Li Hui, Ji Cheng-Ye, Zong Xin-Nan, Zhang Ya-Qin
Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China.
Zhonghua Er Ke Za Zhi. 2009 Jul;47(7):493-8.
To construct the body mass index (BMI) reference data and curves for Chinese children and adolescents from birth to 18 years of age.
Data from two national representative cross-sectional surveys which were The National Growth Survey of Children under 7 years in the Nine Cities of China in 2005 and The Physical Fitness and Health Surveillance of Chinese School Students in 2005. Height (length was measured for children under 3 years) and weight data of 93,702 urban healthy children from nine cities/provinces used to calculate the BMI. The LMS method was used to smooth the BMI, with estimates of L, M, and S parameters, values of percentile and Z-score curves which were required were calculated, and then standardized growth charts were generated. Adult cut-offs for overweight and obesity at 18 years was used to study the cut-offs for children 2 to 18 years of age.
The smoothed percentiles and Z-scores reference data and curves of BMI-for-age for boys and girls aged 0-18 years were made out respectively. BMI cut-off values for overweight and obesity for children from 2 to 18 years of age were also defined. At 18 years, the BMI values are equivalent to the overweight cut-off (> or =24 kg/m2) and obesity cut-off (> or =28 kg/m2) for Chinese adults. Comparison with the reference of the WHO and 2000 CDC for the United States, there were some difference among them, at the 97th percentile curve there was a big difference between Chinese and U. S. adolescents. On the whole, the China BMI curve for boys was higher than the new WHO curve and lower than 2000 CDC at 97 percentile curve, but the China BMI curve for girls was lowest among the three curves. There was also significant difference between China and Japan BMI values at 97 percentile curve.
BMI growth curves are very useful in child growth monitoring and nutritional surveillance, discovering overweight and obesity. The BMI growth charts are recommended for use in pediatric clinic and public health service.
构建中国0至18岁儿童青少年的体重指数（BMI）参考数据及曲线。
数据来自两项具有全国代表性的横断面调查，即2005年中国九城市7岁以下儿童国家生长发育调查和2005年中国学生体质与健康监测。来自九个城市/省份的93702名城市健康儿童的身高（3岁以下儿童测量身长）和体重数据用于计算BMI。采用LMS方法对BMI进行平滑处理，计算L、M和S参数估计值、百分位数和Z分数曲线值，进而生成标准化生长图表。采用18岁成人超重和肥胖的界值来研究2至18岁儿童的界值。
分别得出了0至18岁男孩和女孩年龄别BMI的平滑百分位数和Z分数参考数据及曲线。还定义了2至18岁儿童超重和肥胖的BMI界值。18岁时，BMI值相当于中国成年人的超重界值（≥24 kg/m²）和肥胖界值（≥28 kg/m²）。与世界卫生组织（WHO）和美国2000年疾病控制与预防中心（CDC）的参考标准相比，它们之间存在一些差异，在第97百分位数曲线处，中国和美国青少年之间存在较大差异。总体而言，男孩的中国BMI曲线在第97百分位数曲线处高于新的WHO曲线且低于2000年CDC曲线，但女孩的中国BMI曲线在三条曲线中最低。在第97百分位数曲线处，中国和日本的BMI值也存在显著差异。
BMI生长曲线在儿童生长监测和营养监测、发现超重和肥胖方面非常有用。建议在儿科临床和公共卫生服务中使用BMI生长图表。
