Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan.
Center for Medical Education, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
J Physiol Anthropol. 2022 May 10;41(1):21. doi: 10.1186/s40101-022-00293-1.
In Japan, height and weight measurements, taken for all children at birth and 1.5- and 3-year health checks, are recorded in the Mother and Child Health (MCH) Handbook, as required by the law. The present population-based retrospective cohort study aimed to evaluate the diagnostic performance of height and weight records in the Handbook for predicting excessive adiposity in adolescents.
The source population consisted of 8th grade students (800 students aged 14 years) registered at two public junior high schools. Of these, we excluded students who were born at a gestational age < 37 weeks or > 42 weeks. The present analyses included 435 participants who provided complete information. Body mass index (BMI) was calculated using height and weight records. Body fat mass at 14 years of age was measured by dual-energy X-ray absorptiometry (DXA). Diagnostic performance of BMI calculated from the MCH Handbook records to discriminate between the presence and absence of excessive adiposity at 14 years of age was evaluated using receiver operating characteristic (ROC) curve analysis. The area under the ROC curve (AUC) was used to quantify the diagnostic accuracy of BMI.
With regard to the prediction of excessive fat at 14 years of age, AUCs and 95% confidence intervals for BMI at 1.5 and 3 years of age were greater than 0.5. Meanwhile, the AUC of BMI at birth was not significantly greater than 0.5.
The present study findings indicate that BMI values calculated using MCH Handbook data have potential ability to distinguish between the presence and absence of excessive fat at 14 years of age.
在日本,所有婴儿出生时、1.5 岁和 3 岁健康检查时的身高和体重测量值都按照法律规定记录在《母子保健手册》中。本基于人群的回顾性队列研究旨在评估《母子保健手册》中记录的身高和体重值预测青少年肥胖的诊断性能。
该研究的源人群由两所公立初中的 8 年级学生(800 名 14 岁学生)组成。我们排除了胎龄<37 周或>42 周的学生。本分析纳入了提供完整信息的 435 名参与者。使用身高和体重记录计算体重指数(BMI)。通过双能 X 射线吸收法(DXA)测量 14 岁时的体脂肪量。使用受试者工作特征(ROC)曲线分析评估《母子保健手册》记录中 BMI 对 14 岁时是否存在肥胖的诊断性能。ROC 曲线下面积(AUC)用于量化 BMI 的诊断准确性。
在预测 14 岁时的肥胖程度方面,1.5 岁和 3 岁时 BMI 的 AUC 和 95%置信区间大于 0.5。然而,出生时 BMI 的 AUC 并不显著大于 0.5。
本研究结果表明,使用《母子保健手册》数据计算的 BMI 值具有区分 14 岁时是否存在肥胖的潜力。