内蒙古自治区3~18岁儿童体格发育调查

  目的  调查内蒙古自治区3~18岁儿童的体格发育情况。  方法  在2017年10月—2018年10月期间,采用分层整群抽样的方法选取内蒙古自治区4盟市(呼和浩特市、包头市、通辽市、呼伦贝尔市)15 199名儿童为研究对象,收集身高、体重并计算体重指数;以2005年九市儿童体格发育调查数据为参考标准,计算超重、肥胖的检出率,并分析其特点。  结果  内蒙古自治区3~18岁男、女儿童均有2个身高增长高峰段,男童为3~4岁和11岁阶段;女童为4~5岁和10~11岁阶段;随年龄的增长体重增长无明显规律,青春期前后出现增幅单高峰,男、女儿童分别出现在15岁、10岁。各年龄段身高、体重均明显高于2005中国九市标准(均P＜0.001),其中6岁男童、13岁女童身高超过全国标准最明显;7岁男童、10岁女童体重高于全国标准最明显。超重的总检出率为12.31%,肥胖的总检出率为20.27%,其中男、女童超重检出率差异无统计学意义,分别为11.55%、13.10%(P=0.132);男童肥胖检出率显著高于女童,分别为22.67%、17.76%(P＜0.001)。  结论  内蒙古自治区3~18岁儿童体格发育状况良好,但超重、肥胖检出率高。建议相关部门重视儿童的体格发育,加强儿童健康管理,养成良好的生活习惯。      

拟合生长标准百分位数曲线的不同方法比较

目的 寻找适合于拟合各种人体测量指标的生长标准曲线的方法和途径。方法 采用损失函数（ｌｏｓｓ ｆｕｎｃｔｉｏｎ）和残差平方和（ｒｅｓｉｄｕａｌ ｓｕｍ ｏｆ ｓｑｕａｒｅ）对加权三次样条法（ｗｅｉｇｈｔｅｄ ｃｕｂｉｃ ｓｍｏｏｔｈｉｎｇｓｐｌｉｎｅ）和λ－中位数－变异系数法（λ－ｗｅｄｉａｎ－ｃｏｅｆｆｉｃｉｅｎｔ ｏｆ ｖａｒｉａｔｉｏｎ,ＬＭＳ）进行对比研究。结果 计算了两种方法拟合各组的     

Malnutrition Prevalence in Lasa Xizang Children and Adolescents

Objective To assess the prevalence of malnutrition among children and adolescents in Xizang （Tibet）. Methods We analyzed data from the Chinese National Survey on Students＇ Constitution and Health for the years 1995, 2000, 2005, and 2010 pertaining to Tibetan children and adolescents in Lase （Lhasa）, aged 7-18 years old. Numbers of survey subjects for these years were：2 393, 2 754, 2 397, and 2 643, respectively. Results Our results indicated that the rate of occurrence of stunting in Tibet has evidenced a gradual decline：for boys, from 26.8%in 2000 to 9.3%in 2010;and for girls, from 25.8%in 2000 to 10.8%in 2010. In general, the wasting rate for both boys and girls in Tibet has gradually decreased over time：for boys, from 17.7%in 1995 to 4.6%in 2005;and for girls from 12.5%in 1995 to 2.3%in 2005. The stunting rates of boys aged 7-13 years old and of girls aged 7-11 years old were 67.5%and 53.1%, respectively, while these rates for boys aged 14-18 years old and girls aged 12-18 years old were 32.5%and 46.9%, respectively. Conclusion Stunting and wasting rates of Tibetan children and adolescents indicate a gradual declining trend over time. The stunting rates of both boys and girls during early puberty were significantly higher than those during late puberty.     

