Roelants M, Hauspie R, Hoppenbrouwers K
Laboratory of Anthropogenetics, Vrije Universiteit Brussel (VUB), Belgium.
Ann Hum Biol. 2009 Nov-Dec;36(6):680-94. doi: 10.3109/03014460903049074.
Due to the secular trend in length and height, growth references need to be updated regularly. Reference charts that were until recently used in Belgium are based on samples collected more than 30 years ago, and references for body mass index (BMI) and pubertal development have not been established before.
To establish contemporary cross-sectional reference charts for height, weight, BMI, head circumference, and pubertal development from birth to 21 years of age, based on a representative sample of children from Flanders, Belgium.
15 989 healthy subjects of Belgian origin, 0-25 years of age, were measured in 2002-2004. Growth curves were fitted with the LMS method, and percentiles for the pubertal development were estimated with generalized additive models on status quo data from 8690 subjects aged 6-22 years of age.
A positive secular trend in height and weight is observed in children above 5 years of age. Adult median height has increased by 1.2 cm/decade in boys and 0.8 cm/decade in girls; median weight by 0.9 kg/decade in boys, and 1.0 kg/decade in girls, and the weight distribution became more skewed. The BMI curve is comparable to that of other populations, except for higher percentiles. This reflects the increasing prevalence of overweight and obesity. Median age at menarche (13.0 years) has not advanced any more over the past 50 years. Median ages at menarche and B2 in girls and G2 or T4 in boys are comparable to other West European estimates, but approximately 10% enter G2/T4 before 9 years of age.
The ongoing secular trend in height and weight makes growth charts previously used in Belgium obsolete. New representative charts for growth and pubertal development are introduced. For weight monitoring, it is advised that the now-available BMI growth charts are used.
由于身高和体长的长期变化趋势，生长参考标准需要定期更新。比利时直到最近仍在使用的参考图表是基于30多年前收集的样本，而体重指数（BMI）和青春期发育的参考标准此前尚未确立。
基于比利时弗拉芒地区具有代表性的儿童样本，建立从出生到21岁的身高、体重、BMI、头围和青春期发育的当代横断面参考图表。
2002年至2004年期间，对15989名0至25岁的比利时裔健康受试者进行了测量。采用LMS方法拟合生长曲线，并根据8690名6至22岁受试者的现状数据，用广义相加模型估计青春期发育的百分位数。
5岁以上儿童的身高和体重呈现正向长期变化趋势。成年男性的中位身高每十年增加1.2厘米，成年女性每十年增加0.8厘米；男性中位体重每十年增加0.9千克，女性每十年增加1.0千克，且体重分布变得更加不均衡。除百分位数较高外，BMI曲线与其他人群的曲线相当。这反映了超重和肥胖患病率的上升。初潮的中位年龄（13.0岁）在过去50年中没有进一步提前。女孩初潮和B2期以及男孩G2期或T4期的中位年龄与其他西欧国家的估计值相当，但约10%的儿童在9岁之前进入G2/T4期。
比利时此前使用的生长图表因身高和体重持续的长期变化趋势而过时。引入了新的生长和青春期发育代表性图表。对于体重监测，建议使用现有的BMI生长图表。
