Ellert Ute, Brettschneider Anna-Kristin, Wiegand Susanna, Kurth Bärbel-Maria
Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str, 62-66, 12101 Berlin, Germany.
BMC Res Notes. 2014 Mar 27;7:181. doi: 10.1186/1756-0500-7-181.
Prevalence rates for overweight and obesity based on self-reported height and weight are underestimated, whereas the prevalence rate for underweight is slightly overestimated. Therefore a correction is needed. Aim of this study is to apply correction procedures to the prevalence rates developed on basis of (self-reported and measured) data from the representative German National Health Interview and Examination Survey for Children and Adolescents (KiGGS) to (self-reported) data from the German Health Behaviour in School Aged Children (HBSC) study to determine whether correction leads to higher prevalence estimates of overweight and obesity as well as lower prevalence rates for underweight.
BMI classifications based on self-reported and measured height and weight from a subsample of the KiGGS study (2,565 adolescents aged 11-15) were used to estimate two different correction formulas. The first and the second correction function are described. Furthermore, the both formulas were applied to the prevalence rates from the HBSC study (7,274 adolescents aged 11-15) which are based on self-reports collected via self-administered questionnaires.
After applying the first correction function to self-reported data of the HBSC study, the prevalence rates of overweight and obesity increased from 5.5% to 7.8% (compared to 10.4% in the KiGGS study) and 2.7% to 3.8% (compared to 7.8% in the KiGGS study), respectively, whereas the corrected prevalence rates of underweight and severe underweight decreased from 8.0% to 6.7% (compared to 5.7% in the KiGGS study) and from 5.5% to 3.3% (compared to 2.4% in the KiGGS study), respectively. Application of the second correction function, which additionally considers body image, led to further slight corrections with an increase of the prevalence rates for overweight to 7.9% and for obese to 3.9%.
Subjective BMI can be used to determine the prevalence of overweight and obesity among children and adolescents. Where there is evidence of bias, the prevalence estimates should be corrected using conditional probabilities that link measured and subjectively assessed BMI from a representative validation study. These corrections may be improved further by considering body image as an additional influential factor.
基于自我报告的身高和体重得出的超重和肥胖患病率被低估，而体重过轻的患病率则被略微高估。因此需要进行校正。本研究的目的是将校正程序应用于根据德国全国儿童和青少年健康访谈与检查调查（KiGGS）（自我报告和测量）数据得出的患病率，以德国学龄儿童健康行为（HBSC）研究的（自我报告）数据，来确定校正是否会导致超重和肥胖的患病率估计值更高，以及体重过轻的患病率更低。
基于KiGGS研究一个子样本（2565名11 - 15岁青少年）的自我报告和测量的身高及体重的BMI分类，用于估计两种不同的校正公式。描述了第一种和第二种校正函数。此外，这两种公式都应用于HBSC研究（7274名11 - 15岁青少年）的患病率，该研究基于通过自填问卷收集的自我报告。
将第一种校正函数应用于HBSC研究的自我报告数据后，超重和肥胖的患病率分别从5.5%增至7.8%（KiGGS研究中为10.4%）以及从2.7%增至3.8%（KiGGS研究中为7.8%），而校正后的体重过轻和严重体重过轻的患病率分别从8.0%降至6.7%（KiGGS研究中为5.7%）以及从5.5%降至3.3%（KiGGS研究中为2.4%）。应用额外考虑身体意象的第二种校正函数，导致进一步的轻微校正，超重患病率增至7.9%，肥胖患病率增至3.9%。
主观BMI可用于确定儿童和青少年中超重和肥胖的患病率。在存在偏差证据的情况下，应使用来自代表性验证研究的、将测量的和主观评估的BMI联系起来的条件概率来校正患病率估计值。通过将身体意象视为一个额外的影响因素，这些校正可能会进一步改善。