Age at maximum growth spurt in body height for Saudi school children aged 9-18 years

OBJECTIVE: To provide growth reference values in body height, to determine the specific age at peak height velocity for Saudi male and female adolescences aged 9-18 years and to evaluate the appropriateness of using the Centers for Disease Control/National Center for Health Statistics (CDC/NCHS) growth standards in body height for the assessment of Saudi adolescents. METHODS: A cross-sectional anthropometric survey was conducted in 1053 Saudi male and female school children living in Riyadh city. The study sample was collected in the year 2000 and data were completed and refined in the year 2002. Standing height measurements were recorded for each subject using standard measuring techniques. The 10th, 25th, 50th, 75th, 90th percentiles for body height were calculated separately for boys and girls in one year intervals. The median reference values were compared with the corresponding values in the CDC/NHCS and with other similar studies on Saudi population. RESULTS: The results revealed that the age at peak height velocity for Saudi boys is 13-14 years and for Saudi girls is 10-11 years. The median value for body height at 18 years old for male and female was comparable with other studies reported in similar ethnic group. CONCLUSION: The use of the CDC/NCHS growth standard for height does not appear appropriate for the assessment of growth of Saudi children aged 9-18 years.     

广州地区市属幼儿园儿童体格生长发育普查结果分析

目的：了解广州地区儿童体格生长和肥胖发生率的情况以及有否青春期发育提前.方法：对广州地区市属三所一级幼儿园1788名3～7岁儿童进行身高、体质量和性征发育检查.结果：男、女童身高、体质量较1985年全国9市城区正常男女童的平均水平明显增高,较1995年稍高.肥胖儿童检出率为3.4%,5岁半起肥胖儿童明显增多,以轻度肥胖为主,男女童肥胖发生率无明显差别.女孩乳房发育发生率为1.5%,男孩无1例出现性征发育.结论：广州地区幼儿身高体质量略高于8年前,明显高于18年前全国九市城区正常男女童的平均水平.肥胖儿童检出率较高,应尽早干预.青春期发育无明显提前,性早熟的诊断标准仍适用.     

采用三次样条函数拟合身高百分位数曲线

目的：生长标准科学的表达方法是以年龄为协变量绘制年龄别百分位数曲线图或列表,这在欧美等发达国家已广泛采用,而我国尚无全国性的从出生到成年的生长发育指标的百分位数曲线图,我们旨在提供制定生长标准曲线的方法和途径。给出精确直观的百分位数曲线。方法：采用三次样条对西安市0－18岁儿童青少年身高百分位数进行拟合。结果：给出了男,女生P3,P10,P25,P50,P75,P90,P97百分位数的拟合结果和平滑后的百分位数曲线图。结论：三次样条兼顾了曲线拟合中的拟合优度和光滑度,能更好的实现曲线拟合的目的。该法不仅可用于儿童各种生长标准研究,也适用于制定其他随年龄变化的临床参考值。     

Nationwide reference data for height, weight and body mass index of Indian schoolchildren

BACKGROUND. The assessment of growth is crucial for child care and reference data are central to growth monitoring. We aimed to assess the height, weight and body mass index (BMI) of Indian schoolchildren in order to develop genderappropriate growth charts for children 5-18 years of age. METHODS. Cross-sectional evaluation of anthropometric parameters (height, weight and BMI) was done in Indian schoolchildren (3-18 years) randomly selected from both fee-paying (upper socioeconomic strata) and non-fee paying (lower socioeconomic strata) schools from 4 regions (north, south, east and west) of India. A total of 106 843 children were evaluated, of which 42 214 children (19 303 boys, 22 911 girls) were from the lower socioeconomic strata and 64 629 children (34 411 boys, 30 218 girls) were from the upper socioeconomic strata. Normative charts, using the lambda-mu-sigma (LMS) method to smoothen the curves, were drawn from children belonging to the upper socioeconomic strata, in view of the gross discrepancy between the two socioeconomic strata. RESULTS. Height, weight and BMI percentile (3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th) data were calculated and charts generated. The height of boys and girls was consistently higher at all ages when compared with earlier India data, but the final height was 2-4 cm lower than that reported in the WHO multicentre study of 2007. Weight centiles showed a rising trend both in boys and girls compared not only to earlier Indian data published in 1992, but also to that reported by the WHO multicentre study. The median weight at all ages in both boys and girls was approximately 4 kg more than that reported in affluent Indian children two decades earlier. CONCLUSION. This large nationwide study indicates secular trends in height, weight and BMI in Indian children from the upper socioeconomic strata. We suggest that the height and weight percentiles reported by us may be used as reference standards for India.     

