TAPCHIY Dl/gC HQC CAN THg - SO 11-12/2018
K H A O SAT TINH T R A N G D I N H DU*OfNG 6 TRE EM V A VAI TRO CUA T i LE V O N G E O / C H l i u C A O T R O N G T A M SOAT TINH TRANG T H I T A CAN, B E O PHI H Q C SINH TRlTOfNG TIEU H O C N G U Y E N D I N H CHIEU
PHlTOfNG 8, T H A N H P H 6 CA M A U , T I N H CA M A U
Huynh Nggc Linh*, Li Yin Ly, Ong Thi My Dung Truang Cao ddng Y ti Cd Mau
* Email: [email protected] TOM T A T
Bgt van de: Thira cdn. beo phi vd suy dinh duang & tri em Id gdnh ndng kep & cdc nu&c dang phdt triin. Cd nhiiu tieu chudn nhu: chi sd, bdng di ddnh gid thira cdn, beo phi & tre em.
Tuy nhiin, cdc chi sd, bdng thu&ng rdt phirc tgp vd cd su thay doi theo gi&i tinh. tudi nen phdi tinh todn hogc tra bdng m&i ddnh gid dugc. Dieu ndy rdt khd dp dung chg vi?c ddnh gid nhanh tinh trgng dinh duang ciia tre em tgi cdng ddng. Hiin nay chi sd ddnh gid thira cdn, beo phi dugc chdp nhgn rgng rdi la bdng phdn logi dinh du&ng cua tri em nam 2007 cua WHO vd bdng ndy phdn theo timg nhdm tudi vd gi&i viic ddnh gid phdi tra bdng. Vi vdy, cdn thiit cd mgt chi sd ddnh gid thica cdn, bio phi dan gidn di dp dung trong cgng dong. Muc tiiu nghiin ciia: 1) Xdc dinh ty le thira cdn, beo phi, suy dinh duang hgc sinh tru&ng tiiu hgc Nguyin Dinh Chiiu, thdnh pho Cd Mau. 2) Xdc dinh gid tri ciia chi sd vong eo/chieu cao de ddnh gid tinh trgng thira cdn, beg phi.
Boi tugng vd phuang phdp nghiin ciiu: 772 tre dang hgc tgi tnrong tiiu hgc Nguyin Dinh Chiiu, Cd Mau; thiit ki nghiin ciru md td cdt ngang. Ket qud: ty li thira cdn: 14,5%; beo phi:
4.67%; Suy dinh dudng :5.96%; chi sd vong eo/chiiu cao ddnh gid beo phi & tre trai: 0,511: tre gdi: 0,503. Ngu&ng chdn dodn thira cdn & tre trai la 0,494 vd tre gdi la 0,489. Ket lugn: ty li thira cdn. beo phi chiim ty li cao. Chi sd vong eo/chiiu cao co the ddnh gid dugc thira cdn beo phi v&i dg nhgy vd do ddc hiiu cao.
Tir khda: thira cdn. beo phi,suy dinh duang, chi so eo/chiiu cao.
ABSTRACT
SURVEY ON O V E R W E I G H T , O B E S I T Y A N D THE R O L E OF WAIST T O HEIGHT RATIO IN D E T E C T I N G O V E R W E I G H T A N D OBESITY OF
STUDENTS A T N G U Y E N D I N H C H I E U E L E M E N T A R Y SCHOOL, W A R D 8, C A M A U CITY, CA M A U PROVINCE
Huynh Ngoc Linh, Le Yen Ly, Ong Thi My Dung Background: Overweight, obesity and malnutrition among children are a double burden in developing countries. There are many indexes, the table to evaluate overweight and obesity of children. However, the indicators and tables are often complex and changeable according to gender and age, so it should be calculated or look up the table to evaluate the status of overweight and obesity. This is very difficult to apply to rapid assessment of the nutritional status of children in the community. Currently, the nutritional classification of WHO 2007 is widely accepted and it is classified according to age group and gender. Therefore, it is necessary to have a simple and easily applicable tool to assess overweight in the community. Objectives: I) To investigate the rate of overweight, obesity and malnutrition at Nguyen Dinh Chieu elementary school. Ca Mau city. 2) To define the value of the waist / height to assess overweight, obesity. Materials and method: 772 students studying at Nguyen Dinh Chieu elementary school, Ca Mau. Cross-sectional study.
