不同超重、肥胖体重指数标准筛查中国儿童青少年的比较研究
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摘要
研究目的:目前儿童青少年超重、肥胖逐渐成为世界性的公共卫生问题,在发达国家和发展中国家儿童肥胖率均迅速上升。国际肥胖问题工作组(International Obesity TaskForce,IOTF)标准和世界卫生组织(World Health Organization,WHO)是两个筛查儿童青少年超重、肥胖最广泛的两个国际标准,中国肥胖问题工作组(Working Group onObesity in China,WGOC)于2003年推出了BMI标准。三个标准的参照人群不同,超重、肥胖界值点也不同。本研究通过使用IOTF标准、WHO标准和WGOC标准对中国儿童青少年超重、肥胖筛查,从而客观了解和比较IOTF标准、WHO标准与WGOC标准的差异性,检验IOTF标准、WHO标准在中国推广有无可行性,并了解我国的南北儿童青少年的超重、肥胖的差异。为更好的筛查儿童超重肥胖检验提供理论依据。
研究方法:选取《中国人手腕骨发育标准—中华05》的标准样本中7-18岁的10581例城市汉族正常儿童少年,其中包括男:7～18岁,5095例;女:7～18岁,5486例。抽样城市为上海市、温州市、广州市、大连市、石家庄市。每岁一组,分层整群取样。各年龄组儿童均在出生日前后15天之内测量身高、体重。分别以性别、年龄和南北区域进行分组后,分别用IOTF标准、WHO标准及WGOC标准对各个年龄组进行超重、肥胖的筛选,以卡方检验进行WHO标准和ITOF标准与WGOC标准之间的儿童青少年超重率、肥胖率差异性的比较,以WGOC标准为“金标准”对WHO标准和ITOF标准的灵敏性和特异性进行计算。
研究结果:WGOC标准筛查男生、女生的超重率分别为男生15.9%,女生10.5%,北方男生、女生超重率分别为18.7%,17.2%,南方男生、女生超重率分别为14.0%,9.1%;WGOC标准筛查男生、女生的肥胖率分别为10.8%,6.0%,北方男生、女生肥胖率分别为15.2%,9.3%,南方男生、女生7.9%,3.8%。IOTF标准筛查男生、女生的超重率分别为男生17.8%,女生11.9%,北方男生、女生超重率分别为21.3%,14.7%,南方男生、女生超重率分别为15.5%,9.7%;IOTF标准筛查男生、女生的肥胖率分别为6.7%,2.9%,北方男生、女生肥胖率分别为10.1%,4.9%,南方男生、女生肥胖率分别为4.4%,1.3%。WHO标准筛查男生、女生的超重率分别为男生11.3%,女生9.8%,北方男生、女生超重率分别为14.1%,11.3%,南方男生、女生超重率分别为9.8%,8.6%;WHO标准筛查男生、女生的肥胖率分别为6.3%,1.5%,北方男生、女生肥胖率分别为8.7%,3.5%,南方男生、女生肥胖率分别为2.7%,1.1%。IOTF标准与WHO标准筛查中国儿童青少年筛查的超重率与WGOC标准的筛查结果差异的显著性(P<0.05)主要在9-14岁之间,而IOTF标准和WHO标准肥胖的界值点高,筛查的肥胖率普遍存在显著性差异性(P<0.05)。IOTF标准对男生超重筛查的灵敏性、特异性分别为0.863、0.956,对男生肥胖筛查的灵敏性、特异性分别为0.632、1;对女生超重筛查的灵敏性、特异性分别为0.815、0.963,对女生肥胖筛查的灵敏性、特异性分别为0.521、1。WHO标准对男生超重筛查的灵敏性、特异性分别为0.763、0.923,对男生肥胖筛查的灵敏性、特异性分别为0.612、1;对女生超重筛查的灵敏性、特异性分别为0.786、0.906;对女生肥胖筛查的灵敏性、特异性分别为0.482、1。
结论:IOTF标准、WHO标准和WGOC标准筛查中国儿童青少年超重、肥胖结果显示有一定的年龄,性别特征,超重率和肥胖率男生高于女生,超重率、肥胖率高峰期出现在9-14之间的青春期;IOTF标准与WHO标准筛查中国儿童青少年筛查的超重率与WGOC标准的筛查结果差异的显著性主要在9-14岁之间,而IOTF标准和WHO标准筛查的肥胖率与WGOC标准的筛查结果普遍存在显著性差异性。IOTF标准和WHO标准会低估中国儿童青少年的超重和肥胖;IOTF标准、WHO标准和WGOC标准筛查南北区域儿童青少年超重、肥胖显示北方儿童青少年超重率、肥胖率高于南方儿童青少年超重率、肥胖率。
Objective:At present,the overweight and obesity of children and adolescents has gradually become a worldwide public health problem in developed and developing countries,childhood obesity rates are rising rapidly.The standards of International Obesity Task Force(IOTF) and the World Health Organization(WHO) are most extensive international standards in evaluating the overweight and obesity of children and adolescents,the Working Group on Obesity in China(WGOC) in 2003 and launched its own BMI standards.These standards have different reference population and overweight,obesity cutoff points.In this study,by using the IOTF,WHO and WGOC standards to screen the overweight and obesity of children and adolescents in China,to compare the differences between IOTF,WHO and WGOC standards,test the feasibility of IOTF and WHO standards in the promotion of Chinese,and know the differences between north and south of overweight and obesity children and adolescents in China.Provide a better theoretical basis test in screening overweight and obesity children and adolescents.
