Nash Andrea, Secker Donna, Corey Mary, Dunn Michael, O'Connor Deborah L
Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
JPEN J Parenter Enteral Nutr. 2008 Mar-Apr;32(2):145-53. doi: 10.1177/0148607108314386.
The World Health Organization (WHO) recently released a growth standard, a first attempt at describing how children should grow in an ideal environment. These charts introduce body mass index (BMI)-for-age percentiles for children younger than 2 years. Adopting the WHO standard may affect the number of children screened to require follow-up; hence, field testing needs to be completed in a tertiary care center where the incidence of suboptimal nutrition is high. The objectives of this study were to quantify differences between the new WHO and 2000 Centers for Disease Control and Prevention (CDC) growth charts for children younger than 2 years. The interchangeability of the WHO weight-for-length and WHO BMI percentiles was also assessed.
Percentile scores were computed for children younger than 2 years (n = 547) admitted to a pediatric tertiary health care center in Toronto, Canada.
The WHO standard identified more children younger than 2 years as at risk of overweight/obesity compared with the CDC reference (21.0% vs 16.6%, >or=85th weight-for-length percentile) and fewer children as wasted (18.6% vs 23.0%, <5th weight-for-length percentile). The WHO BMI-for-age and WHO weight-for-length percentiles were highly correlated (r2 = 0.83) but not interchangeable. For approximately 9% of all children, and approximately 16% of those aged <or=6 months, BMI-for-age and weight-for-length percentiles differed by >25 percentile points.
These data describe for the first time the magnitude of differences in the number of children screened as undernourished (4.4% decrease) or overnourished (4.4% increase) with adoption of the WHO standard in a tertiary care setting. Furthermore, the WHO's BMI-for-age and weight-for-length percentiles for children younger than 2 years are correlated but are not interchangeable.
世界卫生组织（WHO）最近发布了一项生长标准，这是首次尝试描述儿童在理想环境中的生长情况。这些图表引入了2岁以下儿童的年龄别体重指数（BMI）百分位数。采用WHO标准可能会影响需要后续跟进筛查的儿童数量；因此，需要在营养状况欠佳发生率较高的三级护理中心完成现场测试。本研究的目的是量化WHO新生长图表与2000年美国疾病控制与预防中心（CDC）生长图表在2岁以下儿童中的差异。同时还评估了WHO身长别体重百分位数与WHO年龄别BMI百分位数的互换性。
计算了加拿大多伦多一家儿科三级医疗保健中心收治的2岁以下儿童（n = 547）的百分位数得分。
与CDC参考标准相比，WHO标准识别出更多2岁以下儿童有超重/肥胖风险（分别为21.0%和16.6%，身长别体重百分位数≥第85百分位），而识别出消瘦儿童更少（分别为18.6%和23.0%，身长别体重百分位数＜第5百分位）。WHO年龄别BMI百分位数与WHO身长别体重百分位数高度相关（r2 = 0.83），但不可互换。在所有儿童中，约9%，以及6个月及以下儿童中约16%，年龄别BMI百分位数与身长别体重百分位数相差超过25个百分位点。
这些数据首次描述了在三级护理环境中采用WHO标准筛查出的营养不良儿童数量（减少4.4%）或营养过剩儿童数量（增加4.4%）的差异程度。此外，WHO 2岁以下儿童的年龄别BMI百分位数与身长别体重百分位数相关，但不可互换。
