Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK.
Am J Clin Nutr. 2011 Aug;94(2):571-7. doi: 10.3945/ajcn.110.008300. Epub 2011 Jun 22.
In 2007 new World Health Organization (WHO) growth references for children aged 5-19 y were introduced to replace the National Center for Health Statistics (NCHS) references.
This study aimed to compare the prevalence of stunting, wasting, and thinness estimated by the NCHS and WHO growth references.
NCHS and WHO height-for-age z scores were calculated with the use of cross-sectional data from 20,605 schoolchildren aged 5-17 y in 11 low-income countries. The differences in the percentage of stunted children were estimated for each year of age and sex. The z scores of body mass index-for-age and weight-for-height were calculated with the use of the WHO and NCHS references, respectively, to compare differences in the prevalence of thinness and wasting.
No systematic differences in mean z scores of height-for-age were observed between the WHO and NCHS growth references. However, z scores of height-for-age varied by sex and age, particularly during early adolescence. In children for whom weight-for-height could be calculated, the estimated prevalence of thinness (WHO reference) was consistently higher than the prevalence of wasting (NCHS reference) by as much as 9% in girls and 18% in boys.
In undernourished populations, the application of the WHO (2007) references may result in differences in the prevalence of stunting for each sex compared with results shown when the NCHS references are used as well as a higher estimated prevalence of thinness than of wasting. An awareness of these differences is important for comparative studies or the evaluation of programs. For school-age children and adolescents across all ranges of anthropometric status, the same growth references should be applied when such studies are undertaken.
2007 年，世界卫生组织（WHO）推出了新的儿童生长标准（适用于 5-19 岁儿童），用以替代美国国家卫生统计中心（NCHS）的标准。
本研究旨在比较使用 NCHS 和 WHO 生长标准估计的儿童生长迟缓、消瘦和消瘦的发生率。
使用来自 11 个低收入国家的 20605 名 5-17 岁学龄儿童的横断面数据，计算 NCHS 和 WHO 的身高年龄 z 评分。分别使用 WHO 和 NCHS 标准计算体质指数年龄 z 评分和体重身高 z 评分，以比较消瘦和消瘦发生率的差异。
WHO 和 NCHS 生长标准的身高年龄 z 评分均值无系统差异。然而，身高年龄 z 评分存在性别和年龄差异，尤其是在青春期早期。对于可以计算体重身高的儿童，消瘦的估计发生率（WHO 标准）始终高于消瘦的发生率（NCHS 标准），女孩高达 9%，男孩高达 18%。
在营养不足的人群中，与使用 NCHS 标准相比，应用 WHO（2007 年）标准可能会导致男女生长迟缓的发生率存在差异，并且消瘦的估计发生率高于消瘦的发生率。了解这些差异对于比较研究或方案评估非常重要。对于所有体格发育状况的学龄儿童和青少年，在进行此类研究时，应使用相同的生长标准。