Results: The percentage of overweight was 14.5%; of Obesity was 4.67%; of Malnutrition was 5.96%; The ratio of waist/ height in assessing obesity in boys was 0.511 and in girls was 0.503.
The threshold for diagnosing overweight of boys is 0.494 and for girls is 0.489. Conclusion: The
TAP CHf Y Dl/QC HQC C^N THP - s 6 11-12/2018
prevalence of overweight and obesity is high The waist / height ratio can be used to assess overweight and obesity with high sensitivity and specificity.
Keywords: overweight, obesity, malnutrition, waist / height ratio.
I. D A T VAN D E
Cftng vdi tang huySt ap, dai thao dudng, ung thu thi thfta can, beo phi hiSn dang dugc xem la mot dai dich ctm the ky 21 bdi su gia tang nhanh chdng cung nhu nhiing he luy \h sue khde va ganh ngng b^nh tat ma nd gay ra. Nhftng tre mac bSo phi de cd nguy co cao vS cac vdn dd nhu: anh hudng tam ly, hgi chftng chuyen hda, benh ly tim mgch, dai thao dudng, benh thgn, benh vS dudng mat, hay ca xuang khdp... Hien nay, viec danh gia thfta can va beo phi d tie em Ifta tudi tft 6 dSn 10 tudi chu ySu dua ttSn chi sd khdi ca tiiS, tuy nhien chi sd nay phu thudc Ifta tudi, gidi, can danh gia theo dudng cong bach phin vi (percentile) nSn khd sft dgng ttong cdng ddng nhdt la cho ngudi khdng chuySn mdn.
Trong cac nghiSn cftu trudc day, ti IS vdng eo/ chieu cao, chi sd eo mdng dugc chftng minh la cd mdi liSn he vdi nguy ca benh tim mach tdt hon ca chi sd khdi ca thS ddi vdi ca ngudi ldn ihx ttS ldn [2],[4],[7]. Odn day, mgt sd nai ttSn the gidi bat dau sft dung ti Ie vdng eo/ chiSu cao dS tdm soat tmh ttgng thiia cftn beo phi, v i | c sft dung tuang ddi don gian chi sd nay it phu thudc tudi. Vi vay chftng tdi thuc hien nghiSn cftu dS tai "Khao sat ti le thfta can, bSo phi, suy dinh dudng va vai ttd cfta ti le vdng eo/ chieu cao trong tam soat tinh trang thfta can, beo phi d hgc sinh trudng tieu hgc Nguyen Dinh Chieu Tlmnh Phd Ca Mau tir thang 10/2016 ddn tlmng 12/2016" vdi cac myc tiSu sau:
1. Khao sat ti Ie thfta can, beo phi, suy dinh dudng d hgc sinh tirudng tieu hpc NguySn Dinh ChiSu Thanh Phd Ca Mau.
2. xac dinh tri sd t ^ d n g cfta ty IS vdng eo/ chieu cao ttong tam softt tinh ttgng thfta can, beo phi d hpc sinh trudng tiSu hgc NguySn Dinh Chieu Tlmnh Phd Cft Mau.
II. DOI TU*QfNG VA PHl/ONG PHAP NGHIEN ClTU 2.1. B^i tirgng nghien cuu
Tieu chi chon mSu
Hpc sinh tiirdng tiSu hpc NguySn Dinh ChiSu, phudng 8 TP Ca Mau tft thang 10/2016 dSn thang 12/2016.
Tieu chi loai trii
Hpc sinh cd nhiing bSnh ly bdt thudng gay ra biSn ddi ve chi sd ca thS: benh tim mgch, benh ly gan tl4n, phu, benh chuyen hda, bien dgng xuong.
2.2. Phirong phap nghien cuu - ThiSt kS nghien cftu: md ta cdt ngang.
- Cd mlu va phuong phap chpn mlu: ldy ttpn mlu.
