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300 ∂ƒ∂À¡∏∆π∫∏ ∂ƒ°∞™π∞ ORIGINAL ARTICLE
Paediatriki 2007;70:300-307
∂ηÙÔÛÙÈ·›Â˜ ı¤ÛÂȘ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ ·È‰ÈÒÓ Ù˘ ∫Ú‹Ù˘
ËÏÈΛ·˜ 3 ¤ˆ˜ 16 ÂÙÒÓ
∂. §ÈÓ·Ú‰¿Î˘, ∫. µ·Ú‰·‚¿˜, ∞. ∫·Ê¿ÙÔ˜
¶ÂÚ›ÏË„Ë
∂ÈÛ·ÁˆÁ‹: ™ÎÔ fi˜ Ù˘ ·ÚÔ‡Û·˜ ÌÂϤÙ˘ ‹Ù·Ó Ô ˘ ÔÏÔÁÈÛÌfi˜ ÂηÙÔÛÙÈ·›ˆÓ ı¤ÛÂˆÓ (∂£) Î·È Ë ‰ËÌÈ-
Ô˘ÚÁ›· Î·Ì ˘ÏÒÓ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ (¶ª) ·È‰ÈÒÓ Î·È ÂÊ‹‚ˆÓ Ù˘ ∫Ú‹Ù˘.
ÀÏÈÎfi Î·È Ì¤ıÔ‰ÔÈ: ™ÙË ÌÂϤÙË Û˘ÌÌÂÙ›¯·Ó 5.321 ·È‰È¿ - 2.643 ·ÁfiÚÈ· Î·È 2.678 ÎÔÚ›ÙÛÈ·, ËÏÈΛ·˜ 2,5-
16,5 ÂÙÒÓ, Î·È ‰ÈÂÓÂÚÁ‹ıËÎ·Ó 7.538 ÌÂÙÚ‹ÛÂȘ ¶ª. √È ÌÂÙÚ‹ÛÂȘ ·˘Ù¤˜ ÚÔ¤Ú¯ÔÓÙ·È · fi  ٿ ÌÂϤÙ˜
Ô˘ ‰ÈÂÍ‹¯ıËÛ·Ó ÌÂٷ͇ 1992-2005 Û ·ÓÙÈ ÚÔÛˆ ¢ÙÈο ‰Â›ÁÌ·Ù· ·È‰ÈÒÓ, · fi ÙËÓ ∫ÏÈÓÈ΋ ¶ÚÔÏË-
ÙÈ΋˜ π·ÙÚÈ΋˜ Î·È ¢È·ÙÚÔÊ‹˜, Ù˘ π·ÙÚÈ΋˜ ™¯ÔÏ‹˜ ÙÔ˘ ¶·Ó ÈÛÙËÌ›Ô˘ ∫Ú‹Ù˘. OÈ ÂÍÔÌ·Ï˘Ṳ̂Ó˜ ∂£
Ù˘ ¶ª ˘ ÔÏÔÁ›ÛÙËÎ·Ó Ì ÙË ¯Ú‹ÛË ÔÏ˘ˆÓ˘ÌÈÎÒÓ ÌÔÓ٤ψÓ, ÂÓÒ ¤ÁÈÓ ۇÁÎÚÈÛË Ù˘ ¶ª ÙˆÓ ·È‰ÈÒÓ
Ù˘ ·ÚÔ‡Û·˜ ÌÂϤÙ˘ Ì ÌÂÙÚ‹ÛÂȘ ¿ÏÏˆÓ ‰ÈÂıÓÒÓ ÌÂÏÂÙÒÓ.
∞ ÔÙÂϤÛÌ·Ù·: ∏ ¶ª ˘ ÔÏÔÁ›ÛÙËΠ·Ó¿ ʇÏÔ Î·È ËÏÈΛ· ηıÒ˜ Î·È ÔÈ ÂÍÔÌ·Ï˘Ṳ̂Ó˜ ∂£: 5Ë, 10Ë, 25Ë,
50‹, 75Ë, 85Ë, 90‹ Î·È 95Ë. ™˘ÁÎÚÈÙÈο, ‚Ú¤ıËΠfiÙÈ Ù· ·È‰È¿ Î·È ÔÈ ¤ÊË‚ÔÈ Ù˘ ∫Ú‹Ù˘ ¤¯Ô˘Ó, ÛÙȘ Â-
ÚÈÛÛfiÙÂÚ˜ ËÏÈ˘, ÛËÌ·ÓÙÈο ÌÂÁ·Ï‡ÙÂÚË ¶ª · fi Ù· ·È‰È¿ Î·È ÙÔ˘˜ ÂÊ‹‚Ô˘˜ Ù˘ ∫‡ ÚÔ˘ Î·È ÙˆÓ
∏¶∞ (p<0,05), Î·È Û fiϘ ÙȘ ËÏÈ˘ ÛËÌ·ÓÙÈο ˘„ËÏfiÙÂÚ˜ ̤Û˜ ÙÈ̤˜ · fi Ù· ·È‰È¿ Ù˘ √ÏÏ·Ó‰›·˜,
Ù˘ ª. µÚÂÙ·Ó›·˜, Ù˘ ∞˘ÛÙÚ·Ï›·˜ Î·È ÙÔ˘ ∫·Ó·‰¿. øÛÙfiÛÔ, ‰ÂÓ ‰È¤ÊÂÚ·Ó ÛËÌ·ÓÙÈο (p>0,05) ÛÙȘ Â-
ÚÈÛÛfiÙÂÚ˜ ËÏÈ˘ · fi Ù· ·È‰È¿ Ù˘ πÛ ·Ó›·˜, ÂÓÒ Û fiϘ ÙȘ ËÏÈ˘ ›¯·Ó ÛËÌ·ÓÙÈο ¯·ÌËÏfiÙÂÚ˜ ÙÈ-
̤˜ ¶ª (50‹ ∂£) · fi Ù· ·È‰È¿ Ù˘ πÙ·Ï›·˜ (p<0,001).
™˘Ì ÂÚ¿ÛÌ·Ù·: ∏ ¯Ú‹ÛË ÙˆÓ ∂£ Ù˘ ¶ª · ÔÙÂÏ› ¯Ú‹ÛÈÌÔ Î·È ·ÍÈfi ÈÛÙÔ ÂÚÁ·ÏÂ›Ô ÁÈ· ÁÔÓ›˜ Î·È ·È-
‰›·ÙÚÔ˘˜, ÂÓÒ Ë ¶ª ηٷ‰ÂÈÎÓ‡ÂÈ ÙÔ ÛÔ‚·Úfi Úfi‚ÏËÌ· Ù˘ ·È‰È΋˜ ÎÂÓÙÚÈ΋˜ ·¯˘Û·ÚΛ·˜ ÛÙ· ·È-
‰È¿ Ù˘ ∫Ú‹Ù˘.
§¤ÍÂȘ ÎÏÂȉȿ: ¶·È‰È¿, ÂÚ›ÌÂÙÚÔ˜ ̤Û˘, ÎÂÓÙÚÈ΋ ·¯˘Û·ÚΛ·, ÂηÙÔÛÙÈ·›Â˜ ı¤ÛÂȘ.
Waist circumference percentiles of children of Crete aged 3 to 16 years
E. Linardakis, K. Vardavas, A. Kafatos
Abstract
Background: The aim of this study was to estimate percentiles and growth curves of the waist
circumference (WC) in children and adolescents of Crete, Greece.
Methods: WC measurements were recorded for 5,321 subjects, 2,643 boys and 2,678 girls, aged 2.5 to
16.5 years, on whom a total of 7,538 were made. These measurements were derived from seven studies
conducted between 1992 and 2005, on representative samples of children and adolescents in Crete, by
the Preventive Medicine and Nutrition Clinic of the University of Crete. Smoothed percentiles of WC were
estimated using polynomial models. The WC distribution was compared with that reported in other
countries.
Results: The age-sex specific descriptive characteristics and the smoothed percentiles of the 5th, 10th,
25th, 50th, 75th, 85th, 90th and 95th place were estimated. The mean WC of children and adolescents in
this study in most age groups was found to be higher than that of children from Cyprus and the U.S
(p<0.05) and higher in all age groups than that of children from the Netherlands, the U.K, Australia and
Canada. The WC of the Cretan children did not differ significantly from that of Spanish children in most
age groups but was lower (50th percentiles) in all age groups compared to Italian children (p<0.001).
Conclusions: WC percentiles can be a useful and reliable tool for use by parents and paediatricians. The
use of WC percentiles confirms that childhood central obesity is a major health problem in Crete.
Key words: Children, waist circumference, central obesity, percentiles.
¶·Ó ÈÛÙ‹ÌÈÔ ∫Ú‹Ù˘,
∆Ì‹Ì· π·ÙÚÈ΋˜,
∆Ô̤·˜ ∫ÔÈÓˆÓÈ΋˜ π·ÙÚÈ΋˜,
∫ÏÈÓÈ΋ ¶ÚÔÏË ÙÈ΋˜
π·ÙÚÈ΋˜ Î·È ¢È·ÙÚÔÊ‹˜,
∏Ú¿ÎÏÂÈÔ ∫Ú‹Ù˘
AÏÏËÏÔÁÚ·Ê›·:
EÌÌ·ÓÔ˘‹Ï §ÈÓ·Ú‰¿Î˘
linman@med.uoc.gr
¢È·ÛÙ·‡ÚˆÛË µÔ‡Ù˜ –
™Ù·˘Ú¿ÎÈ·
∆.∫. 71 003, ∆.£. 2208
∏Ú¿ÎÏÂÈÔ ∫Ú‹Ù˘
University of Crete, Faculty
of Medicine
Department of Social
Medicine, Division of
Preventive Medicine and
Nutrition, Heraklion, Crete,
Greece
Correspondence:
Emmanouil Linardakis
linman@med.uoc.gr
Voutes-Stavrakia Junction
71 003, PO Box.: 2208
Heraklion, Crete, Greece
™˘ÓÙÔÌÔÁڷʛ˜
¶M ¶ÂÚ›ÌÂÙÚÔ˜ ª¤Û˘
∂£ ∂ηÙÔÛÙÈ·›· £¤ÛË
¢ª™ ¢Â›ÎÙ˘ ª¿˙·˜ ™ÒÌ·ÙÔ˜
IOTF International Obesity Task Force
Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·300
∂ÈÛ·ÁˆÁ‹
∏ ¤Ó·ÚÍË Ù˘  ȉËÌÈ΋˜ ¤Í·ÚÛ˘ Ù˘ ·¯˘-
Û·ÚΛ·˜ ¯ÚÔÓÔÏÔÁÂ›Ù·È · fi ÙȘ ·Ú¯¤˜ ÙÔ˘ 1960 ÁÈ·
ÙÔ˘˜ ÂÓ‹ÏÈΘ Î·È ÙÔ˘ 1980 ÁÈ· Ù· ·È‰È¿ Î·È ÙÔ˘˜
ÂÊ‹‚Ô˘˜ (1,2). Œ¯Ô˘Ó ˆÛÙfiÛÔ ·Ó· Ù˘¯ı› ‰È¿ÊÔÚÔÈ
‰Â›ÎÙ˜ ̤ÙÚËÛ˘ Ù˘ ·¯˘Û·ÚΛ·˜ Î·È ¯ÚËÛÈÌÔ-
ÔÈËı› ÙfiÛÔ ÁÈ· ÙËÓ Î·Ù·ÁÚ·Ê‹ Ù˘ fiÛÔ Î·È ÁÈ· ÙË
‰È·¯ÚÔÓÈ΋ Î·È ‰È· ÔÏÈÙÈÛÌÈ΋ Û‡ÁÎÚÈÛË ÙÔ˘ Ê·È-
ÓÔ̤ÓÔ˘.
¶ÔÏϤ˜ ÌÂϤÙ˜ Ù· ÙÂÏÂ˘Ù·›· ¯ÚfiÓÈ· ¤¯Ô˘Ó ·Ó·-
‰Â›ÍÂÈ ÙÔÓ ÛËÌ·ÓÙÈÎfi ÚfiÏÔ Ù˘ ̤ÙÚËÛ˘ Ù˘ ÂÚÈ-
̤ÙÚÔ˘ ̤Û˘ (¶ª) ˆ˜ ‰Â›ÎÙË ÎÂÓÙÚÈ΋˜ ·¯˘Û·Ú-
Λ·˜ ÙfiÛÔ ÛÙÔÓ ÂÓ‹ÏÈÎÔ fiÛÔ Î·È ÛÙÔÓ ·È‰ÈÎfi ÏË-
ı˘ÛÌfi (3-11).
∏ ̤ÙÚËÛË Ù˘ ¶ª Û ·È‰È¿ Î·È ÂÊ‹‚Ô˘˜ · Ô-
ÙÂÏ› ·ÍÈfi ÈÛÙÔ ÚÔÁÓˆÛÙÈÎfi ‰Â›ÎÙË, ÛÂ Û˘Ó‰˘·ÛÌfi
Ì ¿ÏÏÔ˘˜ ·Ú¿ÁÔÓÙ˜ ÎÈÓ‰‡ÓÔ˘, ÁÈ· ÙËÓ ·Ó¿ Ù˘ÍË
ηٿ ÙËÓ ÂÓ‹ÏÈÎË ˙ˆ‹ ηډȷÁÁÂÈ·ÎÒÓ Î·È ¿ÏψÓ
¯ÚfiÓÈˆÓ ÓÔÛËÌ¿ÙˆÓ (3-6). ∏ ¶ª ·È‰ÈÒÓ Î·È ÂÓË-
Ï›ÎˆÓ · ÔÙÂÏ›  ›Û˘ Ì›· · fi ÙȘ ¤ÓÙÂ Û˘ÓÈÛÙÒ-
Û˜ ÙÔ˘ ÌÂÙ·‚ÔÏÈÎÔ‡ Û˘Ó‰ÚfiÌÔ˘ (6-11). ∏ ·˘ÍË̤-
ÓË ÂÓ· fiıÂÛË ÎÔÈÏÈ·ÎÔ‡ Ï› Ô˘˜ Û˘Óԉ‡ÂÙ·È · fi
·˘ÍË̤ÓË ·ÓÙ›ÛÙ·ÛË ÛÙË ‰Ú¿ÛË Ù˘ ÈÓÛÔ˘Ï›Ó˘ ηÈ
·˘ÍË̤ÓÔ Î›Ó‰˘ÓÔ ÁÈ· ÙËÓ ·Ó¿ Ù˘ÍË Û·Î¯·ÚÒ‰Ë
‰È·‚‹ÙË Ù‡ Ô˘ 2. ∏ Û‡ÓıÂÛË Â ›Û˘ ÙÔ˘ ÎÔÈÏÈ·ÎÔ‡
Ï› Ô˘˜ Û ÏÈ ·Ú¿ Ôͤ· Â›Ó·È ‰˘ÛÌÂÓ¤ÛÙÂÚË ¤Ó·ÓÙÈ
ÙÔ˘ ÁÏÔ˘ÙÈ·›Ô˘ (5).
∏ ̤ÙÚËÛË Ù˘ ¶ª ˆ˜ ‰Â›ÎÙË ÎÂÓÙÚÈ΋˜ ·¯˘-
Û·ÚΛ·˜ Â›Ó·È · Ï‹, Ë Èı·ÓfiÙËÙ· ÛÊ¿ÏÌ·ÙÔ˜ ÛÙË
‰È·‰Èηۛ· ̤ÙÚËÛ˘ ÌÈÎÚ‹ Î·È Ë Î·ıȤڈۋ Ù˘
ÛÙËÓ Î·ıËÌÂÚÈÓ‹ ·È‰È·ÙÚÈ΋ ÎÏÈÓÈ΋ ÂͤٷÛË Ê·›-
ÓÂÙ·È Â È‚Â‚ÏË̤ÓË.
∏ ·ÚÔ‡Û· ÌÂϤÙË ÛÙԯ‡ÂÈ ÛÙÔ Ó· Ù·ÍÈÓÔÌ‹ÛÂÈ
·È‰È¿ Î·È ÂÊ‹‚Ô˘˜ Û ÂηÙÔÛÙÈ·›Â˜ ı¤ÛÂȘ (∂£),
ÒÛÙ ӷ ˘ ¿Ú¯ÂÈ ¤Ó· ̤ÙÚÔ Û‡ÁÎÚÈÛ˘ ÛÙËÓ Î·ıËÌÂ-
ÚÈÓ‹ ·È‰È·ÙÚÈ΋ ÂͤٷÛË, ηıÒ˜ Î·È ‚·ÛÈο ‰Â‰Ô-
̤ӷ Û‡ÁÎÚÈÛ˘ ÁÈ· ÌÂÏÏÔÓÙÈ΋ ·ÍÈÔÏfiÁËÛË ÙÔ˘  È-
ÔÏ·ÛÌÔ‡ Ù˘ ÎÂÓÙÚÈ΋˜ ·¯˘Û·ÚΛ·˜.
ÀÏÈÎfi Î·È Ì¤ıÔ‰ÔÈ
¶ÂÚÈÔ¯‹ ÌÂϤÙ˘
∏ ÌÂϤÙË Ú·ÁÌ·ÙÔ ÔÈ‹ıËΠ۠·È‰È¿ Î·È ÂÊ‹‚Ô˘˜ Ù˘
∫Ú‹Ù˘ Ô˘ Û˘ÌÌÂÙ›¯·Ó Û ÌÂϤÙ˜ Ù˘ ∫ÏÈÓÈ΋˜ ¶ÚÔÏË-
ÙÈ΋˜ π·ÙÚÈ΋˜ Î·È ¢È·ÙÚÔÊ‹˜ ÙÔ˘ ¶·Ó ÈÛÙËÌ›Ô˘ ∫Ú‹Ù˘.
∏ ∫Ú‹ÙË ‰È·ÈÚÂ›Ù·È Û ٤ÛÛÂÚȘ ÓÔÌÔ‡˜, ÂÎÙ›ÓÂÙ·È ÛÂ
8.335 km2
, Ì ÌfiÓÈÌÔ ÏËı˘ÛÌfi 594.368 ηÙÔ›ÎÔ˘˜ (· ÔÁÚ·-
Ê‹ 2001), · fi ÙÔ˘˜ Ô Ô›Ô˘˜ 142.880 ‹ 24% Â›Ó·È <19 ÂÙÒÓ.
∆Ô 42% ÙÔ˘ ÏËı˘ÛÌÔ‡ Â›Ó·È ·ÁÚÔÙÈÎfi˜, ÙÔ 46% ·ÛÙÈÎfi˜ ηÈ
ÙÔ 12% ËÌÈ·ÛÙÈÎfi˜.