中国儿童青少年生长长期趋势及其公共卫生意义

目的:分析中国大城市儿童青少年1979至2005年的生长长期趋势,为制定宏观干预策略措施提供科学依据.方法:来自16个省/直辖市7～18岁汉族中、小学生,分析其身高、体重、体重指数(BMI)增幅和不同阶段增速.结果:26年来男、女平均身高增幅为6.5和4.7 cm,体重增幅为8.9和5.2 kg.男、女增速均以1985至1995年期间最快,身高分别达每10年增加3.8和3.0 cm;体重分别达每10年增加4.7和3.1 kg;该长期趋势迄今仍保持强劲.青春期发育年龄持续提前,身高生长突增峰值(女12岁和男14岁分别达每10年3.3和2.4 cm)不断增长,对长期趋势贡献最大.男、女成年身高分别增长3.2和2.1 cm,增幅为每10年1.2和0.8 cm.近20年来BMI分布曲线加速右移,提示儿童肥胖流行增势迅猛.结论:我国正出现儿童期生长加速、青春期提前、成年身高增长和身体比例变化等迅猛的全方位生长长期趋势.不仅应看到该趋势对提高我国儿童少年体质健康水平的积极意义,还应高度关注该趋势在引发成年期慢性疾病(尤其如高血压、高血脂、2型糖尿病等代谢综合征疾病危险)等方面的消极影响.     

The effect of platyspondyly and pubertal growth spurt on the stature of patients with beta-thalassaemia major

OBJECTIVE To study the effect of the body proportion and pubertal growth spurt on the stature of children with beta-thalassaemia major.

METHODS The height, sitting height, upper to lower segment (U:L) ratio and pubertal development were determined in 71 Chinese children (38 girls and 33 boys) with beta-thalassaemia. The growth patterns of 20 patients with complete growth data between 3 years and final height, were analyzed according to whether they underwent a pubertal growth spurt or not.

RESULTS 27% of the boys and 32% of the girls had a height below the 3rd percentile. About 60% of all the children had a U:L ratio below the 10th percentile for age. Abnormal body proportion was found in patients with or without growth retardation. 34% of the 41 children over the age of 14 years underwent spontaneous puberty. In 28 patients over the age of 16 years, a growth spurt was observed in 46% of the children during spontaneous or induced puberty. The retrospective analysis showed that the height deviation from the mean in adulthood was significantly higher in patients without pubertal growth acceleration than in those with a growth spurt (x = -11.8 cm, s = 7.6 cm vs x = -4.4 cm, s = 4.4 cm; P = 0.02).

CONCLUSIONS An abnormal U:L ratio was commonly observed in patients with beta-thalassaemia major and may be one factor contributing to the short stature of these patients. Abnormal puberty was present in a significant proportion of children and the lack of a pubertal growth spurt was found to be detrimental to adult height.

     

