11-15 yaş çocuklarda vücut yağ yüzdesinin beden kütle indeksi ve biyoelektriksel impedans analizi ile değerlendirilmesi

Amaç: Bu çalışma, 11-15 yaş çocukların vücut yağ yüzdelerini vücut kütle indeksi (VKİ) ve biyoelektriksel impedans analizi (BİA) ile değerlendirmek amacıyla yapıldı. Yöntem: Konya il merkezinde rasgele örneklenen iki ilköğretim okulunun ikinci kısım öğrencilerinden 11-15 yaşlardaki toplam 473 çocuk araştırma kapsamına alındı. Çocukların boy ve ağırlık ölçümleri yapılıp, VKİ değerleri hesaplandı ve persantil eğrileri çıkarıldı. Ayrıca, BİA ile çocukların vücut yağ yüzdeleri hesaplandı. VKİ ve BİA değerlerine göre hafif şişman ve şişman oranları belirlendi. Yaş, cinsiyet ve pubertal döneme göre VKİ ve BİA değerleri karşılaştırıldı. Bulgular: VKİ’ye göre postpubertal dönem çocuklarda hafif şişman olma oranı (% 10.4) prepubertal dönem çocuklarla (% 8.0) benzer bulundu. Obezite prevalansı ise postpubertal dönem çocuklarda (% 9.1) prepubertal dönem çocuklardakinden (% 3.1) daha yüksekti. BİA ile vücut yağ yüzdesi (VYY) de postpubertal dönem çocuklarda (19.2±9.5) prepubertal dönem çocuklardan (17.2±8.5) daha yüksek bulundu. Her yaş için, VKİ ortalamaları cinsiyete göre farksızken, VYY ortalamaları kızlarda yüksekti. Puberteye giren erkeklerde sadece VKİ değeri artarken kızlarda hem VKİ hem VYY değerleri artmaktaydı. Sonuç: Sonuç olarak, prepubertal ve postpubertal çocuklarda aşırı ağırlık veya şişmanlık tanısı için yapılacak taramalarda VKİ yerine daha duyarlı olan BİA’nin tercih edilebileceği kanaatine varıldı.

___

1. Guo SS, Wu W, Chumlea WC and Roche AF. Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence. Am J Clin Nutr 2002;76:653-8.

2. Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM and Johnson CL. Overweight prevalence and trends for children and adolescents, The National Health and Nutrition Examination Surveys, 1963 to 1991. Arch Pediatr Adolesc Med 1995;149:1085-91.

3. Rios M, Fluiters E, Perez Mendez LF, Garcia-Mayor EG, Garcia-Mayor RV. Prevalence of childhood overweight in Northwestern Spain: A comparative study of two periods with a ten year interval. Int J Obes Relat Metab Disord 1999;23:1095-8.

4. Massa G. Body mass index measurements and prevalence of overweight and obesity in school children living in the province of Belgian Limburg. Eur J Pediatr 2002;116:343-6.

5. Ramachandran A, Snehalatha C, Vinitha R, Thayyil M, Sathish Kumar CK, Sheeba L, et al. Prevalence of overweight in urban Indian adolescent school children. Diabetes Res Clin Pr 2002;57:185–90.

6. El-Hazmi MAF, Warsy AS. The prevalence of obesity and overweight in 1-18- year- old Saudi children. Ann Saudi Med 2002;22:303-7.

7. Koçoğlu G, Özdemir L, Sümer H, Demir DA, Çetinkaya S, Polat HH. Prevalence of obesity among 11-14 years old students in Sivas-Turkey. Pakistan J Nutr 2003;2:292-5.

8. Tuna C, Şıklar Z, Ünsal R, Dallar Y. Obez çocuklarda risk faktörlerinin değerlendirilmesi. Türkiye Klin J Pediatr 2003;12:169-75.

9. Strauss RS. Chilhood obesity and self-esteem. Pediatrics 2000;105:E15.

10. Moreno LA, Sarria A, Fleta J, Rodriguez G, Gonzalez JM, Bueno M. Sociodemographic factors and trends on overweight prevalence in children and adolescent an Aragan (Spain) from 1985 to 1995. J Clin Epidemiol 2001;54:921-27.

11. Chinn S, Rona RJ. International definitions of overweight and obesity for children: A lasting solution? Ann Human Biol 2002;29:306-13.

12. WHO/NUT/NCD. Obesity: Preventing and managing the global epidemic. Geneva: Report of the WHO; 1998.

13. Sun SS, Chumlea WC, Heymsfield SB, Lukaski HC, Schoeller D, Friedl K, et al. Development of bioelectrical impedance analysis prediction equations for body composition with the use of a multi-component model for use in epidemiologic surveys. Am J Clin Nutr 2003;77:331-40.

14. Lintsi M, Kaarma H, Kull I. Comparison of hand-to-hand bioimpedance and anthropometry equations versus dual-energy X-ray absorptiometry for the assessment of body fat percentage in 17-18-year-old conscripts. Clin Physiol Funct Imaging 2004; 24: 85-90.

15. Forbes GB. Lean body mass-body fat interrelationships in humans. Nutr Rev 1987;45:225–31.

16. Martorell R, Malina RM, Castillo RO, Mendoza FS, Pawson IG: Body proportions in three ethnic groups: Children and youths 2–17 years in NHANES II and HHANES. Hum Biol 1988;60: 205–22.

