济南市2021年儿童青少年超重肥胖的中国和国际标准比较

姜娜娜; 刘佳慧; 田亚兰; 赵月; 许华茹

doi:10.16835/j.cnki.1000-9817.2023.09.028

济南市2021年儿童青少年超重肥胖的中国和国际标准比较

doi: 10.16835/j.cnki.1000-9817.2023.09.028

姜娜娜^{1, 2},
刘佳慧¹,
田亚兰¹,
赵月¹,
许华茹^2, ,

1.
山东大学齐鲁医学院公共卫生学院儿少卫生与妇幼保健学系, 济南 250012
2.
山东省济南市疾病预防控制中心

详细信息

作者简介:
姜娜娜(1999-), 女, 山东青岛人, 在读硕士, 主要研究方向为儿童青少年保健

通讯作者:
许华茹, E-mail: xhr0527@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R723.14 R179
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- 被引次数: 0
出版历程
- 收稿日期: 2023-05-22
- 修回日期: 2023-07-15
- 网络出版日期: 2023-09-28
- 刊出日期: 2023-09-25

Overweight and obesity among children and adolescents in Jinan City in 2021 and comparison with Chinese and international standards

JIANG Nana^{1, 2},
LIU Jiahui¹,
TIAN Yalan¹,
ZHAO Yue¹,
XU Huaru.^{2
, ,}

1.
Department of Maternal and Child Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan (250012), China

摘要

摘要: 目的采用国内外儿童青少年超重肥胖筛查标准，描述济南市儿童青少年超重和肥胖的流行现状，并对中国标准和国际标准进行比较分析，为有关部门制定干预策略提供基础数据。方法于2021年9—12月，使用2021年济南市746 985名中小学生健康体检身高、体重数据，计算体质量指数(BMI)，描述济南市6~18岁儿童青少年超重和肥胖流行现状。通过计算加权Kappa值(Kw)，比较中国标准、美国疾病预防控制中心(CDC)标准、国际肥胖问题工作组(IOTF)标准和世界卫生组织(WHO)标准的一致性。结果基于中国、美国CDC、IOTF、WHO标准，济南市6~18岁儿童青少年超重率分别为17.3%，16.5%，21.1%，13.6%，肥胖率分别为23.1%，19.5%，13.5%，6.6%。4种标准下，男生超重率和肥胖率均高于女生(中国：χ²值分别为1 418.48，9 868.51；美国CDC：χ²值分别为145.78，23 211.41；IOTF：χ²值分别为1 326.94，13 615.62；WHO：χ²值分别为873.13，46.41；P值均＜0.01)。13~18岁年龄段青少年超重率高于6~12岁儿童(中国：χ²=29.13，美国CDC：χ²=6.43，IOTF：χ²=15.87，WHO：χ²=19.48，P值均＜0.01)；而6~10岁组肥胖率高于11~18岁组(中国：χ²=217.02，美国CDC：χ²=227.54，IOTF：χ²=171.91，WHO：χ²=165.91，P值均＜0.01)。城镇儿童青少年超重率和肥胖率均略高于乡村儿童青少年(中国：χ²值分别为25.06，245.12；美国CDC：χ²值分别为56.13，205.93；IOTF：χ²值分别为182.34，22.04；WHO：χ²值分别为200.88，21.61；P值均＜0.01)。中国标准与IOTF标准和美国CDC标准表现出较好的一致性，Kw值分别为0.72, 0.83;但与WHO标准的一致性较差，Kw值为0.33。结论济南市儿童青少年超重肥胖流行现状严峻。中国标准与IOTF标准、美国CDC标准一致性较好，与WHO标准一致性较差。
- 超重 /
- 肥胖症 /
- 参考标准 /
- 儿童 /
- 青少年
Abstract: Objective To describe the prevalence of overweight and obesity among children and adolescents in Jinan City according the national and international criteria, as well as to compare the Chinese and international standards, so as to provide basic data for relevant intervention strategies. Methods From September to December 2021, using the height and weight data obtained from the health checkup reports of 746 985 primary and secondary school students in Jinan City in 2021, body mass index(BMI) was calculated to evaluate the current status of the prevalence of overweight and obesity among this sample of children and adolescents aged 6-18 years old. The consistency of the Chinese standard, U.S. Centers for Disease Control and Prevention (CDC) standard, International Obesity Task Force (IOTF) standard, and World Health Organization (WHO) standard was compared by calculating the weighted Kappa value. Results Based on the Chinese, U.S. CDC, IOTF and WHO standards, the overweight rates of children and adolescents aged 6-18 years in Jinan were 17.3%, 16.5%, 21.1% and 13.6%, respectively, and the obesity rates were 23.1%, 19.5%, 13.5% and 6.6%, respectively. The overweight and obesity rates of boys were higher than those of girls under the four criteria (China: χ²=1 418.48, 9 868.51, U.S. CDC: χ²=145.78, 23 211.41, IOTF: χ²=1 326.94, 13 615.62, WHO: χ²=873.13, 46.41, P < 0.01).The overweight rate of adolescents in the 13-18 year-old age group was higher than that of children aged 6-12 years (China: χ²=29.13, U.S. CDC: χ²=6.43, IOTF: χ²=15.87, WHO: χ²=19.48, P < 0.01) and the obesity rate of the group aged 6-10 years was significantly higher than that of the group aged 11-18 years (China: χ²=217.02, U.S. CDC: χ²=227.54, IOTF: χ²=171.91, WHO: χ²=165.91, P < 0.01). The rates of overweight and obesity in urban children and adolescents were slightly higher than those in rural children and adolescents (China: χ²=25.06, 245.12, U.S. CDC: χ²=56.13, 205.93, IOTF: χ²=182.34, 22.04, WHO: χ²=200.88, 21.61, P < 0.01). The Chinese standard showed good agreement with the IOTF standard and U.S. CDC standard, with weighted Kappa values of 0.72 and 0.83, but poor agreement with the WHO standard, with a weighted Kappa value of 0.33. Conclusion The current prevalence of overweight and obesity among children and adolescents in Jinan is serious. The Chinese standard has good consistency with IOTF standard and American CDC standard, and poor consistency with WHO standard.
- Overweight /
- Obesity /
- Reference standards /
- Child /
- Adolescent
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表 1 不同年龄城镇男女生BMI比较(x±s，kg/m²)

