英国国家儿童测量计划中南亚和黑人参与者的儿童体重指数 (BMI)、超重和肥胖模式：应用 BMI 调整标准来校正 BMI-体脂肪关联中的种族差异的效果。
Patterns of childhood body mass index (BMI), overweight and obesity in South Asian and black participants in the English National child measurement programme: effect of applying BMI adjustments standardising for ethnic differences in BMI-body fatness associations.
机构信息
Population Health Research Institute, St George's, University of London, London, UK.
Childhood Nutrition Research Centre, Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK.
出版信息
Int J Obes (Lond). 2018 Apr;42(4):662-670. doi: 10.1038/ijo.2017.272. Epub 2017 Nov 2.
BACKGROUND
The National Child Measurement Programme (NCMP) records weight and height and assesses overweight-obesity patterns in English children using body mass index (BMI), which tends to underestimate body fatness in South Asian children and overestimate body fatness in Black children of presumed African ethnicity. Using BMI adjustments to ensure that adjusted BMI was similarly related to body fatness in South Asian, Black and White children, we reassessed population overweight and obesity patterns in these ethnic groups in NCMP.
METHODS
Analyses were based on 2012-2013 NCMP data in 582 899 children aged 4-5 years and 485 362 children aged 10-11 years. Standard centile-based approaches defined weight status in each age group before and after applying BMI adjustments for English South Asian and Black children derived from previous studies using the deuterium dilution method.
FINDINGS
Among White children, overweight-obesity prevalences (boys, girls) were 23% and 21%, respectively, in 4-5 year olds and 33% and 30%, respectively, in 10-11 year olds. Before adjustment, South Asian children had lower overweight-obesity prevalences at 4-5 years (19%, 19%) and slightly higher prevalences at 10-11 years (42%, 34%), whereas Black children had higher overweight-obesity prevalences both at 4-5 years (31%, 29%) and 10-11 years (42%, 45%). Following adjustment, overweight-obesity prevalences were markedly higher in South Asian children both at 4-5 years (39%, 35%) and at 10-11 years (52%, 44%), whereas Black children had lower prevalences at 4-5 years (11%, 12%); at 10-11 years, prevalences were slightly lower in boys (32%) but higher in girls (35%).
INTERPRETATION
BMI adjustments revealed extremely high overweight-obesity prevalences among South Asian children in England, which were not apparent in unadjusted data. In contrast, after adjustment, Black children had lower overweight-obesity prevalences except among older girls.
FUNDING
British Heart Foundation, NIHR CLAHRC (South London), NIHR CLAHRC (North Thames).
背景
国家儿童测量计划（NCMP）记录体重和身高，并使用身体质量指数（BMI）评估英国儿童的超重-肥胖模式，该指数往往低估南亚儿童的体脂率，高估非裔黑人儿童的体脂率。通过使用 BMI 调整来确保调整后的 BMI 与南亚、黑人和白人儿童的体脂率有类似的关系，我们重新评估了 NCMP 中这些族裔群体的人群超重和肥胖模式。
方法
分析基于 2012-2013 年 NCMP 数据，涉及 4-5 岁 582899 名儿童和 10-11 岁 485362 名儿童。在应用先前使用氘稀释法进行的研究中为英国南亚和黑人儿童得出的 BMI 调整之前，标准百分位法定义了每个年龄组的体重状况。
结果
在白人儿童中，4-5 岁时超重肥胖的患病率（男孩，女孩）分别为 23%和 21%，10-11 岁时分别为 33%和 30%。调整前，南亚儿童在 4-5 岁时的超重肥胖患病率较低（19%，19%），在 10-11 岁时略高（42%，34%），而黑人儿童在 4-5 岁和 10-11 岁时的超重肥胖患病率均较高（31%，29%；42%，45%）。调整后，南亚儿童的超重肥胖患病率在 4-5 岁时明显升高（39%，35%），在 10-11 岁时更高（52%，44%），而黑人儿童在 4-5 岁时的患病率较低（11%，12%）；在 10-11 岁时，男孩的患病率略低（32%），但女孩的患病率较高（35%）。
解释
BMI 调整揭示了英国南亚儿童的超重肥胖患病率极高，而在未调整的数据中并不明显。相比之下，调整后，除了年龄较大的女孩外，黑人儿童的超重肥胖患病率较低。
资金
英国心脏基金会、NIHR CLAHRC（伦敦南部）、NIHR CLAHRC（泰晤士河北部）。
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