榆林市高新区学龄儿童体格发育状况

目的 分析榆林市高新区儿童体格发育状况,为促进榆林市儿童健康成长提供科学依据。方法 采用随机整群抽样方法,抽取高新区4所小学在校学生,共3 180人。检测身高、体重、坐高、胸围、腰围、视力等身体发育指标,由医务人员一对一严格按照规范进行测量。结果 榆林市高新区6~12岁儿童的身体发育各项指标随着年龄的增大而增加,各个年龄段男童、女童的身高和体重,均高于2005年制定的全国同龄儿童标准（均为P<0.05）;6~12岁男童身高平均值范围为125~156 cm,女童身高平均值范围为123~156 cm,10岁之前,各年龄段男童均高于女童（均为P<0.05）;各个年龄段男童坐高个体差异较大,女童分布比较集中,在10岁之前,各年龄段男童身高均高于女童（均为P<0.05）;6~12岁男童体重平均值范围为26.53~50.30 kg,女童体重平均值范围为24.65~48.02 kg,12岁之前,各年龄段男童高于女童（均为P<0.05）,男童的超重和肥胖率为19.53%,高于女生的15.40%,表现在9~、10~岁;各个年龄段男童胸围分布比较分散,女童较男童集中,在12岁之前,各年龄段男童均高于女童（均为P<0.05）;各个年龄段男童的腰围分布较分散,女童分布较集中,各年龄段男童均高于女童（均为P<0.05）。结论 榆林市高新区儿童的各种生长发育指标随年龄的增大而增加,符合儿童生长发育规律,但超重和肥胖率较高,应引起相关部门的重视。     

用LMS法建立长沙市3～11岁儿童体质指数生长曲线

目的 建立长沙市3～11岁儿童体质指数生长百分位曲线.方法 测量18 214名儿童的身高、体重,计算每个儿童的体质指数值,应用LMS方法对体质指数百分位数进行拟合.结果 获得了按年龄的L、M、S 3个参数并计算出长沙市3～11岁儿童体质指数百分位曲数.结论 LMS法拟合曲线效果良好,长沙市男、女儿童体质指数与世界卫生组织资料及全国水平存在差异.     

Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions.

OBJECTIVE: To review the prevalence of overweight and obesity in Australian children and adolescents in two national samples, 10 years apart, using the new standard international definitions of the International Obesity Task Force Childhood Obesity Working Group. DESIGN: Body mass index (BMI) cut-off points defining overweight and obesity were applied to the individual BMI values in the two cross-sectional samples. SETTING: Australian community. PARTICIPANTS: 8,492 schoolchildren aged 7-15 years (Australian Health and Fitness Survey, 1985) and 2,962 children aged 2-18 years (National Nutrition Survey, 1995). MAIN OUTCOME MEASURE: Prevalence of overweight and obesity. RESULTS: In the 1985 sample, 9.3% of boys and 10.6% of girls were overweight and a further 1.7% [corrected] of boys and 1.6% [corrected] of girls were obese. In the 1995 sample, overall 15.0% of boys (varied with age from 10.4% to 20.0%) and 15.8% of girls (varied with age from 14.5% to 17.2%) were overweight, and a further 4.5% of boys (2.4%-6.8%) and 5.3% of girls (4.2%-6.3%) were obese. The prevalence of overweight and obesity in the 1995 sample peaked at 12-15 years in boys and 7-11 years in girls. In schoolchildren aged 7-15 years, the rates represent a relative risk of overweight in 1995 compared with 1985 of 1.79 (95% CI, 1.59-2.00) and of obesity of 3.28 (95% CI, 2.51-4.29). Compared with previous estimates from these samples, the revised prevalence data are slightly higher for the 1985 data and considerably higher for the 1995 data. CONCLUSION: The secular trend of increasing overweight and obesity in the decade from 1985 and the high prevalence rates in Australian children and adolescents are a major public health concern.     

Secular Changes of Stature in Rural Children and Adolescents in China, 1985-2010

Objective To analyze and assess secular change in stature in rural children and adolescents in China from 1985 to 2010.Methods Data were obtained from the 6 rounds of the Chinese National Survey on Student’s Constitution and Health.The subjects enrolled in the study were children and adolescents aged 7-18years in rural areas of provincial capitals.Results An overall positive secular trend in stature occurred in rural areas of provincial capitals in China from 1985 to 2010.The overall average increase rates were 3.1 and 2.4 cm/decade for boys and girls,respectively.The total body height increases for grown up boys and girls were 3.6 and 2.3 cm and the increase rates were 1.4 and 0.9 cm/decade,respectively.There were differences in body height increase among eastern,central and western regions.The average body height of the children or adolescents in eastern region was highest,followed by central region and western region.The overall increase rates in central region were highest among the three regions.The difference between eastern/central region and western region was obvious.Conclusion Positive secular trend in stature of children or adolescents has occurred in rural area of China,and rural boys and girls showed a great potential for continuous growth.More attention should be paid to the differences in children’s body height between western region and eastern/central region.     

