6至18岁儿童及青少年中心性肥胖的国际腰围百分位数切点
International Waist Circumference Percentile Cutoffs for Central Obesity in Children and Adolescents Aged 6 to 18 Years.
作者信息
Xi Bo, Zong Xin'nan, Kelishadi Roya, Litwin Mieczysław, Hong Young Mi, Poh Bee Koon, Steffen Lyn M, Galcheva Sonya V, Herter-Aeberli Isabelle, Nawarycz Tadeusz, Krzywińska-Wiewiorowska Małgorzata, Khadilkar Anuradha, Schmidt Michael D, Neuhauser Hannelore, Schienkiewitz Anja, Kułaga Zbigniew, Kim Hae Soon, Stawińska-Witoszyńska Barbara, Motlagh Mohammad Esmaeil, Ruzita Abd Talib, Iotova Violeta M, Grajda Aneta, Ismail Mohd Noor, Krzyżaniak Alicja, Heshmat Ramin, Stratev Velin, Różdżyńska-Świątkowska Agnieszka, Ardalan Gelayol, Qorbani Mostafa, Świąder-Leśniak Anna, Ostrowska-Nawarycz Lidia, Yotov Yoto, Ekbote Veena, Khadilkar Vaman, Venn Alison J, Dwyer Terence, Zhao Min, Magnussen Costan G, Bovet Pascal
机构信息
Department of Epidemiology, School of Public Health, Shandong University, Jinan, China.
Department of Growth and Development, Capital Institute of Pediatrics, Beijing, China.
出版信息
J Clin Endocrinol Metab. 2020 Apr 1;105(4):e1569-83. doi: 10.1210/clinem/dgz195.
CONTEXT
No universal waist circumference (WC) percentile cutoffs used have been proposed for screening central obesity in children and adolescents.
OBJECTIVE
To develop international WC percentile cutoffs for children and adolescents with normal weight based on data from 8 countries in different global regions and to examine the relation with cardiovascular risk.
DESIGN AND SETTING
We used pooled data on WC in 113,453 children and adolescents (males 50.2%) aged 4 to 20 years from 8 countries in different regions (Bulgaria, China, Iran, Korea, Malaysia, Poland, Seychelles, and Switzerland). We calculated WC percentile cutoffs in samples including or excluding children with obesity, overweight, or underweight. WC percentiles were generated using the general additive model for location, scale, and shape (GAMLSS). We also estimated the predictive power of the WC 90th percentile cutoffs to predict cardiovascular risk using receiver operator characteristics curve analysis based on data from 3 countries that had available data (China, Iran, and Korea). We also examined which WC percentiles linked with WC cutoffs for central obesity in adults (at age of 18 years).
MAIN OUTCOME MEASURE
WC measured based on recommendation by the World Health Organization.
RESULTS
We validated the performance of the age- and sex-specific 90th percentile WC cutoffs calculated in children and adolescents (6-18 years of age) with normal weight (excluding youth with obesity, overweight, or underweight) by linking the percentile with cardiovascular risk (area under the curve [AUC]: 0.69 for boys; 0.63 for girls). In addition, WC percentile among normal weight children linked relatively well with established WC cutoffs for central obesity in adults (eg, AUC in US adolescents: 0.71 for boys; 0.68 for girls).
CONCLUSION
The international WC cutoffs developed in this study could be useful to screen central obesity in children and adolescents aged 6 to 18 years and allow direct comparison of WC distributions between populations and over time.
背景
目前尚未提出用于筛查儿童和青少年中心性肥胖的通用腰围百分位数临界值。
目的
基于来自全球不同地区8个国家的数据，制定国际儿童和青少年正常体重者的腰围百分位数临界值，并研究其与心血管风险的关系。
设计与研究地点
我们使用了来自不同地区8个国家（保加利亚、中国、伊朗、韩国、马来西亚、波兰、塞舌尔和瑞士）的113453名4至20岁儿童和青少年（男性占50.2%）的腰围汇总数据。我们计算了包含或排除肥胖、超重或体重不足儿童的样本中的腰围百分位数临界值。腰围百分位数使用位置、尺度和形状的广义相加模型（GAMLSS）生成。我们还基于来自3个有可用数据的国家（中国、伊朗和韩国）的数据，使用受试者工作特征曲线分析估计了腰围第90百分位数临界值预测心血管风险的能力。我们还研究了哪些腰围百分位数与成人（18岁时）中心性肥胖的腰围临界值相关。
主要观察指标
根据世界卫生组织的建议测量的腰围。
结果
通过将百分位数与心血管风险联系起来（曲线下面积[AUC]：男孩为0.69；女孩为0.63），我们验证了在正常体重（不包括肥胖、超重或体重不足的青少年）的儿童和青少年（6至18岁）中计算出的年龄和性别特异性第90百分位数腰围临界值的性能。此外，正常体重儿童的腰围百分位数与成人中心性肥胖的既定腰围临界值相关性相对较好（例如，美国青少年的AUC：男孩为0.71；女孩为0.68）。
结论
本研究中制定的国际腰围临界值可能有助于筛查6至18岁儿童和青少年的中心性肥胖，并允许直接比较不同人群之间以及随时间变化的腰围分布情况。
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