上海市2～18岁人群体质指数消瘦最佳界值点探讨  

Optimal thinness boundary value points of BMI for Shanghai children

作　　者：林钟芳[1] 蒋一方[1] 居美芳[1] 张雷[1] 

机构地区：[1]上海市儿童医院上海交通大学附属儿童医院,上海200040

出　　处：《上海预防医学》2011年第12期589-592,共4页Shanghai Journal of Preventive Medicine

基　　金：上海市科学技术发展基金2003年(034023)

摘　　要：[目的]探讨上海市男女童体质指数消瘦最佳界值点及相应百分位。[方法]①采用分层整群抽样方法,收集上海市12个区78 458例(男39 588例,女38 870例)2～18岁少年儿童身高、体重和年龄,其中2～11.5岁男23 233例,2～10岁女17 742例。②以上海市儿童身高别体重(WFH)作为参照标准,WFH<第10百分位定义为轻度消瘦,WFH的z分<-2(相当于<第2.28百分位)定义为中重度消瘦。分析2～11.5岁儿童在不同的BMI百分位的灵敏度和特异度,并根据受试者操作曲线(ROC曲线)来确定消瘦的最佳界值点百分位。[结果]①在轻度消瘦的分析中,BMI第10、第12.5和第15百分位的特异度男性分别为98.7%、96.8%和94.3%,女性分别为99.4%、97.8%和95.0%;灵敏度男性分别为89.2%、96.9%和99.0%,女性分别为85.3%、95.7%和98.9%。②在中重度消瘦的分析中,BMI第3、第4和第5百分位的特异度男性分别为99.3%、98.6%和97.7%,女性分别为99.5%、98.7%和97.9%;灵敏度男性分别为95.7%、99.6%和98.6%,女性分别为91.3%、98.4%和99.5%。③上海市2～18岁中重度消瘦率(BMI<P4)为男性3.1%和女性3.3%,轻度消瘦率(BMI<P12.5并且>P4)为男性7.9%和女性7.5%。[结论]上海市儿童中重度和轻度消瘦最佳BMI界值点分别为第4及12.5百分位,其男性18岁时的界值点分别为16.9和18.2 kg/m2,女童分别为16.5和17.6 kg/m2。To discuss the optimal BMI boundary value points for thinness of Shanghai children and its corresponding percentiles. [ Methods ] （ 1 ） The data （ height, weight and age ） from 78458 children （ 39588 boys and 38870 girls） aged 2 - 18 years in Shanghai City were collected, including 23233 boys aged 2 - 11.5 years and 17742 girls aged 2 - 10 years. （ 2 ） Weight for height （WFH） for Shanghai children was used as the gold standard. Grade 1 slight thinness and Grade 2 middle and serious thinness were defined as those with weight below the 10th centile of WFH, and those with weight below the 2.28th centile of WFH （ corresponding to z score 〈 - 2）. （ 3 ） The Subject operating characteristic curve （ROC ）was used to characterize the sensitivity and specificity of different BMI boundary value points in classifying underweight. [ Results ] （ 1 ） When classifying grade 1 thinness, the specificity on 10th,12.5th,and 15th centile of BMI is 98.7% ,96.8% and 94.3% respectively for boys,and 99.4%, 97.8% and 95.0% respectively for girls;the sensitivity on 10th,12.5th,and 15th centile of BMI is 89.2% ,96.9% and 99.0% respectively for boys,and 85.3% ,95.7% and 98.9% respectively for girls. （2） When classifying grade 2 thinness,the specificity on 3th, 4th and 5th centile of BMI is 99.3% ,98.6% and 97.7% respectively for boys, and 99.5 %, 98.7 % and 97.9 % respectively for girls ; the sensitivity on 3 th,4th and 5 th centile of BMI is 95.7 % ,99.6 % and 98.6% respectively for boys,and 91.3% ,98.4% and 99.5% respectively for girls. （3） The rate of grade 1 thinness （ BMI 〈 PI2.5 and 〉 P4） in Shanghai boys and girls aged 2 - 18yr is 7.9% and 7.5% respectively, and the rate of grade 2 underweight （ BMI 〈 P4 ） is 3.1% and 3.3 % respectively. [ Conclusion] The optimal BMI bound- ary value points for grade 1 and grade 2 thinness is the 12.5th and the 4th centile of BMI. The corresponding BMI value for 18 years old is 18.2 and 16.9 kg/m^2 for boys,and 17.6 and 16.5 kg/m^2 for girls r

关 键 词：消瘦 ROC曲线 BMI界值点 百分位 

分 类 号：R195[医药卫生—卫生统计学]