Wickramasinghe V P, Arambepola C, Bandara D M P S, Abeysekera M, Kuruppu S, Dilshan P, Dissanayake B S
Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Ann Hum Biol. 2013 May;40(3):280-5. doi: 10.3109/03014460.2013.769629. Epub 2013 Mar 18.
Excess body fat leads to obesity-related morbidity and population/ethnicity-specific cut-off values of anthropometric measures are useful for better diagnosis. This study assesses the suitability of newly-developed Sri Lankan anthropometric cut-off values in the diagnosis of obesity in Sri Lankan children.
A cross-sectional study was conducted at University of Colombo, Sri Lanka involving 5-15 year old children. Height, weight, waist (WC), and hip (HC) circumferences were measured. Total body fat (FM) was measured using whole body BIA. WHR and WHtR were calculated. Validity of anthropometric measures in detecting childhood obesity (Sri Lankan BMI/WC; IOTF, WHO, British and CDC BMI and British WC cut-off values) were evaluated.
Nine hundred and twenty children were assessed. FM showed significant associations with BMI (r = 0.92, p < 0.001), WC (r = 0.90, p < 0.001) and HC (r = 0.85, p < 0.001), but poor association with WHR (r = 0.17, p < 0.001). However, WHtR had a high association with FM (r = 0.75, p < 0.001) and %FM (r = 0.78, p < 0.001). Based on %FM cut-offs, 85 (22.8%) girls and 101 (18.5%) boys were obese. All international anthropometric cut-off values under-estimated obesity. Sri Lankan WC and BMI cut-off values over-estimated obesity. International BMI based cut-off values had high specificity (>99%) but a low sensitivity (∼12-33%), while Sri Lankan BMI cut-off values had high sensitivity (>93.1) but low specificity (>79.7).
Internationally available BMI cut-off values are poor in diagnosing obesity in Sri Lankan children. Newly developed Sri Lankan BMI cut-off values for children improved the diagnosis. WC can be used successfully as an alternative diagnostic tool of obesity.
体内脂肪过多会导致与肥胖相关的疾病，而针对不同人群/种族的人体测量指标临界值有助于更准确的诊断。本研究评估新制定的斯里兰卡人体测量临界值在诊断斯里兰卡儿童肥胖症方面的适用性。
在斯里兰卡科伦坡大学开展了一项横断面研究，纳入5至15岁儿童。测量身高、体重、腰围（WC）和臀围（HC）。采用全身生物电阻抗分析法测量全身脂肪（FM）。计算腰臀比（WHR）和腰高比（WHtR）。评估人体测量指标在检测儿童肥胖症方面的有效性（斯里兰卡BMI/WC；国际肥胖工作组（IOTF）、世界卫生组织（WHO）、英国和美国疾病控制与预防中心（CDC）的BMI以及英国WC临界值）。
共评估了920名儿童。FM与BMI（r = 0.92，p < 0.001）、WC（r = 0.90，p < 0.001）和HC（r = 0.85，p < 0.001）显著相关，但与WHR的相关性较差（r = 0.17，p < 0.001）。然而，WHtR与FM（r = 0.75，p < 0.001）和FM百分比（r = 0.78，p < 0.001）高度相关。根据FM百分比临界值，85名（22.8%）女孩和101名（18.5%）男孩肥胖。所有国际人体测量临界值均低估了肥胖情况。斯里兰卡的WC和BMI临界值高估了肥胖情况。基于国际BMI的临界值具有较高的特异性（>99%）但敏感性较低（约12 - 33%），而斯里兰卡的BMI临界值具有较高的敏感性（>93.1）但特异性较低（>79.7）。
国际通用的BMI临界值在诊断斯里兰卡儿童肥胖症方面效果不佳。新制定的斯里兰卡儿童BMI临界值改善了诊断效果。WC可成功用作肥胖症的替代诊断工具。
