Al-Isa Abdulwahab Naser, Thalib Lukman
Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, University of Kuwait, P.O. Box 24923, Safat, Code 13110, Kuwait.
J R Soc Promot Health. 2006 Jan;126(1):41-6. doi: 10.1177/1466424006061176.
The suitability of using the standards for body mass index (BMI), produced in the U.S. by the National Center for Health Statistics, for assessing overweight and obesity among children in Kuwait and other Arabian Gulf countries has not been examined. These standards were obtained from better-nourished and genetically different populations to those found in Kuwait and in other Gulf region countries. The purpose of this study was to develop BMI reference percentiles and curves appropriate for children aged 3-9 in these countries.
Attempts were made to include all healthy Kuwaiti kindergarten and elementary education children in this study The total sample was 113,013, comprising 55,053 males and 57,960 females. The children were measured for weight and height from which the BMI was calculated. Appropriate polynomial regression smoothing techniques were used to obtain the best-fitting percentile curves.
At percentiles < or =25th, the BMI of boys exceeded that of girls. At the 50th percentile, boys' BMI was mostly higher than or equal to that of the girls except at age nine where it was lower At the 75th percentile, the BMI of both genders was similar, with exceptions at age six and nine years. At the 85th and 95th percentiles, girls' BMI was consistently higher than males. At the lowest percentile, the BMI of US children was higher than Kuwaiti, Saudi (starting at six) and Iranian children. The BMI of Kuwaiti children at higher percentiles was higher than that of Saudi, Iranian (except at age < four years) and US children.
BMI curves for Kuwaiti children follow almost the same pattern as their US counterparts but with noticeable variations especially at the lower and higher percentiles. This study may reflect that western standards may not be directly applicable to assess the level of BMI in Kuwait and possibly in the neighbouring Gulf countries, since they may overestimate the levels of overweight, obesity and underweight.
美国国家卫生统计中心制定的体重指数（BMI）标准，用于评估科威特及其他阿拉伯海湾国家儿童超重和肥胖情况的适用性尚未得到检验。这些标准所依据的人群营养状况更好且基因与科威特及其他海湾地区国家的人群不同。本研究的目的是制定适用于这些国家3至9岁儿童的BMI参考百分位数和曲线。
本研究试图纳入所有健康的科威特幼儿园和小学儿童。总样本为113,013名，包括55,053名男性和57,960名女性。测量了儿童的体重和身高，并据此计算BMI。采用适当的多项式回归平滑技术获得最佳拟合百分位数曲线。
在百分位数≤25时，男孩的BMI超过女孩。在第50百分位数时，男孩的BMI大多高于或等于女孩，9岁时除外，此时男孩BMI较低。在第75百分位数时，两性的BMI相似，6岁和9岁时除外。在第85和95百分位数时，女孩的BMI始终高于男性。在最低百分位数时，美国儿童的BMI高于科威特、沙特（从6岁开始）和伊朗儿童。科威特儿童在较高百分位数时的BMI高于沙特、伊朗（4岁以下除外）和美国儿童。
科威特儿童的BMI曲线与美国儿童的曲线模式几乎相同，但存在明显差异，尤其是在较低和较高百分位数处。本研究可能反映出西方标准可能不适用于直接评估科威特以及可能其邻国海湾国家的BMI水平，因为这些标准可能高估超重、肥胖和体重不足的水平。
