济南市4～6岁儿童体成分分析
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摘要
目的分析济南市4～6岁儿童体成分发育特点,研究学龄前儿童体脂百分比(PBF)与体重指数(BMI)的关系,比较两者在肥胖诊断中的差异。方法 2017年5月—2018年6月选取儿保科健康查体的1 788例济南市4～6岁健康儿童,运用生物电阻抗法进行体成分测试。结果 4～6岁男、女童部分体成分指标随年龄增长而增加,肌肉量、躯干肌肉量、去脂体重、蛋白质、体脂肪、无机盐、基础代谢率和水分、PBF指标差异有统计学意义(P<0.05)。Pearson检验中,若不区分性别,BMI和PBF的相关系数r=0.841;若区分性别,男性r=0.872,女性r=0.830,以PBF与BMI标准判断儿童肥胖率具有较强的一致性(Kappa值=0.64)。结论 1)生物电阻抗法测定学龄前儿童体成分,可客观反映体脂肪含量,准确判断肥胖。2)BMI与PBF在判断肥胖时,男童的一致性高于女童。PBF在评估肥胖男童时灵敏性高于BMI。
Objective To analyze the characteristics of body composition development of preschool children aged 4-6 years in Jinan,and to study the relationship between body fat percentage(PBF) and body mass index(BMI) in preschool children,in order to compare the difference on obesity diagnosis between PBF and BMI. Method Totally 1 788 healthy children aged 4-6 years in Jinan City were selected for body composition test by bioelectrical impedance method from May 2017 to June 2018. Results The partial body composition of boys and girls before 4-6 years old increased with age. The difference was statistically significant in muscle mass,trunk muscle mass,fat-free body weight,protein,body fat,inorganic salt,basal metabolic rate moisture and PBF(P<0.05). In Pearson test, BMI was correlated to PBF(r=0.841) if gender was not distinguished,and the correlation coefficient was 0.872 for boys while 0.830 for girls. There was a strong consistency between PBF and BMI in evaluating the obesity rate of children(Kappa=0.64). Conclusions 1)Bioelectrical impedance method can objectively reflect body fat content and accurately evaluate obesity in preschool children. 2) When BMI and PBF were used to assess obesity,the consistency in boys was higher than that in girls. PBF was more sensitive than BMI in assessing obese boys.
Objective To analyze the characteristics of body composition development of preschool children aged 4-6 years in Jinan,and to study the relationship between body fat percentage(PBF) and body mass index(BMI) in preschool children,in order to compare the difference on obesity diagnosis between PBF and BMI. Method Totally 1 788 healthy children aged 4-6 years in Jinan City were selected for body composition test by bioelectrical impedance method from May 2017 to June 2018. Results The partial body composition of boys and girls before 4-6 years old increased with age. The difference was statistically significant in muscle mass,trunk muscle mass,fat-free body weight,protein,body fat,inorganic salt,basal metabolic rate moisture and PBF(P<0.05). In Pearson test, BMI was correlated to PBF(r=0.841) if gender was not distinguished,and the correlation coefficient was 0.872 for boys while 0.830 for girls. There was a strong consistency between PBF and BMI in evaluating the obesity rate of children(Kappa=0.64). Conclusions 1)Bioelectrical impedance method can objectively reflect body fat content and accurately evaluate obesity in preschool children. 2) When BMI and PBF were used to assess obesity,the consistency in boys was higher than that in girls. PBF was more sensitive than BMI in assessing obese boys.
引文
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[11] 张倩,杜维婧,胡小琪,等.北京市儿童少年体重指数与体脂百分比关系的分析[J].中华流行病学杂志,2004,25(2):26-29.
[12] 刘惠双.腹腔内脏脂肪面积与慢性疾病相关性研究[J].中国现代药物应用,2016,10(2):88-89.
[13] 丁文清.肥胖儿童代谢状态与高血压关系的前瞻性队列研究[D].北京:北京协和医学院,2015.
[14] Dias IBF,Panazzolo DG,Marques MF,et al.Relationshipsbetween emerging cardiovascular risk factors,z-BMI,waistcircumference and body adiposity index (BAI) on adolescents[J].Clin Endocrinol (Oxf),2013,79 (5):667-674.
[15] Wu YK,Chu NF,Huang YH,et al.BMI,body fat mass and plasma leptin level in relation to cardiovasculardiseasesrisk factors amongadolescents in Taitung [J].Obes Res Clin Pract,2016,10 (4):432-441.
[16] Martin-Espinosa N,Diez-Fernandez A,Sanchez-Lopez M,et al.Prevalence of high blood pressure and association withobesity in Spanish school children aged 4～6 years old [J].PLoS One,2017,12(1):e0170926.
[2] 杨露,蒋琪,李雪婷,等.北京市海淀区儿童青少年体成分特征分析[J].中国学校卫生,2017,38(2):304-306.
[3] Cole,TJ,Bellizzi,MC,Flegal,KM,et al.Establishing a standard definition for child overweight and obesity worldwide:international survey[J].BMJ,2000,320(7244):1240-1243.
[4] Deurenberg P,Yap M,van Staveren WA.Body mass index and percent body fat:a meta analysis among different ethnic groups[J].Int J Obesity,1998,22(12):1164-1171.
[5] 温爱玲,游永豪,张猛,等.不同年龄阶段小学生体脂状况对比分析[J].西昌学院学报:自然科学版,2015,29(2):140-142.
[6] Javed A,Jumean M,Murad MH,et al.Diagnostic performance of body mass index to identify obesity as definedby body adiposity in children and adolescents:a systematicreview and meta-analysis [J].Pediatr Obes,2015,10 (3):234-244.
[7] Vanavanan S,Srisawasdi P,Rochanawutanon M,et al.Performance of body mass index and percentage of body fat in predicting cardiometabolic risk factors in Thai adults [J].Diabetes Metab Syndr Obes,2018,11:241-253.
[8] 马冠生.中国肥胖报告[R].北京:人民卫生出版社,2017.
[9] 苗琳,徐冉,袁芳琪,等.河北邢台市3～18岁儿童少年单纯性肥胖流行模式的调查[J].公共卫生与预防医学,2017,28(6):122-123.
[10] 王文澜.大连市西岗区0～3岁儿童单纯性肥胖现况及相关因素分析[J].中国疗养医学,2017,26(6):661-663.
[11] 张倩,杜维婧,胡小琪,等.北京市儿童少年体重指数与体脂百分比关系的分析[J].中华流行病学杂志,2004,25(2):26-29.
[12] 刘惠双.腹腔内脏脂肪面积与慢性疾病相关性研究[J].中国现代药物应用,2016,10(2):88-89.
[13] 丁文清.肥胖儿童代谢状态与高血压关系的前瞻性队列研究[D].北京:北京协和医学院,2015.
[14] Dias IBF,Panazzolo DG,Marques MF,et al.Relationshipsbetween emerging cardiovascular risk factors,z-BMI,waistcircumference and body adiposity index (BAI) on adolescents[J].Clin Endocrinol (Oxf),2013,79 (5):667-674.
[15] Wu YK,Chu NF,Huang YH,et al.BMI,body fat mass and plasma leptin level in relation to cardiovasculardiseasesrisk factors amongadolescents in Taitung [J].Obes Res Clin Pract,2016,10 (4):432-441.
[16] Martin-Espinosa N,Diez-Fernandez A,Sanchez-Lopez M,et al.Prevalence of high blood pressure and association withobesity in Spanish school children aged 4～6 years old [J].PLoS One,2017,12(1):e0170926.