Chen Rui, Ji Lang, Chen Yitong, Meng Linghui
Center for Evidence-Based Medicine, Capital Institute of Pediatrics, Beijing, China.
Central Laboratory, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
Transl Pediatr. 2022 Mar;11(3):318-329. doi: 10.21037/tp-21-479.
To assess the relationship between five anthropometric indicators, which includes body mass index (BMI), weight-to-height ratio (WHtR), a body shape index (ABSI), ABSI-adolescents, and body roundness index (BRI) in Chinese children and adolescents, and select which could better predict cardio-metabolic risk factors (CMRFs).
Cross-sectional study with 1,587 participants aged 3 to 17 years. Five anthropometric indicators were calculated according to weight, height and waist circumference (WC). Anthropometric measurements and laboratory indicators were used to diagnose CMRFs, which included hypertension, dyslipidemia, impaired fasting glucose and abdominal obesity. Partial correlation analysis was used to evaluate the relationship among anthropometric indicators, area under the receiver operating characteristic curve (AUCs) were used to compare the predict ability of each anthropometric indicators, the cut-off value, sensitivity, specificity and Youden Index of each indicator were calculated.
In 3-6 years old children, ABSI-adolescent positively correlated with WC (r=0.727, P<0.001), BMI (r=0.218, P<0.001) and WHtR (r=0.752, P<0.001), and in 7-17 years old participants, the correlation coefficients increased to 0.842, 0.563 and 0.850 (P<0.001), respectively. BRI were strong correlated with BMI, WHtR and ABSI-adolescents in both age group (P<0.001). In 3-6 years group, the ROC analysis showed that BMI and ABSI were significantly better in identifying hypertension in both genders, WHtR and BRI were significantly better in identifying abdominal obesity in girls, but all of them were failed in identifying dyslipidemia and hyperglycemia. In 7-17 years group, WHtR and BRI were significantly better in identifying hypertension, dyslipidemia, abdominal obesity in both genders, BMI and ABSI performed better in identifying hyperglycemia in girls.
In Chinese children aged 3-6 years, there is no indicator performed best in all the CMRFs, in 7-17 years old teenagers, WHtR and BRI can be recommended to identify hypertension, dyslipidemia, abdominal obesity and clustered CMRFs in both genders. However, ABSI showed weak discriminative power.
评估包括体重指数（BMI）、体重身高比（WHtR）、体型指数（ABSI）、青少年体型指数（ABSI-青少年）和体圆度指数（BRI）在内的五项人体测量指标与中国儿童及青少年心血管代谢危险因素（CMRFs）之间的关系，并选择能更好预测心血管代谢危险因素的指标。
对1587名3至17岁的参与者进行横断面研究。根据体重、身高和腰围（WC）计算五项人体测量指标。使用人体测量数据和实验室指标诊断心血管代谢危险因素，包括高血压、血脂异常、空腹血糖受损和腹型肥胖。采用偏相关分析评估人体测量指标之间的关系，使用受试者工作特征曲线下面积（AUCs）比较各人体测量指标的预测能力，计算各指标的截断值、敏感性、特异性和约登指数。
在3至6岁儿童中，青少年体型指数（ABSI-青少年）与腰围（r=0.727，P<0.001）、BMI（r=0.218，P<0.001）和体重身高比（WHtR）（r=0.752，P<0.001）呈正相关，在7至17岁参与者中，相关系数分别增至0.842、0.563和0.850（P<0.001）。在两个年龄组中，体圆度指数（BRI）均与BMI、体重身高比（WHtR）和青少年体型指数（ABSI-青少年）密切相关（P<0.001）。在3至6岁组中，ROC分析表明，BMI和ABSI在识别男女高血压方面显著更好，WHtR和BRI在识别女孩腹型肥胖方面显著更好，但在识别血脂异常和高血糖方面均失败。在7至17岁组中，WHtR和BRI在识别男女高血压、血脂异常和腹型肥胖方面显著更好，BMI和ABSI在识别女孩高血糖方面表现更好。
在3至6岁中国儿童中，没有指标在所有心血管代谢危险因素方面表现最佳；在7至17岁青少年中，推荐使用WHtR和BRI来识别男女的高血压、血脂异常、腹型肥胖和聚集性心血管代谢危险因素。然而，ABSI的判别能力较弱。