Table 1. Comparison of the BMI among boys and girls of different age in towns and cities(x±s, kg/m²)

年龄/岁	男生		女生
年龄/岁	人数	BMI	人数	BMI
6	23 774	16.9±2.9	21 744	16.1±2.5
7	31 325	17.5±3.2	27 755	16.5±2.7
8	24 284	18.5±3.7	21 756	17.2±3.1
9	25 734	19.4±4.0	22 939	18.0±3.4
10	22 180	20.5±4.3	19 434	18.9±3.8
11	21 074	21.2±4.5	18 501	19.8±3.9
12	22 885	21.9±4.7	20 349	20.6±4.0
13	24 269	22.2±4.7	21 930	21.2±4.0
14	23 096	22.8±4.8	20 579	21.7±4.0
15	13 026	22.9±4.7	12 832	21.9±3.8
16	10 289	23.2±4.7	10 235	22.0±3.9
17	8 688	23.6±4.5	8 534	21.9±3.8
18	1 227	23.4±4.7	840	22.1±4.1
合计	251 851	20.4±4.7	227 428	19.2±4.2

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表 2 不同年龄乡村男女生BMI比较(x±s，kg/m²)

Table 2. Comparison of the BMI among boys and girls of different age in villages(x±s, kg/m²)

年龄/岁	男生		女生
年龄/岁	人数	BMI	人数	BMI
6	10 973	17.0±2.9	9 922	16.3±2.6
7	14 428	17.5±3.2	12 896	16.7±2.8
8	12 252	18.4±3.8	11 125	17.4±3.2
9	14 187	19.3±4.1	12 376	18.1±3.5
10	14 358	20.2±4.4	12 712	18.9±3.8
11	14 303	20.9±4.6	12 702	19.8±4.0
12	12 368	21.5±4.7	10 984	20.6±4.0
13	11 431	21.7±4.6	10 246	21.2±4.0
14	11 335	22.1±4.7	10 604	21.7±3.9
15	9 511	22.6±4.8	9 319	22.1±3.9
16	8 763	22.9±4.7	9 193	22.2±3.8
17	5 007	23.0±4.5	5 302	22.1±3.8
18	844	23.4±4.6	565	22.2±3.8
合计	139 760	20.3±4.7	127 946	19.5±4.2

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表 3 4种标准下不同年龄、性别儿童青少年超重和肥胖检出率/%

