Abstract: Objective To evaluate the consistency between body fat percentage(BFP) and body mass index(BMI) in screening overweight and obesity of school-age children, and to explore the screening efficacy of body composition in screening dyslipidemia and nonalcoholic fatty liver(NAFL) of school-age children. Methods Children aged 7 to 12 years who visited the clinic of Children's Health Center of Hunan Children's Hospital from March to September in 2020 were selected as the study subjects, and the body composition was measured by bioelectrical impedance method. The consistency of BFP and BMI in screening overweight and obesity in children was evaluated. ROC curve was used to analyze the AUC of body composition indexes in screening dyslipidemia and NAFL, then the sensitivity and specificity of each best cutoff value were calculated. Results Totally 20.11% of children judged as normal by BMI were overweight and obese by BFP, and 4.98% of children judged as normal by BFP were overweight and obese by BMI with Kappa value of 0.867. The AUC for body fat mass (BF)screening dyslipidemia was 0.659 (P<0.05), with the sensitivity of 0.767 and specificity of 0.521 at an optimal cut-off value of 9.85 kg. The AUC for visceral fat area (VFA) screening NAFL was 0.851 (P<0.05), with a sensitivity of 0.781 and specificity of 0.778 at an optimal cut-off value of 86.50 cm². Conclusions BFP and BMI are highly consistent in screening overweight and obesity of school-age children. Body composition has better screening efficacy for NAFL in school-age children, and lower screening efficacy for dyslipidemia.

Key words: body composition, overweight and obesity, abnormal blood lipid, nonalcoholic fatty liver, children

摘要： 目的 评价体成分体脂百分比(BFP)与体重指数(BMI)筛查学龄儿童超重肥胖的一致性,探讨体成分对学龄儿童血脂异常、非酒精性脂肪肝(NAFL)的筛查效能。方法 以2020年3—9月在湖南省儿童医院儿童保健所门诊就诊的7~12岁儿童为研究对象,应用生物电阻抗法测量体成分,评价BFP与BMI筛查儿童超重肥胖的一致性,采用ROC曲线分析体成分指标判断血脂异常、NAFL的曲线下面积(AUC),计算各最佳截断值的灵敏度、特异度等。结果 BMI判断为正常的儿童中有20.11%的儿童被BFP判断为超重肥胖,BFP判断为正常的儿童中有4.98%的儿童被BMI判断为超重肥胖,Kappa值为0.867;体脂肪量(BF)筛查血脂异常的AUC为0.659(P＜0.05),最佳截断值为9.85 kg时,灵敏度为0.767,特异度为0.521;内脏脂肪面积(VFA)筛查NAFL的AUC为0.851(P＜0.05),最佳截断值为86.50 cm²时,灵敏度为0.781,特异度为0.778。结论 体成分BFP与BMI筛查学龄儿童超重肥胖有高度一致性;体成分对学龄儿童非酒精性脂肪肝有较好的筛查效能,对血脂异常的筛查效能较低。

关键词: 体成分, 超重肥胖, 血脂异常, 非酒精性脂肪肝, 儿童