Department of Pediatrics and Clinical Epidemiology, Sitaram Bhrtia Institute of Science and Research, B 16, Qutab Institutional Area, New Delhi 110016, India; Departments of Human Nutrition and Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi 110029, India; Medical Research Council Lifecourse Epideiology Unit, University of Southampton, Southampton General Hospital, Southampton S016 6YD, UK; Current affiliation: Conjoint Associate Lecturer, School of Womens and Children Health, University of New South Wales and Department of Community Pediatrics, Liverpool Hospital, NSW, Australia; Current affiliation: Senior Programme Associate, Public Health Foundation of India (PHFI), Vasant Kunj, New Delhi 110070 and Current affiliation: Statistical Officer, Planning Department, Government of NCT of Delhi, New Delhi 110002. Correspondence to: Prof HPS Sachdev, Senior Consultant Pediatrics and Clinical Epidemiology, E 6/12, Vasant Vihar, New Delhi 110 057, India.
Indian Pediatr. 2013 Nov 8;50(11):1025-32. doi: 10.1007/s13312-013-0283-x.
To compare: (i) prevalences of thinness in school-children by four body mass index references in common use viz., Centre for Disease Control (CDC); Cole; Indian Academy of Pediatrics (IAP); World Health Organization (WHO); and (ii) relationship of thinness with absence of cardio-metabolic risk factors in these BMI references.
Cross-sectional.
Schools in Delhi.
Anthropometry and blood pressure were measured in 16,245 school children aged 5 to 18 years. Fasting lipids and blood sugar were estimated in 2796 subjects.
Age and sex-specific prevalences of thinness and predictive ability of reference cut-off for detecting any cardio-metabolic risk factor were compared.
Prevalence of thinness varied with the reference employed; more so for boys. Overall prevalence of thinness was least with IAP reference and highest with CDC cut-offs (6.6% to 16.9% in boys, 6.5% to 10.3% in girls). Children identified as thin by any reference had comparable, significantly lower risks (OR 0.59 to 0.73) of associated cardio-metabolic aberrations. In subjects with any cardio-metabolic or blood pressure aberration, the prevalence of thinness was highest with CDC and least with IAP definition.
Prevalence of thinness varies considerably with the reference employed. Thin children, identified by any reference, have a lower risk of associated cardio-metabolic aberrations; however, thinness is a poor diagnostic test for this purpose. In populations undergoing nutrition transition, there is a need to link cardio-metabolic risk factors with recommended anthropometric criteria to define undernutrition.
比较（i）使用四种常用的体重指数（BMI）参考标准，即疾病控制中心（CDC）、科尔、印度儿科学会（IAP）和世界卫生组织（WHO），在校儿童中消瘦的流行率；（ii）这些 BMI 参考标准中消瘦与无心血管代谢危险因素之间的关系。
横断面研究。
德里的学校。
对 16245 名 5 至 18 岁的在校儿童进行了人体测量和血压测量。对 2796 名受试者进行了空腹血脂和血糖检测。
比较了年龄和性别特异性消瘦流行率以及参考截止值检测任何心血管代谢危险因素的能力。
消瘦的流行率因所采用的参考标准而异；男孩更为明显。消瘦的总体流行率以 IAP 参考最低，CDC 切点最高（男孩为 6.6%至 16.9%，女孩为 6.5%至 10.3%）。任何参考标准定义为消瘦的儿童，其相关心血管代谢异常的风险显著降低（OR 0.59 至 0.73）。在存在任何心血管代谢或血压异常的受试者中，CDC 和 IAP 定义的消瘦流行率最高。
消瘦的流行率因所采用的参考标准而异。通过任何参考标准确定的消瘦儿童，相关心血管代谢异常的风险较低；然而，消瘦作为一种诊断工具，其效果不佳。在经历营养转型的人群中，需要将心血管代谢危险因素与推荐的人体测量标准联系起来，以定义营养不良。
