学龄前儿童颈围与体重指数的相关性

胡宁宁; 贺苗; 李玉凤; 王仁媛; 杨静; 李婉君; 林素兰

doi:10.7499/j.issn.1008-8830.2203072

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中国当代儿科杂志 ›› 2022, Vol. 24 ›› Issue (9) : 1042-1046. DOI: 10.7499/j.issn.1008-8830.2203072

论著·临床研究

学龄前儿童颈围与体重指数的相关性

胡宁宁, 贺苗, 李玉凤, 王仁媛, 杨静, 李婉君, 林素兰

作者信息 +

Correlation of neck circumference with body mass index in preschool children

HU Ning-Ning, HE Miao, LI Yu-Feng, WANG Ren-Yuan, YANG Jing, LI Wan-Jun, LIN Su-Lan

Author information +

文章历史 +

摘要

目的探讨学龄前儿童颈围与体重指数的相关性及颈围对学龄前儿童超重/肥胖的诊断价值。方法采用分层整群抽样的方法抽取乌鲁木齐市10所幼儿园3 719名7岁以下儿童，收集儿童一般资料并进行体格测量，采用Pearson相关分析法评估颈围与体重指数的相关性，采用受试者工作特征（receiver operating characteristic，ROC）曲线分析颈围判断超重/肥胖的准确性，采用Kappa一致性检验评价颈围与体重指数判断超重/肥胖的一致性。结果各年龄阶段的男童、女童颈围与体重指数均呈正相关（r ≥0.50，均P<0.001）。以体重指数作为判断超重/肥胖的标准分为超重/肥胖组与非超重/肥胖组，各年龄阶段的超重/肥胖组颈围均大于非超重/肥胖组（P<0.001）。ROC曲线分析显示，男童和女童颈围判断超重/肥胖的曲线下面积均大于0.7。Kappa一致性检验显示，各年龄阶段男童、女童的颈围和体重指数判断超重/肥胖的Kappa值均大于0.40。结论学龄前儿童颈围与体重指数呈正相关；颈围可较好地判断学龄前儿童超重/肥胖。［中国当代儿科杂志，2022，24（9）：1042-1046］

Abstract

Objective To study the correlation between neck circumference and body mass index and the value of neck circumference in identifying overweight and obesity in preschool children. Methods The stratified cluster sampling method was used to recruit 3 719 children under 7 years from 10 kindergartens in Urumqi, China. General data were collected, and physical measurements were performed. A Pearson correlation analysis was used to evaluate the correlation between neck circumference and body mass index. The receiver operating characteristic (ROC) curve was used to assess the accuracy of neck circumference in identifying overweight/obesity. The Kappa consistency test was used to assess the consistency of neck circumference and body mass index in identifying overweight/obesity. Results There was a positive correlation between neck circumference and body mass index in boys and girls of all ages (r≥0.50, P<0.001). According to body mass index as the criteria for overweight/obesity, the children were divided into an overweight/obesity group and a non-overweight/obesity group, and the analysis showed that the overweight/obesity group had a significantly larger neck circumference than the non-overweight/obesity group (P<0.001). The ROC curve analysis showed that neck circumference had an area under the ROC curve of >0.7 in identifying overweight/obesity for boys and girls. The Kappa consistency test showed that the neck circumference and body mass index had a Kappa value of >0.40 in identifying overweight/obesity in boys and girls of all ages. Conclusions Neck circumference is positively correlated to body mass index, and neck circumference can be used to identify overweight/obesity in preschool children.

导出引用

胡宁宁, 贺苗, 李玉凤, 王仁媛, 杨静, 李婉君, 林素兰. 学龄前儿童颈围与体重指数的相关性[J]. 中国当代儿科杂志. 2022, 24(9): 1042-1046 https://doi.org/10.7499/j.issn.1008-8830.2203072

HU Ning-Ning, HE Miao, LI Yu-Feng, WANG Ren-Yuan, YANG Jing, LI Wan-Jun, LIN Su-Lan. Correlation of neck circumference with body mass index in preschool children[J]. Chinese Journal of Contemporary Pediatrics. 2022, 24(9): 1042-1046 https://doi.org/10.7499/j.issn.1008-8830.2203072