Method:Select the "carpal manpower development of the Chinese standards - Chinese 05" standard samples of 7-18 year-old Chinese children and adolescents,10,581.including Male:7-18 years old,5095;Female:7-18 years old,5486.Sample of cities are Shanghai, Wenzhou,Guangzhou,Dalian,Shijiazhuang.Every age group,stratified cluster sampling. Children in each age group measure the height and weight before and after birth within 15 days.Devided with gender,age,and the North-South sub-region,and use IOTF,WHO and the WGOC standards screen all groups,use chi-square compare the difference of ITOF,WHO and WGOC standards,use WGOC as the "gold standard" to calculate the sensitivity and specificity of ITOF and WHO standards.
Resoult:The WGOC standard screen male,female overweight rates are male 15.9%,female 10.5%,and North male,female overweight rates are 18.7%,17.2%,and South male,female overweight rates are 14.0%,9.1%;the WGOC standard screen male,female obsity rates are male 10.8%,female 6.0%,and North male,female overweight rates are 15.2%,9.3%,and South male,female overweight rates are 7.9%,3.8%.The IOTF standard screen male,female overweight rates are male 17.8%,female 11.9%,and North male,female overweight rates are 21.3%,14.7%,and South male,female overweight rates are 15.5%,9.7%;the IOTF standard screen male,female obsity rates are male 6.7%,female 2.9%,and North male,female overweight rates are 10.1%,4.9%,and South male,female overweight rates are 4.4%,1.3%. The WHO standard screen male,female overweight rates are male 11.3%,female 9.8%,and North male,female overweight rates are 14.1%,11.3%,and South male,female overweight rates are 9.8%,8.6%;the WHO standard screen male,female obsity rates are male 6.3%, female 1.5%,and North male,female overweight rates are 8.7%,3.5%,and South male, female overweight rates are 2.7%,1.1%.IOTF and WHO standards screen overweight rate of children and adolescents in China are different with WGOC standard between the ages of 9-14 and has a statistical significance(P＜0.05),and the IOTF and WHO standards screen obesity rate of children and adolescents in China are lower than WGOC standard and has a statistical significance(P＜0.05).The IOTF standard screen overweight males sensitivity and specificity are 0.863,0.956,obesity males sensitivity and specificity are 0.632,1;screen overweight females sensitivity and specificity are 0.815,0.963,obesity males sensitivity and specificity are 0.521,1.The WHO standard screen overweight males sensitivity and specificity are 0.763,0.923,obesity males sensitivity and specificity are 0.612,1;screen overweight females sensitivity and specificity are 0.786,0.906,obesity males sensitivity and specificity are 0.482,1.
