Al-Hashem Fahaid H
Department of Physiology, College of Medicine, King Khalid University, PO Box 641, Abha, Kingdom of Saudi Arabia.
Saudi Med J. 2008 Jan;29(1):116-21.
To assess the current status of protein energy malnutrition (PEM) in the high and low altitude preschool children aged 12-71 months.
A cross-sectional study conducted during the year of 2003 and involved 572 and 469 preschool children of Southwestern Saudi Arabia born and living permanently at high and low altitude areas. Anthropometric measurements were carried out to assess the prevalence of PEM using 3 indicators such as underweight, wasting and stunting following World Health Organization standards. Prevalence differences were examined by age, gender, altitude, and parental socioeconomic status.
The prevalence of the 3 types of PEM was significantly higher at low altitude than at high altitude and significantly higher among children born to illiterate than to educated parents. Older children were more underweight and stunted than younger children and underweight and wasting were significantly more common in boys than girls. Annual family income per person was negatively and significantly associated with underweight and stunting, but not with wasting. Multivariate analysis showed that after controlling for all sociobiological factors, low altitude remained a strong risk factor.
The difference in PEM between high and low altitude preschool children could be related to the milder environmental conditions at high altitude and the higher incidence of tropical infections in lowland children. Future studies are required to verify these speculations, and to establish programs to control and prevent PEM in preschool children at low altitude.
评估12至71个月大的高海拔和低海拔学龄前儿童蛋白质能量营养不良（PEM）的现状。
2003年进行的一项横断面研究，涉及沙特阿拉伯西南部572名和469名分别出生并长期生活在高海拔和低海拔地区的学龄前儿童。按照世界卫生组织标准，通过人体测量学方法，使用体重不足、消瘦和发育迟缓这3项指标评估PEM的患病率。对患病率差异按年龄、性别、海拔和父母社会经济地位进行了检验。
3种类型的PEM患病率在低海拔地区显著高于高海拔地区，在文盲父母所生儿童中显著高于受过教育的父母所生儿童。年龄较大的儿童比年龄较小的儿童体重不足和发育迟缓情况更严重，男孩体重不足和消瘦情况比女孩显著更常见。人均家庭年收入与体重不足和发育迟缓呈显著负相关，但与消瘦无关。多变量分析表明，在控制所有社会生物学因素后，低海拔仍然是一个强有力的风险因素。
高海拔和低海拔学龄前儿童PEM的差异可能与高海拔地区较温和的环境条件以及低地儿童较高的热带感染发病率有关。需要进一步研究以验证这些推测，并制定计划来控制和预防低海拔地区学龄前儿童的PEM。