17. Maynard LM, Wisemandle WA, Roche AF, Chumlea WC, Guo SS, Siervogel RM. Childhood body composition in relation to body mass index: the Fels Longitudinal Study. Pediatrics 2001;107:344–50.

18. 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. J Pediatr 1998;132:204–10.

19. Bowden RG, Lanning BA, Doyle EI, Johnston HM, Nassar EI, Slonaker B, et al. Comparison of body composition measures to dual-energy x-ray absorptiometry. J Exercise Physiol 2005;8:1-9.

20. Deurenberg P, Kusters CS, Smit HE. Assessment of body composition by bioelectrical impedance in children and young adults is strongly age-dependent. Eur J Clin Nutr. 1990;44:261–8.

21. Phillips SM, Bandini LG, Compton DV, Naumova EN, Must A. A longitudinal comparison of body composition by total body water and bioelectrical impedance in adolescent girls. J Nutr 2003;133:1419–25.

22. Pecoraro P, Guida B, Caroli M, Trio R, Falconi C, Principato S, et al. Body mass index and skinfold thickness versus bioimpedance analysis: fat mass prediction in children. Acta Diabetol 2003;40(Supl 1):278-81.

23. Bray GA, DeLany JP, Harsha DW, Volaufova J, Champagne CC. Evaluation of body fat in fatter and leaner 10-y-old African American and white children: The Baton Rouge Children’s Study. Am J Clin Nutr 2001;73:687-702.

24. Lahti-Koski M, Gill T. Defining Childhood Obesity. In: Kiess W, Marcus C, Wabitsch M (eds): Obesity in Childhood and Adolescence. Pediatr Adolesc Med. Basel: Karger; 2004:9:1-19.

25. Williams DP, Going SB, Lohman TG, Harsha DW, Srinivasan SR, Webber LS, et al: Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein ratios in children and adolescents. Am J Publ Hlth 1992;82:358–63.

26. American Council on Exercise. General Body Fat Percentage Categories. http://www.healthchecksystems.com/bodyfat.htm (2006).

27. Segal KR, Van Loan M, Fitzgerald PI, Hodgdon JA, Van Itallie TB. Lean body mass estimation by bioelectrical impedance analysis: A four-site cross-validation study. Am J Clin Nutr 1988;47:7-14.

28. Charbonneau-Roberts G, Saudny-Unterberger H, Kuhnlein HV, Egeland GM. Body mass index may overestimate the prevalence of overweight and obesity among the Inuit. Int J Circumpolar Health 2005;64:163-9.

29. Kasa-Vubu JZ, Lee CC, Rosenthal A, Singer K, Halter JB. Cardiovascular Fitness and Exercise as Determinants of Insulin Resistance in Postpubertal Adolescent Females. J Clin Endocrinol Metab 90:849–54.

30. Raustorp A, Mattsson E, Svensson K, Ståhle A. Physical activity, body composition and physical self-esteem: A 3-year follow-up study among adolescents in Sweden. Scand J Med Sci Sports 2005;15:1-9.

31. Sun G, French CR, Martin GR, Younghusband B, Green RC, Xie Y, et al. Comparison of multifrequency bioelectrical impedance analysis with dual-energy X-ray absorptiometry for assessment of percentage body fat in a large, healthy population. Am J Clin Nutr 2005;81:74-8.

32. Dwyer T, Blizzard CL: Defining obesity in children by biological endpoint rather than population distribution. Int J Obes Relat Metab Disord 1996;20:472–80.

33. Eisenmann JC, Heelan KA, Welk GJ. Assessing body composition among 3- to 8-year-old children: Anthropometry, BIA, and DXA. Obesity Research 2004;12:1633-40.

34. Sancak R, Dündar C, Totan M, Çakır M, Sunter T, Küçüködük Ş. Ortaokul ve Lise öğrencilerinde obesite prevelansı ve predispozan faktörler. OMÜ Tıp Derg 1999;16:19-24.

35. Fogelholm M, Nuutinen O, Pasanen M, Myöhanen E, Saatela T. Parent-child relationship of physical activity patterns and obesity. Int J Obesity Rel Metab Dis 1999;23:1262-8.

36. Akış N, Pala K, İrgil E, Aydın N, Aksu H. Bursa ili Orhangazi ilçesi 6 merkez ilköğretim okulunda 6-14 yaş grubu öğrencilerde kilo fazlalığı ve obezite. Uludağ Ü. Tıp Fak.Derg 2003;29:17-20.

37. Mirza NM, Kadow K, Palmer M, Solano H, Rosche C, Yanovski JA. Prevalence of overweight among inner city Hispanic-American children and adolescents. Obes Res 2004;12:1298–310.

38. Kanbur NO, Derman O, Kinik E. Prevalence of obesity in adolescent and the impact of sexual maturation stage on body mass index in obese adolescent. Int J Adolesc Med Health 2002;14:61-5.

39. Berkey CS, Rockett HRH, Gillman MW, Colditz GA. One-year changes in activity and in inactivity among 10- to 15-year-old boys and girls: relationship to change in body mass index. Pediatrics 2003;111:836-43.

40. Kaplowitz PB, Slora EJ, Wasserman RC, Pedlow SE, Herman-Giddens ME. Earlier onset of puberty in girls: Relation to increased body mass index and race. Pediatrics 2001;108:347-54.