Corrigendum to "Growth standard charts for Japanese children with mean and standard deviation (SD) values based on the year 2000 national survey".

[This corrects the article DOI: 10.1297/cpe.25.71.].

Reference Ranges for the Non-High-Density Lipoprotein Cholesterol Levels in Japanese Children and Adolescents.

AIM: The aim of this study was to identify the age and sex-specific reference ranges for the non-high-density 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.

Prognosis of infantile obesity: Is infantile obesity "benign" childhood obesity?

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.

Problems with body mass index as an index to evaluate physical status of children in puberty.

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.

Reference charts of body proportion for Japanese girls and boys.

BACKGROUND: Data from previous studies provided the mean values of body proportions for each age group of healthy Japanese children, but not the standard curves describing the distribution. AIM: The aim of the study was to construct a chart of body proportion of girls and boys in Japan. SUBJECTS AND METHODS: About 4% of the nationwide student population in Japan, more than 20,000 children per group of both boys and girls of all ages, was included randomly. The upper/lower ratio (ULR) was calculated from correlation tables containing stature and sitting height data reported in the Statistical Report on School Health and Hygiene. The subischial leg length was calculated by subtracting sitting height from stature. RESULTS: The present study showed that Japanese boys (13.5-17.5 years old) were taller and had relatively longer legs than Japanese girls in the same age group, and that the median ULRs of Japanese girls and boys (5.5-17.5 years old) were larger than the average of Caucasian girls and boys reported previously. In boys, the percentile values reached the lowest at 13.5 years, then increased slightly. On the other hand, in girls, the percentile values remained constant after 11.5 years, which is different in boys in the present study and in other Caucasian populations obtained from several studies. CONCLUSION: The new chart provides useful information in the assessment of the body proportions of Japanese children.

Criteria for medical intervention in obese children: a new definition of 'obesity disease' in Japanese children.

The Committee of the Japan Society for the Study of Obesity reported the new criteria for 'obesity disease' for Japanese adults in 2000. We defined the criteria for the diagnosis of obesity in children with medical problems, corresponding to the 'obesity disease' criteria in adults. Obesity in childhood was defined as follows: percentage of overweight (POW) and body fat exceeded the criteria. 'Obesity disease in childhood' was defined as obesity associated with health or medical problems, and with indications for medical intervention. Medical problems with indications for immediate intervention were grouped as A problems, which consisted of (i). hypertension; (ii). sleep apnea or hypoventilation; (iii). Type 2 diabetes mellitus or impaired glucose tolerance; and (iv). increased waist circumference or accumulation of visceral adipose tissue. Metabolic derangements or equivalent associated with obesity were grouped as B problems: (i). liver dysfunction; (ii). hyperinsulinemia; (iii). hypercholesterolemia; (iv). hypertriglyceridemia; (v). low serum high-density lipoprotein cholesterol; (vi). acanthosis nigricans, and (vii). hyperuricemia. Obese children over 5 years of age with following conditions were diagnosed as 'obesity disease in childhood': (i). any 'A problem', (ii) POW >or= 50% and any 'B problem', or (3) POW < 50% and more than one 'B problem' or equivalent. We decided to take physicosocial problems related to obesity into consideration as the criteria. The resultant criteria are proposed by the Committee for Research of Appropriate Body Build in Children*.

New criteria of normal serum lipid levels in Japanese children: the nationwide study.

AIM: To make new criteria of serum lipid levels in current Japanese children using the large nationwide data provided from Japan Association of Health Service for the analysis. METHODS: The subjects were schoolchildren who received screening and care programs for lifestyle related diseases since 1993-1999. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDLC) and triglyceride (TG) levels were measured, and low-density lipoprotein cholesterol (LDLC) levels were calculated. Serum lipid levels were analyzed by age and sex. For each serum lipid, we extracted age- and sex-specific group which the mean value was not statistically different from that in 1999 by Student's t-test analysis. RESULTS: The level below the 75th percentile was defined to be acceptable, from the 75th to 95th to be borderline and over the 95th to be high in TC/LDLC. The level below the fifth percentile in HDLC was defined to be low and the level over the 95th percentile in TG to be high. Therefore, TC level was categorized as follows: acceptable < 190 mg/dL; borderline 190-219 mg/dL; and high > 220 mg/dL. The LDLC level was also categorized into: acceptable < 110 mg/dL; borderline 110-139 mg/dL; and high > 140 mg/dL. The cut-off value in TG was determined to be 140 mg/dL and in HDLC was 40 mg/dL. CONCLUSIONS: This new criteria should prove valuable in health strategies for rational prevention and intervention in children. It should be emphasized to provide some intervention for Japanese children immediately.