颈围在儿童青少年筛查超重肥胖中的应用价值  

Application value of neck circumference in screening for overweight and obesity among children and adolescents

作　　者：刘芳[1] 袁淑娴 李园[1] 郝会民 林一凡 陈永兴 卫海燕[1] LIU Fang;YUAN Shuxian;LI Yuan;HAO Huimin;LIN Yifan;CHEN Yongxing;WEI Haiyan(Department of Endocrinology and Inherited Metabolic,Children's Hospital Affiliated to Zhengzhou University/Henan Children's Hospital Zhengzhou Children's Hospital,Zhengzhou(450018),Henan Province,China)

机构地区：[1]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

出　　处：《中国学校卫生》2024年第7期1040-1044,共5页Chinese Journal of School Health

基　　金：国家重点研发计划(2021YFC2701902,2021YFC2701901)。

摘　　要：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2493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。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 2493 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 adolescence 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 periods[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<0.01).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-

关 键 词：颈 超重 肥胖症 ROC曲线 儿童 青少年 

分 类 号：R179[医药卫生—妇幼卫生保健] R723.14[医药卫生—公共卫生与预防医学] R339.35