measurements was 0.934 (p less than 0.01), and the intraclass correlation coefficient was 0.933. By contrast, analysis of differences revealed that the limits of agreement were from -1.99 to 2.03 cm, indicating that 5% of measurements differed by 2 cm or more. Using clinicians' measurements as the gold standard, ultrasound technologists detected abnormal head circumferences with a sensitivity of 91.2%, a specificity of 97.2%, and a positive predictive value of 88.0%. For clinical purposes this level of reliability may be acceptable, but in research studies this degree of misclassification would lead to attenuation of the odds ratio.     

Accuracy of blood pressure measurement and anthropometry among volunteer observers in a large community survey

The Busselton Survey is a population survey that is held about every three years. In 1994-1995 a re-survey was held of all past participants and 8,502 attended. Financial constraints precluded employing staff for data collection for blood pressure and anthropometry, these therefore were collected by unpaid lay volunteers. Quality control by a health professional was critical to the assessment and maintenance of accuracy in these measurements. For blood pressure three readings were taken simultaneously by a quality control person and the volunteer using a dual stethoscope. Duplicate anthropometric measurements were taken by a criterion anthropometrist and the volunteer. Inter and intra-observer technical errors of measurement (TEM) were calculated. Sixty-two volunteers were trained to take BP measurements; of these, 38 collected data, and 63 were trained in anthropometry; of these, 30 were suitable as measurers. Training was conducted on a group and individual basis by the quality assurance person for the study both in the Perth metropolitan area and rural Busselton. The TEM for SBP was 1.6 mm Hg (SD 1.0 mm Hg) and 1.5 mm Hg (SD 0.8) for DBP. For skin-folds intra-observer TEM ranged from 0.6 mm to 1.0 mm. Between-observer TEM ranged from 2.1 mm to 5.4 mm. For limb and waist circumferences, intra-observer TEM ranged from 0.3 cm to 1.6 cm. Between-observer TEM for circumferences ranged from 0.5 cm to 1.9 cm. Unpaid volunteer measurers can, if carefully trained and supervised, provide acceptable blood pressure data and anthropometry in large population surveys.     

不同胎龄初生儿头围与胸围比值关系研究

目的:研究孕26～44周初生儿头围与胸围比值关系,探索初生儿胎内体格发育规律。方法:引用2005年深圳不同胎龄初生儿头围、胸围均值和1986年中国15城市不同胎龄新生儿头围、胸围均值,研究孕26～44周初生儿头围与胸围比值关系。结果:2005年深圳孕26～28周初生儿平均头围均值为26.3cm、胸围均值为24.3cm,头围与胸围的比值为1.08:1;孕37周头围均值为32.9cm、胸围均值为32.2cm,比值为1.02:1;孕41周头围均值为34.1cm、胸围均值为33.4cm,比值为1.02:1;孕44周头围均值为34.9cm、胸围均值为33.7cm,比值为1.04:1。结论:头围与胸围的比值与孕周大小有关,孕周越小比值越大,随着孕周增大比值不断变小;孕26～37周是头围发育的快速增长期,显示了脑部优先发育的生长规律,男性头围发育明显快于女性;孕37～43周是头围与胸围的均衡发育期。     

An evaluation of upper arm measurements used in nutritional assessment.

Triceps skinfold thickness and upper arm circumference (parameters used in assessing protein-calorie malnutrition) were measured on both arms of 91 adult volunteers who fulfilled criteria for absence of disease and conditions affecting nutritional status. For the total study group and subgroups of men only and women only, no significant differences were noted between right and left arm measurements of triceps skinfold thickness, arm circumference, or arm muscle circumference. Median values for significant right-left arm measurement differences were + 1.7 mm for the triceps skinfold thickness of left-handed subjects (P less than 0.05) and + 0.3 cm for the arm circumference of volunteers regularly engaged in predominately right-armed activities (P less than 0.05). Criteria of weight within 15% of "ideal" and nine serum and plasma values within a specified range were fulfilled by 77 subjects, and they comprised the "healthy" subgroup. Left arm median values for healthy men and healthy women differed from a currently accepted standard for each of three anthropometric parameters: triceps skinfold thickness (P less than 0.05), arm circumference (P less than 0.05), and arm muscle circumference (P less than 0.01).     

