中国学龄儿童青少年腰围的地区分布和人群特征

Waist circumference distribution of Chinese school-age children and adolescents

目的分析中国儿童青少年代表性人群的腰围分布，为建立标准腰围界值点提供依据。方法收集内地15省（区、市）和香港地区7～18岁人群横断面调查资料，样本对象共178865人，划分沿海城市、其他城市、北方乡村、南方乡村和香港地区5个群体，分析各人群腰围分布状况。结果5个群体人群体格发育水平的差异有统计学意义。“沿海城市”群体在7～18岁时腰围第85百分位数（P85）始终高于其他群体。相反，“南方乡村”群体腰围P85不仅低于城市且低于“北方乡村”群体。“香港地区”群体在学龄初期腰围水平高，但进入青春期后增长缓慢，腰围Pss最终落后于“北方乡村”群体。南、北方乡村群体自青春期开始腰围水平表现为追赶趋势。该差异不仅源自地区社会经济发展水平和城乡差异，也源于南、北方地区差异，预示在使用腰围进行筛查时，超重、肥胖检出率在上述群体中将呈梯层分布趋势。相关分析显示腰围与身高、体重、BMI等体格指标间高度相关。将中国人群腰围分布与美国、荷兰比较，提示有必要建立适合本国人群的腰围筛查界值点，应用LMS法为中国儿童建立性别年龄别腰围百分位数曲线。结论研究结果将为建立中国儿童人群腰围筛查界值点提供依据。

Objective To study the distribution of waist circumference （WC） in a representative group of Chinese children for establishing the Chinese WC cut-off points. Methods Cross-sectional data obtained from 15 mainland provinces and Hong Kong were collected. There were 178 865 children and adolescents, aged 7-18 years-old in total. All subjects were divided into five regional groupscostal city, non-coastal city, northern rural, southem rural, and Hong Kong, for analyzing the distribution of WC. Results Large variations in WC distribution were found among the five groups for both sexes. The coastal city group had the highest P85 WC values consistently from the early school age to 1 8-year-old, when comparing with other groups. In contrast, southern rural group had P85 values consistently lagged behind, in both city group and in the north rural group. Hong Kong group had a high P85 WC at early ages, but because of the smaller increments of WC during adolescence, the P,5 curve was gradually exceeded by the northern rural groups. Catch-up trend was found in the two rural groups since peak puberty. These disparities were caused not only by factors related to socioeconomic and urban-rural but also to the geographic differences between the north and the south. Because of the regional variation of WC, a ＂gradient＂ prevalence of central obesity was prospected among these groups. Closed associations were found between WC and height, weight and BMI in all age period. Comparison on the WC distributions between people from China, U.S.A or the Netherlands demonstrated the necessity of setting up China＇ s own WC cutoffs. Sex and age-specific percentiles were obtained and smoothed by using the LMS method. Conclusion Data obtained from this study could be used to develop the national WC cutoff points for Chinese children and adolescents.