University of California, San Francisco, Department of Pediatrics, 3333 California St, Box 0503, San Francisco, CA 94118, USA.
Pediatrics. 2010 Sep;126(3):434-42. doi: 10.1542/peds.2009-3411. Epub 2010 Aug 16.
The objective of this study was to investigate trends in prevalence of high BMI from 2001 to 2008 and examine racial/ethnic disparities.
Records for a total of 8 283 718 fifth-, seventh-, and ninth-grade students who underwent California's school-based BMI screening between 2001 and 2008 were included. Logistic regression identified trends in prevalence of high BMI (>or=85th, >or=95th, >or=97th, and >or=99th percentiles).
For 3 of 4 BMI cut points, prevalence continued to increase for black and American Indian girls through 2008, Hispanic girls plateaued after 2005, non-Hispanic white girls declined to 2001 prevalence levels after peaking in 2005, and Asian girls showed no increases. Non-Hispanic white boys peaked in 2005, then declined to 2001 prevalence levels for all BMI cut points; Hispanic and Asian boys declined after 2005 (for 3 lowest BMI cut points only) but remained above 2001 levels; and American Indian boys peaked later (2007) and declined only for BMI>or=95th. No girls and few boys showed a decline after peaking in prevalence of BMI>or=99th percentile. In 2008, disparities in prevalence were greatest for BMI>or=99th percentile, with prevalence of 4.9% for American Indian girls and 4.6% for black girls versus 1.3% for non-Hispanic white girls.
On the basis of statewide California data, prevalence of high BMI is declining for some groups but has not declined for American Indian and black girls. These trends portend greater disparities over time, particularly in severe obesity. Interventions and policies that are tailored to the highest risk groups should be pursued.
本研究旨在调查 2001 年至 2008 年期间高 BMI 患病率的变化趋势，并探讨种族/民族差异。
共纳入 2001 年至 2008 年期间参加加利福尼亚州基于学校的 BMI 筛查的 8283718 名五、七、九年级学生的记录。采用 logistic 回归分析方法，确定高 BMI（≥第 85 百分位、≥第 95 百分位、≥第 97 百分位和≥第 99 百分位）患病率的变化趋势。
对于 4 个 BMI 切点中的 3 个，黑人和美国印第安裔女孩的患病率在 2008 年持续上升，西班牙裔女孩在 2005 年之后达到峰值后趋于平稳，非西班牙裔白种女孩在 2005 年达到峰值后降至 2001 年的水平，而亚裔女孩没有增加。非西班牙裔白种男孩在 2005 年达到峰值，随后降至所有 BMI 切点的 2001 年水平；西班牙裔和亚裔男孩在 2005 年之后（仅在 3 个最低 BMI 切点）下降，但仍高于 2001 年的水平；而美国印第安裔男孩的峰值较晚（2007 年），仅在 BMI≥第 95 百分位时下降。在 BMI≥第 99 百分位的峰值后，很少有女孩和男孩的患病率下降。2008 年，在 BMI≥第 99 百分位的患病率方面，差异最大，美国印第安裔女孩为 4.9%，黑人女孩为 4.6%，而非西班牙裔白种女孩为 1.3%。
根据加利福尼亚州全州数据，一些人群的高 BMI 患病率呈下降趋势，但美国印第安裔和黑人女孩的 BMI 患病率并未下降。这些趋势预示着随着时间的推移，差异会更大，尤其是在严重肥胖方面。应该针对风险最高的群体，采取有针对性的干预措施和政策。
