Lenders Carine M, Wright Julie A, Apovian Caroline M, Hess Donald T, Shukla Rishi R, Adams William G, Lee Kayoung
Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.
Obesity (Silver Spring). 2009 Jan;17(1):150-5. doi: 10.1038/oby.2008.477. Epub 2008 Nov 13.
A BMI cutoff point at the 99th percentile for age and gender or at 40 kg/m(2) has been suggested for more aggressive treatment of adolescent obesity. The main objective of this study was to determine the proportion of adolescents eligible for weight loss surgery (WLS) based on various BMI cutoff points. Data was extracted from the electronic medical record database of an urban pediatric ambulatory care center over 4 years. National data were used to calculate BMI percentiles (Centers for Disease Control and Prevention (CDC), 2000). Eligibility for WLS was based on a BMI percentile criterion (>or=99th percentile) or the adult WLS cutoff point (>or=40 kg/m(2)). The sample consisted of 3,220 adolescents aged 12-17.9 years, of which 53% were female, 55% were of black race, and 17% of Hispanic ethnicity. Overall, 88 (3%) adolescents had a BMI >or=40 kg/m(2) and 236 (7%) had a BMI >or=99th percentile (P < 0.001). All adolescents with BMI >or=40 kg/m(2) had a BMI >or=99th percentile. A total of 159/2,007 (8%) of 12-14.9-year olds had a BMI >or=99th percentile compared with 77/1,213 (6%) 15-17.9-year olds (P = 0.10), whereas 43/2,007 (2%) of 12-14.9-year olds had a BMI >or=40 kg/m(2) compared with 45/1,213 (4%) 15-17.9-year olds (P = 0.003). In summary, a relatively large proportion of adolescents from a diverse urban population would qualify for WLS based on the percentile criterion. Fewer adolescents would be eligible based on the adult WLS criterion, and younger adolescents would be less likely to be eligible for WLS than older adolescents.
有人建议，以年龄和性别的第99百分位数或40千克/平方米作为身体质量指数（BMI）的临界点，以便对青少年肥胖症进行更积极的治疗。本研究的主要目的是根据不同的BMI临界点，确定符合减重手术（WLS）条件的青少年比例。数据从一家城市儿科门诊护理中心4年多的电子病历数据库中提取。使用国家数据来计算BMI百分位数（疾病控制与预防中心（CDC），2000年）。WLS的 eligibility基于BMI百分位数标准（≥第99百分位数）或成人WLS临界点（≥40千克/平方米）。样本包括3220名12至17.9岁的青少年，其中53%为女性，55%为黑人，17%为西班牙裔。总体而言，88名（3%）青少年的BMI≥40千克/平方米，236名（7%）青少年的BMI≥第99百分位数（P<0.001）。所有BMI≥40千克/平方米的青少年的BMI均≥第99百分位数。12至14.9岁的青少年中，共有159/2007名（8%）的BMI≥第99百分位数，而15至17.9岁的青少年中有77/1213名（6%）（P = 0.10）；12至14.9岁的青少年中，有43/2007名（2%）的BMI≥40千克/平方米，而15至17.9岁的青少年中有45/1213名（4%）（P = 0.003）。总之，根据百分位数标准，来自不同城市人口的青少年中，有相对较大比例符合WLS条件。根据成人WLS标准，符合条件的青少年较少，且年龄较小的青少年比年龄较大的青少年更不太可能符合WLS条件。
