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颈围在儿童青少年筛查超重肥胖中的应用价值

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目的 探讨颈围用于筛查儿童青少年超重肥胖的应用价值,为筛查儿童青少年超重肥胖提供理论依据和新思路。方法 于2023年5-7月,采取整群随机抽样法抽取郑州市3所学校的3~16岁儿童青少年共2 493名,收集一般资料及颈围、体质量指数(BMI)、腰高比等信息。采用Mann-Whitney秩和检验、Spearman相关分析、受试者工作特征曲线对数据进行统计分析。结果 3~16岁儿童青少年超重肥胖率为33。05%,腹型肥胖率为28。33%。男女童超重肥胖组颈围在学龄前期、学龄期、青春期与正常体重组相比差异均有统计学意义(Z=-16。69~-4。54,P值均<0。05)。不同性别各年龄分期儿童青少年颈围与BMI均呈正相关(r=0。50~0。79,P值均<0。01)。ROC曲线分析显示男女童颈围在学龄前期、学龄期、青春期时协助筛查超重肥胖发生准确性较好[男童AUC值(95%CI)分别为0。80(0。71~0。89),0。89(0。86~0。91),0。84(0。81~0。87);女童分别为 0。76(0。67~0。86),0。81(0。74~0。88),0。73(0。68~0。77),P值均<0。01],男童最佳颈围界值分别为26。95,28。95,33。55 cm,女童分别为25。05,26。55,28。35 cm。男女童在学龄期、青春期颈围与腰高比均呈正相关(r=0。41~0。70,P值均<0。01)。ROC曲线显示男女童颈围在学龄期、青春期时协助筛查腹型肥胖发生准确性较好[男童AUC值(95%CI)分别为 0。89(0。86~0。92),0。82(0。78~0。85);女童分别为 0。84(0。75~0。93),0。87(0。75~0。93)],男童最佳界值分别为28。95,32。75 cm;女童最佳界值分别为26。45,31。85 cm。结论 颈围可应用于儿童青少年超重肥胖和腹型肥胖筛查,为儿童青少年超重肥胖防控工作提供了新思路。
Application value of neck circumference in screening for overweight and obesity among children and adolescents
Objective To discuss the clinical value of neck circumference in screening for overweight and obesity in children and adolescents,so as to provide a theoretical basis and new ideas for overweight and obesity screening.Methods From May to July 2023,a total of 2 493 children and adolescents aged 3 to 16 were sampled from three schools by the cluster random sampling method.General data,neck circumference,body mass index(BMI),waist-to-height ratio,and other information were collected.Mann-Whitney rank-sum test,Spearman correlation analysis,and receiver operating characteristic(ROC)curve analysis were used to statistically analyze the data.Results The prevalence of overweight and obesity in children and adolescents aged 3 to 16 was 33.05%,and the prevalence of abdominal obesity was 28.33%.The neck circumferences of boys and girls in the overweight and obese group showed statistically significant differences from the normal weight group during the pre-school,school-age,and adoles-cence periods(Z=-16.69--4.54,P<0.05).The neck circumferences of children of different genders were moderately positively correlated with BMI(r=0.50-0.79,P<0.01).ROC curve analysis showed that neck circumference had good accuracy in assisting the screening for the occurrence of overweight and obesity in boys and girls during the pre-school,school-age,and adolescence peri-ods[the AUC for boys:0.80(0.71-0.89),0.89(0.86-0.91),0.84(0.81-0.87);the AUC for girls:0.76(0.67-0.86),0.81(0.74-0.88),0.73(0.68-0.77),P<0.01],the optimal neck circumference cut-off values for boys were 26.95,28.95,33.55 cm,and for girls were 25.05,26.55,28.35 cm respectively.The neck circumferences of boys and girls were moderately positively correlated with the waist-to-height ratio during the school-age and adolescence periods(r=0.41-0.70,P<0.0l).ROC curves showed that neck circumferences had good accuracy in assisting the screening for the occurrence of abdominal obesity in boys and girls during the school-age and adolescence periods[the AUC for boys:0.89(0.86-0.92),0.82(0.78-0.85);the AUC for girls:0.84(0.75-0.93),0.87(0.75-0.93)],the optimal cut-off values for boys were 28.95,32.75 cm;for girls were 26.45,31.85 cm respectively.Conclusion The neck circumference can be applied to screen for overweight and abdominal obesity in children and adolescents,and can provide new ideas for the prevention and control of overweight and obesity in children and adolescents.

NeckOverweightObesityROC curveChildAdolescent

刘芳、袁淑娴、李园、郝会民、林一凡、陈永兴、卫海燕

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郑州大学附属儿童医院/河南省儿童医院郑州儿童医院内分泌遗传代谢科,河南 450018

超重 肥胖症 ROC曲线 儿童 青少年

国家重点研发计划国家重点研发计划

2021YFC27019022021YFC2701901

2024

中国学校卫生
中华预防医学会

中国学校卫生

CSTPCD北大核心
影响因子:1.423
ISSN:1000-9817
年,卷(期):2024.45(7)