Bi Cunjian, Ran Xiaokang, Zhang Feng, Liu Yun, Li Jun, Niu Yintao, Yang Guangyan
School of Physical Education, Chizhou University, Chizhou, China.
College of Physical Education and Health, East China Normal University, Shanghai, China.
Front Nutr. 2025 Mar 4;12:1511639. doi: 10.3389/fnut.2025.1511639. eCollection 2025.
Body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) have long been important physical assessment indicators. In recent years a body shape index (ABSI) and body roundness index (BRI) have gained importance as new physical assessment indicators. However, it is unclear how these physical assessment indicators assess psychological symptoms in adolescents. The main purpose of this study was to determine the ability of BMI, WC, WHtR, ABSI, and BRI indicators to recognize psychological symptoms in Chinese adolescents and to examine whether ABSI and BRI are superior to the traditional BMI, WC, and WHtR.
In this study, 42,472 (boys, 21,026, 49.5%) adolescents aged 12-18 years from six geographic regions in China were assessed for multiple physical assessment indicators (BMI, WC, WHtR, ABSI, BRI) and psychological symptoms from 2015 to 2016. One-way analysis of variance, Spearman's rank test, multifactor logistic regression analysis, and ROC analysis were used to analyze the validity of multiple physical assessment indicators to identify psychological symptoms.
The prevalence of psychological symptoms among Chinese adolescents aged 12-18 years was 26.17%. The BMI, WC, WHtR, ABSI, and BRI of the adolescents were (20.19 ± 3.43) kg/m2, (69.68 ± 10.05) cm, (0.42 ± 0.06), (0.06 ± 0.01), and (2.05 ± 0.92), respectively. The results of Spearman's rank test showed a positive correlation ( < 0.001) between BMI, WC, WHtR, and BRI were positively associated with psychological symptoms ( < 0.001). The highest Spearman correlation coefficient was found between WC and psychological symptoms ( = 0.134, < 0.001), and BMI was the lowest ( = 0.108, < 0.001). Overall, the prevalence of psychological symptoms for all five physical assessment indicators (BMI, WC, WHtR, ABSI, and BRI) showed an increasing trend from Q1 to Q4 ( < 0.001). Overall, WC (AUC: 0.61, 95%CI: 0.61-0.62), WHtR (AUC: 0.61, 95%CI: 0.60-0.61), and BRI (AUC: 0.61, 95%CI: 0.60-0.61) were highly and identically predictive of psychological symptoms; ABSI was the least predictive of psychological symptoms (AUC: 0.51, 95%CI: 0.50 ~ 0.51).
This study found that neither the ABSI nor the BRI was superior to BMI, WC, or WHtR in predicting psychological symptoms in Chinese adolescents. The ABSI was the least predictive of psychological symptoms in Chinese adolescents, whereas the BRI showed potential as a surrogate for WC and WHtR indicators for assessing psychological symptoms. This study provides additional help and suggestions for better identification of psychological symptoms in Chinese adolescents.
体重指数（BMI）、腰围（WC）和腰高比（WHtR）长期以来一直是重要的身体评估指标。近年来，体型指数（ABSI）和体圆度指数（BRI）作为新的身体评估指标变得越来越重要。然而，尚不清楚这些身体评估指标如何评估青少年的心理症状。本研究的主要目的是确定BMI、WC、WHtR、ABSI和BRI指标识别中国青少年心理症状的能力，并检验ABSI和BRI是否优于传统的BMI、WC和WHtR。
在本研究中，对来自中国六个地理区域的42472名12至18岁青少年（男孩21026名，占49.5%）在2015年至2016年期间进行了多种身体评估指标（BMI、WC、WHtR、ABSI、BRI）和心理症状评估。采用单因素方差分析、Spearman秩检验、多因素逻辑回归分析和ROC分析来分析多种身体评估指标识别心理症状的有效性。
12至18岁中国青少年心理症状的患病率为26.17%。青少年的BMI、WC、WHtR、ABSI和BRI分别为（20.19±3.43）kg/m²、（69.68±10.05）cm、（0.42±0.06）、（0.06±0.01）和（2.05±0.92）。Spearman秩检验结果显示，BMI、WC、WHtR与心理症状呈正相关（<0.001），BRI与心理症状呈正相关（<0.001）。WC与心理症状之间的Spearman相关系数最高（=0.134，<0.001），BMI最低（=0.108，<0.001）。总体而言，所有五项身体评估指标（BMI、WC、WHtR、ABSI和BRI）的心理症状患病率从第一季度到第四季度呈上升趋势（<0.001）。总体而言，WC（AUC：0.61，95%CI：0.61-0.62）、WHtR（AUC：0.61，95%CI：0.60-0.61）和BRI（AUC：0.61，95%CI：0.60-0.61）对心理症状具有高度且相同的预测性；ABSI对心理症状的预测性最低（AUC：0.51，95%CI：0.50~0.51）。
本研究发现，在预测中国青少年心理症状方面，ABSI和BRI均不优于BMI、WC或WHtR。ABSI对中国青少年心理症状的预测性最低，而BRI显示出作为WC和WHtR指标替代品评估心理症状的潜力。本研究为更好地识别中国青少年的心理症状提供了额外的帮助和建议。
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