Monzani Alice, Rapa Anna, Prodam Flavia, Fuiano Nicola, Diddi Giuliana, Petri Antonella, Bellone Simonetta, Bona Gianni
Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.
Pediatric Unit, Prevention and Public Health, ASL FG, Foggia, Italy.
PLoS One. 2016 Jan 8;11(1):e0146579. doi: 10.1371/journal.pone.0146579. eCollection 2016.
Waist circumference (WC) is a good proxy measure of central adiposity. Due to the multiplicity of existing WC cut-offs and different measurement methods, the decision to use one rather than another WC chart may lead to different prevalence estimates of abdominal obesity in the same population. Aim of our study was to assess how much the prevalence of abdominal obesity varies in Italian schoolchildren using the different available WC cut-offs.
We measured WC at just above the uppermost lateral border of the right ilium in 1062 Italian schoolchildren aged 7-14 years, 499 living in Northern Italy and 563 in Southern Italy. Abdominal obesity was defined as WC ≥90th percentile for gender and age according to nine WC charts.
We found an extremely high variability in the prevalence of abdominal obesity detected in our study-populations according to the different WC charts, ranging in the overall group from 9.1% to 61.4%. In Northern Italy children it varied from 2.4% to 35.7%, and in Southern ones from 15.1% to 84.2%.
On the basis of the chosen WC cut-offs the prevalence of abdominal obesity varies widely, because percentile-charts are strongly influenced by the population status in a particular moment. A further rate of variability may lay on the site of WC measurement and on the statistical method used to calculate WC cut-offs. Risk-weighted WC cut-offs measured in a standardized anatomic site and calculated by the appropriate method are needed to simply identify by WC measurement those children at high risk of cardio-metabolic complications to whom specific and prompt health interventions should be addressed.
腰围（WC）是衡量中心性肥胖的良好替代指标。由于现有的WC临界值多种多样且测量方法不同，选择使用某一WC图表而非另一图表可能会导致同一人群中腹部肥胖患病率的估计值不同。我们研究的目的是评估在意大利学龄儿童中，使用不同的可用WC临界值时腹部肥胖患病率的差异程度。
我们在1062名7至14岁的意大利学龄儿童右髂嵴最上侧边界上方测量了WC，其中499名生活在意大利北部，563名生活在意大利南部。根据九个WC图表，腹部肥胖定义为WC大于等于性别和年龄的第90百分位数。
我们发现，根据不同的WC图表，在我们的研究人群中检测到的腹部肥胖患病率存在极高的变异性，在整个组中从9.1%到61.4%不等。在意大利北部儿童中，患病率从2.4%到35.7%不等，在南部儿童中从15.1%到84.2%不等。
基于所选的WC临界值，腹部肥胖的患病率差异很大，因为百分位数图表受到特定时刻人群状况的强烈影响。进一步的变异性可能在于WC测量的部位以及用于计算WC临界值的统计方法。需要在标准化的解剖部位测量并通过适当方法计算的风险加权WC临界值，以便仅通过WC测量来识别那些有心血管代谢并发症高风险的儿童，应对这些儿童进行特定且及时的健康干预。