- Ndi dung nghiSn cftu: phdng vdn true tiSp hpc sinh bdng bang cau hdi sogn sin;
can tte bang can sftc khde Cammy EB554, hgc sinh khdng mang ^idy, cap, dftng thdng khi can; do bang thudc do Koma decal dan tudng, do tft gdt chan den dinh dau khi tie dftng thdng sftt thudc do dan tudng; cin va do cung thdi diSm ttong ngay Iftc 9 gid ttong cac ngay ngien cftu. Danh gia tinh ttang beo phi: danh gia tinh trang dinh duong tte em dga vfto Z-Score cfta WHO 2007. Dien tich dudi dudng cong (DTDDC) dugc chpn dd cd ngudng chdn doan tot la tft 0,7 -0,9 ttd ISn. NghiSn cftu nay diing chi so BMI d^ iam tiSu
226
TiBtP CHf Y Dl/QC HQC CAN THg - s6 11-12/2018
chimn vang dS chdn doan thfta can, beo phi. Dung chi sd Youden (Youden index) J dS xac dinh diem cat nao cd dp nhay va do chuyen cao nhat.
- Xft Iy va phan tich du kien: du^ lieu thd tft phiSu thu thap sd lieu se dugc nhgp vao phan mSm Epidata 3.02 dS quan ly du lieu va xft ly dft lieu bdng phdn mSm SPSS 20.0.
III. KET QUA NGHIEN CUtJ
Tft tiiang 11/2016 dSn thang 04/2017, khao sftt tdng sd 772 em hgc sinh tiiugc nam ddi tugng tft lap 1 dSn Idp 5 dang hpc tgi trudng tiSu hpc NguySn Dinh ChiSu Thanh phd Ca Mau. Chftng tdi thu dugc ket qim nhu sau:
3.1. Dgc diem chung ciia S6i tirgng nghien cuu Bang 3.1. Dac diem nhan trac hoc cua doi tucmg ngh Bien so
SSlugmg Vong eo(cm) Cliieu cao (cm) Can nang (kg) BMI (kg/m^) Chi so vong eo / eiiieu cao
Gioi tinh Nam Na Nam Nii Nam Nit Nam
Na Nam Nii Nam NO
6 tuoi 70 66 60,17±8,67 57,48±5,33 121,1±7,18 118,4±5,83 26,09±6,9I 23,56±4,7 17,46±3,56
16,7±2,76 0,49±0,058 0,48±0,039
7 tuoi 104
89 61,1±8,02 58,25±7,67 124,5±5,78 123,9±6,28 26,5±6,74 25,13±6,01 16,94±3,42 16,23±2,91 0,4ft±0,056 0,47±D,053
ien ciiu 8 moi
74 41 63,56±7,91 61,46±7,35 129,4±5,95 128,1 ±6,01 29,7±7,37
29±6,84 17,58±3,23
17,5±3,27 0,49±0,053 0,48±0,045
9 tuoi 138 116 63,36±9,17
62,3±8,29 133,5±6,87 134,4±6,88 32,44±8,84 32,02±7,42 18,06±4,1 17,57±3,06 0,47±0,059 0,46±0,052
10 tuoi 33 41 64,8±9,27 62,02±6,32 139,5±7,79 138,4±8,44 35,73±7,61 34,3±6,41 18,21±4,26 17,7±3,02 0,46±0,057 0,4S±0,043 Nhgn xet: Vdng eo it thay ddi theo Ifta tudi va gidi tinh. BMI d nhdm thdp ban so vdi nhdm tudi Idn ban va d nft nhd ban d nam.
