Department of Family Practice and Community Health, Ajou University Hospital, Suwon, Republic of Korea.
Diabetes Res Clin Pract. 2010 Jun;88(3):307-13. doi: 10.1016/j.diabres.2010.02.005. Epub 2010 Mar 11.
Body mass index (BMI, kg/m(2)) thresholds of children predicting cardiovascular risk, reported in previous studies were inconsistent and that predicting increased insulin resistance is lacking. We determined the BMI threshold that predicts increased cardiovascular risk and insulin resistance in children.
The entire 4th grade students (187 boys and 218 girls) from 5 schools were included. Cardiovascular risk was defined as the presence of three or more of cardiovascular risk factors. Increased insulin resistance was estimated using homeostasis model assessment of insulin resistance and fasting insulin level.
The BMI percentile predicting cardiovascular risk was the 71.3th percentile for boys and the 77.1th percentile for girls. The BMI value was 21.4 kg/m(2) for boys and 20.6 kg/m(2) for girls. 34% of boys and 42% of girls with a BMI above the cut-off values had cardiovascular risk. The BMI percentile predicting increased insulin resistance was the 66.3th percentile for boys and the 67.9th percentile for girls. The children with cardiovascular risk had significantly greater (P<0.01) insulin resistance than those without risk.
This study demonstrated that the BMI thresholds at which cardiovascular risk and insulin resistance begin to increase in Korean children were lower than current definition of childhood obesity, proposed by the international obesity task force.
此前的研究报告表明，儿童的体重指数（BMI，kg/m²）阈值预测心血管风险的结果并不一致，且预测胰岛素抵抗的结果也有所欠缺。本研究旨在确定 BMI 阈值，以预测儿童心血管风险和胰岛素抵抗的增加。
我们纳入了来自 5 所学校的所有 4 年级学生（男生 187 名，女生 218 名）。心血管风险定义为存在 3 种或 3 种以上心血管危险因素。胰岛素抵抗采用稳态模型评估胰岛素抵抗和空腹胰岛素水平来估计。
预测心血管风险的 BMI 百分位数，男生为第 71.3 百分位数，女生为第 77.1 百分位数。男生的 BMI 值为 21.4 kg/m²，女生的 BMI 值为 20.6 kg/m²。超过临界值的男生中 34%和女生中 42%存在心血管风险。预测胰岛素抵抗增加的 BMI 百分位数，男生为第 66.3 百分位数，女生为第 67.9 百分位数。有心血管风险的儿童的胰岛素抵抗显著高于无风险的儿童（P<0.01）。
本研究表明，韩国儿童中开始出现心血管风险和胰岛素抵抗增加的 BMI 阈值低于国际肥胖工作组提出的当前儿童肥胖定义。