¶ÏËı˘ÛÌfi˜ ÌÂϤÙ˘
°È· ÙË ÌÂϤÙË Â ÈϤ¯ıËÎ·Ó Î·È ÂÏ‹ÊıËÛ·Ó · fi fiϘ Û¯Â-
‰fiÓ Ù˘ ÂÚÈÔ¯¤˜ Ù˘ ∫Ú‹Ù˘ (∂ÈÎfiÓ· 1) 5.321 ·È‰È¿ ηÈ
¤ÊË‚ÔÈ - 2.643 ·ÁfiÚÈ· Î·È 2.678 ÎÔÚ›ÙÛÈ·, ËÏÈΛ·˜ 2,5-16,5
ÂÙÒÓ, ÙˆÓ Ô Ô›ˆÓ ÌÂÙÚ‹ıËÎÂ Ë ¶ª. ∆· ·È‰È¿ Î·È ÔÈ ¤ÊË‚ÔÈ
Û˘ÌÌÂÙ›¯·Ó Û ·ÓÙÈ ÚÔÛˆ ¢ÙÈο ‰Â›ÁÌ·Ù· ·È‰ÈÎÒÓ Î·È
ÂÊË‚ÈÎÒÓ ÏËı˘ÛÌÒÓ Â Ù¿ ‰È·¯ÚÔÓÈÎÒÓ Î·È Û˘Á¯ÚÔÓÈÎÒÓ
ÌÂÏÂÙÒÓ (¶›Ó·Î·˜ 1) Ô˘ ‰ÈÂÍ‹¯ıËÛ·Ó · fi ÙËÓ ∫ÏÈÓÈ΋
¶ÚÔÏË ÙÈ΋˜ π·ÙÚÈ΋˜ Î·È ¢È·ÙÚÔÊ‹˜, Ù˘ π·ÙÚÈ΋˜ ™¯ÔÏ‹˜
ÙÔ˘ ¶·Ó ÈÛÙËÌ›Ô˘ ∫Ú‹Ù˘.
√È ÌÂϤÙ˜ ·˘Ù¤˜ Ô˘ ‰ÈÂÍ‹¯ıËÛ·Ó ÌÂٷ͇ ÙˆÓ ÂÙÒÓ
1992 Î·È 2005, ·ÊÔÚÔ‡Û·Ó ¶ÚÔÁÚ¿ÌÌ·Ù· ∞ÁˆÁ‹˜ Î·È ¶ÚÔ·-
ÁˆÁ‹˜ Ù˘ ÀÁ›·˜ ÁÈ· ÙË ÛˆÌ·ÙÈ΋ ·Ó¿ Ù˘ÍË Î·È ÙËÓ ÚfiÏË-
„Ë ·Ú·ÁfiÓÙˆÓ ÎÈÓ‰‡ÓÔ˘.
∏  ÈÏÔÁ‹ ÙˆÓ ·È‰ÈÒÓ ÛÙȘ  ٿ ÌÂϤÙ˜ ‹Ù·Ó Ù˘¯·›· -
ÔÏ˘ÛÙ·‰È·Î‹. ∞ÊÔ‡  ÈϤ¯ıËÎ·Ó Ù˘¯·›· ÔÈ ÂÚÈÔ¯¤˜ ÌÂϤÙ˘
(·ÛÙÈΤ˜, ËÌÈ·ÛÙÈΤ˜ Î·È ·ÁÚÔÙÈΤ˜) Î·È ÂÓ Û˘Ó¯›· Ù· Û¯ÔÏ›·
ÙˆÓ ÂÚÈÔ¯ÒÓ, Û˘Ì ÂÚÈÂÏ‹ÊıËÛ·Ó fiÏ· Ù· ·È‰È¿ ÙˆÓ Û¯ÔÏ›-
ˆÓ. ¶ÂÚÈÛÛfiÙÂÚ˜ Ï ÙÔ̤ÚÂȘ ˆÛÙfiÛÔ ·Ó·Ê¤ÚÔÓÙ·È ÛÂ
ÚÔËÁÔ‡ÌÂÓ˜ ‰ËÌÔÛÈÂ˘Ì¤Ó˜ ÂÚÁ·Û›Â˜ ÙˆÓ ÌÂÏÂÙÒÓ (12-20).
∂ ›Û˘, ÔÈ ÂÍÂÙ¿ÛÂȘ ÙˆÓ ·È‰ÈÒÓ ¤ÁÈÓ·Ó ÛÙÔÓ ¯ÒÚÔ ÙˆÓ
Û¯ÔÏ›ˆÓ ÙÔ˘˜ ηÙfi ÈÓ ¤ÁÎÚÈÛ˘ ÙˆÓ ÚÔÁÚ·ÌÌ¿ÙˆÓ Î·È ÙˆÓ
ÂÍÂÙ¿ÛÂÒÓ ÙÔ˘˜ · fi ÙÔ À Ô˘ÚÁÂ›Ô ¶·È‰Â›·˜, ÂÓÒ ÁÈ· ÙË Û˘Ì-
ÌÂÙÔ¯‹ ÙÔ˘˜ ÚÔËÁ‹ıËΠϠÙÔÌÂÚ‹˜ ÂÓË̤ڈÛË Î·È ÂÓ˘-
fiÁÚ·ÊË Û˘ÁηٿıÂÛË ÙˆÓ ÁÔÓ¤ˆÓ. ¶ÚÔËÁ‹ıËΠ·ÎfiÌË
¤ÁÎÚÈÛË ÙˆÓ ÌÂÏÂÙÒÓ · fi ÙËÓ Â ÈÙÚÔ ‹ ∏ıÈ΋˜ Î·È ¢ÂÔÓÙÔ-
ÏÔÁ›·˜ ÙÔ˘ ¶·Ó ÈÛÙËÌ›Ô˘ ∫Ú‹Ù˘.
ª¤ÙÚËÛË ¶ÂÚÈ̤ÙÚÔ˘ ª¤Û˘
∏ ̤ÙÚËÛË Ù˘ ¶ª ¤ÁÈÓ ¯ˆÚ›˜ ÚÔ‡¯·, Û ÂηÙÔÛÙ¿, ÌÂ
Ï·ÛÙÈ΋ ÌÂÙÚÈ΋ Ù·ÈÓ›·, οوıÂÓ ÙÔ˘ Ï¢ÚÈÎÔ‡ ÙfiÍÔ˘ -
ÛÙÔ Ì¤ÛÔ Ù˘ · fiÛÙ·Û˘ ÌÂٷ͇ Ï¢ÚÈÎÔ‡ ÙfiÍÔ˘ Î·È Ï·ÁÔ-
Ó›Ô˘ ·ÎÚÔÏÔÊ›·˜ (∂ÈÎfiÓ· 2).
™Ù·ÙÈÛÙÈ΋ ·Ó¿Ï˘ÛË
∏ ·Ó¿Ï˘ÛË ÙˆÓ ‰Â‰ÔÌ¤ÓˆÓ ¤ÁÈÓ Ì ÙË ¯Ú‹ÛË ÙÔ˘ ÚÔ-
ÁÚ¿ÌÌ·ÙÔ˜ SPSS 13.0. ™ÙÔÓ ˘ ÔÏÔÁÈÛÌfi ÙˆÓ ∂£ Ù˘ ¶ª, η-
ıÒ˜ Î·È ÛÙË ÁÚ·ÊÈ΋ · ÂÈÎfiÓÈÛË ÙˆÓ Î·Ì ˘ÏÒÓ ÙÔ˘˜, ˘ Ô-
ÏÔÁ›ÛÙËÎ·Ó ÔÈ ËÏÈ˘ Û ‰È·ÛÙ‹Ì·Ù· ËÏÈÎÈ·ÎÒÓ ÔÌ¿‰ˆÓ. ™˘-
ÁÎÂÎÚÈ̤ӷ, Ë ËÏÈΛ· ÙˆÓ 3 ÂÙÒÓ ·ÊÔÚ¿ ÙÔ ‰È¿ÛÙËÌ· · fi 2,5
¤ˆ˜ 3,4 ¤ÙË, ÙˆÓ 4 ÙÔ ‰È¿ÛÙËÌ· · fi 3,5 ¤ˆ˜ 4,4 ¤ÙË, Î.Ô.Î.
¶ÔÏ˘ˆÓ˘ÌÈο ÌÔÓ٤Ϸ ÚÔÛ·ÚÌÔÁ‹˜ Áã ‚·ıÌÔ‡ (cubic
models) (21,22) ¯ÚËÛÈÌÔ ÔÈ‹ıËÎ·Ó ÁÈ· ÙËÓ ÂÍÔÌ¿Ï˘ÓÛË ÙˆÓ
ÙÈÌÒÓ ÙˆÓ ·‰ÚÒÓ ∂£, Ù· Ô Ô›· ¤‰ˆÛ·Ó Û˘ÓÙÂÏÂÛÙ¤˜ ÚÔÛ·Ú-
ÌÔÁ‹˜ (R2
) ÌÂÁ·Ï‡ÙÂÚÔ˘˜ ÙÔ˘ 98%.
ªÂ ÙË Ì¤ıÔ‰Ô ÂϤÁ¯Ô˘ Student · ÏÔ‡ ‰Â›ÁÌ·ÙÔ˜ (One
sample t test) ¤ÁÈÓ ۇÁÎÚÈÛË ÙˆÓ Ì¤ÛˆÓ ÙÈÌÒÓ Ù˘ ¶ª ÙˆÓ
·È‰ÈÒÓ Ù˘ ·ÚÔ‡Û·˜ ÌÂϤÙ˘ Ì ÂΛӘ ¿ÏÏˆÓ ÂÚ¢ÓÒÓ
(22-30), ÂÓÒ ·Ó· ·Ú·ÛÙ¿ıËÎ·Ó ÁÚ·ÊÈο ÔÈ 90¤˜ ∂£ ÙˆÓ ÌÂ-
ÏÂÙÒÓ ·˘ÙÒÓ (· fi ÙË ÌÂϤÙË ÙˆÓ Fredriks et al, 2005 (23)
¯ÚËÛÈÌÔ ÔÈ‹ıËÎ·Ó ÔÈ ÙÈ̤˜ Ù˘ +2SD). ∏  ÈÏÔÁ‹ Ù˘ 90‹˜
∂£ Ù˘ ¶ª ·ÊÔÚ¿ ÙË ¯Ú‹ÛË Ù˘ ˆ˜ fiÚÈÔ Î·ıÔÚÈÛÌÔ‡ ÙˆÓ
Ê˘ÛÈÔÏÔÁÈÎÒÓ - ·¯‡Û·ÚÎˆÓ ·È‰ÈÒÓ Î·È ÂÊ‹‚ˆÓ.
¡. ÷ӛˆÓ
¢È·¯ÚÔÓÈΤ˜
ÌÂϤÙ˜ ™‡Á¯ÚÔÓ˜
ÌÂϤÙ˜
¡. ƒÂı‡ÌÓÔ˘
¡. ∏Ú·ÎÏ›Ԣ
¡. §·ÛÈı›Ô˘
∂ÈÎfiÓ· 1. ÿÚÙ˘ Ù˘ ∫Ú‹Ù˘. √È Î‡ÎÏÔÈ ‰Â›¯ÓÔ˘Ó ÙȘ ÂÚÈÔ¯¤˜
· fi ÙȘ Ô Ô›Â˜ ÚÔ¤Ú¯ÔÓÙ·È Ù· ·È‰È¿ Î·È ÔÈ ¤ÊË‚ÔÈ Ù˘ ÌÂϤÙ˘.
301∂ηÙÔÛÙÈ·›Â˜ ı¤ÛÂȘ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ ·È‰ÈÒÓ
¶·È‰È·ÙÚÈ΋ 2007;70:300-307
Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·301
302 ∂. §ÈÓ·Ú‰¿Î˘ Î·È Û˘Ó.
Paediatriki 2007;70:300-307
¶›Ó·Î·˜1.™˘Á¯ÚÔÓÈΤ˜Î·È‰È·¯ÚÔÓÈΤ˜ÌÂϤÙ˜-ÚÔÁÚ¿ÌÌ·Ù·ÙÔ˘¶·ÓÂÈÛÙËÌ›Ô˘∫Ú‹ÙË˜Ô˘Û˘ÌÌÂÙ›¯·ÓÛÙËÓ·ÚÔ‡Û·ÌÂϤÙË,ÁÈ·ÙÔÓ˘ÔÏÔÁÈÛÌfiÙˆÓÂηÙÔÛÙÈ·›ˆÓı¤ÛˆÓÙ˘ÂÚÈ̤ÙÚÔ˘
̤Û˘5.321·È‰ÈÒÓÙ˘∫Ú‹Ù˘,ËÏÈΛ·˜2,5¤ˆ˜16,5ÂÙÒÓ,ÌÂ7.538ÌÂÙÚ‹ÛÂȘ
ªÂϤÙË-∂›‰Ô˜ŒÙÔ˜ÃÒÚÔ˜∏ÏÈΛ·ªÂÙÚ‹ÛÂȘµÈ‚ÏÈÔÁÚ·Ê›·
¶ÚfiÁÚ·ÌÌ·∂ͤٷÛ˘ÌÂϤÙ˘(¤ÙË)∞ÁfiÚÈ·∫ÔÚ›ÙÛÈ·
¶ÚfiÁÚ·ÌÌ·∂Î·È‰Â˘ÙÈ΋˜¢È·¯ÚÔÓÈ΋1ËÂͤÙ.-1992¢ËÌÔÙÈο™¯ÔÏ›·¡ÔÌÒÓ∏Ú·ÎÏ›Ԣ,5,0-8,5621574∫·Ê¿ÙԘηÈÛ˘Ó,1998[12]
¶·Ú¤Ì‚·Û˘ƒÂı‡ÌÓÔ˘,÷ӛˆÓηȧ·ÛÈı›Ô˘†
2ËÂͤÙ.-1995¢ËÌÔÙÈο™¯ÔÏ›·¡ÔÌÒÓ∏Ú·ÎÏ›Ԣ,7,6-9,9241233Maniosetal,1999[13]
ƒÂı‡ÌÓԢηÈ÷ӛˆÓ
3ËÂͤÙ.-1998¢ËÌÔÙÈο™¯ÔÏ›·¡ÔÌÒÓ∏Ú·ÎÏ›Ԣ,10,2-13,1408409Maniosetal,2002[14]
ƒÂı‡ÌÓԢηÈ÷ӛˆÓ
4ËÂͤÙ.-2002°˘ÌÓ¿ÛÈ·-§‡ÎÂÈ·¡ÔÌÒÓ∏Ú·ÎÏ›Ԣ,13,6-16,5292322Kafatosetal,2005[15]
ƒÂı‡ÌÓԢηÈ÷ӛˆÓ
¶ÚfiÁÚ·ÌÌ·∂Î·È‰Â˘ÙÈ΋˜¢È·¯ÚÔÓÈ΋1ËÂͤÙ.-1999¢ËÌÔÙÈοηȰ˘ÌÓ¿ÛÈ·¡ÔÌÒÓ9,2-16,5373430Moschandreasetal,2003[16]
¶·Ú¤Ì‚·Û˘∏Ú·ÎÏ›Ԣ,ƒÂı‡ÌÓÔ˘Î·È§·ÛÈı›Ô˘
2ËÂͤÙ.-2000-//-10,0-16,5215258¶·È‰·ÁˆÁÈÎfiπÓÛÙÈÙÔ‡ÙÔ[17]
¶ÚfiÁÚ·ÌÌ·¶ÚÔ·ÁˆÁ‹˜Ù˘ÀÁ›·˜™˘Á¯ÚÔÓÈ΋2000¢ËÌÔÙÈο™¯ÔÏ›·
(¢‹ÌÔ˜∞Á.¡ÈÎÔÏ¿Ô˘)¢‹ÌÔ˘∞Á.¡ÈÎÔÏ¿Ô˘8,1-13,8173175∞‰ËÌÔÛ›Â˘Ù·™ÙÔȯ›·
¶ÚfiÁÚ·ÌÌ·¶ÚÔ·ÁˆÁ‹˜Ù˘ÀÁ›·˜™˘Á¯ÚÔÓÈ΋2001¡ËÈ·ÁˆÁ›Ô,¢ËÌÔÙÈÎfiηȰ˘ÌÓ¿ÛÈÔ4,0-15,39299ªÔÛ¯·Ó‰Ú¤·Î·ÈÛ˘Ó,2003[18]
(¢‹ÌÔ˜ƒÔ‡‚·)¢‹ÌÔ˘ƒÔ‡‚·∏Ú·ÎÏ›Ԣ
¶ÚfiÁÚ·ÌÌ·ÕıÏËÛ˘ηȢȷÙÚÔÊ‹˜™˘Á¯ÚÔÓÈ΋2003-04™¯ÔÏ›·¢‹ÌˆÓ∏Ú·ÎÏ›Ԣ,2,8-16,5382426§ÈÓ·Ú‰¿Î˘ª,2005[19]
∆˘Ï›ÛԢηÈÃÂÚÛÔÓ‹ÛÔ˘
¶ÚfiÁÚ·ÌÌ·¶ÚÔ·ÁˆÁ‹˜Ù˘ÀÁ›·˜™˘Á¯ÚÔÓÈ΋2004¶·È‰ÈÎÔ›™Ù·ıÌÔ›∏Ú·ÎÏ›Ԣ2,5-6,17345∞‰ËÌÔÛ›Â˘Ù·™ÙÔȯ›·
(¶·È‰ÈÎÔ›™Ù·ıÌÔ›∏Ú·ÎÏ›Ԣ)
¶ÚfiÁÚ·ÌÌ·∂Î·È‰Â˘ÙÈ΋˜¢È·¯ÚÔÓÈ΋1ËÂͤÙ.-2004/05¡ËÈ·ÁˆÁ›·fiψÓÙˆÓ¢‹ÌˆÓηÈ4,0-7,0864833∫·Ê¿ÙԘηÈÛ˘Ó,2005[20]
¶·Ú¤Ì‚·Û˘∫ÔÈÓÔًوÓÙÔ˘¡ÔÌԇ÷ӛˆÓ
™‡ÓÔÏÔÌÂÙÚ‹ÛˆÓ3.7343.804
™‡ÓÔÏԷȉÈÒÓ2.643*
2.678
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109·ÁfiÚȷηÈ111ÎÔÚ›ÙÛÈ·
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Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·302
∞ ÔÙÂϤÛÌ·Ù·
√È ·Ó¿ ËÏÈΛ· Î·È Ê‡ÏÔ Ì¤Û˜ ÙÈ̤˜ Î·È Ù˘ ÈΤ˜
· ÔÎÏ›ÛÂȘ Ù˘ ¶ª ÙˆÓ ·È‰ÈÒÓ Î·È ÙˆÓ ÂÊ‹‚ˆÓ
·ÚÔ˘ÛÈ¿˙ÔÓÙ·È ÛÙÔÓ ¶›Ó·Î· 2.
™ÙÔÓ ¶›Ó·Î· 3 ÂÚÈÏ·Ì‚¿ÓÔÓÙ·È ÔÈ ÂȉÈΤ˜ ·Ó¿
ʇÏÔ Î·È ËÏÈΛ· ÂÍÔÌ·Ï˘Ṳ̂Ó˜ ∂£ Ù˘ ¶ª. √È ∂£
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∂£ Ì ÙË ÁÚ·ÊÈ΋ ÙÔ˘˜ · ÂÈÎfiÓÈÛË Ó· ·ÚÔ˘ÛÈ¿˙Â-
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™ÙÔÓ ¶›Ó·Î· 4 ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È ÔÈ ·Ó¿ ʇÏÔ Î·È
ËÏÈΛ· ̤Û˜ Î·È ‰È¿ÌÂÛ˜ ÙÈ̤˜ Ù˘ ¶ª, Ù˘ ·-
ÚÔ‡Û·˜ ÌÂϤÙ˘ Û ۇÁÎÚÈÛË Ì ÂΛӘ ÌÂÏÂÙÒÓ
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Ÿ ˆ˜ Ê·›ÓÂÙ·È, Ù· ·È‰È¿ Ù˘ ∫Ú‹Ù˘ ¤¯Ô˘Ó ÛÙȘ
ÂÚÈÛÛfiÙÂÚ˜ ËÏÈ˘ ÛËÌ·ÓÙÈο (p<0,05) ˘„ËÏfiÙÂ-
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Λ·˜ ·È‰È¿ Ù˘ ∫‡ ÚÔ˘ Î·È ÙˆÓ ∏¶∞, ÂÓÒ Û fiϘ
ÙȘ ËÏÈ˘ ¤¯Ô˘Ó ÛËÌ·ÓÙÈο ˘„ËÏfiÙÂÚ˜ ̤Û˜ ÙÈ-
̤˜ · fi Ù· ·È‰È¿ Ù˘ √ÏÏ·Ó‰›·˜, Ù˘ ª. µÚÂÙ·Ó›·˜,
Ù˘ ∞˘ÛÙÚ·Ï›·˜ Î·È ÙÔ˘ ∫·Ó·‰¿. ∂ ›Û˘, ‰ÂÓ ‰È·Ê¤-
ÚÔ˘Ó ÛËÌ·ÓÙÈο ÛÙȘ ÂÚÈÛÛfiÙÂÚ˜ ËÏÈ˘ · fi Ù·
·È‰È¿ Ù˘ πÛ ·Ó›·˜ (p>0,05), ÂÓÒ ¤¯Ô˘Ó ÛËÌ·ÓÙÈο
¯·ÌËÏfiÙÂÚ˜ ÙÈ̤˜ ¶ª (50‹ ∂£) · fi ÂΛӷ Ù˘
πÙ·Ï›·˜ (p<0,001).
