Die genormte Taille

H. Weberruß; R. Pirzer; B. Böhm; R. Dalla Pozza; H. Netz; R. Oberhoffer

doi:10.1055/s-0037-1618923

Adipositas - Ursachen, Folgeerkrankungen, Therapie, Table of Contents

Adipositas - Ursachen, Folgeerkrankungen, Therapie 2015; 09(02): 93-98
DOI: 10.1055/s-0037-1618923

Originalarbeit

Schattauer GmbH

Die genormte Taille

Referenzwerte für Taillenumfang und Taille-Größe-Index für deutsche Kinder- und Jugendliche von 7–18 JahrenWhich waist circumference is normal?Reference values for waist circumference and waist-to-height ratio for german children and adolescents aged 7–18 years

H. Weberruß

¹Lehrstuhl für Präventive Pädiatrie, Technische Universität München, München, Deutschland, Leitung Prof. Dr. med. Renate Oberhoffer

,

R. Pirzer

²Abteilung Kinderkardiologie und Pädiatrische Intensivmedizin, Ludwig-Maximilians-Universität, München, Deutschland, Leitung Prof. Dr. med. Heinrich Netz

,

B. Böhm

¹Lehrstuhl für Präventive Pädiatrie, Technische Universität München, München, Deutschland, Leitung Prof. Dr. med. Renate Oberhoffer

,

R. Dalla Pozza

²Abteilung Kinderkardiologie und Pädiatrische Intensivmedizin, Ludwig-Maximilians-Universität, München, Deutschland, Leitung Prof. Dr. med. Heinrich Netz

,

H. Netz

²Abteilung Kinderkardiologie und Pädiatrische Intensivmedizin, Ludwig-Maximilians-Universität, München, Deutschland, Leitung Prof. Dr. med. Heinrich Netz

,

R. Oberhoffer

¹Lehrstuhl für Präventive Pädiatrie, Technische Universität München, München, Deutschland, Leitung Prof. Dr. med. Renate Oberhoffer

› Author Affiliations

Abstract

Zusammenfassung

Hintergrund: Abdominelles Übergewicht ist für das Herzkreislaufsystem gefährlicher als ein erhöhter Gesamtkörperfettanteil bei normalem Taillenumfang. Der Body-Mass-Index (BMI) lässt die abdominelle Fettverteilung unberücksichtigt, im Gegensatz zu Taillenumfang (waist circumference, WC) und TailleGröße-Index (Waist-to-Heigh-Ratio, WHtR).

Ziel der Arbeit: WC- und WHtR-Normwerte für Kinder- und Jugendliche (7–18 Jahre) zu erstellen und die Übereinstimmung zwischen der 90. Perzentile für WHtR mit dem, im Erwachsenenalter gültigen Grenzwert von 0,5 zu prüfen.

Material und Methoden: Daten von 1 015 Kindern (534 Mädchen) gingen in die Berechnung der Normwerte ein (1).

Ergebnis: Der Kappa-Koeffizient belegt eine hohe Übereinstimmung zwischen P90 und 0,5 (0,91 für Jungen/ 0,88 für Mädchen).

Diskussion: Die Studie stellt WCund WHtR-Normwerte für Mädchen und Jungen zwischen 7–18 Jahren bereit und belegt eine hohe Übereinstimmung der 90. Perzentile mit dem Grenzwert von 0,5. Im Vergleich mit existierenden Normwerten zeigen unsere Ergebnisse eine Zunahme des abdominellen Übergewichtes, die jedoch nicht in erhöhten Blutdruckwerten resultiert.

Summary

Background: Overweight and obesity are defined by body mass index (BMI) – a measure in question for not discriminating between fat and fat-free mass without focus on central obesity. However, persons with abdominal obesity are at higher risk for cardiovascular disease than overweight persons with a normal waist circumference.

Objective: Provide WC and WHtR reference values for boys and girls aged 7–18. For WHtR, it was further tested, if the 90^th percentile, that defines abdominal obesity, corresponds well with the fix cut-off value of 0.5.

Material and methods: Reference values were calculated on 1 015 children (534 girls) according to the LMS method (1).

Results: There was strong agreement between the 90^th percentile and 0.5 (Cohen’s Kappa: 0.91 for boys/ 0.88 for girls). No significant correlation was found between BMI, WC, WHtR, and BP.

Conclusions: This study provides WC and WHtR reference values for children and adolescents aged 7–18. For WHtR, there’s good agreement between the 90^th percentile and 0.5. Compared to existing reference values, our results indicate an increase of abdominal obesity. So far, this increase does not result in elevated BP levels.