3.2. Danh gia tinh trgng dinh duong
Bang 3.2 Danh gia tmh ttang dinh dudng tiieo cac chi sd
tudi nhd
Nhom tuoi 6 tuoi (n=136)
7 tuSi (n=193 )
8tuSi (n=115)
9tu6i (n=254)
Phan loai Thua can Beo phi Suy dinh duong Thua can Beo phi Suy dinh du5ng Thira can Beo phi Suy dinh du5ng Thua can Beo phi
Can nang theo tuoi (n;%) Nam
18(25,71) 6(8,57) 2(2,85) 17(16,34)
4(3,84) 5(4.8) 9(12,16)
3(4,05) 6(8,1) 16(11,59)
3(2,17) Nft 7(10,6) 1(1,51) 1(1,51) 7(7,86) 2(2,24) 3(3,37) 5(12,19) 2(4,87) 3(7,31) 8(6,89) 1(0,86)
25(18,38) 7(5,14)
3(2,2) 24(12,43)
6(3,1) 8(4,14) 14(12,17)
5(4,34) 9(7,82) 24(9,44) 4(1,57)
BMI(n;%) Nam
12(17,14) 10(14,28) 3(4,28) 17(16,34)
7(6,73) 9(8,65) 9(12,16) 5(6,75) 8(10,81) 25(18,11) 4(2,89)
Nft 10(15,15)
4(6,06) 1(1,51) 9(10,11) 2(2,24) 6(6,74) 4(9,75) 1(2,43) 2(4,86) 18(15,51)
1(0,86) 22(16,17) 14(10,29) 4(2,94) 26(13,47)
9(4,66) 15(7,77) 13(11,3) 6(5,21) 10(8,69) 43(16,92)
5(1,96)
TAP CHi Y DirpC HQC CAN THC - SO 11-12/2018 Nhom
tuoi
10 tuoi (n=74)
T6ng (n=772)
PhSn lo^i Suy dinh dirang Thira can Beo phi Suy dinli du5ng Thira cSn Beo phi Suy dinh du&ng
CSn nang theo tu6i (n;%) Nam
8(5,79) 2(6,06) 1(3,03) 2(6,06) 62(14,79)
17(4,05) 23(5,51)
Nft 6(5,17) 5(12,19)
1(2,43) 1(2,43) 32(9,06) 7(1,98) 14(3,98)
14(5,51) 7(9,45) 2(2,7) 3(4,05) 94(12,18)
24(3,1) 37(4,8)
BMI(n;%) Nam
7(5,07) 5(15,15)
1(3,03) 4(12,12) 68(16,22) 27(6,43) 31(7,43)
Nir 4(3,44) 3(7,31) 1(2,43) 2(4,86) 44(12,47)
9(2,54) 15(4,25)
11(4,33) 8(10,81) 2(2,7) 6(8,1) 112(14,5) 36(4,67) 46(5,96) Nhgn xet: vS can nang theo tudi cd 94 tte thfta can
24 tte chiSm 3,1%. Khi xet theo BMI tiii thfta can cd 112 tre chiSm 4,67%.
chiSm ty I^ 12,18% , beo phi cd tte chiSra 14,5%, beo phi cd 36
0 2 5 O.SD
Bieu dd 3.1 Dudng cong ROC danh gia thua cSn, beo phi theo vdng eo/chieu cao d tte ttai
aOO 025 0.5D
BiSu dd 3.2 Dudng cong ROC danh gia thua can, bSo phi theo vdng eo/chiSu cao d ttS gdi
TAP CHi Y Dirge HOC CAN T H O - so 11-12/2018 Bang 3 . 3 . Danh gia tinh trang dinh duong theo cac chi so
Nhom hoc sinh
Chi so vong eo/chieu cao
Dien tich dirdidirtmg cong (sai so chuan)
Chi so
Jouden P
(KTC 95%)
Dd nhay
(%)'
Bo dac hiSu(%)
Nam Beo phi Thira can
0,512 0,494
0,965 (0,02) 0,926 (0,02)
91,35 77,78
0,000 (0,88-0,96)
0,000 (0,88-0,96)
92,89 83,88
98,46 93,9 Nir
Beo phi Thira can
0,505 0,489
0,937 (0,015)
0,911 (0,016)
81,11 81,97
0,000 (0,90-0,97)
0,000 (0,87-0,94)
86,78 88,64
94,33 93,33 IV. B A N L U A N
4.1. Bgc diem chung cua doi tirgng nghien cuu
Trong 772 hpc sinh dugc klmo sat, lua tudi nhd nlmt la 73 tlmng tudi, Idn nhat la 134 thang tudi. Can ngng thdp nhdt ttong nhdm nghien cftu la 13kg tuang ftng vdi thang tudi la 73 timng, can nang cao nhdt la 70kg. Trong nghien ciru cd 419 nam va 353 nft.