∆¤ÏÔ˜, ÛÙËÓ ∂ÈÎfiÓ· 4 ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È Ì¤Ûˆ ÁÚ·-
ÊÈÎÒÓ Ù· fiÚÈ· Ù˘ 90‹˜ ∂£ Ù˘ ¶ª ÁÈ· ÙȘ ÚÔ·Ó·-
ÊÂÚı›Û˜ ¯ÒÚ˜. ∆· ·È‰È¿ Ù˘ πÙ·Ï›·˜ Ê·›ÓÔÓÙ·È
Ó· ¤¯Ô˘Ó ÙËÓ ˘„ËÏfiÙÂÚË 90‹ ∂£ Î·È Ù· ·È‰È¿ Ù˘
ª. µÚÂÙ·Ó›·˜ ÙË ¯·ÌËÏfiÙÂÚË, ÂÓÒ ÂΛӷ Ù˘ ∫Ú‹-
Ù˘ ¤¯Ô˘Ó ۯ‰fiÓ ·ÚfiÌÔÈ· 90‹ ∂£ ÌfiÓÔ Ì ٷ ·È-
‰È¿ ÙˆÓ ∏¶∞.
™˘˙‹ÙËÛË
™ÙËÓ ·ÚÔ‡Û· ÌÂϤÙË ˘ ÔÏÔÁ›ÛÙËÎ·Ó Î·È ·-
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Ù˘ ∫Ú‹Ù˘. ∆· ·È‰È¿ Î·È ÔÈ ¤ÊË‚ÔÈ Ù˘ ∫Ú‹Ù˘
‚Ú¤ıËÎ·Ó Ó· ¤¯Ô˘Ó · fi ÙȘ ˘„ËÏfiÙÂÚ˜ ÙÈ̤˜ ÎÂ-
ÓÙÚÈ΋˜ ·¯˘Û·ÚΛ·˜, Ì ÂÍ·›ÚÂÛË ·Ó¿ÏÔÁ˘ ËÏÈ-
Λ·˜ ·È‰È¿ Ù˘ πÙ·Ï›·˜.
√È ÂÚÈÛÛfiÙÂÚ˜ · fi ÙȘ ‰ËÌÔÛÈÂ˘Ì¤Ó˜ ÌÂϤÙ˜
ÙˆÓ ¯ˆÚÒÓ ∫‡ ÚÔ˘, πÙ·Ï›·˜, πÛ ·Ó›·˜, ª. µÚÂÙ·Ó›·˜,
¶›Ó·Î·˜ 2. ¶ÂÚ›ÌÂÙÚÔ˜ ̤Û˘ 7.538 ÌÂÙÚ‹ÛÂˆÓ 5.321 ·È‰ÈÒÓ
Ù˘ ∫Ú‹Ù˘
∞ÁfiÚÈ· ∫ÔÚ›ÙÛÈ·
∏ÏÈΛ· ¡ ª¤ÛË ÙÈÌ‹ ¡ ª¤ÛË ÙÈÌ‹
(¤ÙË)†
(∆∞)#
(∆∞)
3 44 50,5 (3,9)*
33 52,2 (3,9)
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5 421 55,1 (5,9) 389 54,7 (5,4)
6 872 56,3 (7,1) 834 55,1 (6,0)
7 213 56,8 (6,3) 181 55,1 (5,7)
8 113 59,7 (6,4) 108 59,9 (8,2)
9 220 62,6 (8,4) 213 61,7 (8,9)
10 170 68,1 (9,9) 173 66,2 (9,2)
11 384 71,4 (10,7) 414 68,6 (9,7)
12 427 71,6 (10,6) 417 69,2 (9,8)
13 84 72,5 (9,7) 113 69,5 (9,2)
14 156 76,9 (10,8) 192 71,8 (7,9)
15 357 78,2 (10,4) 457 71,8 (8,0)
16 177 81,8 (12,9) 181 72,7 (9,1)
#
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†
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*
√È ÙÈ̤˜ Â›Ó·È Û ÂηÙÔÛÙ¿ (cm)
∂ÈÎfiÓ· 2. ™¯ËÌ·ÙÈ΋ · ÂÈÎfiÓÈÛË Ì¤ÙÚËÛ˘ ÂÚÈ̤ÙÚÔ˘ ̤Û˘.
ªÂٷ͇
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ÛÙÔ ‡„Ô˜
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100
90
80
70
60
50
40
3 4 5 6 7 8 9 10 11 12 13 14 15 16
∏ÏÈΛ· (¤ÙË)
ÎÔÚ›ÙÛÈ·
510
25
50
75
85
90
95
¶ÂÚ›ÌÂÙÚÔ˜ª¤Û˘(cm)
·ÁfiÚÈ·
510
25
50
75
85
90
95
110
100
90
80
70
60
50
40
3 4 5 6 7 8 9 10 11 12 13 14 15 16
∏ÏÈΛ· (¤ÙË)
¶ÂÚ›ÌÂÙÚÔ˜ª¤Û˘(cm)
∂ÈÎfiÓ· 3. ∫·Ì ‡Ï˜ ÂηÙÔÛÙÈ·›ˆÓ ı¤ÛÂˆÓ ÂÚÈ̤ÙÚÔ˘ ̤Û˘.
303∂ηÙÔÛÙÈ·›Â˜ ı¤ÛÂȘ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ ·È‰ÈÒÓ
¶·È‰È·ÙÚÈ΋ 2007;70:300-307
Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·303
√ÏÏ·Ó‰›·˜, ∞˘ÛÙÚ·Ï›·˜, ∫·Ó·‰¿ Î·È ∏¶∞ (22-29),
Ô˘ ·ÊÔÚÔ‡Ó ÂÚÁ·Û›Â˜ ˘ ÔÏÔÁÈÛÌÔ‡ ∂£ Ù˘ ¶ª,
· ÔÙÂÏÔ‡Ó Û˘Á¯ÚÔÓÈΤ˜ ÌÂϤÙ˜ Î·È ¤¯Ô˘Ó ‰ÈÂÍ·-
¯ı› Û ‰È·ÛÙ‹Ì·Ù· ‰È¿ÚÎÂÈ·˜ ÌÈÎÚfiÙÂÚ˘ ÙˆÓ ‰‡Ô
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¯ÚÔÓÈο ‰È·ÛÙ‹Ì·Ù· ¤¯ÂÈ ‹‰Ë ÂÊ·ÚÌÔÛÙ› Û ∏¶∞
Î·È ª. µÚÂÙ·Ó›· (30,31).
∏ ¶ª Â›Ó·È · Ï‹ Î·È Â‡ÎÔÏË ÛÙË Ì¤ÙÚËÛ‹ Ù˘
·ÏÏ¿ Î·È ÌÂÁ¿Ï˘ Û Ô˘‰·ÈfiÙËÙ·˜, ηıÒ˜ Â›Ó·È ‰Â›-
ÎÙ˘ ÎÂÓÙÚÈ΋˜ ·¯˘Û·ÚΛ·˜. √È Mamalakis Î·È Û˘Ó.
(5), ¤‰ÂÈÍ·Ó fiÙÈ Ë Û‡ÓıÂÛË Û ÏÈ ·Ú¿ Ôͤ· ÙÔ˘ ÎÔÈ-
ÏÈ·ÎÔ‡ ˘ Ô‰fiÚÈÔ˘ Ï› Ô˘˜ Â›Ó·È ÛËÌ·ÓÙÈο ‰˘ÛÌÂÓ¤-
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ÛÌ¤ÓˆÓ Î·È trans ÏÈ ·ÚÒÓ ÔͤˆÓ Î·È ¯·ÌËÏfiÙÂÚ·
ÌÔÓÔ·ÎfiÚÂÛÙˆÓ Î·È ÔÏ˘·ÎfiÚÂÛÙˆÓ) Î·È Û¯ÂÙ›˙ÂÙ·È
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ϤÔÓ, Ë ÎÂÓÙÚÈ΋ ·¯˘Û·ÚΛ· · ÔÙÂÏ› ¤Ó·Ó · fi
ÙÔ˘˜ ·Ú¿ÁÔÓÙ˜ ÙÔ˘ ÌÂÙ·‚ÔÏÈÎÔ‡ Û˘Ó‰ÚfiÌÔ˘ (6-
11). √È Moreno Î·È Û˘Ó. (11), ·Ó·Ê¤ÚÔ˘Ó fiÙÈ Ë ¶ª
ˆ˜ ‰Â›ÎÙ˘ ·¯˘Û·ÚΛ·˜ · ÔÙÂÏ› Û ·È‰È¿ ηÈ
ÂÊ‹‚Ô˘˜ ηχÙÂÚÔ ÚÔÁÓˆÛÙÈÎfi ‰Â›ÎÙË ÙÔ˘ ÌÂÙ·-
‚ÔÏÈÎÔ‡ Û˘Ó‰ÚfiÌÔ˘, · fi fi,ÙÈ Ô ‰Â›ÎÙ˘ Ì¿˙·˜ ÛÒ-
Ì·ÙÔ˜ (¢ª™) ‹ ÙÔ ¿¯Ô˜ ÙˆÓ ‰ÂÚÌ·ÙÈÎÒÓ Ù˘¯ÒÓ.
°È· ÙËÓ ·˘Í·ÓfiÌÂÓË Û˘¯ÓfiÙËÙ· Ù˘ ·¯˘Û·ÚΛ·˜
Î·È ÙÔ˘ ÌÂÙ·‚ÔÏÈÎÔ‡ Û˘Ó‰ÚfiÌÔ˘ ÛÙ· ·È‰È¿ ηÈ
ÛÙÔ˘˜ ÂÊ‹‚Ô˘˜ ¢ı‡ÓÔÓÙ·È Î˘Ú›ˆ˜ Ë ¤ÏÏÂÈ„Ë ÛˆÌ·-
ÙÈ΋˜ ¿ÛÎËÛ˘, Ë Î·Î‹ ‰È·ÙÚÔÊ‹ Î·È ÙÔ stress, Ô˘
Ô‰ËÁÔ‡Ó Û · ÔÚÚ‡ıÌÈÛË ÙÔ˘ ¿ÍÔÓ· ˘ Ôı·Ï¿ÌÔ˘-
˘ fiÊ˘Û˘- ÈÓÂÊÚȉ›ˆÓ (32). ∏ ÎÂÓÙÚÈ΋ ·¯˘Û·Ú-
Λ· Û¯ÂÙ›˙ÂÙ·È Ì ·ÓÙ›ÛÙ·ÛË ÛÙË ‰Ú¿ÛË Ù˘ ÈÓÛÔ˘Ï›-
Ó˘, ·‡ÍËÛË ÙˆÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ, Ì›ˆÛË Ù˘ HDL
¯ÔÏËÛÙÂÚfiÏ˘ Î·È ·‡ÍËÛË ÙÔ˘ ۷ί¿ÚÔ˘. ™ Ô˘‰·›Ô
ÚfiÏÔ Â ›Û˘ Ê·›ÓÂÙ·È ˆ˜ ¤¯ÂÈ Ë ÔÚÌÔÓÈ΋ ‰Ú¿ÛË
Ù˘ Ï ٛÓ˘, ηıÒ˜ ¤¯ÂÈ ‚ÚÂı› Û ·È‰È¿ Î·È ÂÓ‹-
ÏÈΘ Ó· Û¯ÂÙ›˙ÂÙ·È Ì ÙÔ˘˜ ·Ú· ¿Óˆ ·Ú¿ÁÔÓÙ˜
Î·È È‰È·›ÙÂÚ· Ì ÙËÓ ÎÂÓÙÚÈ΋ ·¯˘Û·ÚΛ· Ô˘ Ô‰Ë-
Á› Û ۷ί·ÚÒ‰Ë ‰È·‚‹ÙË Ù‡ Ô˘ 2 (33-35).
™Â 1.209 ·È‰È¿ Î·È ÂÊ‹‚Ô˘˜ Ù˘ ∫Ú‹Ù˘ ËÏÈΛ·˜
3-18 ÂÙÒÓ (19), ‚Ú¤ıËÎ·Ó 48 ·È‰È¿ (3,9%) Ì ÙÚÂȘ ‹
ÂÚÈÛÛfiÙÂÚ˜ Û˘ÓÈÛÙÒÛ˜ ÌÂÙ·‚ÔÏÈÎÔ‡ Û˘Ó‰ÚfiÌÔ˘,
ÂÎ ÙˆÓ Ô Ô›ˆÓ ÙÔ 62% ›¯·Ó ÎÂÓÙÚÈ΋ ·¯˘Û·ÚΛ·
(¶ª>90‹ ∂£). ™ÙÔ Û‡ÓÔÏÔ ÙˆÓ ·È‰ÈÒÓ, ÙÔ 8,5%
‚Ú¤ıËΠ̠ÎÂÓÙÚÈ΋ ·¯˘Û·ÚΛ·, ÂÓÒ, Ì ‚¿ÛË ÙÔÓ
¢ª™ (fiÚÈ· International Obesity Task Force - IOTF)
304 ∂. §ÈÓ·Ú‰¿Î˘ Î·È Û˘Ó.
Paediatriki 2007;70:300-307
¶›Ó·Î·˜ 3. ∆È̤˜ ÂÍÔÌ·Ï˘ÛÌ¤ÓˆÓ ÂηÙÔÛÙÈ·›ˆÓ ı¤ÛÂˆÓ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ 7.538 ÌÂÙÚ‹ÛÂˆÓ 5.321 ·È‰ÈÒÓ Ù˘ ∫Ú‹Ù˘
∏ÏÈΛ· (¤ÙË) 5Ë 10Ë 25Ë 50‹ 75Ë 85Ë 90‹ 95Ë
∞ÁfiÚÈ·
3 45,4 46,8 49,0 51,3 53,1 55,3 56,3 59,1
4 46,3 47,6 49,8 52,0 54,3 56,9 58,5 62,1
5 47,3 48,6 50,8 53,2 56,2 59,0 61,2 65,3
6 48,6 49,8 52,2 54,8 58,6 61,8 64,3 68,6
7 50,0 51,3 53,8 56,8 61,5 64,9 67,7 72,2
8 51,5 52,8 55,6 59,1 64,7 68,3 71,3 75,8
9 53,2 54,6 57,5 61,6 68,1 71,9 75,1 79,5
10 54,9 56,5 59,6 64,2 71,6 75,7 79,0 83,3
11 56,8 58,5 61,8 66,8 75,0 79,4 82,9 87,1
12 58,8 60,6 64,1 69,4 78,2 83,0 86,6 90,9
13 60,9 62,8 66,3 71,9 81,1 86,4 90,2 94,6
14 63,0 65,1 68,5 74,1 83,6 89,4 93,6 98,4
15 65,2 67,5 70,7 76,1 85,5 92,1 96,6 102,0
16 67,4 69,9 72,7 77,8 86,8 94,2 99,1 105,6
∫ÔÚ›ÙÛÈ·
3 46,3 47,4 49,8 52,2 55,2 55,7 56,7 60,5
4 46,3 47,4 49,8 52,2 55,3 57,1 58,5 62,2
5 46,6 47,7 49,9 52,9 56,4 59,2 61,0 64,8
6 47,3 48,5 50,7 54,3 58,3 61,8 64,0 67,8
7 48,4 49,7 52,1 56,2 60,8 64,8 67,3 71,3
8 49,8 51,3 53,9 58,4 63,7 68,0 70,7 75,0
9 51,3 53,0 56,0 60,7 66,8 71,2 74,2 78,6
10 53,0 54,9 58,2 63,2 69,8 74,3 77,4 82,1
11 54,8 56,8 60,4 65,5 72,6 77,0 80,2 85,2
12 56,5 58,6 62,5 67,5 74,9 79,2 82,5 87,8
13 58,2 60,3 64,3 69,2 76,5 80,7 84,1 89,6
14 59,8 61,7 65,6 70,3 77,2 81,4 84,7 90,5
15 61,1 62,8 66,4 70,7 76,8 81,0 84,2 90,3
16 62,2 63,4 66,4 70,7 75,1 79,5 82,5 88,7
Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·304
¶›Ó·Î·˜4.™‡ÁÎÚÈÛË̤ۈÓÙÈÌÒÓÙ˘ÂÚÈ̤ÙÚÔ˘Ì¤Û˘·È‰ÈÒÓÙ˘·ÚÔ‡Û·˜ÌÂϤÙ˘ηÈÌÂÏÂÙÒÓ¿ÏψӯˆÚÒÓ
¶·ÚÔ‡Û·∫‡ÚÔ˜,∏¶∞,√ÏÏ·Ó‰›·,πÛ·Ó›·ª.µÚÂÙ·Ó›·,∞˘ÛÙÚ·Ï›·,πÙ·Ï›·∫·Ó·‰¿˜,
ÌÂϤÙË1999†
(22)1988-94*(27)1996(23)(25)1990(24)1985(26)(30)1981(29)
∏ÏÈΛ·M.T.##
M.T.p-value¢È¿ÌÂÛÔ˜p-valueM.T.p-valueM.T.p-valueM.T.p-valueM.T.p-value¢È¿ÌÂÛÔ˜p-valueM.T.p-value
(¤ÙË)
∞ÁfiÚÈ·
350,5-49,20,03849,70,200-----
454,0-51,3<0,00151,2<0,001-----
555,1-53,3<0,00152,1<0,001-52,3<0,001---
656,355,60,00255,4<0,00153,3<0,00156,00,16052,7<0,001-61,0<0,001-
756,857,60,06857,50,10054,8<0,00157,30,23654,6<0,00155,90,04164,0<0,001-
859,760,40,21859,60,92656,5<0,00160,60,11955,7<0,00158,10,01167,0<0,001-
962,662,80,70161,70,11858,2<0,00163,20,27558,1<0,00160,2<0,00169,0<0,001-
1068,166,50,03463,7<0,00159,9<0,00165,4<0,00159,6<0,00161,3<0,00172,0<0,001-
1171,466,9<0,00165,8<0,00161,8<0,00168,0<0,00161,5<0,00164,6<0,00175,0<0,00163,3<0,001
1271,669,1<0,00167,9<0,00163,9<0,00168,0<0,00163,8<0,00166,6<0,00180,0<0,00165,8<0,001
1372,571,40,29170,00,02066,1<0,00170,60,07366,4<0,00169,40,00482,0<0,00166,5<0,001
1476,975,90,26272,1<0,00168,2<0,00172,8<0,00168,7<0,00171,3<0,001-69,7<0,001
1578,275,2<0,00174,1<0,00170,3<0,001-70,8<0,00173,2<0,001-72,5<0,001
1681,878,70,00276,2<0,00172,3<0,001-71,8<0,001--73,6<0,001
∫ÔÚ›ÙÛÈ·
352,2-49,3<0,00149,2<0,001-----
452,8-51,20,00150,6<0,001-----
554,7-53,1<0,00151,3<0,001-51,3<0,001---
655,155,60,01455,00,68152,5<0,00154,90,37252,2<0,001-63,0<0,001-
755,158,1<0,00156,9<0,00154,00,01156,60,00154,40,10755,60,23566,5<0,001-
859,958,80,15058,80,15055,7<0,00159,00,23455,3<0,00157,30,00169,0<0,001-
961,762,10,52360,70,09957,3<0,00161,40,61156,8<0,00159,1<0,00171,0<0,001-
1066,265,40,25262,5<0,00159,0<0,00164,10,0358,0<0,00161,0<0,00176,0<0,001-
1168,666,1<0,00164,4<0,00160,6<0,00164,9<0,00160,0<0,00162,3<0,00177,0<0,00160,9<0,001
1269,267,0<0,00166,3<0,00162,4<0,00165,3<0,00161,6<0,00164,6<0,00182,0<0,00162,5<0,001
1369,566,4<0,00168,20,12764,1<0,00167,30,01163,6<0,00166,80,00285,0<0,00164,8<0,001
1471,868,1<0,00170,10,00465,6<0,00166,8<0,00164,7<0,00168,2<0,001-65,9<0,001
1571,869,5<0,00172,00,66666,8<0,001-64,9<0,00169,8<0,001-68,3<0,001
1672,768,5<0,00173,90,08167,9<0,001-66,2<0,001--67,9<0,001
#
OnesampleStudenttest
†
√È̤Û˜ÙÈ̤˜‰fiıËηÓÌÂÙ¿·fiÚÔÛˆÈ΋ÂÈÎÔÈÓˆÓ›·,ÂÓÒÔÈ∂£‰ËÌÔÛȇÔÓÙ·ÈÛÙÔObes.Res.2001.*
∆È̤˜ÙˆÓÂ˘Úˆ-·ÌÂÚÈηÓÒÓ.##
M.T.:ª¤ÛË∆ÈÌ‹
305∂ηÙÔÛÙÈ·›Â˜ ı¤ÛÂȘ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ ·È‰ÈÒÓ
¶·È‰È·ÙÚÈ΋ 2007;70:300-307
Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·305
(2), ÙÔ ÔÛÔÛÙfi ÙˆÓ ·¯‡Û·ÚÎˆÓ ·È‰ÈÒÓ ‹Ù·Ó
9,9%. ∏ ‰È·ÊÔÚ¿ ·˘Ù‹ ÔÊ›ÏÂÙ·È Î·Ù¿ ·ÚÈÔ ÏfiÁÔ
ÛÙËÓ Î·Ù·ÓÔÌ‹ ÙÔ˘ Ï› Ô˘˜ ÛÙÔ ÛÒÌ· (ÎÂÓÙÚÈο ‹ Â-
ÚÈÊÂÚÂȷο) Î·È ÛÙÔ fiÙÈ Ù· fiÚÈ· ÙÔ˘ IOTF ‰ÂÓ ÂÚÈ-
Ï·Ì‚¿ÓÔ˘Ó ·È‰È¿ · fi ÙËÓ ∂ÏÏ¿‰· Î·È ÙËÓ ∫Ú‹ÙË.
