长沙市3～11岁儿童肥胖超重筛查BMI界值点的建立

Establishment of BMI reference values in screening for obesity/overweight of children aged 3-11 in Changsha

目的了解长沙市儿童生长发育状况，建立该地区3-11岁儿童超重和肥胖筛查的BMI界值点。方法采用随机整群抽样方法，抽取长沙市20所幼儿园及15所小学的儿童，测量入选儿童的身高和体重，并记录性别和年龄，采用LMS方法拟合儿童体质指数（BMI）生长曲线，按百分位法，建立儿童超重和肥胖的BMI参考值。以身高体质量的z评分法对该参考值进行初步验证。结果采用LMS法，经过多次调整和验证，拟合了长沙市3-11岁儿童BMI的生长曲线，拟合值与实测值误差很小，拟合效果良好。采用百分住法，以第85百分位及第95百分位曲线分别作为儿童超重及肥胖筛查的界值点，并以身高体重的z评分法对该参考值进行初步验证，结果BMI方法筛查出的肥胖儿童略多于身高标准体重法，但经配对卡方检验，两者差异均无显著性（P值均〉0．05）。结论长沙市3～11岁儿童BMI生长曲线的第85百分位及第95百分位曲线可以作为该地区3-11岁儿童超重及肥胖筛查的BMI界值点。但BMI筛查界值点是以人群为基础的统计界值，仅用于初步筛查儿重超重和肥胖状况，不是儿童肥胖症的独立诊断标准，社区和临床应用时必须结合其他指标及临床症状或体征综合评价。

[Objective] To understand growth and development situation of ehildrenincluding height, establish BMI reference values in screening for obesity/overweight of children aged 3-11 in Changsha. [ Methods ] Children were collected at 20 kindergartens and 15 primary schools in Changsha by random cluster sampling method. Their height and weight were measured, and the sex and age were recorded. Children growth curves of body mass index （BMI） were fitted by LMS method. BMI reference values in screening for children overweight and obesity were established by percentile method and were verified by height and weight method. [ Results ] Children growth curves of body mass index （BMI） of children aged 3-11 in Changsha were fitted by LMS method, their fitting error were small and fitting results were good. The eighty fifth, ninety fifth percentile curves as the border points in screening for children overweight and obesity were verified by height and weight method. BMI reference values in screening for overweight and obesity of male and female children aged 3-1 in Changsha were established as a section per haft year. [Conclusions] The eighty fifth and ninety fifth percentile curves of BMI could be used to screen for overweight and obesity of male and female children aged 3-11 in Changsha.