Santos José Luiz F, Valério Valentin P, Fernandes Rafael N, Duarte Ligia, Assumpção Antonio C, Guerreiro Jayme, Sickler Antonio L, Lemos Álvaro A R, Goulart Filho Jayro G, Cesar Luiz Antonio Machado, Pinto Ibraim Masciarelli, Magalhães Carlos, Hussid Maria Fernanda, Camacho Cleber, Avezum Alvaro, Sangaleti Carine T, Consolim-Colombo Fernanda Marciano
Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil.
Instituto do Coração (InCor) - Cardiopneumologia,São Paulo, SP - Brasil.
Arq Bras Cardiol. 2020 May-Jun;114(3):530-537. doi: 10.36660/abc.20190043.
The prevalence of obesity has systematically been increased in the population, including children and adolescents, around the world.
To describe reference percentile curves for waist circumference (WC) in Brazilian children and provide cut-off values of WC to identify children at risk for obesity.
A multicenter, prospective, cross-sectional study was performed with children aged from 6 to 10 years old, enrolled in public and private elementary schools from 13 cities of the São Paulo State. Height, weight, and WC were measured in duplicate in 22,000 children (11,199 boys). To establish the WC best cut-off value for obesity diagnosis, ROC curves with children classified as normal weight and obese were calculated, according to BMI curves, stratified by gender and age, and the Youden Index was utilized as the maximum potential effectiveness of this biomarker. A p < 0.05 was considered statistically significant.
WC values increased with age in both boys and girls. The prevalence of obesity in each age group varied from 17% (6 years old) to 21.6% (9 years old) among boys, and from 14.1% (7 years old) to 17.3 % (9 years old) among girls. ROC analyses have shown the 75th percentile as a cut-off for obesity risk, and the diagnosis of obesity is classified on the 85th percentile or more.
Age and gender specific reference curves of WC for Brazilian children and cut-off values for obesity risk may be used for national screening and interventional studies to reduce the obesity burden in Brazil. (Arq Bras Cardiol. 2020; 114(3):530-537).
在全球范围内，包括儿童和青少年在内的人群中，肥胖患病率一直在系统性上升。
描述巴西儿童腰围（WC）的参考百分位数曲线，并提供WC的临界值以识别肥胖风险儿童。
对圣保罗州13个城市公立和私立小学中6至10岁的儿童进行了一项多中心、前瞻性横断面研究。对22000名儿童（11199名男孩）的身高、体重和WC进行了两次测量。为确定肥胖诊断的WC最佳临界值，根据BMI曲线，按性别和年龄分层，计算将儿童分类为正常体重和肥胖的ROC曲线，并将约登指数用作该生物标志物的最大潜在有效性。p<0.05被认为具有统计学意义。
男孩和女孩的WC值均随年龄增加。各年龄组男孩的肥胖患病率从17%（6岁）到21.6%（9岁）不等，女孩从14.1%（7岁）到17.3%（9岁）不等。ROC分析显示，第75百分位数为肥胖风险临界值，肥胖诊断分类为第85百分位数及以上。
巴西儿童WC的年龄和性别特异性参考曲线以及肥胖风险临界值可用于全国筛查和干预研究，以减轻巴西的肥胖负担。（《巴西心脏病学杂志》。2020；114(3):530 - 537）