Vdng eo khdng cd su khac biet nhieu d cac nhdm tudi ca hai gidi nam va nft. Chi sd BMI cua nam cao hon d nu d tdt ca nhdm tudi, BMI tang theo tudi d ca hai nhdm. Chi sd vdng eo /chiSu cao d nhdm tudi nhd thi cao hon so vdi nhdm tudi ldn ban va nhdm nam cao hon nhdm nu.
Danh gja thfta can bSo phi theo can ngng va tudi ta thay 617 tte cd can ngng binh thudng, 94 tte thfta can chiSm 12,18%, beo phi la 24 tie chiSm 3,1% va suy dmh dudng la 37 ttS chiSm 4,8%. Trong cd dd ty IS thfta can d nam la 14,09%, beo phi la 4,05%, suy dinh dudng la 5,51%; d nu ty IS thua can la 9,06%, beo phi la 1,98%, suy dinh dudng la 3,98%. Phuong phap danh gia rmy vdn thudng dugc ap dung dS danh gia dinh dudng cho tre dudi 5 tudi. Khi tte ttSn 5 tudi tiii phuang phap nay it chinh xac han. Vi vgy phan logi tiiua can, beo phi theo BMI tiiudng dugc ap dung hon. Danh gia theo BMI kSt qua cho thdy cd 112 tte thua can chiSm 14,5%, beo phi la 36 tte chiSm 4,67%, suy dinh dudng la 46 tte chiSm 5,96%. Ty IS tiiua can d tte ttai la 16,22% cao ban so vdi 12,47% cfta nhdm tte gai, su khac biet nay cd y nghia tiidng kS, p=0,042. Cac nghiSn cuu dSu cho thdy d Ifta tudi tiSu hgc tie ti:ai cd ty IS thfta can, beo phi cao ban so vdi tie gai. Theo nghien cftu cua NguySn Dd Huy tai 2 trudng tiSu hgc cho thdy ty IS thua can beo phi theo BMI la 10,2%
nhdm tte ttai la 12,5% so vdi 7,7% cfta nhdm tte gai[6]. Ty IS nay thdp hon nghien cuu cua chftng tdi. Tuy nghiSn cftu imy ciing thuc hien tai mgt huyen ngi thanh nhung cd mau tiiong ddi nhd chi cd 492 tte va thdi diSm khda sat la nam 2012. NghiSn cuu cfta Do Thi Ngpc Diep tgi Quan 10 thanh phd Hd Chi Minh cho thdy ty I? tiifta can la 20,8% va beo phi la 7,7% va gaiJ hdu hSt d tire ti^[3]. KSt qua nay cho thdy ty le thfta can beo phi d tiling tan thanh phd rdt cao. Va ciing ttong nghiSn cftu nay ty IS suy dinh dudng rat thap chi cd 2,3%. VS phan logi suy dinh dudng theo BMI ttong nghiSn cftu cfta chung tdi cho thdy cd 46 tte chiSm ty 1^ tucmg ddi thdp. Vi nghiSn cftu nay dugc thuc hien tgi phucmg 8 cung la mgt phudng ndi d thanh phd Ca Mau nSn hdu hSt cac be dugc cham sdc tdt vS
T»P CHI Y Dl/gC HQC CAN THQ - s611-12/2018
dinh dudng. NghiSn cftu cfta Vuong Thugn An tai thi xa tay Ninh cho thdy ty IS suy dinh dudng la 9,3%[1] ty IS nay cao hon nghiSn cuu cua chung tdi.
4.2. Vai trd cfta chi so ti IS vdng eo/ chi^u cao trong danh gia thfta cSn, bSo phi DS chdn doan nhanh tinh ttang beo phi d tte, can chpn chi sd cd dien tich dudi dudng cong tu 0,7 - 0,9 ttd ISn, do nhgy cao va dp dgc hieu kha. Khi chpn chi sd chung dS chdn doan thfta can, beo phi cho tte ttai va tte gai ket qim cho thay dien tich DTDDC thdp chi cd 0,892 vdi dd nhgy la 87,64% va dp dac hieu la 79,23%. Vi vgy dS tang dd chinh xac chftng tdi chia lam hai nhdm trai, gai riSng biet dS danh gia.