£· Ú¤ ÂÈ,  Ô̤ӈ˜, ÛÙȘ ÌÂϤÙ˜ Ô˘ ·ÊÔÚÔ‡Ó ÙË
ۈ̷ÙÈ΋ ·Ó¿ Ù˘ÍË ÙˆÓ ·È‰ÈÒÓ, ÙË ÌÂÙ·‚ÔÏ‹ ÙˆÓ
ۈ̷ÙÔÌÂÙÚ‹ÛÂÒÓ ÙÔ˘˜ ·ÏÏ¿ Î·È ÙÔÓ ˘ ÔÏÔÁÈÛÌfi
∂£ Î·È ÙËÓ Î·Ù·Û΢‹ Î·Ì ˘ÏÒÓ ·Ó¿ Ù˘Í˘, Ó·
Ï·Ì‚¿ÓÔÓÙ·È ˘ fi„Ë ÎÔÈÓˆÓÈÎÔ›, ÔÏÈÙÈÛÌÈÎÔ›, ÂÚÈ-
‚·ÏÏÔÓÙÈÎÔ› Î·È ‚ÈÔÏÔÁÈÎÔ› ·Ú¿ÁÔÓÙ˜ (1,36).
∞ fi ÙË Û‡ÁÎÚÈÛË Ù˘ ¶ª ÙˆÓ ·È‰ÈÒÓ Ù˘ ∫Ú‹-
Ù˘ Ì ·È‰È¿ ¿ÏÏˆÓ ¯ˆÚÒÓ Î·È ·Ú¿ ÙÔ ÁÂÁÔÓfi˜ fiÙÈ
Ô Î·ıÔÚÈÛÌfi˜ ÙˆÓ ËÏÈÎÈ·ÎÒÓ ÔÌ¿‰ˆÓ ‰È¤ÊÂÚ ÛÙȘ
ÂÚÈÛÛfiÙÂÚ˜ ÂÚÈ ÙÒÛÂȘ, ‰È· ÈÛÙÒıËΠfiÙÈ Ù·
·È‰È¿ Ù˘ ∫Ú‹Ù˘ ¤¯Ô˘Ó ÌÂÁ·Ï‡ÙÂÚË ¶ª Û ۇ-
ÁÎÚÈÛË Ì ·È‰È¿ ¿ÏÏˆÓ ¯ˆÚÒÓ, Ì ÌÔÓ·‰È΋ ÂÍ·›ÚÂ-
ÛË ÂΛӷ Ù˘ πÙ·Ï›·˜. ∞˘Ùfi ÙÂÎÌËÚÈÒÓÂÙ·È Î·È · fi
ÙÔ ˘„ËÏfi ÔÛÔÛÙfi ÙˆÓ ˘ ¤Ú‚·ÚˆÓ Î·È ·¯‡Û·ÚΈÓ
·È‰ÈÒÓ Ù˘ ∫Ú‹Ù˘ Ô˘ Ì ‚¿ÛË ÙÔÓ ¢ª™ (fiÚÈ·
IOTF) ·Ó¤Ú¯ÂÙ·È Ù· ÙÂÏÂ˘Ù·›· ¯ÚfiÓÈ· ÛÙÔ 33,1%
(19). ™ÙËÓ πÙ·Ï›·, ·ÓÙ›ÛÙÔȯ·, ÙÔ ÔÛÔÛÙfi ˘ ¤Ú‚·-
ÚˆÓ Î·È ·¯‡Û·ÚÎˆÓ ·È‰ÈÒÓ ‚Ú¤ıËΠ˘„ËÏfiÙÂÚÔ,
ÊÙ¿ÓÔÓÙ·˜ ÙÔ 36%, ÂÓÒ ·ÎÔÏÔ˘ıÔ‡Ó Ô ∫·Ó·‰¿˜ ÌÂ
30%, Ë πÛ ·Ó›· Ì 27%, ÔÈ ∏¶∞ Ì 25,6% (ÙÔ 1988-
94) Î·È Ë ª. µÚÂÙ·Ó›· Ì 20% (2).
¢˘ÛÙ˘¯Ò˜, Ë ¤ÏÏÂÈ„Ë ‰ËÌÔÛÈÂ˘Ì¤ÓˆÓ ‰Â‰Ô̤-
ÓˆÓ ∂£ Ù˘ ¶ª ·È‰ÈÒÓ Î·È ÂÊ‹‚ˆÓ · fi ¿ÏϘ Â-
ÚÈÔ¯¤˜ Ù˘ ∂ÏÏ¿‰·˜, ηıÈÛÙÔ‡Ó ·‰‡Ó·ÙË ÙË Û‡ÁÎÚÈ-
ÛË Ì ·È‰È¿ ¿ÏÏˆÓ ÂÚÈÔ¯ÒÓ. ∂ È Ï¤ÔÓ, ÏfiÁˆ
¤Í·ÚÛ˘ Ù˘ ·¯˘Û·ÚΛ·˜ ηٿ Ù· ÙÂÏÂ˘Ù·›· ¯Úfi-
ÓÈ·, ‰ÂÓ ‰‡Ó·Ù·È Ó· ÂÏÂÁ¯ı› Ë ÏËı˘ÛÌȷ΋ Ù¿ÛË
(secular trend) ÙÔ˘ ·È‰ÈÎÔ‡ ÏËı˘ÛÌÔ‡ Û ۯ¤ÛË
Ì ÙËÓ ¶ª. °È’ ·˘Ùfi Ô ˘ ÔÏÔÁÈÛÌfi˜ ∂£ Ù˘ ¶ª ·È-
‰ÈÒÓ Î·È ÂÊ‹‚ˆÓ Ù˘ ∫Ú‹Ù˘, ¤¯ÂÈ È‰È·›ÙÂÚË Û Ô˘-
‰·ÈfiÙËÙ·, ÒÛÙ ÌÂÏÏÔÓÙÈο Ó· ˘ ¿ÚÍÂÈ Ì¤ÙÚÔ Û‡-
ÁÎÚÈÛ˘ ÁÈ· ÙÔÓ ¤ÏÂÁ¯Ô ‰È·¯ÚÔÓÈÎÒÓ ·ÏÏ·ÁÒÓ.
°ÂÓÈο, Â›Ó·È ·Ó·Áη›· Ë ‰ÈÂÍ·ÁˆÁ‹ ÌÂϤÙ˘ ÛÂ
ÂıÓÈÎfi  › Â‰Ô Ì ÙË Ï‹„Ë ·ÓÙÈ ÚÔÛˆ ¢ÙÈÎÔ‡
ÂıÓÈÎÔ‡ ‰Â›ÁÌ·ÙÔ˜ ·È‰ÈÒÓ fiÏˆÓ ÙˆÓ ËÏÈÎÈÒÓ, ÚÔ-
ÎÂÈ̤ÓÔ˘ Ó· ˘ ÔÏÔÁÈÛıÔ‡Ó Î·È Ó· ‰ËÌÈÔ˘ÚÁËıÔ‡Ó
∂£ Î·È Î·Ì ‡Ï˜ ¶ª. ¶·Ú¿ÏÏËÏ·, ÂÎÙfi˜ · fi ÙËÓ
ÂÎÙ›ÌËÛË ÙÔ˘ Â È ¤‰Ô˘ ˘Á›·˜, ıÚ¤„˘ Î·È ·Ó¿ Ù˘-
͢, ÔÈ ∂£ Ù˘ ¶ª Ì ÔÚÔ‡Ó Ó· ÂÓۈ̷وıÔ‡Ó Î·È
ÛÙÔ Û‡ÓÔÏÔ ÙˆÓ Î·Ì ˘ÏÒÓ ·Ó¿ Ù˘Í˘ ÙÔ˘ ‚È‚ÏÈ·Ú›-
Ô˘ ˘Á›·˜ ÙˆÓ ·È‰ÈÒÓ, ÒÛÙ ӷ · ÔÙÂÏÔ‡Ó ¤Ó· ÔÏÔ-
ÎÏËڈ̤ÓÔ Î·È Û‡Á¯ÚÔÓÔ ÂÚÁ·ÏÂ›Ô ÁÈ· ÙÔÓ ¤ÏÏËÓ·
·È‰›·ÙÚÔ Î·È ÁÔÓÈfi.
XÚËÌ·ÙÔ‰fiÙËÛË
∏ ¯ÚËÌ·ÙÔ‰fiÙËÛË ÙˆÓ ¶ÚÔÁÚ·ÌÌ¿ÙˆÓ ∞ÁˆÁ‹˜ Î·È ¶ÚÔ·-
ÁˆÁ‹˜ Ù˘ ÀÁ›·˜ ÙˆÓ ·È‰ÈÒÓ ÚÔÛ¯ÔÏÈ΋˜ ËÏÈΛ·˜ ¤ÁÈÓ · fi
ÙË Friesland Hellas, Î·È ÂÎÂ›ÓˆÓ Ô˘ ·ÊÔÚÔ‡Û·Ó ·È‰È¿ Û¯ÔÏÈ-
΋˜ ËÏÈΛ·˜, · fi ÙË °ÂÓÈ΋ °Ú·ÌÌ·Ù›· ∞ıÏËÙÈÛÌÔ‡, ÙÔ
À Ô˘ÚÁÂ›Ô ¶·È‰Â›·˜ Î·È £ÚËÛÎÂ˘Ì¿ÙˆÓ, ÙÔ ¶·È‰·ÁˆÁÈÎfi
πÓÛÙÈÙÔ‡ÙÔ, ÙȘ ‰ËÌÔÙÈΤ˜ ·˘ÙÔ‰ÈÔÈ΋ÛÂȘ ÙˆÓ ¢‹ÌˆÓ ∞Á. ¡È-
ÎÔÏ¿Ô˘, ƒÔ‡‚·, ÃÂÚÛÔÓ‹ÛÔ˘, ∏Ú·ÎÏ›Ԣ Î·È Ã·Ó›ˆÓ, ηıÒ˜
Î·È ÙË ¡Ô̷گȷ΋ ∞˘ÙÔ‰ÈÔ›ÎËÛË Ã·Ó›ˆÓ.
∂˘¯·ÚÈÛٛ˜
∂˘¯·ÚÈÛÙԇ̠ıÂÚÌ¿ ÁÈ· ÙËÓ ÔÏÔÎÏ‹ÚˆÛË Ù˘ ÌÂϤÙ˘
ÙÔ˘˜ Û˘ÓÂÚÁ¿Ù˜: ÃÚ‹ÛÙÔ Ã·Ù˙‹, ∂ÈÚ‹ÓË ª¿ÚηÙ˙Ë, πˆ¿ÓÓ·
ªÔÛ¯·Ó‰Ú¤·, ªÈ¯¿ÏË ∫˘ÚȷοÎË, ™ÔÊ›· ºÏÔ˘Ú‹, ª·Ú›·
ª ÈÙÛÒÚË, πˆ¿ÓÓ· ∞ ÔÛÙÔÏ¿ÎË, ºÚfiÛˆ ª ÂÚ‚·Ó¿ÎË,
Caroline Codrington, ∞ϛӷ ¶· ·‰¿ÎË, ∫·ÙÂÚ›Ó· ™·ÚÚ‹,
ª˘ÚˆÓ›· §·ÓÙ˙Ô˘Ú¿ÎË Î·È · fi ÙËÓ ¶·È‰È·ÙÚÈ΋ ∫ÏÈÓÈ΋ ÙÔ˘
°ÂÓÈÎÔ‡ ¡ÔÛÔÎÔÌ›Ԣ ÷ӛˆÓ ÙÔ˘˜ ¢ËÌ‹ÙÚË ∞ı·Ó·Ûfi Ô˘ÏÔ
Î·È ∂˘·ÁÁÂÏ›· ª ·ÏˆÌÂÓ¿ÎË. ∂ ›Û˘, · ÔÙÂÏÂÛÌ·ÙÈο Û˘-
Ó¤‚·Ï·Ó ÙÔ π·ÙÚÔÎÔÈÓˆÓÈÎfi ∫¤ÓÙÚÔ Î·È Ë ¢È‡ı˘ÓÛË ¶ÚˆÙÔ-
‚¿ıÌÈ·˜ ∂Î ·›‰Â˘Û˘ ÙÔ˘ ¡ÔÌÔ‡ ÷ӛˆÓ.
µÈ‚ÏÈÔÁÚ·Ê›·
1. Cole TJ. The secular trend in human physical growth: a bi-
ological view. Econ Hum Biol 2003;1:161-168.
2. Lobstein T, Baur L, Uauy R; IASO International Obesity
Taskforce. Obesity in children and young people: a crisis
in public health. Obes Rev 2004;1 (Suppl 5):4-104.
306 ∂. §ÈÓ·Ú‰¿Î˘ Î·È Û˘Ó.
Paediatriki 2007;70:300-307
ª. µÚÂÙ·Ó›·
∞˘ÛÙÚ·Ï›·
ÎÔÚ›ÙÛÈ·
¶ÂÚ›ÌÂÙÚÔ˜ª¤Û˘(cm)
·ÁfiÚÈ·
¶ÂÚ›ÌÂÙÚÔ˜ª¤Û˘(cm)100
95
90
85
80
75
70
65
60
55
50
100
95
90
85
80
75
70
65
60
55
50
∏ÏÈΛ· (¤ÙË)
3 4 5 6 7 8 9 10 11 12 13 14 15 16 3 4 5 6 7 8 9 10 11 12 13 14 15 16
∏ÏÈΛ· (¤ÙË)
πÙ·Ï›·
∫Ú‹ÙË
∏¶∞
∫‡ ÚÔ˜
√ÏÏ·Ó‰›·
∫·Ó·‰¿˜
∞˘ÛÙÚ·Ï›·
ª. µÚÂÙ·Ó›·
πÙ·Ï›·
∫Ú‹ÙË
∏¶∞
∫‡ ÚÔ˜
√ÏÏ·Ó‰›·
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∞˘ÛÙÚ·Ï›·
ª. µÚÂÙ·Ó›·
∂ÈÎfiÓ· 4. ™¯ËÌ·ÙÈ΋ Û‡ÁÎÚÈÛË Î·Ì ˘ÏÒÓ 90˘ ÂηÙÔÛÙÈ·›·˜ ı¤Û˘ ‹/Î·È +2SD Ù˘ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ ·È‰ÈÒÓ ‰È·ÊfiÚˆÓ ÌÂÏÂÙÒÓ.
