中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准

BMI20007～18244200BMINCHSBMIP85P90P95B-splineBMIP85P9518BMI24287～1817.00%9.46%9.99%6.47%10.86%6.64%4.27%3.07%6.95%4.23%2.84%2.09%BodymassindexreferencenormforscreeningoverweightandobesityinChinesechildrenandadolescentsGroupofChinaObesityTaskForceCorrespondenceJICheng-ye.InstituteofChildandAdolescentHealthPekingUniversityHealthScienceCenterBeijing100083ChinaAbstractObjectiveToestablishanationalbodymassindexBMIreferencenormforthepurposeofscreeningandmoreactivepreventionandcureonoverweightandobesityinChinesechildrenandadolescents.MethodsThe2000ChineseNationalSurveyonStudentsConstitutionandHealthwasusedasreferencepopulation.Intotalthereweremorethan244.2thousandsofprimaryandsecondaryHannationalitystudentsaged7through18yearsoldincludedinthisstudy.TheBMIdistributionofvariousChinesechildrenandadolescentgroupswerecomparedwiththeNCHSinternationalnormthepercentagevaluesandwithadvancedageswerecalculated.InthebeginningthreetemporarynormsweresetupusingthedifferentcombinationofP85P90andP95BMIpercentages.Basedontheintersecttestingandvarifyingofphysiologicallipidemiabiochemicalandbodycompositionmeasuresthebestnormwasthenselected.B-splinesmoothingmethodwasusedtocorrectthecurvesbothformalesandfemalescomposedbycut-offpointsatdifferentages.ResultsUsingsamplesfromthecostaldevelopedmetropolistheBMIcurvessuccessfullyovercametheshortcomingsoflowanddepressivephenomenonofthetotalpopulationinparticularafterthemid-adolescentperiod.ThetemporaryNormⅡcomposedbycut-offpointsofP85foroverweightandP95forobesitywasfoundtobethebestamongthethreetemporarynormsbothshownbyitssensitivityandspecificity.24and28wereusedascut-offpointsforoverweightandobesityinthisnormbothformalesandfemalesaged18years.Thesetwocut-offpointswereconsistentwiththoseshownintheBodyMassIndexReferenceNormforScreeningOverweightandObesityinChineseAdults.ThreesamplesfromBeijingHenanandSichuanusedasrepresentativesofuppermiddleandrelativelowlevelsofphysicalgrowthofchildrenandadolescentsinChinawereusedforextratests.Thescreeningresultsshowedthatamongthemaleandfemalesubjectsaged7through18yearstheprevalencerateswere17.00%and9.46%foroverweight9.99%and6.47%forobesityinBeijingwhile10.86%and6.64%foroverweight4.27%and3.07%forobesityinHenanand6.95%and4.23%foroverweightand2.84%and2.09%forobesityinSichuanrespectively.Dataclearlyshowedthattheresultswerein1000837920042252ChinJEpidemiolFebruary2004Vol.25No.2accordancewiththeacturalsituationseenintheChinesestudentsin2000.ConclusionThenewlyestablishedreferencenormseemedtobegoodforprospectivestudiesasitconsideredthefactsregardingtherapidandstrongtendencyofseculargrowthchangesseenintheChinesechildrenandadolescents.ItalsodecreasedthedifferenceofgrowthlevelsbetweentheChinesechildrenandadolescentsandthoseoftheinternationalnorms.ThisnormwasparticularlydevelopedfortheChinesewhichwasalsoinconsistentwiththeEasternAsiaethniccharacteristicssocouldbepromotedinChina.KeywordsOverwightObesityBodymassindexScreeningnormChildrenandadolescents20609011997IOTFBMI2BMI3200311BMI1.12000BMI2P85BMIBMI34BMI182428B-spline2.2000419855307～18147～161277～4465～72425751.BMI2000BMIP75P80P85P90P95P97NCHSIOTFBMI1～4NCHS①18BMI2530P97NCHSP908920042252ChinJEpidemiolFebruary2004Vol.25No.2P95P97②1513NCHS③BMI3～412000BMINCHS22000BMINCHS2.BMINCHSP85P90P9512①ⅠP85P90②ⅡP85P95③ⅢP90P95BMINCHS32000BMINCHS42000BMINCHS1BMINCHSⅠP85P90ⅡP85P95ⅢP90P95NCHS7～17.017.817.019.617.819.617.3719.188～17.718.517.720.418.520.418.1120.339～18.419.418.421.319.421.318.8521.4710～19.420.519.422.220.522.219.6022.6011～20.121.220.123.021.223.020.3523.7312～21.022.121.023.922.123.921.1224.8913～21.923.021.925.023.025.021.9325.9314～22.823.922.825.923.925.922.7726.9315～23.525.023.526.825.026.823.6327.7616～24.226.124.227.726.127.724.4528.5317～25.027.025.028.527.028.525.2829.321825.828.025.829.128.029.125.9230.029920042252ChinJEpidemiolFebruary2004Vol.25No.22BMINCHSⅠP85P90ⅡP85P95ⅢP90P95NCHS7～17.017.817.019.617.819.617.3719.188～17.718.517.720.418.520.418.1120.339～18.419.418.421.319.421.318.8521.4710～19.420.519.422.220.522.219.6022.6011～20.121.220.123.021.223.020.3523.7312～21.022.121.023.922.123.921.1224.8913～21.923.021.925.023.025.021.9325.9314～22.823.922.825.923.925.922.7726.9315～23.525.023.526.825.026.823.6327.7616～24.226.124.227.726.127.724.4528.5317～25.027.025.028.527.028.525.2829.321825.828.025.829.128.029.125.9230.023.567P85P90P85P95P904.ⅠⅢⅢ0Ⅱ①1585%1672%②Ⅱ3～52:1①182428BMI②7320007～18Ⅱ%7～15.1015.126.263.2110.928.565.173.2110～17.5610.289.773.475.779.194.602.4013～16.639.597.752.7910.495.574.594.5416～1818.714.9512.575.1010.662.568.921.7517.009.998.813.539.466.475.633.10420007～18Ⅱ%7～6.225.784.011.785.553.552.221.3310～12.894.005.561.345.565.331.560.6713～12.894.675.551.007.782.003.781.5616～1811.442.625.571.017.712.006.441.0010.864.275.171.116.643.073.501.06520007～18Ⅱ%7～8.894.001.700.862.603.701.410.5710～10.253.562.561.103.182.242.110.0013～5.562.001.491.594.421.652.491.1816～184.142.371.760.596.571.144.520.006.952.841.640.414.232.092.570.16①7②182428③00120042252ChinJEpidemiolFebruary2004Vol.25No.2④⑤B-splineBMI6566BMI7～17.419.217.218.98～18.12