卫生研究

目的 分析中国6～17岁儿童青少年体质指数和腰围变化趋势及人群特征。方法 利用1982—2016年5轮全国性营养调查/监测中的6～17岁儿童青少年调查数据，排除人口学信息和体质指数及腰围等关键指标缺失者，共纳入185 491名6～17岁儿童青少年。利用复杂加权方法对体质指数、腰围、肥胖率及高腰围率进行调整。绘制分性别不同年份中国6～17岁儿童青少年体质指数和腰围的分布曲线及不同百分位数变化曲线。根据是否存在体质指数肥胖和高腰围肥胖，描述不同肥胖类型构成百分比的流行变化趋势。结果 1982—2016年中国6～17岁儿童青少年体质指数和腰围分布曲线整体均呈现峰值下降，曲线右移的趋势，且随时间增幅加快。1982—2016年男生和女生体质指数均值分别增加了1.80和1.23,腰围均值2012—2016年分别增加了1.40 cm和1.05 cm。男生各年龄段的体质指数和腰围水平均高于女生，不论男生和女生较大体质指数和腰围人群增幅明显高于较低水平者。中国儿童青少年肥胖类型以高腰围肥胖为主，不同类型肥胖的流行趋势存在人群差异。男生和7～11岁儿童中肥胖类型以体质指数肥胖合并高腰围肥胖的混合型肥胖为主；女生和12～17岁青少年中肥胖类型以单独的高腰围肥胖为主，但混合型肥胖占比逐年增加；单独的体质指数肥胖在各人群中均占比最低。结论 1982—2016年，中国6～17岁儿童青少年体质指数和腰围增长趋势明显，且呈现性别和年龄差异。

OBJECTIVE To analyze the trends and demographic characteristics of body mass index and waist circumference changes in children and adolescents aged 6-17 in China.METHODS Using the survey data of 6-17 children and adolescents from five rounds of national nutrition surveys/surveillance from 1982 to 2016, excluding those with missing demographic information and key indicators such as body mass index and waist circumference. A total of 185 491 children and adolescents aged 6-17 were included. Complex weighting method were used to adjust body mass index, waist circumference, obesity rate, and high waist circumference rate. The distribution curves and percentile variation curves of body mass index and waist circumference for Chinese children and adolescents aged 6-17 in different years by gender were drawn. The trends of the prevalence of different types of obesity based on the occurrence of body mass index obesity and high waist circumference obesity were described.RESULTS From 1982 to 2016, the overall distribution curves of body mass index and waist circumference for children and adolescents aged 6-17 in China showed a peak decrease, a trend of rightward shift, and an accelerating increase over time. The average body mass index of boys and girls increased by 1.80 and 1.23 respectively over the decades, and the average waist circumference increased by 1.40 cm and 1.05 cm respectively from 2012 to 2016. The body mass index and waist circumference levels of boys in all age groups were generally higher than those of girls. The higher increase of body mass index and waist circumference were both observed among boys and girls with higher values than those with lower values. The main type of obesity among children and adolescents in China was high waist circumference obesity, and there were population differences in the ratios of different types of obesity. The main type of obesity in boys and children aged 7-11 was a mixture of body mass index obesity and high waist circumference obesity. The main type of obesity among girls and adolescents aged 12-17 was high waist circumference obesity alone, but the proportion of mixed obesity increased year by year. Body mass index obesity alone had the lowest proportion among all populations.CONCLUSION From 1982 to 2016, the body mass index and waist circumference of children and adolescents aged 6-17 in China showed a significant increase trend, with gender and age differences.