摘要目的 研究中国2～18岁儿童青少年超重、肥胖筛查体重指数(BMI)界值点.方法 在中国0～18岁儿童青少年BMI生长参照值的基础上,根据常用的超重、肥胖筛查界值点选择方法(与成年人界值点接轨法、百分位法或Z分值法),初步分别确定[BMI 24kg/m2 (BMI24)、28 kg/m2(BMI28)]、(P85、P95)和(Z1、Z2)三组界值点,通过对不同界值点进行差值和检出率比较,并与中国肥胖问题工作组(WGOC)和国际肥胖问题工作组(IOTF)的超重、肥胖界值点做对比分析,最后确定适宜界值点.结果 按照不同的超重、肥胖筛查BMI界值点选择方法获得三组界值点,不同界值点之间存在不同程度差异,但在超重合并肥胖检出率上差异相对较小.与WGOC相比,男章超重、肥胖及女童肥胖界值点非常接近,女童在8.5～15.5岁其超重界值点比WGOC标准低0.3～1.0 kg/m2,通过筛查"2004年北京市儿童代谢综合征调查"数据库,女童超重检出率比WGOC标准高约3.4%.结论 采用与成年人界值点接轨法(BMI24、BMI28)获得的中国2～18岁儿童青少年超重、肥胖筛查BMI界值点是适宜的,实现了在使用BMI指标上年龄的连贯性和筛查标准的一致性.

abstractsObjective To study the body cut-offs of mass index (BMI) for the purpose of screening overweight and obesity for Chinese children and adolescents aged 2-18 years. Methods Based on the BMI growth reference values for Chinese children aged 0-18, using the common methods to establish the BMI cut-offs for screening overweight and obesity. These methods were having the same empirical percentile or Z scores and the BMI value at 18 years consistent with adults.Three sets of BMI cut-offs, including (BMI24, BMI28) , (P85, P95) and (Z1, Z2) , were initially identified. Differences were compared on different cut-off points and prevalence rates of overweight and obesity with different BMI reference, different values and "prevalence" of overweight and obesity based on "2004 Beijing Child and Adolescent Metabolic Syndrome Study ". Cut-offs standards which recommended by the Chinese Working Group on Obesity for Children (WGOC) and by the International Obesity Task Force (IOTF) were also used. Finally the appropriate cut-offs were defined. Results Three sets of BMI cut-offs for screening overweight and obesity for Chinese children and adolescents aged 2-18 years were obtained according to the above mentioned methods for selection. The prevalence rates of overweight and obesity defined by those cut-offs appeared not to be significantly different. Compared with the WGOC, the BMI cut-off points for screening overweight and obesity for both boys and girls from our study were very close to the WGOC', but cut-off points for screening overweight for girls aged 8.5-15.5 y was 0.3-1.0 kg/m2 lower than the WGOC'. Going through the database on screening of "2004 Beijing Children's Metabolic Syndrome Survey ", the prevalence of overweight for girls was about 3.4% higher than using the cut-offs of WGOC. Conclusion Results from this study suggested that the BMI cut-offs passed through the cut-off point of BMI24 and BMI28 at 18 years was appropriate for screening overweight and obesity in Chinese children from 2 to 18 years, and achieved the continuity in age and consistency in screening standard when using the BMI indicator in children and adolescents.