Predictability and Implications of Anthropometric Indices for Metabolic Abnormalities in Children: Nutrition and Health Survey in Taiwan Elementary Children, 2001-2002

學童體位測量指標對代謝異常疾病的預測力與涵義：臺灣地區國小學童營養健康狀況調查，2001-2002

Shao-Yuan Chuang ； Wen-Harn Pan

《Asia Pacific Journal of Clinical Nutrition》 18卷2期 (2009/06) Pp. 272-279

https://doi.org/10.6133/apjcn.2009.18.2.17

摘要

背景：探討在學童中，對於肥胖與代謝異常症候群的篩檢，個別的體位測量篩檢工具是否需要。我們比較各項體位測量指標對代謝異常疾病的預測力，包括腰圍與身體質量指數。研究設計：臺灣地區國小學童營養健康狀況調查（2000-2001年），共計收集2,215位學童的資料。羅吉斯回歸被用來評估體位測量指標與代謝異常的關係，代謝異常定義為具兩個或兩個以上的下列危險因子：偏高的空腹三酸甘油脂、偏高的空腹血糖、高血壓與偏低的高密度脂蛋白膽固醇。接受器操作特性曲線（ROC curves）被用來研究各項體位測量指標的敏感度與精確度。結果：預測力最高是腰圍（R^2=10.69%）、依次為身體質量指數（R^2=9.80%）、上臂周長（R^2=9.75%）、臀圍（R%2=9.43%）、肩胛皮下脂肪厚度（R^2=9.28%）、腰圍-身高比值（R^2=9.25%）。以年齡與性別分層之腰圍或身體質量指數，其理想切點靠近60百分位。切點的數值會隨著年齡而增加，且男孩有較高的切點值。結論：以腰圍的切點標準來定義兒童代謝症候群是合理的。考量實用性，身體質量指數仍然是最適合定義過重或肥胖的指標。對預測代謝異常疾病而言，這兩個常用肥胖指標的敏感度與精確度僅在中等。

關鍵字

體位測量指標 ； 兒童 ； 代謝症候群 ； 腰圍 ； 身體質量指數

並列摘要

Background: To determine whether separate anthropometric screening tools are needed for obesity and the metabolic syndrome in children, we compared the predictability of several anthropometric indices, including waist circumference (WC) and body mass index (BMI), with regard to metabolic disorders. Study design: The Nutrition and Health Survey in Taiwan Elementary School Children (2000-2001) collected data from 2,215 children. Logistic regression analysis was used to study the association between anthropometric indices and metabolic abnormalities, which was defined as two or more of the following conditions: high fasting triglycerides, high fasting glucose levels, high blood pressure and low high-density lipoprotein-cholesterol. The receiver operating characteristic curve was used to study the sensitivity and specificity of these anthropometric indices. Results: predictability was the ranked highest for WC (R^2 = 10.69%), followed by BMI (R^2 = 9.80%), arm girth (R^2 = 9.75%), hip circumference (R^2 = 9.43%), scapular skinfold thickness (R^2 = 9.28%) and waist-to-height ratio (R^2 = 9.25%). Waist circumference or BMI cut-offs for maximal balanced sensitivity and specificity were close to the 60th percentile for each age and gender group. Values were greater in boys than in girls and increased with age. Conclusion: It is justifiable to use the WC criteria to define the metabolic syndrome in children. Due to its practicality, BMI remains the most suitable index for defining overweight/obesity. Only moderate levels of sensitivity and specificity were achieved with these two popular obesity indices with regard to metabolic abnormalities.

並列關鍵字

anthropometric index ； children ； the metabolic syndrome ； waist circumference ； body mass index