不同BMI筛查标准判别大学生肥胖准确性评价
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摘要
目的分析不同体质量指数(body mass index,BMI)肥胖筛查标准判别大学生肥胖的准确性,为制定科学合理的学生生长发育评判标准提供参考。方法采用生物阻抗法(bioelectricalimpedanceanalysis, BIA)对北京体育大学非体育专业1 977名大学生(男生1 320名,女生657名)进行体脂测定。以WHO推荐的体脂率肥胖判定标准(男>25%,女>35%)作为"金标准",分别对不同BMI筛查标准的真实性、可靠性、收益等进行评价。结果以体脂率判定标准检出的肥胖率为11.6%;分别以BMI≥28 kg/m~2,BMI≥25 kg/m~2为肥胖判定标准时,肥胖检出率分别为2.0%,8.2%;BMI≥28 kg/m~2,BMI≥25 kg/m~2作为大学生肥胖筛查标准的真实性评价结果为特异度高(0.999和0.966)、灵敏度过低(0.175和0.450),尤其是女生(0.063和0.304);Kappa分析表明,BMI≥25 kg/m~2与体脂率"金标准"一致性比BMI≥28 kg/m~2高,分别为0.477和0.269;BMI≥28 kg/m~2阳性预测率比阴性预测率高,BMI≥25 kg/m~2阴性预测率比阳性预测率高。结论 BMI不能客观反映大学生的体脂含量,尤其对女大学生;建议分性别制定BMI肥胖判定标准。
Objective To analyze the accuracy of different BMI obesity screening criteria in discriminating the obesity of college students, and to provide a reference for formulation scientific and reasonable grouth and development evaluation criteria for students. Methods The bioelectrical impedance analysis(BIA) was used to measure BF of 1 977 non-sports-major-students. Based on WHO "golden standard" of BF%(BF>25% for male and BF >35% for female) for obesity, the accuracy, reliability, and benefits of different BMI screening standards for obesity were evaluated. Results The obesity rate was 11.6% according to the BF% standard, and was 2.0% and 8.2% based on BMI ≥28 kg/m~2 and BMI ≥25 kg/m~2, respectively; A higher specificity(0.999, 0.966) and a low sensitivity(0.175,0.450) were noticed when BMI≥28 kg/m~2 and BMI≥25 kg/m~2 was used as screening standard for obesity, especially among female(0.063,0.304); The reliability evaluation of consistency with "gold standard" of BMI≥25 kg/m~2 was higher than BMI≥25 kg/m~2; when BMI≥28 kg/m~2 was used as screening standard for obesity, the positive predictive value was higher than negative predictive value, BMI≥25 kg/m~2 was on the contrary. Conclusion BMI cannot adequately reflect body fat content of college students, especially for female; The standard for obesity diagnosis should be based on gender.
Objective To analyze the accuracy of different BMI obesity screening criteria in discriminating the obesity of college students, and to provide a reference for formulation scientific and reasonable grouth and development evaluation criteria for students. Methods The bioelectrical impedance analysis(BIA) was used to measure BF of 1 977 non-sports-major-students. Based on WHO "golden standard" of BF%(BF>25% for male and BF >35% for female) for obesity, the accuracy, reliability, and benefits of different BMI screening standards for obesity were evaluated. Results The obesity rate was 11.6% according to the BF% standard, and was 2.0% and 8.2% based on BMI ≥28 kg/m~2 and BMI ≥25 kg/m~2, respectively; A higher specificity(0.999, 0.966) and a low sensitivity(0.175,0.450) were noticed when BMI≥28 kg/m~2 and BMI≥25 kg/m~2 was used as screening standard for obesity, especially among female(0.063,0.304); The reliability evaluation of consistency with "gold standard" of BMI≥25 kg/m~2 was higher than BMI≥25 kg/m~2; when BMI≥28 kg/m~2 was used as screening standard for obesity, the positive predictive value was higher than negative predictive value, BMI≥25 kg/m~2 was on the contrary. Conclusion BMI cannot adequately reflect body fat content of college students, especially for female; The standard for obesity diagnosis should be based on gender.
引文
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[15] 乌云格日勒,陈勇,谭清国,等.根据BMI和体脂百分比标准判别成人肥胖度效力的评估性研究[J].山东体育学院学报,2009,25(1):51-56.
[16] 梁洁,张凤兰,潘伟华,等.大学生肥胖认知现状及减肥行为的调查与分析[J].现代预防医学,2008,35(15):2918-2919.
[17] 崔思栋,杨显彪,普照民.大学生身体活动指数与心理健康状况的相关研究[J].体育科技,2015,36(2):85-86.
[18] 张国海.运动对大学生骨密度和体成分的影响及相互关系的研究[J].中国体育科技,2008,44(5):56-62.
[19] 单绿叶.有氧运动对女大学生身体形态和体脂的影响[J].浙江体育科学,2010,32(3):125-127.
[20] 季玉珍.大学生BMI与体成分和部分素质指标的关系[D].杭州:浙江大学,2011.
