Department of Pediatrics, University of California, San Francisco, San Francisco, CA 94118, USA.
Pediatrics. 2011 Aug;128(2):e317-23. doi: 10.1542/peds.2010-2559. Epub 2011 Jul 18.
To examine the relationship between BMI status (normal, overweight, and obese) and preventive screening among adolescents at their last checkup.
We used population-based data from the 2003-2007 California Health Interview Surveys, telephone interviews of adolescents aged 12 to 17 years with a checkup in the past 12 months (n = 9220). Respondents were asked whether they received screening for nutrition, physical activity, and emotional distress. BMI was calculated from self-reported height and weight: (1) normal weight or underweight (<85th percentile); (2) overweight (85th-94th percentile); and (3) obese (>95th percentile). Multivariate logistic regression models tested how screening by topic differed according to BMI status, adjusting for age, gender, income, race/ethnicity, and survey year.
Screening percentages in the pooled sample (all 3 years) were higher for obese, but not overweight, adolescents for physical activity (odds ratio: 1.4; P < .01) and nutrition (odds ratio: 1.6; screening did not differ P < .01). Stratified analysis by year revealed higher screening for obese (versus normal-weight) adolescents for nutrition and physical activity in 2003 and for all 3 topics in 2005. However, by 2007, screening did not differ according to BMI status. Overall screening between 2003 and 2007 declined for nutrition (75%-59%; P < .01), physical activity (74%-60%; P < .01), and emotional distress (31%-24%; P < .01).
Obese adolescents receive more preventive screening versus their normal-weight peers. Overweight adolescents do not report more screening, but standards of care dictate increased attention for this group. These results are discouraging amid a rise in pediatric obesity and new guidelines that recommend screening by BMI status.
研究青少年最后一次体检时的 BMI 状况（正常、超重和肥胖）与预防筛查之间的关系。
我们使用了基于人群的 2003-2007 年加利福尼亚健康访谈调查的数据，对过去 12 个月内进行过体检的 12-17 岁青少年进行了电话访谈（n=9220）。受访者被问及是否接受了营养、身体活动和情绪困扰的筛查。体重指数（BMI）由自报身高和体重计算得出：（1）正常体重或体重不足（<85 百分位）；（2）超重（85-94 百分位）；和（3）肥胖（>95 百分位）。多变量逻辑回归模型检验了按 BMI 状态筛查时，在调整年龄、性别、收入、种族/民族和调查年份后，各主题的筛查差异。
在汇总样本（所有 3 年）中，肥胖青少年的身体活动（优势比：1.4；P<.01）和营养（优势比：1.6；筛查无差异，P<.01）筛查百分比较高，但超重青少年的筛查百分比不高。按年份分层分析显示，2003 年肥胖（与正常体重）青少年的营养和身体活动筛查率较高，2005 年所有 3 个主题的筛查率都较高。然而，到 2007 年，BMI 状况不再影响筛查率。2003 年至 2007 年期间，营养（75%-59%；P<.01）、身体活动（74%-60%；P<.01）和情绪困扰（31%-24%；P<.01）的总体筛查率下降。
与正常体重的同龄人相比，肥胖青少年接受更多的预防筛查。超重青少年的筛查率并不高，但护理标准要求对这一人群给予更多关注。在儿科肥胖率上升和新的 BMI 状态筛查指南出台之际，这些结果令人沮丧。
