体质量指数、腰臀比、体脂百分率评价青少年肥胖的研究

摘要

Objective To compare the sensitivity of body mass index (BMI),waist-hip ratio (WHR)and percentage body fat (PBF)in the evaluation of the obese adolescents population,and find a more sensitive evaluation method.Methods In this study,2 045 adolescents were recruited in the city of Chongqing by using multiple-stage random cluster sampling,and they were identified as overweight or obesity on the base of BMI,WHR and PBF.Results There was significant difference among the detection rate of the three methods (P<0.05),the detection rate of PBF was the highest (12.9%),then BMI (7.2%)and WHR (6.0%).consistency test showed that the concordance of three methods was poor and Kappa (BMI and WHR)=0.199,Kappa (BMI and PBF )=0.441,Kappa (WHR and PBF)=0.187;comprehensive evaluation was chosen as the gold standard and compared with three meth-ods respectively by ROC curve,the analysis showed that area under curve (AVC):PBF(0.954)>BMI(0.918)>WHR (0.694). Conclusion The sensitivity of PBF and BMI was higher.Although the WHR sensitivity was lower,WHR is a good predictor asso-ciated for chronic diseases,which suggests that the development of appropriate adolescent WHR standard is necessary.%目的：比较体质量指数（BMI）、腰臀比（WHR）、体脂百分率（PBF）评价青少年人群肥胖的灵敏度，得出较为灵敏的评价方法。方法采用多阶段随机整群抽样，对重庆2045名青少年进行相关指标的测定，并采用 BMI、WHR、PBF评价青少年是否超体质量、肥胖。结果3种方法的检出率相差较大，其中PBF的检出率最高（12．9％），其次为BMI（7．2％）、WHR（6．0％），且差异有统计学意义（P＜0．05）；一致性检验发现，3种方法两两之间一致性较差，其中 Kappa（BMI与 WHR）＝0．199，Kappa （BMI与PBF）＝0．441，Kappa（WHR与 PBF）＝0．187；采用综合评价作为金标准，分别与3种方法进行受试者工作特征曲线（ROC曲线）分析发现曲线下面积：PBF（0．954）＞BMI（0．918）＞WHR（0．694）。结论 PBF和 BMI评价青少年肥胖的灵敏度较高，WHR灵敏度虽然较低，但对相关慢性疾病有很好的预测作用。