Severe obesity and cardiometabolic risk in children: comparison from two international classification systems.
Severe obesity and cardiometabolic risk in children: comparison from two international classification systems.
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DOI：
10.1371/journal.pone.0083793
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Childhood Obesity Group of the Italian Society of Pediatric Endocrinology and Diabetology
中科院分区：
文献类型：
--
作者：
Valerio G;Maffeis C;Balsamo A;Del Giudice EM;Brufani C;Grugni G;Licenziati MR;Brambilla P;Manco M;Childhood Obesity Group of the Italian Society of Pediatric Endocrinology and Diabetology
对于儿童严重肥胖（Sev-OB），目前还没有统一的定义。我们比较了来自疾病控制和预防中心（CDC）或世界卫生组织（WHO）曲线的身体质量指数（BMI）的不同切割点所定义的Sev-OB的估计值，以及每组切割点筛选心脏代谢危险因素的能力。横断面、多中心研究涉及3340名超重/肥胖青年受试者。Sev-OB定义为BMI≥99百分位或≥1.2倍CDC或WHO曲线的95百分位。高血压、高甘油三酯血症、低高密度脂蛋白-胆固醇和空腹血糖受损被认为是心脏代谢的危险因素。Sev-OB的估计患病率在两种参考系统之间差异很大。无论采用临界值≥99百分位或≥1.2倍95百分位，CDC定义为Sev-OB的儿童少于WHO（分别p<0.001、46.8比89.5%和63.3比80.4%）。CDC第99百分位在识别具有≥2种心脏代谢危险因素的肥胖儿童方面比WHO的敏感性低（58.5 vs 94.2），特异性高（57.6 vs 12.3），阳性预测值高（34.4 vs 28.9）。使用1.2倍的第95百分位数来缓解这些差异（敏感性73.9 vs 88.1；特异性40.7 vs 22.5；阳性预测值32.1 vs 30.1）。使用1.2倍的第95百分位数发现生长曲线之间的基本一致，特别是在≤10岁的儿童中。由BMI的不同切点定义的Sev-OB和心脏代谢风险的估计受到所使用的参考系统的影响。疾病控制与预防中心或世界卫生组织标准的体重指数为第95百分位数的1.2倍，在识别心脏代谢风险增加的严重肥胖儿童，特别是10岁以下儿童方面，比第99百分位数具有歧视性优势。
There is no agreed-upon definition for severe obesity (Sev-OB) in children. We compared estimates of Sev-OB as defined by different cut-points of body mass index (BMI) from the Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO) curves and the ability of each set of cut-points to screen for the presence of cardiometabolic risk factors. Cross-sectional, multicenter study involving 3,340 overweight/obese young subjects. Sev-OB was defined as BMI ≥99th percentile or ≥1.2 times the 95th percentile of the CDC or the WHO curves. High blood pressure, hypertriglyceridemia, low High Density Lipoprotein -cholesterol and impaired fasting glucose were considered as cardiometabolic risk factors. The estimated prevalence of Sev-OB varied widely between the two reference systems. Either using the cut-point ≥99th percentile or ≥1.2 times the 95th percentile, less children were defined as Sev-OB by CDC than WHO (46.8 vs. 89.5%, and 63.3 vs. 80.4%, respectively p<0.001). The CDC 99th percentile had lower sensitivity (58.5 vs 94.2), higher specificity (57.6 vs 12.3) and higher positive predictive value (34.4 vs 28.9) than WHO in identifying obese children with ≥2 cardiometabolic risk factors. These differences were mitigated using the 1.2 times the 95th percentile (sensitivity 73.9 vs. 88.1; specificity 40.7 vs. 22.5; positive predictive value 32.1 vs. 30.1). Substantial agreement between growth curves was found using the 1.2 times the 95th percentile, in particular in children ≤10 years. Estimates of Sev-OB and cardiometabolic risk as defined by different cut-points of BMI are influenced from the reference systems used. The 1.2 times the 95th percentile of BMI of either CDC or WHO standard has a discriminatory advantage over the 99th percentile for identifying severely obese children at increased cardiometabolic risk, particularly under 10 years of age.
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影响因子：
8
作者：
Barlow, Sarah E.
通讯作者：
Barlow, Sarah E.
影响因子：
7.1
作者：
Flegal, Katherine M.;Wei, Rong;Curtin, Lester R.
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影响因子：
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作者：
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Ogden, Cynthia L.
DOI：
10.2471/blt.07.043497
发表时间：
2007-09-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
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通讯作者：
Siekmann, Jonathan
影响因子：
3.2
作者：
Calcaterra, V.;Klersy, C.;Larizza, D.
通讯作者：
Larizza, D.