Fitting weight centile curve with weighted cubic smoothing spline

Aged-relatedcentilesareimportantreferencesnotonlyintheassessmentofchildren'Sgrowthanddevelopmentbutalsoinclinicaldiagnosis.Forthemeasurementsthatapproximatetoanormaldistri-bution,suchasheightandheadcircumference,centilesatagivenagecanbeeasilycalculatedfrommean(x)andstandarddeviation(S),butforthosethatdiffersubstantiallyfromanormaldistri-bution,suchasweightandskinfoldthickness,em-piricalpercentileshavetobeused.Inordertoob-tainpercentilesthataresmoothfromagegrouptoagegroup,traditionallyaged-rela…     

HEIGHT AND WEIGHT PATTERNS AS INDICATORS OF GROWTH AMONG SCHOOL CHILDREN IN AN AIR FORCE STATION : A CROSS-SECTIONAL STUDY

A cross sectional study of school children between 6-17 years of age was carried out in an Air Force Station to determine their growth patterns as indicated by weight and height with a view to detect gender bias, if any, and compare the findings with those of affluent Indian children and National Centre for Health Statistics (NCHS), USA, standards. A total of 763 boys and 605 girls were examined. There was no gender bias in growth. Though the children compared almost favourably, with affluent Indian children, particularly in respect to stature, they were lagging far behind the NCHS standard. Goal for achieving the NCHS standards in the long run has been discussed.KEY WORDS: Adolescents, Anthropometry, Growth, School children, Under-nutrition     

2 793例3岁以下儿童体格发育情况调查分析

目的了解0~3岁儿童体格发育情况,为儿童保健的指导和干预提供参考依据。方法采用分层随机抽样的方法,选择安庆市的开发区各社区内常住居民的儿童作为调查对象,按照不同月龄段以接近1:1的年龄别比例抽取2014-2016年出生的0~3岁儿童最后一次体检的健康档案数据,共收集有效资料2 793例。与《WHO儿童生长发育标准》标准进行对比,用WHO推荐的Z评分法进行评价。结果男女童体质量、身长均高于WHO标准,且生长趋势与参考标准一致。各月龄体质量男童均大于女童（P < 0.05~P < 0.01）;除9个月和30个月外,其他月龄身长（身高）男童均大于女童（P < 0.01）;身高别体质量和年龄别体质量在中和中上所占比例女童高于男童（P < 0.01）;0~3岁儿童消瘦率0.7%,低体质量率1.8%,发育迟缓率0.6%,超重率7.4%,肥胖率8.2%。肥胖率和超重率男童高于女童（P < 0.01）。结论总体儿童体格发育情况较好,女童较男童发育情况更合理。营养不良情况仍然存在。儿童肥胖和超重成为儿童保健工作关注的重点。     

青春期血压调查研究

目的:了解青春期血压状况,探讨青春期血压的评价参考标准。方法:选择漯河市某中专学校14～18岁健康男女学生共4196人进行血压调查研究,以本次调查所测血压值计算出第25、50、75、90及95百分位值。结果:共检出高血压(血压在第95百分位以上)383例。高血压检出率为9.12％;血压与体重、身高、体重指数、皮脂厚度及年龄呈正相关。结论:血压各百分位值可作为河南省青少年青春期(14～18岁)血压评价的参考标准;预防高血压应从(儿童)青少年时期开始。     

The Influence of Secular Trends in Body Height and Weight on the Prevalence of Overweight and Obesity among Chinese Children and Adolescents

