儿童少年肥胖筛选标准的研究

Study on Selection Standard of Children Obesity

目的：运用皮体贡数法（ISBM）建立儿童少年肥胖筛选标准。方法：ISBM一[皮褶厚度（上臂＋背部）（mm）／身高（m^2）]×0．67＋[体重（妇）／身高（m^2）]×0．33。应用受试者工作特性曲线（ROC）法制订正常值，采用水下称重法测定身体脂肪含量（F％），与其判定肥胖的5种指数做相关分析。结果：ISBM：男性≥16．0；女性≥18．0判为肥胖，以男、女各增加4ISBM划分中度、重度、极度肥胖界值，提出了儿童少年肥胖筛选标准。依据ISBM筛选标准，在7377名男、女中小学生中评价肥胖发生率为10．06％，其中男性为12．80％，高于女性的7．24％，u=7．94，P〈0．01。通过利用国内、外10种评价方法的综合判定（10种或9种方法有6种以上方法判为肥胖时为“标准”肥胖者）为金标准，以各种评价标准判出的肥胖者与金标准进行对比分析，ISBM筛选标准评价肥胖符合率为92．86％。约登指数为95．43，高于其他9种评价方法。对295名7～15岁中小学生测试（F％），ISBM、BMI、皮褶指数（PZZS）、劳雷尔指数、克托莱指数与（F％）都呈正相关。以ISBM相关程度最高，相关系数男=0．86；女=0．80。结论：该筛选标准适用于国内儿童少年判定肥胖，ISBM法合理、准确，宜在不同国家、民族种族间验证使用。

The purpose of this study was to establish the selection standard of obese children with ISBM. ISBM = [skin folding thickness （upper arm ＋ Back （mm）/height （m^2）]× 0. 67＋ [weight （kg）/height （m^2）]×0.33. The normal value was set by ROC legality to determine the body fat content （F%） with the underwater weight measurement and the correlation analysis among five indexes was made to evaluate the obesity. The result showed that ISBM ：Male≥16. 0,female≥18.0. It was judged as obesity. Adding four ISBM to male and female separately,the middle ,serious and extreme obesity was separated. It suggested the selection standard of obese children. According to ISBM selection standard, the occurrence of obese rate was 10. 06% among 7377 male and female students. The obese rate of male students was 12. 80%, higher than the 7.24% of female students,u=7.94,P〈0.01. Through using ten appraising internal and external method synthetically as golden standard and making comparison with other evaluation methods,the according rate was 92. 86%. Youdens index was 95. 43, higher than other nine appraising method. Among 295 students aged at 7-15 from primary and middle schools, ISBM, BMI, PZZS, Rohrer and Quetelet index were positively correlated with F%. It concluded that the selection standard was suitable for judgment on children obesity.