拟合体重百分位数曲线的加权三次样条

目的：年龄别百分位数是许多临床参考值的基本参数,研究一种适用于各种分布,能更精确描述这些基本参数随年龄变化的曲线平滑方法。方法：采用另权三次样条对西安市０￣１８岁儿童青少年体重百分位数进行拟合。结果：计算城市儿童体重百分位数的拟合结果和平滑后的百分位数曲线。结论：加权三次样条兼顾了曲线拟合中的拟合优度和光滑度,该法不仅可用于各种儿童生长标准研究,也适用于测定其它随年龄变化的临床参考值。     

儿童青少年胸围百分位数

目的：胸围是评价儿童青少年生长发育水平及体型的重要指标之一，建立胸围的年龄别百分位数，为临床及儿保工作提供参考很有必要．方法：采用LMS(λ-中位数-变异系数)法对0～18岁儿童青少年胸围百分位数进行拟合。结果：计算了城男、城女、乡男、乡女的年龄别λ(L)，中位数(M)，变异系数(S)值，给出了各组的年龄别百分位数。结论：LMS法用于拟合胸围百分位数，结果非常满意，所得百分位数可用于临床及儿保工作中。     

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。     

健康儿童300名脂蛋白a水平调查

目的 调查健康儿童脂蛋白a正常水平。方法 用Roche-7600生化分析仪测定体检正常的300名健康儿童脂蛋白a，其中男、女各150名，年龄1～14岁。结果 男女性别间、各年龄组间的脂蛋白a无显著性差异；按百分位数的方法和5％～95％范围计算，健康儿童脂蛋白a参考值为18．6～300．5mg／L。结论 健康儿童脂蛋白a的参考值与国内成人正常参考范围基本一致，可作为健康儿童脂蛋白a正常参考范围。     

儿科HIV感染抗反转录病毒药物的使用（二）（2）儿科HIV感染的监护

2 儿科HIV感染的监护 2．1儿童免疫学指标内科医生解释儿童CD4^＋T细胞计数必须考虑年龄差异。在非HIV感染健康婴儿，其CD4^＋T细胞计数和百分值明显较非感染成人为高，并在6a时缓慢下降到成人值。对HIV感染的儿科临床和免疫学阶段应包括年龄相关免疫抑制的含义。     

碘缺乏对儿童骨生长发育的影响

运用李果珍等骨龄百分计数法及判断骨发育程度的方法,对承德缺碘地区7～12岁非地方性克汀病(以下简称地克病)的健康儿童骨发育水平进行了调查分析,并选取晋县非缺碘地区同龄儿童进行对比观察。结果表明,前者儿童骨发育水平落后于非缺碘地区,骨发育落后儿童明显多于后者;缺碘地区有相当一部分非地克病的“正常”儿童骨发育轻度落后,碘缺乏影响了儿童骨胳的生长发育。     

用LMS法建立长沙市3～11岁儿童身高生长曲线

目的 建立长沙市3～11岁儿童身高生长百分位曲线.方法 测量长沙市18214名3～11岁儿童的身高,应用LMS方法对身高百分位数进行拟合.结果 获得了按年龄的L、M和S 3个参数并计算出长沙市3～11岁儿童身高百分位曲数.结论 LMS法拟合曲线效果良好,长沙市3～11岁儿童身高与世界卫生组织及全国水平存在差异.     

建立儿童超重和肥胖的国际标准定义：世界性调查

目的 :确立一个国际上可广泛接受的儿童超重和肥胖的定义 ,并就测定指标、参考人群、不同年龄和性别的诊断标准进行探讨。研究设计 :对 6个国家大规模有代表性的横断面生长研究进行国际化综合研究。数据来源 :巴西、英国、香港、荷兰、新加坡以及美国。研究对象 :自出生至 2 5岁的 97876名男性和 94 851名女性。主要结果的测定指标 :体质指数 (体重 /身高2 )。结果 :采用目前广泛使用的成人超重和肥胖标准 ( 2 5ｋｇ/ｍ2 和 3 0ｋｇ/ｍ2 ) ,确定每项调查中 1 8岁时所处的百分位数 ,并以此百分位数作出跨越各年龄的体质指数百分位数曲线。根…     

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.     

1989～2000年低收入家庭2～4岁儿童超重和低体重的州别发生率趋势

目的:描述在低收入家庭2～4岁儿童的超重和低体重的州别发生率,并调查其趋势。方法:描述了1989年、1994年和2000年超重和低体重的州别和总体发生率及其在研究期间的趋势。超重定义为性别特异性体重指数(BM I)高于或等于在2000年疾病预防控制中心(CD C)生长图上年龄别的第95个百分位数,而低体重定义为BM I低于年龄别的第5个百分位数。这些分析是基于30个州每位儿童每年的随机选择记录,这些州始终参与了1989年、1994年和2000年的CD C儿童营养监测系统。1989年和1994年的发生率根据州别的2000年人群的年龄和种族分布进行了校正。超重和低…     