Assessment of intra-abdominal and subcutaneous abdominal fat: relation between anthropometry and computed tomography

The ability to distinguish between intra-abdominal and subcutaneous abdominal fat may be important in epidemiologic and clinical research. In this study anthropometric measurements were taken from 71 men and 34 women presenting for routine computed tomography (CT). Areas of abdominal fat were calculated from CT scans made at the level of the L4 vertebra. The amounts of intra-abdominal and subcutaneous abdominal fat could be accurately predicted from several circumferences, skinfold measurements, body mass index, and age (R2 ranged from 0.79 to 0.84). In addition, it was found that the area of intra-abdominal fat on the CT scan was related to the waist:hip circumference ratio (r = 0.75 in men, r = 0.55 in women) and to the waist:thigh circumference ratio (r = 0.55 in men, r = 0.70 in women). The correlations of the circumference ratios with the areas of subcutaneous fat were invariably lower.     

Antropometric measurements of elderly

Body composition was assessed in a group of 344 free-living elderly between 60 and 89 years by means of anthropometry. The height, weight and body mass indexes of the elderly were reduced with advancing age in both the males and females. Skinfold thickness measurements also declined with age. Overall, the female elderly had a greater tricep skinfold thickness but smaller mid-arm circumferences, mid-arm muscle circumference and mid-arm muscle area compared to the male.     

Simple skinfold-thickness measurements complement conventional anthropometric assessments in predicting glucose tolerance

BACKGROUND: Skinfold-thickness measurements are considered to have limited clinical utility. OBJECTIVE: To assess whether skinfold-thickness measurements may be a useful adjunct to conventional anthropometric assessments in predicting glucose and insulin regulation, we studied responses to replicate 75-g oral-glucose-tolerance tests (OGTTs) and performed simple anthropometry in a cross section of subjects. DESIGN: Thirty-five subjects completed the study: 11 lean [mean (+/-SEM) age: 33 +/- 3.2 y; body mass index (BMI; in kg/m(2)): 24.1 +/- 0.8; and percentage body fat (%BF): 11.5 +/- 1.5%], 12 normal-weight (age: 33 +/- 2.9 y; BMI: 23.9 +/- 0.7; and %BF: 24.3.5 +/- 1.3%), and 12 obese (age: 41 +/- 4.5 y; BMI: 34.5 +/- 1.7; and %BF: 34.2 +/- 1.5%) individuals. The lean and normal-weight groups were selected to have similar BMIs but different %BFs. We measured the participants' heights, weights, %BFs, waist circumferences, hip circumferences, and truncal and peripheral skinfold thicknesses. Subjects received nine 75-g OGTTs and blood samples were collected at 0, 15, 30, 45, 60, 90, and 120 min. Mean plasma glucose and insulin values were used to calculate the insulin sensitivity index. RESULTS: The obese group had higher plasma glucose concentrations and areas under the curve (AUCs) than did the normal-weight or lean group and higher plasma insulin concentrations and AUCs than did the lean group (P < 0.05). Stepwise multiple regression, with adjustment for demographic and anthropometric measurements, identified the following predictors: waist circumference, peripheral skinfold thickness, and BMI for fasting plasma glucose (partial R(2) = 0.20, 0.13, and 0.13, P < 0.05); waist circumference and truncal skinfold thickness for plasma glucose AUC (partial R(2) = 0.20 and 0.13, P < 0.05); age, waist-to-hip ratio, and peripheral skinfold thickness for fasting plasma insulin (partial R(2) = 0.26, 0.22, and 0.15, P < 0.05); truncal skinfold thickness for plasma insulin AUC (partial R(2) = 0.41, P < 0.001); and peripheral skinfold thickness for both 2-h plasma glucose (partial R(2) = 0.59, P < 0.001) and the insulin sensitivity index (partial R(2) = 0.49, P < 0.001). CONCLUSION: Skinfold-thickness measurements may complement other established measurements for predicting abnormal glucose and insulin regulation.     

