Graduate Division of Biological, Biomedical Sciences, Emory University, Atlanta, GA 30322, United States of America.
Rev Panam Salud Publica. 2013 May;33(5):349-55. doi: 10.1590/s1020-49892013000500006.
To compare the International Obesity Task Force (IOTF) 2005, Centers for Disease Control and Prevention (CDC) 2000, and World Health Organization (WHO) 2007 body mass index (BMI) classification systems in terms of prevalence estimation and association with demographic factors.
The 18 265 children and adolescents ages 5 to 18 years (mean = 11.2 years, standard deviation = 3.9 years) in the nationally representative Colombian National Nutrition Survey of 2005 were classified as overweight or obese according to IOTF, CDC, and WHO criteria. Prevalence estimates were compared according to each system and associations with age, sex, socioeconomic status, and population density were tested.
Prevalence estimates of combined overweight and obesity differed by system (males: IOTF = 8.5%, CDC = 10.8%, WHO = 14.1%; females: IOTF = 14.6%, CDC = 13.8%, WHO = 17.1%; P < 0.001). The association between combined overweight and obesity and age and sex varied by system. The odds of having overweight and obesity in children (5 to 10 years) compared with adolescents (11 to 18 years) were: IOTF, odds ratio (OR) = 0.87 and 95% confidence interval (CI) = 0.77-0.98; CDC, OR = 1.27 and CI = 1.14-1.42; WHO, OR = 1.21 and CI = 1.08-1.35. The values for females compared with males were: IOTF, OR = 1.84 and CI = 1.6-2.10; CDC, OR = 1.33 and CI = 1.17-1.51; WHO, OR = 1.25 and CI = 1.12-1.41.
There is a lack of consistency among the three main international systems in assessing overweight and obesity in children and adolescents. Appreciably different estimates of prevalence and associations with age and sex are obtained depending on which system is used. Future studies should assess how well each system reflects valid measures of body composition.
比较国际肥胖特别工作组（IOTF）2005 年、疾病控制和预防中心（CDC）2000 年以及世界卫生组织（WHO）2007 年的体重指数（BMI）分类系统在流行率估计和与人口统计学因素的关联方面的差异。
2005 年哥伦比亚全国营养调查对年龄在 5 至 18 岁（平均 11.2 岁，标准差 3.9 岁）的 18265 名儿童和青少年进行了分类，按照 IOTF、CDC 和 WHO 的标准，将其分为超重或肥胖。根据每个系统比较了流行率估计值，并测试了与年龄、性别、社会经济地位和人口密度的关联。
不同系统的合并超重和肥胖流行率估计值不同（男性：IOTF=8.5%，CDC=10.8%，WHO=14.1%；女性：IOTF=14.6%，CDC=13.8%，WHO=17.1%；P<0.001）。合并超重和肥胖与年龄和性别的关联因系统而异。与青少年（11 至 18 岁）相比，儿童（5 至 10 岁）超重和肥胖的可能性为：IOTF，比值比（OR）=0.87，95%置信区间（CI）=0.77-0.98；CDC，OR=1.27，CI=1.14-1.42；WHO，OR=1.21，CI=1.08-1.35。与男性相比，女性的比值为：IOTF，OR=1.84，CI=1.6-2.10；CDC，OR=1.33，CI=1.17-1.51；WHO，OR=1.25，CI=1.12-1.41。
在评估儿童和青少年超重和肥胖方面，三个主要国际系统之间缺乏一致性。使用不同的系统会得到明显不同的流行率估计值和与年龄和性别的关联。未来的研究应评估每个系统如何反映身体成分的有效测量值。
