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首页> 外文期刊>Annals of epidemiology >Adiposity in adolescents: change in actual BMI works better than change in BMI z score for longitudinal studies.
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Adiposity in adolescents: change in actual BMI works better than change in BMI z score for longitudinal studies.

机译：青少年肥胖：对于纵向研究，实际BMI的变化要好于BMI z分数的变化。

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PURPOSE: Longitudinal epidemiologic studies often relate adiposity changes to suspected causal factors. In growing adolescents, this becomes complicated. Many investigators use within-child change in body mass index (BMI) z scores (Delta z) from sex- and age-specific BMI charts developed by the Centers for Disease Control and Prevention (CDC). These charts, derived from cross-sectional data, may not represent BMI growth patterns of real children. Furthermore, because cross-sectional BMIs are not Gaussian, these z scores are from month-specific transformed distributions, with possible unintended consequences when used longitudinally. Alternatively, we can directly analyze BMI change (Delta BMI). We compare these two widely used measures of change in adiposity. METHODS AND RESULTS: With real adolescent data, we show that annual Delta BMIs have nonlinear peaks that are inconsistent with the CDC curves. We also show that a specified Delta z represents a broad range of adiposity changes for children measured at the same two ages. To see how this affects power, we performed simulation studies confirming that analyzing Delta BMIs in models with hypothesized factors is more powerful than analyzing Delta zs. CONCLUSIONS: In longitudinal studies of adolescent adiposity, investigators should be encouraged to analyze Delta BMI rather than Delta z because analyses using BMI are more powerful and findings presented in BMI units are more interpretable.
机译：目的：纵向流行病学研究通常将肥胖的变化与可疑的致病因素联系起来。在成长中的青少年中，这变得很复杂。许多研究人员使用疾病控制和预防中心（CDC）制定的按性别和年龄划分的BMI图表，对儿童体重指数（BMI）z分数（Delta z）进行了变化。这些从横截面数据得出的图表可能并不代表真实儿童的BMI生长模式。此外，由于横截面BMI不是高斯分布，因此这些z分数来自特定月份的转换分布，纵向使用时可能会产生意想不到的后果。或者，我们可以直接分析BMI变化（Delta BMI）。我们比较了这两种广泛使用的肥胖变化量度。方法和结果：根据真实的青少年数据，我们显示，年度Delta BMI的非线性峰值与CDC曲线不一致。我们还表明，对于在相同两个年龄段测量的儿童，指定的Delta z代表了广泛的肥胖变化。为了了解这如何影响功率，我们进行了仿真研究，确认了在具有假设因素的模型中分析Delta BMI比分析Delta zs更有效。结论：在青少年肥胖的纵向研究中，应鼓励研究者分析Delta BMI而不是Delta z，因为使用BMI进行分析的功能更强大，并且以BMI单位呈现的发现更易解释。

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