Report on Childhood Obesity in China (1) Body Mass Index Reference for Screening Overweight and Obesity in Chinese School-age Children

Purpose To establish and propose a national body mass index （BMI） reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH （Chinese National Survey on Students Constitution and Health） data, including 216 620 primary and secondary school students aged 7 to 18 years old, were used as a reference population. Compared with those of the NCHS intematioanl reference, three temporary sets of cut-off BMI were proposed by testing different combinations of P85, P90, and P95. When physiological and biochemical measures between and among “obesity” “overweight”, and “normal weight” groups were taken into consideration, set Ⅱ was selected to be the most appropriate one. The sex-age-specific curves were then plotted and smoothed by using B-spline method. Results Based on the samples from costal developed metropolis, the BMI curves successfully overcame the shortcomings of lower and level-off tendency of the Chinese total population. Temporary set H, composed by cut-offs of P85 for overweight and P95 for obesity, was finally selected by its sensitivity and peculiarity. BMI 24 and 28 were used as cut-offs for overweight and obesity for both males and females aged 18 years old. These cut-offs, consistent with Chinese Adult＇s Reference, was proposed as the Body mass index reference for screening overweight and obesity in Chinese school-age children and adolescents. Conehlsion The new reference clearly showed its superiorty in both prospectivity and actuality. The proposed reference minimized the gaps of the BMI curve between Chinese adolescents and the international reference. Most importantly was that it was consistent with the Eastern Asia ethnic characteristics of body fatness growth. It was therefore proposed by the Working Group on Obesity in China （WGOC） to use it as an nationwide reference for screening overweight and obesity of school-age children and adolescents in China.

Secular Changes on the Distribution of Body Mass Index among Chinese Children and Adolescents, 1985-2010

Objective To analyze the change in Body Mass Index （BMI） distribution among Chinese children and adolescents for the development of more effective intervention for childhood obesity. Methods Data on the national students＇ constitution and health survey between 1985 and 2010 was used for this study. Subjects were students aged 7-18 randomly selected from 30 provinces in China. BMI for-age curves were developed by LMS method, and the trend of BMI distribution was determined by comparing the upper BMI percentiles and analyzing the skew shift of distribution between 2985 and 2010. Results An overall positive swift trend of BMI between 1985 and 2010 was observed among the Chinese school-age children and adolescents. The average median of the BMI increased from 16.8 and 17.0 ks/m2 to 18.2 and 17.9 kg/m2 in 25 years, with increments 0.56 and 0.36 kg/m2 per decade for males and females, respectively. The more obvious increments were found at the high BMI. The total increments of BMI in this period were 4.03 and 2.20 kg/m2 at the 85th, 6.24 and 3.57 kg/m2 at the 95th, and 6.99 and 4.27 kg/m2 at the 97th percentiles, for males and females, respectively. Conclusion Obvious increments were observed at high BMI of the Chinese children and adolescents. More effective interventions should be taken for control and prevention of obesity and its health consequence for these subgroups. It is necessary to establish a risk-complex system consisting of the identification of BMI scope, the screen of the disease risk factors and the assessment of excessive adiposity.

Physical activity, physical fitness, and body mass index in the Chinese child and adolescent populations： An update from the 2016 Physical Activity and Fitness in China The Youth Study

In this special issue of the Journal of Sport and Health Science,analyses of the most recent national prevalence estimates from the 2016 Physical Activity and Fitness in China—The Youth Study(PAFCTYS)are presented.These include the prevalence of moderate-to-vigorous physical activity(MVPA)。

Hospital-Based Phenotypic Features and Treatment Outcomes of Chinese Women with Polycystic Ovary Syndrome: The Effect of Body Mass Index and Geographic Distribution

