Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China.
Clin Nutr. 2021 Mar;40(3):1289-1295. doi: 10.1016/j.clnu.2020.08.012. Epub 2020 Aug 19.
BACKGROUND & AIMS: The rise in the prevalence of childhood obesity has increased the demand for accurately evaluating body fatness in pediatric population. The aim of this study was to provide a series of sex- and age-specific body fat reference centiles for evaluating total body fat development and fat distribution in Chinese children and adolescents using dual-energy x-ray absorptiometry (DXA).
A nationwide sample of Chinese children and adolescents aged 3-18 years (n = 12,790) was drawn from a cross-sectional survey of the China Child and Adolescent Cardiovascular Health study (2013-2019). Fat measurements, including total fat mass index (FMI), total body fat percentage (BF%), regional FMI, trunk to leg (T/L) fat ratio and android to gynoid (A/G) fat ratio, were derived from whole body DXA scans. Sex- and age-specific centiles were estimated using the lambda-mu-sigma method and then compared with values derived from the US National Health and Nutrition Examination Survey (1999-2004) and Korean National Health and Nutrition Examination Survey (2008-2011).
During early childhood, almost all body fat parameters decreased with age, except an increase in A/G ratio. After 7 years onward, drastic upward trends of total FMI and BF% were exhibited in boys till 10 years, followed by opposite downward trends during 11-14 years; while sustained increase of FMI was shown in girls across ages accompanied by relatively constant BF% levels. Meanwhile, steady increases were noticed for A/G ratio and T/L ratio, which were more pronounced in boys. In addition, the proposed body fat references were much lower than the US but similar to Koreans despite of subtle differences.
This is the first study to present a set of DXA-based body fat reference for Chinese children and adolescents aged 3-18 years. The new reference provides clinicians and researchers a useful tool for assessing body fat development and distribution patterns throughout early childhood and adolescence.
儿童肥胖症患病率的上升增加了对儿科人群体脂准确评估的需求。本研究旨在提供一系列性别和年龄特异性体脂参考百分位数，以使用双能 X 射线吸收法（DXA）评估中国儿童和青少年的总体体脂肪发育和脂肪分布。
从中国儿童心血管健康研究（2013-2019 年）的横断面调查中抽取了一个全国性的中国儿童和青少年样本（n=12790）。从全身 DXA 扫描中得出脂肪测量值，包括总脂肪量指数（FMI）、全身脂肪百分比（BF%）、区域 FMI、躯干到腿部（T/L）脂肪比和安卓到女性（A/G）脂肪比。使用 lambda-mu-sigma 方法估计性别和年龄特异性百分位数，然后将其与美国国家健康和营养检查调查（1999-2004 年）和韩国国家健康和营养检查调查（2008-2011 年）得出的值进行比较。
在幼儿期，除 A/G 比增加外，几乎所有体脂参数都随年龄下降。7 岁以后，男孩的总 FMI 和 BF%呈急剧上升趋势，直到 10 岁，然后在 11-14 岁期间呈相反的下降趋势；而女孩的 FMI 则持续增加，同时 BF%水平相对稳定。同时，A/G 比和 T/L 比也稳步增加，男孩更为明显。此外，提出的体脂参考值远低于美国，但与韩国相似，尽管存在细微差异。
这是第一项针对 3-18 岁中国儿童和青少年的 DXA 体脂参考值的研究。新的参考值为评估儿童和青少年早期的体脂肪发育和分布模式提供了临床医生和研究人员的有用工具。