[21] OKORODUDU D O,JUMEAN MFMONTORI V M,ROMERO C A,et al.Diagnostic performance of body mass index to identify obesity as defined by body adiposity:a systematic review and meta-analysis[J].Int J Obes,2010,34(5):791.
[22] ROMERO-CORRAL A,SOMERS V K,SIERRA-JOHNSON J,et al.Accuracy of body mass index in diagnosing obesity in the adult general population[J].Int J Obes,2008,32(6):959-966.
[23] NIRAV R S,ERIC R.Measuring adiposity in patients:the utility of Body Mass Index(BMI),percent body fat,and leptin[J].PLoS One,2012,7(4):e33308.
[24] 李红娟,杨柳,张楠.身体质量指数作为肥胖筛查标准的判别准确性评价[J].中国预防医学杂志,2014,15(6):571-575.
[25] 何英剑,陶秋山,李晓婷,等.性别、年龄对成人BMI超重与肥胖诊断标准影响[J].中国公共卫生,2009,25(4):441-443.
[2] 秦双兰,贾卫国,王冬.大学生体重超重、肥胖对体质健康状况影响的研究[J].河北体育学院学报,2008,22(1):78-80.
[3] 刘卫,李丰祥.大学生身体成分特征与运动能力及体质健康的关系[J].体育学刊,2004,11(1):52-55.
[4] 尹小俭,季成叶,王树明.我国大学生肥胖流行现状及体质变化趋势[J].成都体育学院学报,2009,35(1):65-68.
[5] JAMES W P,MASCIETAYLOR G C,NORGAN N G,et al.The value of arm circumference measurements in assessing chronic energy deficiency in third world adults[J].Eur J Clin Nutr,1994,48(12):883.
[6] 王红娟,李立,陈玉娟.BMI和体脂%在判定大学生肥胖时的差异性研究[J].体育科技,2015,36(1):74-76.
[7] 黄津虹,齐玉刚,王洪泱.大学生体脂率与BMI指数的相关分析[J].天津轻工业学院学报,2003,18(4):64-67.
[8] 国家体育总局群体司.国家国民体质监测中心.2010年国民体质监测工作手册[M].北京:国家体育总局,2009.10.
[9] World Health Organization.Physical status:the use and in terpretation of anthropometry[R].World Health Organ Tech Ser,1995,854(6):1-452.
[10] 中国肥胖问题工作组数据汇总分析协作组.我国成人体重指数和腰围对相关疾病危险因素异常的预测价值:适宜体重指数和腰围切点的研究[J].中华流行病学杂志,2002,23(1):5-10.
[11] Steering Committee.The Asia pacific perspective:redefining obesity and its treatment[M].Melbourne:international diabetes institute,2000.
[12] 李敏,王东生.石家庄高校女生隐性肥胖现状分析[J].中国学校卫生,2012,33(3):366-367.
[13] 肖国强,马冀平,刘晓光,等.我国大学生隐形肥胖者的体质形态和体力特征[J].体育学刊,2004(5):39-42.
[14] 季成叶.我国大城市与南方乡村学生学生两类超重/肥胖筛查标准比较[J].中国学校卫生,2010,31(4):385-389.
[15] 乌云格日勒,陈勇,谭清国,等.根据BMI和体脂百分比标准判别成人肥胖度效力的评估性研究[J].山东体育学院学报,2009,25(1):51-56.
[16] 梁洁,张凤兰,潘伟华,等.大学生肥胖认知现状及减肥行为的调查与分析[J].现代预防医学,2008,35(15):2918-2919.
[17] 崔思栋,杨显彪,普照民.大学生身体活动指数与心理健康状况的相关研究[J].体育科技,2015,36(2):85-86.
[18] 张国海.运动对大学生骨密度和体成分的影响及相互关系的研究[J].中国体育科技,2008,44(5):56-62.
[19] 单绿叶.有氧运动对女大学生身体形态和体脂的影响[J].浙江体育科学,2010,32(3):125-127.
[20] 季玉珍.大学生BMI与体成分和部分素质指标的关系[D].杭州:浙江大学,2011.
[21] OKORODUDU D O,JUMEAN MFMONTORI V M,ROMERO C A,et al.Diagnostic performance of body mass index to identify obesity as defined by body adiposity:a systematic review and meta-analysis[J].Int J Obes,2010,34(5):791.
[22] ROMERO-CORRAL A,SOMERS V K,SIERRA-JOHNSON J,et al.Accuracy of body mass index in diagnosing obesity in the adult general population[J].Int J Obes,2008,32(6):959-966.
[23] NIRAV R S,ERIC R.Measuring adiposity in patients:the utility of Body Mass Index(BMI),percent body fat,and leptin[J].PLoS One,2012,7(4):e33308.
[24] 李红娟,杨柳,张楠.身体质量指数作为肥胖筛查标准的判别准确性评价[J].中国预防医学杂志,2014,15(6):571-575.
[25] 何英剑,陶秋山,李晓婷,等.性别、年龄对成人BMI超重与肥胖诊断标准影响[J].中国公共卫生,2009,25(4):441-443.