Yoo S, Lee S-Y, Kim K-N, Sung E
Department of Family Medicine, SanggyePaik Hospital, Inje University, College of Medicine, Nowon-gu, Seoul, Republic of Korea.
Int J Obes (Lond). 2006 Jul;30(7):1086-90. doi: 10.1038/sj.ijo.0803327. Epub 2006 Mar 21.
To examine the relationships between body mass index (BMI), percentage-weight-for-height (PWH) and percentage body fat (PBF), and to compare their validity based on PBF with the BMI criteria of International Obesity Task Force (IOTF) for childhood obesity in Korean pre-adolescent school children.
Statistical comparative analysis for anthropometric measures.
Korean pre-adolescent children (438 boys and 454 girls, aged 8-12 years, mean BMI 19.5+/-3.4 kg/m2).
Body mass index and PWH were calculated as body size indices from height and weight. Hand-to-foot bioelectrical impedance analysis (BIA) was performed to obtain PBF values, with obese children defined as PBF above 35%. Sensitivity and specificity were displayed with the gold standard of PBF, and receiver operating characteristic (ROC) curves were used to assess the performance of BMI and PWH in detecting obesity.
The prevalence of obesity varied by the criteria: 18.8% by Korean BMI standards for 95 percentile, 11% by the IOTF-BMI 30 kg/m2 and 29.4% by Korean PWH cutoffs. Body mass index and PWH were significantly correlated with PBF after adjusting for age, 0.910 (P<0.01) and 0.915 (P<0.01), respectively. The sensitivity and specificity of the PWH cutoffs were 0.909 and 0.882, respectively. The local BMI 95 percentiles had lower sensitivity (0.714) and specificity (0.790). The IOTF-BMI definition showed much lower sensitivity (0.457) and higher specificity (0.990). The BMI cutoffs corresponding with the highest accuracy were smaller than IOTF-BMI 30 kg/m2 for all age groups in both boys and girls.
The prevalence of obesity among Korean pre-adolescent children widely varied according to the diagnostic criteria applied. Universally recommended cutoffs for children by IOTF showed the lowest sensitivity among the criteria used, and may therefore underestimate obesity in this population.
研究体重指数（BMI）、身高体重百分比（PWH）与体脂百分比（PBF）之间的关系，并根据PBF比较它们与国际肥胖特别工作组（IOTF）儿童肥胖BMI标准在韩国青春期前学龄儿童中的有效性。
人体测量指标的统计比较分析。
韩国青春期前儿童（438名男孩和454名女孩，年龄8 - 12岁，平均BMI 19.5±3.4kg/m²）。
根据身高和体重计算BMI和PWH作为身体尺寸指标。采用手足生物电阻抗分析（BIA）获取PBF值，肥胖儿童定义为PBF高于35%。以PBF的金标准展示敏感性和特异性，并使用受试者工作特征（ROC）曲线评估BMI和PWH在检测肥胖方面的表现。
肥胖患病率因标准而异：韩国BMI标准95百分位数为18.8%，IOTF - BMI 30kg/m²为11%，韩国PWH临界值为29.4%。调整年龄后，BMI和PWH与PBF显著相关，分别为0.910（P<0.01）和0.915（P<0.01）。PWH临界值的敏感性和特异性分别为0.909和0.882。当地BMI 95百分位数的敏感性（0.714）和特异性（0.790）较低。IOTF - BMI定义的敏感性低得多（0.457），特异性高（0.990）。在男孩和女孩的所有年龄组中，对应最高准确性的BMI临界值均小于IOTF - BMI 30kg/m²。
韩国青春期前儿童肥胖患病率因应用的诊断标准不同而有很大差异。IOTF普遍推荐的儿童临界值在所用标准中敏感性最低，因此可能低估了该人群中的肥胖情况。
