Objective To establish percentile reference standards for body fat percentage (BFP) in Chinese children aged 3 - 6 years, and to determine BFP thresholds to complement BMI in obesity screening, so as to provide a scientific reference for the early identification of childhood obesity in China. Methods From 2020 to 2023, a stratified random sampling method was used to select 25 604 children aged 3 - 6 years from 120 kindergartens across 27 provinces in China.Physical and body composition measurements were conducted.The generalized additive model for location, scale, and shape (GAMLSS) was applied to establish percentile references for BFP.Receiver operating characteristic (ROC) curves were used to compare the sensitivity of different anthropometric indicators in reflecting BFP and to evaluate the performance of different BFP percentiles in identifying obesity.The optimal percentile for obesity screening in children aged 3 - 6 years was selected. Results 1) Boys had significantly greater height, weight, body mass index (BMI), and waist circumference than girls (P<0.01), while BFP was lower in boys (P<0.01).Height, weight, and waist circumference increased with age, whereas BFP and waist-to-height ratio generally decreased, and BMI showed minor fluctuations.2) Compared to height, weight, and waist circumference, BMI and weight-for-height (WFH) were more sensitive indicators of BFP in children aged 3 - 6 years.3) The 90th percentile of BFP (P90) achieved the best balance between sensitivity and specificity and was identified as the most suitable threshold for obesity screening. Conclusions BMI and WFH are sensitive indicators of body fat levels in children.Percentile reference values for BFP specific to Chinese children aged 3 - 6 years were established.The P90 percentile of BFP demonstrated the best performance in obesity screening for this age group and is recommended as a complementary threshold to BMI to improve screening accuracy and reduce misdiagnosis/underdiagnosis.
Key words
3 - 6 years /
obesity /
evaluation standards /
body fat percentage
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References
[1] 中国居民营养与慢性病状况报告(2020年)[J].营养学报, 2020, 42(6): 521.
Report on nutrition and chronic disease status of chinese residents (2020)[J].Journal of Nutrition, 2020, 42(6): 521.(in Chinese)
[2] 马冠生,张玉.中国儿童肥胖防控面临的挑战和机遇[J].中国儿童保健杂志, 2020, 28(2):117-119.
Ma GS, Zhang Y.Challenges and opportunities in the prevention and control of childhood obesity in China[J].Chin J Child Health Care, 2020, 28(2): 117-119.(in Chinese)
[3] Chooi YC, Ding C, Magkos F.The epidemiology of obesity[J].Metabolism-Clinical and Experimental, 2019, 92: 6-10.
[4] Zhao Y, Gong JX, Ji YT, et al.Cross-sectional study of characteristics of body composition of 24 845 children and adolescents aged 3-17 years in Suzhou[J].BMC Pediatr, 2023, 23(1): 358.
[5] Hampl SE, Hassink SG, Skinner AC, et al.Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity[J].Pediatrics, 2023, 151(2).
[6] 王伊敏, 王蜜源, 韦梦娜, 等.不同人体测量指标评价学龄前儿童肥胖的比较[J].华中科技大学学报(医学版), 2024, 53(2): 214-219,228.
Wang YM,Wang MY,Wei MN, et al.Comparison of different anthropometric indicators in evaluating obesity among preschool children[J].Acta Med Univ Sci Technol Huazhong,2024,53(2):214-219,228.(in Chinese)
[7] Plachta-Danielzik S, Gehrke MI, Kehden B, et al. Body fat percentiles for German children and adolescents[J]. Obes Facts, 2012, 5(1):77-90.
[8] Koyama S, Sairenchi T, Shimura N, et al.Association between timing of adiposity rebound and body weight gain during infancy[J].J Pediatr, 2015, 166(2): 309-12.
[9] 全国儿童期单纯肥胖症研究协作组, 中国疾病预防控制中心妇幼保健中心.全国0～6 岁儿童单纯性肥胖流行病学研究[J].中华儿科杂志,2008,46(3):179-184.
National Collaborative Group for the Study of Simple Obesity in Childhood, Center for Maternal and Child Health, Chinese Center for Disease Control and Prevention.Epidemiologic study of simple obesity in children aged 0-6 years[J].Chin J Pediatr 2008,46(3):179-184.(in Chinese)
[10] 张婷, 孟浩然, 张莉, 等.体脂率、身长别体重及体质量指数评价婴幼儿超重/肥胖的一致性分析[J].中国儿童保健杂志, 2023, 31(10): 1054-1057,1064.
Zhang T,Meng HR,Zhang L, et al.Consistency analysis of fat mass percentage, weight for length and body mass index in evaluating overweight/obesity in infants[J].Chin J Child Health Care,2023, 31(10): 1054-1057,1064.(in Chinese)
[11] 范冬梅,吴广飞,王星,等.早期糖代谢异常对青年男性骨骼肌含量影响的研究[J].中国糖尿病杂志,2024,32(10):746-749.
Fan DM, Wu GF, Wang X, et al.The imPact of early abnormal glucose metabolism on skeletal muscle mass in young men[J].Chin J Diabetes Mellitus, 2024, 32(10): 746-749.(in Chinese)
[12] 余波,石坤,周小娟,等.正常体重肥胖儿童青少年的心率变异性,心率减速力与心血管代谢性疾病的关系[J].中华实用儿科临床杂志, 2024, 39(6):450-454.
Yu B, Shi K, Zhou XJ, et al.RelationshiP between heart rate variability, deceleration capacity, and cardiometabolic diseases in children and adolescents with normal-weight obesity[J].Chin J Pediatr Clin Med, 2024, 39(6): 450-454.(in Chinese)
[13] Tekola-Ayele F, Lee A, Workalemahu T, et al.Shared genetic under pinnings of childhood obesity and adult cardiometabolic diseases[J].Hum Genomics, 2019, 13(1): 17.
[14] Chrysant SG, Chrysant GS.The single use of body mass index for the obesity paradox is misleading and should be used in conjunction with other obesity indices[J].Postgrad Med, 2019, 131(2): 96-102.
[15] Bellafronte NT, Diani LM, Vega-piris L, et al.ComParison between dual-energy X-ray absor ptiometry and bioelectrical impedance for body composition measurements in adults with chronic kidney disease: A cross-sectional, longitudinal, multi-treatment analysis[J].Nutrition, 2021, 82: 111059.
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