Genetic,lifestyle,and environmental factors contribute to the etiology of polycystic ovary syndrome(PCOS).Increased body mass index(BMI)exacerbates the reproductive and metabolic parameters and reduces the fecundity of women with PCOS.This is a secondary analysis of a large-sample,multicenter,randomized controlled trial conducted at 21 sites in Chinese mainland.A total of 1000 women diagnosed with PCOS were enrolled in this trial.Of these,998 women with PCOS were included in the analysis.Increased BMI was associated with more severe menstrual irregularities,elevated testosterone level,higher prevalence of metabolic syndrome,and poorer quality of life.The rates of ovulation per woman for the normal,overweight,and obese BMI groups were 83.0%,78.2%,and 63.6%,respectively(P<0.001),and the rates of live birth were 23.6%,18.1%,and 15.3%(P=0.030).Northern PCOS patients showed more severe reproductive,glucose,and lipid profiles;less exercise;and lower total ovulation rates compared with PCOS patients from Southern China(74.8%vs 81.2%,absolute difference 6.4%,95%confidence interval 1.2%–11.5%).The results show the typical phenotypic features of Han women with PCOS in Northern and Southern China.The women living in Northern China showed a higher BMI,more severe glycolipid metabolism profiles,and subsequently worse clinical outcomes by the same interventions than those living in Southern China.The difference in phenotypic features can be explained mostly by differences in BMI and the resulting difference in ovulation.

Calcium Intake in Relation to Body Mass Index and Fatness in Thai School-Aged Children

An emerging evidence suggests that dietary calcium may play a role in the regulation of body weight in humans. This study examined the relationship of calcium intake with body mass index and body fatness in Thai children. Methods: A cross-sectional study in 1570, 6 - 12 year-old children were conducted in representative provinces of Thailand. Body weight, height, sitting height and 4 sites skinfolds thickness were measured as well as the dietary intake using a 24 h recall and a food frequency questionnaire (FFQ). General linear model (GLM) analysis was used to determine the effect of calcium intake on body mass index (BMI) and body fatness of children. Results: There were no differences in parental education and family’s socio-economic status between genders. Girls had significantly greater sitting height (p?= 0.035), sitting height to height ratio (p?= 0.014) and sum of four skinfold thickness (p?= 0.001) than boys. Mean calcium intake was lower in girls than in boys. GLM analysis demonstrated that lower calcium intake among children was associated with higher body weight, BMI and sum 4-skinfold thickness. Conclusion: Lower calcium intake is associated with higher BMI and body fatness of Thai children. Further studies need to determine the optimal calcium intake to prevent overweight and obesity in children.

Height and body mass index trajectories from 1975 to 2015 and prevalence of stunting,underweight and obesity in 2016 among children in Chinese cities:findings from five rounds of a national survey

Background A more comprehensive assessment of growth and nutrition in children is required in China due to rapid socioeconomic processes.We aimed to investigate height and body mass index(BMI)trajectories from 1975 to 2015 and the prevalence of stunting and obesity in 2016 among children in Chinese cities.Methods A total of 904,263 children from birth to 6.9 years were collected from a series of nationally representative surveys in China.Height and BMI trajectories and prevalence of stunting,underweight,overweight and obesity were assessed.Results The average height level of Chinese urban children under 7 years presented a positive secular trend from 1975 to 2015;however,a slowing tendency occurred in 2005‒2015.An apparent increase was observed at the 5th,50th and 95th percentiles of BMI in urban children aged 3 years and older,with a more prominent increase at the 95th percentile.The total prevalence of stunting and underweight under 7 years was 1.4%and 2.0%,respectively.The total prevalence of overweight and obesity under 7 years was 12.6%and 4.3%,respectively,with 12.7%and 4.9%for boys,12.6%and 3.6%for girls,12.1%and 4.0%in urban areas and 13.1%and 4.5%in suburban rural areas.Conclusions The average height level of Chinese urban children has reached World Health Organization child growth standards since 2005 and presented a slowing tendency in secular trend in 2005‒2015.More attention and efforts and public health interventions should be urgently made to combat overweight and obesity among preschool children.

