Gillison Fiona, Cumming Sean, Standage Martyn, Barnaby Catherine, Katzmarzyk Peter
Department for Health, Centre for Motivation and Behaviour Change, University of Bath, Bath, UK.
Bath Institute for Mathematical Innovation, University of Bath, Bath, UK.
BMJ Open. 2017 Jun 26;7(6):e015769. doi: 10.1136/bmjopen-2016-015769.
To compare the weight categorisation of a cohort of UK children using standard procedures (ie, comparing body mass index (BMI) centiles to age-matched UK reference data) versus an approach adjusted for maturation status (ie, matching relative to biological age).
Analysis of data collected from an observational study of UK primary school children.
Schools in South West England.
Four hundred and seven 9-11 year-old children (98% white British).
Weight status was classified using BMI centiles using (1) sex and chronological age-matched referents and (2) sex and biological age-matched referents (based on % of predicted adult stature) relative to UK 1990 reference growth charts. For both approaches, children were classified as a normal weight if >2nd centile and <85thcentile, overweight if 85th and <95thcentiles, and obese if ≥95thcentile.
Fifty-one children (12.5%) were overweight, and a further 51 obese (12.5%) according to standard chronological age-matched classifications. Adjustment for maturity resulted in 32% of overweight girls, and 15% of overweight boys being reclassified as a normal weight, and 11% and 8% of obese girls and boys, respectively, being reclassified as overweight. Early maturing children were 4.9 times more likely to be reclassified from overweight to normal weight than 'on-time' maturers (OR 95% CI 1.3 to 19).
Incorporating assessments of maturational status into weight classification resulted in significant changes to the classification of early-maturing adolescents. Further research exploring the implications for objective health risk and well-being is needed.
比较使用标准程序（即将体重指数（BMI）百分位数与年龄匹配的英国参考数据进行比较）与根据成熟状态调整的方法（即相对于生物年龄进行匹配）对一组英国儿童进行体重分类的情况。
对从英国小学生观察性研究中收集的数据进行分析。
英格兰西南部的学校。
407名9至11岁的儿童（98%为英国白人）。
根据BMI百分位数对体重状况进行分类，使用（1）性别和实足年龄匹配的参照标准，以及（2）相对于英国1990年参考生长图表的性别和生物年龄匹配的参照标准（基于预测成人身高的百分比）。对于这两种方法，如果儿童的BMI百分位数>第2百分位数且<第85百分位数，则分类为正常体重；如果在第85百分位数及以上且<第95百分位数，则为超重；如果≥第95百分位数，则为肥胖。
根据标准的实足年龄匹配分类，51名儿童（12.5%）超重，另有51名肥胖（12.5%）。对成熟度进行调整后，32%的超重女孩和15%的超重男孩被重新分类为正常体重，肥胖女孩和男孩分别有11%和8%被重新分类为超重。早熟儿童从超重重新分类为正常体重的可能性是“按时”成熟儿童的4.9倍（比值比95%置信区间为1.3至19）。
将成熟状态评估纳入体重分类会导致早熟青少年分类发生显著变化。需要进一步研究探讨其对客观健康风险和幸福感的影响。
