St-Jean Audray, Meziou Salma, Ayotte Pierre, Lucas Michel
Population Health and Optimal Health Practices Research Unit, CHU de Québec - Université Laval, Hôpital du Saint-Sacrement, 1050 Chemin Sainte-Foy, Québec, QC, G1S 4L8, Canada.
Institut National de Santé Publique du Québec (INSPQ), 945 Avenue Wolfe, Québec, QC, G1V 5B3, Canada.
BMC Pediatr. 2017 Nov 22;17(1):196. doi: 10.1186/s12887-017-0951-4.
Little is known about the suitability of three commonly used body mass index (BMI) classification systems for Indigenous youth. We estimated overweight and obesity prevalence among Cree youth of Eeyou Istchee according to three BMI classification systems, assessed the level of agreement between them, and evaluated their accuracy through body fat and cardiometabolic risk factors.
Data on 288 youth (aged 8-17 years) were collected. Overweight and obesity prevalence were estimated with Centers for Disease Control and Prevention (CDC), International Obesity Task Force (IOTF) and World Health Organization (WHO) criteria. Agreement was measured with weighted kappa (κw). Associations with body fat and cardiometabolic risk factors were evaluated by analysis of variance.
Obesity prevalence was 42.7% with IOTF, 47.2% with CDC, and 49.3% with WHO criteria. Agreement was almost perfect between IOTF and CDC (κw = 0.93), IOTF and WHO (κw = 0.91), and WHO and CDC (κw = 0.94). Means of body fat and cardiometabolic risk factors were significantly higher (P < 0.001) from normal weight to obesity, regardless of the system used. Youth considered overweight by IOTF but obese by CDC or WHO exhibited less severe clinical obesity.
IOTF seems to be more accurate in identifying obesity in Cree youth.
对于三种常用的体重指数（BMI）分类系统在原住民青年中的适用性知之甚少。我们根据三种BMI分类系统估计了伊尤伊斯特奇克里族青年的超重和肥胖患病率，评估了它们之间的一致性水平，并通过体脂和心脏代谢危险因素评估了它们的准确性。
收集了288名青年（8至17岁）的数据。使用疾病控制与预防中心（CDC）、国际肥胖特别工作组（IOTF）和世界卫生组织（WHO）的标准估计超重和肥胖患病率。用加权kappa（κw）测量一致性。通过方差分析评估与体脂和心脏代谢危险因素的关联。
根据IOTF标准，肥胖患病率为42.7%；根据CDC标准为47.2%；根据WHO标准为49.3%。IOTF与CDC之间（κw = 0.93）、IOTF与WHO之间（κw = 0.91）以及WHO与CDC之间（κw = 0.94）的一致性几乎完美。无论使用哪种系统，从正常体重到肥胖，体脂和心脏代谢危险因素的平均值均显著更高（P < 0.001）。IOTF判定为超重但CDC或WHO判定为肥胖的青年，其临床肥胖程度较轻。
IOTF在识别克里族青年肥胖方面似乎更准确。