0 nhdm tie trai chung tdi de nghi chpn chi sd ngudng chdn doan vdng eo/chieu cao la 0,511 vdi dp nhgy 92,89%, do dac hieu la 98,46%, chi sd Jouden la 0,913 dS chdn doan beo phi. Khi dd DTDDC la 0,965 [0,92-0,99], p=0,000. Nhdm tiifta can khi chpn chi s6 0,494 iam ngudng chdn doan thi dd nhgy 83,88%, do dgc hi?u la 93,9%, chi sd Jouden la 0,777 dS chan doan tiiua can d tte ttai, DTDDC la 0,926 [0,88-0,96], p=0,000. Nhu vgy ngudi chan doan beo phi d tte ttai cd chi sd vdng eo/chieu cao la 0,511 thfta can la 0,494 vdi do nhgy va do dac hieu rat cao va DTDDC cd gia tti gdn nhu tuy$t ddi. Trong nghiSn cftu cfta NguySn Thi Thu Hau tai Benh vien Nhi ddng 2 cho thay ngudng chan doan beo phi d tte ttai la 0,501 vdi dien tich dudi dudng cong la 0,96-0,98[5]. Tuy nhien, nghiSn cftu nfty chi thgc hi^n ttSn 204 tte sd li^u cdn tuong ddi it. Nghien ciin ciaa Weili Yan ttSn 4187 tte tgi trung Qudc cho timy ngudng chdn doan bSo phi d tie trai la 0,485[10]. Chi s6 nay thap hon nghiSn cftu ciia chung tdi. Tuy nhien nghiSn cftu nay dugc thuc hien ttSn tte tft 8 den 18 tudi khac biet so vdi nhdm tudi cua nghiSn chftng tdi. NghiSn cftu Seeja Thomachan ttSn 6000 tte tgi An Dd d^ nghi ngudng chdn doan bSo phi la 0,48 cho ca hai gidi, mac dft v$y vdi ngudng rmy dp nhgy chi cd 63%, dp chuyen la 97,8% va dien tich dudi dudng cong chi cd 0,827[9]. NghiSn cuu ciia Santomauro ttSn 1575 tte de nghj ngudng chan doan beo phi la 0,5 cho ca hai gidi[8].
d nhdm tte gai khi chpn chi sd ngudng chdn doan vdng eo/chieu cao la 0,505 vdi do nhay 86,78%, dp dgc hieu la 93,9%, chi sd Jouden la 0,811 dS chdn doan beo phi. Khi do DTDDC la 0,937 [0,902-0,97], p=0,000. Nhdm tiifta cftn khi chpn chi sd 0,489 lam ngudng chan doan thi dp nhgy 88,64%, dp dgc hieu la 93,33%, chi sd Jouden la 0,819 dl chdn doan tiifta can d tte gai, DTDDC la 0,911 [0,87-0,94], p=0,000. Nhu vgy ngudng chdn doan thfta can d tte gai cd chi sd vdng eo/chieu cao la 0,489 vdi dd nhgy la 88,64%, dp dgc hieu la 93,33%, chi sd chdn doan beo phi la 0,505 vdi do nhay va dp dac hiSu tuong ddi cao. Trong nghiSn cftn cua NguySn TTii Thu Hau tgi BSnh vien Nhi ddng 2 cho thay ngudng chan doan beo phi d tte gai la 0,489 vdi dien tich dudi dudng cong la 0,96- 0,98[5]. NghiSn cftu cfta Weill Yan tten 4187 ttS tgi Trung Qudc cho thdy ngudng chdn doan beo phi d tte gfti la 0,475 [10]. Chi so d tre gai ciing thdp ban nghiSn cftu cua chung tdi. Nghien cftu cfta Santomauro tren 1575 ttd de nghi ngudng chdn doan beo phi la 0,5 cho ca hai gidi [8]. NghiSn cftu nay ciing cho tiidy chiSu cao trung bmh la 134±10 cm d nhdm tte ttai va 132±I0 cm d nhdm tte gai deu cao hon so vdi chiSu cao trung binh ttong nghiSn ctm cua chftng tdi chi cd I28,7±9,l cm. Chinh vi vay chi sd ngudng chan doan beo phi cac nghien cftu nay thap han nghien cftu cfta chung tdi. Ngoai ra ttong nghien cftu cfta Weili Yan tai Trung Qudc, nhdm tte ngudi Han va ngudi Uygur cung cd muc do beo phi va ti IS md khac nhau[10]. DiSu nay chung td chung tdc khac nhau se cd nhung dac diSm khac nhau ttong phan bo ma.
