Garnett S P, Cowell C T, Baur L A, Shrewsbury V A, Chan A, Crawford D, Salmon J, Campbell K, Boulton T J
Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Australia.
Int J Obes (Lond). 2005 Nov;29(11):1353-60. doi: 10.1038/sj.ijo.0803038.
Estimates of the prevalence of overweight and obesity in young people are typically based on body mass index (BMI). However, BMI may not indicate the level of central adiposity. Waist circumference has therefore been recommended to identify young people at risk of morbidity associated with central adiposity.
To investigate (a) change in total and central adiposity between 7-8 and 12-13 y (b) agreement between classifying young people as overweight or obese based on total adiposity and central adiposity, and (c) risk factors associated with the development of total and central adiposity.
Anthropometric measurements were taken on 342 children in 1996/97 and 5 y later. Risk factors examined included birth weight, physical activity, TV viewing, pubertal status, parental adiposity, diet and socio-economic status.
Between 7-8 and 12-13 y indices of central adiposity increased more than total adiposity; waist circumference z-score increased by (mean+/-s.d.) 0.74+/-0.92 and BMI z-score increased by 0.18+/-0.67. At 12-13 y there was moderate agreement between the two measures of adiposity (weighted kappa=0.64). However, waist circumference identified a greater number of young people as overweight or obese compared to BMI (41.2 vs 29.3%, P<0.001). Adiposity status at 7-8 y, maternal obesity, and pubertal stage were the strongest predictors of BMI status at 12-13 y. Risk factors associated with increased central adiposity were similar.
Overweight and obesity, as measured by waist circumference, is a bigger problem than is currently assessed by BMI. Targeting known risk factors for total adiposity may be an appropriate strategy for preventing increased central adiposity.
对年轻人超重和肥胖患病率的估计通常基于体重指数（BMI）。然而，BMI可能无法表明中心性肥胖的程度。因此，建议使用腰围来识别有中心性肥胖相关发病风险的年轻人。
调查（a）7至8岁与12至13岁之间总体和中心性肥胖的变化；（b）基于总体肥胖和中心性肥胖将年轻人分类为超重或肥胖的一致性；以及（c）与总体和中心性肥胖发展相关的风险因素。
1996/1997年对342名儿童进行了人体测量，并在5年后再次测量。检查的风险因素包括出生体重、身体活动、看电视时间、青春期状态、父母肥胖情况、饮食和社会经济地位。
在7至8岁与12至13岁之间，中心性肥胖指标的增加超过了总体肥胖；腰围z评分增加了（均值±标准差）0.74±0.92，BMI z评分增加了0.18±0.67。在12至13岁时，两种肥胖测量方法之间存在中度一致性（加权kappa=0.64）。然而，与BMI相比，腰围将更多年轻人识别为超重或肥胖（41.2%对29.3%，P<0.001）。7至8岁时的肥胖状态、母亲肥胖和青春期阶段是12至13岁时BMI状态最强的预测因素。与中心性肥胖增加相关的风险因素相似。
以腰围衡量的超重和肥胖问题比目前通过BMI评估的更为严重。针对已知的总体肥胖风险因素可能是预防中心性肥胖增加的合适策略。
