目的 采用腰围和腰围身高比的不同诊断标准,全面描述济南市城区儿童青少年腹型肥胖流行状况,为儿童青少年肥胖的防治提供基础依据。方法 数据来源于2012年9月-2014年9月进行的十二五国家科技支撑计划项目“儿童心血管疾病的预警、诊治技术研究”分课题济南调查点。腹型肥胖分别采用腰围和腰围身高比的不同标准进行评价。采用χ2检验比较不同年龄段男女的腹型肥胖检出率差异,并计算kappa值,比较腰围与腰围身高比(WHtR)不同诊断标准之间的一致性。结果 济南市城区7~17岁儿童青少年的腹型肥胖检出率分别为28.1%(WC-中国标准)、22.2%(WC-北京标准)、17.7%(WHtR-国际标准)和27.3%(WHtR-中国标准)。低学龄组(7~11岁)腹型肥胖检出率随年龄增加表现为上升趋势,高学龄组(12~17岁)腹型肥胖检出率随年龄增加呈现下降趋势。无论采用何种标准,高学龄组(12~17岁)中男生腹型肥胖检出率明显高于女生。结论 济南市城区7~17岁儿童青少年腹型肥胖处于流行状态,应当引起政府和教育相关部门的重点关注。
Abstract
Objective To comprehensively describe the prevalence of abdominal obesity among children and adolescents in the urban area of Jinan, using different definitions of waist circumference (WC) and waist to height ratio (WHtR), in order to provide a scientific evidence for obesity prevention in children and adolescents.Methods Data were from the Twelfth Five-year National Science and Technology Support Program "Early Warning, Diagnosis and Treatment of Cardiovascular Disease in Children" conducted in Jinan from September, 2012 to September, 2014. Abdominal obesity was evaluated using different WC and WHtR standards. Chi-Squared test was used to compare the sex-difference on prevalence of abdominal obesity within different ages and the kappa value was calculated to compare the agreements of different definitions using WC and WHtR. Results The prevalence of abdominal obesity was 28.1% (WC-Chinese standard), 22.2% (WC-Beijing standard), 17.7% (WHtR-International standard) and 27.3% (WHtR-Chinese standard) respectively. In children aged 7~11 years, there was an upward trend in the prevalence of abdominal obesity with age. In adolescents aged 12~17 years, there was a downward trend with age. Regardless of the used standards, the prevalence of abdominal obesity in adolescent boys was significantly higher than that in adolescent girls. Conclusions In urban area of Jinan, abdominal obesity in children and adolescents is prevalent, and more attentions should be paid by related government and education departments.
关键词
儿童青少年 /
腰围 /
腰围身高比 /
腹型肥胖
Key words
children and adolescent /
waist circumference /
waist-to-height ratio /
abdominal obesity
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Afshin A, Forouzanfar MH, Reitsma MB, et al. Health effects of overweight and Obesity in 195 Countries over 25 Years[J].N Engl J Med, 2017, 377(1): 13-27.
[2] 北京大学,首都儿科研究所,农业部食物与营养发展研究所,等.中国儿童肥胖报告[R],北京:人民卫生出版社, 2017.
[3] Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adultcardiometabolic risk factors: systematic review and meta-analysis[J]. Obes Rev, 2012, 13(3): 275-286.
[4] Lo K, Wong M, Khalechelvam P, et al. Waist-to-height ratio, body mass index and waist circumference for screeningpaediatric cardio-metabolic risk factors: a meta-analysis[J]. Obes Rev, 2016, 17(12): 1258-1275.
[5] Khoury M, Manlhiot C, Mccrindle BW. Role of the waist/height ratio in thecardiometabolic risk assessment of children classified by body mass index[J]. J Am Coll Cardiol, 2013, 62(8): 742-751.
[6] 马冠生,季成叶,马军,等.中国7～18岁学龄儿童青少年腰围界值点研究[J]. 中华流行病学杂志, 2010, 31(6): 609-615.
[7] 孟玲慧, 罗纳,程红,等.北京与全国7～18岁儿童青少年腰围适宜界值对心血管危险因素筛查效度的对比分析[J]. 中华预防医学杂志, 2011, 45(8): 717-722.
[8] Ashwell M, Gibson S. A proposal for a primary screening tool: 'Keep your waist circumference to less than half your height'[J]. BMC Med, 2014, 12: 207.
[9] 中华医学会儿科学分会内分泌遗传代谢学组,中华医学会儿科学分会心血管学组,中华医学会儿科学分会儿童保健学组,等.中国儿童青少年代谢综合征定义和防治建议[J]. 中华儿科杂志, 2012, 50(6): 420-422.
[10] Lone S, Lone K, Khan S, et al. Assessment of metabolic syndrome in Kashmiri population with type 2 diabetes employing the standard criteria′s given by WHO, NCEPATP III and IDF[J]. J Epidemiol Glob Health, 2017, 7(4): 235-239.
[11] 徐珏,黄春萍,李青卿.杭州市儿童青少年腰围特征及肥胖分析[J]. 预防医学, 2017, 29(6): 596-598,602.
[12] 杨云娟,常利涛,吕慧,等.中国部分民族儿童青少年超重肥胖流行态势及影响因素[J]. 中国学校卫生, 2016, 37(8): 1147-1150.
[13] 何宇纳,赵文华,赵丽云,等.2010—2012年中国10~17岁儿童青少年代谢综合征流行情况[J]. 中华预防医学杂志, 2017, 51(6): 513-518.
[14] Zhang YX, Li YL, Zhao JS, et al. Distributions of waist circumference and waist-to-height ratio for children and adolescents in Shandong, China[J]. Eur J Pediatr, 2013, 172(2): 185-191.
基金
国家自然科学青年基金项目(81302496);国家自然科学基金面上项目(81673195);国家科技支撑计划 (2012BAI03B03)
PDF(652 KB)
