上海市2000—2014年中小学生体质量指数变化趋势

Changes of body mass index distribution for 7-18 years old children and adolescents in Shanghai from 2000 to 2014

目的了解2000—2014年上海市学龄儿童青少年体质量指数(BMI)的变化趋势,为儿童青少年超重、肥胖判别标准研制及预防干预提供参考。方法选取2000,2005,2010,2014年4次全国学生体质与健康调研中7~18岁儿童青少年作为研究对象。应用最小均方(Least Mean Square,LMS)法探讨不同性别、年龄组儿童青少年BMI的变化趋势。结果14年间学生BMI P_(85)低年龄组差异比较小,随年龄增加差异逐渐增大,青春期后有减小的趋势,男生平均增加2.1百分点,女生平均增加1.3百分点。学生BMI增长主要集中在中等和高百分位数,尤其是P_(90)后,差值逐渐增大。7~11,12~15岁男生在P_(50)后差值均逐渐增大,P_(95)分别达2.0,3.2百分点,其中12岁男生从23.4 kg/m^2增加到26.8 kg/m^2,14岁女生从24.0 kg/m^2增加到25.9 kg/m^2。与WGOC标准相比,2014年男生BMI P_(85),P95均较高,而女生BMI P_(85)10岁之前高于WGOC标准,从11岁开始与WGOC标准基本相一致。2014年上海市7~18岁儿童青少年超重、肥胖检出率分别为15.4%,9.1%,较2000年总体均呈上升趋势,分别上升6.4,5.2百分点。结论 BMI分布高百分位的个体比低百分位个体的变化更大。在肥胖防治工作中,加强对群体BMI曲线的监测分析,对适时调整宏观调控战略意义重大。

Objective To examine the change in body mass index （BMI） among school aged children and adolescents in Shanghai. Methods National Student Health and Physical Fitness Survey in China of 2000, 2005, 2010 and 2014 were analyzed. LMS method was used to assess changes of BMI for 7-18 years old children and adolescents. Results During the past 14 years, the difference of BMI in the 85th percentile was relatively small among younger children, slightly increasing with age and decreasing after puberty. Average growth rate was 2.1% and 1.3% among boys and girls, respectively. BMI growth rate was highest among mid- dle to high percentile, especially among boys aged 7-11 years old and 12-15 year old, growth rate of BMI in the 95th percentile was 2.0% and 3.2%, respectively. Among 12-year-old boys, BMI in the 95th percentile increased from 23.4 kg/m2 to 26.8 kg/m2, while it was from 24.0 kg/m2 to 25.9 kg/m2 among 14-year-old girls. Compared with the WGOC standard, the 85th, 95th percentile BMI curves of boys were higher than the overweight curves of WGOC, while the 85th curves of girls younger than 10-year-old higher than the overweight curves of WGOC. Overweight and obesity rate was 15.4% and 9.1%, respectively, which increased by 6.4 and 5.2 percentage points, respectively. Conclusion Significant changes are found in BMI at high percentiles among children and adolescents in Shanghai. Studies that characterize population change should examine pattern of change across the entire distribution and not just average trends or single indicators.