课件：哈尔滨医科大学-儿童少年卫生学-儿童少年单纯性肥胖.ppt

Obesity in Childhood and Adolescence 儿童少年单纯性肥胖,张慧颖,Bibliography,儿童少年卫生学（第6版），季成叶主编。人民卫生出版社 Falkner F. and Tanner J.M. Human Growth. Plenum Press. New York and London Lowrey GH. Growth and development of children. 7th ed, Chicago, London: Year Book Medical Publishers 现代儿童少年卫生学，叶广俊主编。人民卫生出版社 儿童少年生长发育唐锡麟 人民卫生出版社,I. General,1997, WHO formally announced that obesity is a disease,obesity will become the biggest enemy to threaten human health and life satisfaction in 21 century - IOTF 国际肥胖特别工作组,International Obesity Task Force,II. Defining Obesity,Obesity is defined as an excessive accumulation of body fat.,increasing of body fat cell enlargement of body fat cell,Two types: Primary obesity Secondary obesity,肥胖，是一种常见的营养代谢疾病， 是指由于营养过剩、缺乏运动以及遗传因素共同作用引起的身体内脂肪过度堆积的现象，表现为全身脂肪组织异常性的增加,III. Screening obesity,eyeball test weight-for-height body mass index body fat content waist / hip ratio ,weight-for-height 身高标准体重,Obesity: scale by BMI,BMI =,Weight (kg) Height (m)2,Overweight Obesity China 24 28 WHO 25 30,Classification of body weight WHO and NHLBI classification of BMI,NHLBI: National Heart, Lung, and Blood Institute Adapted from Mckdad AH, et al. JAMA. 1999; 282: 1519-1522,中国学龄儿童青少年超重、肥胖筛查BMI分类标准,年龄（岁） 男-超重 男-肥胖 女-超重 女-肥胖,7 17.4 19.2 17.2 18.9 8 18.1 20.3 18.1 19.9 9 18.9 21.4 19.0 21.0 10 19.6 22.5 20.0 22.1 11 20.3 23.6 21.1 23.3 12 21.0 24.7 21.9 24.5 13 21.9 25.7 22.6 25.6 14 22.6 26.4 23.0 26.3 15 23.1 26.9 23.4 26.9 16 23.5 27.4 23.7 27.4 17 23.8 27.8 23.8 27.7 18 24.0 28.0 24.0 28.0,Waist-to-hip ratio (WHR): fat distribution,WAIST - HIP RATIO (WHR) 腰臀比,Most people store their body fat in two distinct ways: around their middle (apple shape) around their hips (pear shape).,Women 0.8 Man 0.95,BMI - WHR,Waist circumference: 腰围 best indicator of visceral fat,Female,80 cm = increase risk,Male,90 cm = increase risk,WHO 推荐： 肥胖度 = 实际体重(kg)身高标准体重(kg) / 身高标准体重(kg) 100% 凡肥胖度20%，两处的皮下脂肪厚度80百分位数或其中一处皮下脂肪厚度95 百分位数者为肥胖儿童 凡肥胖度10%，无论两处的皮下脂肪厚度如何，均为体重正常儿童,皮褶厚度（skinfold thickness）：测量右侧肱三头肌肌腹部和右肩胛下角部 上臂肱三头肌部 代表四肢 肩胛下角 代表躯干 上述二部位之和 代表全身皮下指标 体脂比（body fat ratio）: 轻度肥胖 中度肥胖 高度肥胖 男性 20 25 30 女性 20 25 30 以上两种方法推算的体脂比和判定的肥胖程度易受身高和肌肉发达程度影响,CT断层法： 皮下脂肪面积/内脏脂肪面积 0.4：内脏型肥胖 0.4：皮下脂肪型肥胖 超声波法： 腹膜前脂肪的最大厚度/腹壁皮下脂肪的最小厚度 MALE: 1.0 内脏型肥胖 FEMALE: 0.7内脏型肥胖,IV. Epidemiology,“the global obesity epidemic” “globesity”,Major problem in developed countries,Overweight and Obesity,WHO（2002） World-wild: one of 10 health risk factors Developed countries: one of 5 health ris