Department of Epidemiology, Emory University, CNR 3rd floor, 1518 Clifton Road, NE, Atlanta, GA, 30322, USA.
Winship Cancer Institute, Emory University, Atlanta, GA, USA.
BMC Pediatr. 2019 Apr 10;19(1):103. doi: 10.1186/s12887-019-1484-9.
Obesity is a major public health concern in the United States and should be addressed as early as possible, in childhood. Disparities exist in obesity prevalence and its associated comorbidities by racial/ethnic group, however less is known about the smaller racial/ethnic subclasses that are often aggregated and assumed to be homogeneously at risk. As the racial and ethnic composition of the US shifts towards greater diversity, it is important that epidemiologic research addresses these new challenges.
In this short communication, we focus on Asian American children given that subgroups are historically understudied and emerging evidence among adults suggest heterogeneous associations for both obesity and cardio-metabolic outcomes. Existing limitations in this research area include: (1) identifying the appropriate measurement of adiposity in Asian American children; (2) determining high-risk cutoffs for intervention; and (3) developing strategies to ensure study robustness.
Data disaggregation is a necessary approach to understand potentially heterogeneous associations in childhood obesity and cardio-metabolic risk, but epidemiologic investigators must address these challenges. Ultimately, successful strategies could help better identify high risk subgroups, target interventions, and effectively reduce the burden of obesity among American youth.
肥胖是美国的一个主要公共卫生问题，应尽早在儿童时期解决。然而，不同种族/族裔群体之间的肥胖患病率及其相关合并症存在差异，对于那些经常被归为一类且被认为处于同质风险中的较小种族/族裔亚类，人们知之甚少。随着美国的种族和族裔构成向更多元化发展，流行病学研究应对这些新挑战非常重要。
正 文：在这篇简短的交流中，我们主要关注亚裔美国儿童，因为历史上对这些亚组的研究较少，而成年人中的新证据表明，肥胖和心脏代谢结果存在异质关联。这一研究领域存在的现有局限性包括：(1)确定亚裔美国儿童肥胖的适当测量方法；(2)确定干预的高风险截止值；以及(3)制定确保研究稳健性的策略。
结 论：数据细分是了解儿童肥胖和心脏代谢风险中潜在异质关联的必要方法，但流行病学研究人员必须应对这些挑战。最终，成功的策略可以帮助更好地识别高风险亚组，确定干预目标，并有效减轻美国青少年肥胖的负担。
