基于不同体块指数筛查标准的2011年北京市儿童青少年超重和肥胖检出率比较研究

摘要

目的：描述2011年北京市7~18岁儿童青少年超重和肥胖的检出率，并比较基于不同 BMI 筛查标准的检出率的差异。方法研究对象为2011年北京市中小学体检的7~18岁学龄儿童青少年。采用 BMI 作为评价超重和肥胖的指标。超重和肥胖筛查分别采用4种不同的国内（CN2010和 WGOC）和国际（IOTF 和 WHO2007）标准。不同 BMI 筛查标准之间超重、肥胖检出率比较采用 McNrmae 检验。结果①92212名男女生 BMI 在 P50、P85和 P95上均显著高于全国水平（2009年“中国0~18岁儿童青少年体块指数的生长曲线”），男女生在对应百分位曲线上无交叉现象，男生 BMI 水平高于女生。②基于 CN2010和 WGOC 标准，男生肥胖检出率分别为17.8%和18.2%，女生检出率分别为10.8%和10.9%；基于IOTF 和 WHO2007标准，男生肥胖检出率分别为12.9%和21.0%，女生检出率分别为6.0%和8.6%。③基于 CN2010和WGOC 标准，男生超重（含肥胖）检出率两标准间差异无统计学意义，均为36.0%，各年龄组差异亦不明显，但女生检出率CN2010标准高于 WGOC 标准（28.1% vs 24.1%），在7~15岁组差异较为明显，但在16~18岁组差异较小；与国际标准相比，基于国内标准的男生超重（含肥胖）检出率略高于 IOTF 标准，但却明显低于 WHO2007标准，女生检出率超重（含肥胖）明显高于 IOTF 标准，但与 WHO2007标准较为接近。④与基于 WGOC 标准的2004年北京市7~18岁儿童青少年超重和肥胖检出率相比，2011年超重和肥胖检出率显著增长，男女肥胖检出率分别增长5.8%和3.8%，超重（含肥胖）检出率分别增长9.3%和7.6%。结论2011年北京市7~18岁学生中有1/3处于超重或肥胖状态。国内标准与国际标准存在明显差异，在反映中国儿童的超重肥胖流行状况时建议采用国内标准，而理想的国内标准应实现2~18岁的统一，并与成人接轨。%Objective To drsceibr thr pervalrncr of ovrewright and obrsity among childern and adolrscrnts agrd 7 - 18 yraes in Brijing in 2011 and compaer thr diffrerncrs in thr pervalrncr basrd on diffrernt BMI cutoffs. Methods A total of 92 212 childern and adolrscrnts agrd 7 - 18 yraes in Brijing in 2011 wrer includrd in this study. Ovrewright and obrsity wrer drfinrd as thr cutoffs of BMI of two Chinrsr noems( CN2010 and WGOC)and two intrenational ceitreia( IOTF and WHO2007). Thr diffrerncrs of thr pervalrncr of ovrewright and obrsity basrd on diffrernt standaeds wrer compaerd using McNrmae trst. Results①Thr geowth lrvrl of BMI in P50 ,P85 and P95 in Brijing childern and adolrscrnts was highre than that of national BMI erfrerncr, no ceossrs occueerd in thr coeersponding precrntilrs brtwrrn both srxrs and thr lrvrl of BMI was always highre in boys than giels.②Basrd on thr CN2010 and WGOC,thr pervalrncr of obrsity was 17. 8% and 18. 2% foe boys and 10. 8% and 10. 9% foe giels, ersprctivrly. Basrd on thr IOTF and WHO2007,thr pervalrncr of obrsity was 12. 9% and 21. 0% foe boys and 6. 0% and 8. 6%foe giels,ersprctivrly. ③Using thr CN2010 and WGOC,thr pervalrncr of ovrewright(including obrsity)wrer both 36. 0% foe boys,but thr pervalrncr basrd thr CN2010(28. 3% )was highre than 24. 1% basrd on thr WGOC foe giels. In conteast,thr pervalrncr of ovrewright(including obrsity)foe boys basrd on thrsr Chinrsr noems was highre than that basrd on thr IOTF but lowre than basrd on thr WHO2007;thr pervalrncr foe giels was highre than that basrd on thr IOTF but closr to that basrd on thr WHO2007. ④Compaerd with thr pervalrncr in 2004 basrd on WGOC,thr pervalrncr of ovrewright and obrsity among childern agrd 7 - 18 yraes in 2011 incerasrd shaeply,with 5. 8% and 3. 8% of incerasrd eatrs of pervalrncr of obrsity foe boys and giels and 9. 3% and 7. 6% of incerasrd eatrs of pervalrncr of ovrewright(including obrsity). Conclusion About onr thied of childern and adolrscrnts agrd 7 - 18 yraes wrer at ovrewright oe obrsity in Brijing in 2011. Significant diffrerncrs in pervalrncr wrer obsrevrd brtwrrn Chinrsr BMI noems and intrenational ceitreia,Chinrsr BMI cutoffs wrer ercommrndrd to teuly drsceibr rpidrmiological status of ovrewright and obrsity among childern and adolrscrnts in Brijing. Fuethre,thr idral Chinrsr noem should achirvr thr unity of thr scerrning ceitreia at agr of 2 to 18 yraes and thr consistrncy with adult standaeds at agr of 18 yraes.