Height centile curve for child and adolescents in Shaanxi province

Objective:It has been recommended that age-related centile curves of anthropometric indexes(such as height,weight)be used rountinly to evaluate the growth and development statues in children.Prewsented here is the age-related height centile curves for children aged 0-18 years in Shaanxi,China,1995.Methods:Data of the Shaanxi population were retrieved from The Third Nationwide Growth Survey to construct the age-related height centile curves.The LMS method was used for curve fitting;all analyses were carried out on the basis of different sexes through a special program for LMS(λ-median-coefficient)method which was devised by Cole TJ.Results:Centile curves for boys and girls,showing similar age-related features but girls‘ puberty coming two years earlier than boys‘.The period of puberty growth increment was about 2 years longer for boys.At age 18,boys were taller than girls for about 14 cm.Compared with beight standard of NCHS(national center of bealth statistics).Shaanxi children were taller than American children before 14 years for boys,12 years for girls,but after 15 years for boys and 13 years for girls,Shaanxi chilgren were shorter than American ones.At age 18,Shaanxi children was 5.6 cm for boys and 4.9 cm for girls shorter than NCHS.Shaanxi children‘s height increase range from 1958 to 1995 at the same age was 4.9-15.1 cm,with the mean of 9.59 cm for boys,and 3.7-12.5 cm,with the mean of 8.38 cm for girls.Between 1958-1995,the increasing velocity every ten years were 2.57 cm for boys and 2.26 cm for girls,which indicated that the children have reached the optimum.Conclusion:By means of LMS method,we constructed age-related height centile curves for Shaanxi children aged 0-18 years,these height centile curves are the first one for the Chinese children.It can be used as a reference for assessing growth and development status of Shaanxi children aged 0-18 years.     

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     

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…     

Growth differentiation factor 15 in a community-based sample: age-dependent reference limits and prognostic impact

Background: Despite the growing body of evidence on growth differentiation factor 15 (GDF-15) reference values for patients with existing cardiovascular disease, limited investigation has been dedicated to characterizing the distribution and prognostic impact of GDF-15 in predominantly healthy populations. Furthermore, current cutoff values for GDF-15 fail to account for the well-documented age-dependence of circulating GDF-15.

Methods: From 810 community-dwelling older adults, we selected a group of apparently healthy participants (n?=?268). From this sample, circulating GDF-15 was modeled using the generalized additive models for location scale and shape (GAMLSS) to develop age-dependent centile values. Unadjusted and adjusted Cox proportional hazards models were used to assess the association between the derived GDF-15 reference values (expressed as centiles) and all-cause mortality.

Results: Smoothed centile curves showed increasing GDF-15 with age in the apparently healthy participants. An approximately three-fold difference was observed between the 95th and 5th GDF-15 centiles across ages. In a median 8.0 years of follow-up, 97 all-cause deaths were observed in 806 participants with eligible values. In unadjusted Cox regression analyses, the hazard ratio (95% CI) for all-cause mortality per 25-unit increase in GDF-15 centile was 1.80 (1.48–2.20) and dichotomized at the 95th centile, ≥95th versus <95th, was 3.04 (1.99–4.65). Age-dependent GDF-15 centiles remained a significant predictor of all-cause mortality in all subsequent adjusted models.

Conclusions: Age-dependent GDF-15 centile values developed from a population of apparently healthy older adults are independently predictive of all-cause mortality. Therefore, GDF-15 reference values could be a useful tool for risk-stratification in a clinical setting.

ClinicalTrials.gov Identifier: NCT01452178.     

Maternal leucocyte zinc deficiency at start of third trimester as a predictor of fetal growth retardation

Leucocyte zinc concentrations were measured in 70 mothers at the beginning of the third trimester of pregnancy and compared with the weight centiles of their subsequently delivered babies. The median maternal leucocyte zinc concentrations rose progressively with weight centile. Thus the median leucocyte zinc concentration of the mothers delivering babies weighing below the 10th centile was 112 nmol/10(9) leucocytes and that of the mothers with babies weighing above the 90th centile was 229.5 nmol/10(9) leucocytes. A maternal leucocyte zinc concentration less than 120 nmol/10(9) leucocytes strongly predicted a baby weighing below the 10th centile (positive predictive value = 71.9%, negative predictive value = 91.5%, sensitivity = 64.3%, specificity = 81.8%). These findings suggest that maternal zinc concentration might have a role in antenatal screening, but larger studies are required.     

Is weighing babies in clinics worth while?

An appraisal of the widely implemented clinic practice of weighing babies to monitor their physical well being showed that these weighing practices are often inadequately administered through faulty weighing techniques, insufficient use of centile charts, and misunderstanding of normal variations in, and nutritional influences on, early weight gain. If measurements of weight are accurate and the counts of weight gain plotted on centile charts and the resulting profile sensibly interpreted it becomes a valuable method of monitoring health. Possibly the greatest benefit is that the mothers have the opportunity to discuss any anxieties about the baby's health.     

采用SPSS软件快速构建儿童生长曲线

目的 建立通过SPSS软件快速构建儿童生长曲线的方法.方法 根据2005年中国九省市7岁以下儿童横断面调查获取的体格生长发育数据,应用SPSS软件计算17 721名上海市0～7岁儿童中男童年龄别体质量指标的均值、标准差以及第3百分位(P3)、第10百分位(P10)、第50百分位(P50)、第90百分位(P90)和第97百分位(P97)数值,通过软件曲线估计功能选择合适的多项式拟合模型;绘制体质量百分位数曲线,修改曲线的相关属性以实现曲线的最佳拟合效果,通过调用模板功能实现曲线叠加.结果 应用SPSS软件,通过数据计算、曲线估计、曲线拟合、模板调用与曲线叠加等过程,成功构建了形态光滑、趋势一致的上海市0～7岁男童年龄别体质量的P3、P10、P50、P90、P97生长曲线.结论 应用SPSS软件可快速构建儿童生长曲线,操作简单,实用性强,值得推广应用.