Table 3. Detection rate of overweight and obesity among children and adolescents of different ages and sexes for the four criteria/%

性别	年龄/岁	人数	超重				肥胖
性别	年龄/岁	人数	中国	美国CDC	IOTF	WHO	中国	美国CDC	IOTF	WHO
男	6	34 747	16.3	13.5	14.6	11.2	28.2	22.5	15.1	7.8
	7	45 753	16.6	13.9	16.9	12.7	27.0	24.5	16.4	7.9
	8	36 536	15.4	15.1	19.8	14.9	30.8	29.0	20.1	7.5
	9	39 921	17.1	17.6	23.6	15.7	32.5	31.3	21.0	6.8
	10	36 538	18.8	18.8	26.4	16.2	33.7	32.3	21.3	5.7
	11	35 377	20.6	19.5	27.5	16.3	32.3	31.2	20.4	5.4
	12	35 253	21.6	19.9	28.1	16.2	30.1	29.6	19.9	5.7
	13	35 700	21.8	18.9	25.5	16.1	24.9	24.9	17.6	6.7
	14	34 431	20.6	18.1	24.6	15.5	22.6	23.0	15.5	7.0
	15	22 537	19.5	16.8	22.7	14.4	20.7	19.9	14.8	7.3
	16	19 052	20.2	16.3	22.4	13.9	19.3	17.6	13.0	7.0
	17	13 695	21.6	15.5	22.1	13.1	17.1	14.9	11.1	6.8
	18	2 071	19.5	13.0	20.0	13.2	16.7	13.5	10.1	6.7
	小计	391 611	18.9	17.0	22.8	14.8	27.7	26.1	17.9	6.8
女	6	31 666	16.5	12.4	13.9	10.6	21.8	13.2	9.5	6.6
	7	40 651	15.9	13.1	15.5	11.5	19.0	13.0	9.3	6.8
	8	32 881	14.7	14.7	18.4	12.9	21.1	14.6	10.4	6.5
	9	35 315	14.1	17.3	20.7	13.9	21.9	14.4	10.5	6.5
	10	32 146	14.3	18.1	22.8	13.4	22.0	14.9	10.5	6.5
	11	31 203	14.6	18.6	23.6	13.6	21.0	14.6	10.0	6.3
	12	31 333	14.6	18.7	23.5	13.5	19.2	13.6	8.9	6.1
	13	32 176	16.5	17.9	22.1	12.7	15.6	11.3	7.3	6.3
	14	31 183	17.3	17.5	20.1	12.1	13.7	9.6	6.7	6.2
	15	22 151	17.6	15.4	17.7	10.8	11.6	8.0	6.0	6.4
	16	19 428	16.3	13.8	16.0	11.1	9.8	6.0	5.2	6.0
	17	13 836	15.9	11.5	14.3	11.3	8.4	4.8	4.6	6.2
	18	1 405	16.2	11.0	13.1	11.7	8.5	5.1	5.6	6.5
	小计	355 374	15.6	16.0	19.3	12.4	18.0	12.2	8.6	6.4

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表 4 中国标准与国际标准的一致性比较[Kw(95%CI)]

Table 4. Comparison of consistency between Chinese standards and international standards[Kw(95%CI)]

性别	年龄/岁	中国标准vs.美国CDC标准	中国标准vs.IOTF标准	中国标准vs.WHO标准
男	6~12	0.86(0.86~0.87)	0.68(0.68~0.69)	0.24(0.24~0.25)
	13~18	0.92(0.91~0.92)	0.82(0.82~0.83)	0.31(0.31~0.32)
	6~18	0.88(0.87~0.88)	0.73(0.73~0.74)	0.26(0.26~0.27)
女	6~12	0.75(0.74~0.75)	0.65(0.65~0.66)	0.35(0.35~0.36)
	13~18	0.79(0.79~0.80)	0.75(0.75~0.76)	0.55(0.54~0.55)
	6~18	0.76(0.76~0.77)	0.68(0.68~0.69)	0.41(0.41~0.42)
合计	6~12	0.81(0.81~0.82)	0.67(0.67~0.68)	0.29(0.28~0.29)
	13~18	0.86(0.86~0.87)	0.79(0.79~0.80)	0.41(0.41~0.42)
	6~18	0.83(0.83~0.84)	0.72(0.71~0.72)	0.33(0.33~0.34)

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