Facultad de Farmacia. Universidad CEU San Pablo.
Fundación Española de la Nutrición.
Nutr Hosp. 2021 Feb 23;38(1):85-93. doi: 10.20960/nh.03197.
Introduction: early detection of childhood obesity plays a crucial role in the prevention of diseases during adulthood. At present, the most commonly used screening tool for detecting overweight/obesity in children is the percentile for age of body mass index, although this rate is unable to provide information about fat distribution. An emerging marker of abdominal fat distribution is waist circumference (WC). Objective: the aim of this study was to evaluate the differences between the different diagnostic criteria available to define overweight and obesity in order to establish the optimal WC cut-off values for the Spanish children population. Methods: a cross-sectional study was carried out in 8,241 schoolchildren aged 3 to 12 years from Villanueva de la Cañada (Madrid, Spain). WC (cm), weight (kg) and height (cm) were measured according to the recommendations of the Society for the Advancement of Kineanthropometry (ISAK). The values obtained for the diagnostic criteria (Spanish Orbegozo Foundation (OF), the International Obesity Task Force (IOTF), and the World Health Organization (WHO) were compared using McNemar's test for paired proportions. The kappa coefficient (κ) was used to assess the degree of agreement of the three classifications. We analyzed the validity of body mass index (BMI) and WC using the receiver operating characteristic (ROC) curve analysis. The Youden index was used to determine cut-off values for WC that identify childhood obesity Results: overweight and obesity prevalences were calculated according to the OF, IOTF, and WHO criteria. There was a "substantial" agreement for the overweight and obesity categories between the Spanish criteria and IOTF (κ = 0.636), while agreement was "slight" between the Spanish criteria and those of WHO (κ = 0.198). The estimated cut-off WC criteria ranged from 54.5 to 88.0, varying according to sex and age. Conclusion: the proposed WC cut-off values, stated for the first time in a young Spanish population, are a simple and valid alternative as diagnostic criteria of abdominal obesity.
儿童肥胖的早期检测在预防成年期疾病方面起着至关重要的作用。目前，用于检测儿童超重/肥胖的最常用筛查工具是身体质量指数（BMI）的年龄百分位，尽管这一比率无法提供关于脂肪分布的信息。腹部脂肪分布的一个新兴标志物是腰围（WC）。目的：本研究旨在评估现有用于定义超重和肥胖的不同诊断标准之间的差异，以确定西班牙儿童人群中腰围的最佳截断值。方法：对来自西班牙马德里维拉努埃瓦·德·拉·卡尼亚达（Villanueva de la Cañada）的 8241 名 3 至 12 岁的学童进行了横断面研究。根据人体测量学促进协会（ISAK）的建议测量 WC（cm）、体重（kg）和身高（cm）。使用 McNemar 检验对配对比例比较诊断标准（西班牙奥贝戈佐基金会（OF）、国际肥胖特别工作组（IOTF）和世界卫生组织（WHO））获得的数值。使用 Kappa 系数（κ）评估三种分类的一致性程度。我们使用受试者工作特征（ROC）曲线分析评估 BMI 和 WC 的有效性。使用 Youden 指数确定识别儿童肥胖的 WC 截断值。结果：根据 OF、IOTF 和 WHO 标准计算超重和肥胖的患病率。西班牙标准和 IOTF 之间的超重和肥胖类别具有“中等”一致性（κ=0.636），而西班牙标准与 WHO 标准之间的一致性为“轻微”（κ=0.198）。估计的 WC 截断值标准范围为 54.5 至 88.0，因性别和年龄而异。结论：首次在年轻的西班牙人群中提出的 WC 截断值是一种简单有效的腹部肥胖诊断标准的替代方法。