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Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·307

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  • 1. 300 ∂ƒ∂À¡∏∆π∫∏ ∂ƒ°∞™π∞ ORIGINAL ARTICLE Paediatriki 2007;70:300-307 ∂ηÙÔÛÙÈ·›Â˜ ı¤ÛÂȘ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ ·È‰ÈÒÓ Ù˘ ∫Ú‹Ù˘ ËÏÈΛ·˜ 3 ¤ˆ˜ 16 ÂÙÒÓ ∂. §ÈÓ·Ú‰¿Î˘, ∫. µ·Ú‰·‚¿˜, ∞. ∫·Ê¿ÙÔ˜ ¶ÂÚ›ÏË„Ë ∂ÈÛ·ÁˆÁ‹: ™ÎÔ fi˜ Ù˘ ·ÚÔ‡Û·˜ ÌÂϤÙ˘ ‹Ù·Ó Ô ˘ ÔÏÔÁÈÛÌfi˜ ÂηÙÔÛÙÈ·›ˆÓ ı¤ÛÂˆÓ (∂£) Î·È Ë ‰ËÌÈ- Ô˘ÚÁ›· Î·Ì ˘ÏÒÓ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ (¶ª) ·È‰ÈÒÓ Î·È ÂÊ‹‚ˆÓ Ù˘ ∫Ú‹Ù˘. ÀÏÈÎfi Î·È Ì¤ıÔ‰ÔÈ: ™ÙË ÌÂϤÙË Û˘ÌÌÂÙ›¯·Ó 5.321 ·È‰È¿ - 2.643 ·ÁfiÚÈ· Î·È 2.678 ÎÔÚ›ÙÛÈ·, ËÏÈΛ·˜ 2,5- 16,5 ÂÙÒÓ, Î·È ‰ÈÂÓÂÚÁ‹ıËÎ·Ó 7.538 ÌÂÙÚ‹ÛÂȘ ¶ª. √È ÌÂÙÚ‹ÛÂȘ ·˘Ù¤˜ ÚÔ¤Ú¯ÔÓÙ·È · fi  ٿ ÌÂϤÙ˜ Ô˘ ‰ÈÂÍ‹¯ıËÛ·Ó ÌÂٷ͇ 1992-2005 Û ·ÓÙÈ ÚÔÛˆ ¢ÙÈο ‰Â›ÁÌ·Ù· ·È‰ÈÒÓ, · fi ÙËÓ ∫ÏÈÓÈ΋ ¶ÚÔÏË- ÙÈ΋˜ π·ÙÚÈ΋˜ Î·È ¢È·ÙÚÔÊ‹˜, Ù˘ π·ÙÚÈ΋˜ ™¯ÔÏ‹˜ ÙÔ˘ ¶·Ó ÈÛÙËÌ›Ô˘ ∫Ú‹Ù˘. OÈ ÂÍÔÌ·Ï˘Ṳ̂Ó˜ ∂£ Ù˘ ¶ª ˘ ÔÏÔÁ›ÛÙËÎ·Ó Ì ÙË ¯Ú‹ÛË ÔÏ˘ˆÓ˘ÌÈÎÒÓ ÌÔÓ٤ψÓ, ÂÓÒ ¤ÁÈÓ ۇÁÎÚÈÛË Ù˘ ¶ª ÙˆÓ ·È‰ÈÒÓ Ù˘ ·ÚÔ‡Û·˜ ÌÂϤÙ˘ Ì ÌÂÙÚ‹ÛÂȘ ¿ÏÏˆÓ ‰ÈÂıÓÒÓ ÌÂÏÂÙÒÓ. ∞ ÔÙÂϤÛÌ·Ù·: ∏ ¶ª ˘ ÔÏÔÁ›ÛÙËΠ·Ó¿ ʇÏÔ Î·È ËÏÈΛ· ηıÒ˜ Î·È ÔÈ ÂÍÔÌ·Ï˘Ṳ̂Ó˜ ∂£: 5Ë, 10Ë, 25Ë, 50‹, 75Ë, 85Ë, 90‹ Î·È 95Ë. ™˘ÁÎÚÈÙÈο, ‚Ú¤ıËΠfiÙÈ Ù· ·È‰È¿ Î·È ÔÈ ¤ÊË‚ÔÈ Ù˘ ∫Ú‹Ù˘ ¤¯Ô˘Ó, ÛÙȘ Â- ÚÈÛÛfiÙÂÚ˜ ËÏÈ˘, ÛËÌ·ÓÙÈο ÌÂÁ·Ï‡ÙÂÚË ¶ª · fi Ù· ·È‰È¿ Î·È ÙÔ˘˜ ÂÊ‹‚Ô˘˜ Ù˘ ∫‡ ÚÔ˘ Î·È ÙˆÓ ∏¶∞ (p<0,05), Î·È Û fiϘ ÙȘ ËÏÈ˘ ÛËÌ·ÓÙÈο ˘„ËÏfiÙÂÚ˜ ̤Û˜ ÙÈ̤˜ · fi Ù· ·È‰È¿ Ù˘ √ÏÏ·Ó‰›·˜, Ù˘ ª. µÚÂÙ·Ó›·˜, Ù˘ ∞˘ÛÙÚ·Ï›·˜ Î·È ÙÔ˘ ∫·Ó·‰¿. øÛÙfiÛÔ, ‰ÂÓ ‰È¤ÊÂÚ·Ó ÛËÌ·ÓÙÈο (p>0,05) ÛÙȘ Â- ÚÈÛÛfiÙÂÚ˜ ËÏÈ˘ · fi Ù· ·È‰È¿ Ù˘ πÛ ·Ó›·˜, ÂÓÒ Û fiϘ ÙȘ ËÏÈ˘ ›¯·Ó ÛËÌ·ÓÙÈο ¯·ÌËÏfiÙÂÚ˜ ÙÈ- ̤˜ ¶ª (50‹ ∂£) · fi Ù· ·È‰È¿ Ù˘ πÙ·Ï›·˜ (p<0,001). ™˘Ì ÂÚ¿ÛÌ·Ù·: ∏ ¯Ú‹ÛË ÙˆÓ ∂£ Ù˘ ¶ª · ÔÙÂÏ› ¯Ú‹ÛÈÌÔ Î·È ·ÍÈfi ÈÛÙÔ ÂÚÁ·ÏÂ›Ô ÁÈ· ÁÔÓ›˜ Î·È ·È- ‰›·ÙÚÔ˘˜, ÂÓÒ Ë ¶ª ηٷ‰ÂÈÎÓ‡ÂÈ ÙÔ ÛÔ‚·Úfi Úfi‚ÏËÌ· Ù˘ ·È‰È΋˜ ÎÂÓÙÚÈ΋˜ ·¯˘Û·ÚΛ·˜ ÛÙ· ·È- ‰È¿ Ù˘ ∫Ú‹Ù˘. §¤ÍÂȘ ÎÏÂȉȿ: ¶·È‰È¿, ÂÚ›ÌÂÙÚÔ˜ ̤Û˘, ÎÂÓÙÚÈ΋ ·¯˘Û·ÚΛ·, ÂηÙÔÛÙÈ·›Â˜ ı¤ÛÂȘ. Waist circumference percentiles of children of Crete aged 3 to 16 years E. Linardakis, K. Vardavas, A. Kafatos Abstract Background: The aim of this study was to estimate percentiles and growth curves of the waist circumference (WC) in children and adolescents of Crete, Greece. Methods: WC measurements were recorded for 5,321 subjects, 2,643 boys and 2,678 girls, aged 2.5 to 16.5 years, on whom a total of 7,538 were made. These measurements were derived from seven studies conducted between 1992 and 2005, on representative samples of children and adolescents in Crete, by the Preventive Medicine and Nutrition Clinic of the University of Crete. Smoothed percentiles of WC were estimated using polynomial models. The WC distribution was compared with that reported in other countries. Results: The age-sex specific descriptive characteristics and the smoothed percentiles of the 5th, 10th, 25th, 50th, 75th, 85th, 90th and 95th place were estimated. The mean WC of children and adolescents in this study in most age groups was found to be higher than that of children from Cyprus and the U.S (p<0.05) and higher in all age groups than that of children from the Netherlands, the U.K, Australia and Canada. The WC of the Cretan children did not differ significantly from that of Spanish children in most age groups but was lower (50th percentiles) in all age groups compared to Italian children (p<0.001). Conclusions: WC percentiles can be a useful and reliable tool for use by parents and paediatricians. The use of WC percentiles confirms that childhood central obesity is a major health problem in Crete. Key words: Children, waist circumference, central obesity, percentiles. ¶·Ó ÈÛÙ‹ÌÈÔ ∫Ú‹Ù˘, ∆Ì‹Ì· π·ÙÚÈ΋˜, ∆Ô̤·˜ ∫ÔÈÓˆÓÈ΋˜ π·ÙÚÈ΋˜, ∫ÏÈÓÈ΋ ¶ÚÔÏË ÙÈ΋˜ π·ÙÚÈ΋˜ Î·È ¢È·ÙÚÔÊ‹˜, ∏Ú¿ÎÏÂÈÔ ∫Ú‹Ù˘ AÏÏËÏÔÁÚ·Ê›·: EÌÌ·ÓÔ˘‹Ï §ÈÓ·Ú‰¿Î˘ linman@med.uoc.gr ¢È·ÛÙ·‡ÚˆÛË µÔ‡Ù˜ – ™Ù·˘Ú¿ÎÈ· ∆.∫. 71 003, ∆.£. 2208 ∏Ú¿ÎÏÂÈÔ ∫Ú‹Ù˘ University of Crete, Faculty of Medicine Department of Social Medicine, Division of Preventive Medicine and Nutrition, Heraklion, Crete, Greece Correspondence: Emmanouil Linardakis linman@med.uoc.gr Voutes-Stavrakia Junction 71 003, PO Box.: 2208 Heraklion, Crete, Greece ™˘ÓÙÔÌÔÁڷʛ˜ ¶M ¶ÂÚ›ÌÂÙÚÔ˜ ª¤Û˘ ∂£ ∂ηÙÔÛÙÈ·›· £¤ÛË ¢ª™ ¢Â›ÎÙ˘ ª¿˙·˜ ™ÒÌ·ÙÔ˜ IOTF International Obesity Task Force Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·300
  • 2. ∂ÈÛ·ÁˆÁ‹ ∏ ¤Ó·ÚÍË Ù˘  ȉËÌÈ΋˜ ¤Í·ÚÛ˘ Ù˘ ·¯˘- Û·ÚΛ·˜ ¯ÚÔÓÔÏÔÁÂ›Ù·È · fi ÙȘ ·Ú¯¤˜ ÙÔ˘ 1960 ÁÈ· ÙÔ˘˜ ÂÓ‹ÏÈΘ Î·È ÙÔ˘ 1980 ÁÈ· Ù· ·È‰È¿ Î·È ÙÔ˘˜ ÂÊ‹‚Ô˘˜ (1,2). Œ¯Ô˘Ó ˆÛÙfiÛÔ ·Ó· Ù˘¯ı› ‰È¿ÊÔÚÔÈ ‰Â›ÎÙ˜ ̤ÙÚËÛ˘ Ù˘ ·¯˘Û·ÚΛ·˜ Î·È ¯ÚËÛÈÌÔ- ÔÈËı› ÙfiÛÔ ÁÈ· ÙËÓ Î·Ù·ÁÚ·Ê‹ Ù˘ fiÛÔ Î·È ÁÈ· ÙË ‰È·¯ÚÔÓÈ΋ Î·È ‰È· ÔÏÈÙÈÛÌÈ΋ Û‡ÁÎÚÈÛË ÙÔ˘ Ê·È- ÓÔ̤ÓÔ˘. ¶ÔÏϤ˜ ÌÂϤÙ˜ Ù· ÙÂÏÂ˘Ù·›· ¯ÚfiÓÈ· ¤¯Ô˘Ó ·Ó·- ‰Â›ÍÂÈ ÙÔÓ ÛËÌ·ÓÙÈÎfi ÚfiÏÔ Ù˘ ̤ÙÚËÛ˘ Ù˘ ÂÚÈ- ̤ÙÚÔ˘ ̤Û˘ (¶ª) ˆ˜ ‰Â›ÎÙË ÎÂÓÙÚÈ΋˜ ·¯˘Û·Ú- Λ·˜ ÙfiÛÔ ÛÙÔÓ ÂÓ‹ÏÈÎÔ fiÛÔ Î·È ÛÙÔÓ ·È‰ÈÎfi ÏË- ı˘ÛÌfi (3-11). ∏ ̤ÙÚËÛË Ù˘ ¶ª Û ·È‰È¿ Î·È ÂÊ‹‚Ô˘˜ · Ô- ÙÂÏ› ·ÍÈfi ÈÛÙÔ ÚÔÁÓˆÛÙÈÎfi ‰Â›ÎÙË, ÛÂ Û˘Ó‰˘·ÛÌfi Ì ¿ÏÏÔ˘˜ ·Ú¿ÁÔÓÙ˜ ÎÈÓ‰‡ÓÔ˘, ÁÈ· ÙËÓ ·Ó¿ Ù˘ÍË Î·Ù¿ ÙËÓ ÂÓ‹ÏÈÎË ˙ˆ‹ ηډȷÁÁÂÈ·ÎÒÓ Î·È ¿ÏÏˆÓ ¯ÚfiÓÈˆÓ ÓÔÛËÌ¿ÙˆÓ (3-6). ∏ ¶ª ·È‰ÈÒÓ Î·È ÂÓË- Ï›ÎˆÓ · ÔÙÂÏ›  ›Û˘ Ì›· · fi ÙȘ ¤ÓÙÂ Û˘ÓÈÛÙÒ- Û˜ ÙÔ˘ ÌÂÙ·‚ÔÏÈÎÔ‡ Û˘Ó‰ÚfiÌÔ˘ (6-11). ∏ ·˘ÍË̤- ÓË ÂÓ· fiıÂÛË ÎÔÈÏÈ·ÎÔ‡ Ï› Ô˘˜ Û˘Óԉ‡ÂÙ·È · fi ·˘ÍË̤ÓË ·ÓÙ›ÛÙ·ÛË ÛÙË ‰Ú¿ÛË Ù˘ ÈÓÛÔ˘Ï›Ó˘ Î·È ·˘ÍË̤ÓÔ Î›Ó‰˘ÓÔ ÁÈ· ÙËÓ ·Ó¿ Ù˘ÍË Û·Î¯·ÚÒ‰Ë ‰È·‚‹ÙË Ù‡ Ô˘ 2. ∏ Û‡ÓıÂÛË Â ›Û˘ ÙÔ˘ ÎÔÈÏÈ·ÎÔ‡ Ï› Ô˘˜ Û ÏÈ ·Ú¿ Ôͤ· Â›Ó·È ‰˘ÛÌÂÓ¤ÛÙÂÚË ¤Ó·ÓÙÈ ÙÔ˘ ÁÏÔ˘ÙÈ·›Ô˘ (5). ∏ ̤ÙÚËÛË Ù˘ ¶ª ˆ˜ ‰Â›ÎÙË ÎÂÓÙÚÈ΋˜ ·¯˘- Û·ÚΛ·˜ Â›Ó·È · Ï‹, Ë Èı·ÓfiÙËÙ· ÛÊ¿ÏÌ·ÙÔ˜ ÛÙË ‰È·‰Èηۛ· ̤ÙÚËÛ˘ ÌÈÎÚ‹ Î·È Ë Î·ıȤڈۋ Ù˘ ÛÙËÓ Î·ıËÌÂÚÈÓ‹ ·È‰È·ÙÚÈ΋ ÎÏÈÓÈ΋ ÂͤٷÛË Ê·›- ÓÂÙ·È Â È‚Â‚ÏË̤ÓË. ∏ ·ÚÔ‡Û· ÌÂϤÙË ÛÙԯ‡ÂÈ ÛÙÔ Ó· Ù·ÍÈÓÔÌ‹ÛÂÈ ·È‰È¿ Î·È ÂÊ‹‚Ô˘˜ Û ÂηÙÔÛÙÈ·›Â˜ ı¤ÛÂȘ (∂£), ÒÛÙ ӷ ˘ ¿Ú¯ÂÈ ¤Ó· ̤ÙÚÔ Û‡ÁÎÚÈÛ˘ ÛÙËÓ Î·ıËÌÂ- ÚÈÓ‹ ·È‰È·ÙÚÈ΋ ÂͤٷÛË, ηıÒ˜ Î·È ‚·ÛÈο ‰Â‰Ô- ̤ӷ Û‡ÁÎÚÈÛ˘ ÁÈ· ÌÂÏÏÔÓÙÈ΋ ·ÍÈÔÏfiÁËÛË ÙÔ˘  È- ÔÏ·ÛÌÔ‡ Ù˘ ÎÂÓÙÚÈ΋˜ ·¯˘Û·ÚΛ·˜. ÀÏÈÎfi Î·È Ì¤ıÔ‰ÔÈ ¶ÂÚÈÔ¯‹ ÌÂϤÙ˘ ∏ ÌÂϤÙË Ú·ÁÌ·ÙÔ ÔÈ‹ıËΠ۠·È‰È¿ Î·È ÂÊ‹‚Ô˘˜ Ù˘ ∫Ú‹Ù˘ Ô˘ Û˘ÌÌÂÙ›¯·Ó Û ÌÂϤÙ˜ Ù˘ ∫ÏÈÓÈ΋˜ ¶ÚÔÏË- ÙÈ΋˜ π·ÙÚÈ΋˜ Î·È ¢È·ÙÚÔÊ‹˜ ÙÔ˘ ¶·Ó