文章摘要
中国肥胖问题工作组,季成叶.中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准[J].中华流行病学杂志,2004,25(2):97-102
中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准
Body mass index reference norm for screening overweight and obesity in Chinese children and adolescents
收稿日期:2003-12-22  出版日期:2014-09-15
DOI:
中文关键词: 超重;肥胖;体重指数;筛查标准;儿童青少年
英文关键词: Overwight;Obesity;Body mass index;Screening norm;Children and adolescents
基金项目:
作者单位
中国肥胖问题工作组 北京大学儿童青少年卫生研究所 100083 
季成叶 北京大学儿童青少年卫生研究所 100083 
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中文摘要:
      目的 建立全国统一的学龄儿童、青少年超重、肥胖筛查体重指数(BMI)值分类标准。方法 以“2000年全国学生体质调研”为参照人群,共调查汉族7~18岁中小学生244 200余人。比较中国儿童青少年BMI分布与美国国立卫生统计中心(NCHS)国际标准差距,计算随年龄BMI百分位数分布。利用P85、P90和P95,组合成三个暂定标准,利用生理、血脂生化和体成分指标进行交叉验证。运用B-spline曲线对选定标准作平滑化拟合。结果 利用中国沿海发达大城市样本作BMI分布曲线有助克服青春中期后曲线的低平现象。交叉验证显示以P85和P95为超重、肥胖筛查标准较适宜,灵敏性和特异性符合要求。18岁时男女性BMI均以24和28为超重、肥胖界值点,与已颁布实施的中国成人超重、肥胖筛查标准接轨。以北京、河南、四川等省(市)分别作为中国儿童青少年生长发育上、中、下水平的三个代表人群作回代验证。城市7~18岁男女生中,北京市超重率17.00%和9.46%,肥胖率9.99%和6.47%;河南省超重率10.86%和6.64%,肥胖率4.27%和3.07%;四川省超重率6.95%和4.23%,肥胖率2.84%和2.09%,符合现实状况。结论 本标准兼顾前瞻性和现实性,既充分考虑近年来中国学龄儿童青少年生长的长期加速趋势,显著缩短和国际标准的差距,又具有中国特色。
英文摘要:
      Objective To establish a national body mass index (BMI) reference norm for the purpose of screening and more active prevention and cure on overwight and obesity in Chinese children and adolescente. Methods The 2000 Chinese National Survey on Students Constitution and Health was used as reference population. In total there were more than 244.2 thousands of primary and secondary Han nationality students aged 7 through 18 years old included in this study. The BMI distribution of various Chinese children and adolescent groups were compared with the NCHS international norm, the percentage values and with advanced ages, were calculated. In the beginning, three temporary norms were set up, using the different combination of P85, P90 and P95 BMI percentages. Based on the intersect testing and varifying of physiological, lipidemia biochemical and body composition measures, the best norm was then selected. B-spline smoothing method was used to correct the curves, both for males and females, composed by cut-off points at different ages. Results Using samples from the costal developed metropolis, the BMI curves successfully overcame the shortcomings of low and depressive phenomenon of the total population, in particular after the mid--adolescent period. The temporary Norm Ⅱ, composed by cut-off points of P85 for overweight and P95 for obesity, was found to be the best among the three temporary norms, both shown by its sensitivity and specificity. 24 and 28 were used as cut-off points for overweight and obesity in this norm, both for males and females aged 18 years. These two cut-off points were consistent with those shown in the Body Mass Index Reference Norm for Screening Overweight and Obesity in Chinese Adults. Three Samples from Beijing, Henan and Sichuan, used as representatives of upper, middle and relative low levels of physical growth of children and adolescents in China, were used for extra tests. The screening results showed that among the male and female subjects aged 7 through 18 years, the prevalence rates were 17. 00% and 9. 46% for overweight, 9. 99% and 6. 47% for obesity in Beijing while 10. 86% and 6. 64% for overweight, 4.27% and 3.07% for obesity in Henan, and 6.95% and 4.23% for overweight and 2. 84 % and 2. 09 % for obesity in Sichuan, respectively. Data clearly showed that the results were in accordance with the actural situation seen in the Chinese studens in 2000. Conclusion The newly established reference norm seemed to be good for prospective studies as it considered the facts regarding the rapid and strong tendency of secular growth changes seen in the Chinese children and adolesconts. It also decreased the difference of growth levels between the Chinese children and adolescents and those of the international norms. Ths norm was particularly developed for the Chinese which was also in consistent with the Eastern Asia ethnic charcteristics so could be promoted in China.
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