新生儿出生头围影响因素分析

目的 探讨新生儿出生头围的影响因素,为建立新生儿头围正常参考值范围样本筛选,制定小头畸形诊断标准提供科学依据。方法 收集2014年1月-2017年12月广东省某医院分娩新生儿信息,对48 928例活产单胎新生儿资料使用t检验/单因素方差分析和多因素广义线性回归进行统计分析。结果 新生儿的平均出生头围为(33.4±1.7)cm。新生儿胎龄越大、剖宫产分娩、男性、羊水过多和产妇年龄越大、籍贯隶属北方省份、多孕、多产、合并妊娠期糖尿病导致新生儿出生头围偏大(P<0.05)。新生儿宫内生长受限、脐带绕颈、脐带扭转、羊水过少和产妇妊娠期合并高血压疾病、胆汁淤积症、贫血导致新生儿出生头围偏小(P<0.05)。新生儿结构异常、辅助生殖受孕、羊水浑浊和产妇甲状腺功能异常、瘢痕子宫、前置胎盘和生殖道感染对头围无显著影响(P>0.05)。结论 新生儿出生头围影响因素众多,在制定出生头围正常参考值范围时,除了考虑生理因素的差异,还应排除有相关疾病因素的样本,如宫内生长受限、妊娠期合并症(妊娠期糖尿病、高血压疾病、胆汁淤积症、贫血)、羊水异常、脐带异常等,以确保参考值范围的科学性。     

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。     

Efficiency of various anthropometric measurements in determining low birth weight babies

Anthropometric measurements were applied to 119 healthy, singleton, full-term infants born during June 1993-January 1994 in the obstetric ward of the community medicine department of SKIMS in Srinagar, Kashmir, India. Researchers aimed to identify an alternative simple and accurate measurement to birth weight for field conditions. The anthropometric measurements included weight, crown-heel length, mid-arm circumference, head circumference, thigh circumference, calf circumference, and chest circumference. The researchers applied their findings to a separate cohort of 250 newborns at the child health clinic of the same department to determine specificity, sensitivity, and predictive values. The mean birth weight was 2.8 kg. Mean mid-arm, calf, thigh, chest, and head circumferences were 10.45, 10.15, 015.73, 32.18, and 34.96 cm, respectively. Mean crown-heel length was 49.78 cm. Birth weight had a very significant correlation with calf circumference (r = 0.87), thigh circumference (r = 0.7), mid-arm circumference (r = 0.7), and chest circumference (r = 0.40). Calf circumference accounted for 75.69% of the total variance. Thigh circumference and mid-arm circumference accounted for 49% and 46.24%, respectively. The critical level value of birth weight to 2.5 kg was 9.78 cm for calf circumference, 14.8 cm for thigh circumference, 9.94 cm for mid-arm circumference, 32.23 cm for chest circumference, 34.72 cm for head circumference, and 49.58 cm for chest circumference. Calf circumference had the highest sensitivity and specificity (93.55% and 98.92%, respectively), compared to 77.42% and 92.63%, respectively, for thigh circumference and 64.52% and 93.55%, respectively, for mid-arm circumference. The likelihood of missing low birth weight infants was lowest for calf circumference (7-8% vs. 22-23% for thigh circumference and 30-35% for mid-arm circumference). These findings show that calf circumference is the most effective alternative anthropometric measurement to birth weight for identifying low birth weight newborns.     

Validation of a 3-Dimensional Laser Body Scanner for Assessment of Waist and Hip Circumference

Objectives: To evaluate the reliability and validity of a 3-dimensional laser body scanner for estimation of waist and hip circumferences and waist:hip ratio.

Methods: Seventy women were evaluated for waist and hip circumference and waist∶hip ratio via laser scanner and tape measure. In a subset of 34 participants, 8 repeated measures of laser scanning were performed for reproducibility analysis. Validity of the instrument was assessed by regression and Bland-Altman comparison of measures of waist and hip circumferences and waist∶hip ratio to tape measure.

Results: Reproducibility analysis showed little difference between within-subjects measurements of circumferences (intraclass correlation coefficient ≥0.992, p < 0.01). Evaluation of waist and hip circumferences measured by body scanning did not differ significantly from tape measure (p > 0.05). Bland-Altman analysis showed no bias between laser scanning and tape measure.

Conclusion: These findings indicate that the 3-dimensional laser body scanner is a reliable and valid technique for the estimation of waist and hip circumferences as compared with tape measure. This instrument is promising as a quick and simple method of body circumference analysis.     