ÈÛÙËÌ›Ô˘ ∫Ú‹Ù˘. ∏ ∫Ú‹ÙË ‰È·ÈÚÂ›Ù·È Û ٤ÛÛÂÚȘ ÓÔÌÔ‡˜, ÂÎÙ›ÓÂÙ·È Û 8.335 km2 , Ì ÌfiÓÈÌÔ ÏËı˘ÛÌfi 594.368 ηÙÔ›ÎÔ˘˜ (· ÔÁÚ·- Ê‹ 2001), · fi ÙÔ˘˜ Ô Ô›Ô˘˜ 142.880 ‹ 24% Â›Ó·È <19 ÂÙÒÓ. ∆Ô 42% ÙÔ˘ ÏËı˘ÛÌÔ‡ Â›Ó·È ·ÁÚÔÙÈÎfi˜, ÙÔ 46% ·ÛÙÈÎfi˜ Î·È ÙÔ 12% ËÌÈ·ÛÙÈÎfi˜. ¶ÏËı˘ÛÌfi˜ ÌÂϤÙ˘ °È· ÙË ÌÂϤÙË Â ÈϤ¯ıËÎ·Ó Î·È ÂÏ‹ÊıËÛ·Ó · fi fiϘ Û¯Â- ‰fiÓ Ù˘ ÂÚÈÔ¯¤˜ Ù˘ ∫Ú‹Ù˘ (∂ÈÎfiÓ· 1) 5.321 ·È‰È¿ Î·È ¤ÊË‚ÔÈ - 2.643 ·ÁfiÚÈ· Î·È 2.678 ÎÔÚ›ÙÛÈ·, ËÏÈΛ·˜ 2,5-16,5 ÂÙÒÓ, ÙˆÓ Ô Ô›ˆÓ ÌÂÙÚ‹ıËÎÂ Ë ¶ª. ∆· ·È‰È¿ Î·È ÔÈ ¤ÊË‚ÔÈ Û˘ÌÌÂÙ›¯·Ó Û ·ÓÙÈ ÚÔÛˆ ¢ÙÈο ‰Â›ÁÌ·Ù· ·È‰ÈÎÒÓ Î·È ÂÊË‚ÈÎÒÓ ÏËı˘ÛÌÒÓ Â Ù¿ ‰È·¯ÚÔÓÈÎÒÓ Î·È Û˘Á¯ÚÔÓÈÎÒÓ ÌÂÏÂÙÒÓ (¶›Ó·Î·˜ 1) Ô˘ ‰ÈÂÍ‹¯ıËÛ·Ó · fi ÙËÓ ∫ÏÈÓÈ΋ ¶ÚÔÏË ÙÈ΋˜ π·ÙÚÈ΋˜ Î·È ¢È·ÙÚÔÊ‹˜, Ù˘ π·ÙÚÈ΋˜ ™¯ÔÏ‹˜ ÙÔ˘ ¶·Ó ÈÛÙËÌ›Ô˘ ∫Ú‹Ù˘. √È ÌÂϤÙ˜ ·˘Ù¤˜ Ô˘ ‰ÈÂÍ‹¯ıËÛ·Ó ÌÂٷ͇ ÙˆÓ ÂÙÒÓ 1992 Î·È 2005, ·ÊÔÚÔ‡Û·Ó ¶ÚÔÁÚ¿ÌÌ·Ù· ∞ÁˆÁ‹˜ Î·È ¶ÚÔ·- ÁˆÁ‹˜ Ù˘ ÀÁ›·˜ ÁÈ· ÙË ÛˆÌ·ÙÈ΋ ·Ó¿ Ù˘ÍË Î·È ÙËÓ ÚfiÏË- „Ë ·Ú·ÁfiÓÙˆÓ ÎÈÓ‰‡ÓÔ˘. ∏  ÈÏÔÁ‹ ÙˆÓ ·È‰ÈÒÓ ÛÙȘ  ٿ ÌÂϤÙ˜ ‹Ù·Ó Ù˘¯·›· - ÔÏ˘ÛÙ·‰È·Î‹. ∞ÊÔ‡  ÈϤ¯ıËÎ·Ó Ù˘¯·›· ÔÈ ÂÚÈÔ¯¤˜ ÌÂϤÙ˘ (·ÛÙÈΤ˜, ËÌÈ·ÛÙÈΤ˜ Î·È ·ÁÚÔÙÈΤ˜) Î·È ÂÓ Û˘Ó¯›· Ù· Û¯ÔÏ›· ÙˆÓ ÂÚÈÔ¯ÒÓ, Û˘Ì ÂÚÈÂÏ‹ÊıËÛ·Ó fiÏ· Ù· ·È‰È¿ ÙˆÓ Û¯ÔÏ›- ˆÓ. ¶ÂÚÈÛÛfiÙÂÚ˜ Ï ÙÔ̤ÚÂȘ ˆÛÙfiÛÔ ·Ó·Ê¤ÚÔÓÙ·È Û ÚÔËÁÔ‡ÌÂÓ˜ ‰ËÌÔÛÈÂ˘Ì¤Ó˜ ÂÚÁ·Û›Â˜ ÙˆÓ ÌÂÏÂÙÒÓ (12-20). ∂ ›Û˘, ÔÈ ÂÍÂÙ¿ÛÂȘ ÙˆÓ ·È‰ÈÒÓ ¤ÁÈÓ·Ó ÛÙÔÓ ¯ÒÚÔ ÙˆÓ Û¯ÔÏ›ˆÓ ÙÔ˘˜ ηÙfi ÈÓ ¤ÁÎÚÈÛ˘ ÙˆÓ ÚÔÁÚ·ÌÌ¿ÙˆÓ Î·È ÙˆÓ ÂÍÂÙ¿ÛÂÒÓ ÙÔ˘˜ · fi ÙÔ À Ô˘ÚÁÂ›Ô ¶·È‰Â›·˜, ÂÓÒ ÁÈ· ÙË Û˘Ì- ÌÂÙÔ¯‹ ÙÔ˘˜ ÚÔËÁ‹ıËΠϠÙÔÌÂÚ‹˜ ÂÓË̤ڈÛË Î·È ÂÓ˘- fiÁÚ·ÊË Û˘ÁηٿıÂÛË ÙˆÓ ÁÔÓ¤ˆÓ. ¶ÚÔËÁ‹ıËΠ·ÎfiÌË ¤ÁÎÚÈÛË ÙˆÓ ÌÂÏÂÙÒÓ · fi ÙËÓ Â ÈÙÚÔ ‹ ∏ıÈ΋˜ Î·È ¢ÂÔÓÙÔ- ÏÔÁ›·˜ ÙÔ˘ ¶·Ó ÈÛÙËÌ›Ô˘ ∫Ú‹Ù˘. ª¤ÙÚËÛË ¶ÂÚÈ̤ÙÚÔ˘ ª¤Û˘ ∏ ̤ÙÚËÛË Ù˘ ¶ª ¤ÁÈÓ ¯ˆÚ›˜ ÚÔ‡¯·, Û ÂηÙÔÛÙ¿, Ì ϷÛÙÈ΋ ÌÂÙÚÈ΋ Ù·ÈÓ›·, οوıÂÓ ÙÔ˘ Ï¢ÚÈÎÔ‡ ÙfiÍÔ˘ - ÛÙÔ Ì¤ÛÔ Ù˘ · fiÛÙ·Û˘ ÌÂٷ͇ Ï¢ÚÈÎÔ‡ ÙfiÍÔ˘ Î·È Ï·ÁÔ- Ó›Ô˘ ·ÎÚÔÏÔÊ›·˜ (∂ÈÎfiÓ· 2). ™Ù·ÙÈÛÙÈ΋ ·Ó¿Ï˘ÛË ∏ ·Ó¿Ï˘ÛË ÙˆÓ ‰Â‰ÔÌ¤ÓˆÓ ¤ÁÈÓ Ì ÙË ¯Ú‹ÛË ÙÔ˘ ÚÔ- ÁÚ¿ÌÌ·ÙÔ˜ SPSS 13.0. ™ÙÔÓ ˘ ÔÏÔÁÈÛÌfi ÙˆÓ ∂£ Ù˘ ¶ª, η- ıÒ˜ Î·È ÛÙË ÁÚ·ÊÈ΋ · ÂÈÎfiÓÈÛË ÙˆÓ Î·Ì ˘ÏÒÓ ÙÔ˘˜, ˘ Ô- ÏÔÁ›ÛÙËÎ·Ó ÔÈ ËÏÈ˘ Û ‰È·ÛÙ‹Ì·Ù· ËÏÈÎÈ·ÎÒÓ ÔÌ¿‰ˆÓ. ™˘- ÁÎÂÎÚÈ̤ӷ, Ë ËÏÈΛ· ÙˆÓ 3 ÂÙÒÓ ·ÊÔÚ¿ ÙÔ ‰È¿ÛÙËÌ· · fi 2,5 ¤ˆ˜ 3,4 ¤ÙË, ÙˆÓ 4 ÙÔ ‰È¿ÛÙËÌ· · fi 3,5 ¤ˆ˜ 4,4 ¤ÙË, Î.Ô.Î. ¶ÔÏ˘ˆÓ˘ÌÈο ÌÔÓ٤Ϸ ÚÔÛ·ÚÌÔÁ‹˜ Áã ‚·ıÌÔ‡ (cubic models) (21,22) ¯ÚËÛÈÌÔ ÔÈ‹ıËÎ·Ó ÁÈ· ÙËÓ ÂÍÔÌ¿Ï˘ÓÛË ÙˆÓ ÙÈÌÒÓ ÙˆÓ ·‰ÚÒÓ ∂£, Ù· Ô Ô›· ¤‰ˆÛ·Ó Û˘ÓÙÂÏÂÛÙ¤˜ ÚÔÛ·Ú- ÌÔÁ‹˜ (R2 ) ÌÂÁ·Ï‡ÙÂÚÔ˘˜ ÙÔ˘ 98%. ªÂ ÙË Ì¤ıÔ‰Ô ÂϤÁ¯Ô˘ Student · ÏÔ‡ ‰Â›ÁÌ·ÙÔ˜ (One sample t test) ¤ÁÈÓ ۇÁÎÚÈÛË ÙˆÓ Ì¤ÛˆÓ ÙÈÌÒÓ Ù˘ ¶ª ÙˆÓ ·È‰ÈÒÓ Ù˘ ·ÚÔ‡Û·˜ ÌÂϤÙ˘ Ì ÂΛӘ ¿ÏÏˆÓ ÂÚ¢ÓÒÓ (22-30), ÂÓÒ ·Ó· ·Ú·ÛÙ¿ıËÎ·Ó ÁÚ·ÊÈο ÔÈ 90¤˜ ∂£ ÙˆÓ ÌÂ- ÏÂÙÒÓ ·˘ÙÒÓ (· fi ÙË ÌÂϤÙË ÙˆÓ Fredriks et al, 2005 (23) ¯ÚËÛÈÌÔ ÔÈ‹ıËÎ·Ó ÔÈ ÙÈ̤˜ Ù˘ +2SD). ∏  ÈÏÔÁ‹ Ù˘ 90‹˜ ∂£ Ù˘ ¶ª ·ÊÔÚ¿ ÙË ¯Ú‹ÛË Ù˘ ˆ˜ fiÚÈÔ Î·ıÔÚÈÛÌÔ‡ ÙˆÓ Ê˘ÛÈÔÏÔÁÈÎÒÓ - ·¯‡Û·ÚÎˆÓ ·È‰ÈÒÓ Î·È ÂÊ‹‚ˆÓ. ¡. ÷ӛˆÓ ¢È·¯ÚÔÓÈΤ˜ ÌÂϤÙ˜ ™‡Á¯ÚÔÓ˜ ÌÂϤÙ˜ ¡. ƒÂı‡ÌÓÔ˘ ¡. ∏Ú·ÎÏ›Ԣ ¡. §·ÛÈı›Ô˘ ∂ÈÎfiÓ· 1. ÿÚÙ˘ Ù˘ ∫Ú‹Ù˘. √È Î‡ÎÏÔÈ ‰Â›¯ÓÔ˘Ó ÙȘ ÂÚÈÔ¯¤˜ · fi ÙȘ Ô Ô›Â˜ ÚÔ¤Ú¯ÔÓÙ·È Ù· ·È‰È¿ Î·È ÔÈ ¤ÊË‚ÔÈ Ù˘ ÌÂϤÙ˘. 301∂ηÙÔÛÙÈ·›Â˜ ı¤ÛÂȘ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ ·È‰ÈÒÓ ¶·È‰È·ÙÚÈ΋ 2007;70:300-307 Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·301
  • 3. 302 ∂. §ÈÓ·Ú‰¿Î˘ Î·È Û˘Ó. Paediatriki 2007;70:300-307 ¶›Ó·Î·˜1.™˘Á¯ÚÔÓÈΤ˜Î·È‰È·¯ÚÔÓÈΤ˜ÌÂϤÙ˜-ÚÔÁÚ¿ÌÌ·Ù·ÙÔ˘¶·ÓÂÈÛÙËÌ›Ô˘∫Ú‹ÙË˜Ô˘Û˘ÌÌÂÙ›¯·ÓÛÙËÓ·ÚÔ‡Û·ÌÂϤÙË,ÁÈ·ÙÔÓ˘ÔÏÔÁÈÛÌfiÙˆÓÂηÙÔÛÙÈ·›ˆÓı¤ÛˆÓÙ˘ÂÚÈ̤ÙÚÔ˘ ̤Û˘5.321·È‰ÈÒÓÙ˘∫Ú‹Ù˘,ËÏÈΛ·˜2,5¤ˆ˜16,5ÂÙÒÓ,ÌÂ7.538ÌÂÙÚ‹ÛÂȘ ªÂϤÙË-∂›‰Ô˜ŒÙÔ˜ÃÒÚÔ˜∏ÏÈΛ·ªÂÙÚ‹ÛÂȘµÈ‚ÏÈÔÁÚ·Ê›· ¶ÚfiÁÚ·ÌÌ·∂ͤٷÛ˘ÌÂϤÙ˘(¤ÙË)∞ÁfiÚÈ·∫ÔÚ›ÙÛÈ· ¶ÚfiÁÚ·ÌÌ·∂Î·È‰Â˘ÙÈ΋˜¢È·¯ÚÔÓÈ΋1ËÂͤÙ.-1992¢ËÌÔÙÈο™¯ÔÏ›·¡ÔÌÒÓ∏Ú·ÎÏ›Ԣ,5,0-8,5621574∫·Ê¿ÙԘηÈÛ˘Ó,1998[12] ¶·Ú¤Ì‚·Û˘ƒÂı‡ÌÓÔ˘,÷ӛˆÓηȧ·ÛÈı›Ô˘† 2ËÂͤÙ.-1995¢ËÌÔÙÈο™¯ÔÏ›·¡ÔÌÒÓ∏Ú·ÎÏ›Ԣ,7,6-9,9241233Maniosetal,1999[13] ƒÂı‡ÌÓԢηÈ÷ӛˆÓ 3ËÂͤÙ.-1998¢ËÌÔÙÈο™¯ÔÏ›·¡ÔÌÒÓ∏Ú·ÎÏ›Ԣ,10,2-13,1408409Maniosetal,2002[14] ƒÂı‡ÌÓԢηÈ÷ӛˆÓ 4ËÂͤÙ.-2002°˘ÌÓ¿ÛÈ·-§‡ÎÂÈ·¡ÔÌÒÓ∏Ú·ÎÏ›Ԣ,13,6-16,5292322Kafatosetal,2005[15] ƒÂı‡ÌÓԢηÈ÷ӛˆÓ ¶ÚfiÁÚ·ÌÌ·∂Î·È‰Â˘ÙÈ΋˜¢È·¯ÚÔÓÈ΋1ËÂͤÙ.-1999¢ËÌÔÙÈοηȰ˘ÌÓ¿ÛÈ·¡ÔÌÒÓ9,2-16,5373430Moschandreasetal,2003[16] ¶·Ú¤Ì‚·Û˘∏Ú·ÎÏ›Ԣ,ƒÂı‡ÌÓÔ˘Î·È§·ÛÈı›Ô˘ 2ËÂͤÙ.-2000-//-10,0-16,5215258¶·È‰·ÁˆÁÈÎfiπÓÛÙÈÙÔ‡ÙÔ[17] ¶ÚfiÁÚ·ÌÌ·¶ÚÔ·ÁˆÁ‹˜Ù˘ÀÁ›·˜™˘Á¯ÚÔÓÈ΋2000¢ËÌÔÙÈο™¯ÔÏ›· (¢‹ÌÔ˜∞Á.¡ÈÎÔÏ¿Ô˘)¢‹ÌÔ˘∞Á.¡ÈÎÔÏ¿Ô˘8,1-13,8173175∞‰ËÌÔÛ›Â˘Ù·™ÙÔȯ›· ¶ÚfiÁÚ·ÌÌ·¶ÚÔ·ÁˆÁ‹˜Ù˘ÀÁ›·˜™˘Á¯ÚÔÓÈ΋2001¡ËÈ·ÁˆÁ›Ô,¢ËÌÔÙÈÎfiηȰ˘ÌÓ¿ÛÈÔ4,0-15,39299ªÔÛ¯·Ó‰Ú¤·Î·ÈÛ˘Ó,2003[18] (¢‹ÌÔ˜ƒÔ‡‚·)¢‹ÌÔ˘ƒÔ‡‚·∏Ú·ÎÏ›Ԣ ¶ÚfiÁÚ·ÌÌ·ÕıÏËÛ˘ηȢȷÙÚÔÊ‹˜™˘Á¯ÚÔÓÈ΋2003-04™¯ÔÏ›·¢‹ÌˆÓ∏Ú·ÎÏ›Ԣ,2,8-16,5382426§ÈÓ·Ú‰¿Î˘ª,2005[19] ∆˘Ï›ÛԢηÈÃÂÚÛÔÓ‹ÛÔ˘ ¶ÚfiÁÚ·ÌÌ·¶ÚÔ·ÁˆÁ‹˜Ù˘ÀÁ›·˜™˘Á¯ÚÔÓÈ΋2004¶·È‰ÈÎÔ›™Ù·ıÌÔ›∏Ú·ÎÏ›Ԣ2,5-6,17345∞‰ËÌÔÛ›Â˘Ù·™ÙÔȯ›· (¶·È‰ÈÎÔ›™Ù·ıÌÔ›∏Ú·ÎÏ›Ԣ) ¶ÚfiÁÚ·ÌÌ·∂Î·È‰Â˘ÙÈ΋˜¢È·¯ÚÔÓÈ΋1ËÂͤÙ.-2004/05¡ËÈ·ÁˆÁ›·fiψÓÙˆÓ¢‹ÌˆÓηÈ4,0-7,0864833∫·Ê¿ÙԘηÈÛ˘Ó,2005[20] ¶·Ú¤Ì‚·Û˘∫ÔÈÓÔًوÓÙÔ˘¡ÔÌԇ÷ӛˆÓ ™‡ÓÔÏÔÌÂÙÚ‹ÛˆÓ3.7343.804 ™‡ÓÔÏԷȉÈÒÓ2.643* 2.678 † ∞fiÙÔÓ¡ÔÌfi§·ÛÈı›Ô˘ÂÈϤ¯ıËÎÂηÈÛ˘ÌÌÂÙ›¯Â·ÓÙÈÚÔÛˆÂ˘ÙÈÎfi‰Â›Á̷وӷȉÈÒÓÛÙȘÎÏÈÓÈΤ˜ÂÍÂÙ¿ÛÂȘÌfiÓÔηٿÙËÓÚÒÙË̤ÙÚËÛË(1992-93)ηȷÔÙÂÏÔ‡ÓÙ·Ó·fi 109·ÁfiÚȷηÈ111ÎÔÚ›ÙÛÈ· * ™ÙȘ‰È·¯ÚÔÓÈΤ˜ÌÂϤÙ˜˘‹Ú¯·Ó·È‰È¿Ô˘ÂÓÙ¿¯ıËηÓÛ·˘Ù¤˜Î·Ù¿ÙˉȿÚÎÂÈ·ÙˆÓ·ӷϷ̂·ÓfiÌÂÓˆÓÂÍÂÙ¿ÛÂˆÓ Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·302
  • 4. ∞ ÔÙÂϤÛÌ·Ù· √È ·Ó¿ ËÏÈΛ· Î·È Ê‡ÏÔ Ì¤Û˜ ÙÈ̤˜ Î·È Ù˘ ÈΤ˜ · ÔÎÏ›ÛÂȘ Ù˘ ¶ª ÙˆÓ ·È‰ÈÒÓ Î·È ÙˆÓ ÂÊ‹‚ˆÓ ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È ÛÙÔÓ ¶›Ó·Î· 2. ™ÙÔÓ ¶›Ó·Î· 3 ÂÚÈÏ·Ì‚¿ÓÔÓÙ·È ÔÈ ÂȉÈΤ˜ ·Ó¿ ʇÏÔ Î·È ËÏÈΛ· ÂÍÔÌ·Ï˘Ṳ̂Ó˜ ∂£ Ù˘ ¶ª. √È ∂£ ·ÊÔÚÔ‡Ó ÙËÓ 5Ë, 10Ë, 25Ë, 50‹, 75Ë, 85Ë, 90‹ Î·È 95Ë ∂£ Ì ÙË ÁÚ·ÊÈ΋ ÙÔ˘˜ · ÂÈÎfiÓÈÛË Ó· ·ÚÔ˘ÛÈ¿˙Â- Ù·È ÛÙËÓ ∂ÈÎfiÓ· 3. ™ÙÔÓ ¶›Ó·Î· 4 ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È ÔÈ ·Ó¿ ʇÏÔ Î·È ËÏÈΛ· ̤Û˜ Î·È ‰È¿ÌÂÛ˜ ÙÈ̤˜ Ù˘ ¶ª, Ù˘ ·- ÚÔ‡Û·˜ ÌÂϤÙ˘ Û ۇÁÎÚÈÛË Ì ÂΛӘ ÌÂÏÂÙÒÓ ¿ÏÏˆÓ ¯ˆÚÒÓ. Ÿ ˆ˜ Ê·›ÓÂÙ·È, Ù· ·È‰È¿ Ù˘ ∫Ú‹Ù˘ ¤¯Ô˘Ó ÛÙȘ ÂÚÈÛÛfiÙÂÚ˜ ËÏÈ˘ ÛËÌ·ÓÙÈο (p<0,05) ˘„ËÏfiÙÂ- Ú˜ ̤Û˜ ÙÈ̤˜ ¶ª Û ۯ¤ÛË Ì ٷ ·ÓÙ›ÛÙÔȯ˘ ËÏÈ- Λ·˜ ·È‰È¿ Ù˘ ∫‡ ÚÔ˘ Î·È ÙˆÓ ∏¶∞, ÂÓÒ Û fiϘ ÙȘ ËÏÈ˘ ¤¯Ô˘Ó ÛËÌ·ÓÙÈο ˘„ËÏfiÙÂÚ˜ ̤Û˜ ÙÈ- ̤˜ · fi Ù· ·È‰È¿ Ù˘ √ÏÏ·Ó‰›·˜, Ù˘ ª. µÚÂÙ·Ó›·˜, Ù˘ ∞˘ÛÙÚ·Ï›·˜ Î·È ÙÔ˘ ∫·Ó·‰¿. ∂ ›Û˘, ‰ÂÓ ‰È·Ê¤- ÚÔ˘Ó ÛËÌ·ÓÙÈο ÛÙȘ ÂÚÈÛÛfiÙÂÚ˜ ËÏÈ˘ · fi Ù· ·È‰È¿ Ù˘ πÛ ·Ó›·˜ (p>0,05), ÂÓÒ ¤¯Ô˘Ó ÛËÌ·ÓÙÈο ¯·ÌËÏfiÙÂÚ˜ ÙÈ̤˜ ¶ª (50‹ ∂£) · fi ÂΛӷ Ù˘ πÙ·Ï›·˜ (p<0,001). ∆¤ÏÔ˜, ÛÙËÓ ∂ÈÎfiÓ· 4 ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È