230
TAP CHI Y Dl/QfC HQC C&N THO - SO 11-12/2018
Tdm lgi, chi sd ti IS vdng eo/chiSu cao it phu thudc vao tudi, dS tinh toan nen de ap dgng rgng rai ttong cdng ddng, do chinh xac cao so vdi chudn BMI cd kha nang phan each rdt tdt gifta bdo phi va khdng bdo phi.
V. K E T L U ^ N
Ty IS tiifta can tiieo chi sd BMI la 14,5% ttong dd nam 16,22% nft 12,47%; ty IS beo phi la 4,67% nam chiSm 6,43% nu chiSm 2,54%; ty IS suy dinh dudng la 5,96%.
Chi sd dS nghi chan doan beo phi cho tte ttai la 0,511, tte gai 0,505. Ngudng chan doan thua can d tte ttai la 0,494 va tte gai la 0,489.
VI. K I E N N G H I
De cd chi sd chinh xac hon, can tiSn hanh nhiing nghiSn cftu cd cd mdu dft Idn dS tft do ap dung chi sd danh gja thira can beo phi theo vdng eo va chiSu cao ftp dung cho tie em Vi§t nam.
TAI L I E U T H A M K H A O
1. Vuang Thuan An, (2010). "Tinh ttgng dinh dudng vh mdt sd ySu td lien quan cua tte Ifta tu6i tft 6-11 tai tnrdng tieu hpc Kim Ddng, thi xS Tay Ninh, tinh Tay Ninh nam 2009", Y hgc thdnh phd Hd Chi Minh 14(2), 306-311.
2. Nguyin Thj Hoa (2011), "Thfta cSn - beo phi", Dinh Duong Hgc, Nha xudt ban Y hpc chi nhanh thanh pho Hd Chi Minh, 264 - 271.
3. DS Thi Ngpc Diep, (2011). "Thfta can, bSo phi vi mdt s6 dac diSm dich tl hgc dhpc sinh tiiu hpc tgi quan 10, thanh pho Hd Chi Minh n5m hpc 2008-2009", Thai siry hgc, 67, 3-6.
4. Phgm Duy Tudng (2012), Dinh duang vd an todn thgc phdm, tnrdng Dai Hpc Y Ha Npi, Nha Xudt ban y hoc, 35,97 - 99.
5. NguySn Thi Thu HSu va cdng sg, (2010), "Vai ttd ciia ty le vdng eo/ chilu cao ttong tdm soat tinh trgng beo phi d tte em ", Tgp chi dinh du&ng vd thucphdm,6(\), 88-93.
6. NguySn Dd Huy, (2013). "Tinh trgng thfta can bSo phi va mdt sd yiu td lien quan d hpc sinh hai tnrdng tiSu hpc cua huyen Ddng Anh, Ha Ngi", Tgp chi nghien cuu yhgc, 82(2), 159-165.
7. Freedman DS, et al, (2007). "Relation of body mass index and waist-to-height ratio to cardiovascular disease risk factors in children and adolescents: the Bogalusa Heart Study", AmJClinNutr, 86(1),33-40.
8. Santomauro et al, (2017). "Waist-to-hight ratio and its association with body mass index in a sample of Tuscan children in primary school", Italian Journal ofPediatics 43:53 9. Seeja Thomachan, (2013). "Waist to Height Ratio for Recording the Risks of Overweight
in Schoolchildren m Kerala", Indian Pediatrics, 50,493-495.
10. Weili Yan, He Bingxian, Yao Hua, et al (2007). "Waist - to- Height Ratio is an Accurate and Easier Index for Evaluating Obessity in Children and Adoslescents", Obessity, 15, 748-752
(Ngdy nhdn bdi: 11/11/2017 - Ngdy duyet ddng: 05/01/2018)
