杉浦 令子

Aim: The aim of this study was to identify the age and sex-specific reference ranges for the non-highdensity lipoprotein cholesterol (non-HDLC) levels in Japanese children. Methods: The subjects included 441,431 schoolchildren (207,015 boys, 234,416 girls) 9-16 years of age who participated in a screening and care program for lifestyle-related diseases from 2006 to 2011. The serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels were measured, and the non-HDL-C levels were calculated. The serum lipid levels were analyzed according to age and sex. Results: The overall mean non-HDL-C level was 105.7 +/- 24.0 mg/dL, with a sex difference: boys 103.0 +/- 24.0 mg/dL and girls 108.2 +/- 23.8 mg/dL. In boys, the median non-HDL-C level decreased gradually from 104 mg/dL in the 9-year-old age group to 96 mg/dL in the 15-year-old age group. The 75th percentile level was approximately 120 mg/dL in the 9- to 11-year-old groups and decreased at approximately 113 mg/dL in the 12- to 15-year-old groups, whereas the 95th percentile level was approximately 150 mg/dL in the 9- to 11-year-old groups and decreased at approximately 140 mg/dL in the 13- to 15-year-old groups. In girls, the median non-HDL-C level remained unchanged at approximately 105 mg/dL, with 75th and 95th percentile levels of approximately 122 and 150 mg/dL, respectively. Conclusions: The non-HDL-C levels vary by age and sex. The age-and sex-specific reference ranges for the non-HDL-C levels may be a valuable tool for management with respect to preventing the development of atherosclerosis in childhood.

Background: The aim of the present study was to examine the problems associated with using body mass index (BMI) for evaluating the physical status of children during puberty and the problems associated with establishing international standard values as cut-off points for obesity and thinness in children. Methods: A cohort study was undertaken on BMI as an indicator of physical status in puberty based on the data in the 2000 Annual Report of School Health Statistics. The subjects were 695,600 children from 5 to 17 years of age. Results: In puberty, even in those with the optimal weight for their sex and age, BMI increases as height increases; therefore, a considerable variation in the range of BMI is observed in normal individuals of the same degree of fatness. For this reason, there is considerable overlap in the "healthy weight", "overweight" and "obese" groups defined by the CDC using BMI percentile with regard to fatness in puberty. When the pubertal growth patterns are different among children from different countries, it is difficult to determine internationally average BMI by sex and age. Conclusions: Distinguishing the respective healthy weight, overweight, and obese groups based on cut-off points using BMI percentile during puberty is difficult. If differences exist in the socioeconomic status of the subject cohorts and in the passage through puberty among children from different countries, we must consider that average values of BMI for the same age of children in puberty will have different meanings. With regard to evaluation of physical status in pubertal children, only BMI average values for the same stage of pubertal development are meaningful, rather than individual values.

Background: Obesity occurring earlier than 2 years of age is categorized as "benign" childhood obesity. In other words, no treatment is required for this type of obesity, and its course can simply be followed without any particular intervention. The purpose of the present study was to determine whether early infantile obesity is actually benign childhood obesity. Methods: The stature (length) and weight growth distance curves and growth velocity curves were determined for an obese infant (patient A), of his parents in infancy, and of his younger sister to determine whether their obesity in infancy was the benign childhood obesity. These data were also compared with other obese infants and those of normal infants. Results: Patient A's weight growth velocity declined until the age of 6 months and was then constant from 7 months onward. Because patient A's weight growth velocity curve followed the same pattern as that seen in a normal infant, despite differing in degree, the reason why this patient became obese in early infancy was probably insufficient deceleration of his weight growth velocity compared to that of a normal infant. In addition, the weight growth patterns and growth velocities of his parents and young sister during infancy were similar to those of the patient. Conclusions: The present four subjects had benign childhood obesity. In addition, six other cases of infantile obesity have been encountered at the authors' pediatric outpatient clinic. The clinical characteristics of infantile obesity are discussed.

A risk of life-style related diseases has recently been found in the younger generation. This study identifies the risk factors of life-style related diseases during the last 19 years in young children who have been living in the suburbs of Tokyo. The subjects were 5, 001 children aged 4 to 6 years who attended nursery schools in this city during the period 1984 to 2002. The indicators observed were weight and height, blood pressure, serum biochemical measurements and food intake. Obesity and a high level of serum total cholesterol (TC) were used as risk factors for lifestyle related diseases. The prevalence of obesity varied according to the year by±5-15%, while the prevalence of a high level of TC tended to increase. To assess the relationship between the primary factors for obesity, a principal component analysis was performed in respect of the food intake of meat and fish, while a similar analysis was performed on the primary factors for a high level of TC in respect of the food intake of vegetables and fruit. The results indicate that an excessive intake of saturated fatty acids and cholesterol and lack of antioxidative materials in foods would influence the prevalence of a high level of TC even in young children. It will be important to provide early care and support for children through nutritional education to prevent obesity and a high level of TC.