Ì¤Ûˆ ÁÚ·- ÊÈÎÒÓ Ù· fiÚÈ· Ù˘ 90‹˜ ∂£ Ù˘ ¶ª ÁÈ· ÙȘ ÚÔ·Ó·- ÊÂÚı›Û˜ ¯ÒÚ˜. ∆· ·È‰È¿ Ù˘ πÙ·Ï›·˜ Ê·›ÓÔÓÙ·È Ó· ¤¯Ô˘Ó ÙËÓ ˘„ËÏfiÙÂÚË 90‹ ∂£ Î·È Ù· ·È‰È¿ Ù˘ ª. µÚÂÙ·Ó›·˜ ÙË ¯·ÌËÏfiÙÂÚË, ÂÓÒ ÂΛӷ Ù˘ ∫Ú‹- Ù˘ ¤¯Ô˘Ó ۯ‰fiÓ ·ÚfiÌÔÈ· 90‹ ∂£ ÌfiÓÔ Ì ٷ ·È- ‰È¿ ÙˆÓ ∏¶∞. ™˘˙‹ÙËÛË ™ÙËÓ ·ÚÔ‡Û· ÌÂϤÙË ˘ ÔÏÔÁ›ÛÙËÎ·Ó Î·È ·- ÚÔ˘ÛÈ¿˙ÔÓÙ·È ∂£ Ù˘ ¶ª ÁÈ· ·È‰È¿ Î·È ÂÊ‹‚Ô˘˜ Ù˘ ∫Ú‹Ù˘. ∆· ·È‰È¿ Î·È ÔÈ ¤ÊË‚ÔÈ Ù˘ ∫Ú‹Ù˘ ‚Ú¤ıËÎ·Ó Ó· ¤¯Ô˘Ó · fi ÙȘ ˘„ËÏfiÙÂÚ˜ ÙÈ̤˜ ÎÂ- ÓÙÚÈ΋˜ ·¯˘Û·ÚΛ·˜, Ì ÂÍ·›ÚÂÛË ·Ó¿ÏÔÁ˘ ËÏÈ- Λ·˜ ·È‰È¿ Ù˘ πÙ·Ï›·˜. √È ÂÚÈÛÛfiÙÂÚ˜ · fi ÙȘ ‰ËÌÔÛÈÂ˘Ì¤Ó˜ ÌÂϤÙ˜ ÙˆÓ ¯ˆÚÒÓ ∫‡ ÚÔ˘, πÙ·Ï›·˜, πÛ ·Ó›·˜, ª. µÚÂÙ·Ó›·˜, ¶›Ó·Î·˜ 2. ¶ÂÚ›ÌÂÙÚÔ˜ ̤Û˘ 7.538 ÌÂÙÚ‹ÛÂˆÓ 5.321 ·È‰ÈÒÓ Ù˘ ∫Ú‹Ù˘ ∞ÁfiÚÈ· ∫ÔÚ›ÙÛÈ· ∏ÏÈΛ· ¡ ª¤ÛË ÙÈÌ‹ ¡ ª¤ÛË ÙÈÌ‹ (¤ÙË)† (∆∞)# (∆∞) 3 44 50,5 (3,9)* 33 52,2 (3,9) 4 96 54,0 (4,9) 99 52,8 (4,5) 5 421 55,1 (5,9) 389 54,7 (5,4) 6 872 56,3 (7,1) 834 55,1 (6,0) 7 213 56,8 (6,3) 181 55,1 (5,7) 8 113 59,7 (6,4) 108 59,9 (8,2) 9 220 62,6 (8,4) 213 61,7 (8,9) 10 170 68,1 (9,9) 173 66,2 (9,2) 11 384 71,4 (10,7) 414 68,6 (9,7) 12 427 71,6 (10,6) 417 69,2 (9,8) 13 84 72,5 (9,7) 113 69,5 (9,2) 14 156 76,9 (10,8) 192 71,8 (7,9) 15 357 78,2 (10,4) 457 71,8 (8,0) 16 177 81,8 (12,9) 181 72,7 (9,1) # ∆∞: Ù˘ È΋ · fiÎÏÈÛË † ∏ ËÏÈΛ· ·ÊÔÚ¿ ËÏÈÎȷΤ˜ ÔÌ¿‰Â˜: Ù· 3 ¤ÙË ÂÚÈÏ·Ì‚¿- ÓÔ˘Ó ·È‰È¿ ËÏÈΛ·˜ 2,5-3,4 ¯ÚfiÓˆÓ Î.Ô.Î. * √È ÙÈ̤˜ Â›Ó·È Û ÂηÙÔÛÙ¿ (cm) ∂ÈÎfiÓ· 2. ™¯ËÌ·ÙÈ΋ · ÂÈÎfiÓÈÛË Ì¤ÙÚËÛ˘ ÂÚÈ̤ÙÚÔ˘ ̤Û˘. ªÂٷ͇ Ï¢ÚÈÎÔ‡ ÙfiÍÔ˘ Î·È Ï·ÁÔÓ›Ô˘ ∆Ô Ôı¤ÙËÛË ÛÙÔ ‡„Ô˜ ÙÔ˘ ÔÌÊ·ÏÔ‡ 100 90 80 70 60 50 40 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ∏ÏÈΛ· (¤ÙË) ÎÔÚ›ÙÛÈ· 510 25 50 75 85 90 95 ¶ÂÚ›ÌÂÙÚÔ˜ª¤Û˘(cm) ·ÁfiÚÈ· 510 25 50 75 85 90 95 110 100 90 80 70 60 50 40 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ∏ÏÈΛ· (¤ÙË) ¶ÂÚ›ÌÂÙÚÔ˜ª¤Û˘(cm) ∂ÈÎfiÓ· 3. ∫·Ì ‡Ï˜ ÂηÙÔÛÙÈ·›ˆÓ ı¤ÛÂˆÓ ÂÚÈ̤ÙÚÔ˘ ̤Û˘. 303∂ηÙÔÛÙÈ·›Â˜ ı¤ÛÂȘ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ ·È‰ÈÒÓ ¶·È‰È·ÙÚÈ΋ 2007;70:300-307 Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·303
  • 5. √ÏÏ·Ó‰›·˜, ∞˘ÛÙÚ·Ï›·˜, ∫·Ó·‰¿ Î·È ∏¶∞ (22-29), Ô˘ ·ÊÔÚÔ‡Ó ÂÚÁ·Û›Â˜ ˘ ÔÏÔÁÈÛÌÔ‡ ∂£ Ù˘ ¶ª, · ÔÙÂÏÔ‡Ó Û˘Á¯ÚÔÓÈΤ˜ ÌÂϤÙ˜ Î·È ¤¯Ô˘Ó ‰ÈÂÍ·- ¯ı› Û ‰È·ÛÙ‹Ì·Ù· ‰È¿ÚÎÂÈ·˜ ÌÈÎÚfiÙÂÚ˘ ÙˆÓ ‰‡Ô ÂÙÒÓ. øÛÙfiÛÔ, Ë · fi ÎÔÈÓÔ‡ ¯Ú‹ÛË ‰È·¯ÚÔÓÈÎÒÓ Î·È Û˘Á¯ÚÔÓÈÎÒÓ ÌÂÏÂÙÒÓ ÁÈ· ÙË ‰ËÌÈÔ˘ÚÁ›· ∂£ Î·Ì ˘- ÏÒÓ ·Ó¿ Ù˘Í˘ Ô˘ ηχ ÙÔ˘Ó Â ›Û˘ ÌÂÁ·Ï‡ÙÂÚ· ¯ÚÔÓÈο ‰È·ÛÙ‹Ì·Ù· ¤¯ÂÈ ‹‰Ë ÂÊ·ÚÌÔÛÙ› Û ∏¶∞ Î·È ª. µÚÂÙ·Ó›· (30,31). ∏ ¶ª Â›Ó·È · Ï‹ Î·È Â‡ÎÔÏË ÛÙË Ì¤ÙÚËÛ‹ Ù˘ ·ÏÏ¿ Î·È ÌÂÁ¿Ï˘ Û Ô˘‰·ÈfiÙËÙ·˜, ηıÒ˜ Â›Ó·È ‰Â›- ÎÙ˘ ÎÂÓÙÚÈ΋˜ ·¯˘Û·ÚΛ·˜. √È Mamalakis Î·È Û˘Ó. (5), ¤‰ÂÈÍ·Ó fiÙÈ Ë Û‡ÓıÂÛË Û ÏÈ ·Ú¿ Ôͤ· ÙÔ˘ ÎÔÈ- ÏÈ·ÎÔ‡ ˘ Ô‰fiÚÈÔ˘ Ï› Ô˘˜ Â›Ó·È ÛËÌ·ÓÙÈο ‰˘ÛÌÂÓ¤- ÛÙÂÚË ÙÔ˘ ÁÏÔ˘ÙÈ·›Ô˘ (˘„ËÏfiÙÂÚ·  › ‰· ÎÔÚÂ- ÛÌ¤ÓˆÓ Î·È trans ÏÈ ·ÚÒÓ ÔͤˆÓ Î·È ¯·ÌËÏfiÙÂÚ· ÌÔÓÔ·ÎfiÚÂÛÙˆÓ Î·È ÔÏ˘·ÎfiÚÂÛÙˆÓ) Î·È Û¯ÂÙ›˙ÂÙ·È Â ›Û˘ ηχÙÂÚ· Ì ٷ ÏÈ ›‰È· ÔÚÔ‡ ·›Ì·ÙÔ˜. ∂ È- ϤÔÓ, Ë ÎÂÓÙÚÈ΋ ·¯˘Û·ÚΛ· · ÔÙÂÏ› ¤Ó·Ó · fi ÙÔ˘˜ ·Ú¿ÁÔÓÙ˜ ÙÔ˘ ÌÂÙ·‚ÔÏÈÎÔ‡ Û˘Ó‰ÚfiÌÔ˘ (6- 11). √È Moreno Î·È Û˘Ó. (11), ·Ó·Ê¤ÚÔ˘Ó fiÙÈ Ë ¶ª ˆ˜ ‰Â›ÎÙ˘ ·¯˘Û·ÚΛ·˜ · ÔÙÂÏ› Û ·È‰È¿ Î·È ÂÊ‹‚Ô˘˜ ηχÙÂÚÔ ÚÔÁÓˆÛÙÈÎfi ‰Â›ÎÙË ÙÔ˘ ÌÂÙ·- ‚ÔÏÈÎÔ‡ Û˘Ó‰ÚfiÌÔ˘, · fi fi,ÙÈ Ô ‰Â›ÎÙ˘ Ì¿˙·˜ ÛÒ- Ì·ÙÔ˜ (¢ª™) ‹ ÙÔ ¿¯Ô˜ ÙˆÓ ‰ÂÚÌ·ÙÈÎÒÓ Ù˘¯ÒÓ. °È· ÙËÓ ·˘Í·ÓfiÌÂÓË Û˘¯ÓfiÙËÙ· Ù˘ ·¯˘Û·ÚΛ·˜ Î·È ÙÔ˘ ÌÂÙ·‚ÔÏÈÎÔ‡ Û˘Ó‰ÚfiÌÔ˘ ÛÙ· ·È‰È¿ Î·È ÛÙÔ˘˜ ÂÊ‹‚Ô˘˜ ¢ı‡ÓÔÓÙ·È Î˘Ú›ˆ˜ Ë ¤ÏÏÂÈ„Ë ÛˆÌ·- ÙÈ΋˜ ¿ÛÎËÛ˘, Ë Î·Î‹ ‰È·ÙÚÔÊ‹ Î·È ÙÔ stress, Ô˘ Ô‰ËÁÔ‡Ó Û · ÔÚÚ‡ıÌÈÛË ÙÔ˘ ¿ÍÔÓ· ˘ Ôı·Ï¿ÌÔ˘- ˘ fiÊ˘Û˘- ÈÓÂÊÚȉ›ˆÓ (32). ∏ ÎÂÓÙÚÈ΋ ·¯˘Û·Ú- Λ· Û¯ÂÙ›˙ÂÙ·È Ì ·ÓÙ›ÛÙ·ÛË ÛÙË ‰Ú¿ÛË Ù˘ ÈÓÛÔ˘Ï›- Ó˘, ·‡ÍËÛË ÙˆÓ ÙÚÈÁÏ˘ÎÂÚȉ›ˆÓ, Ì›ˆÛË Ù˘ HDL ¯ÔÏËÛÙÂÚfiÏ˘ Î·È ·‡ÍËÛË ÙÔ˘ ۷ί¿ÚÔ˘. ™ Ô˘‰·›Ô ÚfiÏÔ Â ›Û˘ Ê·›ÓÂÙ·È ˆ˜ ¤¯ÂÈ Ë ÔÚÌÔÓÈ΋ ‰Ú¿ÛË Ù˘ Ï ٛÓ˘, ηıÒ˜ ¤¯ÂÈ ‚ÚÂı› Û ·È‰È¿ Î·È ÂÓ‹- ÏÈΘ Ó· Û¯ÂÙ›˙ÂÙ·È Ì ÙÔ˘˜ ·Ú· ¿Óˆ ·Ú¿ÁÔÓÙ˜ Î·È È‰È·›ÙÂÚ· Ì ÙËÓ ÎÂÓÙÚÈ΋ ·¯˘Û·ÚΛ· Ô˘ Ô‰Ë- Á› Û ۷ί·ÚÒ‰Ë ‰È·‚‹ÙË Ù‡ Ô˘ 2 (33-35). ™Â 1.209 ·È‰È¿ Î·È ÂÊ‹‚Ô˘˜ Ù˘ ∫Ú‹Ù˘ ËÏÈΛ·˜ 3-18 ÂÙÒÓ (19), ‚Ú¤ıËÎ·Ó 48 ·È‰È¿ (3,9%) Ì ÙÚÂȘ ‹ ÂÚÈÛÛfiÙÂÚ˜ Û˘ÓÈÛÙÒÛ˜ ÌÂÙ·‚ÔÏÈÎÔ‡ Û˘Ó‰ÚfiÌÔ˘, ÂÎ ÙˆÓ Ô Ô›ˆÓ ÙÔ 62% ›¯·Ó ÎÂÓÙÚÈ΋ ·¯˘Û·ÚΛ· (¶ª>90‹ ∂£). ™ÙÔ Û‡ÓÔÏÔ ÙˆÓ ·È‰ÈÒÓ, ÙÔ 8,5% ‚Ú¤ıËΠ̠ÎÂÓÙÚÈ΋ ·¯˘Û·ÚΛ·, ÂÓÒ, Ì ‚¿ÛË ÙÔÓ ¢ª™ (fiÚÈ· International Obesity Task Force - IOTF) 304 ∂. §ÈÓ·Ú‰¿Î˘ Î·È Û˘Ó. Paediatriki 2007;70:300-307 ¶›Ó·Î·˜ 3. ∆È̤˜ ÂÍÔÌ·Ï˘ÛÌ¤ÓˆÓ ÂηÙÔÛÙÈ·›ˆÓ ı¤ÛÂˆÓ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ 7.538 ÌÂÙÚ‹ÛÂˆÓ 5.321 ·È‰ÈÒÓ Ù˘ ∫Ú‹Ù˘ ∏ÏÈΛ· (¤ÙË) 5Ë 10Ë 25Ë 50‹ 75Ë 85Ë 90‹ 95Ë ∞ÁfiÚÈ· 3 45,4 46,8 49,0 51,3 53,1 55,3 56,3 59,1 4 46,3 47,6 49,8 52,0 54,3 56,9 58,5 62,1 5 47,3 48,6 50,8 53,2 56,2 59,0 61,2 65,3 6 48,6 49,8 52,2 54,8 58,6 61,8 64,3 68,6 7 50,0 51,3 53,8 56,8 61,5 64,9 67,7 72,2 8 51,5 52,8 55,6 59,1 64,7 68,3 71,3 75,8 9 53,2 54,6 57,5 61,6 68,1 71,9 75,1 79,5 10 54,9 56,5 59,6 64,2 71,6 75,7 79,0 83,3 11 56,8 58,5 61,8 66,8 75,0 79,4 82,9 87,1 12 58,8 60,6 64,1 69,4 78,2 83,0 86,6 90,9 13 60,9 62,8 66,3 71,9 81,1 86,4 90,2 94,6 14 63,0 65,1 68,5 74,1 83,6 89,4 93,6 98,4 15 65,2 67,5 70,7 76,1 85,5 92,1 96,6 102,0 16 67,4 69,9 72,7 77,8 86,8 94,2 99,1 105,6 ∫ÔÚ›ÙÛÈ· 3 46,3 47,4 49,8 52,2 55,2 55,7 56,7 60,5 4 46,3 47,4 49,8 52,2 55,3 57,1 58,5 62,2 5 46,6 47,7 49,9 52,9 56,4 59,2 61,0 64,8 6 47,3 48,5 50,7 54,3 58,3 61,8 64,0 67,8 7 48,4 49,7 52,1 56,2 60,8 64,8 67,3 71,3 8 49,8 51,3 53,9 58,4 63,7 68,0 70,7 75,0 9 51,3 53,0 56,0 60,7 66,8 71,2 74,2 78,6 10 53,0 54,9 58,2 63,2 69,8 74,3 77,4 82,1 11 54,8 56,8 60,4 65,5 72,6 77,0 80,2 85,2 12 56,5 58,6 62,5 67,5 74,9 79,2 82,5 87,8 13 58,2 60,3 64,3 69,2 76,5 80,7 84,1 89,6 14 59,8 61,7 65,6 70,3 77,2 81,4 84,7 90,5 15 61,1 62,8 66,4 70,7 76,8 81,0 84,2 90,3 16 62,2 63,4 66,4 70,7 75,1 79,5 82,5 88,7 Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·304