Association between body mass index and body fat measured by dual-energy X-ray absorptiometry (DXA) in China: a systematic review and meta-analysis

Objective:We examined the association between body mass index(BMI)and body fat percentage(BF%)measured by dual-energy X-ray absorptiometry(DXA)among adults and children in China.Methods:We searched four databases-PubMed,China National Knowledge Infrastructure,Wanfang,and Vip for studies published in the past 22 years.Meta-analysis was conducted using random-or fixed-effect models.Results:In total of 21 studies met inclusion criteria and were included in review,and 17 ot them in meta-analysis.They were conducted across China.Their sample size ranged from 62 to 5726,and participants'age ranged from 6-80 years.Meta-analysis revealed strong associations between BMI and BF% measured by DXA in adults(pooled r=0.71,95% CI:0.66 to 0.74)and children(pooled r=0.60,95% CI:0.52 to 0.68).The association was stronger in Northern China than in East China in children(β=-0.40,95%CI:-0.65 to-0.14)and in Central China in adults(β=-0.25;95% CI:-0.51 to-0.01).Urban children's BMI was strongly associated with BF%than rural(β=0.19;95%CI:0.04 to 0.35),whereas it was stronger in adults living in rural than in urban(β=-0.35;95% CI:-0.66 to-0.05).Conclusions:BMI was strongly associated with BF%measured by DXA,and the association in children and adults in China varied by residence and region.

The Relationship of Psychological Symptoms among Mothers of Children in Different Body Mass Index Categories

We tried to emphasize the importance of psychological status analysis of the mothers of children, who have abnormal Body Mass Index (BMI), when treating these children. Materials and methods: Our study enrolled mothers of 150 children in normal, high and low BMI categories who were admitted to Kagithane State Hospital. The inclusion criteria required that these children had no chronic disease, developmental defect, and diagnosed psychological or physical disease impairing the reliability of the interview. Symptom Check List (SCL-90-R) and Beck Depression Scale (BDS) were used on all mothers of these children. In this study, BDS values of high BMI children’s mothers were significantly higher than those of normal BMI children’s mothers and BDS values of mothers of low BMI children were found to be higher than those of mothers of normal BMI children. The SCL-90-R results between mothers of high and normal BMI, high and low BMI, normal and low BMI children were statistically significant. We observed the effect of the psychological state of the family on childhood eating habits and the higher incidence of childhood feeding problems in families with psychopathology. Currently family therapy is indicated according to guidelines in solving eating disorders in children. This approach may also be useful for children with abnormal BMI.

Association of Body Mass Index and Lipid Profiles in Children

We examined the lipid values of obese and normal-weight children, to look if there is an association between Body Mass Index (BMI) and lipid profiles. Our study group included 100 volunteers (50 children with normal BMI and 50 with high BMI) who were admitted to Kagithane State Hospital Pediatrics Clinic for various reasons between July 2010 and May 2011. The inclusion criteria were as follows: age between 2 and 14 years, no chronic disease and no developmental defects. The high BMI group had significantly higher Low Density Lipoprotein (LDL) levels in comparison to the normal BMI group (p?< 0.05). We also found that the high BMI group had higher cholesterol levels close to upper limit than the normal BMI group. We found high triglyceride levels not only in the high BMI group but also in the normal BMI group with a rate of 26% and 24% respectively. The difference of 2% was not significant. We advise that identification and treatment of elevated LDL cholesterol levels is of tremendous significance for obese children or adolescents for future cardiovascular disease risk in adulthood. In the light of these findings, we must not overlook cardiovascular risk in the normal BMI group children. We believe that necessary precautions must be taken for preventing overweight and dyslipidemia in early childhood. Accordingly, it is of paramount importance not only to reduce obesity in children and adolescents but also to monitor dyslipidemia in normal BMI children to avoid the subsequent risk for cardiovascular disease.

Accuracy and capability of tri-ponderal mass index in assessing cardio-metabolic risk factors in Chinese children and adolescents aged 3 to 17 years,compared with body mass index

