目的 通过制定的最新标准了解婴幼儿超重/肥胖的流行病学现状,结合体脂率(FMP)的检测结果,分析其与年龄别体质量指数Z评分(BMIZ)及身长别体重Z评分(WLZ)评价超重、肥胖结果的一致性,为更好地实现儿童超重/肥胖的精准评估提供依据。方法 2021年3月—2022年10月在山东省开展多中心婴幼儿体成分横断面研究,招募正常健康查体的婴幼儿为研究对象。调查内容包括电子问卷调查(受试婴幼儿的基本信息与父母特征)和体成分测量。最终纳入11 472份有效数据。结果 以2013年《5岁以下儿童生长状况判定》为诊断标准,WLZ诊断的男童和女童(＜2岁)超重/肥胖总检出率分别为6.6%和6.5%;BMIZ诊断的男童和女童(≥2岁)总检出率分别为0.8%和2.3%;以2022年发布并于2023年实施的《7岁以下儿童生长标准》为诊断标准,WLZ诊断男童和女童(＜2岁)超重/肥胖总检出率分别为23.3%和23.5%,BMIZ(≥2岁)诊断超重/肥胖总检出率分别为10.7%和16.0%。新诊断标准的实施使超重/肥胖的检出率明显增高。以体脂率为评价标准男童和女童超重/肥胖的总检出率分别为22.9%和21.0%。新标准的制定使体脂率与WLZ及BMIZ评定超重/肥胖结果的一致性明显增高,并且女童体脂率与BMIZ的Kappa值都达到0.95。结论 新标准的制定使婴幼儿超重/肥胖的检出率明显增高,有利于超重/肥胖的早期识别和早期干预。体成分检测结合2023年儿童超重/肥胖诊断新标准,更有助于儿童超重/肥胖的精准评估以及制定合理的干预措施。
Abstract
Objective To understand the epidemiological status of overweight/obesity in infants by the latest standards, and to evaluate the consistency of fat mass percentage (FMP) with body mass index for age Z score (BMIZ) andweight for length Z score (WLZ)in diagnosing overweight/obesity, so as to provide basis for accurate evaluation of overweight/obesity in children. Methods From March 2021 to October 2022, a multicenter cross-sectional study on body composition of infants and toddlers was carried out in Shandong Province, infants and toddlers with normal health were recruited as study subjects. An electronic questionnaire on basic information and parents′ characteristics of the tested infants was used in this survey and body composition measurement was conducted. Valid data of 11 472 cases were finally included. Results Taking the 2013 Assessment for growth status of children under 5 years of age as the diagnostic standard, the overall detection rate of overweight/obesity in boys and girls (＜2 years) diagnosed by WLZ were 6.6% and 6.5%, respectively; the total detection rates ofoverweight/obesity in boys and girls (≥2 years) diagnosed by BMIZ was 0.8% and 2.3%, respectively. Taking the Growth Standards for Children under 7 years of age issued in 2022 and implemented in 2023 as the diagnostic standard, the total detection rates of overweight/obesity in boys and girls (＜2 years) diagnosed by WLZ were 23.3% and 23.5%, respectively, and the total detection rates of overweight/obesity in boys and girls diagnosed by BMIZ (≥2 years) were 10.7% and 16.0%, respectively. The implementation of the new diagnostic criteria had significantly increased the detection rate of overweight/obesity. Taking FMP as the evaluation standard, the total detection rates of overweight/obesity in boys and girls were 22.9% and 21.0%, respectively. The new standards had resulted in a significant increase in the consistency between FMP and overweight/obesity assessed by WLZ and BMIZ, and a Kappa value of 0.95 for FMP and BMIZ in girls. Conclusions The new standards have significantly increased in the detection of overweight/obesity in infants and toddlers, which is conducive to early identification and intervention of overweight/obesity. The combination of body composition test with the new diagnostic standard for overweight/obesity in children in 2023 will facilitate the accurate assessment of overweight/obesity in children and the development of appropriate interventions.
关键词
婴幼儿 /
体脂率 /
体质量指数 /
身长别体重 /
超重 /
肥胖
Key words
infants and toddlers /
fat mass percentage /
body mass index /
weight for length /
overweight /
obesity
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基金
国家卫生健康委医药卫生科技发展研究中心项目(WA2020HK24);山东省自然科学基金(ZR2021MH296)
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