Objective To explore the influence of secular trends in body height and weight on the prevalence of overweight and obesity among Chinese children and adolescents. Methods The data were obtained from five cross-sectional Chinese National Surveys on Students’ Constitution and Health. Overweight/obesity was defined as BMI-for-age Z-score of per the Wold Health Organization (WHO) reference values. Body height and weight for each sex and age were standardized to those reported in 1985 (standardized height: SHY; standardized weight: SWY) and for each sex and year at age 7 (standardized height: SHA; standardized weight: SWA) using the Z-score method. Results The prevalence of overweight/obesity in Chinese children was 20.2% among boys and 10.7%among girls in 2010 and increased continuously from 1985 to 2010. Among boys and girls of normal weight, SHY and SHA were significantly greater than SWY and SWA, respectively (P < 0.001). Among boys and girls with overweight/obesity, SHY was significantly lower than SWY (P < 0.001), and showed an obvious decreasing trend after age 12. SHA was lower than SWA among overweight boys aged 7-8 years and girls aged 7-9 years. SHY/SHW and SHA/SWA among normal-weight groups were greater than among overweight and obese groups (P < 0.001). Conclusion The continuous increase in the prevalence of overweight/obesity among Chinese children may be related to a rapid increase in body weight before age 9 and lack of secular increase in body height after age 12.     

大庆市健康男性青少年正常青春发育时间调查

目的了解目前我国大庆市健康男性青少年正常青春发育时间及过程,帮助临床医师对青春发育异常疾病进行诊断。方法采用纵向和横向相结合的研究方法,对我国北方地区大庆市150名年龄在6—15岁的健康男性青少年学生的血促黄体生成素（LH）、促卵泡生成素（FSH）和睾酮水平以及身高、体重、青春发育的Tanner分期等人体测量学指标进行了连续4年的跟踪随访,按年龄以人次将数据资料合并分析,观察上述各项指标的变化趋势。并观察在本调查期间青春发育启动者的年龄。结果我国北方大庆市地区健康男性青少年的青春发育启动年龄为（12．0±1．6）岁;青春启动后第一年生长速度为（6．9±0．4）cm／年;血清睾酮水平为（1．0±0．3）nmol／L。结论我国北方大庆市地区健康男性青少年的青春发育启动年龄8—14岁。     

1985年至2010年中国18个少数民族17岁学生身高趋势分析

目的：分析我国18个少数民族学生1985年至2010年成年身高生长长期变化的特点、规律和趋势。方法：利用1985、1995、2000、2005和2010年全国学生体质调查资料,对蒙古族、回族、维吾尔族、壮族、朝鲜族、藏族、苗族、布依族、侗族、白族、土家族、哈尼族、傣族、傈僳族、佤族、纳西族、土族和羌族18个少数民族17岁学生身高进行了分析。结果：我国大部分少数民族男生的成年身高有很大幅度提高,2010年18个少数民族17岁男生平均身高均超过162 cm,回族、蒙古族、朝鲜族17岁男生平均身高均超过170 cm;身高每10年增速超过2 cm的民族分别是回族（2.64 cm/10年）和侗族男生（2.05 cm/10年）,身高每10年增速超过1 cm的民族有朝鲜族（1.99 cm/10年）、藏族（1.90 cm/10年）、哈尼族（1.80 cm/10年）等12个少数民族。2010年,所调查的18个少数民族17岁女生平均身高均超过150 cm,有15个少数民族女生的成年身高出现不同程度的增长,身高每10年增速超过1 cm的民族分别是回族（1.56 cm/10年）和朝鲜族女生（1.29 cm/10年）,身高增长幅度具有显著性的民族有回族（3.89 cm）、朝鲜族（3.23 cm）、侗族（2.35 cm）等9个少数民族（P<0.05）。结论：我国大部分少数民族学生出现了较为明显的生长长期趋势,但各民族男、女生成年身高增长幅度存在明显不平衡,要给予生长长期趋势增长缓慢的少数民族更高的关注度。同时,对成年身高增长较为迅速的少数民族亦要注意其生长长期趋势所带来的负面效应。