Background:Tri-ponderal mass index(TMI)has been reported to be a more accurate estimate of body fat than body mass index(BMI).This study aims to compare the effectiveness of TMI and BMI in identifying hypertension,dyslipidemia,impaired fasting glucose(IFG),abdominal obesity,and clustered cardio-metabolic risk factors(CMRFs)in 3-to 17-year-old children.Methods:A total of 1587 children aged 3 to 17 years were included.Logistic regression was used to evaluate correlations between BMI and TMI.Area under the curves(AUCs)were used to compare discriminative capability among indicators.BMI was converted to BMI-z scores,and accuracy was compared by false-positive rate,false-negative rate,and total misclassification rate.Results:Among children aged 3 to 17 years,the mean TMI was 13.57±2.50 kg/m 3 for boys and 13.3±2.33 kg/m 3 for girls.Odds ratios(ORs)of TMI for hypertension,dyslipidemia,abdominal obesity,and clustered CMRFs ranged from 1.13 to 3.15,higher than BMI,whose ORs ranged from 1.08 to 2.98.AUCs showed similar ability of TMI(AUC:0.83)and BMI(AUC:0.85)in identifying clustered CMRFs.For abdominal obesity and hypertension,the AUC of TMI was 0.92 and 0.64,respectively,which was significantly better than that of BMI,0.85 and 0.61.AUCs of TMI for dyslipidemia and IFG were 0.58 and 0.49.When 85th and 95th of TMI were set as thresholds,total misclassification rates of TMI for clustered CMRFs ranged from 6.5%to 16.4%,which was not significantly different from that of BMI-z scores standardized according to World Health Organization criteria.Conclusions:TMI was found to have equal or even better effectiveness in comparison with BMI in identifying hypertension,abdominal obesity,and clustered CMRFs TMI was more stable than BMI in 3-to 17-year-old children,while it failed to identify dyslipidemia and IFG.It is worth considering the use of TMI for screening CMRFs in children and adolescents.

Analysis of TCM Syndrome Characteristics of 122 Cases of Simple Obesity in Germany and its Correlation with Body Mass Index

Objective:To investigate the distribution of TCM syndromes,the regularity of syndrome differentiation and the correlation between syndromes and body mass index(BMI)of simple obesity in Germany.Methods:From July 2020 to May 2021,122 patients with simple obesity were collected from the Bad Koetzting hospital of Beijing University of Chinese Medicine.The basic information of age,gender,height,weight and TCM syndrome were collected.The distribution of syndrome and its correlation with BMI were analyzed by frequency analysis and single sample chi square test.Results:According to the frequency,the syndrome distribution of simple obesity was as follows:yin deficiency and internal heat type,liver stagnation and qi stagnation type,qi stagnation and blood stasis type,spleen and kidney deficiency type,spleen deficiency and dampness resistance type and stomach heat and dampness resistance type.The BMI of spleen kidney deficiency type was the highest,while that of stomach heat dampness stagnation type was the lowest.There was no significant difference in BMI between stomach heat and dampness stagnation type,liver qi stagnation type,qi stagnation and blood stasis type(P=0.110,P=0.111).There was no significant difference in BMI between yin deficiency and internal heat type and liver stagnation,qi stagnation and blood stasis type(P=0.175,P=0.437).However,there were significant differences in BMI among other TCM syndromes(P<0.01).Conclusion:The most common TCM syndrome type of simple obesity in Germany is yin deficiency and internal heat type,and the highest BMI value is spleen and kidney deficiency type,and there is a certain correlation between BMI value and different TCM syndrome types of simple obesity.

Body Mass Index and Health Related Physical Fitness in Saudi Girls and Adolescents Aged 8 - 15 Years

Health related physical fitness (HRPF) is considered to be an indirect marker of a person’s health and wellbeing, reflecting the interplay and integration of many persons’ systems and body functions. Purpose: To investigate the relationship between body mass index (BMI) and HRPF in a national cross-sectional sample of Saudi girls and adolescents. Methods: Weight, height and four components of HRPF (body fat composition, strength and endurance, flexibility and cardio-respiratory fitness) were measured in three age groups [(8 - 10), (11 - 12) and (13 - 15) years]. Pearson correlation coefficient and regressions analysis using a non-linear quadratic model were used to evaluate the relationship between BMI and HRPF in three age groups. Results: The results revealed variable relationships among tests. Lower scores in body fat composition and cardio-respiratory fitness were associated with higher body mass indexes in each age group. Also lower scores in muscle strength and endurance were recorded in girls aged from 11 to 15 years. Relationships between BMI and flexibility differed among age groups. Conclusion: BMI significantly and differentially influenced individual HRPF, but effects varied with age. Higher body mass indexes were generally associated with lower HRPF. The level of HRPF determined by this study may serve as an indicator of potential health risks that overweight and obese children girls and adolescents faced.