  • 6. ¶›Ó·Î·˜4.™‡ÁÎÚÈÛË̤ۈÓÙÈÌÒÓÙ˘ÂÚÈ̤ÙÚÔ˘Ì¤Û˘·È‰ÈÒÓÙ˘·ÚÔ‡Û·˜ÌÂϤÙ˘ηÈÌÂÏÂÙÒÓ¿ÏψӯˆÚÒÓ ¶·ÚÔ‡Û·∫‡ÚÔ˜,∏¶∞,√ÏÏ·Ó‰›·,πÛ·Ó›·ª.µÚÂÙ·Ó›·,∞˘ÛÙÚ·Ï›·,πÙ·Ï›·∫·Ó·‰¿˜, ÌÂϤÙË1999† (22)1988-94*(27)1996(23)(25)1990(24)1985(26)(30)1981(29) ∏ÏÈΛ·M.T.## M.T.p-value¢È¿ÌÂÛÔ˜p-valueM.T.p-valueM.T.p-valueM.T.p-valueM.T.p-value¢È¿ÌÂÛÔ˜p-valueM.T.p-value (¤ÙË) ∞ÁfiÚÈ· 350,5-49,20,03849,70,200----- 454,0-51,3<0,00151,2<0,001----- 555,1-53,3<0,00152,1<0,001-52,3<0,001--- 656,355,60,00255,4<0,00153,3<0,00156,00,16052,7<0,001-61,0<0,001- 756,857,60,06857,50,10054,8<0,00157,30,23654,6<0,00155,90,04164,0<0,001- 859,760,40,21859,60,92656,5<0,00160,60,11955,7<0,00158,10,01167,0<0,001- 962,662,80,70161,70,11858,2<0,00163,20,27558,1<0,00160,2<0,00169,0<0,001- 1068,166,50,03463,7<0,00159,9<0,00165,4<0,00159,6<0,00161,3<0,00172,0<0,001- 1171,466,9<0,00165,8<0,00161,8<0,00168,0<0,00161,5<0,00164,6<0,00175,0<0,00163,3<0,001 1271,669,1<0,00167,9<0,00163,9<0,00168,0<0,00163,8<0,00166,6<0,00180,0<0,00165,8<0,001 1372,571,40,29170,00,02066,1<0,00170,60,07366,4<0,00169,40,00482,0<0,00166,5<0,001 1476,975,90,26272,1<0,00168,2<0,00172,8<0,00168,7<0,00171,3<0,001-69,7<0,001 1578,275,2<0,00174,1<0,00170,3<0,001-70,8<0,00173,2<0,001-72,5<0,001 1681,878,70,00276,2<0,00172,3<0,001-71,8<0,001--73,6<0,001 ∫ÔÚ›ÙÛÈ· 352,2-49,3<0,00149,2<0,001----- 452,8-51,20,00150,6<0,001----- 554,7-53,1<0,00151,3<0,001-51,3<0,001--- 655,155,60,01455,00,68152,5<0,00154,90,37252,2<0,001-63,0<0,001- 755,158,1<0,00156,9<0,00154,00,01156,60,00154,40,10755,60,23566,5<0,001- 859,958,80,15058,80,15055,7<0,00159,00,23455,3<0,00157,30,00169,0<0,001- 961,762,10,52360,70,09957,3<0,00161,40,61156,8<0,00159,1<0,00171,0<0,001- 1066,265,40,25262,5<0,00159,0<0,00164,10,0358,0<0,00161,0<0,00176,0<0,001- 1168,666,1<0,00164,4<0,00160,6<0,00164,9<0,00160,0<0,00162,3<0,00177,0<0,00160,9<0,001 1269,267,0<0,00166,3<0,00162,4<0,00165,3<0,00161,6<0,00164,6<0,00182,0<0,00162,5<0,001 1369,566,4<0,00168,20,12764,1<0,00167,30,01163,6<0,00166,80,00285,0<0,00164,8<0,001 1471,868,1<0,00170,10,00465,6<0,00166,8<0,00164,7<0,00168,2<0,001-65,9<0,001 1571,869,5<0,00172,00,66666,8<0,001-64,9<0,00169,8<0,001-68,3<0,001 1672,768,5<0,00173,90,08167,9<0,001-66,2<0,001--67,9<0,001 # OnesampleStudenttest † √È̤Û˜ÙÈ̤˜‰fiıËηÓÌÂÙ¿·fiÚÔÛˆÈ΋ÂÈÎÔÈÓˆÓ›·,ÂÓÒÔÈ∂£‰ËÌÔÛȇÔÓÙ·ÈÛÙÔObes.Res.2001.* ∆È̤˜ÙˆÓÂ˘Úˆ-·ÌÂÚÈηÓÒÓ.## M.T.:ª¤ÛË∆ÈÌ‹ 305∂ηÙÔÛÙÈ·›Â˜ ı¤ÛÂȘ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ ·È‰ÈÒÓ ¶·È‰È·ÙÚÈ΋ 2007;70:300-307 Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·305
  • 7. (2), ÙÔ ÔÛÔÛÙfi ÙˆÓ ·¯‡Û·ÚÎˆÓ ·È‰ÈÒÓ ‹Ù·Ó 9,9%. ∏ ‰È·ÊÔÚ¿ ·˘Ù‹ ÔÊ›ÏÂÙ·È Î·Ù¿ ·ÚÈÔ ÏfiÁÔ ÛÙËÓ Î·Ù·ÓÔÌ‹ ÙÔ˘ Ï› Ô˘˜ ÛÙÔ ÛÒÌ· (ÎÂÓÙÚÈο ‹ Â- ÚÈÊÂÚÂȷο) Î·È ÛÙÔ fiÙÈ Ù· fiÚÈ· ÙÔ˘ IOTF ‰ÂÓ ÂÚÈ- Ï·Ì‚¿ÓÔ˘Ó ·È‰È¿ · fi ÙËÓ ∂ÏÏ¿‰· Î·È ÙËÓ ∫Ú‹ÙË. £· Ú¤ ÂÈ,  Ô̤ӈ˜, ÛÙȘ ÌÂϤÙ˜ Ô˘ ·ÊÔÚÔ‡Ó ÙË ÛˆÌ·ÙÈ΋ ·Ó¿ Ù˘ÍË ÙˆÓ ·È‰ÈÒÓ, ÙË ÌÂÙ·‚ÔÏ‹ ÙˆÓ ÛˆÌ·ÙÔÌÂÙÚ‹ÛÂÒÓ ÙÔ˘˜ ·ÏÏ¿ Î·È ÙÔÓ ˘ ÔÏÔÁÈÛÌfi ∂£ Î·È ÙËÓ Î·Ù·Û΢‹ Î·Ì ˘ÏÒÓ ·Ó¿ Ù˘Í˘, Ó· Ï·Ì‚¿ÓÔÓÙ·È ˘ fi„Ë ÎÔÈÓˆÓÈÎÔ›, ÔÏÈÙÈÛÌÈÎÔ›, ÂÚÈ- ‚·ÏÏÔÓÙÈÎÔ› Î·È ‚ÈÔÏÔÁÈÎÔ› ·Ú¿ÁÔÓÙ˜ (1,36). ∞ fi ÙË Û‡ÁÎÚÈÛË Ù˘ ¶ª ÙˆÓ ·È‰ÈÒÓ Ù˘ ∫Ú‹- Ù˘ Ì ·È‰È¿ ¿ÏÏˆÓ ¯ˆÚÒÓ Î·È ·Ú¿ ÙÔ ÁÂÁÔÓfi˜ fiÙÈ Ô Î·ıÔÚÈÛÌfi˜ ÙˆÓ ËÏÈÎÈ·ÎÒÓ ÔÌ¿‰ˆÓ ‰È¤ÊÂÚ ÛÙȘ ÂÚÈÛÛfiÙÂÚ˜ ÂÚÈ ÙÒÛÂȘ, ‰È· ÈÛÙÒıËΠfiÙÈ Ù· ·È‰È¿ Ù˘ ∫Ú‹Ù˘ ¤¯Ô˘Ó ÌÂÁ·Ï‡ÙÂÚË ¶ª Û ۇ- ÁÎÚÈÛË Ì ·È‰È¿ ¿ÏÏˆÓ ¯ˆÚÒÓ, Ì ÌÔÓ·‰È΋ ÂÍ·›ÚÂ- ÛË ÂΛӷ Ù˘ πÙ·Ï›·˜. ∞˘Ùfi ÙÂÎÌËÚÈÒÓÂÙ·È Î·È · fi ÙÔ ˘„ËÏfi ÔÛÔÛÙfi ÙˆÓ ˘ ¤Ú‚·ÚˆÓ Î·È ·¯‡Û·ÚÎˆÓ ·È‰ÈÒÓ Ù˘ ∫Ú‹Ù˘ Ô˘ Ì ‚¿ÛË ÙÔÓ ¢ª™ (fiÚÈ· IOTF) ·Ó¤Ú¯ÂÙ·È Ù· ÙÂÏÂ˘Ù·›· ¯ÚfiÓÈ· ÛÙÔ 33,1% (19). ™ÙËÓ πÙ·Ï›·, ·ÓÙ›ÛÙÔȯ·, ÙÔ ÔÛÔÛÙfi ˘ ¤Ú‚·- ÚˆÓ Î·È ·¯‡Û·ÚÎˆÓ ·È‰ÈÒÓ ‚Ú¤ıËΠ˘„ËÏfiÙÂÚÔ, ÊÙ¿ÓÔÓÙ·˜ ÙÔ 36%, ÂÓÒ ·ÎÔÏÔ˘ıÔ‡Ó Ô ∫·Ó·‰¿˜ Ì 30%, Ë πÛ ·Ó›· Ì 27%, ÔÈ ∏¶∞ Ì 25,6% (ÙÔ 1988- 94) Î·È Ë ª. µÚÂÙ·Ó›· Ì 20% (2). ¢˘ÛÙ˘¯Ò˜, Ë ¤ÏÏÂÈ„Ë ‰ËÌÔÛÈÂ˘Ì¤ÓˆÓ ‰Â‰Ô̤- ÓˆÓ ∂£ Ù˘ ¶ª ·È‰ÈÒÓ Î·È ÂÊ‹‚ˆÓ · fi ¿ÏϘ Â- ÚÈÔ¯¤˜ Ù˘ ∂ÏÏ¿‰·˜, ηıÈÛÙÔ‡Ó ·‰‡Ó·ÙË ÙË Û‡ÁÎÚÈ- ÛË Ì ·È‰È¿ ¿ÏÏˆÓ ÂÚÈÔ¯ÒÓ. ∂ È Ï¤ÔÓ, ÏfiÁˆ ¤Í·ÚÛ˘ Ù˘ ·¯˘Û·ÚΛ·˜ ηٿ Ù· ÙÂÏÂ˘Ù·›· ¯Úfi- ÓÈ·, ‰ÂÓ ‰‡Ó·Ù·È Ó· ÂÏÂÁ¯ı› Ë ÏËı˘ÛÌȷ΋ Ù¿ÛË (secular trend) ÙÔ˘ ·È‰ÈÎÔ‡ ÏËı˘ÛÌÔ‡ Û ۯ¤ÛË Ì ÙËÓ ¶ª. °È’ ·˘Ùfi Ô ˘ ÔÏÔÁÈÛÌfi˜ ∂£ Ù˘ ¶ª ·È- ‰ÈÒÓ Î·È ÂÊ‹‚ˆÓ Ù˘ ∫Ú‹Ù˘, ¤¯ÂÈ È‰È·›ÙÂÚË Û Ô˘- ‰·ÈfiÙËÙ·, ÒÛÙ ÌÂÏÏÔÓÙÈο Ó· ˘ ¿ÚÍÂÈ Ì¤ÙÚÔ Û‡- ÁÎÚÈÛ˘ ÁÈ· ÙÔÓ ¤ÏÂÁ¯Ô ‰È·¯ÚÔÓÈÎÒÓ ·ÏÏ·ÁÒÓ. °ÂÓÈο, Â›Ó·È ·Ó·Áη›· Ë ‰ÈÂÍ·ÁˆÁ‹ ÌÂϤÙ˘ Û ÂıÓÈÎfi  › Â‰Ô Ì ÙË Ï‹„Ë ·ÓÙÈ ÚÔÛˆ ¢ÙÈÎÔ‡ ÂıÓÈÎÔ‡ ‰Â›ÁÌ·ÙÔ˜ ·È‰ÈÒÓ fiÏˆÓ ÙˆÓ ËÏÈÎÈÒÓ, ÚÔ- ÎÂÈ̤ÓÔ˘ Ó· ˘ ÔÏÔÁÈÛıÔ‡Ó Î·È Ó· ‰ËÌÈÔ˘ÚÁËıÔ‡Ó ∂£ Î·È Î·Ì ‡Ï˜ ¶ª. ¶·Ú¿ÏÏËÏ·, ÂÎÙfi˜ · fi ÙËÓ ÂÎÙ›ÌËÛË ÙÔ˘ Â È ¤‰Ô˘ ˘Á›·˜, ıÚ¤„˘ Î·È ·Ó¿ Ù˘- ͢, ÔÈ ∂£ Ù˘ ¶ª Ì ÔÚÔ‡Ó Ó· ÂÓۈ̷وıÔ‡Ó Î·È ÛÙÔ Û‡ÓÔÏÔ ÙˆÓ Î·Ì ˘ÏÒÓ ·Ó¿ Ù˘Í˘ ÙÔ˘ ‚È‚ÏÈ·Ú›- Ô˘ ˘Á›·˜ ÙˆÓ ·È‰ÈÒÓ, ÒÛÙ ӷ · ÔÙÂÏÔ‡Ó ¤Ó· ÔÏÔ- ÎÏËڈ̤ÓÔ Î·È Û‡Á¯ÚÔÓÔ ÂÚÁ·ÏÂ›Ô ÁÈ· ÙÔÓ ¤ÏÏËÓ· ·È‰›·ÙÚÔ Î·È ÁÔÓÈfi. XÚËÌ·ÙÔ‰fiÙËÛË ∏ ¯ÚËÌ·ÙÔ‰fiÙËÛË ÙˆÓ ¶ÚÔÁÚ·ÌÌ¿ÙˆÓ ∞ÁˆÁ‹˜ Î·È ¶ÚÔ·- ÁˆÁ‹˜ Ù˘ ÀÁ›·˜ ÙˆÓ ·È‰ÈÒÓ ÚÔÛ¯ÔÏÈ΋˜ ËÏÈΛ·˜ ¤ÁÈÓ · fi ÙË Friesland Hellas, Î·È ÂÎÂ›ÓˆÓ Ô˘ ·ÊÔÚÔ‡Û·Ó ·È‰È¿ Û¯ÔÏÈ- ΋˜ ËÏÈΛ·˜, · fi ÙË °ÂÓÈ΋ °Ú·ÌÌ·Ù›· ∞ıÏËÙÈÛÌÔ‡, ÙÔ À Ô˘ÚÁÂ›Ô ¶·È‰Â›·˜ Î·È £ÚËÛÎÂ˘Ì¿ÙˆÓ, ÙÔ ¶·È‰·ÁˆÁÈÎfi πÓÛÙÈÙÔ‡ÙÔ, ÙȘ ‰ËÌÔÙÈΤ˜ ·˘ÙÔ‰ÈÔÈ΋ÛÂȘ ÙˆÓ ¢‹ÌˆÓ ∞Á. ¡È- ÎÔÏ¿Ô˘, ƒÔ‡‚·, ÃÂÚÛÔÓ‹ÛÔ˘, ∏Ú·ÎÏ›Ԣ Î·È Ã·Ó›ˆÓ, ηıÒ˜ Î·È ÙË ¡Ô̷گȷ΋ ∞˘ÙÔ‰ÈÔ›ÎËÛË Ã·Ó›ˆÓ. ∂˘¯·ÚÈÛٛ˜ ∂˘¯·ÚÈÛÙԇ̠ıÂÚÌ¿ ÁÈ· ÙËÓ ÔÏÔÎÏ‹ÚˆÛË Ù˘ ÌÂϤÙ˘ ÙÔ˘˜ Û˘ÓÂÚÁ¿Ù˜: ÃÚ‹ÛÙÔ Ã·Ù˙‹, ∂ÈÚ‹ÓË ª¿ÚηÙ˙Ë, πˆ¿ÓÓ· ªÔÛ¯·Ó‰Ú¤·, ªÈ¯¿ÏË ∫˘ÚȷοÎË, ™ÔÊ›· ºÏÔ˘Ú‹, ª·Ú›· ª ÈÙÛÒÚË, πˆ¿ÓÓ· ∞ ÔÛÙÔÏ¿ÎË, ºÚfiÛˆ ª ÂÚ‚·Ó¿ÎË, Caroline Codrington, ∞ϛӷ ¶· ·‰¿ÎË, ∫·ÙÂÚ›Ó· ™·ÚÚ‹, ª˘ÚˆÓ›· §·ÓÙ˙Ô˘Ú¿ÎË Î·È · fi ÙËÓ ¶·È‰È·ÙÚÈ΋ ∫ÏÈÓÈ΋ ÙÔ˘ °ÂÓÈÎÔ‡ ¡ÔÛÔÎÔÌ›Ԣ ÷ӛˆÓ ÙÔ˘˜ ¢ËÌ‹ÙÚË ∞ı·Ó·Ûfi Ô˘ÏÔ Î·È ∂˘·ÁÁÂÏ›· ª ·ÏˆÌÂÓ¿ÎË. ∂ ›Û˘, · ÔÙÂÏÂÛÌ·ÙÈο Û˘- Ó¤‚·Ï·Ó ÙÔ π·ÙÚÔÎÔÈÓˆÓÈÎfi ∫¤ÓÙÚÔ Î·È Ë ¢È‡ı˘ÓÛË ¶ÚˆÙÔ- ‚¿ıÌÈ·˜ ∂Î ·›‰Â˘Û˘ ÙÔ˘ ¡ÔÌÔ‡ ÷ӛˆÓ. µÈ‚ÏÈÔÁÚ·Ê›· 1. Cole TJ. The secular trend in human physical growth: a bi- ological view. Econ Hum Biol 2003;1:161-168. 2. Lobstein T, Baur L, Uauy R; IASO International Obesity Taskforce. Obesity in children and young people: a crisis in public health. Obes Rev 2004;1 (Suppl 5):4-104. 306 ∂. §ÈÓ·Ú‰¿Î˘ Î·È Û˘Ó. Paediatriki 2007;70:300-307 ª. µÚÂÙ·Ó›· ∞˘ÛÙÚ·Ï›· ÎÔÚ›ÙÛÈ· ¶ÂÚ›ÌÂÙÚÔ˜ª¤Û˘(cm) ·ÁfiÚÈ· ¶ÂÚ›ÌÂÙÚÔ˜ª¤Û˘(cm)100 95 90 85 80 75 70 65 60 55 50 100 95 90 85 80 75 70 65 60 55 50 ∏ÏÈΛ· (¤ÙË) 3 4 5 6 7 8 9 10 11 12 13 14 15 16 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ∏ÏÈΛ· (¤ÙË) πÙ·Ï›· ∫Ú‹ÙË ∏¶∞ ∫‡ ÚÔ˜ √ÏÏ·Ó‰›· ∫·Ó·‰¿˜ ∞˘ÛÙÚ·Ï›· ª. µÚÂÙ·Ó›· πÙ·Ï›· ∫Ú‹ÙË ∏¶∞ ∫‡ ÚÔ˜ √ÏÏ·Ó‰›· ∫·Ó·‰¿˜ ∞˘ÛÙÚ·Ï›· ª. µÚÂÙ·Ó›· ∂ÈÎfiÓ· 4. ™¯ËÌ·ÙÈ΋ Û‡ÁÎÚÈÛË Î·Ì ˘ÏÒÓ 90˘ ÂηÙÔÛÙÈ·›·˜ ı¤Û˘ ‹/Î·È +2SD Ù˘ ÂÚÈ̤ÙÚÔ˘ ̤Û˘ ·È‰ÈÒÓ ‰È·ÊfiÚˆÓ ÌÂÏÂÙÒÓ. Pediatri July-Aug 07 09-07-07 15:11 ™ÂÏ›‰·306
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