Cross-sectional reference values for mid-upper arm circumference,triceps skinfold thickness and arm fat area of Turkish children and adolescents

The aim of the study was to establish cross-sectional reference values for the mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF) and arm fat area (AFA) of Turkish children and adolescents. In total 5,553 students aged between 6 and 17 years were selected by a multistage sampling method from schools representing city centre, rural and urban areas of Kayseri, Central Anatolia. The MUAC and TSF were measured, and the arm muscle area, arm area, AFA and fat percentage (%) were calculated. The LMS method was employed to calculate the MUAC, TSF and AFA curve parameters. The MUAC, TSF, AFA and fat percentage in each age group were significantly higher in girls than in boys. In boys, the TSF 50th percentile ranged from 7.6 mm at 17 years to 9.0 mm at 11 years; whereas in girls this ranged from 9.4 mm at 6 years to 14.6 mm at 17 years. The MUAC 50th percentile ranged from 17.0 to 23.6 cm in boys, and from 15.6 cm to 20.9 cm in girls. The AFA 50th percentile measurements ranged from 4.5 cm at 6 years to 5.8 cm at 12–14 years in boys; and ranged from 7.2 cm at 6 years to 14.8 cm at 17 years in girls. The percentile distribution was more disperse towards higher TSF and AFA values in boys than in girls.     

超声检测胎儿腹围及半肩径对新生儿体重的预测

目的 分析超声检测胎儿腹围及半肩径对新生儿体重的预测价值.方法 选取承德市妇幼保健院自2015年4月至2016年4月收治的200例足月新生儿作为研究对象,按照出生时的实际体重分为非巨大儿179例及巨大儿21例,对两组胎儿在妊娠30周时的超声检测腹围及半肩径结果进行回顾性分析.结果 巨大儿组较非巨大儿组相比腹围、半肩径均较大,差异均具有统计学意义(t值分别为4.14、3.25,均P＜0.05).腹围大于267.90mm和(或)半肩径大于75.00mm,腹围最佳临界值预测巨大儿的灵敏度为71.43％、特异度为61.90％,约登指数为0.334,ROC曲线下面积为0.693(95％ CI:0.613 ～0.773).半肩径最佳临界值预测巨大儿的灵敏度为76.19％、特异度为66.67％,约登指数为0.429,ROC曲线下面积为0.723(95％ CI:0.649～0.799).胎儿腹围和半肩径与出生体重均呈正相关(r值分别为0.603、0.661,均P＜0.05),即胎儿腹围、半肩径增大,其出生体重增加.结论 于妊娠30周时采用超声检测胎儿的腹围及半肩径可作为判断新生儿体重异常与否的重要指标,当腹围大于267.90mm和(或)半肩径大于75.00mm对预测巨大儿有一定的临床价值.     

蒙古族与汉族男生身体形态发育的差异分析

目的 分析蒙古族与汉族男生身体形态发育指标的差异。方法 从2010年全国学生体质与健康调研数据中选取内蒙古自治区蒙古族和汉族男生身体测量数据,整理身高、体重、胸围、坐高、上臂部皮褶厚度(TST)、肩胛部皮褶厚度(SST)、腹部皮褶厚度(AST)、城乡及“是否遗精”指标,按“是否遗精”分层且调整城乡因素分析蒙古族与汉族男生身体形态发育指标的差异。结果 11、12、14岁蒙古族男生“已遗精”比例低于汉族男生(0 vs. 8.1%,3.2% vs. 15.3%,62.5% vs. 76.0%,均P<0.05);“未遗精”(11～14岁)汉族男生身高高于蒙古族(1.4 cm,P<0.01)、坐高、胸围、体重、TST、SST、AST、BMI与蒙古族差异无统计学意义(均P>0.05);“已遗精”(12～17岁)汉族男生身高、坐高、胸围、体重、SST、BMI高于蒙古族(1.8 cm、0.6 cm、3.1 cm、3.1 kg、1.7 mm、0.7 kg/m²,均P<0.05),TST、AST与蒙古族差异无统计学意义(均P>0.05).结论 汉族男生身高指标可能优于蒙古族男生,汉族“已遗精”男生坐高、胸围、体重、SST、BMI指标优于蒙古族,遗精前后两民族男生身体形态发育指标差异可能不同。     

人体脂肪含量测定方法的研究

本文以上海划船运动员为对象(男41名、女31名)用排水法,皮褶厚度法和体围测量法测定体脂含量,求得回归方程并对三种测量方法比较。 1.体脂与人体测量指标的回归方程 男≥19岁 F(％)=-5.0550-1.4078X_7+0.5970X_8 ≤18岁 F(％)=-64.3668+0.8293X_8 女≥19岁 F(％)=-36.4334+0.7898X_9 ≤18岁 F(％)=-66.5345-1.8139X_2+1.4359X_9 X_7:肩胛骨下角皮褶厚度 X_7:前臂围 x_8:腹围 X_9:臀围 2.排水法、皮褶厚度测量和体围测量法测定体脂含量的比较。男运动员三种方法所得体脂含量无显著差别(P>0.05)。女运动员三者所得体脂含量有显著差别(P<0.05),其中排水法与体围测量所得体脂含量相似(P>0.05),而皮褶厚度法所测得体脂含量与另二种测定方法测得的体脂含量有显著差异(P<0.05)。所以,划船队运动员的体脂测量,可采用简便、易行,误差较小的体围测量方法。     