Pediatric body mass index trajectories and the risk of hypertension among adolescents in China:a retrospective cohort study

Background The impact of pediatric body mass index(BMI)trajectories on the risk of adolescent hypertension(HTN)determined by three separate visits remains unclear.This longitudinal study aims to identify potential pediatric sex-specific BMI trajectories and to assess their associations with HTN and HTN subtypes.Methods Based on the Health Promotion Program for Children and Adolescents(HPPCA)in Suzhou,China,a total of 24,426 participants who had initial normal blood pressure(BP)and had at least four BMI measurements during 2012-2020 were included.HTN was defined as simultaneously having three separate visits of elevated BP in 2020.Latent class growth models were used to explore sex-specific BMI trajectories,whose associations with HTN and HTN subtypes were further examined by logistic regression.Results The incidence of HTN determined through three separate visits was 3.34%.Four trajectories were identified for both sexes:low BMI increasing,medium BMI increasing,high BMI increasing,and highest BMI increasing.Compared to the medium BMI increasing group,the odds ratio(95%confidential interval)for developing adolescent HTN of the low,high,and highest BMI increasing groups among boys were 0.54(0.39,0.75),1.90(1.44,2.51),and 2.89(1.90,4.39),respectively;and the corresponding values for girls were 0.66(0.48,0.90),2.30(1.72,3.09),and 4.71(3.06,7.26).Similar gradually elevated associations between different trajectories with isolated systolic hypertension,systolic and diastolic hypertension were observed.Conclusion Current results emphasized the adverse effects of stable high BMI on HTN and the benefits of maintaining normal weight throughout childhood.

Close Correlations Between Carotid Arterial Mean Blood Flow Velocity,Body Mass Index,and Temperature in Normal Individuals

Objective:Assessing carotid and radial pulses is an essential sphygmology method in traditional Chinese medicine(TCM).It is believed in TCM and by doctors that pulse force is markedly linked with the physiological state of a human,including body mass index(BMI)and temperature.However,comprehensive analysis elucidating these potential correlations remains undetermined.Therefore,this investigation aimed to assess the association of pulse strength with human metabolism.Materials and Methods:The mean blood flow velocity(MBFV)of the carotid artery and pulse force of 122 healthy adults included in this investigation were assessed using ultrasound and manual palpation.Their thermal texture map was also acquired.Results:No substantial variation was observed in the carotid arterial MBFV among normal individuals(P>0.05)regardless of body side and gender.However,young individuals had higher blood velocity than middle-aged individuals(P<0.05).Furthermore,it was identified that MBFV was negatively associated with BMI and torso temperature;however,it was positively linked with hand temperature.Conclusions:This investigation revealed that carotid arterial MBFV could indicate the physical state of humans,including BMI and temperature,and therefore,is valuable for elucidating the effect of TCM on yin–yang.The data validated some TCM beliefs and supported the implementation of sphygmology in TCM.

Abnormal Adipokines Associated with Various Types of Obesity in Chinese Children and Adolescents

Objective To explore the role of adipokines including insulin, resistin, leptin, adiponectin, acylation stimulating protein （ASP） and complement C3 （C3） in various types of obesity （peripheral obesity, abdominal obesity and mixed obesity） in Chinese children and adolescents, and their relationships with body size and pubertal development. Methods Children and adolescents （n=3 508） aged 6 to 18 years, with 1 788 boys and 1 720 girls were assessed for body mass index, waist circumference, pubertal development, blood insulin, resistin, leptin, adiponectin, ASP and C3 levels. Three types of obesity [peripheral obesity （n=43）, abdominal obesity （n=473）, mixed obesity （n=1 187）] and non‐obese control （n=1 805） were defined with combined use of Chinese body mass index and waist circumference criteria. Results Serum resistin, leptin and adiponectin levels were higher in girls than those in boys （all P0.01）. Insulin and leptin increased and adiponectin decreased across five Tanner stages in both girls and boys （all P0.001）, while ASP changed only in girls （P0.001） and C3 only in boys （P0.001）. Insulin, leptin and ASP were higher, but adiponectin was lower in all three types of obesity vs. the non‐obese control （all P0.05）. The greatest abnormalities of all six adipokines were found in the mixed obesity group. With inclusion of body mass index and waist circumference in simultaneous regression analyses, both body size indices were independently and significantly correlated with insulin, leptin and adiponectin after age and gender adjustment. Compared with waist circumference, the body mass index was stronger in interpreting insulin, leptin, adiponectin and ASP levels, whereas it was weaker in explaining variance of plasma C3. Conclusions Obese children have a worse metabolic profile with high insulin, resistin, leptin, ASP and C3, and low adiponectin levels. The adipokine profile in mixed obesity is worse than that in peripheral or abdominal obesity. Identification of obese subjects with a malignant adipokine profile using a combination of body mass index and waist circumference is important for the prevention of obesity‐related disease.

