School of Kinesiology and Recreation, Illinois State University, Normal, Illinois;
Pediatrics. 2014 Feb;133(2):e330-8. doi: 10.1542/peds.2013-1308. Epub 2014 Jan 27.
To compare the diagnostic performance of the Centers for Disease Control and Prevention (CDC) and FITNESSGRAM (FGram) BMI standards for quantifying metabolic risk in youth.
Adolescents in the NHANES (n = 3385) were measured for anthropometric variables and metabolic risk factors. BMI percentiles were calculated, and youth were categorized by weight status (using CDC and FGram thresholds). Participants were also categorized by presence or absence of metabolic syndrome. The CDC and FGram standards were compared by prevalence of metabolic abnormalities, various diagnostic criteria, and odds of metabolic syndrome. Receiver operating characteristic curves were also created to identify optimal BMI percentiles to detect metabolic syndrome.
The prevalence of metabolic syndrome in obese youth was 19% to 35%, compared with <2% in the normal-weight groups. The odds of metabolic syndrome for obese boys and girls were 46 to 67 and 19 to 22 times greater, respectively, than for normal-weight youth. The receiver operating characteristic analyses identified optimal thresholds similar to the CDC standards for boys and the FGram standards for girls. Overall, BMI thresholds were more strongly associated with metabolic syndrome in boys than in girls.
Both the CDC and FGram standards are predictive of metabolic syndrome. The diagnostic utility of the CDC thresholds outperformed the FGram values for boys, whereas FGram standards were slightly better thresholds for girls. The use of a common set of thresholds for school and clinical applications would provide advantages for public health and clinical research and practice.
比较疾病控制与预防中心（CDC）和 FITNESSGRAM（FGram）BMI 标准在量化青少年代谢风险方面的诊断性能。
NHANES 中的青少年（n=3385）接受了人体测量变量和代谢风险因素的测量。计算 BMI 百分位数，并根据体重状况（使用 CDC 和 FGram 阈值）对青少年进行分类。还根据代谢综合征的存在与否对参与者进行分类。通过代谢异常的患病率、各种诊断标准和代谢综合征的可能性来比较 CDC 和 FGram 标准。还创建了受试者工作特征曲线来确定最佳 BMI 百分位数以检测代谢综合征。
肥胖青少年的代谢综合征患病率为 19%至 35%，而正常体重组的患病率则<2%。肥胖男孩和女孩患代谢综合征的几率分别是正常体重青少年的 46 至 67 倍和 19 至 22 倍。受试者工作特征分析确定了最佳阈值，这些阈值与男孩的 CDC 标准和女孩的 FGram 标准相似。总体而言，BMI 阈值与男孩的代谢综合征的相关性强于女孩。
CDC 和 FGram 标准都可预测代谢综合征。CDC 阈值的诊断效用优于男孩的 FGram 值，而 FGram 标准对于女孩则是稍微更好的阈值。在学校和临床应用中使用一套共同的阈值将为公共卫生和临床研究与实践提供优势。
