Zhang Cai-Xia, Tse Lap-Ah, Deng Xue-Qing, Jiang Zhuo-Qin
Dept of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, PR China.
Eur J Nutr. 2008 Aug;47(5):244-50. doi: 10.1007/s00394-008-0718-7. Epub 2008 Jun 28.
BACKGROUND: Childhood obesity is a widespread and growing problem in the world. Body mass index (BMI) and weight-for-height criterion have been used to determine childhood obesity. No data was available to evaluate cardiovascular risk factors in overweight and obese Chinese children screened by weight-for-height index and Chinese newly developed BMI criterion. AIM OF THE STUDY: To evaluate cardiovascular risk factors in overweight and obese Chinese children by using Chinese BMI and weight-for-height index as screening criterion. METHODS: A total of 215 children aged 7.5-13 years were recruited from 3 primary schools in Guangzhou, PR China. Measurements included body weight, height, waist and hip circumference, fasting serum glucose, insulin, total triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A (apo A), apolipoprotein B (apo B). Chinese BMI and weight-for- height criterion were used to classify overweight and obesity. RESULTS: According to Chinese BMI criterion, 65 from 108 obese children originally identified by weight-for-height were reclassified as obese and other 41 children were classified as overweight. Compared with non-obese children, obese children screened by Chinese BMI and weight-for-height index had increased levels of TG, LDL-C, apo B, insulin; decreased levels of HDL-C, apo A; and significantly higher prevalence of hypertriglyceridemia and high LDL-C. Children identified as overweight by Chinese BMI criterion had also shown high TG, LDL-C, apo B, insulin levels, low HDL-C, apo A levels, and significantly higher prevalence of hypertriglyceridemia than the normal weight children. CONCLUSIONS: Our study reveals that overweight and/or obesity screened by both Chinese new BMI and weight-for-height criterion are associated with increased levels of cardiovascular risk factors (e.g., elevated serum TG, LDL, apo B, and reduced HDL-C, apo A levels). Using Chinese BMI criterion may underestimate the prevalence of childhood obesity but it could be adopted as a unique tool for screening children's overweight in population-based screening programs.
背景：儿童肥胖是一个在全球广泛存在且日益严重的问题。体重指数（BMI）和身高别体重标准已被用于判定儿童肥胖。目前尚无数据可用于评估按照身高别体重指数和中国新制定的BMI标准筛查出的超重和肥胖中国儿童的心血管危险因素。 研究目的：以中国BMI和身高别体重指数作为筛查标准，评估超重和肥胖中国儿童的心血管危险因素。 方法：从中国广州的3所小学招募了215名7.5至13岁的儿童。测量项目包括体重、身高、腰围和臀围、空腹血清葡萄糖、胰岛素、总甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A（apo A）、载脂蛋白B（apo B）。采用中国BMI和身高别体重标准对超重和肥胖进行分类。 结果：根据中国BMI标准，最初按身高别体重判定为肥胖的108名儿童中，有65名仍被重新分类为肥胖，另有41名儿童被分类为超重。与非肥胖儿童相比，按照中国BMI和身高别体重指数筛查出的肥胖儿童的TG、LDL-C、apo B、胰岛素水平升高；HDL-C、apo A水平降低；高甘油三酯血症和高LDL-C患病率显著更高。按照中国BMI标准被判定为超重的儿童也表现出血清TG、LDL-C、apo B、胰岛素水平较高，HDL-C、apo A水平较低，且高甘油三酯血症患病率显著高于正常体重儿童。 结论：我们的研究表明，按照中国新的BMI和身高别体重标准筛查出的超重和/或肥胖与心血管危险因素水平升高（如血清TG、LDL、apo B升高，HDL-C、apo A水平降低）相关。使用中国BMI标准可能会低估儿童肥胖的患病率，但它可作为基于人群的筛查项目中筛查儿童超重的唯一工具。
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