Lipidomics reveals association of circulating lipids with body mass index and outcomes in IgA nephropathy patients

IgA nephropathy(IgAN)is a leading cause of chronic kidney disease(CKD),which are commonly accompanied by dyslipidemia.Obesity is also associated with dyslipidemia and risk of CKD,but the relation of the dyslipidemia patterns with obesity and disease progression in IgAN patients remains unknown.Traditional Chinese medicine(TCM)and the combined treatment with corticosteroids and TCM have been shown to be of benefit for IgAN patients,but predictive markers for guiding these treatments are lacking.Here,we quantified 545 lipid species in the plasma from 196 participants,including 140 IgAN patients and 56 healthy volunteers,and revealed an altered plasma lipidome in IgAN patients as compared to healthy participants.Association analysis showed that a subgroup of glycerides,particularly triacylglycerols(TGs)containing docosahexaenoic acid,were positively associated with high body mass index(BMI)in under-or normal-weight IgAN patients,while several free fatty acids and sphingomyelins were positively associated with high BMI in overweight or obese IgAN patients.Further,our study suggested that elevated levels of eight lipids,mainly TG species containing linolenic acid,were independent risk factors for IgAN progression and also reported the prospective association of circulating lipids with treatment outcomes in IgAN.Taken together,our findings may not only help to achieve precision medicine but also provide a knowledge base for dietary intervention in the treatment of IgAN.

Prevalence and Correlates of Elevated Blood Pressure in Chinese Children Aged 6-13 Years: a Nationwide School-Based Survey

Objective To estimate the prevalence of elevated blood pressure（EBP） in Chinese children and identify individual and family factors associated with EBP. Methods A nationwide cross-sectional study was conducted in 2010 using stratified cluster sampling. Participants＇ blood pressure was measured, and their parents completed a questionnaire on personal and family characteristics. Prevalence and correlates of EBP were assessed. Results Among a total of 24,333 participants, 20.2% of boys and 16.3% of girls had EBP. The prevalence of EBP increased with the ascending trend of waist circumference, Waist-to-height ratio, and body mass index. The adjusted prevalence ratios（aP Rs） for obese boys and girls were 2.50 and 2.97, respectively. Fewer urban boys（16.2%） had EBP than rural boys（21.7%）. Boys with a family history of hypertension were 12% more likely to have EBP. Children whose mothers received a college education tended to have lower likelihood of EBP; with an aP R was 0.85 among boys and 0.78 among girls. Conclusion EBP is common among obese students and those who have a family history of hypertension. A negative association between mothers＇ education levels and EBP risk in children was found.

Associations between body mass index in different childhood age periods and hyperuricemia in young adulthood:the China Health and Nutrition Survey cohort study