Conclusion:Results of IOTF,WHO and WGOC standards screen Chinese children and adolescents overweight and obesity showed that there is an age,gender identity,overweight and obesity rates for boys higher than girls,overweight and obesity rates have peak during 9-14 at the puberty;IOTF and WHO standards screen the overweight rates of Chinese children and adolescents have significant differences with WGOC results mainly in the 9-14 years old,IOTF and WHO standards screen obesity rate have significant differences with WGOC standard.IOTF and WHO standards may underestimate overweight and obesity of Chinese children and adolescents;IOTF,WHO and WGOC standards screen overweight and obesity of South and North Chinese children and adolescents indicate that overweight and obesity of children and adolescents in North higher than South.
研究方法:选取《中国人手腕骨发育标准—中华05》的标准样本中7-18岁的10581例城市汉族正常儿童少年,其中包括男:7～18岁,5095例;女:7～18岁,5486例。抽样城市为上海市、温州市、广州市、大连市、石家庄市。每岁一组,分层整群取样。各年龄组儿童均在出生日前后15天之内测量身高、体重。分别以性别、年龄和南北区域进行分组后,分别用IOTF标准、WHO标准及WGOC标准对各个年龄组进行超重、肥胖的筛选,以卡方检验进行WHO标准和ITOF标准与WGOC标准之间的儿童青少年超重率、肥胖率差异性的比较,以WGOC标准为“金标准”对WHO标准和ITOF标准的灵敏性和特异性进行计算。
研究结果:WGOC标准筛查男生、女生的超重率分别为男生15.9%,女生10.5%,北方男生、女生超重率分别为18.7%,17.2%,南方男生、女生超重率分别为14.0%,9.1%;WGOC标准筛查男生、女生的肥胖率分别为10.8%,6.0%,北方男生、女生肥胖率分别为15.2%,9.3%,南方男生、女生7.9%,3.8%。IOTF标准筛查男生、女生的超重率分别为男生17.8%,女生11.9%,北方男生、女生超重率分别为21.3%,14.7%,南方男生、女生超重率分别为15.5%,9.7%;IOTF标准筛查男生、女生的肥胖率分别为6.7%,2.9%,北方男生、女生肥胖率分别为10.1%,4.9%,南方男生、女生肥胖率分别为4.4%,1.3%。WHO标准筛查男生、女生的超重率分别为男生11.3%,女生9.8%,北方男生、女生超重率分别为14.1%,11.3%,南方男生、女生超重率分别为9.8%,8.6%;WHO标准筛查男生、女生的肥胖率分别为6.3%,1.5%,北方男生、女生肥胖率分别为8.7%,3.5%,南方男生、女生肥胖率分别为2.7%,1.1%。IOTF标准与WHO标准筛查中国儿童青少年筛查的超重率与WGOC标准的筛查结果差异的显著性(P<0.05)主要在9-14岁之间,而IOTF标准和WHO标准肥胖的界值点高,筛查的肥胖率普遍存在显著性差异性(P<0.05)。IOTF标准对男生超重筛查的灵敏性、特异性分别为0.863、0.956,对男生肥胖筛查的灵敏性、特异性分别为0.632、1;对女生超重筛查的灵敏性、特异性分别为0.815、0.963,对女生肥胖筛查的灵敏性、特异性分别为0.521、1。WHO标准对男生超重筛查的灵敏性、特异性分别为0.763、0.923,对男生肥胖筛查的灵敏性、特异性分别为0.612、1;对女生超重筛查的灵敏性、特异性分别为0.786、0.906;对女生肥胖筛查的灵敏性、特异性分别为0.482、1。
结论:IOTF标准、WHO标准和WGOC标准筛查中国儿童青少年超重、肥胖结果显示有一定的年龄,性别特征,超重率和肥胖率男生高于女生,超重率、肥胖率高峰期出现在9-14之间的青春期;IOTF标准与WHO标准筛查中国儿童青少年筛查的超重率与WGOC标准的筛查结果差异的显著性主要在9-14岁之间,而IOTF标准和WHO标准筛查的肥胖率与WGOC标准的筛查结果普遍存在显著性差异性。IOTF标准和WHO标准会低估中国儿童青少年的超重和肥胖;IOTF标准、WHO标准和WGOC标准筛查南北区域儿童青少年超重、肥胖显示北方儿童青少年超重率、肥胖率高于南方儿童青少年超重率、肥胖率。
Objective:At present,the overweight and obesity of children and adolescents has gradually become a worldwide public health problem in developed and developing countries,childhood obesity rates are rising rapidly.The standards of International Obesity Task Force(IOTF) and the World Health Organization(WHO) are most extensive international standards in evaluating the overweight and obesity of children and adolescents,the Working Group on Obesity in China(WGOC) in 2003 and launched its own BMI standards.These standards have different reference population and overweight,obesity cutoff points.In this study,by using the IOTF,WHO and WGOC standards to screen the overweight and obesity of children and adolescents in China,to compare the differences between IOTF,WHO and WGOC standards,test the feasibility of IOTF and WHO standards in the promotion of Chinese,and know the differences between north and south of overweight and obesity children and adolescents in China.Provide a better theoretical basis test in screening overweight and obesity children and adolescents.