参考文献

1 马冠生, 米杰, 马军. 中国儿童肥胖报告[M]. 北京: 人民卫生出版社, 2017: 5.
2 首都儿科研究所, 九市儿童体格发育调查协作组. 2016年中国九城市七岁以下儿童单纯性肥胖流行病学调查[J]. 中华儿科杂, 2018, 56 (10): 745-752. PMID: 30293278. DOI: 10.3760/cma.j.issn.0578-1310.2018.10.006.
3 Ashwell M, Gibson S. A proposal for a primary screening tool: 'keep your waist circumference to less than half your height'[J]. BMC Med, 2014, 12: 207. PMID: 25377944. PMCID: PMC4223160. DOI: 10.1186/s12916-014-0207-1.
4 Ashok U, Baliga SS, Walvekar PR. Neck circumference measurement as a screening tool for obesity in children—a cross sectional study[J]. Clin Epidemiol Glob Health, 2021, 10: 100683. DOI: 10.1016/j.cegh.2020.100683.
5 Valencia-Sosa E, Chávez-Palencia C, Vallarta-Robledo JR, et al. Percentile reference values for the neck circumference of Mexican children[J]. Children (Basel), 2021, 8(5): 407. PMID: 34069920. PMCID: PMC8157592. DOI: 10.3390/children8050407.
6 Mendes CG, Barbalho SM, Tofano RJ, et al. Is neck circumference as reliable as waist circumference for determining metabolic syndrome?[J]. Metab Syndr Relat Disord, 2021, 19(1): 32-38. PMID: 32990516. DOI: 10.1089/met.2020.0083.
7 Asif M, Aslam M, Wyszyńska J, et al. Diagnostic performance of neck circumference and cut-off values for identifying overweight and obese Pakistani children: a receiver operating characteristic analysis[J]. J Clin Res Pediatr Endocrinol, 2020, 12(4): 366-376. PMID: 32295325. PMCID: PMC7711643. DOI: 10.4274/jcrpe.galenos.2020.2019.0212.
8 Ma C, Wang R, Liu Y, et al. Diagnostic performance of neck circumference to identify overweight and obesity as defined by body mass index in children and adolescents: systematic review and meta-analysis[J]. Ann Hum Biol, 2017, 44(3): 223-229. PMID: 27588606. DOI: 10.1080/03014460.2016.1224387.
9 Kondolot M, Horoz D, Poyrazo?lu S, et al. Neck circumference to assess obesity in preschool children[J]. J Clin Res Pediatr Endocrinol, 2017, 9(1): 17-23. PMID: 27660068. DOI: 10.4274/jcrpe.3525.
10 胡宁宁, 王仁媛, 李玉凤, 等. 乌鲁木齐学龄前儿童超重肥胖现状及相关因素分析[J]. 中国学校卫生, 2022, 43(6): 920-924. DOI: 10.16835/j.cnki.1000-9817.2022.06.029.
11 中华人民共和国国家卫生和计划生育委员会. 人群健康监测人体测量方法: WS/T 424-2013[S]. 北京: 中国标准出版社, 2013.
12 李辉, 宗心南, 季成叶, 等. 中国2~18岁儿童青少年超重和肥胖筛查体重指数界值点的研究[J]. 中华流行病学杂志, 2010, 31(6): 616-620. PMID: 21163089. DOI: 10.3760/cma.j.issn.0254-6450.2010.06.004.
13 陶诗怡, 于林童, 王子涵, 等. Logistic回归联合ROC曲线模型评价动脉弹性和内皮功能指标对绝经后冠心病血瘀证的诊断效能[J]. 中国中药杂志, 2022, 47(8): 2244-2250. PMID: 35531741. DOI: 10.19540/j.cnki.cjcmm.20211201.501.
14 夏邦世, 吴金华. Kappa一致性检验在检验医学研究中的应用[J]. 中华检验医学杂志, 2006, 29(1): 83-84. DOI: 10.3760/j:issn:1009-9158.2006.01.030.
15 Ke D, Lu D, Cai G, et al. Accelerated skeletal maturation is associated with overweight and obesity as early as preschool age: a cross-sectional study[J]. BMC Pediatr, 2020, 20(1): 452. PMID: 32988365. PMCID: PMC7520956. DOI: 10.1186/s12887-020-02353-w.
16 Barros WMA, da Silva KG, Silva RKP, et al. Effects of overweight/obesity on motor performance in children: a systematic review[J]. Front Endocrinol (Lausanne), 2022, 12: 759165. PMID: 35126307. PMCID: PMC8812008. DOI: 10.3389/fendo.2021.759165.
17 Tajima H, Pawankar R. Obesity and adiposity indicators in asthma and allergic rhinitis in children[J]. Curr Opin Allergy Clin Immunol, 2019, 19(1): 7-11. PMID: 30507714. DOI: 10.1097/ACI.0000000000000504.
18 Atef A, Ibrahim A, Hassan NE, et al. Neck circumference as a novel screening method for estimating fat distribution and metabolic complications in obese children[J]. Egypt Pediatr Assoc Gaz, 2015, 63(3-4): 91-97. DOI: 10.1016/j.epag.2015.09.001.
19 宋晴阳, 李翀, 郑连斌, 等. 颈围预测成人肥胖的可行性分析[J]. 解剖学报, 2021, 52(6): 986-991. DOI: 10.16098/j.issn.0529-1356.2021.06.024.
20 Polo TCF, Miot HA. Use of ROC curves in clinical and experimental studies[J]. J Vasc Bras, 2020, 19: e20200186. PMID: 34211533. PMCID: PMC8218006. DOI: 10.1590/1677-5449.200186.
21 Mucelin E, Traebert J, Zaidan MA, et al. Accuracy of neck circumference for diagnosing overweight in six- and seven-year-old children[J]. J Pediatr (Rio J), 2021, 97(5): 559-563. PMID: 33358966. DOI: 10.1016/j.jped.2020.11.005.
22 Tang W, Hu J, Zhang H, et al. Kappa coefficient: a popular measure of rater agreement[J]. Shanghai Arch Psychiatry, 2015, 27(1): 62-67. PMID: 25852260. PMCID: PMC4372765. DOI: 10.11919/j.issn.1002-0829.215010.
23 Sehn AP, Brand C, Welser L, et al. Neck circumference and cardiometabolic risk in children and adolescents: the moderator role of cardiorespiratory fitness[J]. BMC Pediatr, 2021, 21(1): 234. PMID: 34001053. PMCID: PMC8127299. DOI: 10.1186/s12887-021-02696-y.