Garnett Sarah P, Baur Louise A, Jones Aimee M D, Hardy Louise L
Institute of Endocrinology and Diabetes and Kids Research Institute at the Children's Hospital at Westmead, Sydney, Australia.
The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, NSW, Australia.
PLoS One. 2016 May 12;11(5):e0154879. doi: 10.1371/journal.pone.0154879. eCollection 2016.
Children with severe obesity have greater risk of adverse health outcomes. The purpose of this study was to assess trends in the prevalence of morbid and severe obesity in Australian children between 1985 and 2012.
Secondary analysis of four national Australian cross-sectional surveys of measured height/weight in 7-15 year olds: Australian Health and Fitness Survey 1985 (n = 8,486), National Nutrition Survey 1995 (n = 1,541), the National Children's Nutrition and Physical Activity Survey 2007 (n = 2,585) and the National Health Survey 2012 (n = 2,940). International Obesity Taskforce cut-point was used for morbid obesity (equivalent to a BMI ≥35kg/m2 at age 18 years). Severe obesity class 2 was defined as BMI ≥120% and <140% of the 95th percentile of the CDC 2000 growth charts or a BMI ≥35 and <40, and severe obesity class 3 as BMI ≥140% of the 95th percentile or a BMI ≥40.
Between 1985 and 2012 the prevalence of morbid obesity increased from 0.2% to 1.8%, class 2 severe obesity from 0.3% to 2.0%, and class 3 from 0.1% to 0.5%. Children with morbid obesity represented 11.3% of children with obesity in 1985 and increased to 22.5% in 2012 (P = 0.005). Children with severe obesity represented 19.3% of children with obesity in 1985 and increased to 32.0% in 2012 (P = 0.016). The greatest increase was observed between 1995 and 2007. The proportion of children who were classified as morbidly or severely obese was not significantly different between 2007 and 2012, nor was it significantly different between age and sex groups.
Prevalence of morbid and severe obesity among children is low, but has significantly increased between 1985 and 2012. In contrast to overweight and obese children, children with morbid obesity require tertiary intervention. Failure to treat these children will have significant implications for the individual child and community.
重度肥胖儿童出现不良健康结局的风险更高。本研究旨在评估1985年至2012年间澳大利亚儿童中病态肥胖和重度肥胖患病率的趋势。
对四项澳大利亚全国性的7至15岁儿童身高/体重横断面调查进行二次分析:1985年澳大利亚健康与体能调查(n = 8486)、1995年全国营养调查(n = 1541)、2007年全国儿童营养与身体活动调查(n = 2585)以及2012年全国健康调查(n = 2940)。采用国际肥胖问题工作组的切点来定义病态肥胖(相当于18岁时BMI≥35kg/m²)。重度肥胖2级定义为BMI≥美国疾病控制与预防中心2000年生长图表第95百分位数的120%且<140%,或BMI≥35且<40;重度肥胖3级定义为BMI≥第95百分位数的140%或BMI≥40。
1985年至2012年间,病态肥胖的患病率从0.2%增至1.8%,重度肥胖2级从0.3%增至2.0%,重度肥胖3级从0.1%增至0.5%。1985年,病态肥胖儿童占肥胖儿童的11.3%,2012年增至22.5%(P = 0.005)。1985年,重度肥胖儿童占肥胖儿童的19.3%,2012年增至32.0%(P = 0.016)。1995年至2007年间增幅最大。2007年至2012年间,被归类为病态肥胖或重度肥胖的儿童比例无显著差异,不同年龄和性别组之间也无显著差异。
儿童中病态肥胖和重度肥胖的患病率较低,但在1985年至2012年间显著上升。与超重和肥胖儿童不同,病态肥胖儿童需要三级干预。不治疗这些儿童将对个体儿童和社区产生重大影响。