Method:Select the "carpal manpower development of the Chinese standards - Chinese 05" standard samples of 7-18 year-old Chinese children and adolescents,10,581.including Male:7-18 years old,5095;Female:7-18 years old,5486.Sample of cities are Shanghai, Wenzhou,Guangzhou,Dalian,Shijiazhuang.Every age group,stratified cluster sampling. Children in each age group measure the height and weight before and after birth within 15 days.Devided with gender,age,and the North-South sub-region,and use IOTF,WHO and the WGOC standards screen all groups,use chi-square compare the difference of ITOF,WHO and WGOC standards,use WGOC as the "gold standard" to calculate the sensitivity and specificity of ITOF and WHO standards.
Resoult:The WGOC standard screen male,female overweight rates are male 15.9%,female 10.5%,and North male,female overweight rates are 18.7%,17.2%,and South male,female overweight rates are 14.0%,9.1%;the WGOC standard screen male,female obsity rates are male 10.8%,female 6.0%,and North male,female overweight rates are 15.2%,9.3%,and South male,female overweight rates are 7.9%,3.8%.The IOTF standard screen male,female overweight rates are male 17.8%,female 11.9%,and North male,female overweight rates are 21.3%,14.7%,and South male,female overweight rates are 15.5%,9.7%;the IOTF standard screen male,female obsity rates are male 6.7%,female 2.9%,and North male,female overweight rates are 10.1%,4.9%,and South male,female overweight rates are 4.4%,1.3%. The WHO standard screen male,female overweight rates are male 11.3%,female 9.8%,and North male,female overweight rates are 14.1%,11.3%,and South male,female overweight rates are 9.8%,8.6%;the WHO standard screen male,female obsity rates are male 6.3%, female 1.5%,and North male,female overweight rates are 8.7%,3.5%,and South male, female overweight rates are 2.7%,1.1%.IOTF and WHO standards screen overweight rate of children and adolescents in China are different with WGOC standard between the ages of 9-14 and has a statistical significance(P＜0.05),and the IOTF and WHO standards screen obesity rate of children and adolescents in China are lower than WGOC standard and has a statistical significance(P＜0.05).The IOTF standard screen overweight males sensitivity and specificity are 0.863,0.956,obesity males sensitivity and specificity are 0.632,1;screen overweight females sensitivity and specificity are 0.815,0.963,obesity males sensitivity and specificity are 0.521,1.The WHO standard screen overweight males sensitivity and specificity are 0.763,0.923,obesity males sensitivity and specificity are 0.612,1;screen overweight females sensitivity and specificity are 0.786,0.906,obesity males sensitivity and specificity are 0.482,1.
Conclusion:Results of IOTF,WHO and WGOC standards screen Chinese children and adolescents overweight and obesity showed that there is an age,gender identity,overweight and obesity rates for boys higher than girls,overweight and obesity rates have peak during 9-14 at the puberty;IOTF and WHO standards screen the overweight rates of Chinese children and adolescents have significant differences with WGOC results mainly in the 9-14 years old,IOTF and WHO standards screen obesity rate have significant differences with WGOC standard.IOTF and WHO standards may underestimate overweight and obesity of Chinese children and adolescents;IOTF,WHO and WGOC standards screen overweight and obesity of South and North Chinese children and adolescents indicate that overweight and obesity of children and adolescents in North higher than South.
引文
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