Li Hui, Ji Cheng-Ye, Zong Xin-Nan, Zhang Ya-Qin
Department of Growth and Development, Capital Institute of Pediatrics, Beijing 100020, China.
Zhonghua Er Ke Za Zhi. 2009 Jul;47(7):487-92.
To construct the height and weight growth charts for Chinese children and adolescents from birth to 18 years for both clinical and preventive health care uses.
Data from two national representative cross-sectional surveys which were The National Growth Survey of Children under 7 years in the Nine Cities of China in 2005 and The Physical Fitness and Health Surveillance of Chinese School Students in 2005. The data from 94,302 urban healthy children were used to set up the database of length/height (length was measured for children under 3 years) and weight. The LMS method was used to smooth the growth curves, with estimates of L, M, and S parameters, values of percentile and Z-score curves which were required were calculated, and then generated standardized growth charts.
The 3rd, 10th, 25th, 50th, 75th, 90th, 97th smoothed percentiles curves and -3, -2, -1, 0, +1, +2, +3 Z-scores curves of weight-for-age, length/height-for-age for boys and girls aged 0-18 years were made out respectively. Comparison with the new WHO growth charts and 2000 CDC growth charts for the United States, the results showed that there was some big difference in weight and height among the three growth charts. For boys under 15 years of age and girls under 13 years of age, the China curves are slightly higher than WHO and CDC curves, but after those ages, the China curves fall behind and the difference became larger as age progresses. At the age of 18 years, the Chinese children are 3.5 cm shorter in boys and 2.5 cm shorter in girls as compared with the U. S. children. The difference in weights are very large for the school children, especially in girls. The weight of Chinese boys was 5.9 kg less than that of the U. S. boys at 18 years, and the difference was much bigger in girls, the weight of U.S. girls between 8 to 18 years was 4.1-20.5 kg more than that of Chinese girls at the same age range.
The new growth charts of height and weight were based on national survey data and therefore are recommended as the China national growth standards for use in pediatric clinics and public health service. Application of the charts will promote child growth monitoring, discovering early growth disorder, and will be useful to diagnosis of diseases and assessment of therapeutic effects.
构建中国儿童及青少年从出生至18岁的身高和体重生长曲线图表,用于临床及预防保健。
数据来源于两项具有全国代表性的横断面调查,即2005年中国九城市七岁以下儿童体格发育调查和2005年中国学生体质与健康调研。选取94302名城市健康儿童的数据建立身长/身高(3岁以下儿童测量身长)和体重数据库。采用LMS法平滑生长曲线,计算所需的L、M、S参数估计值、百分位数和Z评分曲线值,进而生成标准化生长图表。
分别绘制了0至18岁男、女童年龄别体重、年龄别身长/身高的第3、10、25、50、75、90、97平滑百分位数曲线以及-3、-2、-1、0、+1、+2、+3 Z评分曲线。与世界卫生组织新的生长图表及美国2000年疾病控制与预防中心生长图表比较,结果显示三个生长图表在体重和身高方面存在较大差异。15岁以下男孩和13岁以下女孩,中国的曲线略高于世界卫生组织和疾病控制与预防中心的曲线,但在这些年龄之后,中国的曲线落后,且随着年龄增长差异变大。18岁时,中国儿童男孩比美国儿童矮3.5厘米,女孩矮2.5厘米。在校儿童的体重差异非常大,尤其是女孩。18岁时中国男孩的体重比美国男孩轻5.9千克,女孩的差异更大,8至18岁美国女孩的体重比同年龄范围的中国女孩重4.1至20.5千克。
新的身高和体重生长图表基于全国调查数据,因此推荐作为中国全国生长标准用于儿科临床和公共卫生服务。应用这些图表将促进儿童生长监测,发现早期生长障碍,有助于疾病诊断和治疗效果评估。