Vieira Sarah Aparecida, Ribeiro Andréia Queiroz, Hermsdorff Helen Hermana Miranda, Pereira Patrícia Feliciano, Priore Silvia Eloiza, Franceschini Sylvia do Carmo Castro
Universidade Federal de Viçosa, Viçosa, MG, Brasil.
Rev Paul Pediatr. 2017 Nov 17;36(1):7. doi: 10.1590/1984-0462/;2018;36;1;00002. Print 2018 Jan-Mar.
To identify a low-cost abdominal adiposity index that has a higher accuracy in predicting excess weight in children aged four to seven years old.
A cross-sectional study with a sample of 257 children aged 4 to 7 years old. Indicators of abdominal adiposity assessed were: waist circumference (WC), waist-to-height ratio (WHR) and central fat percentage (measured by dual energy X-ray absorptiometry - DEXA). Overweight children were classified using body mass index by age (BMI/age). In the analysis, the prevalence ratio (PR) using Poisson regression with a robust variance was estimated, and a receiver operating characteristic (ROC) curve was built, with a statistical significance of p<0.05.
The prevalence of overweight children was 24.9% and a higher median of all abdominal adiposity indicators was observed in the overweight group. Children with increased values of WC (PR=4.1; 95%CI 2.86-5.86), WHR (PR=5.76; 95%CI 4.14-8.02) and a central fat percentage (PR=2.48; 95%CI 1.65-3.73) had a higher prevalence of being overweight. Using the ROC curve analysis, the WHR index showed a higher area under the curve, when compared to the WC and to the central fat percentage estimated by DEXA for predicting the classification of being overweight.
Given the results, WHR is suggested for the screening of overweight children.
确定一种低成本的腹部肥胖指数，该指数在预测4至7岁儿童超重方面具有更高的准确性。
对257名4至7岁儿童进行横断面研究。评估的腹部肥胖指标包括：腰围（WC）、腰高比（WHR）和中心脂肪百分比（通过双能X线吸收法 - DEXA测量）。超重儿童采用年龄别体重指数（BMI/年龄）进行分类。在分析中，采用稳健方差的泊松回归估计患病率比（PR），并绘制受试者工作特征（ROC）曲线，统计学显著性为p<0.05。
超重儿童的患病率为24.9%，超重组所有腹部肥胖指标的中位数更高。WC值升高（PR = 4.1；95%CI 2.86 - 5.86）、WHR值升高（PR = 5.76；95%CI 4.14 - 8.02）和中心脂肪百分比升高（PR = 2.48；95%CI 1.65 - 3.73）的儿童超重患病率更高。使用ROC曲线分析，与WC和DEXA估计的中心脂肪百分比相比，WHR指数在预测超重分类时曲线下面积更大。
根据研究结果，建议使用WHR筛查超重儿童。