Schlüsselwörter

Abdominelles Übergewicht - Kinder - Taillenumfang - Herz-Kreislauf-Erkrankung

Keywords

Abdominal obesity - children - waist circumference - cardiovascular disease

Full Text

References

Literatur
1 Cole TJ, Green PJ. Smoothing reference centile curves: the LMS method and penalized likelihood. Statistics in medicine 1992; 11 (10) 1305-1319.
2 Wabitsch M, Moss A, Kromeyer-Hauschild K. Unexpected plateauing of childhood obesity rates in developed countries. BMC medicine 2014; 12: 17.
3 Perez CRodrigo. Current mapping of obesity. Nutricion hospitalaria 2013; 28 (Suppl. 05) 21-31.
4 Bluher S, Meigen C, Gausche R, Keller E, Pfaffle R, Sabin M. et al. Age-specific stabilization in obesity prevalence in German children: a cross-sectional study from 1999 to 2008. International journal of pediatric obesity 2011; 06 (2–2): e199-206.
5 Moss A, Klenk J, Simon K, Thaiss H, Reinehr T, Wabitsch M. Declining prevalence rates for overweight and obesity in German children starting school. European journal of pediatrics 2012; 171 (02) 289-299.
6 Kurth BM, Schaffrath ARosario. [The prevalence of overweight and obese children and adolescents living in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 2007; 50 (5–6): 736-743.
7 Kurth BM, Schaffrath ARosario. [Overweight and obesity in children and adolescents in Germany]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 2010; 53 (07) 643-652.
8 Claire YWang, Gortmaker SL, Taveras EM. Trends and racial/ethnic disparities in severe obesity among US children and adolescents, 1976–2006. International journal of pediatric obesity 2011; 06 (01) 12-20.
9 Skelton JA, Cook SR, Auinger P, Klein JD, Barlow SE. Prevalence and trends of severe obesity among US children and adolescents. Academic pediatrics 2009; 09 (05) 322-329.
10 Kromeyer-Hauschild K, Dortschy R, Stolzenberg H, Neuhauser H, Rosario AS. Nationally representative waist circumference percentiles in German adolescents aged 11.0–18.0 years. International journal of pediatric obesity 2011; 06 (2–2): e129-137.
11 Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obesity reviews 2012; 13 (03) 275-286.
12 Pietrobelli A, Faith MS, Allison DB, Gallagher D, Chiumello G, Heymsfield SB. Body mass index as a measure of adiposity among children and adolescents: a validation study. The Journal of pediatrics 1998; 132 (02) 204-210.
13 Kromeyer K, Wabitsch M, Kunze D, Geller F. Perzentile für den Body-Mass-Index für das Kindesund Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschrift Kinderheilkunde 2001; 149: 807-818.
14 McCarthy HD, Ashwell M. A study of central fatness using waist-to-height ratios in UK children and adolescents over two decades supports the simple message--’keep your waist circumference to less than half your height’. International journal of obesity 2006; 30 (06) 988-992.
15 Ashwell M, Gibson S. A proposal for a primary screening tool: ‘Keep your waist circumference to less than half your height’. BMC medicine 2014; 12: 207.
16 Cameron N, Jones LL, Griffiths PL, Norris SA, Pettifor JM. How well do waist circumference and body mass index reflect body composition in prepubertal children?. European journal of clinical nutrition 2009; 63 (09) 1065-1070.
17 Bluher S, Schwarz P. Metabolically healthy obesity from childhood to adulthood – Does weight status alone matter?. Metabolism: clinical and experimental 2014; 63 (09) 1084-1092.
18 Taylor RW, Jones IE, Williams SM, Goulding A. Evaluation of waist circumference, waist-to-hip ratio, and the conicity index as screening tools for high trunk fat mass, as measured by dual-energy X-ray absorptiometry, in children aged 3–19 y. The American journal of clinical nutrition 2000; 72 (02) 490-495.
19 Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesityrelated health risk. The American journal of clinical nutrition 2004; 79 (03) 379-384.
20 Kromeyer-Hauschild K, Neuhauser H, Schaffrath ARosario, Schienkiewitz A. Abdominal obesity in German adolescents defined by waist-to-height ratio and its association to elevated blood pressure: the KiGGS study. Obesity facts 2013; 06 (02) 165-175.
21 Neuhauser H, Schienkiewitz A, Schaffrath ARosario, Dortschy R, Kurth B. Referenzperzentile für anthropometrische Maßzahlen und Blutdruck aus der Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland (KiGGS) 2003–2006. Berlin: Robert Koch Institut; 2013
22 WHO. Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation. 2008
23 Reinehr T, Holl RW, Wabitsch M. The German Working Group of Obesity in Childhood and Adolescence (AGA): improving the quality of care for overweight and obese children in Germany. Obesity facts 2008; 01 (01) 26-32.
24 Grouven U, Bender R, Ziegler A, Lange S. [The kappa coefficient]. Deutsche medizinische Wochenschrift 2007; 132 (Suppl. 01) e65-68.
25 Cohen J. A coefficient of agreement for nominal scales. Educational and Psychological Measurement 1960; 20: 37-46.
26 Altman D. Practical Statistics for Medical Research. Boca Raton, CRC: Chapman&Hall; 1991
27 Okorodudu DO, Jumean MF, Montori VM, Romero-Corral A, Somers VK, Erwin PJ. et al. Diagnostic performance of body mass index to identify obesity as defined by body adiposity: a systematic review and meta-analysis. International journal of obesity 2010; 34 (05) 791-799.
28 Berenson GS. Bogalusa Heart Study g. Health consequences of obesity. Pediatric blood & cancer 2012; 58 (01) 117-121.
29 Baker JL, Olsen LW, Sorensen TI. Childhood body-mass index and the risk of coronary heart disease in adulthood. The New England journal of medicine 2007; 357 (23) 2329-2337.
30 Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. The New England journal of medicine 1992; 327 (19) 1350-1355.
31 Eissa MA, Dai S, Mihalopoulos NL, Day RS, Harrist RB, Labarthe DR. Trajectories of fat mass index, fat free-mass index, and waist circumference in children: Project HeartBeat! American journal of preventive medicine. 2009; 37 (Suppl. 01) S34-39.
32 Aeberli I, Gut-Knabenhans I, Kusche-Ammann RS, Molinari L, Zimmermann MB. Waist circumference and waist-to-height ratio percentiles in a nationally representative sample of 6–13 year old children in Switzerland. Swiss medical weekly 2011; 141: w13227.
33 Weili Y, He B, Yao H, Dai J, Cui J, Ge D. et al. Waist-to-height ratio is an accurate and easier index for evaluating obesity in children and adolescents. Obesity 2007; 15 (03) 748-752.