Background Few studies have evaluated the specific age period in childhood when the association of body mass index with adult hyperuricemia begins to be operative.This study aimed to examine the associations between body mass index in different childhood age periods and the risk of adult hyperuricemia in China.Methods The study cohort from the China Health and Nutrition Survey included 676 participants who were aged≥18 years and had data on uric acid in 2009 with at least one measurement of body mass index in childhood surveys before 2009.There were 357,365,358,427,and 432 observations in childhood age groups of≤5 years,6–9 years,10–12 years,13–15 years,and 16–18 years,respectively.Body mass index Z score was calculated based on 2000 Center for Disease Control and Prevention growth charts for the United States.Results Childhood body mass index Z scores measured at age≤5 years,6–9 years,10–12 years,and 13–15 years had no statistical association with adult uric acid.In comparison,childhood body mass index Z scores measured at age 16–18 years were significantly associated with adult uric acid(β=11.539,P=0.007),and the strength of association was stronger in girls(β=18.565,P=0.002)than in boys(β=9.209,P=0.087).In addition,childhood body mass index Z scores measured at age 16–18 years were significantly associated with an increased risk of adult hyperuricemia(odds ratio=1.323,95%confidence interval=1.003–1.746,P=0.048),but not for other age groups.Conclusion The association between childhood body mass index and young adulthood hyperuricemia was influenced by childhood age.

不同人体测量指标评价学龄前儿童肥胖的比较

目的旨在建立武汉市学龄前儿童体脂率百分位数参考值及参考曲线,并分析不同人体测量指标与体成分的相关性,评价其在筛查学龄前儿童肥胖中的可靠性。方法采用横断面研究设计,通过整群随机抽样的方法于2021~2023年选取武汉市江汉区及汉阳区2710名3~5岁学龄前儿童进行调查,应用康娃WS-RT-2U体检仪及皮尺测量其身高、体重、腰围(WC)和臀围,同时计算身体质量指数(BMI)、腰围身高比(WHtR)和腰围臀围比(WHR);采用InBody 230体成分仪通过生物电阻抗法测量其体脂率(PBF)、脂肪质量及去脂肪质量。利用广义可加模型(GAMLSS)对儿童体脂率数据进行拟合,构建武汉市学龄前儿童体脂率的百分位数参考值;通过计算脂肪质量指数(FMI)及去脂肪体质量指数(FFMI),对BMI构成进行分解;以建立的PBF P95为肥胖标准参考值,使用受试者工作特征(ROC)曲线来评估BMI、WC、WHtR及WHR在肥胖筛查中的效果。结果在学龄前期,男女童体脂率随年龄增长逐渐下降,且男童下降幅度大于女童。同性别年龄不同体重状态儿童BMI的差异主要由FMI贡献(56%~82%),且BMI越大FMI贡献比例越高。ROC曲线分析显示,BMI的曲线下面积(AUC)接近1.0(男童=0.942;女童=0.937),显著大于WC、WHtR及WHR的AUC值(P<0.05)。结论本研究构建了武汉市学龄前儿童体脂率百分位参考值及生长曲线,并发现BMI是学龄前儿童肥胖筛查最佳评价指标,可为本地区学龄前儿童的生长发育评价和肥胖的识别提供参考依据。

1986—2019年中国经济水平与7~18岁儿童和青少年的身高、BMI关系

目的探索中国7~18岁儿童和青少年的体质量指数(Body Mass Index,BMI)和身高与国民经济发展之间的联系,并预测2025—2030年各年龄段儿童和青少年的身高和BMI,为中国未来制定体质干预政策提供参考。方法1986—2019年7~18岁儿童和青少年的平均BMI和身高数据来自国际心脏代谢危险因素数据库,中国经济发展指标来自中国统计年鉴的历年人均国内生产总值(Gross Domestic Product Per Capita,GDPPC)。分别对男女每一个年龄组检验GDPPC和BMI、身高之间的相关性,使用线性回归和非线性回归来预测随着GDPPC的增长,2025—2030年间每个年龄组的平均身高和BMI。结果男女各年龄组的GDPPC和BMI、身高之间高度相关(P均<0.01)。随着GDPPC的增长,男女各年龄组的BMI稳步增加,但身高增速逐渐下降,各年龄段存在差异。2025—2030年6年的GDPPC增长伴随着7~18岁男、女生的BMI每年增加约0.78%和0.49%,身高每年增加约0.09%和0.18%。结论7~18岁儿童和青少年的身高和BMI在1986—2019年间呈上升趋势,经济发展高度预测身高和BMI增加,要注意各年龄段男女生身高增长速度的差异以及预防儿童和青少年的超重肥胖趋势。