Anthropometric predictors of body fat as measured by hydrostatic weighing in Guatemalan adults

BACKGROUND: Most predictive equations currently used to assess percentage body fat (%BF) were derived from persons in industrialized Western societies. OBJECTIVE: We developed equations to predict %BF from anthropometric measurements in rural and urban Guatemalan adults. DESIGN: Body density was measured in 123 women and 114 men by using hydrostatic weighing and simultaneous measurement of residual lung volume. Anthropometric measures included weight (in kg), height (in cm), 4 skinfold thicknesses [(STs) in mm], and 6 circumferences (in cm). Sex-specific multiple linear regression models were developed with %BF as the dependent variable and age, residence (rural or urban), and all anthropometric measures as independent variables (the "full" model). A "simplified" model was developed by using age, residence, weight, height, and arm, abdominal, and calf circumferences as independent variables. RESULTS: The preferred full models were %BF = -80.261 - (weight x 0.623) + (height x 0.214) + (tricipital ST x 0.379) + (abdominal ST x 0.202) + (abdominal circumference x 0.940) + (thigh circumference x 0.316); root mean square error (RMSE) = 3.0; and pure error (PE) = 3.4 for men and %BF = -15.471 + (tricipital ST x 0.332) + (subscapular ST x 0.154) + (abdominal ST x 0.119) + (hip circumference x 0.356); RMSE = 2.4; and PE = 2.9 for women. The preferred simplified models were %BF = -48.472 - (weight x 0.257) + (abdominal circumference x 0.989); RMSE = 3.8; and PE = 3.7 for men and %BF = 19.420 + (weight x 0.385) - (height x 0.215) + (abdominal circumference x 0.265); RMSE = 3.5; and PE = 3.5 for women. CONCLUSION: These equations performed better in this developing-country population than did previously published equations.     

新生儿吸入性肺炎临床特点及诊治分析

目的:探讨新生儿吸入性肺炎的临床特点及疗效。方法:将67例新生儿吸入性肺炎患儿随机分为观察组34例和对照组33例,两组患儿在抗感染、常规雾化吸入、吸氧并加强保暖等措施的同时观察组加用盐酸氨溴索,分析其临床特点及疗效。结果:观测组治愈23例、显效8例、无效3例,总有效率91.2%;对照组治愈13例,显效10例、无效10例,总有效率69.7%。结论:提高围生期的工作质量,加强新生儿护理及新生儿吸入性肺炎的早期诊断、早期治疗的能力,将大大降低新生儿吸入性肺炎的发病率和死亡率。     

新生儿化脓性脑膜炎的早期临床特征

目的:探讨新生儿化脓性脑膜炎的早期临床特点。方法:选择2008～2010年吉林市儿童医院NICU收治的化脓性脑膜炎患儿,回顾性分析其围生因素、发病时间、临床表现、实验室检查、治疗和预后。结果:新生儿化脓性脑膜炎9例,检出率占同期临床诊断败血症患儿的17.31%,1例早产儿生后6 h发病,表现有反应差、发热、抽搐、硬肿症,1例以屏气发作起病,2例抽搐时出现呼吸停止和频繁呼吸暂停需常频通气治疗,脑脊液常规WBC 42×106/L～脓细胞满视野。2例脑脊液培养阳性,9例血培养均阴性,5例患儿治疗有效,放弃治疗2例,死亡2例。结论:新生儿化脓性脑膜炎起病隐匿,病情重,病死率高,应重视早期临床表现,尽早行病原学检测,选择敏感抗生素治疗,以降低病死率。     

常用感染指标在新生儿尿路感染中诊疗价值的探讨

目的 探讨临床检测常用感染指标在新生儿尿路感染中的诊疗价值,为临床诊疗新生儿尿路感染提供有效的实验室依据.方法 回顾性分析近5年于我院新生儿科住院治疗,并且有尿细菌培养记录的患儿实验室检测结果和临床信息,比较细菌培养阳性患儿和细菌培养阴性患儿实验室检测指标.结果 近5年我院新生儿尿培养阳性率为5.15％(83/1611...