Wang Y, Wang J Q
Department of Human Nutrition, University of Illinois, Chicago 60612, USA.
Eur J Clin Nutr. 2002 Oct;56(10):973-82. doi: 10.1038/sj.ejcn.1601415.
To compare different references assessing child and adolescent overweight and obesity in different populations.
Comparison cross-sectional study.
The United States, Russia, China.
A total of 6108 American, 6883 Russian and 3014 Chinese children aged 6-18 y.
Using nationwide survey data from the USA (NHANES III, 1988-1994), Russia (1992), and China (1991), we compared three references: (1) the International Obesity Task Force (IOTF) reference, sex-age-specific body mass index (BMI) cut-offs that correspond to BMIs of 25 for overweight and 30 for obesity at age 18; (2) the World Health Organization (WHO) reference--BMI 85th percentiles for overweight in adolescents (10-19 y) and weight-for-height Z-scores for obesity in children under 10; (3) a USA reference--BMI 85th and 95th percentiles to classify overweight and obesity, respectively.
Using the IOTF reference and 85th BMI percentiles, overweight prevalence was 6.4 and 6.5% in China, 15.7 and 15.0% in Russia, and 25.5 and 24.4% in the USA, respectively. Notable differences existed for several ages. Kappa (=0.84-0.98) indicated an excellent agreement between the two references in general, although they varied by sex-age groupings and countries. Overweight prevalence was twice as high in children (6-9 y) than in adolescents (10-18 y) in China and Russia, but was similar in the USA. Estimates of obesity prevalence using these three references varied substantially.
The references examined produce similar estimates of overall overweight prevalence but different estimates for obesity. One should be cautious when comparing results based on different references.
University of Illinois and University of North Carolina.
比较不同人群中评估儿童和青少年超重及肥胖的不同参考标准。
比较性横断面研究。
美国、俄罗斯、中国。
共6108名美国儿童、6883名俄罗斯儿童和3014名中国儿童，年龄在6至18岁。
利用来自美国（1988 - 1994年国家健康和营养检查调查III，即NHANES III）、俄罗斯（1992年）和中国（1991年）的全国性调查数据，我们比较了三种参考标准：（1）国际肥胖特别工作组（IOTF）参考标准，即对应18岁时超重BMI为25、肥胖BMI为30的按性别和年龄划分的体重指数（BMI）切点；（2）世界卫生组织（WHO）参考标准——青少年（10 - 19岁）超重的BMI第85百分位数，以及10岁以下儿童肥胖的身高别体重Z评分；（3）美国参考标准——分别用BMI第85和第95百分位数来划分超重和肥胖。
使用IOTF参考标准和BMI第85百分位数时，中国超重患病率分别为6.4%和6.5%，俄罗斯为15.7%和15.0%，美国为25.5%和24.4%。几个年龄段存在显著差异。Kappa值（=0.84 - 0.98）总体表明两种参考标准之间一致性良好，尽管在不同性别 - 年龄组和国家有所不同。在中国和俄罗斯，儿童（6 - 9岁）超重患病率是青少年（10 - 18岁）的两倍，但在美国两者相似。使用这三种参考标准得出的肥胖患病率估计值差异很大。
所研究的参考标准对总体超重患病率的估计相似，但对肥胖的估计不同。在基于不同参考标准比较结果时应谨慎。
伊利诺伊大学和北卡罗来纳大学。
